bluuebunny/crossref_metadata_2025 huggingface dataset:
Mothers of Infants With Congenital Diaphragmatic Hernia Describe “Breastfeeding” in the Neonatal Intensive Care Unit: “As Long as It’s My Milk, I’m Happy”
Authors: Froh Elizabeth B. , Deatrick Janet A. , Curley Martha A. Q. , Spatz Diane L.
Published: June 2017

Background:

Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births. Currently, there are no studies examining the health outcomes of infants with CDH and the effect of human milk.

Research aim:

This study aimed to describe the breastfeeding experience of mothers of infants with CDH cared for in the NICU.

Methods:

A prospective, longitudinal qualitative descriptive design was used. Phased interviews were conducted with a purposive sample of 11 CDH infant–mother dyads from a level 3 NICU in a children’s hospital.

Results:

Six themes emerged from the data: (a) hopeful for breastfeeding, (b) latching on . . . to the pump, (c) we’ve already worked so hard, (d) getting the hang of it—it’s getting easier, (e) a good safety net, and (f) finding a way that works for us.

Conclusion:

For this population of CDH infant–mother dyads, the term breastfeeding is not exclusive to direct feeding at the breast and the mothers emphasized the significance of providing their own mother’s milk through a combination of feeding mechanisms to their infants with CDH.
Enhancing graduate prospects by recording and reflecting on part-time work
Authors: Evans Carl , Richardson Mark
Published: June 2017

Business leaders are becoming increasingly explicit regarding the skills, attributes and behaviours expected of graduate entrants. These skills are often developed through a combination of academic studies and work experience. While universities are increasingly providing opportunities for experiential learning, typically a placement year or internship, a growing number of students are undertaking self-initiated part-time work alongside their full-time degree studies. This part-time employment, typically in retail or hospitality, will help develop the skills, attributes and behaviours that employers demand. However, it is important that graduates are able to elucidate their learning to future employers during the graduate recruitment process. The purpose of this viewpoint article is to challenge full-time degree students who are working part-time to record (perhaps through a logbook) and reflect on their work experience so that they will be able to provide concrete examples to reinforce their skills and experience. The article concludes by discussing the role of universities in the process.
Looking Backward to Look Forward: Reflections of Past Presidents of the Council for Learning Disabilities
Authors: Poch Apryl L.
Published: June 2017

Anniversaries offer a time for reflection, celebration, validation, and sometimes, simply a candid conversation on the current state of a field. In the field of learning disabilities, anniversaries offer a time to consider how far the field has come and just how far is left to go to understand what a learning disability is. Definitional understanding is foundational for moving forward. This column presents findings from a series of short conversations with past presidents of the Council for Learning Disabilities, individuals who are also leading experts in the field of learning disabilities. Results suggest four different thoughts about the definition of learning disabilities, two main themes regarding areas in which the field needs to focus, and two themes specific to where the field may be headed in the next 20 to 25 years. The column concludes with a discussion of implications for the future.
Patient Satisfaction Is Linked to Nursing Workload in a Singapore Hospital
Authors: Goh Mien Li , Ang Emily N. K. , Chan Yiong-Huak , He Hong-Gu , Vehviläinen-Julkunen Katri
Published: June 2017

No studies have examined the association between patient satisfaction and the allocation of nursing care hours using a workload management system. The aim of this study is to examine the correlation between inpatients’ perceived satisfaction with nursing care and nursing workload management in a Singapore hospital. A secondary data analysis was performed based on the results of 270 patients’ perceived satisfaction measured by the Revised Humane Caring Scale and nursing workload management data extracted from the TrendCare Patient Acuity System. Data were collected from March to October 2013. There were weak positive ( rs = .212 to rs = .120) and negative ( rs = −.120 to rs = −.196) correlations between patient satisfaction and nursing workload. Nursing leaders should build positive work environment through maximizing efficient resource allocation and adequate staffing to deliver safe patient care. Future studies could involve other patient outcomes such as incidences of fall and pressure ulcer.
A Case Study: Seclusion and Restraint in Psychiatric Care
Authors: Goulet Marie-Hélène , Larue Caroline
Published: June 2017

A wide breadth of research has recognized that seclusion and restraint affects patients, staff, and organizations alike. Therefore, it is essential to understand the viewpoints of all stakeholders to improve practices. The study aimed to understand the context in which seclusion and restraint practices are employed based on the perceptions of staff and inpatients in a psychiatric ward. A case study was performed using a participatory approach. Methods included a 56-hr immersion in the practice setting and individual interviews with staff and patients ( n = 17). The main themes discussed were patient characteristics (etiology of the violence, difficult experience), staff characteristics (feelings of safety, rationalization of seclusion use), and environmental characteristics. Both explicit (e.g., hospital protocol) and implicit (e.g., ward rules) standards seem to influence seclusion and restraint management. Our results point toward the potential for developing post-seclusion and restraint review in which both patient and staff perspectives are taken into account.
Comparative Analysis of Inpatient Costs for Obstetrics and Gynecology Surgery Patients Treated With IV Acetaminophen and IV Opioids Versus IV Opioid-only Analgesia for Postoperative Pain
Authors: Hansen Ryan N. , Pham An T. , Lovelace Belinda , Balaban Stela , Wan George J.
Published: June 2017

Background: Recovery from obstetrics and gynecology (OB/GYN) surgery, including hysterectomy and cesarean section delivery, aims to restore function while minimizing hospital length of stay (LOS) and medical expenditures. Objective: Our analyses compare OB/GYN surgery patients who received combination intravenous (IV) acetaminophen and IV opioid analgesia with those who received IV opioid-only analgesia and estimate differences in LOS, hospitalization costs, and opioid consumption. Methods: We performed a retrospective analysis of the Premier Database between January 2009 and June 2015, comparing OB/GYN surgery patients who received postoperative pain management with combination IV acetaminophen and IV opioids with those who received only IV opioids starting on the day of surgery and continuing up to the second postoperative day. We performed instrumental variable 2-stage least-squares regressions controlling for patient and hospital covariates to compare the LOS, hospitalization costs, and daily opioid doses (morphine equivalent dose) of IV acetaminophen recipients with that of opioid-only analgesia patients. Results: We identified 225 142 OB/GYN surgery patients who were eligible for our study of whom 89 568 (40%) had been managed with IV acetaminophen and opioids. Participants averaged 36 years of age and were predominantly non-Hispanic Caucasians (60%). Multivariable regression models estimated statistically significant differences in hospitalization cost and opioid use with IV acetaminophen associated with $484.4 lower total hospitalization costs (95% CI = −$760.4 to −$208.4; P = 0.0006) and 8.2 mg lower daily opioid use (95% CI = −10.0 to −6.4), whereas the difference in LOS was not significant, at −0.09 days (95% CI = −0.19 to 0.01; P = 0.07). Conclusion: Compared with IV opioid-only analgesia, managing post-OB/GYN surgery pain with the addition of IV acetaminophen is associated with decreased hospitalization costs and reduced opioid use.
Formulation of symmetry boundary modeling in non-ordinary state-based peridynamics and coupling with finite element analysis
Authors: Yaghoobi Amin , Chorzepa Mi G
Published: June 2017

Peridynamics is an effective method in computational solid mechanics for dealing with discontinuities. However, its computational cost limits its applications, especially when used in the most general form, non-ordinary state-based peridynamics. This paper considers two approaches which decrease the computational cost. The first approach accounts for symmetry boundary conditions in a peridynamic body. In nonlocal peridynamics, boundary conditions are applied to an area. Therefore, when modeling the symmetry boundary condition, assuming fixed particles around the symmetry axis yields incorrect results. The present formulation introduces constraints which allow modeling of local symmetry conditions. Second, the finite-element–peridynamic coupling method is adopted for non-ordinary state-based peridynamics. The coupling method enables the use of peridynamics around discontinuities like cracks, and the faster finite element for the surrounding body. These two methods effectively reduce the solution time with an acceptable accuracy. The validity of these approaches is studied through various examples. Also, ductile crack growth in a compact tension specimen is studied, applying the presented methods. Good agreement is found when comparing experimental results with corresponding numerical results obtained using either fully peridynamic or coupled models.
Application and possible benefits of high hydrostatic pressure or high-pressure homogenization on beer processing: A review
Authors: Santos Lígia MR , Oliveira Fabiano A , Ferreira Elisa HR , Rosenthal Amauri
Published: June 2017

Beer is the most consumed beverage in the world, especially in countries such as USA, China and Brazil.It is an alcoholic beverage made from malted cereals, and the barley malt is the main ingredient, added with water, hops and yeast. High-pressure processing is a non-traditional method to preserve food and beverages. This technology has become more interesting compared to heat pasteurization, due to the minimal changes it brings to the original nutritional and sensory characteristics of the product, and it comprises two processes: high hydrostatic pressure, which is the most industrially used process, and high-pressure homogenization. The use of high pressure almost does not affect the molecules that are responsible for the aroma and taste, pigments and vitamins compared to the conventional thermal processes. Thus, the products processed by high-pressure processing have similar characteristics compared to fresh products, including beer. The aim of this paper was to review what has been investigated about beer processing using this technology regarding the effects on physicochemical, microbiology and sensory characteristics and related issues. It is organized by processing steps, since high pressure can be applied to malting, mashing, boiling, filtration and pasteurization. Therefore, the beer processed with high-pressure processing may have an extended shelf-life because this process can inactivate beer spoilage microorganisms and result in a superior sensory quality related to freshness and preservation of flavors as it does to juices that are already commercialized. However, beyond this application, high-pressure processing can modify protein structures, such as enzymes that are present in the malt, like α- and β-amylases. This process can activate enzymes to promote, for example, saccharification, or instead inactivate at the end of mashing, depending on the pressure the product is submitted, besides being capable of isomerizing hops to raise beer bitterness. As a consequence, the process may reduce steam demand and residue generation. Therefore, the use of high-pressure processing can potentially replace or be combined with heat processes usually applied to beer, thus bringing benefits to the sensory quality of the product and to the environment.
Methylphenidate-Related Improvements in Math Performance Cannot Be Explained by Better Cognitive Functioning or Higher Academic Motivation: Evidence From a Randomized Controlled Trial
Authors: Kortekaas-Rijlaarsdam Anne Fleur , Luman Marjolein , Sonuga-Barke Edmund , Bet Pierre , Oosterlaan Jaap
Published: June 2017

Objective: This study investigated whether improvements in working memory, reaction time, lapses of attention, interference control, academic motivation, and perceived competence mediated effects of methylphenidate on math performance. Method: Sixty-three children (ADHD diagnosis; methylphenidate treatment; age 8-13; IQ > 70) were randomly allocated to a 7-day methylphenidate or placebo treatment in this double-blind placebo-controlled crossover study and compared with 67 controls. Data were collected at schools and analyzed using mixed-model analysis. Methylphenidate was hypothesized to improve all measures; all measures were evaluated as potential mediators of methylphenidate-related math improvements. Results: Controls mostly outperformed the ADHD group. Methylphenidate did not affect measures of cognitive functioning ( p = .082-.641) or academic motivation ( p = .199-.865). Methylphenidate improved parent ratings of their child’s self-perceived competence ( p < .01), which mediated methylphenidate efficacy on math productivity. Conclusion: These results question the necessity of improvements in specific cognitive and motivational deficits associated with ADHD for medication-related academic improvement. They also stimulate further study of perceived competence as a mediator.
Effect of phosphorus film on frictional properties of molybdenum dithiocarbamate
Authors: Otsu Takefumi
Published: June 2017

This paper describes the effects of phosphorus film on the boundary lubrication performance of molybdenum compounds. To study this, ball-on-plate-type spinning friction test was conducted using molybdenum dithiocarbamate and acid phosphate ester as additives. To form surface phosphorus films, specimens were heated in acid phosphate ester for 1, 3, and 6 h, with the results showing that the formation of the phosphorus film depends on the heating time and on the increases in concentration of phosphorus with the heating time. It was also shown that the friction coefficient in the test with the lubricant containing molybdenum dithiocarbamate, depends inversely on the heating time, with specimens heated for 3 and 6 h having lower coefficients that the specimen heated for 1 h. Energy-dispersive X-ray analysis revealed that the chemical reaction films comprising phosphorus, oxygen, and sulfur formed on the friction surfaces after the test, with the concentrations of sulfur in the film increasing with increased concentrations of phosphorus. These results suggest that the thickness of the phosphorus film affected the amount of molybdenum disulfide formed on the surface. Moreover, as more molybdenum disulfide film formed, the friction coefficient decreased.
Dietary factors and pediatric multiple sclerosis: A case-control study
Authors: Pakpoor Julia , Seminatore Brandon , Graves Jennifer S , Schreiner Teri , Waldman Amy T , Lotze Timothy E , Belman Anita , Greenberg Benjamin M , Weinstock-Guttman Bianca , Aaen Gregory , Tillema Jan-Mendelt , McDonald Jamie C , Hart Janace , Ness Jayne M , Harris Yolanda , Rubin Jennifer , Candee Meghan , Krupp Lauren , Gorman Mark , Benson Leslie , Rodriguez Moses , Chitnis Tanuja , Mar Soe , Kahn Ilana , Rose John , Carmichael Suzan L , Roalstad Shelly , Waltz Michael , Casper T Charles , Waubant Emmanuelle ,   for the US Network of Pediatric Multiple Sclerosis Centers
Published: June 2017

Background:

The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease.

Objective:

To determine the association between dietary factors and MS in children.

Methods:

Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging). The validated Block Kids Food Screener questionnaire was administered 2011–2016. Chi-squared test compared categorical variables, Kruskal–Wallis test compared continuous variables, and multivariable logistic regression analysis was performed.

Results:

In total, 312 cases and 456 controls were included (mean ages 15.1 and 14.4 years). In unadjusted analyses, there was no difference in intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables. Dietary iron was lower in cases ( p = 0.04), and cases were more likely to consume below recommended guidelines of iron (77.2% of cases vs 62.9% of controls, p < 0.001). In multivariable analysis, iron consumption below recommended guidelines was associated with MS (odds ratio = 1.80, p < 0.01).

Conclusion:

Pediatric MS cases may be less likely to consume sufficient iron compared to controls, and this warrants broader study to characterize a temporal relationship. No other significant difference in intake of most dietary factors was found.
Pediatric-onset multiple sclerosis and other acquired demyelinating syndromes of the central nervous system in Denmark during 1977–2015: A nationwide population-based incidence study
Authors: Boesen Magnus Spangsberg , Magyari Melinda , Koch-Henriksen Nils , Thygesen Lau Caspar , Born Alfred Peter , Uldall Peter Vilhelm , Blinkenberg Morten
Published: June 2017

Background:

The incidence of acquired demyelinating syndromes (ADS) including multiple sclerosis (MS) has never been investigated in a Danish pediatric population.

Objectives:

We estimated the nationwide age- and sex-specific incidence of pediatric ADS including MS.

Methods:

Data were sourced from the Danish Multiple Sclerosis Registry, providing cases of pediatric MS for 1977–2015, and the National Patient Register, providing cases of ADS during 2008–2015. All medical records were reviewed to validate the register-based diagnoses.

Results:

We identified 364 cases of pediatric MS occurring during 1977–2015 (incidence rate = 0.79 per 100,000 person-years). MS was exceptionally rare before puberty, but the incidence rose considerably from 9 years in girls and 11 years in boys. The female-to-male ratio was 2.5; the median age at onset was 16 years (range = 7–17 years). The MS incidence rate was relatively stable through the study period. During 2008–2015, we identified 219 ADS cases. The incidence was 2.29 per 100,000 person-years with considerable differences in the age peaks for the separate ADS.

Conclusion:

The incidence rates of MS and other ADS in Denmark were higher than those reported for some other European countries. Referral bias and classification differences may account for this disparity, in particular the age-intervals and the definition of onset.
The antecedents of opportunity recognition in internationalized firms
Authors: Urban Boris , Willard Candice
Published: June 2017

The international entrepreneurship (IE) literature has proliferated over the past few decades, where researchers perceive internationalization as rapid and opportunity-driven. Despite the proliferation of research on IE, little is known about the extent of the relationship between the antecedents of opportunity recognition and IE. Hypotheses are formulated to test this relationship and a survey is administered to internationalized firms in South Africa. Following statistical analyses, results show that it is the antecedent of organizational learning which is positively related to opportunity recognition. These findings lead to recommendations in terms of how a combination of different learning and knowledge capabilities can be leveraged by entrepreneurs to increase opportunity recognition in internationalized firms.
The stability and dispersion of carbon nanotube-polymer solutions: A molecular dynamics study
Authors: Jahangiri Sassan , Ozden-Yenigun Elif
Published: June 2017

Carbon nanotubes have been explored to increase the mechanical properties and electrical conductivity of polymeric fibers through compounding with polymer to be extruded into fibers. However, this route creates major challenges because carbon nanotubes have strong cohesion and tend to aggregate and precipitate due to their poor interfacial interaction with polymers. In this study, classical molecular dynamics simulations are used to predict and characterize carbon nanotubes-polymer interface mechanism in two different polymer matrices: polyvinyl butyral and polystyrene-co-glycidyl methacrylate. The dominated interface mechanisms are discovered to shed light on carbon nanotubes dispersion in solvent based systems and to explore the prerequisites for stabilized nanofluids. Our results showed that π-stacking interactions between aromatic groups and graphene surfaces of carbon nanotubes as in polystyrene-co-glycidyl methacrylate systems, play an important role in dispersion of carbon nanotubes, whereas slight repulsions between carbon nanotubes and polyvinyl butyral chains lead to large morphological differences and carbon nanotubes bundles in many chain systems. Altogether, the results indicated that polymers with structures having strong interactions with the surfaces of carbon nanotubes through π–π interactions are more effective in dispersing carbon nanotubes and caused stabilized solutions in wet fiber processing.
Delayed Endovascular Stenting of Right Subclavian Artery Pseudoaneurysm Caused by Gunshot Accident in a Syrian Refugee: A Case Report
Authors: Alawneh Khaled , Raffee Liqaa , Hamouri Shadi
Published: June 2017

Sharp penetrating injuries causing right subclavian artery pseudoaneurysm are considered rare. Surgical repair is reportedly associated with a high mortality rate and is considered technically challenging. 1 In this case report, we report the successful endovascular repair of a delayed pseudoaneurysm of the right subclavian artery caused by a gunshot injury in a 22-year-old Syrian refugee that was associated with significant right brachial panplexopathy. The patient was successfully managed with angioplastic ballooning of the stenotic region of the artery and a covered self-expanding stent. The patient recovered uneventfully, and follow-up evaluation revealed significant improvement in neurological deficit.
Death from Kratom toxicity and the possible role of intralipid
Authors: Aggarwal Geeta , Robertson Edward , McKinlay James , Walter Edward
Published: June 2017

We present the case of a 26-year-old man who was brought into our emergency department in cardiorespiratory arrest, having taken Kratom 24 h previously. Despite multi-organ support, he deteriorated and died from cardiorespiratory failure and hypoxic brain damage 12 h later. Lipid emulsion was given, with significant temporary improvement in the cardiorespiratory failure. Kratom is derived from Mitragyna speciosa, a tropical deciduous and evergreen tree in the coffee family, and is native to Southeast Asia, and its leaves are used as a legal high in some parts of the world. Here, we review the pharmacochemistry of the drug, and wish to highlight that the effects of Kratom may not be as benign as are commonly reported, and the possible role of intralipid in managing the Kratom toxicity in this case.
Venous flaps for coverage of traumatic soft tissue defects of the hand: a systematic review
Authors: Wharton R. , Creasy H. , Bain C. , James M. , Fox A.
Published: June 2017

A PRISMA-guided systematic review was performed of all published cases that detail the use of venous flaps for soft tissue reconstruction of the hand following trauma. Outcome measures examined included flap survival rates, venous congestion, and return to theatre. Database searches were performed on Medline, Embase, AHMED, CINAHL. A total of 381 articles were identified. Data were extracted from 45 articles that met inclusion criteria. A total of 756 flaps were described and their data analysed. A total of 75% of flaps were arterialized and 25% were pure venous flaps. There was no difference in survival rate for arterialized or pure venous flaps. Unplanned return to theatre occurred in 5.3% due to flap compromise or necrosis. Early venous congestion was present in 60% of cases. Total early failure requiring re-operation occurred in 19 flaps (2.5%) of cases. Venous flaps offer a versatile and well-tolerated reconstructive option. Early venous congestion is common, but can be managed non-operatively.

Level of evidence: II
Refined lightweight inertial navigation system for micro air vehicle applications
Authors: Hrishikeshavan Vikram , Chopra Inderjit
Published: June 2017

This paper discusses the design, hardware and software methodology, and testing of an ultralight inertial navigation system (Embedded Lightweight Kinematic Autopilot-Revised (ELKA-R)) that can be used as a controller in a wide range of micro air vehicle systems. ELKA-R was designed using the 32-bit low-power ARM Cortex-M4 microprocessor as the microcontroller unit. The microcontroller unit interfaced with state of the art 9 degrees-of-freedom inertial measurement unit using inter-integrated circuit communication (I2C) protocol. A wireless transceiver was also incorporated with serial peripheral interface to wirelessly coordinate pilot inputs and sensor information with a remote basestation. Multiple timer protocols were configured to generate individual driver signals to a wide variety of motor and actuator configurations. The printed circuit board was designed as a four layer layout. ELKA-R weighed 1.7 g with a board area of 4.82 cm2, thus making it one of the smallest and lightest kinematic autopilots in open literature that can be applied to any generic micro air vehicle system. ELKA-R was tested on a variety of micro air vehicle flight demonstrators. Hover stabilization rates of 1000 Hz were achieved which were comparable to the autopilots on larger quad rotor systems such as DJI Phantom and AR-Drone. Oscillations in attitude were reduced by up to 50%–70% when compared with a previous generation lightweight autopilot.
Revision shoulder arthroplasty for failed humeral head resurfacing hemiarthroplasty
Authors: Thangarajah Tanujan , Ajami Sara , Coathup Melanie , Blunn Gordon W. , Higgs Deborah , Falworth Mark , Lambert Simon
Published: June 2017

Background

The purpose of the present study was to analyze and report the clinical outcomes following revision shoulder arthroplasty for failed humeral head resurfacing hemiarthroplasty (HHRH).

Methods

All patients who underwent revision shoulder arthroplasty for failed HHRH at our institution were retrospectively reviewed. Twenty-two shoulders in 20 patients were available for analysis. Mean age at the time of HHRH was 60 years (range 42 years to 75 years). The cohort consisted of 17 females and three males.

Results

The mean time from HHRH to revision was 5 years (range 1 year to 8 years). Mean age at the time of revision surgery was 62 years (range 44 years to 80 years). Patients were followed-up for a mean of 3.3 years (range 2 years to 4 years) after revision. Following revision surgery, there was an increase in forward elevation from 67° (range 0° to 130°) to 97° (range 40° to 160°) ( p = 0.04). This was accompanied by an improvement in both the Oxford Shoulder Score and the subjective shoulder value, which increased from 13 (range 2 to 28) to 39 (range 24 to 48) ( p = 0.000) and from 23 (range 0 to 65) to 79 (range 25 to 100) ( p = 0.000) respectively.

Conclusions

Revision shoulder arthroplasty for failed HHRH improves functional outcome.
A Preliminary Study Comparing Microfracture and Local Adherent Transplantation of Autologous Adipose-Derived Stem Cells Followed by Intraarticular Injection of Platelet-Rich Plasma for the Treatment of Chondral Defects in Rabbits
Authors: Spakova Timea , Amrichova Judita , Plsikova Jana , Harvanova Denisa , Hornak Slavomir , Ledecky Valent , Rosocha Jan
Published: June 2017

Objective

This study aimed to compare microfracture and application of adipose-derived stem cells (ADSCs) by local adherent technique enhanced by platelet-rich plasma (PRP) to provide a new approach for the repair of cartilage defect.

Design

Full-thickness cylindrical defects were created in the medial femoral condyle in 9 New Zealand White rabbits (5 months old, 4.65 ± 0.20 kg). Two groups of rabbits ( n = 3) were either treated with ADSCs (Group 1) or the microfracture technique (Group 2) following intraarticular injection of PRP 3 times in weekly intervals. Rabbits in control group ( n = 3) remained untreated. The outcome was assessed macroscopically, histologically, and immunohistochemically.

Results

At the end of week 12, Group 1 showed better defect filling compared with Group 2. Specimens treated with the combination of ADSCs and PRP exhibited significant differences from the other groups in all criteria of International Cartilage Repair Society macroscopic scoring system.

Conclusions

Intraarticular injection of autologous PRP in combination with transplantation of autologous ADSCs by local adherent technique enhances the quality of cartilage defect repair with better results in comparison with microfracture surgery in a rabbit model.
Osteoarthritis of the Anterior Cruciate Ligament and Medial Tibial Plateau: A Cadaveric Study
Authors: Immonen Jessica , Siefring Chris , Sanders Luke
Published: June 2017

The objective of this study was to analyze morphometric anatomy and damages with aging in cadaveric knee specimens specific to the cruciate ligaments, the articular cartilage of the tibial plateau, and the menisci. Morphometric analyses to cadaveric anatomy of the knee were performed using Image-Pro® software on 3 age populations: <70 years old, 70 to 79 years old, and ≥80 years old. An average thickness of the cruciate ligaments was assessed with 5 circumferential measurements per specimen using nylon thread. Percent degeneration of the tibial plateau’s articular cartilage and coverage by menisci was assessed with surface area measurements. The articular cartilage of the medial tibial plateau in ≥80 years old specimens showed a 1.7-fold increase in surface area degeneration (mm2) compared to 70 to 79 years old specimens ( P < 0.05). The medial meniscus also experienced degenerative changes with aging, which were expressed as decreases in tibial plateau coverage. The anterior cruciate ligament (ACL) experienced substantial degenerative thinning with aging. The 70 to 79 years old specimens had a 1.2-fold (10.5%) decrease in average ACL circumference (mm) compared to the <70 years old specimens ( P < 0.001). The ≥80 years old specimens had a 1.24-fold (19%) decrease in ACL circumference compared to the <70 years old specimens ( P < 0.001). ACL thinning during aging may be leading to substantial articular cartilage and menisci degeneration given the cruciate ligaments are a primary restraint that combats shearing forces at the knee joint.
Smartphone Internet access and use: Extending the digital divide and usage gap
Authors: Tsetsi Eric , Rains Stephen A.
Published: June 2017

This study uses survey data from the Pew Internet and American Life Project to advance digital divide research by exploring how smartphone dependence—in which one’s only means of accessing the Internet is via a smartphone—and smartphone use differ between key demographic groups in the United States. Results show differences in smartphone dependence and use based on race, age, income, and education. Minority group members, younger, lower income, and less educated users are more likely to be smartphone-dependent. Additionally, minorities and younger individuals use smartphones for more social activity, while White, younger, and higher income individuals use smartphones for more news/information activity. Findings support the usage gap hypothesis and suggest smartphones may act as both a bridge and a barrier for disadvantaged groups to overcome the digital divide.
Work-family Balance and Marital Satisfaction: The Mediating Effects of Mental and Physical Health
Authors: Yucel Deniz
Published: June 2017

Applying the stress-divorce model to explain the impact of spillover stress, this study analyzes 1,961 married participants in the National Study of the Changing Workforce. Specifically, it tests the individual and combined effects of work-to-family conflict, family-to-work conflict, work-to-family enrichment, and family-to-work enrichment on marital satisfaction. Additionally, this study tests whether these effects are mediated by mental and physical health. The results suggest that mental health and physical health both fully mediate the effect of work-to-family conflict, while mental health and physical health both partially mediate the effect of work-to-family enrichment on marital satisfaction. On the other hand, neither of the health measures mediates the effects of family-to-work conflict and family-to-work enrichment on marital satisfaction. These results suggest the importance of examining both the positive and the negative aspects of work-family balance in understanding marital satisfaction and highlight the mediating effects of mental and physical health in shaping how work-family balance affects marital satisfaction.
Between Emulation and Innovation: Upendrakishore Ray and the Ambiguities of Colonial Modernity
Authors: Sengoopta Chandak
Published: June 2017

Using the example of Upendrakishore Ray (1863–1915), a well-known Bengali artist, writer, technologist and publisher, this essay critiques prevalent theories that portray colonial Indian modernity as a largely derivative discourse. Addressing Ray’s globally recognised contributions to the refinement of technologies for the printing of photographs and paintings, the article shows how Ray’s relative lack of resources could not obstruct his innovative approach and investigates why, in spite of his originality, his Western recognition was no more than transient. Turning then to Ray’s views on pictorial art, the essay shows how in this area, he merely followed the precepts of western ‘academic’ art and failed to attain any originality. Indian engagements with modernity, the essay concludes, were neither exclusively original nor invariably imitative, and we need new theoretical approaches that can accommodate this diversity and unpredictability.
Platelet amyloid precursor protein is a modulator of venous thromboembolism in mice
Authors: Canobbio Ilaria , Visconte Caterina , Momi Stefania , Guidetti Gianni Francesco , Zarà Marta , Canino Jessica , Falcinelli Emanuela , Gresele Paolo , Torti Mauro
Published: June 2017

Key Points

APP is dispensable for platelet activation and arterial thrombosis. APP is an important novel regulator of vein thrombosis and controls coagulation and neutrophil extracellular traps formation.
Cichorium intybus L. promotes intestinal uric acid excretion by modulating ABCG2 in experimental hyperuricemia
Authors: Wang Yu , Lin Zhijian , Zhang Bing , Nie Anzheng , Bian Meng
Published: June 2017

Background

Excessive production and/or reduced excretion of uric acid could lead to hyperuricemia, which could be a major cause of disability. Hyperuricemia has received increasing attention in the last few decades due to its global prevalence. Cichorium intybus L., commonly known as chicory, is a perennial herb of the asteraceae family. It was previously shown to exert potent hypouricemic effects linked with decreasing uric acid formation in the liver by down-regulating the activity of xanthine oxidase, and increasing uric acid excretion by up-regulating the renal OAT3 mRNA expression. The present study aimed to evaluate its extra-renal excretion and possible molecular mechanism underlying the transporter responsible for intestinal uric acid excretion in vivo.

Methods

Chicory was administered intragastrically to hyperuricemic rats induced by drinking 10% fructose water. The uricosuric effect was evaluated by determining the serum uric acid level as well as the intestinal uric acid excretion by HPLC. The location and expression levels of ATP-binding cassette transporter, sub-family G, member 2 (ABCG2) in jejunum and ileum were analyzed.

Results

The administration of chicory decreased the serum uric acid level significantly and increased the intestinal uric acid excretion obviously in hyperuricemic rats induced by 10% fructose drinking. Staining showed that ABCG2 was expressed in the apical membrane of the epithelium and glands of the jejunum and ileum in rats. Further examination showed that chicory enhanced the mRNA and protein expressions of ABCG2 markedly in a dose-dependent manner in jejunum and ileum.

Conclusion

These findings indicate that chicory increases uric acid excretion by intestines, which may be related to the stimulation of intestinal uric acid excretion via up-regulating the mRNA and protein expressions of ABCG2.
Transcriptional and epigenetic regulation of T cell hyporesponsiveness
Authors: Pereira Renata M , Hogan Patrick G , Rao Anjana , Martinez Gustavo J
Published: June 2017

Naive CD8+ T cells differentiate into effector and memory cytolytic T cells (CTLs) during an acute infection. In contrast, in scenarios of persistent antigen stimulation, such as chronic infections and cancer, antigen-specific CTLs show a gradual decrease in effector function, a phenomenon that has been termed CD8+ T cell “exhaustion” or “dysfunction.” Another hyporesponsive state, termed “anergy”, is observed when T cells are activated in the absence of positive costimulatory signals. Among the many negative regulators induced in hyporesponsive T cells are inhibitory cell–surface receptors, such as PD-1, LAG-3, CTLA-4, and TIM-3; “checkpoint blockade” therapies that involve treatment of patients with cancer with blocking antibodies to those receptors show considerable promise in the clinic because the blocking antibodies can mitigate hyporesponsiveness and promote tumor rejection. In this review, we describe recent advances in our molecular understanding of these hyporesponsive states. We review evidence for the involvement of diverse transcription factors, metabolic programs, and chromatin accessibility changes in hyporesponsive T cells, and we discuss how checkpoint blockade therapies affect the molecular program of CD8+ T cell exhaustion.
Routine molecular screening of advanced refractory cancer patients: An analysis of the first 2490 patients of the ProfiLER study.
Authors: Tredan Olivier , Corset Veronique , Wang Qing , Varnier Romain , Pacaud Camille , Torroja Alexia , Luppi Nicolas , Ezzalfani Monia , Myard Magali , Jiang Xiaojun , Attignon Valéry , Pissaloux Daniel , Baudet Christian , Cassier Philippe Alexandre , Fayette Jérôme , Carbonnaux Mélodie , Bonneville-Levard Alice , Viari Alain , Pérol David , Blay Jean-Yves ,   LYric Profiler Author's Group
Published: June 2017

LBA100

Background: ProfiLER (NCT01774409) is a molecular profiling clinical trial exploring cancer cell genomic alterations in pts with advanced disease to guide treatment. Methods: Pts with confirmed diagnosis of advanced cancers are eligible. DNA extracted from either archival or fresh collected tumor samples was analyzed by targeted exon sequencing of 60 cancer related genes and whole genome array comparative genomic hybridization (CGH). A multidisciplinary molecular board analyzes genomic data and recommends molecular targeted therapies (MTT) when actionable alterations are found. Results: As of Jan 2017, 2490 pts (55% female, median age 59, range 1-90) were consented; 1826 (73.3%) tumors were analyzed, 301 (12%) are ongoing (not done in 363 pts (14.6%) for technical issues). Tumor types were colorectal (10.3%), gyneco (9.5%), breast (8.8%), head & neck (7.1%) carcinomas, sarcomas (7.1%) and brain tumors (6.5%). 940/1826 pts (51.5%) had at least 1 actionable mutation (AM): 579 pts with only one AM, while 358 with 2 or more AM (up to 6). Mutations (including substitutions and small indels), amplifications and homozygous deletions (HD) were observed respectively in 55.3%, 42.1% and 25.5% of tumor samples. The most common AM were on KRAS (n = 156; 8.5%), PIK3CA (n = 150; 8.2%), CDKN2A HD (n = 174; 9.5% ), PTEN HD (n = 49, 2.7%), CCND1 (n = 97; 5.3%), FGFR1 (n = 56; 3.1%), MDM2 (n = 53; 2.9%), HER2 (n = 42; 2.3%) and HER1(n = 41; 2.2%). MTT were recommended in 644 pts. Among them, 101 (gyn [28%], GI [18%], breast [12%]) initiated a recommended MTT. Collection of treatment data is ongoing for 202 pts. MTT received were mTOR inhibitors (39%), anti-angiogenic TKI (21%), EGFR TKI (9.8%), inhibitors of cell cycle (6.9%). Best responses were CR (n = 2, 2.3%), PR (n = 13, 15.1%), SD (n = 29, 33.7%), PD (n = 42, 48.8%), with a median PFS of 2.8 months (95% IC: 2.2-3.5). 24% are alive progression free at 6 months. Updated data will be presented at the meeting. Conclusions: In this series of 2490 cancer pts, CGH and NGS identified actionable alterations on 51% of pts, with treatment recommendation in 35%. Most patients treated derived benefit from the recommended MTT, but these represent a minority of the whole population screened. Clinical trial information: NCT01774409.
SCORAD III: Randomized noninferiority phase III trial of single-dose radiotherapy (RT) compared to multifraction RT in patients (pts) with metastatic spinal canal compression (SCC).
Authors: Hoskin Peter , Misra Vivek , Hopkins Kirsten , Holt Tanya , Brown Gillian , Arnott Seonaid , Shibu Thomas Sharon , Reczko Krystyna , Beare Sandy , Lopes Andre , Forsyth Sharon
Published: June 2017

LBA10004

Background: SCC is a common complication of metastatic cancer. Most pts receive RT to improve neurological function and mobility and to relieve pain. There is no standard schedule (RT ranges from single dose 8Gy to 40Gy in 20 fractions). SCORAD III was conducted to show whether a single fraction is as effective as multifraction RT without compromising patient outcomes. Methods: Pts from 43 UK and 4 Australian sites were randomized (1:1) to receive external beam spinal canal RT as a single dose of 8Gy or 20Gy in 5 fractions; stratified by RT center, ambulatory status (AS), site of primary, and presence or absence of nonskeletal metastases. Eligible pts had spinal cord or cauda equina (C1-S2) compression confirmed by MRI/CT scan, treatable within a single radiation field, life expectancy >8 weeks (wks), no previous RT to the same area. Primary endpoint was AS at wk 8: graded 1 (full function) to 4 (no/flicker motor power). The noninferiority margin was 11% for comparing the proportion of patients with AS 1 or 2 at wk 8 (whether maintained from baseline or improved from AS 3-4). Results: 688 pts were randomized Feb 2008 to Apr 2016 (n=345 single dose, n=343 multifraction). 73% were male; median age 70 years; ambulatory with/without walking aids 66%; 44% prostate, 18% lung, 11% breast, 11% gastrointestinal. Baseline characteristics were balanced. 69.5% (114/164 pts evaluable at wk 8) single dose vs. 73.3% (129/176) multifraction had AS 1-2 at wk 8 (risk difference: -3.78%, 90%CI -11.85 to 4.28). Importantly, overall survival (OS) was very similar: median OS 12.4 wks single dose vs. 13.7 multifraction, (hazard ratio 1.02 [95%CI 0.86-1.21], p=0.81). Proportion of pts with adverse events was similar for grade 3-4 (20.6% single dose vs. 20.4% multifraction), but grade 1-2 events were lower with single dose (51.0% vs. 56.9%). Conclusions: Using a single dose of 8Gy in pts with metastatic SCC was as effective as multiple fractions for AS at 8 wks and OS. We now recommend using single dose RT in this setting, with the major benefit of requiring only a single instead of multiple hospital visits, important when considering the short survival in these pts. Clinical trial information: 97108008.
Performance of a high-intensity 508-gene circulating-tumor DNA (ctDNA) assay in patients with metastatic breast, lung, and prostate cancer.
Authors: Razavi Pedram , Li Bob T. , Abida Wassim , Aravanis Alex , Jung Byoungsok , Shen Ronglai , Hou Chenlu , De Bruijn Ino , Gnerre Sante , Lim Raymond S. , Reales Dalicia , Maddala Tara , Berger Michael F. , Riely Gregory J. , Scher Howard I. , Novotny William F. , Solit David B. , Lee Mark , Reis-Filho Jorge S. , Baselga Jose
Published: June 2017

LBA11516

Background: ctDNA assays can noninvasively assess tumor burden and biology by identifying tumor-derived somatic alterations. For broad applicability, including early cancer detection, an unprecedented high-intensity approach (ultra-deep sequencing of plasma cell-free DNA (cfDNA) with broad genomic coverage) is needed to address intra-patient and population-level heterogeneity. We present initial results with this approach in patients (pts) with metastatic breast (BC), non-small cell lung (NSCLC), and castration-resistant prostate cancer (CRPC). Methods: Blood and tissue were prospectively collected w/in 6 wks with no intervening therapy change from pts with de novo or progressive cancer. cfDNA and white blood cell (WBC) genomic DNA from each pt were sequenced with a 508-gene panel (2 Mb; >60,000X raw depth). cfDNA variant calling used molecular barcoding for error correction and filtering for WBC variants. Tissue was sequenced using the MSK-IMPACT assay (410 genes, 1.4 Mb, >500X depth) blinded to plasma/WBC sequencing. Variants were classified as clonal or subclonal based on tumor sequencing in BC and NSCLC. Results: Of 161 eligible pts, 124 (39 BC, 41 NSCLC, and 44 CRPC) were evaluable for concordance. In tissue, 864 variants were detected across the 3 tumor types, with 627 (73%) also detected in plasma: single nucleotide variants/indels - 75%, fusions - 67%, and copy number alterations - 58%. In 90% of pts, at least 1 of the variants detected in tumor tissue was also detected in plasma: BC - 97%, NSCLC - 85%, CRPC - 84%. Most actionable mutations detected in tissue were also detected in plasma (54/71, 76%; SNVs only: 28/31, 90%). A subset of driver mutations (eg. in ESR1, PIK3CA, ERBB2, EGFR) were observed in plasma but not tissue. Clonal variants in tissue were more likely to be detected in plasma than subclonal variants (p<.001). Conclusions: This novel, high-intensity ctDNA assay enabled broad detection of genomic variants in plasma at high rates of concordance with corresponding tumor tissue, providing strong evidence for tumor-derivation of these signals. This study will inform development of a high-intensity sequencing approach for early cancer detection.