bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review and Network Meta-Analysis of Post-Imatinib Therapy in Advanced Gastrointestinal Stromal Tumour
Authors: Shah K. , Chan K. K. W. , Ko Y. J.
Published: January 2018

Background: The standard first-line systemic therapy for advanced gastrointestinal stromal tumour (GIST) is imatinib. However, most GISTS develop imatinib resistance, highlighting the need for new agents in the imatinib-refractory setting. Currently, no randomized studies have directly compared the available post–first-line treatments. Methods: In a systematic review, the MEDLINE, EMBASE, and CENTRAL databases, and American Society of Clinical Oncology abstracts to July 2014 were searched to identify randomized controlled trials that included GIST patients treated with post–first-line therapies. Hazard ratios (HRS) for progression-free (PFS) and overall survival (OS) were extracted. Direct pairwise meta-analyses and indirect comparisons using the Butcher method were performed. Results: Four studies were identified for the systematic review. One study showed that sunitinib in the second-line setting (vs. placebo) was associated with improved PFS, but not improved OS. Three studies examined the third-line setting (imatinib resumption vs. placebo, regorafenib vs. placebo, nilotinib vs. best supportive care). In the third-line settings, the two placebo-controlled and the non-placebo-controlled trials showed significant heterogeneity (I2 = 98%). Indirect comparisons of imatinib resumption and regorafenib suggested that the hr for PFS was 0.59 (95% confidence interval: 0.31 to 1.12; p = 0.10), trending in favour of regorafenib. Indirect comparisons found that toxicities were higher in the regorafenib group, with a risk difference of 27.8% for any-grade toxicities and 19.5% for grades 3 and 4 toxicities. Conclusions: Because a head-to-head study of imatinib resumption compared with regorafenib is unlikely ever to be conducted, our study suggests that, in terms of PFS, regorafenib might be the preferred treatment. However, given the increased toxicity observed with regorafenib, clinicians should interpret that evidence with caution at an individual patient level.
Patterns of Cancer Centre Follow-Up Care for Survivors of Breast, Colorectal, Gynecologic, and Prostate Cancer
Authors: Urquhart R. , Lethbridge L. , Porter G. A.
Published: January 2018

Background: Rising demand on cancer system resources, alongside mounting evidence that demonstrates the safety and acceptability of primary care–led follow-up care, has resulted in some cancer centres discharging patients back to primary care after treatment. At the same time, the ways in which routine cancer follow-up care is provided across Canada continue to vary widely. The objectives of the present study were to investigate patterns of routine follow-up care at a cancer centre for breast, colorectal, gynecologic, and prostate cancer survivors; factors associated with receipt of follow-up care at a cancer centre; and changes in follow-up care at a cancer centre over time. Methods: We identified all people diagnosed in Nova Scotia with an invasive breast, colorectal, gynecologic, or prostate cancer between 1 January 2006 and 31 December 2013. We linked the resulting population-based dataset, at the patient level, to cancer centre or clinic data and to census data. We identified a nonmetastatic survivor cohort (n = 12,267) and developed decision rules to differentiate routine from non-routine visits during the follow-up care period (commencing 1 year after diagnosis). Descriptive statistics were computed to describe the patterns of routine follow-up care at a cancer centre. Negative binomial regression was used to examine factors associated with visits made and changes over time. Results: Nearly half the survivors (48.4%) had at least 1 follow-up visit to the cancer centre, with variation by disease site (range: 30.2%–62.4%). Disease site and stage at diagnosis were associated with receipt of follow-up care at a cancer centre. For instance, compared with breast cancer survivors, survivors of gynecologic cancer had more visits [incidence rate ratio (IRR): 1.48; 95% confidence interval (CI): 1.34 to 1.64], and survivors of colorectal cancer had fewer visits (IRR: 0.45; 95% CI: 0.40 to 0.51). Year of diagnosis was associated with follow-up at a cancer centre, with each successive calendar year being associated with an 8% increase in visits made (IRR: 1.08; 95% CI: 1.07 to 1.10). Conclusions: Despite evidence that follow-up care can be effectively and safely delivered in primary care, and despite intensifying demands on oncology services, many survivors continue to receive routine follow-up care at a cancer centre.
Wait Times for Diagnosis and Treatment of Lung Cancer: A Single-Centre Experience
Authors: Labbé C. , Anderson M. , Simard S. , Tremblay L. , Laberge F. , Vaillancourt R. , Lacasse Y.
Published: January 2018

Background: Multiple clinical practice guidelines recommend rapid evaluation of patients with suspected lung cancer. It is uncertain whether delays in diagnosis and management have a negative effect on outcomes. Methods: This retrospective study included 551 patients diagnosed with lung cancer through the diagnostic assessment program at the Institut universitaire de cardiologie et de pneumologie de Québec between September 2013 and March 2015. Median wait times between initial referral, diagnosis, and first treatment were calculated and compared with recommended targets. Analyses were performed to evaluate for specific factors associated with longer wait times and for the effect of delays on the outcomes of progression-free survival (PFS), relapse-free survival (RFS) after primary surgical resection, and overall survival (OS). Results: Most patients were investigated and treated within recommended targets. Of the entire cohort, 379 patients were treated at our institution. Of those 379 patients, 311 (82%) were treated within recommended targets. In comparing patients within and outside target times, the only statistically significant difference was found in the distribution of treatment modalities: patients meeting targets were more likely to be treated with surgery or chemotherapy rather than with radiation. The PFS on first treatment modality was influenced by clinical stage, but not by time to therapy [hazard ratio (HR): 1.10; p = 0.65]. The OS for the entire cohort was also influenced by stage, but not by delays (HR: 1.04; p = 0.87). For the 209 patients treated by surgery with curative intent, a significant reduction in RFS was associated with male sex and TNM stage, but not with delays (HR: 1.11; p = 0.83). The OS after primary surgical resection was also associated with TNM stage, but not with delays (HR: 1.82; p = 0.43). Conclusions: Recommended targets for wait times in the investigation and treatment of lung cancer can be achieved within a diagnostic assessment program. Compared with radiation treatment, treatment with surgery or chemotherapy is more likely to be completed within targets. Delays in investigation and treatment do not appear to negatively affect the clinical outcomes of OS, RFS, and PFS. Prospective studies are needed to evaluate whether efficient work-up and treatment influence other important variables, such as quality of life, cost of care, and access to therapies while performance status is adequate.
Strategic Planning in an Academic Radiation Medicine Program
Authors: Hamilton J. L. , Foxcroft S. , Moyo E. , Cooke-Lauder J. , Spence T. , Zahedi P. , Bezjak A. , Jaffray D. , Lam C. , Létourneau D. , Milosevic M. , Tsang R. , Wong R. , Liu F. F.
Published: January 2018

Background: In this paper, we report on the process of strategic planning in the Radiation Medicine Program (RMP) at the Princess Margaret Cancer Centre. The RMP conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Methods: Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. Results: The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. Conclusions: The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations.
The Predictive Effect of Primary Tumour Location in the Treatment of Metastatic Colorectal Cancer: A Canadian Consensus Statement
Authors: Abrahao A. B. K. , Karim S. , Colwell B. , Berry S. , Biagi J.
Published: January 2018

In recently published data, the predictive value of primary tumour location for the treatment of metastatic colorectal cancer with available biologic therapies has been explored. Recognizing the potential effect of those data on clinical practice, we convened a meeting of Canadian experts who treat metastatic colorectal cancer to develop a set of national, evidence-based treatment guidelines based on primary tumour location. This report summarizes the relevant evidence and presents the consensus recommendations of those experts.
The OncoSim Model: Development and Use for Better Decision-Making in Canadian Cancer Control
Authors: Gauvreau Cindy L. , Fitzgerald N. R. , Memon S. , Flanagan W. M. , Nadeau C. , Asakawa K. , Garner R. , Miller A. B. , Evans W. K. , Popadiuk C. M. , Wolfson M. , Coldman A. J.
Published: January 2018

The Canadian Partnership Against Cancer was created in 2007 by the federal government to accelerate cancer control across Canada. Its OncoSim microsimulation model platform, which consists of a suite of specific cancer models, was conceived as a tool to augment conventional resources for population-level policy- and decision-making. The Canadian Partnership Against Cancer manages the OncoSim program, with funding from Health Canada and model development by Statistics Canada. Microsimulation modelling allows for the detailed capture of population heterogeneity and health and demographic history over time. Extensive data from multiple Canadian sources were used as inputs or to validate the model. OncoSim has been validated through expert consultation; assessments of face validity, internal validity, and external validity; and model fit against observed data. The platform comprises three in-depth cancer models (lung, colorectal, cervical), with another in-depth model (breast) and a generalized model (25 cancers) being in development. Unique among models of its class, OncoSim is available online for public sector use free of charge. Users can customize input values and output display, and extensive user support is provided. OncoSim has been used to support decision-making at the national and jurisdictional levels. Although simulation studies are generally not included in hierarchies of evidence, they are integral to informing cancer control policy when clinical studies are not feasible. OncoSim can evaluate complex intervention scenarios for multiple cancers. Canadian decision-makers thus have a powerful tool to assess the costs, benefits, cost-effectiveness, and budgetary effects of cancer control interventions when faced with difficult choices for improvements in population health and resource allocation.
Design of photonic microcavities in hexagonal boron nitride
Authors: Kim Sejeong , Toth Milos , Aharonovich Igor
Published: January 2018

We propose and design photonic crystal cavities (PCCs) in hexagonal boron nitride (hBN) for diverse photonic and quantum applications. Two dimensional (2D) hBN flakes contain quantum emitters which are ultra-bright and photostable at room temperature. To achieve optimal coupling of these emitters to optical resonators, fabrication of cavities from hBN is therefore required to maximize the overlap between cavity optical modes and the emitters. Here, we design 2D and 1D PCCs using anisotropic indices of hBN. The influence of underlying substrates and material absorption are investigated, and spontaneous emission rate enhancements are calculated. Our results are promising for future quantum photonic experiments with hBN.
A Commentary on the Role of Randomized Controlled Trials in Massage Therapy
Authors: Baskwill, MSc, Bed, RMT Amanda
Published: January 2018

Some massage therapists (MTs) view research as a way to demonstrate to other healthcare professionals (OHPs) that massage therapy is safe and effective and should be an integral part of patients’ health care.  This desire for credibility through research, however, requires studies that are acceptable to medical professionals.  Therefore, researchers have begun to study massage therapy, primarily using randomized controlled trials (RCTs).  Many of the RCTs of massage therapy, rather than proving efficacy, have been met with criticism, including their lack of reproducibility and lack of a suitable control.  The belief that RCTs will save the profession of MT, or any health care practice, by proving treatments work, is unfounded.  Evidence hierarchies suggest that practitioners should accept the results of RCTs, or the systematic review of RCTs, as the gold standard for efficacy research.  Privileging one methodology over another does not use the benefits of the multiple approaches to research available. Researchers should consider whether there are other methodologies that allow for rigorous investigation of massage therapy in a way that would be useful for stakeholders of this research.  It is only through research that is rigorously and authentically conducted that the credibility of massage therapy will be established.
Review of Energy-saving Technologies in Modern Hydraulic Drives
Authors: Karpenko Mykola , Bogdevičius Marijonas
Published: January 2018

This paper focuses on review of modern energy­saving technologies in hydraulic drives. Described main areas of energy conservation in hydraulic drive (which in turn are divided into many under the directions) and was established the popularity of them. Reviewed the comparative analysis of efficiency application of various strategies for energy saving in a hydraulic drive. Based on the review for further research a combined method of real­time control systems with energy­saving algorithms and regeneration unit – selected for maxing efficiency in hydraulic drive. Scientific papers (40 papers), what introduced in review, is not older than 15 years in the databases “Sciencedirect” and “Scopus”.
Flexural Reinforced Concrete Elements, Strengthened with Fibre Reinforced Polymer, Bearing Capacity Evaluation According to Limit Crack Depth
Authors: Šlaitas Justas
Published: January 2018

The research was made on condition assessment of flexed reinforced concrete structures, strengthened with fibre reinforced polymers, in fracture stage. Universal bearing capacity calculation method based on limit normal section crack depth was proposed. This paper confirms the hypothesis of triangular concrete’s compressive zone chart usage for flexural strength calculation, without tensile concrete above crack evaluation. There is established connection between crack depth and FRP stress­strain, which allows to decide about structures bearing capacity reserve. The calculation results are confirmed with experimental studies of 73 reinforced concrete beams, strengthened with carbon fibre reinforced polymer (CFRP) and glass fibre reinforced polymer (GFRP) sheets, plates, strips and rods, taken from different researches. Furthermore, recommended limits of strengthening with FRP were proposed.
Analysis of BIM Methodology Application for Masonry Facade Constructions
Authors: Zigmund Viačeslav , Migilinskas Darius
Published: January 2018

BIM methodology is one of the most effective solutions for the design of masonry veneer construction. BIM implementation in design of veneer facade gives a lot of advantages for architects, designers and masonry contractors. Every participant imagines the model of masonry veneer facades on their own way and use it for different tasks. The three main implementation stages of masonry veneer facades have been analyzed in this article. Using BIM information model analysis of implementation processes, mistakes and solution during the design, production and construction stages.
3He-rich Solar Energetic Particles in Helical Jets on the Sun
Authors: Bučík Radoslav , Innes Davina E. , Mason Glenn M. , Wiedenbeck Mark E. , Gómez-Herrero Raúl , Nitta Nariaki V.
Published: January 2018

Particle acceleration in stellar flares is ubiquitous in the universe; however, our Sun is the only astrophysical object where energetic particles and their source flares can both be observed. The acceleration mechanism in solar flares, tremendously enhancing (up to a factor of 10,000) rare elements like 3He and ultra-heavy nuclei, has been puzzling for almost 50 years. Here we present some of the most intense 3He- and Fe-rich solar energetic particle events ever reported. The events were accompanied by nonrelativistic electron events and type-III radio bursts. The corresponding high-resolution, extreme-ultraviolet imaging observations have revealed for the first time a helical structure in the source flare with a jet-like shape. The helical jets originated in relatively small, compact active regions, located at the coronal-hole boundary. A mini-filament at the base of the jet appears to trigger these events. The events were observed with the two Solar Terrestrial Relations Observatories on the backside of the Sun, during the period of increased solar activity in 2014. The helical jets may be a distinct feature of these intense events that is related to the production of high 3He and Fe enrichments.
Hydrogen-poor Superluminous Supernovae from the Pan-STARRS1 Medium Deep Survey
Authors: Lunnan R. , Chornock R. , Berger E. , Jones D. O. , Rest A. , Czekala I. , Dittmann J. , Drout M. R. , Foley R. J. , Fong W. , Kirshner R. P. , Laskar T. , Leibler C. N. , Margutti R. , Milisavljevic D. , Narayan G. , Pan Y.-C. , Riess A. G. , Roth K. C. , Sanders N. E. , Scolnic D. , Smartt S. J. , Smith K. W. , Chambers K. C. , Draper P. W. , Flewelling H. , Huber M. E. , Kaiser N. , Kudritzki R. P. , Magnier E. A. , Metcalfe N. , Wainscoat R. J. , Waters C. , Willman M.
Published: January 2018

We present light curves and classification spectra of 17 hydrogen-poor superluminous supernovae (SLSNe) from the Pan-STARRS1 Medium Deep Survey (PS1 MDS). Our sample contains all objects from the PS1 MDS sample with spectroscopic classification that are similar to either of the prototypes SN 2005ap or SN 2007bi, without an explicit limit on luminosity. With a redshift range

, PS1 MDS is the first SLSN sample primarily probing the high-redshift population; our multifilter PS1 light curves probe the rest-frame UV emission, and hence the peak of the spectral energy distribution. We measure the temperature evolution and construct bolometric light curves, and find peak luminosities of

erg s−1 and lower limits on the total radiated energies of

erg. The light curve shapes are diverse, with both rise and decline times spanning a factor of ∼5 and several examples of double-peaked light curves. When correcting for the flux-limited nature of our survey, we find a median peak luminosity at 4000 Å of

and a spread of

.
Une approche comparative des pratiques managériales de la Marque Territoriale Régionale
Authors: Albertini Thérèse , Bereni Delphine , Luisi Graziella
Published: January 2018

Le présent article s’intéresse à un concept encore jeune dans son développement et peu étudié dans la littérature marketing à ce jour, la Marque Territoriale Régionale (MTR). Parmi les actions engagées par les collectivités territoriales, la création d’une marque région devient l’un des principaux leviers de différenciation et de promotion au service du développement du territoire. L’objectif de ce papier consiste, tout d’abord, à étudier le processus de construction et la mise en œuvre d’une MTR pour ensuite tenter de voir s’il existe un effet différentiel de ces pratiques managériales selon les territoires considérés. Les auteurs proposent d’apporter des éléments de réponse au travers des recherches documentaires et scientifiques mais aussi par le biais d’une étude qualitative comparative menée auprès de six responsables de MTR. La volonté affichée ici est de faire progresser la réflexion sur la MTR de façon à susciter davantage la curiosité des responsables territoriaux et de démontrer les intérêts managériaux liés à sa mise en place.
Patient, et interprète. Le domaine intermédiaire
Authors: Chervet Emmanuelle
Published: January 2018

Dans les écrits cliniques de Freud, déjà l’interprétation est partagée entre analyste et patient. Un parcours subjectif de l’œuvre freudienne dégage les fonctions successives de l’interprétation. Dans les conjonctures au-delà du principe de plaisir, c’est souvent la réserve interprétative qui s’impose. Lorsqu’elle est possible, l’interprétation est un processus en plusieurs temps, qui fait appel à la mémoire de la cure et à la situation transférentielle du moment.
L’interprétation analytique : un acte subversif
Authors: Eoche-Duval Brigitte
Published: January 2018

Qu’est-ce qui fait interprétation ? À cette question ouvrant sur la complexité de l’expérience analytique, l’auteur s’attache à en établir la genèse, sur un plan théorique en appui sur la clinique. C’est à partir de l’hypothèse d’une forme commune agissant entre l’analyste et l’analysant, au plus près des sources infantiles du transfert, sous l’effet de l’effectuation hallucinatoire de la parole et de l’ Agieren de transfert, que l’acte de parole interprétatif trouvera son énonciation et sa formulation, dans un mouvement de subversion langagier. L’élément sexuel indompté pourra dès lors trouver la voie de la scénarisation pour une aptitude à la représentation.
Rêves, hallucinations, transformations
Authors: Jozef Perelberg Rosine
Published: January 2018

Ce texte interroge le sens de l’expérience hallucinatoire d’une patiente au cours de son analyse. Il y a, pour elle, échec de l’accomplissement hallucinatoire du souhait infantile comme modèle de base de compréhension de la psyché. Cet échec résulte d’une rencontre traumatique avec l’objet primaire. C’est la répétition du traumatisme dans le processus analytique et son élaboration à travers l’écoute analytique qui transforme une suite de coups en après coups , inaugurant ainsi une temporalité psychanalytique.
L’interprétation des souvenirs d’enfance
Authors: Brusset Bernard
Published: January 2018

L’interprétation des souvenirs d’enfance pose des questions qui ont été présentes dans les deux rapports au Congrès : L’image, l’action ou les mots pour les dire en séance ? Leur rapport avec des signifiants formels préverbaux ouvre à l’inconnu ou au primitif. La couleur jaune chez Freud en est un exemple.
Donner la parole…
Authors: Bürgin Dieter
Published: January 2018

Donner la parole est un geste aimable, mais quelquefois aussi un acte violent. Trouver des « mots qui touchent » reste un art, comme nous le montre Winnicott. Chercher les mots nous impose une tâche auto-analytique difficile si nous essayons de clarifier ce qui se passe en nous-mêmes quand nous avons été forcés d’accueillir une identification projective. Prendre la parole et se donner mutuellement la parole pendant les séances ressemble à un morceau à quatre mains.
Figures de la clandestinité psychique. Autour de l’interprétation dans un cas de pédophilie occasionnelle
Authors: Schinaia Cosimo
Published: January 2018

L’auteur se réfère à la clandestinité psychique à laquelle le patient pédophile recourt dans la relation analytique. Elle peut se constituer comme modalité communicative du monde enfantin ou comme le résultat d’une utilisation inconsciente et perverse de la discrétion, au moment où, à partir d’une condition polysémique ouverte et potentiellement riche de sens, passe à une condition régulièrement clivée : une sorte de crypte, de tombe. Le cas clinique met en évidence la relation oscillatoire entre les figures de la clandestinité chez le patient et les oscillations contre-transférentielles entre accueil et répulsion chez l’analyste.
Vérité et réalité, note sur l’interprétation délirante
Authors: Jeanneau Augustin
Published: January 2018

La folie d’interprétation rencontrée dans certains délires se révèle comme le contraire de l’interprétation psychanalytique. Car si elle semble craindre par-dessus tout d’en savoir davantage, c’est moins par peur du secret, que par un besoin immédiat d’explication, qui viendrait au secours d’un questionnement lancinant, concernant une réalité qui manque à délivrer quelque vérité insaisissable et entretient une inquiétante incertitude.
Oppositions islamistes à distance
Authors: Dazey Margot , Zederman Mathilde
Published: January 2018

Résumé Comment se mobilise-t-on à distance ? L'étude des oppositions politiques hors des frontières exige d'expliciter les règles régissant cet espace singulier de mobilisation et d'analyser la façon dont les modes d'organisation et les registres de justification se reconfigurent en situation migratoire. En comparant les mobilisations islamistes tunisiennes et égyptiennes en France, cet article interroge les effets de l'identité politico-religieuse des acteurs sur leurs pratiques d'opposition à distance. Les militants anti-Ben Ali dans les années 1990-2000 et anti-Sissi depuis 2013 sont partagés entre l'ambition de rendre audible leur cause à un public français et le besoin de préserver l'identité religieuse du groupe.
Mobiliser par émotions, mobiliser les émotions
Authors: Salaris Coline
Published: January 2018

Résumé L'étude des mobilisations de victimes de problèmes de santé publique invite à considérer le lien majeur que cette forme d'action collective entretient avec la question des émotions. Celles-ci constituent un motif de passage à l'action et interviennent aussi dans la formation des collectifs de victimes où s'articulent rencontres de pairs et prise de conscience de l'ampleur de l'injustice subie. La question émotionnelle s'illustre également dans le cadre de la mobilisation même. En effet, la rhétorique d'action collective des victimes et leur démarche de publicisation de la cause intègrent ces émotions afin de construire leur cause comme problème de santé publique. La démonstration s'appuie ici sur une enquête qualitative de l'affaire du Distilbène (DES).
Sagesse collective, diversité et mauvais usage des mathématiques
Authors: Houlou-Garcia Antoine
Published: January 2018

Résumé Les thèmes de la sagesse collective et des avantages cognitifs de la diversité ont bénéficié ces dernières années d'un certain attrait en théorie politique, notamment dans le courant dit « démocratie épistémique ». L'un des principaux arguments repose sur un ensemble de démonstrations mathématiques établies par Lu Hong et Scott Page. Nous présentons ces résultats et montrons que les modélisations mises en  uvre pour les établir sont mal construites et que ces résultats sont erronés d'un point de vue mathématique. Enfin, quand bien même les résultats seraient bien construits et justes, ils seraient inapplicables en théorie politique.
Femtosecond Laser–Assisted Stromal Lenticule Addition Keratoplasty for the Treatment of Advanced Keratoconus: A Preliminary Study
Authors: Mastropasqua Leonardo , Nubile Mario , Salgari Niccolò , Mastropasqua Rodolfo
Published: January 2018

PURPOSE:

To investigate the in vivo effect of a novel femtosecond laser–assisted procedure termed stromal lenticule addition keratoplasty for advanced keratoconus.

METHODS:

Ten patients with stage III and IV stable keratoconus were included. Negative meniscus-shaped stromal lenticules were produced from corneoscleral eye bank buttons with a refractive lenticule extraction procedure with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Recipient corneas underwent a modified femtosecond laser flap-cut procedure to produce an intrastromal pocket and lenticules were implanted. Patients were followed up for 6 months after surgery with determination of uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and topographic corneal curvature changes, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy.

RESULTS:

Comparison of preoperative and 6-month postoperative UDVA and CDVA showed statistically significant improvements (
P
= .024 and .007, respectively) from 1.58 ± 0.36 to 1.22 ± 0.37 and from 1.07 ± 0.17 to 0.70 ± 0.23 logMAR. Eight of 10 eyes showed an improvement in UDVA (
P
< .001) that ranged between one and three lines, whereas all but one eye presented improved CDVA. Corneal topography documented a decrease between preoperative and 6-month postoperative anterior mean curvature (AVG-K at 3 mm) and anterior Q values (
P
= .005). AS-OCT showed a significant increase in thickness of the central and mid-peripheral cornea produced by the lenticule implantation (
P
= .005).

CONCLUSIONS:

The stromal lenticule addition keratoplasty procedure was clinically efficient in improving the corneal shape and vision in patients with keratoconus. Negative meniscus-shaped lenticule addition induced a flattening of the cone while increasing corneal thickness.

[
J Refract Surg.
2018;34(1):36–44.]
Unusual Internal Astigmatism Due to Severe Capsule Contraction Syndrome
Authors: Zéboulon Pierre , Gatinel Damien
Published: January 2018

PURPOSE:

To describe a case of severe capsule contraction syndrome causing significant astigmatism due to intraocular lens (IOL) folding.

METHODS:

Case report.

RESULTS:

Capsule fibrosis and contraction resulted in bending of the hydrophilic IOL along its long axis. Anterior Nd:YAG capsulotomy resolved the situation and restored the patient's visual acuity.

CONCLUSIONS:

Hydrophilic IOLs are more susceptible to capsule contraction due to the increased flexibility of highly hydrated materials. They should be avoided in patients at risk of capsule contraction to prevent ocular complications.

[
J Refract Surg.
2018;34(1):65–67.]
Los micromamíferos (Eulipotyphla, Chiroptera, Rodentia y Lagomorpha) del yacimiento del Pleistoceno Superior de la cueva de El Castillo (Cantabria, España)
Authors: Sesé C.
Published: January 2018

El material de micromamíferos del yacimiento del Pleistoceno Superior de la cueva de El Castillo, objeto de estudio detallado en este trabajo, proviene de los niveles auriñacienses 18b y 18c (datados en 40.000-45.000 BP), nivel 19, y niveles musterienses 20b, 20c, 20d, 20e (datados en 41.000-49.000 BP), 21a y 21b. La asociación de micromamíferos es la siguiente: Erinaceus europaeus, Crocidura russula, Sorex coronatus, Sorex minutus, Neomys fodiens, Talpa europaea, Galemys pyrenaicus, cf. Miniopterus schreibersii, Chiroptera indet., Pliomys lenki, Microtus arvalis – Microtus agrestis, Microtus lusitanicus, Microtus oeconomus, Chionomys nivalis, Arvicola terrestris, Apodemus sylvaticus – Apodemus flavicollis y Lepus sp. La mayoría de estas especies están presentes en la fauna actual de Cantabria, excepto Pliomys lenki que se extinguió en el último tercio del Pleistoceno Superior, y Microtus oeconomus, que persistió en la península ibérica durante el Holoceno bien avanzado hasta su desaparición en tiempos históricos, y que actualmente está en regiones euroasiáticas más septentrionales. Hay una gran continuidad de la gran mayoría de los taxones en todos los niveles. La fauna en su conjunto parece indicar un medio predominantemente abierto, por lo general de praderas húmedas (y en mucha menor medida praderas secas) con una buena cobertura vegetal a nivel del suelo, en el que habría también algunas zonas arboladas o boscosas, y algún curso de agua. Los indicadores termófilos son escasos y poco abundantes, lo que podría indicar que el clima podría ser algo menos templado que en otros periodos del Pleistoceno Superior y quizás también que actualmente en la zona.
Entre Francia y España. Conflicto político y defensa hispánica de la frontera en la Cerdaña, 1659-1672
Authors: Espino López Antonio
Published: January 2018

El principal objetivo de este trabajo ha sido analizar la constitución de una nueva frontera militar en Cataluña y el papel específico jugado por la comarca de la Cerdaña, dividida entre las monarquías francesa e hispana desde 1659. Se ha comparado las aportaciones de autores como P. Sahlins y A. Ayats con la documentación exhumada en el Archivo General de Simancas y el Archivo de la Corona de Aragón. Los años que median entre la Paz de los Pirineos y el inicio de la guerra de Holanda nos permiten contextualizar las enormes dificultades tenidas por la Monarquía Hispánica a la hora de desarrollar una política defensiva adecuada en el área, concluyendo que las dificultades económicas lastraron la posibilidad de hacer de Puigcerdà una verdadera fortaleza capaz de representar un peligro real para la corona francesa en el Pirineo.
Escasez de vínculos débiles: el atraso económico de la Andalucía contemporánea desde la perspectiva de redes empresariales
Authors: Rubio-Mondéjar Juan Antonio , Garrués-Irurzun Jósean
Published: January 2018

Las redes empresariales, al favorecer la transmisión de ideas e innovaciones, así como la acumulación de capital, son un elemento que impulsa el desarrollo económico en el largo plazo. Pero, en última instancia, no son más que reflejo de las condiciones institucionales y económicas de un territorio. En este trabajo se presenta un estudio de las redes empresariales que actuaron en Andalucía en el periodo comprendido entre las décadas de 1880 y 1950. Una vez identificadas estas redes, se describen y se reflexiona sobre su relación con el crecimiento económico de la región. La investigación se basa en la información contenida en los libros de sociedades de los registros mercantiles de las ocho provincias andaluzas, sobre la que se ha aplicado la metodología de análisis de redes sociales. Frente a otros trabajos que se limitan a describir los indicadores estadísticos de las redes, aquí se recurre al análisis cualitativo de las mismas, así como de los empresarios que las formaron. Así, se encuentran dos razones que explican que las redes andaluzas no fueran un factor suficiente de desarrollo regional: primero, porque apenas contaron con «vínculos débiles»; segundo, porque no pudieron operar en los sectores más dinámicos de la economía de la región.
Collegiate Football Players' Ankle Range of Motion and Dynamic Balance in Braced and Self-Adherent–Taped Conditions
Authors: Willeford Kristin , Stanek Justin M. , McLoda Todd A.
Published: January 2018

Context: 

Ankle sprains are one of the most common injuries in the physically active population. Previous researchers have shown that supporting the ankle with taping or bracing is effective in preventing ankle sprains. However, no authors have compared the effects of self-adherent tape and lace-up ankle braces on ankle range of motion (ROM) and dynamic balance in collegiate football players.

Objective: 

To examine the effectiveness of self-adherent tape and lace-up ankle braces in reducing ankle ROM and improving dynamic balance before and after a typical collegiate football practice.

Design: 

Crossover study.

Setting: 

Collegiate athletic training room.

Patients or Other Participants: 

Twenty-nine National Collegiate Athletic Association Division I football athletes (age = 19.2 ± 1.14 years, height = 187.52 ± 20.54 cm, mass = 106.44 ± 20.54 kg).

Intervention(s): 

Each participant wore each prophylactic ankle support during a single practice, self-adherent tape on 1 leg and lace-up ankle brace on the other. Range of motion and dynamic balance were assessed 3 times for each leg throughout the testing session (baseline, prepractice, postpractice).

Main Outcome Measure(s): 

Ankle ROM for inversion, eversion, dorsiflexion, and plantar flexion were measured at baseline, immediately after donning the brace or tape, and immediately after a collegiate practice. The Y-Balance Test was used to assess dynamic balance at these same time points.

Results: 

Both interventions were effective in reducing ROM in all directions compared with baseline; however, dynamic balance did not differ between the tape and brace conditions.

Conclusions: 

Both the self-adherent tape and lace-up ankle brace provided equal ROM restriction before and after exercise, with no change in dynamic balance.
Molecular Epidemiology of an Orientia tsutsugamushi Gene Encoding a 56-kDa Type-Specific Antigen in Chiggers, Small Mammals, and Patients from the Southwest Region of Korea
Authors: Park Jung Wook , Kim Sun Hee , Park Duck Woong , Jung So Hyang , Park Hye Jung , Seo Mi Hee , Song Hyeon Je , Lee Jung Yoon , Kim Dong Min , Kim Choon-Mee , Gill Byong Chul , Jeong Hang Jin , Lee Jeong Min , Ha Dong Ryong , Kim Eun Sun , Chung Jae Keun
Published: January 2018

A phylogenetic analysis of Orientia tsutsugamushi was performed to elucidate its antigenic diversity in chiggers, small mammals, and patients. Between September 2014 and December 2016, a total of 3,816 chiggers were identified within nine species of four genera in the southwest region of Korea: Leptotrombidium scutellare (49.9%; 1,907/3,816), Leptotrombidium orientale (21.1%; 804/3,816), Leptotrombidium pallidum (12.4%; 474/3,816), Euchoengastia koreaensis (7.2%; 273/3,816), Leptotrombidium palpale (6.7%; 256/3,816), Neotrombicular gardellai (1.3%; 50/3,816), Leptotrombidium zetum (0.8%; 32/3,816), Walchia fragilis (0.5%; 18/3,816), and Neotrombicular japonica (> 0.1%; 2/3,816). Twelve chiggers (11 L. scutellare and one L. palpale) tested positive for O. tsutsugamushi by polymerase chain reaction and, except for 1 chigger (KY266830), were part of the Boryong strain cluster. Of the 413 small mammals that were analyzed for O. tsutsugamushi, Apodemus agrarius was the most common rodent species (89.5%; 370/413), followed by Crocidura lasiura (6.8%; 28/413) and Myodes regulus (3.6%; 15/413). The sequence identity of an O. tsutsugamushi sample obtained from the A. agrarius sample population belonged to the Saitama strain cluster. Furthermore, a phylogenetic analysis in 125 patients revealed four clusters (Boryong cluster: 82.4% [103/125], Karp: 13.6% [17/125], Kawasaki: 3.2% [4/125], and Saitama: 0.8% [1/125]). This study clarified the phylogenetic relationship for O. tsutsugamushi in chiggers, small mammals, and patients. The Boryong strain was the most common strain in chiggers and patients. In addition, various strains were identified, except for the Boryong strain, in the southwest region of Korea. Overall, the data presented here will be helpful for the establishment of prevention strategies for scrub typhus.
Diagnosis of Trypanosoma cruzi Infection Status using Saliva of Infected Subjects
Authors: Cortes-Serra Nuria , Pinazo Maria-Jesus , de la Torre Leonardo , Galizzi Melina , Gascon Joaquim , Bustamante Juan Manuel
Published: January 2018

Chagas disease has the highest prevalence of any parasitic disease in the Americas, affecting 6–7 million people. Conventional diagnosis requires a well-equipped laboratory with experienced personnel. The development of new diagnostic tools that are easy to use and adapted to the reality of affected populations and health systems is still a significant challenge. The main objective of this study was to measure Trypanosoma cruzi infection status using saliva samples of infected subjects. Blood and saliva samples from 20 T. cruzi-seropositive individuals and 10 controls were tested for T. cruzi infection using two different commercial serological tests. We have shown that detection of T. cruzi infection is possible using saliva samples, supporting the potential use of saliva to diagnose Chagas disease in humans. This method could provide a simple, low-cost but effective tool for the diagnosis of T. cruzi infection. Its noninvasive nature makes it particularly well suited for endemic areas.
Impact of Antiretroviral Therapy on the Risk of Herpes Zoster among Human Immunodeficiency Virus-Infected Individuals in Tanzania
Authors: Kawai Kosuke , Hawkins Claudia A. , Hertzmark Ellen , Francis Joel M. , Sando David , Muya Aisa N. , Ulenga Nzovu , Fawzi Wafaie W.
Published: January 2018

We examined the incidence of herpes zoster (HZ) before and after the initiation of antiretroviral therapy (ART), and risk factors for HZ among human immunodeficiency virus (HIV)-infected individuals in Tanzania. A cohort study was conducted among HIV-positive individuals enrolled in HIV care and treatment clinics in Dar es Salaam, Tanzania. A Cox proportional hazard model was used to examine the effect of ART on the risk of HZ after adjusting for sociodemographics and time-varying clinical and nutritional factors. Among 72,670 HIV-positive individuals, 2,312 incident cases of HZ (3.2%) occurred during the median follow-up of 15 months (interquartile range: 3–35). The incidence rate of HZ significantly declined from 48.9 (95% confidence interval [CI] = 46.7–51.0) per 1,000 person-years before ART to 3.7 (95% CI = 3.3–4.1) per 1,000 person-years after the initiation of ART (P < 0.001). The risk of HZ declined with longer duration on ART. Low CD4 cell count, older age, female sex, district of Dar es Salaam, and year of enrollment were independently associated with the risk of HZ in the multivariate analysis. Low body mass index and anemia were not associated with the risk of HZ. The risk of HZ substantially declined after ART initiation in this large cohort of HIV-infected individuals. Earlier initiation of ART could reduce the risk of HZ and other opportunistic infections among HIV-infected individuals in sub-Saharan Africa.
Low Prevalence of Tuberculin Skin Test Boosting among Community Residents in Uganda
Authors: Sekandi Juliet N. , Zalwango Sarah , Nkwata Allan K. , Martinez Leonardo , Kakaire Robert , Mutanga Jane N. , Whalen Christopher C. , Kiwanuka Noah
Published: January 2018

Boosted tuberculin skin test (TST) reactions can be misclassified as new latent tuberculosis (TB) infection. To our knowledge, no study has evaluated the prevalence of TST boosting in a population-based sample in high TB burden settings. We determined the prevalence of TST boosting among urban residents in Uganda. We evaluated 99 participants with initial TST < 5 mm and repeated a skin test after 2 weeks. We found that only 2% had boosted TST reactions suggesting that most TST conversions could represent new TB infections in this high-burden setting.
The Quality of Medicines Used in Children and Supplied by Private Pharmaceutical Wholesalers in Kinshasa, Democratic Republic of Congo: A Prospective Survey
Authors: Schiavetti Benedetta , Wynendaele Evelien , De Spiegeleer Bart , Mbinze Geremie J. , Kalenda Nicodème , Marini Roland , Melotte Vera , Hasker Epco , Meessen Bruno , Ravinetto Raffaella , Van der Elst Josiane , Mutolo Ngeleka Daniel
Published: January 2018

Poor-quality medicines are a threat to public health in many low- and middle-income countries, and prospective surveys are needed to inform corrective actions. Therefore, we conducted a cross-sectional survey on a sample of products used for children and available in the private market in Kinshasa, Democratic Republic Congo: amoxicillin (AX) and artemether/lumefantrine (AL), powders for suspension, and paracetamol (PC) tablets 500 mg. Overall, 417 products were covertly purchased from 61 wholesalers. To obtain a representative sample, the products were weighted on their market shares and a subset of 239 samples was randomly extracted to undergo in-depth visual inspection locally, and they were chemically assessed at two accredited laboratories in Belgium. Samples were defined of “poor-quality” if they failed to comply with at least one specification of the International Pharmacopoeia (for AL) or United States Pharmacopoeia 37 (for AX and PC). Results are reported according to the Medicine Quality Assessment Reporting Guideline. The visual inspection detected nonconformities in the aspects of antimalarial powders for suspension, and poor-quality labels across all medicine types. According to chemical analysis, 27.2% samples were of poor quality and 59.5% of AL samples were underdosed in artemether. Poor quality was more frequent for locally manufactured antimalarials (83.3%, P = 0.021; 86.4%, P = 0.022) and PC (4.8%, P = 0.000). The poor quality of the surveyed products may decrease the treatment’s efficacy and favor the development of resistances to antimalarials. It is hoped that these findings may guide the corrective actions of the Democratic Republic of Congo Regulatory Authority, which was the main partner in the research.
Case Report: Severe Plasmodium vivax Malaria Mimicking Sepsis in a Neonate
Authors: Tatura Suryadi N. N. , Wowor Elizabeth Clarissa , Mandei Jose M. , Wilar Rocky , Warouw Sarah M. , Rompis Johnny , Kalensang Priscilla , Tuda Joseph
Published: January 2018

Severe congenital malaria associated with Plasmodium vivax is uncommon. In Indonesia, most congenital malaria cases are due to Plasmodium falciparum infections. Most cases of congenital or neonatal malaria in endemic areas are diagnosed from peripheral smear as part of routine sepsis workup. Differentiating congenital and acquired neonatal malaria is very difficult. The case presented in this study describes severe P. vivax malaria with cholestatic jaundice and sepsis-like signs and symptoms in neonates. The mother was asymptomatic and the neonate was successfully treated with intravenous artesunate. Severe P. vivax malaria with cholestatic jaundice in neonates is an uncommon condition that should be included in the differential diagnosis of infants displaying hemolytic anemia, thrombocytopenia, cholestatic jaundice, and hepatosplenomegaly in malaria-endemic zones. Early diagnosis can prevent the use of unnecessary antibiotics and mortality of neonates.
New insights for mesospheric OH: multi-quantum vibrational relaxation as a driver for non-local thermodynamic equilibrium
Authors: Kalogerakis Konstantinos S. , Matsiev Daniel , Cosby Philip C. , Dodd James A. , Falcinelli Stefano , Hedin Jonas , Kutepov Alexander A. , Noll Stefan , Panka Peter A. , Romanescu Constantin , Thiebaud Jérôme E.
Published: January 2018

Abstract. The question of whether mesospheric OH(v) rotational population distributions are in equilibrium with the local kinetic temperature has been debated over several decades. Despite several indications for the existence of non-equilibrium effects, the general consensus has been that emissions originating from low rotational levels are thermalized. Sky spectra simultaneously observing several vibrational levels demonstrated reproducible trends in the extracted OH(v) rotational temperatures as a function of vibrational excitation. Laboratory experiments provided information on rotational energy transfer and direct evidence for fast multi-quantum OH(high-v) vibrational relaxation by O atoms. We examine the relationship of the new relaxation pathways with the behavior exhibited by OH(v) rotational population distributions. Rapid OH(high-v) + O multi-quantum vibrational relaxation connects high and low vibrational levels and enhances the hot tail of the OH(low-v) rotational distributions. The effective rotational temperatures of mesospheric OH(v) are found to deviate from local thermodynamic equilibrium for all observed vibrational levels. Dedicated to Tom G. Slanger in celebration of his 5 decades of research in aeronomy.