bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors secreted from high glucose treated endothelial cells impair expansion and differentiation of human skeletal muscle satellite cells
Authors: Kargl Christopher K. , Nie Yaohui , Evans Sheelagh , Stout Julianne , Shannahan Jonathan H. , Kuang Shihuan , Gavin Timothy P.
Published: August 2019

Key points

Cellular communication occurs between endothelial cells and skeletal muscle satellite cells and is mitogenic for both cell types under normal conditions.

Skeletal muscle atrophy and endothelial cell dysfunction occur in tandem in cardiovascular disease, type II diabetes and ageing.

The present study investigated how induction of endothelial cell dysfunction via high glucose treatment impacts growth and differentiation of human skeletal muscle satellite cells in vitro.

Secreted factors from high glucose treated endothelial cells impaired satellite cell expansion and differentiation via decreased proliferation and dysregulation of p38 mitogen‐activated protein kinase in satellite cells committed to myogenesis.

These findings highlight a novel potential role for endothelial cells in the development and pathology of skeletal muscle atrophy, which is common in patients with endothelial dysfunction related pathologies.

Cross‐talk between endothelial cells (ECs) and skeletal muscle satellite cells (MuSC) has been identified as an important regulator of cellular functions in both cell types. In healthy conditions, EC secreted factors promote MuSC growth and differentiation. Endothelial and satellite cell dysfunction occur in tandem in many disease states; however, no data exist examining the impact of dysfunctional EC signalling on satellite cells. Therefore, the present study aimed to evaluate the effect that factors secreted from high glucose (HG) treated ECs have on the growth and differentiation of human satellite cells (HMuSC) using a conditioned medium (CM) cell culture model. Satellite cells were isolated from human skeletal muscle and grown in CM from normal or HG treated human umbilical vein ECs (HUVECs). Satellite cells grown in CM from HG treated HUVECs reduced growth (25%), differentiation (25%) and myonuclear fusion (35%). These responses were associated with increased superoxide (50%) and inflammatory cytokines (25–50%) in HG treated HUVECs and HG‐CM. Decreased expansion of HG‐CM treated HMuSCs was driven by a decrease in proliferation. Impaired gene expression and protein content of myogenic differentiation factors were preceded by decreased phosphorylation of p38 mitogen‐activated protein kinase in HMuSC treated with CM from HG treated HUVECs. The results obtained in the present study are the first to show that factors secreted from HG treated ECs cause impairments in human muscle satellite cell growth and differentiation in vitro, highlighting endothelial cell health and secretion as a potential target for treating vascular disease‐associated skeletal muscle dysfunction.
US4all (Ultrasound for all)
Authors: Sporea Ioan
Published: August 2019

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What are patient-reported outcomes and why they are important: improving studies of preschool wheeze
Authors: Makrinioti Heidi , Bush Andrew , Griffiths Chris
Published: August 2019

There are no outcomes-based commissioning structures in child health. This needs to change. Preschool wheeze is a very common condition. Many families present at emergency departments with their wheezy children and stay briefly. This highlights that this group of children may be lacking a more personalised approach. There are no user-friendly patient-reported outcome measures in preschool wheeze. This needs to change. Research in this area is therefore highly anticipated.
Macrophage activation syndrome/haemophagocytic lymphohistiocytosis secondary toBurkholderia cepaciacomplex septicaemia in an elderly female carrier of X-linked chronic granulomatous disease with extreme lyonisation: ‘cepacia syndrome’ revisited
Authors: Urriola Nicolás , Williams Andrew , Keat Karuna
Published: August 2019

X-linked carriers of chronic granulomatous disease (CGD) may become phenotypically affected if substantial skewing from lyonisation occurs. We describe a 73-year-old female carrier with an overt CGD phenotype due to skewed lyonisation, complicated by macrophage activation syndrome (MAS)/haemophagocytic lymphohistiocytosis (HLH) secondary toBurkholderiacepaciacomplex septicaemia that was successfully treated with a combination of three antibiotics, an antifungal, granulocyte colony stimulating factor, intravenous immune globulin (IVIG) and ciclosporin. Fully phenotypic immunodeficiency is possible in X-linked CGD carriers when skewed lyonisation occurs, rendering such patients to all the same sequelae of CGD such as MAS/HLH. MAS/HLH should be thoroughly excluded when evaluating ‘cepacia syndrome’ in non-CGD patients.
Retained products of conception in hysteroscopy in a patient with breast cancer on tamoxifen
Authors: Qadir Dhilshad , Chua Monica , Sulaiman Suzanna
Published: August 2019

Tamoxifen is a selective oestrogen receptor modulator widely used in breast cancer treatment, with good survival rates. Its partial agonist action on other tissues such as the uterus, however, promotes the development of endometrial hyperplasia and cancer. It appears that tamoxifen does not alter the age of menopause and women may still get pregnant while on tamoxifen. We present the case of a 47-year-old Chinese woman with breast cancer on tamoxifen, who presented with one episode of heavy per vaginal bleeding after 2 years of amenorrhoea. Her urine pregnancy test was negative and the ultrasound scan was suspicious for malignancy. She underwent a hysteroscopic evaluation for abnormal bleeding on tamoxifen. Histopathology confirmed products of conception. This case illustrates the importance of understanding the rise and decline of human chorionic gonadotropin in pregnancy, as well as the pivotal role of contraception despite having amenorrhoea on tamoxifen.
Thymoma associated paraneoplastic encephalitis (TAPE), a potential cause of limbic encephalitis
Authors: Liu Henry , Edson Randall S
Published: August 2019

A 59-year-old man presents with expressive aphasia and short term memory deficits. Shortly thereafter, he started developing staring spells and intermittent right hand spasms, preliminarily thought to be simple partial seizures. Subsequent MRI brain imaging was highly suggestive of herpes simplex virus (HSV) encephalitis; however, HSV PCR from cerebrospinal fluid was negative. On further testing, the patient was found to have an autoimmune encephalitis thought to be related to an incidentally found thymoma. His clinical presentation, in conjunction with imaging and response to therapy, was strongly suggestive of thymoma associated paraneoplastic encephalitis. Early recognition is the only way to ensure prompt initiation of appropriate treatment. Immunotherapy and cancer directed therapy (including tumour resection, if indicated) have been shown to have favourable outcomes, improved speed of neurological recovery and reduced risk of relapses. Without treatment, progressive neurologic deterioration can occur over months to years, eventually resulting in death.
Neurosyphilis presenting as pure cerebellar ataxia: an atypical manifestation
Authors: Garg Divyani , Vibha Deepti , Pandit Awadh Kishor , Srivastava Achal Kumar
Published: August 2019

Neurosyphilis has become an uncommon diagnosis in the current era. Neurological manifestations of syphilis usually lie within the spectrum of meningovascular syphilis, tabes dorsalis or general paresis of the insane. Although sensory ataxia may occur as part of spinal cord involvement, cerebellar ataxia has been rarely described as a manifestation of neurosyphilis. In this report, we describe a rare case neurosyphilis presenting in the form of a pure pancerebellar syndrome of subacute progression.
von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
Authors: Zou Ziyuan , Yan Xinwen , Li Cheng , Li Xiaofeng , Ma Xiaofen , Zhang Chunqing , Ju Shenghong , Tian Junzhang , Qi Xiaolong
Published: August 2019

Objective

This meta-analysis was performed to investigate the correlation between von Willebrand factor (vWF) antigen and hepatic venous pressure gradient (HVPG) and to evaluate the diagnostic performance of vWF to detect clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH).

Design

Systematic review and meta-analysis.

Methods

MEDLINE, EMBASE, Web of Science and the Cochrane Library were screened up to 5 April 2018. Studies related to the diagnostic performance of vWF to detect CSPH and/or SPH with HVPG as the reference standard were included. Study quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies scale. Two authors independently used a standardised form to extract data.

Outcomes

The primary outcome was the correlation coefficient between vWF and HVPG. The secondary outcome was the diagnostic performance of vWF to detect CSPH or SPH.

Results

A total of six articles involving 994 patients were included in this study. Five of the included articles were used to stratify the results for the correlation coefficient, three for the diagnostic performance of CSPH and two for SPH. The pooled correlation coefficient based on the random effects model was 0.54 (95% CI 0.35 to 0.69), thus suggesting a moderate correlation between vWF and HVPG. The pooled sensitivity, specificity and area under the curve of vWF for CSPH detection were 82% (95% CI 78 to 86), 76% (95% CI 68 to 83) and 0.87 (95% CI 0.80 to 0.94), respectively. Regarding the ability of vWF to detect SPH, the pooled sensitivity and specificity were 86% (95% CI 80 to 90) and 75% (95% CI 66 to 83), respectively. These results supported the satisfactory diagnostic performance of vWF for CSPH and SPH detection.

Conclusions

vWF, as a novel biomarker, has a moderate correlation with HVPG and shows a satisfactory performance for the diagnosis of CSPH and SPH in patients with cirrhosis.
The James Lind Alliance process approach: scoping review
Authors: Nygaard Agnete , Halvorsrud Liv , Linnerud Siv , Grov Ellen Karine , Bergland Astrid
Published: August 2019

Objective

To summarise study descriptions of the James Lind Alliance (JLA) approach to the priority setting partnership (PSP) process and how this process is used to identify uncertainties and to develop lists of top 10 priorities.

Design

Scoping review.

Data sources

The Embase, Medline (Ovid), PubMed, CINAHL and the Cochrane Library as of October 2018.

Study selection

All studies reporting the use of JLA process steps and the development of a list of top 10 priorities, with adult participants aged 18 years.

Data extraction

A data extraction sheet was created to collect demographic details, study aims, sample and patient group details, PSP details (eg, stakeholders), lists of top 10 priorities, descriptions of JLA facilitator roles and the PSP stages followed. Individual and comparative appraisals were discussed among the scoping review authors until agreement was reached.

Results

Database searches yielded 431 potentially relevant studies published in 2010–2018, of which 37 met the inclusion criteria. JLA process participants were patients, carers and clinicians, aged 18 years, who had experience with the study-relevant diagnoses. All studies reported having a steering group, although partners and stakeholders were described differently across studies. The number of JLA PSP process steps varied from four to eight. Uncertainties were typically collected via an online survey hosted on, or linked to, the PSP website. The number of submitted uncertainties varied across studies, from 323 submitted by 58 participants to 8227 submitted by 2587 participants.

Conclusions

JLA-based PSP makes a useful contribution to identifying research questions. Through this process, patients, carers and clinicians work together to identify and prioritise unanswered uncertainties. However, representation of those with different health conditions depends on their having the capacity and resources to participate. No studies reported difficulties in developing their top 10 priorities.
Cardiovascular fitness and risk of migraine: a large, prospective population-based study of Swedish young adult men
Authors: Nyberg Jenny , Gustavsson Sara , Linde Mattias , Åberg N David , Rohmann Jessica L , Åberg Maria , Kurth Tobias , Waern Margda , Kuhn Georg Hans
Published: August 2019

Objectives

To examine the longitudinal relationship between cardiovascular fitness in young adult men and future risk of migraine and to estimate eventual differential effects among categories of body mass index (BMI) and blood pressure.

Design

National, prospective, population-based cohort study.

Setting

Sweden 1968–2014.

Participants

18-year-old Swedish men (n=1 819 828) who underwent mandatory military conscription examinations during the years 1968–2005.

Primary and secondary outcomes

The primary outcome was the first dispensation of prescribed migraine-specific medication, identified using the Swedish Prescribed Drug Register. The secondary outcome was documented migraine diagnosis from the Swedish National Hospital Register.

Results

During follow-up, 22 533 men filled a prescription for migraine-specific medication. After confounding adjustment, compared with high cardiovascular fitness, low and medium fitness increased the risk of migraine-specific medication (risk ratio (RR)low: 1.29, 95% CI 1.24 to 1.35; population attributable fraction: 3.6%, 95% CI 1.7% to 5.3% and RRmedium: 1.15, 95% CI 1.12 to 1.19; population attributable fraction: 8.0%, 95% CI 4.0% to 11.7%). To assess potential effect measure modification, stratified analyses of these association by levels of BMI and blood pressure showed that lower fitness levels increased risk of migraine across all groups except among underweight men or men with high diastolic blood pressure.

Conclusions

Young men with a lower cardiovascular fitness had a higher long-term risk of developing pharmacological prescription-requiring migraine. This study contributes with information regarding risk factors for migraine in men, an understudied population in migraine research.
C reactive protein level as a marker for dyslipidaemia, diabetes and metabolic syndrome: results from the Korea National Health and Nutrition Examination Survey
Authors: Jeong Hyemin , Baek Sun-Young , Kim Seon Woo , Park Eun-Jung , Lee Jaejoon , Kim Hyungjin , Jeon Chan Hong
Published: August 2019

Objective

Plasma C reactive protein (CRP) is a marker of inflammation, and increased plasma CRP is reported in many diseases, including cardiovascular disease, diabetes, metabolic syndrome, arthritis and malignancies. The aim of the study was to evaluate the association between plasma CRP levels and cardiovascular disease, metabolic syndrome, malignancies and other comorbidities.

Design

A retrospective, cross-sectional survey study.

Setting

Large population survey in Korea.

Methods

A total of 5887 (weighted n=40 251 868) participants aged 19 years or older from the 2016 Korea National Health and Nutrition Examination Survey were included for analysis. Weighted prevalence and OR of comorbidities were analysed according to the continuous variable of log plasma high-sensitivity CRP levels.

Results

The mean age was 46.7±0.37 years and the median plasma CRP was 0.58 mg/L (IQR 0.36–1.09). The mean plasma CRP levels were higher in participants with cardiovascular diseases and cardiovascular risk factors, osteoarthritis, rheumatoid arthritis, pulmonary tuberculosis, and several cancers, including gastric, colon, breast and cervix, than in the general population. In the multivariable analysis, plasma CRP concentration was associated with increased prevalence of hypertriglyceridaemia (OR 1.157, 95% CI 1.040 to 1.287, p=0.007), diabetes (OR 1.204, 95% CI 1.058 to 1.371, p=0.005) and metabolic syndrome (OR 1.228, 95% CI 1.112 to 1.357, p<0.001) after adjustment for socioeconomic and lifestyle characteristics. There was no significant association between plasma CRP level and cancers.

Conclusion

Plasma CRP was associated with an increased risk of dyslipidaemia, diabetes and metabolic syndrome in the general population.
Diagnostic performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation at estimating glomerular filtration rate in adults with diabetes mellitus: a systematic review and meta-analysis protocol
Authors: Zafari Neda , Churilov Leonid , MacIsaac Richard J , Torkamani Niloufar , Baxter Helen , Kiburg Katerina V , Ekinci Elif
Published: August 2019

Introduction

Timely detection leading to the implementation of reno-protective measures reduces the progression of diabetic kidney disease. Estimated glomerular filtration rate (eGFR) is a major surrogate of kidney function. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Equation is a tool to estimate GFR. This protocol outlines a systematic-review, assessing the diagnostic accuracy of the CKD-EPI equation in adults with diabetes.

Methods and analysis

MEDLINE, Embase, Cochrane Central Register of Controlled Trials and grey literature will be searched for publications in English, Farsi, Dutch and Chinese from 2009 (when CKD-EPI was first introduced) to January 2019. Bridging searches will be conducted to capture literature published from January 2019 until final review publication. The inclusion criteria will be (1) study participants with diabetes; (2) age ≥18 years; (3) creatinine-based CKD-EPI eGFR as index test; (4) measured GFR using the clearance/plasma disappearance of inulin, iohexol, iothalamate, diethylenetriamine-pentaacetic acid (DTPA) or chromium labelled ethylenediaminetetraacetic acid (Cr-EDTA) as reference test; (5) report of the diagnostic accuracy of the index test. Exclusion criteria will be participants with renal transplant, chronic use of corticosteroids, chronic inflammatory diseases, pregnancy, non-diabetes related kidney disease, thalassaemia, heart failure, pregnancy and potential kidney donors as well as critically ill patients. Screening, eligibility check, risk of bias assessment and data extraction will be carried out by two independent reviewers. Any discrepancies will be discussed, and third-party opinion will be sought. The risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies−2 tool. A quantitative synthesis of the aggregated-data will be used if the included studies are homogenous.

Ethics and dissemination

No ethics approval is required. The outcome will be published in a peer-reviewed journal. The results will help researchers and clinicians evaluate the diagnostic accuracy of the creatinine-based CKD-EPI eGFR in adults with diabetes.

PROSPERO registration number

CRD42018108776
Hydration and symptoms in the last days of life
Authors: Lokker Martine E , van der Heide Agnes , Oldenmenger Wendy H , van der Rijt Carin C D , van Zuylen Lia
Published: August 2019

Objectives

At the end of life oral fluid intake is often reduced. Consensus about the most appropriate management for terminally ill patients with limited oral fluid intake is lacking. The objective of this study is to investigate to what extent the amount of fluid intake, preceding and during the dying phase, is related to the occurrence of death rattle and terminal restlessness.

Methods

A multicentre prospective observational study was performed. Data on the occurrence of death rattle and terminal restlessness, fluid intake and opioid use of patients expected to die within a few days or hours were collected.

Results

371 patients were included. Death rattle was reported at least once in 40% (n=149) of patients during the dying phase. Death rattle occurrence was not associated with the amount of fluid intake during the days before dying. Terminal restlessness was reported in 26% of patients (n=96). Terminal restlessness was not associated with a lower amount of fluid intake during the days before dying. Terminal restlessness during the last 24 hours of life was associated with a higher amount of fluid (ie, >250 mL/day) during 48–25 hours before death.

Conclusions

Caution with fluid intake to prevent development of death rattle does not seem to be necessary. Our study suggests that a higher amount of fluid intake during 48–25 hours before death may be associated with the occurrence of terminal restlessness during the last 24 hours of life. These results suggest that actively providing dying patients with artificial fluid may not be beneficial.
Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care
Authors: Bylicki Olivier , Didier Morgane , Riviere Frederic , Margery Jacques , Grassin Frederic , Chouaid Christos
Published: August 2019

Objectives

Despite recent advances in thoracic oncology, most patients with metastatic lung cancer die within months of diagnosis. Aggressiveness of their end-of-life (EOL) care has been the subject of numerous studies. This study was undertaken to evaluate the literature on aggressive inpatient EOL care for lung cancer and analyse the evolution of its aggressiveness over time.

Methods

A systematic international literature search restricted to English-language publications used terms associated with aggressiveness of care, EOL and their synonyms. Two independent researchers screened for eligibility and extracted all data and another a random 10% sample of the abstracts. Electronic Medline and Embase databases were searched (2000–20 September 2018). EOL-care aggressiveness was defined as follows: 1) chemotherapy administered during the last 14 days of life (DOL) or new chemotherapy regimen during the last 30 DOL; 2) >2 emergency department visits; 3) >1 hospitalisation during the last 30 DOL; 4) ICU admission during the last 30 DOL and 5) palliative care started <3 days before death.

Results

Among the 150 articles identified, 42 were retained for review: 1 clinical trial, 3 observational cohorts, 21 retrospective analyses and 17 administrative data-based studies. The percentage of patients subjected to aggressive therapy seems to have increased over time. Early management by palliative care teams seems to limit aggressive care.

Conclusions

Our analysis indicated very frequent aggressive EOL care for patients with lung cancer, regardless of the definition used. The extent of that aggressiveness and its impact on healthcare costs warrant further studies.
Roles of individual differences and traffic environment factors on children’s street-crossing behaviour in a VR environment
Authors: Wang Huarong , Gao Zhan , Shen Ting , Li Fei , Xu Jie , Schwebel David C
Published: August 2019

Objective

Pedestrian injuries are among the most common cause of death and serious injury to children. A range of risk factors, including individual differences and traffic environment factors, has been investigated as predictors of children’s pedestrian behaviours. There is little evidence examining how risk factors might interact with each other to influence children’s risk, however. The present study examined the independent and joint influences of individual differences (sex and sensation seeking) and traffic environment factors (vehicle speeds and inter-vehicle distances) on children’s pedestrian safety.

Methods

A total of 300 children aged 10–13 years were recruited to complete a sensation-seeking scale, and 120 of those were selected for further evaluation based on having high or low sensation-seeking scores in each gender, with 30 children in each group. Children’s pedestrian crossing behaviours were evaluated in a virtual reality traffic environment.

Results

Children low in sensation seeking missed more opportunities to cross and had longer start gaps to enter the roadway compared with those high in sensation seeking, and these effects were more substantial when vehicles were spread further apart but travelling slowly. Interaction effects between inter-vehicle distance and vehicle speed were also detected, with children engaging in riskier crossings when the car was moving more quickly and the vehicles were spread further than when the vehicles were moving quickly but were closer together. No sex differences or interactions emerged.

Conclusion

Both sensation seeking and traffic environment factors impact children’s behaviour in traffic, and there are interactions between traffic speeds and inter-vehicle distances that impact crossing behaviour.
Understanding people’s ‘unrealistic optimism’ about clinical research participation
Authors: Cho Hae Lin , Miller David Gibbes , Kim Scott Y H
Published: August 2019

Background

Researchers worry that patients in early-phase research experience unrealistic optimism about benefits and risks of participation. The standard measure of unrealistic optimism is the Comparative Risk/Benefit Assessment (CRBA) questionnaire, which asks people to estimate their chances of an outcome relative to others in similar situations. Such a comparative framework may not be a natural way for research participants to think about their chances.

Objective

To examine how people interpret questions measuring unrealistic optimism and how their interpretations are associated with their responses.

Methods

Using an early-phase cancer trial vignette, we administered the CRBA to 297 adults from the general public. They estimated their comparative chances of risk and benefit (7-point scale: −3 less likely to +3 more likely), then provided rationales for their estimates.

Results

For both CRBA benefit and risk questions, about 50% of respondents chose 0 (the ‘correct’ response of ‘average likelihood’), and 50% chose a non-0 response. Respondents’ rationales for their estimates showed that overall only about 40%–44% gave comparative rationales, indicating that they interpreted the CRBA as intended. 68.7% of respondents who gave the ‘correct’ 0 rating gave comparative rationales, whereas only 11.6% of respondents who gave non-0 ratings did so. A similar trend was seen for chances of risk (p<0.001 for both).

Conclusion

Research participants may not understand comparative benefit and risk questions as intended; attributions of unrealistic optimism may require additional evidence that the respondents’ estimates are intended to be comparative.
Intergenerational monitoring in clinical trials of germline gene editing
Authors: Cwik Bryan
Published: August 2019

Design of clinical trials for germline gene editing stretches current accepted standards for human subjects research. Among the challenges involved is a set of issues concerningintergenerational monitoring—long-term follow-up study of subjects and their descendants. Because changes made at the germline would be heritable, germline gene editing could have adverse effects on individuals’ health that can be passed on to future generations. Determining whether germline gene editing is safe and effective for clinical use thus may require intergenerational monitoring. The aim of this paper is to identify and argue for the significance of a set of ethical issues raised by intergenerational monitoring in future clinical trials of germline gene editing. Though long-term, multigenerational follow-up study of this kind is not without precedent, intergenerational monitoring in this context raises unique ethical challenges, challenges that go beyond existing protocols and standards for human subjects research. These challenges will need to be addressed if clinical trials of germline gene editing are ever pursued.
Achieving environmental sustainability in the shell mould foundry through thermal reclamation
Authors: Kumar P. , Mohandas Gandhi N.
Published: August 2019

Shell moulding is a process for producing simple or complex near-net-shape castings and maintaining tight tolerances with a high degree of dimensional stability. The main objective of the present research is to achieve environmental sustainability by thermal reclamation of the used shell mould foundry sand and present the results of achieving environmental sustainability. The investigations indicate that the thermal reclamation of the used foundry sand helps in achieving sustainability, and the selection of optimal process parameters like percentage of resin, catalyst, and fresh silica sand addition are very important in the shell mould foundry.
Determinants of Left Ventricular Dysfunction and Remodeling in Patients With Corrected Tetralogy of Fallot
Authors: Andrade Ana Cristina , Jerosch‐Herold Michael , Wegner Philip , Gabbert Dominik Daniel , Voges Inga , Pham Minh , Shah Ravi , Hedderich Jürgen , Kramer Hans‐Heiner , Rickers Carsten
Published: August 2019

Background

The aim of this study was to identify in asymptomatic patients with repaired tetralogy of Fallot the prevalence and determinants of impaired left‐sided cardiac function and adverse ventricular remodeling and the relation of left ventricular (LV) dysfunction and remodeling with cardiopulmonary exercise capacity.

Methods and Results

In a cross‐sectional study, 103 patients with tetralogy of Fallot (median age, 16.3 years) in New York Heart Association class 1, with surgical repair at a median age of 1.1 years, and 63 age‐matched controls were studied. LV, right ventricular function and geometry, LV myocardial extracellular volume (n=57), and left atrial function were quantified with cardiac magnetic resonance. Peak oxygen consumption was measured by a standardized cardiopulmonary exercise test (n=70). Patients with tetralogy of Fallot had lower LV ejection fraction (
P
=0.001; 49% below age‐adjusted fifth percentile for controls), lower LV mass index (
P
=0.003), lower LV mass/volume ratio (
P
<0.01), and impaired left atrial function. Right ventricular mass/volume ratio was the best predictor for LV systolic dysfunction and for a lower LV mass/volume ratio. Compared with controls, LV extracellular volume was higher (
P
<0.001), particularly in female patients, and associated with subnormal peak oxygen consumption (
P
=0.037). A peak oxygen consumption below the third percentile reference level was more likely with decreasing LV ejection fraction (
P
=0.008), and lower LV mass index (
P
=0.024), but independent of right ventricular ejection fraction.

Conclusions

In New York Heart Association class 1 patients with tetralogy of Fallot, frequent impaired systolic and diastolic LV function, LV adverse remodeling with LV atrophy, a decreased mass/volume ratio, and extracellular matrix expansion suggest cardiomyopathic changes. The best predictor for LV systolic dysfunction was the right ventricular mass/volume ratio. The subnormal peak oxygen consumption indicates that monitoring of LV status may be important for long‐term prognosis.
Catheter Ablation for Atrial Fibrillation: Renal Function Benefit Only Makes Sense
Authors: Wehner Paulette
Published: August 2019

See Editorial
Park et al
A Renewed Reading of Hebrew Ostraca from Cave A-2 at Ramat Beit Shemesh (Naḥal Yarmut), Based on Multispectral Imaging
Authors: Mendel-Geberovich Anat , Faigenbaum-Golovin Shira , Shaus Arie , Sober Barak , Cordonsky Michael , Piasetzky Eli , Finkelstein Israel , Milevski Ianir
Published: August 2019

Three Hebrew ostraca, found near Khirbet Zanu’ (Ḥorvat Zanoaḥ) and published by Milevski and Naveh in 2005, were re-imaged using a high-end multispectral imaging technique. The re-imaging yielded dozens of changed or added characters and resulted in renewed, larger and improved readings, hereby published. In addition, we interpret the texts of the ostraca and place them in the context of the economy and administration of Judah in the seventh century BCE.
A Prayer for Purification
Authors: van Wolde Ellen
Published: August 2019

This article focuses on the pivotal role of verses 12-14 in Psalm 51. In v. 13 the speaker expresses the fear that due to his transgressions God’s spirit of holiness will be taken away, because God does not tolerate impurity of any kind. For the impurity generated by the transgressions will be projected onto the sanctuary, which in this way will be defiled. Therefore, aligned with רוח קדשך in v. 13 is טהור לב in v. 12: purity is the sine qua non for God’s holy spirit to stay and keep active in the midst of the Israelites. In this view, the impure world of words and deeds is the total from which the pure ones are to be separated. It is not the purity of the heart itself, but the process of purification that is expressed here, so that the pure heart remains, cleared of sins.
לֹא as “Yes” and לֹא as “No”
Authors: Kim Dong-Hyuk
Published: August 2019

The one-word negative response lō’ means “no” in Zech 4:5 and “yes” in Gen 18:15. This ambiguity is syntactic in nature and is handled and removed also by BH syntax.
Contact between Old Persian and Hebrew? A Rejoinder to A. Wilson-Wright
Authors: Samuel Harald
Published: August 2019

In his recent article “From Persepolis to Jerusalem: A Reevaluation of Old Persian-Hebrew Contact in the Achaemenid Period”, Aren Wilson-Wright reexamines the list of proposed Persian loans in Biblical Hebrew as well as their distribution, specifically in relation to the distinction between Classical and Late Biblical Hebrew. He seeks to demonstrate direct contact between speakers of Old Persian and Hebrew and proposes two further Old Persian calques.

This paper reevaluates Wilson-Wright’s proposals on both methodological and philological levels, and offers a fuller dataset for several phenomena. While allowing the principal distinction between Classical and Late Biblical Hebrew, questions of textual genesis and transmission are combined with sociolinguistic considerations to explore the possible ramifications of the proposed linguistic interaction: What do we know about the use of Old Persian apart from royal inscriptions? What do we know about Iranians, locals and their use of language in the Achaemenid administration? The result is a much more complex picture of multiple linguistic interference with many unknowns.
The Macrostructural Logic of the Alphabetic Poems in the Psalter
Authors: Ho Peter C. W.
Published: August 2019

With the emergence of the canonical approach to the Psalter, individual psalms are no longer studied as standalone compositions, but viewed along a continuum of psalms to provide meaning. While scholars have analysed alphabetic poems and how they add to meaning, the study of such poems has rarely gone beyond the individual psalm. This paper seeks to understand alphabetic poems within the horizon of the Psalter and whether they function together to provide meaning at the macrostructural level. The paper begins with analyses of eight generally accepted alphabetical acrostics in the Psalter. From their characteristics, a total of forty-six alphabetic poems are suggested. It is observed that these poems mark leitmotifs at prominent locations and develop the motif of David across the entire Psalter. The macrostructural logic of alphabetical poems, as a whole, is subservient to the overarching theological thrust of the Psalter.
Philology and Theory: Exodus 12:21-27 as a Case Study
Authors: Gesundheit Shimon
Published: August 2019

Using Exod 12:21-27 as a case study, this paper shows how literary analysis can find itself subordinated to historical-critical theory. It will be argued that this practice is ill advised. An established reading of a text should never be dismissed when it is found to challenge accepted paradigms. It is, rather, the presumed historical and social settings that must be problematized.
Double Tendance: The Photographic Message in the Egyptian Jewish Youth Magazine L’Illustration Juive, 1929–1931
Authors: Guedj David
Published: August 2019

The present article investigates the visual elements of the illustrated youth quarterly L’Illustration Juive, which was published in Alexandria between 1929 and 1931 in French and Hebrew. The analysis sets out to expose the ideologies and worldviews informing the publication’s editorial board, as well as the conscious or unconscious message that the quarterly tried to communicate to its young readership. The article explores more than 300 photographs and reproductions that featured in twelve issues published over the journal’s three years of existence. Analysis of the visual elements in this article shows that the quarterly featured many photographs of holy sites in the Land of Israel, as well as reproductions of artworks that reflected the religious Jewish way of life in the diaspora and Israel, including the Jewish calendar and Jewish life cycle. These works hold the Old Testament as a key book for Judaism, as well as for Jewish nationalism. Clearly evident in the visual elements, as in the overall visual messages of the quarterly, is the harmony struck between Jewish nationality, Zionism, and a religious Jewish cultural—or diasporic—world. It was this harmonious view that editor Rabbi David Prato sought to convey, upholding as he did a religious nationalist Jewish future, which he defined in the newspaper as a double tendance.
Jewish Childhood Transformed: Through the Looking Glass of Art and Visual Representation in Pre- and Post-Revolutionary Russia
Authors: Kotlyar Eugeny
Published: August 2019

The present article studies the thematic ways in which Jewish childhood was represented in Russian Jewish art and visual media from the 1850s to the 1930s. During this period, Russian Jewry was undergoing important transformations. It saw the establishment of a traditional model of religious life, a subsequent process of modernization and acculturation, and finally the education of the “New Jew” as part of post-Revolutionary secular culture, as well as the seeding of extreme forms of radicalization that would develop in the Soviet era. Jewish art and visual media were always a documentary means of representing collective ideals, key among which was the value associated with Jewish children’s future. The images preserved in art, photography, and print show how diligent study for boys and young men was extolled in traditional communities; this resulted in the formation of an intellectual elite that served as a bulwark of religious and spiritual self-consciousness against outside cultural influences. Along with historical-statistical studies and memoirs, these images recreate a psycho-emotional and social background for the traditional model of children’s education. On the one hand, this model perpetuated the lifestyle and values established over the centuries, yet on the other, it sparked charges of anachronism and fanaticism, which intensified the antagonism of Russian society toward its Jewish minority. The same model proved to be extremely influential for the Jewish masses; it came by its iconic visual representation in various “Cheder” compositions and portraits of the “Talmudist Iluy.” Both types of works brought out the value of religious education. Later artistic depictions demonstrated that upon passing through the grinder of the Soviet atheist system, this model inspired the zeal that Jews had for secular education and the prospect of their children’s being granted equal opportunity, resulting in the loss of their ethno-cultural identity in the new Soviet reality.
Counseling Psychology: From Defining the Field to Promoting World Peace
Authors: Whiteley John M.
Published: August 2019

Dr. John Whiteley, the founding Editor and original publisher of The Counseling Psychologist, discusses foundational and historical resources for psychologists to commemorate the 50th anniversary of the Journal. In this paper, he introduces online resources he would like to share with readers, including documents that were defining for the field of counseling psychology. These resources are presented within the context of the seven defining historical periods of the profession, from 1908 to the present.
A Retrospective Analysis of Adherence to Risk Evaluation and Mitigation Strategies Requirements for Pulmonary Arterial Hypertension Drugs
Authors: Prokes Mackenzie , Root Adam
Published: August 2019

Purpose: The purpose of this quality-improvement project was to assess risk evaluation and mitigation strategies (REMS) program compliance for pulmonary arterial hypertension (PAH) drugs following the initiation of more rigid protocols and informatics changes. The primary objective of the study was to determine the effects of these changes on overall compliance of the REMS program requirements. Method: This was a single-center, retrospective evaluation of protocols and informatics updates that were developed to increase compliance with REMS programs for four drugs used to treat PAH. Two separate time periods were examined for comparison: the preinformatics period, January 2015 to February 2016, and the postinformatics period, October 2016 to April 2017. To be included in the study, patients must have been at least 18 years of age and have been ordered one of the following agents: riociguat, macitentan, bosentan, or ambrisentan. Results: Overall, 94 patients were evaluated with 50 in the preinformatics group and 44 in the postinformatics group. The overall mean age of included patients was 55 years, 57.9% of patients were white, 69.1% were female, and 43.6% were prescribed ambrisentan during the study period. The primary composite endpoint of adherence to REMS protocol (pregnancy tests performed within 30 days of medication initiation for female patients of childbearing potential, liver function tests [LFTs] ordered within 30 days of bosentan initiation, and initiation of therapy order documented by an attending provider enrolled in the REMS program) showed an overall improvement in the postinformatics period, 95% vs 71% ( P = .07).There was a statistically significant increase in pregnancy tests performed within 30 days of medication order in the postinformatics period (36.4% vs 100%; P = .01). Furthermore, during the postinformatics period, the number of documented interventions (iVents) performed by a pharmacist was 90.9%. Conclusion: Initiation of more rigid ordering protocols for the endothelin receptor antagonists (macitentan, bosentan, or ambrisentan) and riociguat improved pharmacist and physician compliance with REMS requirements.
“There’s Nothing So Good as a Practical Theory”: Some Aphorisms for Doing Good Therapy
Authors: Mosher James K.
Published: August 2019

If doing good therapy were easy, everyone would be doing life-changing therapy in every moment of every session. But, it’s not so easy and, despite most clinicians’ best efforts, we aren’t all doing our best work all the time. This may be because layered on top of any therapy are innumerable theories, techniques, philosophies, worldviews, and interpersonal dynamics. Here, I present a series of plain-spoken statements about therapy that invite therapists to think about it in an oversimplified way. I believe such an approach can elucidate some simple truths about how to do good therapy that otherwise may sometimes be obfuscated by the aforementioned layers. Because what constitutes good therapy seems to encompass multiple theoretical orientations, I have presented my ideas absent a predominant one. Finally, I have asserted my positions in all-or-nothing terms to instigate reactions and stimulate thought, though it is understood that the truth of these matters is not so certain. Thus, I invite each reader to determine for herself and himself whether my ideas validly correspond with her or his own experiences, or not, and then to take them or leave them, in accordance with this judgment.
Prospective severity classification of scientific procedures in cephalopods: Report of a COST FA1301 Working Group survey
Authors: Cooke Gavan M , Anderson David B , Begout Marie-Laure , Dennison Ngaire , Osorio Daniel , Tonkins Belinda , Kristiansen Tore , Fiorito Graziano , Galligioni Viola , Ponte Giovanna , Andrews Paul LR
Published: August 2019

Cephalopods are the first invertebrate class regulated by the European Union (EU) under Directive 2010/63/EU on the protection of animals used for scientific purposes, which requires prospective assessment of severity of procedures. To assist the scientific community in establishing severity classification for cephalopods, we undertook a web-based survey of the EU cephalopod research community as represented by the participants in the European COoperation on Science and Technology (COST) Action FA1301, Cephs InAction'. The survey consisted of 50 scenarios covering a range of procedures involving several cephalopod species at different life stages. Respondents (59 people from 15 countries) either allocated a severity classification to each scenario or indicated that they were unable to decide (UTD). Analyses evaluated score distributions and clustering. Overall, the UTD scores were low (7.0 ± 0.6%) and did not affect the severity classification. Procedures involving paralarvae and killing methods (not specified in Annexe IV) had the highest UTD scores. Consensus on non-recovery procedures was reached consistently, although occasionally non-recovery appeared to be confused with killing methods. Scenarios describing procedures above the lower threshold for regulation, including those describing behavioural studies, were also identified and allocated throughout the full range of severity classifications. Severity classification for scenarios based on different species (e.g. cuttlefish vs. octopus) was consistent, comparable and dependent on potentially more harmful interventions. We found no marked or statistically significant differences in the overall scoring of scenarios between the demographic subgroups (age, sex, PhD and cephalopod experience). The COST Action FA1301 survey data provide a basis for a prospective severity classification for cephalopods to serve as guide for researchers, project assessors and regulators.
A Longitudinal Hierarchical Examination of Smart Steps for Stepfamilies With Ethnically and Economically Diverse Couples
Authors: Reck Katie , Higginbotham Brian , Dew Jeffrey
Published: August 2019

Over the past decade, relationship education has grown as a means of enhancing couple relationships. This longitudinal study was designed to examine the experiences and outcomes of 2,828 adults who participated in the Smart Steps for Stepfamilies: Embrace the Journey program. Self-report measures of relationship quality, commitment, and relationship instability were administered prior to participation, then immediately, 6 weeks, 6 months, and 1 year after participation. A three-level growth-curve analysis using hierarchical linear model suggested that stepfamily participants experienced small but statistically significant immediate increases in relationship quality and stability, but those gains diminished over time. The statistical analyses tested for moderating effects of individual and couple characteristics on programmatic outcomes over time. Application of these findings and implications for relationship education for stepfamilies are discussed.