bluuebunny/crossref_metadata_2025 huggingface dataset:
Nationality swapping in the Olympic Games 1978–2017: A supervised machine learning approach to analysing discourses of citizenship and nationhood
Authors: Jansen Joost
Published: May 2018

While the practice of nationality swapping in sports traces back as far as the Ancient Olympics, it seems to have increased over the past decades. Cases of Olympic athletes who switched their national allegiances are often surrounded with controversy. Two strands of thought could help explain this controversy. First, these cases are believed to be indicative of the marketisation of citizenship. Second, these cases challenge established discourses of national identity as the question ‘who may represent the nation?’ becomes contested. Using state-of-the-art machine learning techniques, I analysed 1534 English language newspaper articles about Olympic athletes who changed their nationalities (1978–2017). The results indicate: (i) that switching national allegiance has not necessarily become more controversial; (ii) that most media reports do not frame nationality switching in economic terms; and (iii) that nationality swapping often occurs fairly unnoticed. I therefore conclude that a marketisation of citizenship is less apparent in nationality switching than some claim. Moreover, nationality switches are often mentioned rather casually, indicating the generally banal character of nationalism. Only under certain conditions does ‘hot’ nationalism spark the issue of nationhood.
A case of streptococcus necrotizing fasciitis secondary to acute tonsillitis and review of literatures
Authors: Li Yongsheng , Liu Lu , Huang Zhonghui , Yang Le , Ye Yan , Li Renjie
Published: May 2018

Necrotizing fasciitis, officially named by Wilson in 1952, was a rare potentially life-threatening necrotizing soft tissue infections disease. The main lesions showed subcutaneous fat and fascia layer in progressive necrosis, generally not involving muscles. It was characterized by acute onset, rapid progress, and dangerous condition, often accompanied by systemic toxin shock, which was a relatively rare clinical acute critical disease with high mortality rate. Necrotizing fasciitis is a rare but clinical critical disease. The overall incidence of necrotizing fasciitis is approximately 0.04 cases per 1000 persons in the United States, the 30-day mortality is 27%, and necrotizing fasciitis–related mortality in Asian region is about 28%. Streptococcus pyogenes (group A streptococcus) are human-specific pathogens that can cause upper respiratory tract infection such as tonsillitis, associated with post-infection diseases such as rheumatic fever, and also can induce severe invasive diseases such as necrotizing fasciitis and streptococcus toxin shock syndrome. This article reports a case of streptococcus necrotizing fasciitis secondary to suppurative tonsillitis, which was seldom reported before and our successful management with delayed debridement. This study was anonymous and was approved by the local Research Ethics Committee. Informed consent was obtained from the patient.
Emergency physicians’ attitudes to implementing ultrasound in Dutch emergency departments after a 2-day training: A qualitative study
Authors: Ketelaars Rein , Van Heumen Esther , Baken Lambert P , Witten Marja , Scheffer Gert Jan , Engels Yvonne , Hoogerwerf Nico
Published: May 2018

Background:

Diagnostic ultrasound is increasingly used by nonradiologists in trauma victims and critically ill patients. In the emergency department, the extended focused assessment with sonography for trauma and Polytrauma Rapid Echo-evaluation Program protocol are often used to assess these patients. Dutch Polytrauma Rapid Echo-evaluation Program-trained Emergency physicians are implementing the use of ultrasound in the emergency department but might encounter barriers to overcome.

Objectives:

This study aims to explore individual experiences of Dutch emergency physicians.

Methods:

We performed a qualitative study by conducting semi-structured interviews in Dutch emergency physicians working in a Level 2 emergency department that completed the 2-day Polytrauma Rapid Echo-evaluation Program course at least 1 year before the interviews. Data were analyzed using directed content analysis.

Results:

Eight emergency physicians employed by eight different hospitals were interviewed. Thirteen categories were identified in the transcribed interviews and these were combined into four general themes: (1) the desire to develop the Emergency Medicine specialty, both nationally and local; (2) incentives to start using ultrasound; (3) exploring practical applications of ultrasound; and (4) barriers faced while implementing emergency physician-performed ultrasound on the emergency department. The interviewees regard the course to be a solid base and are eager to independently perform ultrasound examinations, although challenges are faced.

Conclusion:

This exploratory study provides essential insight in Dutch emergency physicians implementing ultrasound in their emergency department. It shows that there is a need to develop a quality assurance system and it identified barriers that have to be dealt with.
Comparison of outcomes before and after establishing a regional trauma center and following a protocol to treat blunt splenic injury in South Korea: A retrospective study
Authors: Lee Min A , Yu Byungchul , Lee Jungnam , Choi Kang Kook , Park Jae Jeong , Park Youngeun , Han Ahram , Gwak Jihun , Lee Gil Jae
Published: May 2018

Background:

Nonoperative management for hemodynamically stable splenic injury has been accepted as appropriate treatment. Objectives: This study aimed to investigate the changes in management and clinical outcomes of splenic injury by introducing a protocol for splenic injury at a newly established regional trauma center.

Methods:

From January 2005 to December 2016, we reviewed the outcomes of all 257 patients who sustained blunt trauma to the spleen at the first regional trauma center in South Korea. This 11‐year period was divided into two intervals, before 1 January 2014 (period I, n = 189 patients) and after 1 January 2014 (period II, n = 68 patients), when the trauma center was established and a formal management protocol was followed for patients with blunt traumatic splenic injuries.

Results:

The proportion of emergency operations performed for patients with more serious (grades 3–5) splenic injuries was lower in period II than in period I (29% vs 22%, respectively, p < 0.001) whereas the rate of angioembolization was higher (89% vs 39.0%, respectively, p < 0.001). The time to intervention, irrespective of whether emergency operation or angioembolization was performed, was shorter in period II than in period I (312.8 min vs 129 min, respectively, p = 0.001). A greater proportion of patients was managed non‐operatively in period II (78% vs 71%), and the non‐operative management success rate was higher in period II than it was in period I (100% vs 83%; p = 0.014). Similarly, the splenic salvage rate was higher in period II (78% vs 59%, p = 0.03).

Conclusion:

After establishing a regional trauma center and introducing a protocol for the management of blunt splenic injuries, the rates of non‐operative management and splenic salvage improved significantly. The reasons for this may be multifactorial, being related to the early involvement of a trauma surgeon, expansion of angiographic facilities and resources, and the introduction and application of a protocol for managing blunt splenic injury.
Mitochondrial Zn2+ Accumulation: A Potential Trigger of Hippocampal Ischemic Injury
Authors: Ji Sung G. , Medvedeva Yuliya V. , Wang Hwai-Lee , Yin Hong Z. , Weiss John H.
Published: May 2018

Ischemic stroke is a major cause of death and disabilities worldwide, and it has been long hoped that improved understanding of relevant injury mechanisms would yield targeted neuroprotective therapies. While Ca2+ overload during ischemia-induced glutamate excitotoxicity has been identified as a major contributor, failures of glutamate targeted therapies to achieve desired clinical efficacy have dampened early hopes for the development of new treatments. However, additional studies examining possible contributions of Zn2+, a highly prevalent cation in the brain, have provided new insights that may help to rekindle the enthusiasm. In this review, we discuss both old and new findings yielding clues as to sources of the Zn2+ that accumulates in many forebrain neurons after ischemia, and mechanisms through which it mediates injury. Specifically, we highlight the growing evidence of important Zn2+ effects on mitochondria in promoting neuronal injury. A key focus has been to examine Zn2+ contributions to the degeneration of highly susceptible hippocampal pyramidal neurons. Recent studies provide evidence of differences in sources of Zn2+ and its interactions with mitochondria in CA1 versus CA3 neurons that may pertain to their differential vulnerabilities in disease. We propose that Zn2+-induced mitochondrial dysfunction is a critical and potentially targetable early event in the ischemic neuronal injury cascade, providing opportunities for the development of novel neuroprotective strategies to be delivered after transient ischemia.
Influence of bridge-based designed TMD on running trains
Authors: Chen Zhaowei , Fang Hui , Han Zhaoling , Sun Shizheng
Published: May 2018

A tuned mass damper (TMD) is a widely used vibration reduction measure in bridge engineering, whose design is based on the modal property of bridge structure. As a consequence, bridge vibrations in certain frequencies are reduced, while vibrations in some other frequencies may be amplified according to the design methodology of the TMD. This paper systematically investigates the influence of these amplified frequencies on the dynamic performance of running trains subject to earthquake loads. Primarily, the design methodology of bridge-based designed TMD (BBD-TMD) is introduced. On this basis, a detailed train–track–bridge coupled dynamic model with attached BBD-TMD is established based on the multi-body dynamics theory and the finite element method. Finally, aiming at a practical engineering problem in China, the influence of BBD-TMD on running trains subject to earthquake loads is investigated. The results indicate that, for the bridge structure adopted in this study, the amplified frequency bands are similar to the natural frequencies of the car body in the train system. To design TMDs for railway bridges, the dynamic performance of running trains caused by these external installations should be seriously considered.
Are there more wound complications or infections with direct anterior approach total hip arthroplasty?
Authors: Tissot Christophe , Vautrin Matthias , Luyet Anais , Borens Olivier
Published: May 2018

Introduction:

Compared to a lateral or posterior approach (PA), the direct anterior approach (DAA) does permit a better muscle preservation for total hip arthroplasty (THA). However, there is concern whether this advantage come with increased wound complication and infection leading to reoperation or sometimes major procedures.

Method:

We retrospectively reviewed all patients who underwent primary THA through the PA between January 2009 and April 2013 ( n = 796) and through the DAA between January 2011 and April 2013 ( n = 399) at our institution with a minimum of 2 years follow up regarding all wound complications and all infections.

Results:

Of the 796 patients in the PA group, there were 6 wound complications leading to reoperation and 6 infections; 4 early and 2 delayed onset. Among the infected cases, one was obese (body mass index [BMI] >30 kg/m2). Two procedures were teaching-based. Of the 399 patients in the DAA group, there were three dehiscences leading to reoperation, two of which were in obese patients. 6 infections were also found; 4 with early and 2 with delayed onset. Of the infected cases, three were obese. 4 procedures were teaching-based.

Conclusion:

In our series of patients undergoing THA, the DAA did not increase the rates of either wound complications leading to reoperation nor early or delayed infection compared to the PA.
Transcriptomic Impacts of Rumen Epithelium Induced by Butyrate Infusion in Dairy Cattle in Dry Period
Authors: Baldwin Ransom L , Li Robert W , Jia Yankai , Li Cong-Jun
Published: May 2018

The purpose of this study was to evaluate the effects of butyrate infusion on rumen epithelial transcriptome. Next-generation sequencing (NGS) and bioinformatics are used to accelerate our understanding of regulation in rumen epithelial transcriptome of cattle in the dry period induced by butyrate infusion at the level of the whole transcriptome. Butyrate, as an essential element of nutrients, is a histone deacetylase (HDAC) inhibitor that can alter histone acetylation and methylation, and plays a prominent role in regulating genomic activities influencing rumen nutrition utilization and function. Ruminal infusion of butyrate was following 0-hour sampling (baseline controls) and continued for 168 hours at a rate of 5.0 L/day of a 2.5 M solution as a continuous infusion. Following the 168-hour infusion, the infusion was stopped, and cows were maintained on the basal lactation ration for an additional 168 hours for sampling. Rumen epithelial samples were serially collected via biopsy through rumen fistulae at 0-, 24-, 72-, and 168-hour (D1, D3, D7) and 168-hour post-infusion (D14). In comparison with pre-infusion at 0 hours, a total of 3513 genes were identified to be impacted in the rumen epithelium by butyrate infusion at least once at different sampling time points at a stringent cutoff of false discovery rate (FDR) < 0.01. The maximal effect of butyrate was observed at day 7. Among these impacted genes, 117 genes were responsive consistently from day 1 to day 14, and another 42 genes were lasting through day 7. Temporal effects induced by butyrate infusion indicate that the transcriptomic alterations are very dynamic. Gene ontology (GO) enrichment analysis revealed that in the early stage of rumen butyrate infusion (on day 1 and day 3 of butyrate infusion), the transcriptomic effects in the rumen epithelium were involved with mitotic cell cycle process, cell cycle process, and regulation of cell cycle. Bioinformatic analysis of cellular functions, canonical pathways, and upstream regulator of impacted genes underlie the potential mechanisms of butyrate-induced gene expression regulation in rumen epithelium. The introduction of transcriptomic and bioinformatic technologies to study nutrigenomics in the farm animal presented a new prospect to study multiple levels of biological information to better apprehend the whole animal response to nutrition, physiological state, and their interactions. The nutrigenomics approach may eventually lead to more precise management of utilization of feed resources in a more effective approach.
A Pooled Analysis of Two Multicenter, Randomized Controlled Trials of a Single Intra-articular Injection of Gel-200 for Treatment of Osteoarthritis of the Knee
Authors: Takamura Junko , Seo Takayuki , Strand Vibeke
Published: May 2018

Background and Objective:

To perform an integrated analysis of 2 randomized controlled trials (RCTs) to assess the efficacy and safety of a single intra-articular injection of Gel-200 compared with phosphate buffered saline (PBS) for treatment of osteoarthritis of the knee.

Methods:

Data from the intention-to-treat (ITT) populations of both RCTs were pooled for this integrated analysis. Mean changes from baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscores were assessed using a longitudinal model; treatment differences were compared between intra-articular Gel-200 and PBS injections. Analyses included secondary outcome measures repeated at individual time points. The safety populations of both RCTs were pooled for an integrated safety analysis to compare adverse events (AEs).

Results:

The pooled ITT population included 1184 subjects (649 Gel-200; 535 PBS); demographic characteristics were similar between treatment groups. Mean improvements in pain subscores from baseline to week 12 were −24.7 mm in Gel-200 and −21.8 mm in PBS groups, a statistically significant treatment group difference of −2.9 mm ( P = .047). From weeks 3 to 26, mean improvements from baseline in pain subscores were −23.8 mm with Gel-200 and −20.8 mm with PBS; this treatment group difference of −3.0 mm was statistically significant ( P = .017). The rate of AEs was similar between Gel-200 and PBS treatment groups.

Conclusion:

This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns.

Trial Registration:

NCT00449696 and NCT00450112.
The psychosocial impact of NHS Digital Badges on a school-aged cohort
Authors: Alexander Joanne H , Neill Sarah
Published: May 2018

Goal-oriented modalities of learning have long been used in educational settings to promote engagement and encourage a step-by-step approach to the acquisition of skills and knowledge. Historically, badges have been material, but in keeping with technological advancements there is a move towards encouraging greater digital engagement. Digital badges are today’s version of the Scouts and Guides badge, a virtual non-material version, increasingly being utilized as a pedagogical resource in education and business settings. In 2015, National Health Service (NHS) England developed and launched its own digital badges aimed at supporting children and young people’s education of health and well-being. This article presents findings from the first study to explore the psychosocial impact of NHS Digital Badges as perceived by primary school-aged children and their teachers. We conducted a small-scale evaluation involving children aged 8–10 ( n = 57) and their teachers ( n = 2), from a primary academy (school) in the north of England using NHS Digital Badges in their curriculum. Overwhelmingly, children and teachers reflected on the badges positively, as tools that have the capacity to build perseverance, develop emotional awareness, build relationships and enhance skill and knowledge acquisition. Some participants, though, raised vulnerability and safeguarding issues, and we explore the implications of these for future practice.
The prevalence of comorbidities among acute burn patients
Authors: Salehi Seyed Hamid , As’adi Kamran , Abbaszadeh-Kasbi Ali
Published: May 2018

Introduction

The elderly population in Iran is growing, and more medical comorbidities can be identified, so hospital admissions of burn patients with associated medical comorbidities are expected to rise as well. As these medical comorbidities may affect the prognosis of burn patients, additional health care services are likely to be required. Therefore, the aim of this study was to determine the prevalence of comorbidities among patients with burn injury.

Methods

A retrospective study of all burn patients admitted to the Motahari Burn Hospital, Iran over a 14-month period was conducted. Variables gathered from patients’ medical record files were demographic characteristics, clinical burn features, hospital course, and preexisting comorbidities. The comorbidity score of patients was calculated by using the updated Charlson comorbidity index.

Results

A total of 732 patients were hospitalized, 136 (18.5%) patients had comorbidities, and more than 57% of elderly people (≥61 years) had one or more comorbid conditions. The most common cause of burn injury among the comorbid patients was scald (38.2%) injury. The two most frequent comorbid conditions among all cases were congestive heart failure (25.8%) and diabetes (23.5%), respectively. As patients got older, the Charlson score also increased. There were no significant differences between comorbid and noncomorbid patients in terms of hospitalization period and mortality rate. Those comorbid patients who died had significantly higher Charlson score and larger mean burn sizes compared to surviving comorbid patients; they were also significantly older.

Conclusion

The prevalence of comorbidities in burn patients was 18.5% and among older burn patients rose to 57%. Diabetes and congestive heart failure were the two most common comorbid conditions.
Familiar or strange? Rediscovering the ‘real’ child of educational policy through film
Authors: Gibbs Alexis
Published: May 2018

The working thesis of my latest research is that cinema can offer a viewer something of a ‘re-education in education’. In the case of policymakers and researchers in the field of education, this means looking again at the reality of the conceptual phenomena with which we occupy ourselves in writing to see whether the two groups are aligned. This article will first look at how the figure of the child is commonly constructed as an object of knowledge within policy and philosophical discourse, suggesting that this approach affirms frameworks in which it is possible to know what a child is, but may fail to do justice to the child of our ordinary experience. I then turn to a discussion of some of Iran’s so-called ‘children’s films’, exploring how their presentation of a world, and the representation of children within that world, allow for a re-education in the lived reality of children. It is suggested that this aesthetic turn in observing the child's behaviour may encourage a more faithful representation of that reality within educational policy and research also.
Depression is a major determinant of both disease-specific and generic health-related quality of life in people with severe COPD
Authors: Jang Sun Mi , Kim Ki Uk , Na Hae Jung , Song Seung Eun , Lee Sang Hee , Lee Haejung , Kim Yun Seong , Lee Min Ki , Park Hye-Kyung
Published: May 2018

The quality of life of patients with chronic obstructive pulmonary disease (COPD) decreases significantly as the disease progresses; those with severe COPD are affected most. This article investigates predictors of the disease-specific and generic health-related quality of life (HRQL) in patients with severe COPD. This multicentre prospective cross-sectional study enrolled 80 patients with severe COPD. At enrolment, all patients completed a disease-specific instrument, the St George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s correlation and multiple linear regression. The mean age of the patients was 66 ± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity significantly predicted the total SGRQ score ( p < 0.05). Depression was the strongest determinant of the total SGRQ score. The SF-36 physical component summary scores were related to depression, dyspnea, and the number of exacerbations ( p < 0.05). In comparison, the SF-36 mental component summary scores were related to depression and anxiety ( p < 0.05). Depression is a significant determinant of both the disease-specific and generic HRQL in patients with severe COPD. Screening and early intervention for depression in patients with severe COPD could improve the HRQL.
A robot for non-destructive testing weld inspection of offshore mooring chains
Authors: Hernandez A , Altuzarra O , Petuya V , Pinto Ch , Amezua E
Published: May 2018

Welding flaw detection is a key step in manufacturing many components. In offshore chains, every link is manufactured from a steel bar that is bent and the ends joined by flash butt welding. Ultrasonic inspection of the welded area is required for classification. Defects, if any, are parallel to the welded area, which do not favour detection by manual inspection with 45° beams, as per usual practice . This article reports on CIRUS, a robot developed for automatic inspection of the weld area using a combination of pulse-echo and pitch-catch ultrasonic testing. The robot kinematic structure includes global positioning, local positioning and inspection subsystems, and each subsystem design is described in detail. A data acquisition system processes ultrasonic inspection results and provides visual information for the inspector as well as traceability for quality manufacturing.
The ‘difficult heritage’ of the Native Mounted Police
Authors: Rowse Tim , Waterton Emma
Published: May 2018

This article intervenes in the debate about whether and how the ‘Frontier Wars’ should be represented in Australia’s military heritage. If they were to be represented, those who resisted British colonial occupation would figure as Aboriginal patriots in a renovated heritage of Australian service to country. We point out, however, that certain historical actors have been, so far (and perhaps forever), excluded from such a revised Indigenous military heritage: those Aboriginal peoples who ‘served’ in the Native Mounted Police. While the archival record is patchy, scholarship tells us that, in their pacification of frontiers, the Native Mounted Police killed many Aboriginal peoples. Interrogating the meaning of war heritage in Australia, we discuss the politics of forgetting against the obligations of historiography to collective memory and ask: must scholarship always interrogate identity-sustaining myth, in service to the truth? To explore this question, we adopt Sharon Macdonald’s concept of ‘difficult heritage’.
Surgical transposition for chronic instability of the extensor carpi ulnaris tendon
Authors: Fram Brianna , Wall Lindley B. , Gelberman Richard H. , Goldfarb Charles A.
Published: May 2018

Painful extensor carpi ulnaris tendon instability has various treatments with limited available outcome data. We treated 12 wrists of 11 patients (including eight collegiate or professional athletes) with dorsal transposition of the extensor carpi ulnaris tendon to lie over the 5th compartment, stabilized with a retinacular sling from 2010–2015. All patients had symptom resolution and returned to sport at the pre-injury level by 3 months after surgery. Mean post-surgical Patient Reported Outcomes Measurement Information System (PROMIS) upper extremity score was 56, and PROMIS pain interference score was 42. Patient overall satisfaction averaged 9.8 points on a 10-point scale for the procedure and pain decreased by 6 points on a 10-point scale from before surgery to final follow-up. We conclude that surgical treatment of the extensor carpi ulnaris tendon instability via dorsal transposition of the extensor carpi ulnaris tendon is an effective surgical option for all patients including the high level athlete.

Level of evidence: IV
Takeoff orientation of the major aortic arch branches irrespective of arch type: Ramifications for brachiocephalic interventions including carotid stenting
Authors: Tayal Rajiv , Khakwani M Zain , Lesar Benjamin , Sinclair Michael , Emporelli Afroditi , Spektor Vadim , Cohen Marc , Wasty Najam
Published: May 2018

Background:

Our previous work demonstrating great ease and predictability of cannulation of the major aortic arch branches with an upwardly pointing 3DR catheter, irrespective of aortic arch type, led us to hypothesize that centering or “cresting” of these vessels must occur along the superior most aspect of the aortic arch in a curvilinear fashion.

Methods:

We retrospectively analyzed 111 computed tomographic scans of the chest and thoracic aorta with intravenous contrast performed at our hospital between April 2011 and May 2012 utilizing TeraRecon image reconstruction software. Four studies were excluded due to poor image quality and/or surgical changes to native aortic architecture.

Results:

Of the 107 studies included, 104 (97.2%) demonstrated centering of the major aortic arch branches on a curvilinear line “cresting” the superior most aspect of the aortic arch irrespective of arch type. Of the three studies that did not demonstrate this “cresting,” two were found to have aberrant right subclavian arteries associated with a type I aortic arch, and one had an aberrant right common carotid associated with a type II aortic arch.

Conclusion:

Operators engaging major aortic arch branches need to be mindful of the fact that these vessels are indeed centered on a line “cresting” along the superior most aspect of the aortic arch, and any algorithm that, by taking this information into account, reduces catheter manipulation in the aortic arch could potentially result in a reduction in distal atheroembolic events.
Comparing Patient Demographics and Tumor Characteristics of HIV-Positive and HIV–Negative Patients with Cancer in South Carolina
Authors: Hallowell Benjamin D. , Kintziger Kristina W. , Duffus Wayne A. , Vena John E. , Robb Sara W.
Published: May 2018

We compared the demographic and disease characteristics of HIV-positive (HIV+) and HIV-negative (HIV−) individuals with a diagnosis of cancer in South Carolina. HIV-positive patients with cancer were reflective of the HIV+ caseload in South Carolina, with HIV+ patients with cancer more likely to be male (odds ratio [OR]: 2.78: 95% confidence interval [CI]: 2.33-3.32), black (OR: 7.68; 95% CI: 6.52-9.06), and younger at cancer diagnosis (OR: 0.92; 95% CI: 0.91-0.92). Controlling for year of birth, HIV+ patients with cancer did not receive cancer diagnoses at a younger age than HIV− controls. HIV-positive individuals did not have more advanced tumor stages or grades at cancer diagnosis; however, after controlling for other factors, HIV+ individuals were still more likely to be deceased at follow-up (OR: 2.64; 95% CI: 2.20-3.17) when compared to HIV− controls. Future studies should use survival analysis methods to identify the characteristics that shorten survival among HIV+ patients with cancer.
Systemic Delays in the Initiation of Antiretroviral Therapy for Clinically Eligible HIV-Infected Patients in Houston, Texas
Authors: Mgbere Osaro , Rodriguez-Barradas Maria , Vigil Karen Joan , McNeese Melanie , Tabassam Fazal , Barahmani Nadia , Wang Jason , Arafat Raouf , Essien Ekere James
Published: May 2018

Background:

The current US HIV treatment guidelines support initiation of antiretroviral therapy (ART) for persons with HIV for personal health benefits and prevention of HIV transmission. However, high levels of adherence to ART are critical to maximize individual and public health benefits. We examined the nonclinical barriers to ART initiation for clinically eligible individuals and the provider- and patient-related factors associated with these barriers among HIV-infected patients in Houston/Harris County, Texas.

Methods:

We analyzed data obtained from a probability sample of HIV medical care providers (HMCPs) in 13 outpatient facilities in Houston/Harris County, Texas surveyed between June and September 2009. We used an inductive thematic approach to code HMCP responses to an open-ended question that asked the main reasons why providers may delay initiating ART for clinically eligible patients.

Results:

The reasons cited by providers for delaying ART for clinically eligible patients were adherence (42.5%; 95% confidence interval [CI]: 28.5-57.8), acceptance (30%; 95% CI: 18.1-45.4), and structural concerns (27.5%; 95% CI: 16.1-42.8), with significant variations ( P < .0001) noted across patients’ race/ethnicity and transmission category. HIV medical care providers with 6 to 10 years’ experience in HIV care and those providing medical care for more than 100 patients monthly were about 4 times (adjusted odds ratio [aOR]: 3.80; 95% CI: 1.20-5.92; P = .039) and 10 times (aOR: 10.36; 95% CI: 1.42-22.70; P = .019) more likely to state adherence and acceptance concerns, respectively, as reasons for delaying ART for clinically eligible patients.

Conclusion:

Our findings highlight the fact that clinical guidelines are only a starting point for medical decision-making process and that patients themselves play an important role. HMCP access to referrals for other medical issues, support services, and treatment education may help improve adherence and patient readiness for ART, thereby avoiding systemic delays.
The poverty consensus: some limitations of the ‘popular agenda’
Authors: Storey Donovan , Bulloch Hannah , Overton John
Published: May 2018

The New Poverty Agenda is said to represent a break with the past and to offer a rationale for aid that is built on partnerships towards a common and realizable goal - the elimination of poverty. However, recent critiques have highlighted problems with the practice of poverty policy, and particularly limitations identified from its association with global actors which stand accused of contributing to poverty. For some, there is no new agenda; a poverty focus merely represents a different path to the same ends (i.e., political reform and economic adjustment). This paper investigates the implications for smaller donors, such as Australia and New Zealand, of adopting poverty policy as defined by the World Bank and others. It argues that certain contexts, such as the Pacific, demonstrate the weaknesses of an all-encompassing policy that remains muddled and contradictory. In terms of effective partnerships, much more could be gained by first seeking to learn more about the nature of poverty in the immediate region and its underlying causes.
A population study of Norwegian psychiatric patients referred for clinical brain scanning
Authors: Beyer Mona K. , Dalaker Turi O. , Greve Ole J. , Pignatiello Siv E. , Agartz Ingrid
Published: May 2018

Background

Patients with psychiatric conditions are often referred for a brain scan during the course of their diagnostic workup.

Aims

The aim of our study is to determine frequency and type of organic brain pathology, the relationship to age, gender and psychiatric diagnosis.

Method

We investigated magnetic resonance imaging and computed tomography brain scans from consecutively referred patients over a 10-year period (January 2002-December 2011). The reasons for referral, estimated psychiatric diagnosis, and the pathology discovered for each patient were registered.

Results

A total of 34% of patients demonstrated organic brain pathology, of which 32.8% were considered clinically relevant. This represents a higher frequency of relevant pathology than reported in healthy subjects. Age (P < 0.001) and diagnosis (P = 0.016) were the most important determinants for frequency of pathological findings.

Conclusions

Brain imaging in clinical psychiatry resulted in approximately 30% positive findings mainly associated with increasing pathologies with age, but also with diagnosis.

Declaration of interest

Both T.O.D. and M.K.B. have received honorary from Novartis for scientific lectures about multiple sclerosis. M.K.B. also received honoraria from Biogen for scientific lectures. The other authors have no conflicts of interest.
Application of n-of-1 treatment trials in schizophrenia: systematic review
Authors: Marwick Katie F. M. , Stevenson Anna J. , Davies Caitlin , Lawrie Stephen M.
Published: May 2018

Background

Single patient or ‘n-of-1’ trials are a pragmatic method to achieve optimal, evidence-based treatments for individual patients. Such trials could be particularly valuable in chronic, heterogeneous, difficult to treat illnesses such as schizophrenia.

Aims

To identify how often, and in what way, n-of-1 trials have been used in schizophrenia.

Method

We performed a systematic search in the major electronic databases for studies adopting n-of-1 methodology in schizophrenia, published in English from the start of records until the end of January 2017.

Results

We identified six studies meeting inclusion criteria. There was wide variability in study methodology and analysis. Each trial reported positive outcomes for their respective intervention, but all studies were at high risk of bias.

Conclusions

In conclusion, n-of-1 trials are currently underutilised in schizophrenia. Existing trials suggest the method is well tolerated and potentially effective in achieving optimal treatments for patients, but more standardised methods of design, execution and analysis are required in future trials.

Declaration of interest

S.M.L. has received grants and personal fees from Janssen, and personal fees from Otsuka and Sunovion, in the past 3 years, outside the submitted work.
Safety of Programmed Death–1 Pathway Inhibitors Among Patients With Non–Small-Cell Lung Cancer and Preexisting Autoimmune Disorders
Authors: Leonardi Giulia C. , Gainor Justin F. , Altan Mehmet , Kravets Sasha , Dahlberg Suzanne E. , Gedmintas Lydia , Azimi Roxana , Rizvi Hira , Riess Jonathan W. , Hellmann Matthew D. , Awad Mark M.
Published: May 2018

Purpose

Although programmed death (PD)-1 pathway inhibitors are now used in nearly all patients with advanced non–small-cell lung cancer (NSCLC), the large number of patients with NSCLC and concurrent autoimmune disease (AID) have been universally excluded from immunotherapy clinical trials. Therefore, the safety of PD-1 and PD-ligand 1 (PD-L1) inhibitors in patients with NSCLC and underlying AID is currently unknown.

Methods

As part of a multi-institutional effort, we retrospectively collected clinicopathologic data from patients with NSCLC and a history of AID who received monotherapy with either a PD-1 or a PD-L1 (herein referred to as PD-[L]1) inhibitor. Qualifying AIDs included but were not limited to: rheumatologic, neurologic, endocrine, GI, and dermatologic conditions.

Results

We identified 56 patients with NSCLC and an AID who received a PD-(L)1 inhibitor. At the time of treatment initiation, 18% of patients had active AID symptoms and 20% were receiving immunomodulatory agents for their AID. A total of 55% of patients developed an AID flare and/or an immune-related adverse event (irAE). Exacerbation of the AID occurred in 13 patients (23% of the whole cohort), four of whom required systemic corticosteroids. Immune-related adverse events occurred in 21 patients (38%). Among irAEs, 74% were grade 1 or 2 and 26% were grade 3 or 4; eight patients required corticosteroids for irAE management. PD-(L)1 therapy was permanently discontinued in eight patients (14%) because of irAEs. The overall response rate to immunotherapy in this population was 22%.

Conclusion

In patients with NSCLC with AID treated with a PD-(L)1 inhibitor, exacerbation of AID occurred in a minority of patients. The incidence of irAEs was similar to reported rates in clinical trials where patients with AID were excluded. Adverse events were generally manageable and infrequently led to permanent discontinuation of immunotherapy.
Contemporary Approaches to In-Transit Melanoma
Authors: Perone Jennifer A. , Farrow Nellie , Tyler Douglas S. , Beasley Georgia M.
Published: May 2018

In-transit melanoma represents a distinct disease pattern of heterogeneous superficial tumors. Many treatments have been developed specifically for this type of disease, including regional chemotherapy and a variety of directly injectable agents. Novel strategies include the intralesional delivery of oncolytic viruses and immunocytokines. The combination of intralesional or regional chemotherapy with systemic immune checkpoint inhibitors also is a promising approach. In the current review, we examine the general management of the workup of patients with in-transit disease, the range of available therapies, and recommendations for specific therapies for an individual patient.
A comprehensive study of calcific aortic stenosis: from rabbit to human samples
Authors: Mourino-Alvarez L. , Baldan-Martin M. , Sastre-Oliva T. , Martin-Lorenzo M. , Maroto A. S. , Corbacho-Alonso N. , Rincon R. , Martin-Rojas T. , Lopez-Almodovar L. F. , Alvarez-Llamas G. , Vivanco F. , Padial L. R. , de la Cuesta F. , Barderas M. G.
Published: May 2018

The global incidence of calcific aortic stenosis (CAS) is increasing due, in part, to a growing elderly population, and poses a great challenge to public health because of the multiple comorbidities of these patients. Using a rabbit model of CAS, we sought to characterize protein alterations associated with calcified valve tissue that can be ultimately measured in plasma as non-invasive biomarkers of CAS.

Aortic valves from healthy and mild stenotic rabbits were analyzed by two-dimensional difference gel electrophoresis, and selected reaction monitoring was used to directly measure the differentially expressed proteins in plasma from the same rabbits to corroborate their potential as diagnostic indicators, and also in plasma from human subjects, to examine their translatability to the clinical setting.

Eight proteins were found differentially expressed in CAS tissue, but only 3 were also altered in plasma samples from rabbits and humans: transitional endoplasmic reticulum ATPase, tropomyosin alpha-1 chain and L-lactate dehydrogenase B chain. Results of receiver operating characteristic curves showed the discriminative power of the scores, which increased when the three proteins were analyzed as a panel. Our study shows that a molecular panel comprising 3 proteins related to osteoblastic differentiation may have utility as a serum CAS indicator and/or therapeutic target.
Should Body Size Categories Be More Common in Endurance Running Events?
Authors: Buresh Robert
Published: May 2018

Thousands of endurance running events are held each year in the United States, and most of them use age and sex categories to account for documented effects of those factors on running performance. However, most running events do not provide categories of body mass, despite abundant evidence that it, too, dramatically influences endurance running performance. The purposes of this article are to (1) discuss how body mass affects endurance running performance, (2) explain several mechanisms through which body mass influences endurance running performance, and (3) suggest possible ways in which body mass might be categorized in endurance running events.
Life course programming of stress responses in adolescents and young adults in India: Protocol of the Stress Responses in Adolescence and Vulnerability to Adult Non-communicable disease (SRAVANA) Study
Authors: Krishnaveni GV , Kumaran Kalyanaraman , Krishna Murali , Sahariah Sirazul , Chandak Giriraj , Kehoe Sarah , Jones Alexander , Bhat Dattatray , Danivas Vijay , Srinivasan Krishnamachari , Suguna Shanthi J , Karat SC , Barker Mary , Osmond Clive , Yajnik Chittaranjan , Fall Caroline
Published: May 2018

Background:Early life nutrition may affect individuals’ susceptibility to adult non-communicable diseases (NCD). Psychological stress is a well-recognised NCD risk factor. Recent evidence suggests that impaired foetal nutrition alters neuro-endocrine pathways, and hypothalamic-pituitary-adrenal axis feedback systems, resulting in abnormal stress responses, and NCD risk. This study aims to examine adolescent cortisol and cardiovascular stress responses in relation to maternal nutrition and contemporaneous NCD risk markers.

Methods: The study sample will be drawn from three well-established birth cohorts in India; the Parthenon cohort, Mysore (N=550, age~20y), the SARAS KIDS prenatal intervention cohort, Mumbai (N=300, age~10-12y) and the Pune Rural Intervention in Young Adults/ PRIYA cohort, Pune (N=100, age~22y). We will perform the ‘Trier Social Stress Test (TSST)’, a well-accepted stress-test module which involves participants performing 5-minutes each of public speaking and mental arithmetic tasks in front of unfamiliar ‘judges’ (stressor). Repeated measures of salivary cortisol and autonomic cardiovascular outcomes relative to the stressor will be assessed. Measures of psychological stress, cognitive function, blood pressure, glucose-insulin metabolism and depression will be carried out. Mechanistic studies including DNA methylation in gluco-corticoid receptor (NR3C1) and11β-HSD2gene loci and neuroimaging will be carried out in a subsample. Qualitative interviews and focus group discussions in a subsample of the Parthenon cohort will explore the perception of stress and stressors among the youth.

We will convert repeated measures into time-weighted averages before analysis. We will carry out multivariable regression analysis to test the associations. We will further refine the analyses using the mixed-model regression and conditional analyses for the association with repeated measures.  

Ethics and dissemination:This study has been approved by the research ethics committee of CSI Holdsworth Memorial Hospital, Mysore. The findings will be disseminated locally and at international meetings, and reports will be submitted to open access peer reviewed journals.
VirMuF: The Virtual Museum Framework
Authors: Elfarargy Mohammed , Rizq Amr
Published: May 2018

With the immergence of 3D object digitization technologies, many museums are digitizing their collections using 3D scanning, photogrammetry and other techniques. These large 3D collections are not only great for documentation and preservation, but they are also a great means for introducing these collections to a wider audience worldwide through virtual museums. However, developing Virtual Museums can be a costly process considering that it needs a team of talented software developers, 3D designers and other software/hardware tools. In this paper we present VirMuF (Virtual Museum Framework), which is a set of tools that can be used by non-developers to easily create and publish 3D virtual museums in a very short time. This way, Museum staff doing collection digitization can also publish 3D virtual museums to exhibit these collections. VirMuF is open-source; hence, teams including software developers can further extend VirMuF to fit their needs.
Weather Data Visualization and Analytical Platform
Authors: Astsatryan Hrachya , Grogoryan Hayk , Gyulgyulyan Eliza , Hakobyan Anush , Kocharyan Aram , Narsisian Wahi , Sahakyan Vladimir , Shoukourian Yuri , Abrahamyan Rita , Petrosyan Zarmandukht , Aligon Julien
Published: May 2018

This article aims to present a web-based interactive visualization and analytical platform for weather data in Armenia by integrating the three existing infrastructures for observational data, numerical weather prediction, and satellite image processing. The weather data used in the platform consists of near-surface atmospheric elements including air temperature, pressure, relative humidity, wind and precipitation. The visualization and analytical platform has been implemented for 2-m surface temperature. The platform gives Armenian State Hydrometeorological and Monitoring Service analytical capabilities to analyze the in-situ observations, model and satellite image data per station and region for a given period.
Modeling and Molecular Dyanamics Simulations Study of Enol-carbonates and their Derivatives
Authors: Bigovic Miljan , Filipovic Luka , Zecevic Zarko , Krstajic Bozo
Published: May 2018

In view of the fact that the mechanisms of the interaction of organic molecules with the properties of the drug occur in most cases by their binding to the receptors (proteins), we wanted to examine the interactions of small organic molecules that we synthesized and certain proteins. In this paper the comparison between molecules, modeled by different software packages, and experimental results is performed. The series of new molecules are synthesized using Barbier reaction of allylation of carbonyl compounds with 4-(bromomethyl)-1,3-dioxol-2-one as a highly fictionalized allylic synthon. Their structure was determined by spectroscopic methods (NMR-, IR- and UV/VIS-spectroscopy and MS-spectrometry), while for three individual molecules analysis of x-ray diffraction (X-ray analysis) was also performed, which gave the final confirmation of the exact arrangement of all atoms in the space. The molecules are represented in standard chemical format, visualized and prepared for simulations. In order to obtain datasets that further can be used to examine and analyze interactions with well-known proteins, molecular dynamic simulations are performed. The purpose of this research was to present that using powerful computer infrastructure and appropriate software tools, an accurate molecule models can be created.