bluuebunny/crossref_metadata_2025 huggingface dataset:
Initially intact neural responses to pain in autism are diminished during sustained pain
Authors: Failla Michelle D , Moana-Filho Estephan J , Essick Greg K , Baranek Grace T , Rogers Baxter P , Cascio Carissa J
Published: May 2017

Pain assessments typically depend on self-report of the pain experience. Yet, in individuals with autism spectrum disorders, this can be an unreliable due to communication difficulties. Importantly, observations of behavioral hypo- and hyperresponsivity to pain suggest altered pain sensitivity in autism spectrum disorder. Neuroimaging may provide insight into mechanisms underlying pain behaviors. The neural pain signature reliably responds to painful stimulation and is modulated by other outside regions, affecting the pain experience. In this first functional magnetic resonance imaging study of pain in autism spectrum disorder, we investigated neural responses to pain in 15 adults with autism spectrum disorder relative to a typical comparison group (n = 16). We explored temporal and spatial properties of the neural pain signature and its modulators during sustained heat pain. The two groups had indistinguishable pain ratings and neural pain signature responses during acute pain; yet, we observed strikingly reduced neural pain signature response in autism spectrum disorder during sustained pain and after stimulus offset. The posterior cingulate cortex, a neural pain signature modulating region, mirrored this late signal reduction in autism spectrum disorder. Intact early responses, followed by diminished late responses to sustained pain, may reflect altered pain coping or evaluation in autism spectrum disorder. Evidence of a dichotomous neural response to initial versus protracted pain may clarify the coexistence of both hypo- and hyperresponsiveness to pain in autism spectrum disorder.
Responsibilisation and female imprisonment in contemporary penal policy: ‘Respect Modules’ (‘Módulos de Respeto’) in Spain
Authors: Ballesteros-Pena Ana
Published: May 2017

In order to advance the study of female penal enforcement in the 21st century, this article examines how new strategies of neoliberal penal governance, introduced over the past decade in Spain, take shape in everyday practices and dynamics of prison life, as well as examining intersections with traditional forms of punishment and discipline. More specifically, this study addresses the case of Respect Modules (‘Módulos de Respeto’) in women’s facilities, and the article reveals that the implementation of practices of classification and responsibilisation reinforces traditional features of female penal enforcement in the Spanish penal system such as discipline, control and obedience. These technologies of the self are built on gender, race and nationality stereotypes. The article demonstrates how the current evolution of the penal system leads to an increasingly severe discipline and to a persistent inadequate attention paid to incarcerated women’s needs. Finally, the methodology of the research was qualitative, consisting of non-participatory direct observation in three prisons and interviews with incarcerated women, technical and management teams, political authorities and former authorities of the prison system.
Fighting Putin and the Kremlin’s grip in neo-authoritarian Russia: The experience of liberal journalists
Authors: Slavtcheva-Petkova Vera
Published: May 2017

Russia is one of the most dangerous countries for journalists, and the conflict with Ukraine and Russia’s involvement in Syria present even further challenges for the future of Russian journalism. In addition to the financial pressures, physical attacks, abductions and harassment, liberal journalists now face an increasing threat to the democratising role they see themselves as playing. President Vladimir Putin’s soaring popularity and the elaborate range of tactics used to suppress press freedom are forcing liberal media to rethink their mission(s) and identity(ies). This article presents empirical evidence on the range of tactics used by the Russian authorities as well as the coping strategies adopted by journalists. The study shows that some Russian media and journalists demonstrate a great degree of resilience in their efforts to expose wrongdoings and hold the powerful to account. The article questions the applicability of Western-centric normative media system theories because it shows that the breadth, depth and mechanisms of control in modern-day Russia are very different from the ones used during Soviet times, and yet, Russian media and society do not appear to be on a linear journey from authoritarianism to democracy. The article presents the findings of a semi-ethnographic study of some of Russia’s most influential liberal news outlets – Novaya Gazeta, Radio Echo of Moscow and Radio Free Europe/Liberty. The study was conducted in May 2014 in the midst of the conflict with Ukraine. It involved observations of editorial meetings, documentary analysis and interviews with editors, deputy editors and journalists.
Likes attract: Students self-sort in a classroom by gender, demography, and academic characteristics
Authors: Freeman Scott , Theobald Roddy , Crowe Alison J , Wenderoth Mary Pat
Published: May 2017

Although a growing literature has documented the effectiveness of informal group work during class sessions, virtually no data exist on which students are collaborating. As a result, instructors rarely know whether students are self-sorting in ways that maximize learning. This article explores which undergraduate students worked together on each of five exercises scheduled throughout the term, in a large-enrollment course for majors that emphasized intensive peer interaction. Pairwise logistic regression models were used to assess the likelihood that students collaborated based on shared demographic characteristics, socioeconomic status, and academic performance. In almost all cases, students self-sorted by ethnicity and gender. In addition, students who were predicted to do well in the course, based on their academic history, worked together initially; students who actually did well in the course, based on their final grade, were working together at the end; and students who were predicted to struggle in the course began collaborating late in the term.
The impact of cross-cultural communication on collective efficacy in NCAA basketball teams
Authors: Bell Robin , Riol Carlos Fernández
Published: May 2017

This research contributes to the knowledge and theory on cross-cultural communication by investigating the impact of cross-cultural communication competence on the collective efficacy of multicultural National Collegiate Athletic Association basketball teams. Data was collected from 140 US National Collegiate Athletic Association basketball coaches via the Cross-Cultural Communication Competence Questionnaire and the Collective Efficacy Questionnaire for Sports. Principle component analysis was conducted on the data, revealing that the cross-cultural communication competence and collective efficacy of basketball teams are multidimensional. The hypothesized relationship between cross-cultural communication competence and collective efficacy was confirmed and statistically measured through regression analysis. It was found that four of the cross-cultural communication competence dimensions produced by the principle component analysis exhibited a significant positive relationship with one of the two dimensions within collective efficacy. Given the well-supported relationship between collective efficacy and team performance in business, this study produces important implications for scholars and practitioners working with multicultural sporting teams.
Caregiver determinants of patient clinical event risk in heart failure
Authors: Bidwell Julie T , Vellone Ercole , Lyons Karen S , D’Agostino Fabio , Riegel Barbara , Paturzo Marco , Hiatt Shirin O , Alvaro Rosaria , Lee Christopher S
Published: May 2017

Background: Preventing hospitalization and improving event-free survival are primary goals of heart failure (HF) treatment according to current European Society of Cardiology guidelines; however, substantial uncertainty remains in our ability to predict risk and improve outcomes. Although caregivers often assist patients to manage their HF, little is known about their influence on clinical outcomes. Aims: To quantify the influence of patient and caregiver characteristics on patient clinical event risk in HF. Methods: This was a secondary analysis of data using a sample of Italian adults with HF and their informal caregivers ( n = 183 patient–caregiver dyads). HF patients were followed over 12 months for the following clinical events: hospitalization for HF, emergency room visit for HF or all-cause mortality. Influence of baseline caregiver- and patient-level factors (patient and caregiver age; dyad relationship type; patient New York Heart Association (NYHA) Class, cognition, and comorbidities; and caregiver strain, mental health status, and contributions to HF self-care) on patient risk of death or hospitalization/emergency room use was quantified using Cox proportional hazards regression. Results: Over the course of follow up, 32.8% of patients died, 19.7% were hospitalized for HF and 10.4% visited the emergency room. Higher caregiver strain, better caregiver mental health status and greater caregiver contributions to HF self-care maintenance were associated with significantly better event-free survival. Worse patient functional class and greater caregiver contributions to patient self-care management were associated with significantly worse patient event-free survival. Conclusion: Considering caregiving factors together with patient factors significantly increases our understanding of patient clinical event risk in HF.
Helicopter noise footprint prediction in unsteady maneuvers
Authors: Gennaretti Massimo , Bernardini Giovanni , Serafini Jacopo , Anobile Alessandro , Hartjes Sander
Published: May 2017

This paper investigates different methodologies for the evaluation of the acoustic disturbance emitted by helicopter’s main rotors during unsteady maneuvers. Nowadays, the simulation of noise emitted by helicopters is of great interest to designers, both for the assessment of the acoustic impact of helicopter flight on communities and for the identification of optimal-noise trajectories. Typically, the numerical predictions consist of the atmospheric propagation of a near-field noise model, extracted from an appropriate database determined through steady-state flight simulations/measurements (quasi-steady approach). In this work, three techniques for maneuvering helicopter noise predictions are compared: one considers a fully unsteady solution process, whereas the others are based on quasi-steady approaches. These methods are based on a three-step solution procedure: first, the main rotor aeroelastic response is evaluated by a nonlinear beam-like rotor blade model coupled with a boundary element method for potential flow aerodynamics; then, the aeroacoustic near field is evaluated through the 1A Farassat formulation; finally, the noise is propagated to the ground by a ray tracing model. Only the main rotor component is examined, although tail rotor contribution might be included as well. The numerical investigation examines the differences among the noise predictions provided by the three techniques, focusing on the assessment of the reliability of the results obtained through the two quasi-steady approaches as compared with those from the fully unsteady aeroacoustic solver.
Phonetic Transcription Training Improves Adults’ Explicit Phonemic Awareness: Evidence From Undergraduate Students
Authors: Werfel Krystal L.
Published: May 2017

The purpose of this study was to evaluate the effects of phonetic transcription training on the explicit phonemic awareness of adults. Fifty undergraduate students enrolled in a phonetic transcription course and 107 control undergraduate students completed a paper-and-pencil measure of explicit phonemic awareness on the first and last days of class. Performance was analyzed for overall accuracy, as well as accuracy on easy-to-segment and hard-to-segment words. A MANCOVA revealed a main effect of group on each dependent variable. In addition, intervention-group pretest and posttest scores were not related. Thus, phonetic transcription training appears to be an effective method of increasing explicit phonemic awareness in adults, and initial skill level is not related to gains as a result of phonetic transcription training.
Midterm Results of Low-Profile Stents to Treat Atherosclerotic Iliac Artery Disease
Authors: Troisi Nicola , Ercolini Leonardo , Chisci Emiliano , Frosini Piefrancesco , Barbanti Enrico , Michelagnoli Stefano
Published: May 2017

Purpose: To evaluate the safety and effectiveness of low-profile 4-F stents for the treatment of atherosclerotic iliac artery lesions. Methods: Between January 2009 and December 2015, 63 patients (mean age 69.3 years; 42 men) received low-profile stents (Astron Pulsar or Pulsar-18) at the discretion of the operator to treat iliac artery occlusive disease. The majority of patients (40, 63.5%) had critical limb ischemia; 36 of 82 lesions were total occlusions. All procedures were performed with 4-F equipment. Outcomes evaluated included mortality, patency (primary, assisted primary, and secondary), absence of target lesion revascularization (TLR), and limb salvage. Associations of patient and procedure variables with patency and TLR outcomes were sought with univariate and multivariate analysis. Results: Via a brachial (n=46/63) or femoral (n=17/63) access, 82 stents were successfully deployed to treat the 82 lesions, with <30% residual stenosis. The overall access-related complication rate was 1.6% (brachial artery occlusion). Mean duration of follow-up was 24.1±22.3 months (range 1–72), during which 3 patients died and 1 major amputation occurred at 10 months. The 4-year Kaplan-Meier estimate of primary patency was 76.9% (95% CI 70.2% to 83.6%); the assisted primary and secondary patency estimates were 79.3% (95% CI 73% to 85.6%) and 91% (95% CI 84.5% to 97.5%). The 4-year freedom from TLR estimate was 73.8% (95% CI 67.4% to 80.2%). On multivariate analysis, the only associations confirmed involved Rutherford category 5/6 with primary patency (hazard ratio [HR] 5.7, 95% CI 4.4 to 7, p=0.02) and assisted primary patency (HR 6.1, 95% CI 4.9 to 7.3, p=0.01). Conclusion: Use of a low-profile 4-F stent in atherosclerotic iliac lesions was safe and effective. At 4 years, the overall patency and the absence of TLR were good. Midterm outcomes were poor in patients with Rutherford category 5/6 ischemia. Finally, the use of stents with a ≥6-mm diameter and postdeployment balloon dilation are recommended in all cases.
Reflections on Equality, Diversity, and Gender at the End of a Media Studies Headship
Authors: Thornham Sue
Published: May 2017

This article reflects, from a feminist perspective, on a five-year period as Head of a School of Media. It considers the position of media studies within the new academic capitalism and the re-masculinization of the university that this has produced. It considers strategies employed by the field to stake its own claim to that masculinization, in particular the embrace of “the digital.” Finally, it describes the challenges this posed for the author, and tactics employed in dealing with them.
Tensile characteristics of sisal and polypropylene fibre non-woven materials for geo-textile applications
Authors: Ilango V , Shabaridharan K , Senthil Kumar N , Perumalraj R
Published: May 2017

The objective of this study is to analyse the cross direction tensile properties of composite non-woven fabrics. Three different blend proportion, that is, 20% sisal/80% polypropylene, 80% sisal/20% polypropylene and 50% sisal/50% polypropylene were used to study the tensile properties of the composite non-woven fabrics. Box–Behnken design has been used with three parameters namely, punch density, depth of needle penetration and mass per unit area. The samples produced were subjected to calendaring at 145℃ temperature and 6.12 kg/cm2 pressure. The tensile strength of tested fabrics has been analysed in detail and it has been found that 20% sisal/80% polypropylene composite non-woven fabric is performing better than other blends.
Impact of Health Literacy on Time Spent Seeking Hand Care
Authors: Alokozai Aaron , Bernstein David N. , Sheikholeslami Nicole , Uhler Lauren , Ring David , Kamal Robin N.
Published: May 2017

Background: Patients with limited health literacy may have less knowledge and fewer resources for efficient access and navigation of the health care system. We tested the null hypothesis that there is no correlation between health literacy and total time spent seeking hand surgery care. Methods: New patients visiting a hand surgery clinic at a suburban academic medical center were asked to complete a questionnaire to determine demographics, total time spent seeking hand surgery care, and outcomes. A total of 112 patients were included in this study. Results: We found health literacy levels did not correlate with total time seeking hand surgery care or from booking an appointment to being evaluated in clinic. Conclusions: In this suburban academic medical center, patients with low health literacy do not spend more time seeking hand surgery care and do have longer delays between seeking and receiving care. The finding that—at least in this setting—health literacy does not impact patient time seeking hand care suggests that resources to improve health disparities can be focused elsewhere in the care continuum.
Fixation Strength in Full and Limited Fixation of Osteoporotic Distal Radius Fractures
Authors: Mansuripur P. Kaveh , Gil Joseph A. , Cassidy Dale , Kane Patrick , Kluk Augusta , Crisco Joseph J. , Akelman Edward
Published: May 2017

Background: The purpose of this investigation is to determine whether osteoporotic intra-articular distal radius fractures surgically treated by filling all 7 distal screws of a volar plate will have a higher load to failure than those treated by filling only 4 distal screws. Methods: Ten matched pairs of fresh frozen cadaveric forearms were randomized within each pair to be treated by using either all 7 of the distal holes of a volar plate or only 4 distal screws. The distal radius fixation was performed with unicortical screws going to but not through the dorsal cortex, and the most distal screws were placed within 4 mm of the joint surface. An AO C2 type fracture was then created. All specimens were tested cyclically, with an axial load of 60 N, at 3 Hz for 1000 cycles to simulate early postoperative motion. All specimens were subsequently tested to mechanical failure. Results: There were no failures in either group during cyclic testing. There was no difference detected between groups for mean stiffness, yield load, peak load, or load to clinical failure. In both groups, the yield load, peak load, and load to clinical failure were higher than the 60- to 100-N forces encountered during postoperative rehabilitation. Conclusions: There was no difference detected between osteoporotic intra-articular distal radius fractures treated by utilizing all 7 of the distal screws of a volar plate compared with those treated with only 4 distal screws.
Back to Basics
Authors: Guthrie George E.
Published: May 2017

Non-drug therapy should be foundational to our treatment plans. These should be evidence-based. Drug based therapies rely heavily on randomized controlled trials while the evidence many lifestyle interventions relies more heavily on epidemiological studies. Both have weaknesses and strengths. Medicine needs a system for evaluating evidence that recognizes the strengths of both types of studies and includes some common measure such as Number Needed to Treat (NNT) and Number Needed to Harm (NNH).
Attribution of global ethical norms: Perceptions of journalistic independence and integrity in Serbia, Macedonia and Croatia
Authors: Pjesivac Ivanka , Spasovska Katerina , Imre Iveta
Published: May 2017

This study examines, by comparative thematic analysis, public perceptions of global journalistic norms of independence and integrity by studying perceptions of news media corruption in three Eastern European countries: Serbia, Macedonia and Croatia. In-depth interviews with 61 representatives of the three nations revealed that, in the public eye, the breaches of journalistic independence and integrity are frequent and take different forms. The participants from Serbia, Macedonia and Croatia thought that journalists from their countries often succumb to pressures from politicians, owners and advertisers; that they receive direct bribes for positive coverage and even extort money from people; and that news media are engaged in hidden advertising and journalists are engaged in nepotism. The results show similarity of public perceptions of breaches of journalistic independence and integrity with academic and professional findings and are discussed from the point of view of the cross-country examination of the attribution theory in the context of audiences’ use of situational and trait characteristics in understanding journalistic ethical norms.
Leadership and management competencies of head nurses and directors of nursing in Finnish social and health care
Authors: Kantanen Kati , Kaunonen Marja , Helminen Mika , Suominen Tarja
Published: May 2017

This paper describes the leadership and management competencies of head nurses and directors of nursing in social and health care. In the nursing profession, studies have tended to describe the role of the nurse manager, or to provide lists of competencies, talents and traits which can be found in successful managers. However, nursing managers’ leadership and management competencies lack any depth of research knowledge. Data were gathered by electronic questionnaire. Respondents ( n = 1025) were head nurses and directors of nursing. The data were statistically analysed. Both groups evaluated their leadership and management competencies to be quite good and their general competence to be better than their special competence. Overall, directors of nursing rated their general competence and special competence better than head nurses. However, the head nurses had a stronger expertise in general competence areas, professional competence and credibility, and also in the special competence areas of substance knowledge than the directors of nursing. While the overall leadership and management competencies were good for both groups, each has identified areas which can be further developed.
Developing an Appreciative Management Scale (AMS 1.0)
Authors: Harmoinen Merja , Niiranen Vuokko , Helminen Mika , Suominen Tarja
Published: May 2017

In working life, ageing and retiring staff and managers are being replaced by younger generations which come from different working life cultures. This may give rise to different management expectations. As a result, this creates a need to assess how the concept of appreciative management is implemented in health care. The aim was to develop a valid and reliable instrument to assess appreciative management. A multi-phase, mixed-method and psychometric evaluation of the Appreciative Management Scale (AMS) was conducted. A concept analysis and systematic literature review were carried out. The instrument’s development employed a two-phase Delphi study approach including essays, survey iteration rounds and expert panel evaluation. The instrument was pre-tested and tested empirically in a survey completed by staff respondents and managers. AMS 1.0 has 83 items that are categorised into Systematic Management, Equality, Appreciation of Know-How, and the Promotion of Wellbeing at Work. The instrument was found to be valid and reliable. The AMS 1.0 scale needs to be tested internationally in order to conduct evaluative surveys of appreciative management in other countries. By using the AMS 1.0 instrument to assess managers’ management practices, managers receive valuable feedback on their own management skills and also the skills of workers.
Superhydrophobic organosilicon-based coating system by a novel ultravoilet-curable method
Authors: Liu Baojiang , Tian Taizhou , Yao Jinlong , Huang Changgen , Tang Wenjun , Xiang Zhonglin , Xu Xiaojun , Min Jie
Published: May 2017

A robust superhydrophobic organosilica sol-gel-based coating on a cotton fabric substrate was successfully fabricated via a cost-effective one-step method. The coating was prepared by modification of silica nanoparticles with siloxane having long alkyl chain that allow to reduce surface energy. The coating on cotton fabric exhibited water contact angle of 151.6°. The surface morphology was evaluated by scanning electron microscopy, and surface chemical composition was measured with X-ray photoelectron spectroscopy. Results showed the enhanced superhydrophobicity that was attributed to the synergistic effect of roughness created by the random distribution of silica nanoparticles and the low surface energy imparted of long-chain alkane siloxane. In addition, the coating also showed excellent durability against washing treatments. Even after washed for 30 times, the specimen still had a water contact angle of 130°, indicating an obvious water-repellent property. With this outstanding property, the robust superhydrophobic coating exhibited a prospective application in textiles and plastics.
Is Incisura Fibularis a Reliable Landmark for Assessing Syndesmotic Stability? A Systematic Review of Morphometric Studies
Authors: Anand Prakash Akilesh
Published: May 2017

Incisura fibularis (IF) is an important landmark in assessing syndesmotic stability radiologically postinjury. The purpose of this review was to explore the anatomy and morphometrics of this widely used anatomical landmark and to further the understanding of the same. A systematic review was conducted online using PubMed and Google Scholar, per PRISMA guidelines. Predefined eligibility criteria were applied, and the data thus compiled were analyzed. Wide variability in morphometrics and, thus, anatomy of IF were observed in the present review, which was influenced by gender. There was no side-to-side variability seen in this study. The study stresses the need to consider the anatomical and gender-based variability while assessing syndesmotic stability and further supports the recommendation of side-to-side comparison.

Levels of Evidence: Anatomical, Level V
Removal of Hardware After Syndesmotic Screw Fixation: A Systematic Literature Review
Authors: Walley Kempland C. , Hofmann Kurt J. , Velasco Brian T. , Kwon John Y.
Published: May 2017

Background. While trans-syndesmotic fixation with metal screws is considered the gold standard in treating syndesmotic injuries, controversy exists regarding the need and timing of postoperative screw removal. Formal recommendations have not been well established in the literature and clinical practice is highly variable in this regard. The purpose of this systematic review is to critically examine the most recent literature regarding syndesmotic screw removal in order to provide surgeons an evidence-based approach to management of these injuries. Methods. The Cochrane Library and PubMed Medline databases were explored using search terms for syndesmosis and screw removal between October 1, 2010 and June 1, 2016. Results. A total of 9 studies (1 randomized controlled trial and 8 retrospective cohort studies) were found that described the outcomes of either retained or removed syndesmotic screws. Overall, there was no difference in functional, clinical or radiographic outcomes in patients who had their syndesmotic screw removed. There was a higher likelihood of recurrent syndesmotic diastasis when screws were removed between 6 and 8 weeks. There was a higher rate of postoperative infections when syndesmotic screws were removed without administering preoperative antibiotics. Conclusion. Removal of syndesmotic screws is advisable mainly in cases of patient complaints related to the other implanted perimalleolar hardware or malreduction of the syndesmosis after at least 8 weeks postoperatively. Broken or loose screws should not be removed routinely unless causing symptoms. Antibiotic prophylaxis is recommended on removal. Radiographs should be routinely obtained immediately prior to removal and formal discussions should be had with patients prior to surgery to discuss management options if a broken screw is unexpectedly encountered intraoperatively. Radiographs and/or computed tomography imaging should be obtained after syndesmotic screw removal when indicated for known syndesmotic malreduction.

Levels of Evidence: Level IV: Systematic review
Distribution and Habitat Suitability of Andean Climbing Catfish in the Napo River Basin, Ecuador
Authors: Alexiades A. V. , Encalada A. C.
Published: May 2017

Astroblepidae face numerous threats in Ecuador, and their range is thought to be decreasing in most basins due to urban development, agriculture, oil and mineral extraction, dams, and introduction of exotic species. In the Napo River Basin, one of the largest and most-diverse river basins in Ecuador, Astroblepus vaillanti is also potentially being displaced by rainbow trout ( Onchorynchus mykiss) introductions at higher altitudes, yet no published information exists on the habitat requirements and distribution of the species. In this study, we developed species–habitat relationships for a suite of physico-chemical variables and compared abundances of A. vaillanti in streams heavily impacted by agriculture and less impacted streams. Interestingly, we found significantly higher abundances of A. vaillanti in heavily impacted streams. We also found that A. vaillanti abundance was positively related to stream temperature, whereas the inverse was true for rainbow trout. Our study highlights the need for further study to understand the habitat requirements and diet of A. vaillanti as well as the impacts of rainbow trout on the species to inform conservation efforts of the species.
Measuring Early Cortical Visual Processing in the Clinic
Authors: Bowns Linda , Beaudot William H.A.
Published: May 2017

We describe a mobile app that measures early cortical visual processing suitable for use in clinics. The app is called Component Extraction and Motion Integration Test (CEMIT). Observers are asked to respond to the direction of translating plaids that move in one of two very different directions. The plaids have been selected so that the plaid components move in one of the directions and the plaid pattern moves in the other direction. In addition to correctly responding to the pattern motion, observers demonstrate their ability to correctly extract the movement (and therefore the orientation) of the underlying components at specific spatial frequencies. We wanted to test CEMIT by seeing if we could replicate the broader tuning observed at low spatial frequencies for this type of plaid. Results from CEMIT were robust and successfully replicated this result for 50 typical observers. We envisage that it will be of use to researchers and clinicians by allowing them to investigate specific deficits at this fundamental level of cortical visual processing. CEMIT may also be used for screening purposes where visual information plays an important role, for example, air traffic controllers.
The Role of Religious Leaders in the Restoration of Hope Following Natural Disasters
Authors: Hirono Tatsushi , Blake Michelle Emery
Published: May 2017

For mental health professionals who are social workers and counselors, the role of clergy is sometimes a missing link. Both the United States and Japan have suffered multiple natural disasters since the 21st century began: Hurricanes Sandy (2012) and Katrina (2005) in the United States and an 8.9 magnitude earthquake (2011) occurred in Japan. Immediately after these devastating natural disasters, victims needed shelter, water, food, and blankets. However, 2 to 3 weeks after the disasters, they needed mental health support more than material supplies as they cope with the after effects of trauma. Hope might be important for natural disaster relief in the long term. A lack of support might contribute to the development of posttraumatic stress disorder (PTSD) symptoms. The investigators hypothesized that religious belief would reduce the natural disaster victims’ PTSD symptoms. In May and June 2013, they sent 500 mailing surveys to Christian and Buddhist clergy in the New Orleans, New York, Tokyo, and Fukushima areas. They asked what these areas did for natural disaster relief. They found cultural differences between the two religious communities: (a) More American Christian clergies thought natural disaster relief efforts are their obligation. (b) American clergies focus more on “comfort,” “reducing pain,” and “hope,” whereas Japanese clergies focus more on “listening” and “praying” when they talk with family members who lost their loved ones.
Deleterious Effects From Occupational Exposure to Ethylene Thiourea in Pregnant Women
Authors: Mutic Abby D. , Baker Brenda J. , McCauley Linda A.
Published: May 2017

Human exposure to endocrine disrupting chemicals (EDCs) has become common as a result of widespread application of these chemicals to the food supply, environmental contamination, and occupational exposures (Caserta et al., 2011). However, relatively little is known about the effects of EDCs such as ethylene thiourea (ETU) in developing fetuses and the lasting implications of this disruption on human development from birth through adulthood. Of highest concern are chronic, low-dose exposures among industrial and agricultural workers. Current knowledge regarding the significance of endocrine thyroid signaling on normal human development raises serious concerns about the possible deleterious effects of EDCs in the developing fetus, children, and mature adults. Occupational health nurses are critical in identifying women and families at increased risk of ETU exposure and mitigating early exposures in pregnancy.
Law Clinics and Advocacy Within the University Community: Risks and Benefits
Authors: Bamgbose Oluyemisi , Tafita Folake
Published: May 2017

The inception of the legal aid scheme in the Nigerian legal system brought about hope for the indigent and with it an increased rate of indigent dependents relying on the scheme to access justice.

This article discusses the advent of legal clinics in Nigeria and its relevance to a university community; in particular, the writers look into the rationale for establishing a specialized Woman’s Law Clinic and discuss the risks and benefits associated with advocacy and practicing as a University Law Clinic. In concluding, a risk–benefit assessment was examined using the unstructured questionnaire method of finding the stakeholders’ views/perspectives on having a clinic within the university community.
Multigene Panel Testing Provides a New Perspective on Lynch Syndrome
Authors: Espenschied Carin R. , LaDuca Holly , Li Shuwei , McFarland Rachel , Gau Chia-Ling , Hampel Heather
Published: May 2017

Purpose

Most existing literature describes Lynch syndrome (LS) as a hereditary syndrome leading to high risks of colorectal cancer (CRC) and endometrial cancer mainly as a result of mutations in MLH1 and MSH2. Most of these studies were performed on cohorts with disease suggestive of hereditary CRC and population-based CRC and endometrial cancer cohorts, possibly biasing results. We aimed to describe a large cohort of mismatch repair (MMR) mutation carriers ascertained through multigene panel testing, evaluate their phenotype, and compare the results with those of previous studies.

Methods

We retrospectively reviewed clinical histories of patients who had multigene panel testing, including the MMR and EPCAM genes, between March 2012 and June 2015 (N = 34,981) and performed a series of statistical comparisons.

Results

Overall, MSH6 mutations were most frequent, followed by PMS2, MSH2, MLH1, and EPCAM mutations, respectively. Of 528 patients who had MMR mutations, 63 (11.9%) had breast cancer only and 144 (27.3%) had CRC only. When comparing those with breast cancer only to those with CRC only, MSH6 and PMS2 mutations were more frequent than MLH1 and MSH2 mutations ( P = 2.3 × 10−5). Of the 528 patients, 22.2% met BRCA1 and BRCA2 ( BRCA1/2) testing criteria and not LS criteria, and 5.1% met neither BRCA1/2 nor LS testing criteria. MSH6 and PMS2 mutations were more frequent than MLH1 and MSH2 mutations among patients who met BRCA1/2 testing criteria but did not meet LS testing criteria ( P = 4.3 × 10−7).

Conclusion

These results provide a new perspective on LS and suggest that individuals with MSH6 and PMS2 mutations may present with a hereditary breast and ovarian cancer phenotype. These data also highlight the limitations of current testing criteria in identifying these patients, as well as the need for further investigation of cancer risks in patients with MMR mutations.
Preoperative Warming Versus no Preoperative Warming for Maintenance of Normothermia in Women Receiving Intrathecal Morphine for Cesarean Delivery: A Single-Blinded, Randomized Controlled Trial
Authors: Munday Judy , Osborne Sonya , Yates Patsy , Sturgess David , Jones Lee , Gosden Edward
Published: May 2017

BACKGROUND:

Rates of hypothermia for women undergoing spinal anesthesia for cesarean delivery are high and prevention is desirable. This trial compared the effectiveness of preoperative warming versus usual care among women receiving intrathecal morphine, which is thought to exacerbate perioperative heat loss.

METHODS:

A prospective, single-blinded, randomized controlled trial compared 20 minutes of forced air warming (plus intravenous fluid warming) versus no active preoperative warming (plus intravenous fluid warming) in 50 healthy American Society of Anesthesiologists graded II women receiving intrathecal morphine as part of spinal anesthesia for elective cesarean delivery. The primary outcome of maternal temperature change was assessed via aural canal and bladder temperature measurements at regular intervals. Secondary outcomes included maternal thermal comfort, shivering, mean arterial pressure, agreement between aural temperature, and neonatal outcomes (axillary temperature at birth, Apgar scores, breastfeeding, and skin-to-skin contact). The intention-to-treat population was analyzed with descriptive statistics, general linear model analysis, linear mixed-model analysis, χ2 test of independence, Mann-Whitney, and Bland-Altman analysis. Full ethical approval was obtained, and the study was registered on the Australia and New Zealand Clinical Trials Registry (Trial No: 367160, registered at http://www.ANZCTR.org.au/).

RESULTS:

Intention-to-treat analysis (n = 50) revealed no significant difference in aural temperature change from baseline to the end of the procedure between groups: F (1, 47) = 1.2, P = .28. There were no other statistically significant differences between groups in any of the secondary outcomes.

CONCLUSIONS:

A short period of preoperative warming is not effective in preventing intraoperative temperature decline for women receiving intrathecal morphine. A combination of preoperative and intraoperative warming modalities may be required for this population.
Relationship Between a Sepsis Intervention Bundle and In-Hospital Mortality Among Hospitalized Patients: A Retrospective Analysis of Real-World Data
Authors: Prasad Priya A. , Shea Erica R. , Shiboski Stephen , Sullivan Mary C. , Gonzales Ralph , Shimabukuro David
Published: May 2017

BACKGROUND:

Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data.

METHODS:

We performed a retrospective cohort study at the University of California, San Francisco, Medical Center among adult patients discharged between January 1, 2012, and December 31, 2014, and who received a diagnosis of severe sepsis/septic shock (SS/SS). Sepsis intervention bundle elements included measurement of blood lactate; drawing of blood cultures before starting antibiotics; initiation of broad spectrum antibiotics within 3 hours of sepsis presentation in the emergency department or 1 hour of presentation on an inpatient unit; administration of intravenous fluid bolus if the patient was hypotensive or had a lactate level >4 mmol/L; and starting intravenous vasopressors if the patient remained hypotensive after fluid bolus administration. Poisson regression for a binary outcome variable was used to estimate an adjusted incidence-rate ratio (IRR) comparing mortality in groups defined by bundle compliance measured as a binary predictor, and to estimate an adjusted number needed to treat (NNT).

RESULTS:

Complete bundle compliance was associated with a 31% lower risk of mortality (adjusted IRR, 0.69, 95% confidence interval [CI], 0.53–0.91), adjusting for SS/SS presentation in the emergency department, SS/SS present on admission (POA), age, admission severity of illness and risk of mortality, Medicaid/Medicare payor status, immunocompromised host status, and congestive heart failure POA. The adjusted NNT to save one life was 15 (CI, 8–69). Other factors independently associated with mortality included SS/SS POA (adjusted IRR, 0.55; CI, 0.32–0.92) and increased age (adjusted IRR, 1.13 per 10-year increase in age; CI, 1.03–1.24).

CONCLUSIONS:

The University of California, San Francisco, sepsis bundle was associated with a decreased risk of in-hospital mortality across hospital units after robust control for confounders and risk adjustment. The adjusted NNT provides a reasonable and achievable goal to observe measureable improvements in outcomes for patients diagnosed with SS/SS.
Prospective External Validation of Three Preoperative Risk Scores for Prediction of New Onset Atrial Fibrillation After Cardiac Surgery
Authors: Cameron Matthew J. , Tran Diem T. T. , Abboud Jean , Newton Ethan K. , Rashidian Houman , Dupuis Jean-Yves
Published: May 2017

BACKGROUND:

Postoperative atrial fibrillation (POAF) is associated with early and late morbidity and mortality of cardiac surgical patients. Prophylactic treatment of atrial fibrillation (AF) has been recommended to improve outcome in cardiac surgical patients at high risk of developing POAF. Reliable models for prediction of POAF are needed to achieve that goal. This study attempted to externally validate 3 risk models proposed for preoperative prediction of POAF in cardiac surgical patients: the POAF score, the CHA2DS2-VASc score, and the Atrial Fibrillation Risk Index.

METHODS:

This was a prospective cohort study of 1416 adult patients who underwent nonemergent coronary artery bypass graft and/or valve surgery in a single cardiac surgical center between February 2014 and September 2015. A risk score for each of the 3 prediction models was calculated in each patient. All patients were followed for up to 2 weeks, or until hospital discharge, to observe the primary outcome of new onset AF requiring treatment. Discrimination was assessed using receiver operating characteristic curves. Calibration was assessed using the Pearson χ2 goodness-of-fit test and calibration plots. Utility of the score to implement AF prophylaxis based on the risk of POAF, in comparison to strategies of treating all patients, or not treating any patients, was assessed via a net benefit analysis.

RESULTS:

Of the 1416 patients included in this study, 478 had the primary outcome (33.8%). The areas under the receiver operating characteristic curve for prediction of POAF in the population subsets for which the scores were validated were as follows: 0.651 (95% confidence interval [CI], 0.621–0.681) for the POAF score, 0.593 (95% CI, 0.557–0.629) for the CHA2DS2-VASc score (P < .001 versus POAF score, P < .222 versus Atrial Fibrillation Risk Index), and 0.563 (95% CI, 0.522–0.604) for the Atrial Fibrillation Risk Index (P < .001 versus POAF score). The calibration analysis showed that the predictive models had a poor fit between the observed and expected rates of POAF. Net benefit analysis showed that AF preventive strategies based on these scores, and targeting patients with moderate or high risk of POAF, improve decision-making in comparison to preventive strategies of treating all patients.

CONCLUSIONS:

The 3 prediction scores evaluated in this study have limited ability to predict POAF in cardiac surgical patients. Despite this, they may be useful in preventive strategies targeting patients with moderate or high risk of PAOF in comparison with preventive strategies applied to all patients.
Epstein-Barr virus-encoded LMP2A stimulates migration of nasopharyngeal carcinoma cells via EGFR/Ca2+/calpain/ITGβ4 axis
Authors: Liang Jiezhen , Zheng Shixing , Xiao Xue , Wei Jiazhang , Zhang Zhe , Ernberg Ingemar , Matskova Liudmila , Huang Guangwu , Zhou Xiaoying
Published: May 2017

Epstein-Barr virus (EBV)-encoded latent membrane protein 2A (LMP2A) promotes the motility of nasopharyngeal carcinoma (NPC) cells. Previously, we have shown that the localization of integrin β4 (ITGβ4) was regulated by LMP2A, with ITGβ4 concentrated at the cellular protrusions in LMP2A expressing NPC cells. In the present study, we aim to further investigate mechanisms involved in this process and its contribution to cell motility. We show that expression of LMP2A was correlated with increased EGFR activation, elevated levels of intracellular Ca2+, calpain activation and accelerated cleavage of ITGβ4. Activation of EGFR and calpain activity was responsible for a redistribution of ITGβ4 from the basal layer of NPC cells, to peripheral membrane structures, which correlated with an increased migratory capacity of NPC cells. Furthermore, we demonstrated that the calpain inhibitor calpastatin was downregulated in NPC primary tumors. In conclusion, our results point to LMP2A-mediated targeting of the EGFR/Ca2+/calpain/ITGβ4 signaling system as a mechanism underlying the increased motility of NPC cells. We suggest that calpain-facilitated cleavage of ITGβ4 contributes to the malignant phenotype of NPC cells.
Mutualistic damselfish induce higher photosynthetic rates in their host coral
Authors: Garcia-Herrera Nur , Ferse Sebastian C. A. , Kunzmann Andreas , Genin Amatzia
Published: May 2017

Coral reefs are amongst the most diverse ecosystems on Earth where complex inter-specific interactions are ubiquitous. An example of such interactions is the mutualistic relationship between damselfishes and branching corals in the Northern Red Sea, where the fish use corals as shelter and provide them with nutrients, enhance the flow between their branches, and protect them from predators. By enhancing the flow between the coral branches, the fish ventilate the coral's inner zone, mitigating hypoxic conditions that otherwise develop within that zone during the night. Here, we tested, for the first time, the effects of the damselfish Dascyllus marginatus on photosynthesis and respiration in its host coral Stylophora pistillata. Laboratory experiments using an intermittent-flow respirometer showed that the presence of fish between the coral branches under light conditions augmented the coral's photosynthetic rate. No effect on the coral's respiration was found under dark conditions. When a fish was allowed to enter the inner zone of a dead coral skeleton, its respiration was higher than when it was in a live coral. Field observations indicated that damselfish were present between coral branches 18–34% of the time during daylight hours and at all times during the night. Considering the changes induced by the fish together with the proportion of time they were found between coral branches in the field, the effect of the fish amounted to an augmentation of 3–6% of the coral's daily photosynthesis. Our findings reveal a previously unknown positive contribution of coral-dwelling fish to their host's photosynthesis.