bluuebunny/crossref_metadata_2025 huggingface dataset:
The Reliability and Validity of Using Ice to Measure Cold Pain Threshold
Authors: Tilley Prue , Bisset Leanne
Published: August 2017

Cold pain threshold (CPT) measures an individual’s pain threshold in response to a cold stimulus. CPT is most accurately determined with specialised equipment; however this technology is not readily accessible to clinicians. Instead, ice has been employed to measure CPT. An optimal ice protocol has not yet been identified. The aim of this study was to evaluate the reliability and validity of two CPT protocols using ice in a young, healthy population. Twenty-two participants aged 22.6 (SD 1.81) years underwent CPT measurements over 6 anatomical sites across 3 protocols, which were repeated in 2 sessions. One protocol measured pain (PVAS) following ice applied for a standardised period of 30 seconds; a second protocol measured time to onset of pain, and the reference standard measured CPT using laboratory equipment (TSA-II). The PVAS protocol demonstrated the best reliability (mean ICC 0.783, 95% CI 0.706 to 0.841), but the Timed protocol demonstrated superior validity compared to the reference standard (mean ICC −0.504, 95% CI −0.621 to −0.365).
Beam-Steering Performance of Flat Luneburg Lens at 60 GHz for Future Wireless Communications
Authors: Foster Robert , Nagarkoti Deepak , Gao Ju , Vial Benjamin , Nicholls Felix , Spooner Chris , Haq Sajad , Hao Yang
Published: August 2017

The beam-steering capabilities of a simplified flat Luneburg lens are reported at 60 GHz. The design of the lens is first described, using transformation electromagnetics, before discussion of the fabrication of the lens using casting of ceramic composites. The simulated beam-steering performance is shown, demonstrating that the lens, with only six layers and a highest permittivity of 12, achieves scan angles of ±30° with gains of at least 18 dBi over a bandwidth from 57 to 66 GHz. To verify the simulations and further demonstrate the broadband nature of the lens, raw high definition video was transmitted over a wireless link at scan angles up to 36°.
Certificateless Key-Insulated Generalized Signcryption Scheme without Bilinear Pairings
Authors: Zhou Caixue , Zhao Zhiqiang , Zhou Wan , Mei Yuan
Published: August 2017

Generalized signcryption (GSC) can be applied as an encryption scheme, a signature scheme, or a signcryption scheme with only one algorithm and one key pair. A key-insulated mechanism can resolve the private key exposure problem. To ensure the security of cloud storage, we introduce the key-insulated mechanism into GSC and propose a concrete scheme without bilinear pairings in the certificateless cryptosystem setting. We provide a formal definition and a security model of certificateless key-insulated GSC. Then, we prove that our scheme is confidential under the computational Diffie-Hellman (CDH) assumption and unforgeable under the elliptic curve discrete logarithm (EC-DL) assumption. Our scheme also supports both random-access key update and secure key update. Finally, we evaluate the efficiency of our scheme and demonstrate that it is highly efficient. Thus, our scheme is more suitable for users who communicate with the cloud using mobile devices.
Diverse BRCA1 and BRCA2 Reversion Mutations in Circulating Cell-Free DNA of Therapy-Resistant Breast or Ovarian Cancer
Authors: Weigelt Britta , Comino-Méndez Iñaki , de Bruijn Ino , Tian Lei , Meisel Jane L. , García-Murillas Isaac , Fribbens Charlotte , Cutts Ros , Martelotto Luciano G. , Ng Charlotte K.Y. , Lim Raymond S. , Selenica Pier , Piscuoglio Salvatore , Aghajanian Carol , Norton Larry , Murali Rajmohan , Hyman David M. , Borsu Laetitia , Arcila Maria E. , Konner Jason , Reis-Filho Jorge S. , Greenberg Roger A. , Robson Mark E. , Turner Nicholas C.
Published: August 2017

Purpose: Resistance to platinum-based chemotherapy or PARP inhibition in germline BRCA1 or BRCA2 mutation carriers may occur through somatic reversion mutations or intragenic deletions that restore BRCA1 or BRCA2 function. We assessed whether BRCA1/2 reversion mutations could be identified in circulating cell-free DNA (cfDNA) of patients with ovarian or breast cancer previously treated with platinum and/or PARP inhibitors.

Experimental Design: cfDNA from 24 prospectively accrued patients with germline BRCA1 or BRCA2 mutations, including 19 patients with platinum-resistant/refractory ovarian cancer and five patients with platinum and/or PARP inhibitor pretreated metastatic breast cancer, was subjected to massively parallel sequencing targeting all exons of 141 genes and all exons and introns of BRCA1 and BRCA2. Functional studies were performed to assess the impact of the putative BRCA1/2 reversion mutations on BRCA1/2 function.

Results: Diverse and often polyclonal putative BRCA1 or BRCA2 reversion mutations were identified in cfDNA from four patients with ovarian cancer (21%) and from two patients with breast cancer (40%). BRCA2 reversion mutations were detected in cfDNA prior to PARP inhibitor treatment in a patient with breast cancer who did not respond to treatment and were enriched in plasma samples after PARP inhibitor therapy. Foci formation and immunoprecipitation assays suggest that a subset of the putative reversion mutations restored BRCA1/2 function.

Conclusions: Putative BRCA1/2 reversion mutations can be detected by cfDNA sequencing analysis in patients with ovarian and breast cancer. Our findings warrant further investigation of cfDNA sequencing to identify putative BRCA1/2 reversion mutations and to aid the selection of patients for PARP inhibition therapy. Clin Cancer Res; 23(21); 6708–20. ©2017 AACR.
Tumor-Treating Fields: A Fourth Modality in Cancer Treatment
Authors: Mun Elijah J. , Babiker Hani M. , Weinberg Uri , Kirson Eilon D. , Von Hoff Daniel D.
Published: August 2017

Despite major advances in therapy, cancer continues to be a leading cause of mortality. In addition, toxicities of traditional therapies pose a significant challenge to tolerability and adherence. TTFields, a noninvasive anticancer treatment modality, utilizes alternating electric fields at specific frequencies and intensities to selectively disrupt mitosis in cancerous cells. TTFields target proteins crucial to the cell cycle, leading to mitotic arrest and apoptosis. TTFields also facilitate an antitumor immune response. Clinical trials of TTFields have proven safe and efficacious in patients with glioblastoma multiforme (GBM), and are FDA approved for use in newly diagnosed and recurrent GBM. Trials in other localized solid tumors are ongoing. Clin Cancer Res; 24(2); 266–75. ©2017 AACR.
ADAM12 Is a Novel Regulator of Tumor Angiogenesis via STAT3 Signaling
Authors: Roy Roopali , Dagher Adelle , Butterfield Catherine , Moses Marsha A.
Published: August 2017

ADAM12, (A Disintegrin and metalloproteinase domain-containing protein 12), is upregulated in epithelial cancers and contributes to increased tumor proliferation, metastasis, and endocrine resistance. However, its role in tumor angiogenesis is unknown. Here, we report that ADAM12 is upregulated in the vessels of aggressive breast tumors and exerts key regulatory functions. ADAM12 significantly increases bFGF-mediated angiogenesis in vivo and ADAM12 levels are upregulated in tumors that have undergone a switch to the angiogenic phenotype. Importantly, ADAM12-overexpressing breast tumors display a higher microvessel density (MVD). Our goal was to identify the mechanisms by which tumor-associated ADAM12 promotes angiogenesis. ADAM12 expression in breast tumor cells correlated with a significant upregulation of proangiogenic factors such as VEGF and MMP-9 and downregulation of antiangiogenic factors such as Thrombospondin-1 (THBS1/TSP1) and Tissue Inhibitor of Metalloproteinases-2 (TIMP-2). Co-culture with ADAM12-expressing tumor cells promoted endothelial cell (EC) recruitment and capillary tube formation. Conversely, downregulation of endogenous ADAM12 in breast cancer cell lines resulted in reduction of pro-angiogenic factors and EC recruitment. These ADAM12-mediated effects are driven by the activation of EGFR, STAT3 and Akt signaling. Blockade of EGFR/STAT3 or silencing of ADAM12 reversed the proangiogenic tumor phenotype, significantly downregulated pro-angiogenic mitogens and reduced EC recruitment. In human breast cancer tissues, ADAM12 expression was significantly positively correlated with pro-angiogenic factors including VEGF and MMP-9 but negatively associated with TSP1.

Implications: These novel findings suggest that ADAM12 regulates EC function and facilitates a proangiogenic microenvironment in a STAT3-dependent manner. A combined approach of targeting ADAM12 and STAT3 signaling in breast cancer may represent a promising strategy to inhibit tumor neovascularization. Mol Cancer Res; 15(11); 1608–22. ©2017 AACR.
Anti-Phosphohistone H3-Positive Mitoses Are Linked to Pathological Response in Neoadjuvantly Treated Breast Cancer
Authors: Sillem Martin , Timme Sylvia , Bronsert Peter , Bogatyreva Lioudmila , Hauschke Dieter , zur Hausen Axel , Werner Martin , Stickeler Elmar
Published: August 2017

Background: We evaluated breast cancer (BC) core biopsies taken before neoadjuvant chemotherapy (NACT) by immunohistochemistry using anti-phosphohistone H3 (PHH3) antibody to determine mitosis, and correlated the results to clinicopathological data and histopathological regression of resected tumor specimens after NACT. Methods: 72 patients with either triple-negative (TN) or luminal type BC received NACT with epirubicin/cyclophosphamide (EC) and Taxotere®. Tumor regression was analyzed in resected specimens; pathological complete response (pCR) was achieved in 22.2%. Immunohistochemistry with PHH3 was performed on biopsy samples taken before treatment, and mitotic figures were evaluated in 10 high-power fields (HPF). Results: PHH3-detected mitoses correlated significantly with tumor grading (p = 0.001). TNBC showed > 10 PHH3-positive mitoses/10 HPF significantly more frequently than luminal type BC (p = 0.003). Tumors with > 10 PHH3-positive mitoses/10 HPF achieved pCR significantly more often than those with ≤ 10 PHH3-positive mitoses/10 HPF (p = 0.031). Even luminal type BC with > 10 PHH3-positive mitoses/10 HPF was associated significantly with pCR compared to luminal type BC with ≤ 10 PHH3-positive mitoses/10 HPF (p = 0.016). Conclusion: NACT with EC and Taxotere is suitable for strong proliferating TNBC and luminal BC (> 10 PHH3-positive mitoses/10 HPF). Immunohistochemical determination of mitoses using anti-PHH3 antibody is a simple and robust method for predicting therapy response to NACT in BC tissue.
Integration of Geriatric Assessment in the Care of Patients with Gastrointestinal Malignancies
Authors: Rostoft Siri
Published: August 2017

Background: The majority of patients with gastrointestinal (GI) malignancies are older. Recently, it has become evident that elements from a geriatric assessment (GA) are powerful predictors of outcomes such as postoperative morbidity and mortality, length of stay, type of treatment received, and survival across several GI tumor types in older adults. A GA is a systematic evaluation of functional status, comorbidities, polypharmacy, cognition, nutritional status, emotional status, and social support. Methods: A PubMed search was performed in order to identify clinical studies investigating the association between GA and outcomes in patients with GI malignancies. Results: A total of 31 studies were included in this review. For colorectal cancer, the evidence linking GA variables and frailty to negative outcomes is substantial and consistent. The data regarding other GI malignancies is more limited, but generally shows the same findings. Conclusion: Increasing data shows that elements from a GA and frailty are consistently associated with negative short- and long-term treatment outcomes in older patients with GI malignancies. Future studies should investigate the impact of geriatric interventions on outcomes.
Septic Complications after Resection for Middle or Low Rectal Cancer: Role of Gut Barrier Function and Inflammatory Serum Markers
Authors: Schietroma Mario , Pessia Beatrice , Colozzi Sara , Carlei Francesco , Clementi Marco , Amicucci Gianfranco , Guadagni Stefano
Published: August 2017

Background: The focus of this study was to understand the relationship between the failure of gut barrier function, inflammatory markers and septic complications after resection for extraperitoneal rectal cancer. Methods: One hundred seven patients were enrolled into this prospective observational study and underwent open colorectal resection for extraperitoneal cancer. All patients underwent an assessment of intestinal permeability (L/M ratio), endotoxemia, interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP) and elastase levels before surgery and on postoperative days 1, 3, and 7. Results: Septic complications developed in 23.3% of patients. There were no significant differences in preoperative L/M ratio, endotoxine, CRP, interleukin-1 (IL-1), IL-6, and elastase levels between septic and non-septic groups. All patients showed a significant increase in intestinal permeability, endotoxemia, IL-1, IL-6, CRP, and elastase on the first postoperative day. At postoperative day 7, the septic group continued to demonstrate an increase in intestinal permeability, endotoxemia and elastase and significant difference was observed between the 2 groups (p < 0.05), whereas there was no significant difference in IL-1, IL-6, and CRP levels. Conclusion: The pattern of change in the postoperative period of intestinal permeability, systemic endotoxemia and elastase concentration is significantly higher in patients in whom sepsis develops, while the concentration of IL-1β, IL-6, and CRP does not permit to distinguish infection from inflammation.
Qualitative and Quantitative Analysis of Primary Neocortical Areas in Selected Mammals
Authors: van Kann Elisabeth , Cozzi Bruno , Hof Patrick R. , Oelschläger Helmut H.A.
Published: August 2017

The present study focuses on the relationship between neocortical structures and functional aspects in three selected mammalian species. Our aim was to compare cortical layering and neuron density in the projection areas (somatomotor, M1; somatosensory, S1; auditory, A1; and visual, V1; each in a wider sense). Morphological and design-based stereological analysis was performed in the wild boar (Sus scrofa scrofa) as a representative terrestrial hoofed animal (artiodactyl) and the common dolphin (Delphinus delphis) as a highly derived related aquatic mammal (cetartiodactyl). For comparison, we included the human (Homo sapiens) as a well-documented anthropoid primate. In the cortex of many mammals, layer IV (inner granular layer) is the main target of specific thalamocortical inputs while layers III and V are the main origins of neocortical projections. Because the fourth layer is indistinct or mostly lacking in the primary neocortex of the wild boar and dolphins, respectively, we analyzed the adjacent layers III and V in these animals. In the human, all the three layers were investigated separately. The stereological data show comparatively low neuron densities in all areas of the wild boar and high cell counts in the human (as expected), particularly in the primary visual cortex. The common dolphin, in general, holds an intermediate position in terms of neuron density but exhibits higher values than the human in a few layers. With respect to the situation in the wild boar, stereological neuron counts in the dolphin are consistently higher, with a maximum in layer III of the visual cortex. The extended auditory neocortical field in dolphins and the hypertrophic auditory pathway indicate secondary neurobiological adaptations to their aquatic habitat during evolution. The wild boar, however, an omnivorous quadruped terrestrial mammal, shows striking specializations as to the sensorimotor neurobiology of the snout region.
Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review
Authors: Barauna Neto José Carlos , Dedivitis Rogério Aparecido , Aires Felipe Toyama , Pfann Robert Zasawadzki , Matos Leandro Luongo , Cernea Claudio Roberto
Published: August 2017

Introduction: Since the introduction of tracheoesophageal puncture (TEP) and placement of voice prosthesis, this has become the method of choice to achieve speech rehabilitation after total laryngectomy. Objective: To compare the complications and success in speech rehabilitation of patients undergoing rehabilitation after primary and secondary TEP (TEP1 and TEP2) through a systematic review. Methods: The literature survey included research in MedLine, Scielo, Lilacs, Cochrane and Websco until June 2016. Results: The rate of leakage around the prosthesis was higher in TEP1 (22.5 vs. 6.9%, p = 0.03). There were higher rates of wound infection (9.1 vs. 3.9%) and tracheal stenosis (8.5 vs. 4.5%) in the TEP1 group compared to TEP2, however with no statistical significance. The evaluation of speech quality was not possible due to the heterogeneity of the studies. Conclusion: There is a reduction in the risk of leakage around the prosthesis among TEP2 patients.
Chest Compressions during Sustained Inflations Improve Recovery When Compared to a 3:1 Compression:Ventilation Ratio during Cardiopulmonary Resuscitation in a Neonatal Porcine Model of Asphyxia
Authors: Li Elliott S. , Görens Immanuel , Cheung Po-Yin , Lee Tze-Fun , Lu Min , O'Reilly Megan , Schmölzer Georg M.
Published: August 2017

Background: Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). Objective: To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia. Intervention and Measurements: Term newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-min normocapnic hypoxia followed by asphyxia. Cardiopulmonary resuscitation (CPR) was initiated when the heart rate decreased to 25% of baseline. Piglets were randomized into 3 groups: CC during SI at a rate of 90 CC/min (SI+CC 90, n = 8), a 3:1 C:V using 90 CC and 30 inflations (3:1, n = 8), or a sham group (n = 6). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. Results: CC+SI significantly reduced the median (IQR) time of ROSC, i.e., 34 s (28-156 s) versus 210 s (72-300 s) in the 3:1 group (p = 0.048). CC+SI also significantly reduced the requirement for 100% oxygen, improved respiratory parameters, and resulted in a similar hemodynamic recovery. Conclusions: CC+SI during CPR significantly improved ROSC in a porcine model of neonatal resuscitation. This is of considerable clinical relevance because improved respiratory and hemodynamic parameters potentially minimize morbidity and mortality in newborn infants.
Definition, Management, and Outcomes of Acute Kidney Injury: An International Survey of Nephrologists
Authors: Farooq Umar , Tober Aaron , Chinchilli Vernon , Reeves W. Brian , Ghahramani Nasrollah
Published: August 2017

Background: Acute kidney injury (AKI) is a complex disease burdened by uncertainties of definition, management strategies, and prognosis. This study explores the relationship between demographic characteristics of nephrologists and their perceptions about the definition, management, and follow-up of AKI. Methods: We developed a Web-based survey, the International Survey on Acute Kidney Injury (ISAKI), consisting of 29 items in 4 categories: (1) demographic and practice characteristics, (2) definition of AKI, (3) management of renal replacement therapy (RRT) in AKI, and (4) sequelae of AKI. A multivariable stepwise logistic regression model was used to examine relationships between the dependent variables and the demographic characteristics of the respondents. Results: Responses from 743 nephrologists from 90 countries were analyzed. The majority (60%) of respondents reported using RIFLE and/or AKIN criteria regularly to define AKI, although US nephrologists were less likely to do so (OR: 0.58; 95% CI: 0.42-0.85). The most common initial RRT modality was intermittent hemodialysis (63.5%), followed by continuous RRT (23.8%). Faculty affiliation was associated with a higher likelihood of using a dialysis schedule of ≥4 times a week (OR: 1.75; 95% CI: 1.20-2.55). The respondents believed that a single episode of AKI increases the likelihood of development of chronic kidney disease (CKD) (55%), subsequent AKI (36%), and rapid progression of preexisting CKD (87%). US nephrologists were less likely to recommend follow-up after resolution of AKI (OR: 0.15; 95% CI: 0.07-0.33). Conclusions: Our findings highlight the need for a widely accepted consensus definition of AKI, a uniform approach to management, and improved follow-up after resolution of AKI episodes.
Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery
Authors: Kim Joonho , Na Han Kyu , Byun Justin , Shin Jiwon , Kim Sungsoo , Lee Byung Hwa , Na Duk L.
Published: August 2017

Background/Aims: Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). Methods: We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. Results: In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). Conclusion: In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness.
Aerodynamic and Laryngeal Characteristics of Place-Dependent Voice Onset Time Differences
Authors: Eshghi Marziye , Alemi Mehdi , Zajac David J.
Published: August 2017

Objective: To investigate aerodynamic and laryngeal factors associated with place-dependent voice onset time (VOT) differences. Methods: The speech materials were /p∧, t∧, k∧/, each produced 15 times by 10 adult English speakers in the carrier phrase “say __ again”. The sound pressure level was targeted within a ±3 dB range. Intraoral air pressure (Po) was obtained using a buccal-sulcus approach. VOT, Po, maximum Po declination rate (MPDR), duration of the laryngeal devoicing gesture (LDG), occlusion duration, and the duration of the Po drop to baseline (atmosphere) to the onset of voicing (PDOV) were determined for each stop. Results: VOT was longer for the alveolar and velar stops compared to the bilabial stop. A constant LDG was observed for all stops regardless of place of articulation. Occlusion duration, however, was significantly shorter for the alveolar and velar stops compared to the bilabial stop. Aerodynamically, Po was greatest for the velar stop, intermediate for the alveolar stop, and smallest for the bilabial stop. MPDR index showed a slower rate of Po drop for the velar and alveolar stops compared with the bilabial stop. PDOV was found to be longer for /p/ than /t/ and /k/. Conclusion: Findings provide empirical evidence for the inter-related roles of Po, rate of Po change, and laryngeal factors in place-dependent variations of VOT.
A Randomized Controlled Trial Examining the Effect of Acupressure on Agitation and Salivary Cortisol in Nursing Home Residents with Dementia
Authors: Kwan Rick Yiu Cho , Leung Mason Chin Pang , Lai Claudia Kam Yuk
Published: August 2017

Background: Acupressure has been used to manage agitation in people with dementia because it is safe and inexpensive. However, its effect on agitation and at the biochemical level is uncertain. Methods: This randomized controlled trial examined the effect of acupressure on agitation, as measured by the Cohen-Mansfield Agitation Inventory (CMAI); and on salivary cortisol, as measured at baseline (T0) and in the 3rd (T1), 5th (T2), and 8th (T3) weeks. There were 119 agitated residents with dementia randomized into 3 groups: acupressure (n = 39), sham (n = 41), and usual-care group (n = 39). Results: A downward trend in agitation over time was noted in the acupressure group, which almost reached a level of significance in interaction effects between groups and time points (p = 0.052). Post hoc pairwise tests in the acupressure group showed that acupressure significantly reduced agitation at T2 (mean difference -6.84, 95% CI -10.60, -3.08) compared to baseline. Significant interaction effects between groups and time points were observed on the level of salivary cortisol (p = 0.022). Conclusion: Acupressure is a multicomponent intervention that can reduce agitation. Acupoint activation may not be a significant component in reducing agitation, although this result may have been limited by the inadequate sample size. Acupressure is effective in reducing salivary cortisol in people with dementia.
The Integrated Care of Asthma in Switzerland (INCAS) Study: Changes in Asthma Control and Perception of Health Care through Asthma Education
Authors: Dürr Selina , Hersberger Kurt E. , Zeller Andreas , Scheuzger Jonas , Miedinger David , Gregoriano Claudia , Joos Zellweger Ladina , Steurer-Stey Claudia , Leuppi Jörg Daniel
Published: August 2017

Background: Despite great efforts in establishing optimal asthma management, asthma may remain uncontrolled. To effectively manage chronic diseases, such as asthma, it is important to train patients in self-management skills. Objectives: The aim of this study was to assess the potential benefit of standardised asthma education in Switzerland for asthma control and patients' perception of received asthma care and of self-management support. Methods: For this multicentre longitudinal controlled study, asthma patients were recruited in Switzerland. The Asthma Control Test (ACT) was used to assess asthma control. The Patient Assessment of Chronic Illness Care questionnaire (PACIC 5A) was applied to evaluate received health-care services and self-management support. Patients were offered the possibility to attend asthma education sessions conducted by the Swiss Lung League and Swiss Allergy Centre. After 1 year, attenders and non-attenders completed the questionnaires again. Changes in ACT and PACIC 5A scores were analysed using dependent t tests. Results: Overall, 223 patients with asthma were investigated (mean age 43 ± 12 years, 38% male, 13% current smokers, 29% ex-smokers). Sixty-one (27%) patients attended education sessions. Both groups had improved asthma control at follow-up (attenders: t(56) = -3.2, r = 0.4 [medium effect size], p = 0.002; non-attenders: t(141) = -2.6, r = 0.2 [small effect size], p = 0.010). Attenders improved in PACIC and 5A sum scores (t(50) = -3.6, r = 0.5 [medium effect size], p = 0.001). Conclusions: A comprehensive self-management asthma education programme in Switzerland improved asthma control and patients' perception of received asthma care and of self-management support. Professionals should motivate patients to attend asthma education in order to become active partners in managing their disease.
Intracorporeal versus Extracorporeal Anastomoses Following Laparoscopic Right Colectomy in Obese Patients: A Case-Matched Study
Authors: Vignali Andrea , Elmore Ugo , Lemma Maria , Guarnieri Giovanni , Radaelli Giovanni , Rosati Riccardo
Published: August 2017

Background/Aims: To compare short- and long-term outcomes of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in obese (body mass index >30 kg/m2) patients. Patients and Methods: Sixty-four consecutive obese patients who underwent laparoscopic (LPS) right colectomy with IA were matched with 64 patients who underwent LPS right colectomy with EA. Intraoperative variables, short-term outcomes, readmission rates, and morbidity and mortality rates were analyzed along with long-term outcomes. Results: Conversion to open surgery occurred in 4 patients in the IA group and 11 patients in the EA group (p = 0.097). The overall 30-day morbidity rate was 29.6% in the IA and 32.8% in the EA (p = 0.70). No 30-day mortality occurred. Anastomotic leak occurred in 4.7% of patients in the IA group vs. 7.8% in the EA group (p = 0.71). In the IA group, an earlier recovery of bowel function was observed (p = 0.01). No differences were observed with respect to the length of stay and reoperation rate. No 30-day readmission occurred in the IA compared to 5 patients readmitted in the EA group (p = 0.058). A higher incidence of incisional hernia was observed in the EA group (p = 0.033). Conclusion: IA in obese patients is associated with similar short-term outcomes, lower incidence of incisional hernias, and might possibly reduce the risk of hospital readmission.
The Hypothalamic Preoptic Area and Body Weight Control
Authors: Yu Sangho , François Marie , Huesing Clara , Münzberg Heike
Published: August 2017

The preoptic area (POA) of the hypothalamus is involved in many physiological and behavioral processes thanks to its interconnections to many brain areas and ability to respond to diverse humoral factors. One main function of the POA is to manage body temperature homeostasis, e.g. in response to ambient temperature change, which is achieved in part by controlling brown adipose tissue thermogenesis. The POA is also importantly involved in modulating food intake in response to temperature change, thus making it relevant for body weight homeostasis and obesity research. POA function in body weight control is highly unexplored, and a better understanding of POA circuits and their integration into classic hypothalamic circuits that regulate energy homeostasis is expected to provide new opportunities for the scientific basis and treatment of obesity and comorbidities.
РИЗИК ІНФІКУВАННЯ ПЛОДА І НОВОНАРОДЖЕНОГО У ВАГІТНИХ ЖІНОК З HBV- І HCV-ІНФЕКЦІЄЮ
Authors: Mateyko H. B. , Matvisiv M. V.
Published: August 2017

Мета роботи – проаналізувати фактори ризику вертикальної трансмісії (ВТ) вірусів гепатитів В (ВГВ) і С (ВГС) від матері до дитини з метою профілактики внутрішньоутробного інфікування плода і новонародженого.Результати дослідження. Реплікативні форми НВV-інфекції діагностували у 32,4 % вагітних жінок, носійство ВГВ – у 67,6 %. У інфікованих НСV переважали реплікативні форми хвороби (61,0 %), а носійство встановили у 39,0 % пацієнток.У жінок з реплікативними формами НВV- та НСV-інфекції (4,4 і 2,8 % відповідно), високим ВН і мінімальним ступенем активності гепатиту спостерігали репродуктивні   втрати – ранні та пізні викидні, завмерлу вагітність. У 8,7 % вагітних з реплікативними формами HBV-інфекції, високим ВН і мінімальним ступенем цитолізу, пологорозрішення яких проведено шляхом кесарського розтину, всі діти народилися неінфіковані. Висновки. Вертикальна передача ВГВ і ВГС відбувається при високому рівні ВН в ІІІ триместрі вагітності, особливо перед пологами, а також під час природного пологорозрішення таких жінок. Ступінь активності гепатиту не впливає на ризик перинатального інфікування.У жінок з реплікативними формами HВV- та HСV-інфекції мали місце репродуктивні втрати, ймовірно, пов’язані із підвищеною проникливістю плаценти до вірусів.
РІВЕНЬ АДАПТАЦІЙНОГО НАПРУЖЕННЯ І КЛІТИННА РЕАКТИВНІСТЬ ОРГАНІЗМУ ХВОРИХ НА ІНФЕКЦІЙНИЙ МОНОНУКЛЕОЗ, АСОЦІЙОВАНИЙ З ВІРУСОМ ЕПШТЕЙНА-БАРР
Authors: Moskaliuk V. D. , Kryvetska S. S. , Balaniuk I. V. , Boiko Yu. I.
Published: August 2017

Метою роботи було встановити рівень адаптаційного напруження і клітинну реактивність організму хворих на ІМ, асоційований з ВЕБ.Для розширення знань з патогенезу ІМ-АВЕБ доцільно було встановити рівень адаптаційного напруження і клітинної реактивності організму цих хворих. Результати досліджень. Для компенсаторної діагностики була проведена полімеразна ланцюгова реакція (ПЛР) у 9 хворих, у 8 випадках виявлено ДНК ВЕБ, в одного хворого ПЛР не підтвердила наявність ВЕБ. А контрольну групу склали 15 практично здорових осіб (9 чоловічої і 6 жіночої статі) віком від 20 до 25 років.Висновки. Інфекційний мононуклеоз, асоційований з ВЕБ, підтверджується в імунологічному тесті на гетерофільні антитіла, характерною клініко-лабораторною маніфестацією, яка проявляється зростанням відносної кількості агранулоцитів на 51,45 %, абсолютної кількості агранулоцитів – на 80,52 %.
РІВЕНЬ ПОРУШЕННЯ МІСЦЕВОГО ІМУНІТЕТУ СЛИЗОВИХ РОТОВОЇ ПОРОЖНИНИ У ДІТЕЙ, ХВОРИХ НА ІНФЕКЦІЙНИЙ МОНОНУКЛЕОЗ
Authors: Nezhoda I. I. , Bobruk S. V.
Published: August 2017

Мета роботи – визначити ступінь порушення показників місцевого імунітету слизових оболонок орофарингеальної зони у дітей, хворих на ІМ. Результати. Проведене дослідження рівня порушення важливих показників місцевого імунітету орофарингеального секрету (ФНП і сироваткового та секреторного IgА) свідчить, що ІМ перебігає не лише як вірусне запалення, а й є імунодефіцитним захворюванням, яке характеризується значними та тривалими змінами з боку показників імунітету.Висновки. Матеріалом дослідження слугував орофарингеальний секрет, який отримували неінвазивним методом. Це дає змогу застосовувати цю методику для визначення ступеня імунологічних порушень у хворих дітей як критерій ефективності лікування та прогнозувати перебіг захворювання.
КОНЦЕПЦІЯ ОПТИМІЗАЦІЇ МЕДИЧНОЇ ДОПОМОГИ ІНФЕКЦІЙНИМ ХВОРИМ НА РЕГІОНАЛЬНОМУ РІВНІ
Authors: Kharytoniuk R. O. , Hoida N. H. , Martyniuk H. A.
Published: August 2017

Мета – запропонувати науково обґрунтовану організаційно-структурну модель обласного центру інфекційних захворювань на відміну від існуючих окремих структурних підрозділів інфекційного профілю у лікарнях різних рівнів медичної допомоги.Висновки. Пропонується створити обласний центр інфекційних захворювань на засадах функціонального об`єднання при єдиному методичному керівництві. До його складу увійдуть існуючі структури: інфекційне відділення для дорослих, інфекційне відділення для дітей, гепатологічний центр, ліжка профільних відділень. Новими структурними елементами мають стати консультативний кабінет інфекційних захворювань, окремий організаційно-методичний кабінет та інформаційно-аналітичний відділ. Невід`ємним елементом має бути навчально-тренінговий центр для підвищення рівня знань у системі безперервного професійного розвитку не тільки лікарів-інфекціоністів, а й лікарів інших спеціальностей з питань інфекційних захворювань.
ВИПАДОК ПАРАНЕОПЛАСТИЧНОЇ БЕШИХИ
Authors: Kopcha Yu. V.
Published: August 2017

Мета роботи – привернути увагу лікарів до можливості розвитку особливої форми бешихи, що супроводжує онкопатологію, – паранеопластичної.Висновки. Онкопатологія здатна суттєво модифікувати клініку бешихи, зокрема призводити до зростання ступеня інтоксикації, площі ураження і навіть стати причиною «нетипової» локалізації запалення. Це підтверджує доцільність виділення особливої клінічної форми бешихи – паранеопластичної. Цінну інформацію для діагностики цієї хвороби надає термографічне дослідження. Зміни на термограмі зберігаються значно довше, ніж відповідні клінічні прояви, що дає можливість виявити формування хронічної форми і прогнозувати рецидиви.
СЛАВНИЙ ЮВІЛЕЙ ПРОФЕСОРА НАТАЛІ АВРУМІВНИ ВАСИЛЬЄВОЇ
Authors: Of authors Collective
Published: August 2017

Наведено коротку біографічну інформацію про знаного українського вченого-інфекціоніста, досвідченого лікаря-клініциста, професора кафедри інфекційних хвороб з епідеміологією, шкірними і венеричними хворобами Тернопільського державного медичного університету ім. І.Я. Горбачевського, багаторічного невтомного працівника, члена редакційної колегії Всеукраїнського науково-практичного медичного журналу «Інфекційні хвороби» Наталю Аврумівну Васильєву.
Incidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population
Authors: Sigurdsson Sigurdur , Aspelund Thor , Kjartansson Olafur , Gudmundsson Elias F. , Jonsdottir Maria K. , Eiriksdottir Gudny , Jonsson Palmi V. , van Buchem Mark A. , Gudnason Vilmundur , Launer Lenore J.
Published: August 2017

Background and Purpose—

The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia.

Methods—

Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines.

Results—

Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5–2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3–2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9–3.4).

Conclusions—

Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels.
The “Hearts and Minds” Fallacy: Violence, Coercion, and Success in Counterinsurgency Warfare
Authors: Hazelton Jacqueline L.
Published: August 2017

Debates over how governments can defeat insurgencies ebb and flow with international events, becoming particularly contentious when the United States encounters problems in its efforts to support a counterinsurgent government. Often the United States confronts these problems as a zero-sum game in which the government and the insurgents compete for popular support and cooperation. The U.S. prescription for success has had two main elements: to support liberalizing, democratizing reforms to reduce popular grievances; and to pursue a military strategy that carefully targets insurgents while avoiding harming civilians. An analysis of contemporaneous documents and interviews with participants in three cases held up as models of the governance approach—Malaya, Dhofar, and El Salvador—shows that counterinsurgency success is the result of a violent process of state building in which elites contest for power, popular interests matter little, and the government benefits from uses of force against civilians.
Let Us Obey. The Rhetoric of Spartan Identity in Tyrtaeus 2W
Authors: Romney Jessica M.
Published: August 2017

This paper examines the construction of a civic we-identity in the fragments of Tyrtaeus’ Eunomia, focusing on fr. 2 and the strategies by which the poet sought to create a salient we-identity predicated on obedience to the Herakleidai/kings of Sparta and on a past history shared by speaker and audience. I end the paper with a comparison of Herakleid descent in fr. 2 with that in fr. 11 to demonstrate how the rhetorical presentation of identity shifts depending on performance context and poetic genre.
Trade in spur-thighed tortoises Testudo graeca in Morocco: volumes, value and variation between markets
Authors: Nijman Vincent , Bergin Daniel
Published: August 2017

Until the late 1970s spur-thighed tortoisesTestudo graeca, endemic to the Mediterranean region, were exported from range countries in large volumes for the pet trade.Testudo graecawas included on CITES Appendix II in 1975, and in 1978 Morocco introduced national protection, banning domestic and international trade. However, the species is still openly traded in Moroccan markets. In 2013-2014 we conducted 48 surveys in 20 Moroccan towns and cities and single surveys in two Spanish exclaves to assess trade levels, size-composition, turnover, and variation between cities. We recorded 3267T. graecain 107 shops in 12 cities. Of 989 tortoises measured, two-thirds measured <10 cm (∼2-8 years of age) and <3% could comprise first-year individuals. There is a clear relationship between price and size, with ‘average’ tortoises costing USD 9.20. The largest volumes were observed in Tangier (869) and Rabat (752), two cities that are well-connected centres of export. The largest proportion of shops selling tortoises was in Agadir (78%) and Fez (63%), and turnover was highest in Tangier (32/week) and Casablanca (28/week). Country-wide turnover was ∼30% after two weeks and ∼80% after 10 weeks. Annual turnover was estimated at 3500-7000 tortoises, with a monetary value of USD 30 000-60 000. Predictors for volumes of trade and proportion of shops selling tortoises are: the number of wildlife shops in markets, diversity of wild vertebrate species the shops have on offer, and city population. While legal, large-scale international trade of spur-thighed tortoises from Morocco has diminished over the last decades, domestic smaller-scale trade continues to impede their conservation. Consistent punitive measures are required to enforce new laws.
A new species of Pirhosigma Giordani Soika, 1978 (Hymenoptera, Vespidae: Eumeninae), with additional notes and a key to the species in the genus
Authors: FERREIRA WELLINGTON D. , OLIVEIRA LETÍCIA A. DE , INEZ TIAGO G. , HERMES MARCEL G.
Published: August 2017

A new Neotropical species of Pirhosigma Giordani Soika, 1978 is described, Pirhosigma transfluvium Ferreira & Oliveira. The male of Pirhosigma limpidum Giordani Soika, 1978 is reported for the first time. An illustrated identification key is presented for all currently recognized species of Pirhosigma.
Defining and Predicting Heat Waves in Bangladesh
Authors: Nissan Hannah , Burkart Katrin , Coughlan de Perez Erin , Van Aalst Maarten , Mason Simon
Published: August 2017

This paper proposes a heat-wave definition for Bangladesh that could be used to trigger preparedness measures in a heat early warning system (HEWS) and explores the climate mechanisms associated with heat waves. A HEWS requires a definition of heat waves that is both related to human health outcomes and forecastable. No such definition has been developed for Bangladesh. Using a generalized additive regression model, a heat-wave definition is proposed that requires elevated minimum and maximum daily temperatures over the 95th percentile for 3 consecutive days, confirming the importance of nighttime conditions for health impacts. By this definition, death rates increase by about 20% during heat waves; this result can be used as an argument for public-health interventions to prevent heat-related deaths. Furthermore, predictability of these heat waves exists from weather to seasonal time scales, offering opportunities for a range of preparedness measures. Heat waves are associated with an absence of normal premonsoonal rainfall brought about by anomalously strong low-level westerly winds and weak southerlies, detectable up to approximately 10 days in advance. This circulation pattern occurs over a background of drier-than-normal conditions, with below-average soil moisture and precipitation throughout the heat-wave season from April to June. Low soil moisture increases the odds of heat-wave occurrence for 10–30 days, indicating that subseasonal forecasts of heat-wave risk may be possible by monitoring soil-moisture conditions.
Risk Factors of Stomal Recurrence After Laryngectomy: A Systematic Review and Meta-analysis
Authors: Mei Jinyu , Huang Zhaohui , Wu Kaile , Zhao Yi , Yang Jianming , Liu Yehai
Published: August 2017

Objective:

We wished to investigate the risk factors for stoma recurrence following laryngectomy.

Methods:

PubMed, Cochrane Library, and Embase were searched to identify primary research studies published between January 1, 1967, and October 31, 2016. We only included observational epidemiological studies and used risk ratios (RRs) and 95% confidence intervals (CI) to summarize the primary risk factors associated with recurrence following laryngectomy.

Results:

A total of 44 articles, including 11 928 patients, were included in the current meta-analysis. The pooled estimates of the stomal recurrence rate and the local recurrence rate following laryngectomy were 6.60% (95% CI, 5.40-7.90) and 19.40% (95% CI, 14.00%-24.80%), respectively. For stomal recurrence, we confirmed a series of earlier identified factors, including tumor site, prior tracheotomy, tracheotomy timing, T-classification, lymph node metastases, postoperative pharyngoperistomal fistula, and a positive surgical margin. For local recurrence, postoperative radiotherapy, overexpression of p53, and overexpression of p21 were significant, while preoperative tracheostomy and postoperative pharyngoperistomal fistula had an unexpectedly low impact on risk.

Conclusion:

This study has confirmed a series of earlier identified factors for stomal recurrence and local recurrence following laryngectomy. Our results will provide important insights for clinical practice.
Online Teacher Professional Development for Gifted Education: Examining the Impact of a New Pedagogical Model
Authors: Edinger Matthew J.
Published: August 2017

This article theoretically develops and examines the outcomes of a pilot study that evaluates the PACKaGE Model of online Teacher Professional Development (the Model). The Model was created to facilitate positive pedagogical change within gifted education teachers’ practice, attitude, collaboration, content knowledge, and goal effectiveness. Kirkpatrick and Kirkpatrick’s model of training evaluation suggests that trainees should evaluate the training for satisfaction at the time the training is completed, as well as 6 months after, to evaluate for behavior change. Applying Kirkpatrick and Kirkpatrick’s model, findings indicate that teachers were immediately satisfied with the Model’s effectiveness, adequacy, and overall quality. Six months after the online teacher professional development, teachers indicated a strong positive change in each of the five gifted education pedagogical components. Overall, these preliminary findings suggest that the use of the Model creates a positive change within teachers’ gifted education pedagogy.
The Idiom of Scripture, Leviticus 18:5, and Theology at a Time of Paradigm Shift
Authors: Johnson Merwyn S.
Published: August 2017

Leviticus 18:5b ( the one doing them shall live in them) offers a prism through which to view the idiom of Scripture—the distinctive dynamics and theology of the Bible. The verse pinpoints the interplay between God's doing-and-living and ours. At issue is whether the commandments reflect a “command-and-do” structure of life with God, which maximizes a quid pro quo dynamic between God and us; or do the commandments delineate a “covenant place where” we abide with God and God with us, as a gift of shared doing pure and simple? The article traces Leviticus 18:5b through both Old and New Testaments, to show how pervasive it is. The main post-World War II English translations misstate the verse at every turn, in contrast to the 16th-century Church Reformation, which understood the verse and the issue under the topic of Law and Gospel.