bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cost Implications of Less Tight Versus Tight Control of Hypertension in Pregnancy (CHIPS Trial)
Authors: Ahmed Rashid J. , Gafni Amiram , Hutton Eileen K. , Hu Zheng Jing , Pullenayegum Eleanor , von Dadelszen Peter , Rey Evelyne , Ross Susan , Asztalos Elizabeth , Murphy Kellie E. , Menzies Jennifer , Sanchez J. Johanna , Ganzevoort Wessel , Helewa Michael , Lee Shoo K. , Lee Terry , Logan Alexander G. , Moutquin Jean-Marie , Singer Joel , Thornton Jim G. , Welch Ross , Magee Laura A. ,   for the CHIPS Trial Collaborative Group
Published: August 2016

The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned “less tight” (target diastolic 100 mm Hg) and “tight” (target diastolic 85 mm Hg) blood pressure management strategies among women with chronic or gestational hypertension. This study examined which of these management strategies is more or less costly from a third-party payer perspective. A total of 981 women with singleton pregnancies and nonsevere, nonproteinuric chronic or gestational hypertension were randomized at 14 to 33 weeks to less tight or tight control. Resources used were collected from 94 centers in 15 countries and costed as if the trial took place in each of 3 Canadian provinces as a cost-sensitivity analysis. Eleven hospital ward and 24 health service costs were obtained from a similar trial and provincial government health insurance schedules of medical benefits. The mean total cost per woman–infant dyad was higher in less tight versus tight control, but the difference in mean total cost (DM) was not statistically significant in any province: Ontario ($30 191.62 versus $24 469.06; DM $5723, 95% confidence interval, −$296 to $12 272;
P
=0.0725); British Columbia ($30 593.69 versus $24 776.51; DM $5817; 95% confidence interval, −$385 to $12 349;
P
=0.0725); or Alberta ($31 510.72 versus $25 510.49; DM $6000.23; 95% confidence interval, −$154 to $12 781;
P
=0.0637). Tight control may benefit women without increasing risk to neonates (as shown in the main CHIPS trial), without additional (and possibly lower) cost to the healthcare system.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01192412.
Renal Denervation Normalizes Arterial Pressure With No Effect on Glucose Metabolism or Renal Inflammation in Obese Hypertensive Mice
Authors: Asirvatham-Jeyaraj Ninitha , Fiege Jessica K. , Han Ruijun , Foss Jason , Banek Christopher T. , Burbach Brandon J. , Razzoli Maria , Bartolomucci Alessandro , Shimizu Yoji , Panoskaltsis-Mortari Angela , Osborn John W.
Published: August 2016

Hypertension often occurs in concurrence with obesity and diabetes mellitus, commonly referred to as metabolic syndrome. Renal denervation (RDNx) lowers arterial pressure (AP) and improves glucose metabolism in drug-resistant hypertensive patients with high body mass index. In addition, RDNx has been shown to reduce renal inflammation in the mouse model of angiotensin II hypertension. The present study tested the hypothesis that RDNx reduces AP and renal inflammation and improves glucose metabolism in obesity-induced hypertension. Eight-week-old C57BL/6J mice were fed either a low-fat diet (10 kcal%) or a high-fat diet (45 kcal%) for 10 weeks. Body weight, food intake, fasting blood glucose, and glucose metabolism (glucose tolerance test) were measured. In a parallel study, radiotelemeters were implanted in mice for AP measurement. High fat–fed C57BL/6J mice exhibited an inflammatory and metabolic syndrome phenotype, including increased fat mass, increased AP, and hyperglycemia compared with low-fat diet mice. RDNx, but not Sham surgery, normalized AP in high-fat diet mice (115.8±1.5 mm Hg in sham versus 96.6±6.7 mm Hg in RDNx). RDNx had no significant effect on AP in low-fat diet mice. Also, RDNx had no significant effect on glucose metabolism or renal inflammation as measured by the number of CD8, CD4, and T helper cells or levels of inflammatory cytokines in the kidneys. These results indicate that although renal nerves play a role in obesity-induced hypertension, they do not contribute to impaired glucose metabolism or renal inflammation in this model.
Who Knows
Authors: Etchells Tim
Published: August 2016

Who Knows (2014) is an installation comprising 12 pairs of colored neon phrases, modeled on the declension of the verb “to know” which moves though a simple set of variations and reversals. Like much of Etchells’s work Who Knows reveals a fascination with rules and systems in language and in culture, especially in the way these structures are both productive and constraining. The work’s repetition and recombination of individual phrases — “I know,” “You know,” “We know,” “They know”— produces a playful paranoia, nodding to the prescient topics of state and corporate surveillance, snooping and data-harvesting. Who Knows was first shown at Contemporary Art Gallery, Vancouver, as part of a collaboration with the PuSh Festival.
Abstractions of Whiteness in Downtown Los Angeles: Ate9’s Kelev Lavan
Authors: Quinlan Meghan
Published: August 2016

Ate9 Dance Company’s Kelev Lavan raised questions about the politics of individualism and the neutrality of whiteness in art, during a period of acute social tension surrounding police violence against people of color in the US. Issues of technique, aesthetics, and the invisibilization of identity politics are explored in the context of this site-specific performance.
The Functional Segregation and Integration Model: Mixture Model Representations of Consistent and Variable Group-Level Connectivity in fMRI
Authors: Churchill Nathan W. , Madsen Kristoffer , Mørup Morten
Published: August 2016

The brain consists of specialized cortical regions that exchange information between each other, reflecting a combination of segregated (local) and integrated (distributed) processes that define brain function. Functional magnetic resonance imaging (fMRI) is widely used to characterize these functional relationships, although it is an ongoing challenge to develop robust, interpretable models for high-dimensional fMRI data. Gaussian mixture models (GMMs) are a powerful tool for parcellating the brain, based on the similarity of voxel time series. However, conventional GMMs have limited parametric flexibility: they only estimate segregated structure and do not model interregional functional connectivity, nor do they account for network variability across voxels or between subjects. To address these issues, this letter develops the functional segregation and integration model (FSIM). This extension of the GMM framework simultaneously estimates spatial clustering and the most consistent group functional connectivity structure. It also explicitly models network variability, based on voxel- and subject-specific network scaling profiles. We compared the FSIM to standard GMM in a predictive cross-validation framework and examined the importance of different model parameters, using both simulated and experimental resting-state data. The reliability of parcellations is not significantly altered by flexibility of the FSIM, whereas voxel- and subject-specific network scaling profiles significantly improve the ability to predict functional connectivity in independent test data. Moreover, the FSIM provides a set of interpretable parameters to characterize both consistent and variable aspects functional connectivity structure. As an example of its utility, we use subject-specific network profiles to identify brain regions where network expression predicts subject age in the experimental data. Thus, the FSIM is effective at summarizing functional connectivity structure in group-level fMRI, with applications in modeling the relationships between network variability and behavioral/demographic variables.
“I thought of all the beautiful things …”
Authors: Eidelberg Martin
Published: August 2016

In 1921, the noted author and critic Gabriel Mourey recalled a visit he had made sixteen years earlier to see the dying Siegfried Bing, the great French champion of Japonisme. On that occasion in the summer of 1905, they met in Vaucresson where Bing was attempting to convalesce. Mourey recalled in exact detail the appearance of Bing’s apartment in Paris. He remembered the displays of painted screens, statues, and vases so vividly as to almost make Bing’s interior come alive. He also gave a sense of Bing’s intense sensual pleasure in seeing the beautiful things he had collected. We discover that Bing was not merely a merchant but an Aesthete.
Simulated Connections between ENSO and Tropical Cyclones near Guam in a High-Resolution GFDL Coupled Climate Model: Implications for Seasonal Forecasting
Authors: Zhang Wei , Vecchi Gabriel A. , Villarini Gabriele , Murakami Hiroyuki , Delworth Thomas , Jia Liwei , Gudgel Richard , Zeng Fanrong
Published: August 2016

This study aims to assess the connections between El Niño–Southern Oscillation (ENSO) and tropical cyclones near Guam (GuamTCs) using the state-of-the-art Geophysical Fluid Dynamics Laboratory (GFDL) Forecast-Oriented Low Ocean Resolution version of CM2.5 (FLOR). In observations, more (fewer) GuamTCs occur in El Niño (La Niña) years, and the ENSO–GuamTC connections arise from TC genesis locations in ENSO phases. The observed ENSO–GuamTC connections are realistically simulated in the two control experiments that use two versions of FLOR: the standard version and another with flux adjustments (FLOR-FA). The ENSO–GuamTC connections in FLOR-FA are closer to observations than those in FLOR because of a better representation of TC genesis during ENSO phases. The physical mechanisms underlying the observed ENSO–GuamTC connections are further supported in the long-term control experiments with FLOR and FLOR-FA. The ENSO–GuamTC connections in sea surface temperature (SST)- and sea surface salinity (SSS)-restoring experiments with FLOR 1990 strongly resemble the observations, suggesting the ENSO–GuamTC connections arise substantially from the forcing of SST. The prediction skill of FLOR-FA for GuamTC frequency is quite promising in terms of correlation and root-mean-square error and is higher than that of FLOR for the period 1980–2014. This study shows the capability of global climate models (FLOR and FLOR-FA) in simulating the linkage between ENSO and TC activity near a highly localized region (i.e., Guam) and in predicting the frequency of TCs at the subbasin scale.
Detrimental Effects of Community-Based Stigma
Authors: Bresnahan Mary , Zhuang Jie
Published: August 2016

This introductory essay provides an update of the state of stigma research. Following this, an overview of the six stigma studies included in this issue is presented.
A Unique Surgical Technique for Tracheostomy in Heterotopic Ossification
Authors: Cheng Esther , Thorpe Eric
Published: August 2016

Objective:

To describe a technique for tracheostomy in heterotopic ossification that has not yet been described in the literature.

Methods:

We report a case of difficult tracheostomy while using conventional techniques in a 68-year-old patient who underwent mitral valve replacement requiring warfarin therapy three months prior. Imaging revealed heterotopic ossification overlying the trachea. A literature review was performed to identify similar cases or techniques.

Results:

Extensive surgical planning was pursued after the initial attempted tracheostomy failed, and the airway was eventually accessed using a lighted intubation stylet for guidance and a drill. Heterotopic ossification has been described after orthopedic and abdominal surgeries. We identified one case report in the literature of tracheostomy performed in the setting of heterotopic ossification by an unspecified mechanism. There are few reported cases of tracheobronchial calcification in cardiac patients receiving warfarin therapy; however, these patients had characteristic imaging findings that were not consistent with those of our patient.

Conclusions:

We illustrate a safe and effective technique for tracheostomy in heterotopic ossification that has not been reported. Coordination with the anesthesia service was paramount for a successful operation.
The investigation of children and adolescents with abnormalities of pubertal timing
Authors: Wei Christina , Davis Nikki , Honour John , Crowne Elizabeth
Published: August 2016

Concerns with pubertal development are common and can cause considerable distress to patients and their carers. Many presentations reflect normal variations of pubertal timing and primarily require reassurance, although patients may opt for interventions. Other presentations need active management to avoid significant adverse effects on growth and psychosocial development. All should undergo careful assessment, particularly as some children or adolescents presenting with abnormalities in pubertal timing may have serious pathology which requires urgent investigations and treatment. This review describes the appropriate investigations and their interpretation for young people presenting with disorders in pubertal timing.
Screening for Spinal Dysraphisms in Newborns With Sacral Dimples
Authors: Wilson Peyton , Hayes Erin , Barber Andrew , Lohr Jacob
Published: August 2016

Sacral dimples are common physical examination findings among newborns and are rarely associated with spinal dysraphism. Screening ultrasonography for simple sacral dimples in the absence of other physical findings leads to unnecessary health care costs and undue stress on families. This study was a retrospective chart review of infants with a sacral dimple on examination who underwent spinal ultrasonography in the first week of life. The documented indication for ultrasonography was compared to standard guidelines. Among 151 infants in the study, 80% had a normal spinal ultrasound. Of infants with abnormal ultrasonography, 7 (5%) had abnormal spinal magnetic resonance imaging and 2 infants (1%) required neurosurgical intervention. Our study revealed that nearly one-third of infants who underwent spinal ultrasonography had a simple sacral dimple and low likelihood of spinal dysraphism according to existing guidelines. Among patients who underwent spinal ultrasonography in accordance with guidelines, only a small percentage required neurosurgical intervention indicating that guidelines may need to be revised. Larger studies involving multiple centers are necessary to assess this need.
Providing Sanctuary in New York Prisons
Authors: Toch Hans
Published: August 2016

The eminent Dr. Hans Toch reflects on a 1975 New York State Department of Corrections staff workshop on the needs of inmates with mental health issues and his assessment of the evolution of intermediate care programming.
Social Capital and Unretirement: Exploring the Bonding, Bridging, and Linking Aspects of Social Relationships
Authors: Gonzales Ernest , Nowell W. Benjamin
Published: August 2016

Working longer is an important area of research given extended life expectancy, shortfalls of retirement income, desires to remain socially engaged, and solvency concerns of social insurance programs. The purpose of this longitudinal population-based study of older adults is to examine how different types of social resources (social bonding, bridging, and linking) relate to returning to work after retirement. Data were drawn from the Health and Retirement Study of fully retired older adults aged 62+ in 1998 ( N = 8,334) and followed to 2008. After controlling for a comprehensive set of fixed and time-varying covariates, findings suggest that social bridging (informal volunteering) and social linking (formal volunteering, partnered with an employed spouse) were strongly and positively related to returning to work (Hazard Ratio [HR]: 1.49, p < .001; HR: 1.58, p < .0001; and HR: 1.75, p < .0001, respectively). Social bonding resources were not significantly associated with returning to work. Implications for social policy are discussed.
Health Literacy Assessment in an Otolaryngology Clinic Population
Authors: Megwalu Uchechukwu C. , Lee Jennifer Y.
Published: August 2016

Objective

To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy.

Study Design

Cross‐sectional study.

Setting

Tertiary care otolaryngology clinic.

Subjects and Methods

The study population included all adult patients treated at 3 of Stanford University’s adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen.

Results

Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy.

Conclusion

Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes.
Does Everyone Benefit Equally From Self-Efficacy Beliefs? The Moderating Role of Perceived Social Support on Motivation
Authors: Bagci Sabahat Cigdem
Published: August 2016

This study investigated whether perceived goal support from family and friends may moderate the relationship between academic self-efficacy and motivational outcomes among early adolescent students recruited from a low-middle socio-economic status(SES) background school in Turkey ( N = 319, [Formula: see text]age = 13.13, SD = .80). Self-report questionnaires included measures of academic self-efficacy, perceived family and friend support, and academic and career motivations. Academic self-efficacy and perceived support from family related positively to both types of motivation. Children who perceived lower family support benefited more from the positive effects of self-efficacy on motivations, whereas children with higher family support seemed to gain less (or not gain at all) from self-enhancing functions of self-efficacy. Same findings were found for peer support, but only when family support was excluded from analyses. Findings implied the need to study larger family and peer contexts under which self-efficacy beliefs may be more or less effective on motivation.
Determinants of Change in the Cost-effectiveness Threshold
Authors: Paulden Mike , O’Mahony James , McCabe Christopher
Published: August 2016

The cost-effectiveness threshold in health care systems with a constrained budget should be determined by the cost-effectiveness of displacing health care services to fund new interventions. Using comparative statics, we review some potential determinants of the threshold, including the budget for health care, the demand for existing health care interventions, the technical efficiency of existing interventions, and the development of new health technologies. We consider the anticipated direction of impact that would affect the threshold following a change in each of these determinants. Where the health care system is technically efficient, an increase in the health care budget unambiguously raises the threshold, whereas an increase in the demand for existing, non-marginal health interventions unambiguously lowers the threshold. Improvements in the technical efficiency of existing interventions may raise or lower the threshold, depending on the cause of the improvement in efficiency, whether the intervention is already funded, and, if so, whether it is marginal. New technologies may also raise or lower the threshold, depending on whether the new technology is a substitute for an existing technology and, again, whether the existing technology is marginal. Our analysis permits health economists and decision makers to assess if and in what direction the threshold may change over time. This matters, as threshold changes impact the cost-effectiveness of interventions that require decisions now but have costs and effects that fall in future periods.
Triple rule-out CT angiography protocol with restricting field of view for detection of pulmonary thromboembolism and aortic dissection in emergency department patients: simulation of modified CT protocol for reducing radiation dose
Authors: Kim Hyun Su , Kim Sung Mok , Cha Min Jae , Kim Yoo Na , Kim Hae Jin , Choi Jin-Ho , Choe Yeon Hyeon
Published: August 2016

Background

Triple rule-out computed tomography (TRO CT) is a CT protocol designed to simultaneously evaluate the coronary, aorta, and pulmonary arteries.

Purpose

To evaluate potential diagnostic performance of TRO CT with restricted volume coverage for detection of pulmonary thromboembolism (PTE) and aortic dissection (AD).

Material and Methods

This study included 1224 consecutive patients with acute chest pain who visited the emergency department and underwent TRO CT using a 128-slice dual-source CT. Image data were reconstructed according to the display field of view (DFOV) of coronary CT angiography (CCTA) and TRO CT protocols in each patient. The presence of PTE and AD was evaluated by independent observers in each DFOV. The radiation dose was calculated to evaluate the potential benefits by restricting z-axis coverage to cardiac scan range instead of the whole thorax.

Results

Among all patients, 22 cases with PTE (1.9%) and nine cases with AD (0.8%) were found. Except for one PTE case, all cases were detected on both DFOV of TRO CT and CCTA. Mean effective dose for evaluation of entire thorax and cardiac scan coverage were 5.9 ± 1.1 mSv and 3.5 ± 0.7 mSv, respectively.

Conclusion

Isolated PTE and AD outside the CCTA DFOV rarely occur. Therefore, modified TRO CT protocol using cardiac scan coverage can be adopted to detect PTE and AD with reduced radiation dose.
New Insights into Rental Housing Markets across the United States: Web Scraping and Analyzing Craigslist Rental Listings
Authors: Boeing Geoff , Waddell Paul
Published: August 2016

Current sources of data on rental housing—such as the census or commercial databases that focus on large apartment complexes—do not reflect recent market activity or the full scope of the US rental market. To address this gap, we collected, cleaned, analyzed, mapped, and visualized eleven million Craigslist rental housing listings. The data reveal fine-grained spatial and temporal patterns within and across metropolitan housing markets in the United States. We find that some metropolitan areas have only single-digit percentages of listings below fair market rent. Nontraditional sources of volunteered geographic information offer planners real-time, local-scale estimates of rent and housing characteristics currently lacking in alternative sources, such as census data.
Rheological and mechanical properties of polyphenylene sulfide reinforced with round and rectangle cross-section glass fibers
Authors: Jiang Tao , Geng Chengzhen , Zhou Hanmei , Lu Ai
Published: August 2016

Two kinds of glass fibers with round (RdGF) and rectangle cross-sections (RcGF) were used to reinforce polyphenylene sulfide (PPS), respectively. In this way, the effect of fiber cross-section shape on rheological and mechanical properties of the composites was studied for the first time. Results showed that the viscosity of the composites reinforced with RcGF was much lower than that of RdGF composites, owing to their higher sensitivity to flow. As a result, PPS/RcGF composites could be injection-molded at high fiber contents. Moreover, RcGF showed a better reinforcing effect on mechanical properties of PPS. So the use of RcGF could better balance the contradiction between processability and reinforcing effect for glass fiber-reinforced composites. Various characterizations were carried out to reveal the reinforcing mechanism. This work demonstrated the importance of fiber cross-section shape on design and production of fiber-reinforced composites.
Validation of an electrophoretic method to detect albuminuria in cats
Authors: Ferlizza Enea , Dondi Francesco , Andreani Giulia , Bucci Diego , Archer Joy , Isani Gloria
Published: August 2016

Objectives

The aims of this study were to validate a semi-automated high-resolution electrophoretic technique to quantify urinary albumin in healthy and diseased cats, and to evaluate its diagnostic performance in cases of proteinuria and renal diseases.

Methods

Urine samples were collected from 88 cats (healthy; chronic kidney disease [CKD]; lower urinary tract disease [LUTD]; non-urinary tract diseases [OTHER]). Urine samples were routinely analysed and high-resolution electrophoresis (HRE) was performed. Within-assay and between-assay variability, linearity, accuracy, recovery and the lowest detectable and quantifiable bands were calculated. Receiver operating curve (ROC) analysis was also performed.

Results

All coefficients of variation were <10%, percentage recovery was between 97% and 109% with a high linearity (r = 0.99). HRE allowed the visualisation of a faint band of albumin and a diffused band between alpha and beta zones in healthy cats, while profiles from diseased cats were variable. Albumin (mg/dl) and urine albumin:creatinine ratio (UAC) were significantly ( P <0.05) different between healthy and diseased cats. After ROC analysis, UAC values of 0.035 and 0.074 had a high sensitivity and high specificity, respectively, to classify proteinuria and identify borderline proteinuric cats. Moreover, a UAC of 0.017 had a high sensitivity in distinguishing between healthy and diseased cats. However, UAC was not able to distinguish between renal (CKD) and non-renal diseases (LUTD/OTHER), probably owing to the pathophysiology of CKD in cats, which is characterised by low-grade proteinuria and less glomerular involvement than in dogs.

Conclusions and relevance

HRE is an accurate and precise method that could be used to measure albuminuria in cats. UAC was useful to correctly classify proteinuria and to discriminate between healthy and diseased cats. HRE might also provide additional information on urine proteins with a profile of all proteins (albumin and globulins) to aid clinicians in the diagnosis of diseases characterised by proteinuria.
Education differences in cancer fatalism: The role of information-seeking experiences
Authors: Emanuel Amber S , Godinho Cristina A , Steinman Christopher , Updegraff John A
Published: August 2016

Cancer fatalism is the belief that cancer is uncontrollable and lethal. Individuals with less education are more likely to hold fatalistic beliefs about cancer, but the mechanism accounting for the relationship is unknown. We tested whether negative health information seeking experiences explain this relationship. Structural equation modeling was used to test this relationship across three datasets from the Health Information National Trends Survey. Across all datasets, the model showed good fit: Cycle 1 (coefficient of determination = .11, comparative fit index = .96, root mean square error of approximation = .047), Cycle 2 (coefficient of determination = .06, comparative fit index = .96, root mean square error of approximation = .046), and Cycle 3 (coefficient of determination = .08, comparative fit index = .95, root mean square error of approximation = .052). The link between lower education level and higher cancer fatalism was partially mediated by negative health information seeking experiences.
The Limits of Liberal Planning
Authors: Kroessler Jeffrey A.
Published: August 2016

Staten Island grew rapidly after the Verrazano Narrows Bridge opened in 1964. Mayor John Lindsay introduced a plan to control and guide development there and encouraged planned unit development. The Rouse Company, then building Columbia, Maryland, was contracted to plan new communities for the southern third of Staten Island to more than double the borough’s population. State Senator John Marchi introduced legislation for the South Richmond Development Corporation in 1971. The plan called for the city to use eminent domain to buy property and transfer it to the Rouse Company, which would also construct residential towers on landfill in Raritan Bay. Behind the banner of private property rights, the Conservative Party led opposition to the proposal, and their influence over elected officials on Staten Island led to the legislation’s defeat in Albany. Private development in South Richmond proceeded apace in the decades after without significant design or environmental constraints, or any master plan.
Voices from across the divide: An industrial relations perspective on employee voice
Authors: Wilkinson Adrian , Barry Michael
Published: August 2016

In this commentary we note that there is increasing interest in the topic of employee voice; however, we argue that there has been little effort to broaden our existing conceptualizations of voice, which are artefacts of disparate disciplines. The siloed approach, we argue, applies in particular to the view of voice in the field of organizational behaviour (OB) which dominates much of this special issue. We explain how taking an Industrial Relations (IR) perspective on voice can add value to our understanding by looking at voice as a means to challenge management, or as a vehicle for employee self-determination
Obesity Severity and Duration Are Associated With Incident Metabolic Syndrome: Evidence Against Metabolically Healthy Obesity From the Multi-Ethnic Study of Atherosclerosis
Authors: Mongraw-Chaffin Morgana , Foster Meredith C. , Kalyani Rita R. , Vaidya Dhananjay , Burke Gregory L. , Woodward Mark , Anderson Cheryl A.M.
Published: August 2016

Context:

Although the health risks of obesity compared to normal weight have been well studied, the cumulative risk associated with chronic obesity remains unknown. Specifically, debate continues about the importance of recommending weight loss for those with metabolically healthy obesity.

Objective:

We hypothesized that relatively greater severity and longer duration of obesity are associated with greater incident metabolic syndrome.

Design, Setting, Participants, and Measures:

Using repeated measures logistic regression with random effects, we investigated the association of time-varying obesity severity and duration with incident metabolic syndrome in 2,748 Multi-Ethnic Study of Atherosclerosis participants with obesity (body mass index ≥30 kg/m2) at any visit. Obesity duration was defined as the cumulative number of visits with measured obesity and obesity severity by the World Health Organization levels I–III based on body mass index. Metabolic syndrome was defined using Adult Treatment Panel III criteria modified to exclude waist circumference.

Results:

Higher obesity severity (level II odds ratio [OR], 1.32 [95% confidence interval, 1.09–1.60]; level III OR, 1.63 [1.25–2.14] vs level I) and duration (by number of visits: two visits OR, 4.43 [3.54–5.53]; three visits OR, 5.29 [4.21–6.63]; four visits OR, 5.73 [4.52–7.27]; five visits OR, 6.15 [4.19–9.03] vs one visit duration of obesity) were both associated with a higher odds of incident metabolic syndrome.

Conclusion:

Both duration and severity of obesity are positively associated with incident metabolic syndrome, suggesting that metabolically healthy obesity is a transient state in the pathway to cardiometabolic disease. Weight loss should be recommended to all individuals with obesity, including those who are currently defined as metabolically healthy.
Diagnosis of Intraabdominal Fluid Extravasation After Hip Arthroscopy With Point-of-Care Ultrasonography Can Identify Patients at an Increased Risk for Postoperative Pain
Authors: Haskins Stephen C. , Desai Natasha A. , Fields Kara G. , Nejim Jemiel A. , Cheng Stephanie , Coleman Struan H. , Nawabi Danyal H. , Kelly Bryan T.
Published: August 2016

BACKGROUND:

Intraabdominal fluid extravasation (IAFE) after hip arthroscopy has historically been diagnosed in catastrophic circumstances with abdominal compartment syndrome requiring diuresis or surgical decompression. A previous retrospective study found the prevalence of symptomatic IAFE requiring diuresis or decompression to be 0.16%, with risk factors including surgical procedure and high pump pressures. IAFE can be diagnosed rapidly by using point-of-care ultrasound (POCUS) via the Focused Assessment With Sonography for Trauma (FAST) examination, which is a well-established means to detect free fluid with high specificity and sensitivity. In this study, we used POCUS to determine the incidence of IAFE in patients undergoing hip arthroscopy. We predicted a higher incidence and that patients with IAFE would have symptoms of peritoneal irritation such as pain and nausea.

METHODS:

One hundred patients undergoing ambulatory hip arthroscopy were prospectively enrolled. A FAST examination was performed after induction by a trained anesthesiologist to exclude the preoperative presence of intraperitoneal fluid. Postoperatively, the same anesthesiologist repeated the FAST examination, and patients with new fluid in the abdominal or pelvic peritoneum were diagnosed with IAFE. Patients were followed up in the postanesthesia care unit (PACU) for 6 hours assessing pain, antiemetic and opioid use, and length of stay.

RESULTS:

Sixteen of 100 patients were found to have IAFE (16.0%; 99% confidence interval [CI], 8.4–28.1). These patients had, on average, a greater increase in pain score from their baseline assessment throughout their entire PACU stay (adjusted difference in means [99% CI]: 2.1 points [0.4–3.9]; P = .002). Patients with IAFE used more opioids, but this difference did not meet statistical significance (adjusted difference in means [99% CI]: 7.8 mg oral morphine equivalents [−2.8 to 18.3]; P = .053). There were no differences in postoperative nausea interventions or length of stay.

CONCLUSIONS:

Our incidence of IAFE was 16%, showing that IAFE occurs quite commonly in hip arthroscopy. Patients with IAFE had a greater increase in pain scores from baseline throughout the PACU stay. None of our patients required interventions. These findings suggest that even a small amount of new fluid in the peritoneum may be associated with a worse postoperative experience. This study brings awareness to a common yet potentially life-threatening complication of hip arthroscopy and highlights a unique and meaningful way that anesthesiologists in the perioperative setting can use POCUS to rapidly identify and guide management of these patients. Further studies with a larger sample size are needed to identify surgical and patient risk factors.
Is Arabic Untranslatable?
Authors: Creswell Robyn
Published: August 2016

In “Embargoed Literature,” an essay written twenty-five years ago, Edward W. Said noted that “of all the major world literatures, Arabic remains relatively unknown and unread in the West.” How is it that one of the world’s great literary corpuses, as rich as those of classical Greek, Sanskrit, and Chinese, has so little echo in English? Is Arabic literature untranslatable? The obstacles in this case are political as much as they are linguistic. Taking its cue from Said’s notion of a “perfect inequality” between the two languages, this essay argues for a situational—rather than literal—approach to translation, emphasizing the intellectual gains (and risks) to be had from thinking of translation as an act of cultural interpretation rather than verbal substitution.
Property, Dispossession, and Citizenship in Turkey; Or, the History of the Gezi Uprising Starts in the Surp Hagop Armenian Cemetery
Authors: Parla Ayşe , Özgül Ceren
Published: August 2016

This article focuses on the state confiscation of the Surp Hagop Armenian cemetery as more than just another fact about the famous 2013 protests in Gezi Park in Istanbul. In addition to coming to terms with the limits of the Gezi uprising in relation to its claims of inclusiveness, such a focus unravels the key tension between, on the one hand, progressive and left-wing calls to promote the allegedly equal, universal citizen in Turkey through protest movements and, on the other hand, the differential property regime on which the Turkish nation-state is founded, the denial of which continues to erode the possibility of equal citizenship. The article demonstrates how the systematic confiscation of Armenian property is normalized in everyday discourse and politics in Turkey in the service of the broader legal governance of minority difference.
Identification of selective inhibitors of RET and comparison with current clinical candidates through development and validation of a robust screening cascade
Authors: Watson Amanda J. , Hopkins Gemma V. , Hitchin Samantha , Begum Habiba , Jones Stuart , Jordan Allan , Holt Sarah , March H. Nikki , Newton Rebecca , Small Helen , Stowell Alex , Waddell Ian D. , Waszkowycz Bohdan , Ogilvie Donald J.
Published: August 2016

RET (REarranged during Transfection) is a receptor tyrosine kinase, which plays pivotal roles in regulating cell survival, differentiation, proliferation, migration and chemotaxis. Activation of RET is a mechanism of oncogenesis in medullary thyroid carcinomas where both germline and sporadic activating somatic mutations are prevalent.

At present, there are no known specific RET inhibitors in clinical development, although many potent inhibitors of RET have been opportunistically identified through selectivity profiling of compounds initially designed to target other tyrosine kinases. Vandetanib and cabozantinib, both multi-kinase inhibitors with RET activity, are approved for use in medullary thyroid carcinoma, but additional pharmacological activities, most notably inhibition of vascular endothelial growth factor - VEGFR2 (KDR), lead to dose-limiting toxicity. The recent identification of RET fusions present in ~1% of lung adenocarcinoma patients has renewed interest in the identification and development of more selective RET inhibitors lacking the toxicities associated with the current treatments.

In an earlier publication [Newton et al, 2016; 1] we reported the discovery of a series of 2-substituted phenol quinazolines as potent and selective RET kinase inhibitors. Here we describe the development of the robust screening cascade which allowed the identification and advancement of this chemical series.  Furthermore we have profiled a panel of RET-active clinical compounds both to validate the cascade and to confirm that none display a RET-selective target profile.
Recent advances in understanding and managing asthma
Authors: Loo Su-Ling , Wark Peter A.B.
Published: August 2016

This review highlights the important articles published in the area of asthma research from January 2015 to July 2016. In basic science, significant advances have been made in understanding the link between the innate immune response and type II acquired immune responses in asthma and the role of the airway epithelium. Novel information continues to emerge with regard to the pathogenesis and heterogeneity of severe asthma. There have been important translational clinical trials in the areas of childhood asthma, treatment of allergy to improve asthma outcomes, and improving drug delivery to optimize the management of asthma. In addition, there are increasing data concerning the application of biological agents to the management of severe asthma. This body of work discusses the most notable advances in the understanding and management of asthma.
Research roundup: August 2016
Authors: Seal Joanne , Thurtle Val , Brook Judy
Published: August 2016

In this section, a range of brief synopses of recently published articles that may be of interest to health visitors is presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.
Domestic abuse: A public health epidemic?
Authors: Forbes Lisa
Published: August 2016

The 2016 Women's Aid annual conference on 7 July brought together a range of speakers, addressing issues such as health commissioning and mental health in relation to domestic abuse. Lisa Forbes reports
The use of a mobile app in health visiting to support school readiness
Authors: Lee Fiona , Wright Paula
Published: August 2016

Starting school is a major milestone in family life, and there is increasing awareness that a child who is ‘ready for school’ when they begin full-time education is more likely to reach their full potential. This is not only in terms of academic achievement, but also social and behavioural skills, which have an impact later in adulthood ( UNICEF, 2012 ). Health visitors' responsibilities include supporting parents to maximise their child's health and development from birth onwards—a complex and challenging remit for which they need to be continually developing engaging strategies and tools ( Department of Health, 2009 ). This article reviews the collaborative development of a school readiness mobile app for Bridgewater Community Foundation NHS Trust. The project won the prestigious 2016 Journal of Health Visiting Award for School Readiness, and the University of Chester was recognised as a key collaborator in this innovative development. The article seeks to inspire health visiting colleagues to search for collaborative partners to address school readiness in an engaging way with parents.
Minor injuries and ailments. 8: Croup
Authors: Tinsley Elizabeth
Published: August 2016

Croup affects about 3% of children a year in the UK, with 75% of cases caused by the para-influenza virus. It is most common in children aged 6 months to 3 years, but can occur from 3 months to 15 years and rarely occurs in adults. It is most common in late autumn and winter; generally affects more boys than girls; and children will usually suffer from croup more then once. This article will focus on managing and treating croup in children at home; when parents should be advised to attend A&E; and when to call an ambulance.
Challenging health inequalities
Authors: Bailey Beverley
Published: August 2016

In over 35 years of health visiting practice at the front line it has been a privilege to have unique access to the lives of families in a wide range of circumstances, says Bev Bailey. But in three decades have we come as far as we think?
What Is Charity?
Authors: Lichtenberg Judith
Published: August 2016

Once revered as the greatest of the classic theological virtues, charity now has something of a bad rap. Can it be rehabilitated with help from the Jewish sage Maimonides?
Regulatory Review and Cost-Benefit Analysis
Authors: Sagoff Mark
Published: August 2016

President Obamas recent memorandum calling for an overhaul of White House regulatory policies provides an opportunity to revisit our reliance on cost-benefit analysis as a fundamental regulatoryprinciple.
Penetrating foreign body in the masticator space with injury to the internal maxillary artery: a surgical challenge
Authors: Tan Shaun S , Yeo MS , Lee GHP , Ho MSY , Ang ML , Lee W , Cheong EC
Published: August 2016

INTRODUCTION

Foreign bodies (FBs) in the masticator space (MS) are a unique problem because of the difficulty of accessing this deep compartment within the head and neck. In addition, MS contents include critical structures such as the internal maxillary artery (IMA) and mandibular nerve.

CASE HISTORY

A 39-year-old tradesman was involved in a construction accident whereby a metallic projectile from a machinery drill penetrated his left cheek. Computed tomography revealed a metallic object of dimension 1.9 ×1.2 cm within the MS, with concomitant fracture of left maxillary anterior and lateral walls. Surgery was indicated in view of constant pain and swelling. The FB was removed through the cheek laceration with the aid of an X-ray image intensifier. Persistent significant bleeding was observed within the wound cavity after FB removal that could not be arrested despite attempts at haemostasis with adrenaline packing and oxidised cellulose polymers. Urgent selective left external carotid angiography showed breach of a distal branch of the left internal maxillary artery with contrast extravasation. Embolisation of this branch was undertaken successfully with a liquid agent.

CONCLUSIONS

This is the first time a FB within the MS with injury to the internal maxillary artery has been described.
A case of gastroduodenal lipomatosis
Authors: Jayasundara JASB , Sellahewa CS , Hall AD , Patel RT
Published: August 2016

Although sporadic lipomas are not uncommon in the upper gastrointestinal tract, diffuse gastroduodenal lipomatosis is a rare clinical entity. Medical literature reveals a limited number of such cases presenting with upper gastrointestinal obstruction or bleeding. We present the management experience of a 43-year-old woman who presented with intussusception causing high small-bowel obstruction secondary to jejunal lipomatosis. Computed tomography showed diffuse fatty thickening of the gastric wall in addition to multiple lipomas in stomach, duodenum and in the jejunum with jejunal intussusception. As complete resection of the affected segment was not possible, a side-to-side jejunal bypass was made. The patient remains well on review after 18 months.
Mantle cell lymphoma: primary oral presentation
Authors: Ainscough S , Power AM , Brown AN
Published: August 2016

Mantle-cell lymphoma is an uncommon lymphoid malignancy of B-cells. It is often aggressive and prognosis is poor. A 69-year-old gentleman with a history of ischaemic heart disease was referred from primary care with a painless right floor of mouth swelling that had been present for 1 month. He otherwise completely asymptomatic. Incisional biopsy of the lesion was undertaken and marker studies demonstrated mantle cell lymphoma. Positron emission tomography–computed tomography and bone marrow biopsy showed widespread but low volume involvement. The patient was referred to the haematology multidisciplinary team for further assessment and treatment.
Picturing the Charlie Hebdo Incident in Arabic Political Cartoons
Authors: Sadam Issa
Published: August 2016

This article investigates how the Arabic political cartoons picture the mocking cartoons of the Prophet Muhammad by the French satirical Charlie Hebdo magazine.1 It is noticed that the cartoons utilize the Charlie Hebdo incident as a locus to deconstruct the unjustness and bias of the Arabic leadership and the international community in their dealing with some Arabic political issues. The surveyed cartoons also used the Charlie Hebdo incident as a locus to formulate the Palestinian “imagined community” (Anderson, 1991). I argue that the surveyed cartoons use the strategy of “differentiation” (Meyer, 2000) based on the self vs. other dichotomy to establish this deconstruction and imagined community. The study uses the semio-linguistic and visual rhetorical tools (Barthes, 1972), and self-categorization (Turner, 1987) to achieve this deconstruction, through an analysis of semiotic-discursive aspects of a small corpus of Arabic political cartoons. The findings indicate that promoting a discourse of fear and danger toward the inside and outside actors is what constitutes this self-other-based identity.