bluuebunny/crossref_metadata_2025 huggingface dataset:
Giant schwannomas of the sciatic nerve
Authors: As-Sultany Mohammed , Ben-Ghashir Najla , Mistry Alpesh , Chandrasekar Coonoor
Published: July 2017

We report a very rare case of giant schwannomas of the sciatic nerve in a 39-year-old woman who presented with increasing swelling and discomfort in the posterior aspect of her right thigh. We demonstrate that even with such large tumours, surgical excision could be successfully carried out to resolve all symptoms while causing no permanent nerve damage. It remains paramount that large soft tissue tumours get referred to a sarcoma centre and be managed by a specialist multidisciplinary team.
Primary greater omental GIST presenting with acute intra-abdominal haemorrhage
Authors: Islam Shariful , Hosein Devin , Bheem Vinoo , Harnarayan Patrick
Published: July 2017

Primary omental gastrointestinal stromal tumours (GISTs) are classified as extra-GISTs with a reported incidence of <1% of all GISTs. There are only a few cases in the English literature reporting omental GIST with none reporting acute intra-abdominal haemorrhage as a presenting feature. We report a case of a 67-year-old man who presented with haemorrhage from a primary omental GIST requiring emergency laparotomy.
Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
Authors: Inada Ryo , Nagasaka Takeshi , Watanabe Ayako , Yagi Tomohiko , Mori Yoshiko , Kondo Yoshitaka , Kishimoto Hiroyuki , Umeda Yuzo , Fujiwara Toshiyoshi
Published: July 2017

Background and aims

Whether asymptomatic patients with colorectal cancer (CRC) who are treated in hospitals show better outcomes than symptomatic patients with CRC still remains unknown. The aim of this study was to evaluate differences in clinical benefits following treatment in asymptomatic and symptomatic patients with CRC.

Methods

This study was a retrospective cohort analysis with data obtained from records. A cohort of 145 asymptomatic and 123 symptomatic patients who underwent CRC surgery between January 2009 and December 2011 was enrolled. To reduce bias in comparing outcomes, propensity score (PS) analysis was used for matching of patients in the symptomatic and asymptomatic groups based on clinicopathological factors. Surgical invasiveness, medical costs and oncological outcomes were examined by unadjusted and PS-matched analysis.

Results

Tumours in the symptomatic group were more often diagnosed in advanced stages compared with tumours in the asymptomatic group. Therefore, fewer symptomatic group patients underwent minimally invasive surgery. Short-term outcomes, including amount of blood loss, duration of postoperative hospital stay and perioperative medical costs, were significantly better in the asymptomatic group. Although overall survival was significantly better in the asymptomatic group, there was no significant difference between the groups when the patients were adjusted on the basis of PS.

Conclusions

Though this study was limited by the retrospective nature and small sample size, favourable outcomes in asymptomatic patients were due to the higher proportion of patients in this group who were diagnosed with CRC in earlier stages, due to participation in CRC screening programmes.
Prevalence and screening for anaemia in mild to moderate Crohn's disease and ulcerative colitis in the United States, 2010–2014
Authors: Akhuemonkhan Eboselume , Parian Alyssa , Miller Kay , Hanauer Stephen , Hutfless Susan
Published: July 2017

Background and aims

Anaemia affects up to 74% patients with Crohn's disease (CD) and ulcerative colitis (UC) and is correlated with decreased quality of life. The European Crohn's and Colitis Organisation (ECCO) recommends at least annual screening for iron-deficiency anaemia. We aimed to determine the prevalence of anaemia, frequency of anaemia screening and factors associated with anaemia in a retrospective study of mild to moderate inflammatory bowel disease (IBD) in the USA.

Methods

Adults with at least two outpatient encounters for IBD between 2010 through 2014 who contributed laboratory information were identified from MarketScan, a US commercial claims database. Hospitalised patients were considered severe and excluded from the study. WHO criteria defined anaemia. Iron-deficiency anaemia was evaluated using ferritin and C reactive protein.

Results

The eligible population included 17 059 adults, 43.9% with CD. During the 2-year median follow-up period, 68.1% of patients with CD and 65.3% of patients with UC were screened for anaemia. The prevalence of anaemia among those screened was 32.4% in CD and 27.6% in UC. Among 669 persons with sufficient information, 79.2% of those with CD and 85.1% of those with UC had iron-deficiency anaemia. Factors associated with anaemia were similar for those with CD and UC and included ≥6 IBD-related outpatient visits, female sex, age and smoking.

Conclusions

More than 30% of patients with IBD in the USA were not screened for anaemia during a 2-year period. Approximately 82% of anaemic patients were iron deficient, although the absence of ferritin results limited the findings. Incorporation of screening for anaemia and, in particular, iron deficiency, should be a component of international treatment guidelines.
Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial
Authors: Bourne Simon , DeVos Ruth , North Malcolm , Chauhan Anoop , Green Ben , Brown Thomas , Cornelius Victoria , Wilkinson Tom
Published: July 2017

Objective

To obtain evidence whether the online pulmonary rehabilitation(PR) programme ‘my-PR’ is non-inferior to a conventional face-to-face PR in improving physical performance and symptom scores in patients with COPD.

Design

A two-arm parallel single-blind, randomised controlled trial.

Setting

The online arm carried out pulmonary rehabilitation in their own homes and the face to face arm in a local rehabilitation facility.

Participants

90 patients with a diagnosis of chronic obstructive pulmonary disease (COPD), modified Medical Research Council score of 2 or greater referred for pulmonary rehabilitation (PR), randomised in a 2:1 ratio to online (n=64) or face-to-face PR (n=26). Participants unable to use an internet-enabled device at home were excluded.

Main outcome measures

Coprimary outcomes were 6 min walk distance test and the COPD assessment test (CAT) score at completion of the programme.

Interventions

A 6-week PR programme organised either as group sessions in a local rehabilitation facility, or online PR via log in and access to 'myPR’.

Results

The adjusted mean difference for the 6 min walk test (6MWT) between groups for the intention-to-treat (ITT) population was 23.8 m with the lower 95% CI well above the non-inferiority threshold of −40.5 m at −4.5 m with an upper 95% CI of +52.2 m. This result was consistent in the per-protocol (PP) population with a mean adjusted difference of 15 m (−13.7 to 43.8). The CAT score difference in the ITT was −1.0 in favour of the online intervention with the upper 95% CI well below the non-inferiority threshold of 1.8 at 0.86 and the lower 95% CI of −2.9. The PP analysis was consistent with the ITT.

Conclusion

PR is an evidenced-based and guideline-mandated intervention for patients with COPD with functional limitation. A 6-week programme of online-supported PR was non-inferior to a conventional model delivered in face-to-face sessions in terms of effects on 6MWT distance, and symptom scores and was safe and well tolerated.
Identification of the delivery of cognitive behavioural therapy for psychosis (CBTp) using a cross-sectional sample from electronic health records and open-text information in a large UK-based mental health case register
Authors: Colling Craig , Evans Lauren , Broadbent Matthew , Chandran David , Craig Thomas J , Kolliakou Anna , Stewart Robert , Garety Philippa A
Published: July 2017

Objective

Our primary objective was to identify cognitive behavioural therapy (CBT) delivery for people with psychosis (CBTp) using an automated method in a large electronic health record database. We also examined what proportion of service users with a diagnosis of psychosis were recorded as having received CBTp within their episode of care during defined time periods provided by early intervention or promoting recovery community services for people with psychosis, compared with published audits and whether demographic characteristics differentially predicted the receipt of CBTp.

Methods

Both free text using natural language processing (NLP) techniques and structured methods of identifying CBTp were combined and evaluated for positive predictive value (PPV) and sensitivity. Using inclusion criteria from two published audits, we identified anonymised cross-sectional samples of 2579 and 2308 service users respectively with a case note diagnosis of schizophrenia or psychosis for further analysis.

Results

The method achieved PPV of 95% and sensitivity of 96%. Using the National Audit of Schizophrenia 2 criteria, 34.6% service users were identified as ever having received at least one session and 26.4% at least two sessions of CBTp; these are higher percentages than previously reported by manual audit of a sample from the same trust that returned 20.0%. In the fully adjusted analysis, CBTp receipt was significantly (p<0.05) more likely in younger patients, in white and other when compared with black ethnic groups and patients with a diagnosis of other schizophrenia spectrum and schizoaffective disorder when compared with schizophrenia.

Conclusions

The methods presented here provided a potential method for evaluating delivery of CBTp on a large scale, providing more scope for routine monitoring, cross-site comparisons and the promotion of equitable access.
The realities of partnership in person-centred care: a qualitative interview study with patients and professionals
Authors: Wolf Axel , Moore Lucy , Lydahl Doris , Naldemirci Öncel , Elam Mark , Britten Nicky
Published: July 2017

Objective

Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships. While this may increase patients’ sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice.

Design

Qualitative study employing a thematic analysis of semistructured interviews with professionals and patients.

Setting

Four internal medicine wards and two primary care centres in western Sweden.

Participants

16 health professionals based at hospital wards or primary care centres delivering person-centred care, and 20 patients admitted to one of the hospital wards.

Results

Our findings identified both informal and formal aspects of partnership. Informal aspects, emerging during the interaction between healthcare professionals and patients, without any prior guidelines or regulations, incorporated proximity and receptiveness of professionals and building a close connection and confidence. This epitomised a caring, respectful relationship congruent across accounts. Formal aspects, including structured ways of sustaining partnership were experienced differently. Professionals described collaborating with patients to encourage participation, capture personal goals, plan and document care. However, although patients felt listened to and informed, they were content to ask questions and felt less involved in care planning, documentation or exploring lifeworld goals. They commonly perceived participation as informed discussion and agreement, deferring to professional knowledge and expertise in the presence of an empathetic and trusting relationship.

Conclusions

In our study, patients appear to value a process of human connectedness above and beyond formalised aspects of documenting agreed goals and care planning. PCC increases patients’ confidence in professionals who are competent and able to make them feel safe and secure. Informal elements of partnership provide the conditions for communication and cooperation on which formal relations of partnership can be constructed.
Incidence of live-attenuated influenza vaccine administration beyond expiry date in children and adolescents aged 2–17 years in the UK: a population-based cohort study
Authors: Caspard Herve , Wise Robert P , Steffey Amy , Brody Robert S
Published: July 2017

Objectives

To estimate the proportion of live-attenuated influenza vaccine (LAIV) doses administered beyond expiry date in children and adolescents during influenza seasons 2013–2014 and 2014–2015 in the UK.

Design

This was a retrospective cohort study. Two cohorts of children and adolescents who received LAIV from 1 September 2013 to 31 March 2014 and from 1 September 2014 to 31 March 2015 and aged 2–17 years at time of LAIV administration were identified from the Clinical Practice Research Datalink (CPRD).

Setting

More than 500 primary care practices in the UK.

Population

Proportions of vaccine doses administered beyond expiry date were assessed among 47 396 and 67 099 LAIV recipients with a documented vaccine lot identifier in influenza seasons 2013–2014 and 2014–2015, respectively.

Intervention

None.

Main outcome measure

Administrations of expired LAIV were ascertained by comparison of vaccination dates in CPRD records with expiration dates in AstraZeneca/MedImmune lot distribution data.

Results

Overall, 245 LAIV recipients, 80 in 2013–2014 and 165 in 2014–2015, received a dose after its expiration date, yielding proportion estimates of 1.7 per 1000 doses (95% CI 1.3 to 2.1) in season 2013–2014 and 2.5 per 1000 doses (95% CI 2.1 to 2.8) in season 2014–2015. This proportion increased above 1.0% after December during each season. Most (84% in influenza season 2013–2014 and 59% in influenza season 2014–2015) received an expired dose <30 days after its expiration date. The proportion was higher in London (relative risk 1.93 (95% CI 1.25 to 2.99)) and when the number of LAIV recipients registered in the practice was lower than the median number per practice (relative risk 2.69 (95% CI 1.99 to 3.62)).

Conclusions

Administration of expired LAIV doses occurs infrequently.
The magnitude of, and factors associated with, loss to follow-up among patients treated for sexually transmitted infections: a multilevel analysis
Authors: Tsadik Mache , Berhane Yemane , Worku Alemayehu , Terefe Wondwossen
Published: July 2017

Objectives

The loss to follow-up (LTFU) among patients attending care for sexually transmitted infections (STIs) in Sub-Saharan Africa is a major barrier to achieving the goals of the STI prevention and control programme. The objective of this study was to investigate individual- and facility-level factors associated with LTFU among patients treated for STIs in Ethiopia.

Methods

A prospective cohort study was conducted among patients attending care for STIs in selected facilities from January to June 2015 in the Tigray region of Ethiopia. LTFU was ascertained if a patient did not present in person to the same facility within 7 days of the initial contact. Multilevel logistic regression was used to identify factors associated with LTFU.

Results

Out of 1082 patients, 59.80% (647) were LTFU. The individual-level factors associated with LTFU included having multiple partners (adjusted OR (AOR) 2.89, 95% CI 1.74 to 4.80), being male (AOR 2.23, 95% CI 1.63 to 3.04), having poor knowledge about the means of STI transmission (AOR 2.08, 95% CI 1.53 to 2.82), having college level education (AOR 0.38, 95% CI 0.22 to 0.65), and low perceived stigma (AOR 0.60, 95% CI 0.43 to 0.82). High patient flow (AOR 3.06, 95% CI 1.30 to 7.18) and medium health index score (AOR 2.80, 95% CI 1.28 to 6.13) were facility-level factors associated with LTFU.

Conclusions

Improving patient retention in STI follow-up care requires focused interventions targeting those who are more likely to be LTFU, particularly patients with multiple partners, male index cases and patients attending facilities with high patient flow.
Two Microrna Signatures for Malignancy and Immune Infiltration Predict Overall Survival in Advanced Epithelial Ovarian Cancer
Authors: Korsunsky Ilya , Parameswaran Janaki , Shapira Iuliana , Lovecchio John , Menzin Andrew , Whyte Jill , Dos Santos Lisa , Liang Sharon , Bhuiya Tawfiqul , Keogh Mary , Khalili Houman , Pond Cassandra , Liew Anthony , Shih Andrew , Gregersen Peter K , Lee Annette T
Published: July 2017

MicroRNAs have been established as key regulators of tumor gene expression and as prime biomarker candidates for clinical phenotypes in epithelial ovarian cancer (EOC). We analyzed the coexpression and regulatory structure of microRNAs and their co-localized gene targets in primary tumor tissue of 20 patients with advanced EOC in order to construct a regulatory signature for clinical prognosis. We performed an integrative analysis to identify two prognostic microRNA/mRNA coexpression modules, each enriched for consistent biological functions. One module, enriched for malignancy-related functions, was found to be upregulated in malignant versus benign samples. The second module, enriched for immune-related functions, was strongly correlated with imputed intratumoral immune infiltrates of T cells, natural killer cells, cytotoxic lymphocytes, and macrophages. We validated the prognostic relevance of the immunological module microRNAs in the publicly available The Cancer Genome Atlas data set. These findings provide novel functional roles for microRNAs in the progression of advanced EOC and possible prognostic signatures for survival.
Detection of markers predictive of macrolide and fluoroquinolone resistance in Mycoplasma genitalium from patients attending sexual health services in England
Authors: Pitt Rachel , Fifer Helen , Woodford Neil , Alexander Sarah
Published: July 2017

Objectives

Resistance to both macrolides and fluoroquinolones has been reported in Mycoplasma genitalium; however, due to limited diagnostics, studies are often small and confined to specific geographical areas. This study sought to determine the rate of predicted resistance in M. genitalium-positive specimens referred for diagnostic testing.

Methods

Seventy-four M. genitalium-positive specimens, referred to the national reference laboratory (2010-2013) from 19 centres across England, were blinded and anonymised. Specimens were examined for markers predictive of resistance to macrolides and fluoroquinolones using PCR followed by sequence analysis of 23S rRNA gene, or gyrA and parC, respectively.

Results

23S rRNA gene PCR sequencing revealed that 82.4% (61/74) of specimens harboured a single nucleotide polymorphism (SNP) associated with macrolide resistance. Differences were observed between the rates of predicted macrolide resistance in male (95.1% (58/61)) and female (23.1% (3/13)) patients (P = <0.001). By contrast, all specimens for which sequencing data were available (73/74) yielded wild-type gyrA sequences; and 58/61 (95.1%) had wild-type parC genes. Three specimens (3/61 4.9%) had SNPs in the parC gene associated with fluoroquinolone treatment failure, and all three also had predicted resistance to macrolides.

Conclusions

Eighty-two per cent and 4.9% of M. genitalium specimens had SNPs associated with macrolide and fluoroquinolone resistance, respectively. Due to lack of widespread availability of testing for M. genitalium in the UK, this study sample was likely to be sourced from patients who may have already failed first-line macrolide therapy. Nevertheless, this study highlights the need for both greater access to M. genitalium diagnostics and genetic antimicrobial resistance testing.
Use of cement-chelated, solidified, municipal solid waste incinerator (MSWI) fly ash for pavement material: mechanical and environmental evaluations
Authors: Tang Qiang , Zhang Yu , Gao Yufeng , Gu Fan
Published: July 2017

As a by-product from the incineration of municipal solid waste (MSW), fly ash usually contains mobile heavy metals that may engender severe pollution when reused. In this study, fly ash was solidified with cement and a chelating agent to immobilize these polluting elements. The possibility of using the solidified fly ash for pavement materials was also assessed through mechanical and environmental perspectives. According to the results, the strength of solidified fly ash was found proportional to both the cement/fly ash ratio and curing time. This indicated that the increase of fly ash loading reduced the concentration of products from cement hydration, and thus destroyed the structure of the products of hydration. With the increase of freeze–thaw cycles, the compressive strength of cement-stabilized fly ash decreased between days 7 and 14, and then increased between days 14 and 28. Subsequently, the finite element analysis showed that placing the solidified fly ash layer as a pavement material between an unbound base course and subgrade was beneficial to prolong fatigue life and reduce rutting distress of asphalt pavements. Finally, leachability of metals from the mixtures was tested, which showed that leaching concentration decreased as the cement/ash ratio, curing time, and chelating agent content increased.
Pre- and post-rehabilitation behaviour of a deteriorated horizontal ellipse culvert
Authors: Tetreault Jacob , Hoult Neil A. , Moore Ian D.
Published: July 2017

An experimental campaign was undertaken to assess the impact of deterioration and rehabilitation on the performance of corrugated steel horizontal ellipse culverts. A corrugated steel horizontal ellipse culvert was corroded using an accelerated corrosion technique and then buried up to a soil cover of 0.45 m. It was subsequently tested using simulated tandem axle loading. The culvert was then rehabilitated using the paved invert technique and tested under the same loading arrangement before being loaded up to its ultimate capacity. Results were compared with a previous study on an intact horizontal ellipse culvert. For the level of corrosion present, there seemed to be no impact on the structural behaviour as both the intact and corroded culverts had similar stiffness. Paving the invert did improve the structural performance compared to the deteriorated culvert. For example, the axial strains were reduced by 23% at the crown and 31% at the shoulder. The ultimate capacity of the rehabilitated structure was also improved as it failed at a total tandem axle load of 1600 kN while the intact culvert failed at 1325 kN. It is worth noting that both of these culverts failed at a load greater than twice the fully factored design load.
Fukushima-derived radioactivity measurements in Pacific salmon and soil samples collected in British Columbia, Canada
Authors: Domingo Thomas , Starosta Krzysztof , Chester Aaron , Williams Jonathan , Lehnert Sarah J. , Gantner Nikolaus , Alava Juan José
Published: July 2017

Despite the many studies that have shown minimal health risks to individuals living outside of Japan following the Fukushima Nuclear Accident, there are persisting concerns regarding the consumption of Pacific seafood that may be contaminated with radioactive species from Fukushima. To address these concerns, the activity concentrations of anthropogenic 134Cs and 137Cs, as well as naturally occurring 40K, were measured in Pacific salmon collected from Kilby Provincial Park, British Columbia (BC), in 2013 and from the Quesnel River, BC, in 2014 using low-background gamma-ray spectroscopy. In addition, soil samples and a single roof-debris sample were collected and analysed to provide a record of Fukushima-derived contamination in BC. Cesium-134 was not detected in the salmon samples. Cesium-137 was not detected in any of the sockeye or chum samples, although it was detected in all of the Chinook samples. The weighted average (±1σ) 137Cs activity concentration in the Chinook salmon collected in 2013 and 2014 was 0.23 (3) and 0.20 (3) Bq/kg fresh weight, respectively. A conservative annual dose estimate for an adult who consumes the average Canadian quantity of seafood per year, contaminated with radiocesium at the maximum concentrations measured in this campaign, was calculated to be 0.054 μSv per year. Cesium-134 was detected in all but two of the soil samples. A weak positive correlation was observed between presence of 134Cs and of 7Be suggesting that the 134Cs arrived via atmospheric deposition. Cesium-137 was present in every soil sample, although the total radiocesium activity concentrations measured were significantly less than action levels set by Health Canada.
Review of bottomonium measurements from CMS
Authors: Hu Z. , Leonardo N. T. , Liu T. , Haytmyradov M.
Published: July 2017

We review the results on the bottomonium system from the CMS experiment at the Large Hadron Collider. Measurements have been carried out at different center-of-mass energies in proton collisions and in collisions involving heavy ions. These include precision measurements of cross sections and polarizations, shedding light on hadroproduction mechanisms, and the observation of quarkonium sequential suppression, a notable indication of quark–gluon plasma formation. The observation of the production of bottomonium pairs is also reported along with searches for new states. We close with a brief outlook of the future physics program.
Theoretical analysis of bifurcations in a microscopic traffic model accounting for optimal velocity
Authors: Wang Yu-Qing , Yan Bo-Wen , Zhou Chao-Fan , Chu Xing-Jian , Zhang De-Chen , Li Wei-Kang , Wang Ji-Xin , Fang Chen-Hao , Jia Bin , Gao Zi-You
Published: July 2017

In this paper, a modified microscopic traffic flow model accounting for the optimal velocity has been proposed. Different with previous models, drivers’ response ability and the maximum of accelerations are considered in the term of the optimal velocity. The effect of parameters in the term of the optimal velocity on bifurcations in the rotary traffic is studied here. Besides, the evolvement of bifurcations in the system is calculated by performing numerical simulation experiments. Moreover, the linear stability analysis of the proposed model is presented.
Personal Narratives and Self-Transformation in Postindustrial Societies
Authors: Dunn Cynthia Dickel
Published: July 2017

This article surveys literature on personal narratives as situated practices in a variety of contexts in primarily Western, postindustrial societies. It begins with an overview of theories that articulate the relationships among narrative, self, and narrating context. I then consider how narratives of the self are shaped in institutional contexts, including those in which narratives are used to evaluate selves or used as a technology for changing selves. The section that follows examines how narrative analysis can be used to examine people's positioning in relation to larger social discourses such as neoliberalism. The final section returns to the relationship between narrative forms and contexts by examining how people narrate themselves across the variety of digital media and online contexts provided by the Internet.
Trimethylamine N-Oxide, the Microbiome, and Heart and Kidney Disease
Authors: Zeisel Steven H. , Warrier Manya
Published: July 2017

Trimethylamine N-oxide (TMAO) is a biologically active molecule and is a putative promoter of chronic diseases including atherosclerosis in humans. Host intestinal bacteria produce its precursor trimethylamine (TMA) from carnitine, choline, or choline-containing compounds. Most of the TMA produced is passively absorbed into portal circulation, and hepatic flavin-dependent monooxygenases (FMOs) efficiently oxidize TMA to TMAO. Both observational and experimental studies suggest a strong positive correlation between increased plasma TMAO concentrations and adverse cardiovascular events, such as myocardial infarction, stroke, and death. However, a clear mechanistic link between TMAO and such diseases is not yet validated. Therefore, it is debated whether increased TMAO concentrations are the cause or result of these diseases. Here, we have tried to review the current understanding of the properties and physiological functions of TMAO, its dietary sources, and its effects on human metabolism. Studies that describe the potential role of TMAO in the etiology of cardiovascular and other diseases are also discussed.
A Serendipitous Scientist
Authors: Lefkowitz Robert J.
Published: July 2017

Growing up in a middle-class Jewish home in the Bronx, I had only one professional goal: to become a physician. However, as with most of my Vietnam-era MD colleagues, I found my residency training interrupted by the Doctor Draft in 1968. Some of us who were academically inclined fulfilled this obligation by serving in the US Public Health Service as commissioned officers stationed at the National Institutes of Health. This experience would eventually change the entire trajectory of my career. Here I describe how, over a period of years, I transitioned from the life of a physician to that of a physician-scientist; my 50 years of work on cellular receptors; and some miscellaneous thoughts on subjects as varied as Nobel prizes, scientific lineages, mentoring, publishing, and funding.
The Molecular Basis for Human Immunodeficiency Virus Latency
Authors: Mbonye Uri , Karn Jonathan
Published: July 2017

Although potent combination antiretroviral therapy can effectively block viral replication in the host, human immunodeficiency virus (HIV) persists due to the existence of latent but replication-competent proviruses residing primarily in a very small population of resting memory CD4+ T cells. Viral latency is established when the expression of the autoregulatory viral trans-activating factor Tat is reduced to subthreshold levels. The absence of Tat reduces HIV transcription and protein production to levels that make the host cell invisible to the immune system and refractory to antiretroviral treatment. Key host cell mechanisms that drive HIV into latency are sequestration of transcription initiation factors, establishment of epigenetic barriers inactivating the proviral promoter, and blockage of the assembly of the host elongation factor P-TEFb. This comprehensive understanding of the molecular control of HIV transcription is leading to the development of optimized combinatorial reactivation and immune surveillance strategies designed to purge the latent viral reservoir.
Defensins in Viral Infection and Pathogenesis
Authors: Holly Mayumi K. , Diaz Karina , Smith Jason G.
Published: July 2017

α, β, and θ defensins are effectors of the innate immune system with potent antibacterial, antiviral, and antifungal activity. Defensins have direct antiviral activity in cell culture, with varied mechanisms for individual viruses, although some common themes have emerged. In addition, defensins have potent immunomodulatory activity that can alter innate and adaptive immune responses to viral infection. In some cases, there is evidence for paradoxical escape from defensin neutralization or enhancement of viral infection. The direct and indirect activities of defensins have led to their development as therapeutics and vaccine components. The major area of investigation that continues to lag is the connection between the effects of defensins in cell culture models and viral pathogenesis in vivo. Model systems to study defensin biology, including more physiologic models designed to bridge this gap, are also discussed.
The Functional Neuroanatomy of Human Face Perception
Authors: Grill-Spector Kalanit , Weiner Kevin S. , Kay Kendrick , Gomez Jesse
Published: July 2017

Face perception is critical for normal social functioning and is mediated by a network of regions in the ventral visual stream. In this review, we describe recent neuroimaging findings regarding the macro- and microscopic anatomical features of the ventral face network, the characteristics of white matter connections, and basic computations performed by population receptive fields within face-selective regions composing this network. We emphasize the importance of the neural tissue properties and white matter connections of each region, as these anatomical properties may be tightly linked to the functional characteristics of the ventral face network. We end by considering how empirical investigations of the neural architecture of the face network may inform the development of computational models and shed light on how computations in the face network enable efficient face perception.
Vision and Action
Authors: Hayhoe Mary M.
Published: July 2017

Investigation of natural behavior has contributed a number of insights to our understanding of visual guidance of actions by highlighting the importance of behavioral goals and focusing attention on how vision and action play out in time. In this context, humans make continuous sequences of sensory-motor decisions to satisfy current behavioral goals, and the role of vision is to provide the relevant information for making good decisions in order to achieve those goals. This conceptualization of visually guided actions as a sequence of sensory-motor decisions has been formalized within the framework of statistical decision theory, which structures the problem and provides the context for much recent progress in vision and action. Components of a good decision include the task, which defines the behavioral goals, the rewards and costs associated with those goals, uncertainty about the state of the world, and prior knowledge.
Teacher Learning within a Multinational Project in an Upper Secondary School
Authors: Ilomäki Liisa , Lakkala Minna , Toom Auli , Muukkonen Hanni
Published: July 2017

In this case study, we investigated teachers’ professional learning within a multinational project in an upper secondary school. The aim of the study was to investigate how the participating teachers adopted and applied the trialogical approach (TLA) in their pedagogical practices and their challenges in doing that. The mixed method approach was used for data collection and analysis. About one‐fourth of the teachers participated in the activities, ten females and three males. Three groups were identified, based on their activity in the project: pilot teachers, active adopters, and adopters. Altogether 79 students (38 males and 41 females) answered a questionnaire concerning the pedagogical practices. The pedagogical revisions were well in line with TLA; the revised courses as well as new iterations and new ideas were indicators of the teachers’ creative implementation processes. However, some of the TLA ideas were more difficult to apply in an upper secondary school context; for example, the implementation of ideas involving cross‐fertilization with other organizations and cultures was rare. In order to learn new pedagogical practices, teachers need organized time for collaborative planning, for reflecting, and for sharing.
Histoplasmosis by Histoplasma capsulatum var. duboisii Observed at the Laboratory of Pathological Anatomy of Lomé in Togo
Authors: Darré Tchin , Saka Bayaki , Mouhari-Touré Abas , Dorkenoo Améyo Monique , Amégbor Koffi , Pitche Vincent Palokinam , Napo-Koura Gado
Published: July 2017

Our study aimed to describe the epidemiological, clinical, and diagnostic aspects of African histoplasmosis in Togo through a descriptive and cross-sectional study on histological diagnosed African histoplasmosis in Pathology Department of Lomé from 2002 to 2016 (15 years). A total of 17 cases of African histoplasmosis were diagnosed. The sex ratio (M/F) was 1.8. The annual incidence was 1.1 cases. The mean age of the patients was 27.2 ± 0.4 years. All our patients were of social categories with a low socioeconomic level. HIV infection was known in 3 patients and one patient contracted tuberculosis. The clinical manifestations were cutaneous in 7 cases, cutaneous and mucous in 3 cases, cutaneous and lymph node in 3 cases, cutaneous and bone in 2 cases, and disseminated in 2 cases. The samples examined consisted of 14 cutaneous biopsies measuring 2-3 cm and 3 ganglionic biopsies each measuring 4 cm of major axis. Histologically, all cases were of chronic form made of granulomatous reaction with ovoid yeasts measuring between 1 and 2 microns. Despite the low frequency of this disease in our country, it should be kept constantly in mind before any granulomatous lesions, especially in the context of the HIV pandemic.
An Evaluation of the Benefits of Simultaneous Acquisition on PET/MR Coregistration in Head/Neck Imaging
Authors: Monti Serena , Cavaliere Carlo , Covello Mario , Nicolai Emanuele , Salvatore Marco , Aiello Marco
Published: July 2017

Coregistration of multimodal diagnostic images is crucial for qualitative and quantitative multiparametric analysis. While retrospective coregistration is computationally intense and could be inaccurate, hybrid PET/MR scanners allow acquiring implicitly coregistered images. Aim of this study is to assess the performance of state-of-the-art coregistration methods applied to PET and MR acquired as single modalities, comparing the results with the implicitly coregistration of a hybrid PET/MR, in complex anatomical regions such as head/neck (HN). A dataset consisting of PET/CT and PET/MR subsequently acquired in twenty-three patients was considered: performance of rigid (RR) and deformable (DR) registration obtained by a commercial software and an open-source registration package was evaluated. Registration accuracy was qualitatively assessed in terms of visual alignment of anatomical structures and qualitatively measured by the Dice scores computed on segmented tumors in PET and MRI. The resulting scores highlighted that hybrid PET/MR showed higher registration accuracy than retrospectively coregistered images, because of an overall misalignment after RR, unrealistic deformations and volume variations after DR. DR revealed superior performance compared to RR due to complex nonrigid movements of HN district. Moreover, simultaneous PET/MR offers unique datasets serving as ground truth for the improvement and validation of coregistration algorithms, if acquired with PET/CT.
Pneumomediastinum and Mediastinal Hematoma Secondary to Right Brachiocephalic Vein Thrombectomy Mimicking STEMI
Authors: Shukla Prem , Dy Prudence , Raj Rishi , Alagusundaramoorthy Sayee Sundar , Nivera Noel
Published: July 2017

A 50-year-old male with a history of hemodialysis dependent chronic kidney disease presented to our emergency department with acute midsternal crushing chest pain. Patient was diagnosed with acute anterolateral wall Myocardial Infraction due to the presence of corresponding ST segment elevations in EKG and underwent emergent cardiac catheterization which revealed normal patent coronaries without any disease. He continued to have chest pain for which CT of the chest was done which revealed pneumomediastinum with mediastinal hematoma, due to the recent attempted thrombectomy for thrombus in his right brachiocephalic vein.
(2+1)-Dimensional Duffin-Kemmer-Petiau Oscillator under a Magnetic Field in the Presence of a Minimal Length in the Noncommutative Space
Authors: Wang Bing-Qian , Long Zheng-Wen , Long Chao-Yun , Wu Shu-Rui
Published: July 2017

Using the momentum space representation, we study the (2 + 1)-dimensional Duffin-Kemmer-Petiau oscillator for spin 0 particle under a magnetic field in the presence of a minimal length in the noncommutative space. The explicit form of energy eigenvalues is found, and the wave functions and the corresponding probability density are reported in terms of the Jacobi polynomials. Additionally, we also discuss the special cases and depict the corresponding numerical results.
Association between Cullin-3 Single-Nucleotide Polymorphism rs17479770 and Essential Hypertension in the Male Chinese Han Population
Authors: Li Jin , Hu Jing , Sun Rong , Zhao Yongpan , Liu Heping , Li Jian , Shi Lei , Zhao Shujin
Published: July 2017

Background. Hypertension, including essential and secondary hypertension, is a multifactorial disease, affecting more than one billion people worldwide. Secondary hypertension can result from mutations of cullin-3 (CUL3); however, whether polymorphisms ofCUL3are associated with essential hypertension (EH) has not been reported. Here, we investigated the association betweenCUL3SNPs rs17479770 and rs3738952 and EH in the Chinese Han population.Methods. This case-control study investigated 520 representatives, including 259 patients with EH and 261 normotensive controls matched for age, gender, BMI, TG, TC, and HbA1c for the distribution of functional rs17479770 and rs3738952 within theCUL3gene by using PCR and RFLP.Results. Our results showed that there was no significant difference in allele and genotype distribution of rs3738952 and haplotype distribution of rs17479770 and rs3738952 between the EH group and normotensive group, whereas the rs17479770 TT genotype in male and the full data set were significantly associated with the decreased risk of EH (P=0.050,P=0.042), and rs17479770 allele T in male was shown to have the correlation tendency of the decreased risk of EH (P=0.064).Conclusion. Our data suggest that theCUL3rs17479770 variant could be a protective factor in the pathogenesis of EH.
Misdiagnosis of a Giant Uterine Leiomyosarcoma: Clinic and Image Challenges
Authors: Agah Jila , Karimzadeh Sedighe , Moharrer Ahmadi Fateme
Published: July 2017

A 41-year-old woman (G3P2L2Ab1) was referred to gynecology clinic with chief complaints of abdominal distension and localized abdominal wall pruritus for three months. She was misdiagnosed with gastrointestinal disorder and ultimately had undergone imaging. Ultrasonography and computed tomography (CT) scan disclosed a huge solid-cystic mass originating from the ovary. On clinical examination the patient had no pain or tenderness and no gynecologic complaints. Laboratory tests showed normal tumor markers and hemoglobin at 8 g/dl. Laparotomy was carried out as diagnosis of ovarian serous cyst adenoma, but a huge tumor with attachment to uterus and ovaries and extension to pelvic floor, peripheral tissues of ureter, and upper abdomen was found. Hysterectomy with bilateral salpingooophorectomy was done. Pathology report demonstrated uterine leiomyosarcoma measuring 40 centimeters and weighing 10 kilograms. In conclusion, as pelvic masses even in a large size may present unspecific symptoms misdiagnosis may occur which lead to overgrowth, local invasion, or other complications. So, it is rather to suggest ultrasonography in patients with persistent abdominal or pelvic symptoms and if needed, more exact diagnostic modalities like magnetic resonance imaging (MRI) could be offered to avoid misdiagnosis and mismanagement.
Management of Traumatic Cataract with Posterior Capsular Rupture: A Case Report and In Vitro Model Study
Authors: Wan Wenjuan , Hu Ke , Ji Yan , Li Can
Published: July 2017

Purpose. To investigate the optimal strategy for surgical management of traumatic cataract with posterior capsular rupture. Methods. We describe four cases of traumatic cataract with posterior capsular rupture and an in vitro model built to evaluate the optimal infusion pressure during surgery. Results. All patients underwent cataract surgery. By using an anterior chamber maintainer to elevate infusion pressure, we safely performed cataract extraction without phacoemulsification. At 3 days after surgery, visual acuity was greater than 20/25 in all patients, without any complications. Phacoemulsification would also be feasible under anterior chamber maintainer infusion in a similar case of traumatic cataract with posterior capsular rupture during intravitreal injection. In addition, an in vitro model that we established using pig’s eyes revealed that the anterior chamber remained stable when the height of infusion bottle was 50–90 mmHg, whereas shallowing of the anterior chamber occurred when the height of infusion bottle was reduced to 40 mmHg, and corneal edema occurred when the height of infusion bottle was raised to 100 mmHg. Conclusions. During management of traumatic cataract with posterior capsular rupture, using an anterior chamber maintainer to maintain optimal infusion pressure may reduce the risk of anterior hyaloid membrane breakup and vitreous loss.
Skin-Limited Graft-versus-Host Disease after Pancreatic Transplantation
Authors: Ilyas Muneeb , Hoss Elika , DiCaudo David J. , Khamash Hasan , Pittelkow Mark R. , Sharma Amit
Published: July 2017

Introduction. The phenomenon of graft-versus-host disease, a solid organ transplant recipient, is a rare development with a very poor prognosis. Case Presentation. A 40-year-old woman with type 1 diabetes developed cutaneous graft-versus-host disease following second pancreas transplantation. Conclusion. The development of a nonspecific rash in the early posttransplant period following a pancreas transplant warrants suspicion for graft-versus-host disease.
Vaccination Coverage and Associated Factors among Children Aged 12–23 Months in Debre Markos Town, Amhara Regional State, Ethiopia
Authors: Gualu Tenaw , Dilie Abebe
Published: July 2017

Introduction. Vaccination is the administration of a vaccine or a biological substance intended to stimulate a recipient’s immune system to produce antibodies or undergo other changes that provide future protection against specific infectious diseases. Objective. To determine vaccination coverage and associated factors among children aged 12–23 months in Debre Markos town 2016. Methods. Community-based cross-sectional study was employed among 288 mothers/caretakers to child (12–23 months) pair. Study populations were selected using systematic random sampling technique. Structured interviewer administered questionnaires were used to collect data. Variables with P value of less than 0.05 in multivariate analysis were considered as statistically significant at 95% CI. Result. About 264 (91.7%) of children were completely vaccinated. Male birth 3.24 (1.16–9.04), wanted pregnancy 2.89 (1.17–7.17), having at least two ANC follow-ups 4.04 (1.35–12.06), and short distance from vaccination site 3.38 (1.29–8.86) were found positively associated with complete immunization. Conclusion and Recommendation. There was relatively high immunization coverage in the study. Child’s sex, ANC follow-up, type of pregnancy, and distance from health institution were factors associated with complete vaccination. Preventing unwanted pregnancy and promoting ANC and postnatal follow-up should be strengthened. Vaccination sites should also be further expanded.
Effect of 2 Bleaching Agents with a Content of High Concentrated Hydrogen Peroxide on Stained 2 CAD/CAM Blocks and a Nanohybrid Composite Resin: An AFM Evaluation
Authors: Karakaya İzgen , Cengiz Esra
Published: July 2017

The aim of this study was to evaluate color stability of 3 restorative materials, discoloration ability of different solutions, efficacy of 2 office bleaching agents, and surface roughness and topography. Sixty specimens for Clearfil Majesty Esthetic (CME), Lava Ultimate (LU), and Vita Enamic (VE) were prepared. They were immersed into 3 staining solutions for 2 weeks and then they were bleached. According to the measuredL⁎,a⁎, andb⁎parameters described by CIELAB system, color changes (ΔE00), translucency parameters (TP), whiteness index values (W⁎), and changes in closeness to pure white (ΔW⁎) were calculated. Then 3 specimens from each group were scanned with an atomic force microscope for surface analysis. After staining, CME groups and control groups of LU and VE showed clinically acceptable color changes (ΔE00<1,8). After bleaching, while a reverse effect on color was observed, VE showed the furthest color values to pure white. There was no statistically significant difference between whiteness index values of LU and CME. LU was the most translucent material during the study and TP values of materials showed minimal differences. Most of the VE groups and a control group of LU showed surface roughness (Ra) values higher than critical value for biofilm accumulation (0,2 μm).