bluuebunny/crossref_metadata_2025 huggingface dataset:
Biochemical individuality and the recognition of personal profiles with a computer.
Authors: Robertson E A , Van Steirteghem A C , Byrkit J E , Young D S
Published: February 2020

Multitest analysis of an individual's blood provides a biochemical profile that reflects his identity and pathophysiological state. During a six-week period we repeatedly profiled 10 volunteers for 22 different analytes, using continuous-flow and discrete analyzers (SMAC, KA 150 enzyme analyzer, ABA-100, AutoAnalyzers) and manual procedures. Two years later, we obtained multiple follow-up profiles. Using linear discriminant functions derived from the first five (or first 10) specimens from each subject, we were able correctly to identify 96% (or 100%) of the specimens collected during the remainder of the six-week testing period. Ninety percent of the two-year follow-up specimens were correctly identified when we used all the original profiles to calculate the discriminant functions. Deliberately mislabeled specimens were also correctly identified by discriminant analysis. Profiles of individual samples (and average profiles for each subject) were graphically displayed as computer-drawn faces and non-linear maps. Covariances between pairs of tests on repeated profiles differed significantly for different subjects. Inter-test relationships were graphically displayed by nonlinear mapping.
Lipid interference in steroid radioimmunoassay.
Authors: Rash J M , Jerkunica I , Sgoutas D S
Published: February 2020

To study lipid interference in steroid radioimmunoassays in which dextran-coated charcoal is used as the separating agent, we tested triolein and phosphatidylcholine as model hydrophobic and amphipathic lipids, respectively. Addition of either caused distortion of the standard curve to an extent that was inversely related to the polarity of the steroid molecule. Both lipids form a dispersion that entraps steroid molecules. When we increased the charcoal concentration, the effect of phosphatidylcholine addition was eliminated for assays of both polar and nonpolar steroids. In contrast, the effect from triacylglycerol was not corrected, particularly in assays of nonpolar steroids. We also studied mixtures of lipids mimicking the mixture of lipids extracted from plasma of normolipemic and hyperlipemic indviduals. The degree of lipemia that can be tolerated differs from assay to assay, and primarily varies directly with the polarity of the steroid being assayed.
Effects of centrifugation, storage, and contamination of amniotic fluid on its total phospholipid content.
Authors: van Voorst tot Voorst E J
Published: February 2020

The total phospholipid content of the supernatant fluid decreases rapidly with increasing relative centrifugal force when amniotic fluid is centrifuged. Possible explanations for this are discussed. The effect of storage on the total phospholipid content of amniotic fluid at different temperatures and the influence of contamination with blood and meconium are also described.
Simultaneous liquid-chromatographic analysis for 4-hydroxy-3-methoxymandelic acid and 4-hydroxy-3-methoxyphenylacetic acid in urine.
Authors: Soldin S J , Hill J G
Published: February 2020

We describe a rapid, reliable “high-performance" liquid-chromatographic method of simultaneously analyzing for 4-hydroxy-3-methoxymandelic acid (I) and 4-hydroxy-3-methoxyphenylacetic acid (II) in urine. Paired-ion chromatography and amperometric detection are used in the method. A 5-mL aliquot of urine is adjusted to pH 6.1 and subjected to anion-exchange chromatography (Dowex AG 1-X4, 1.8 X 0.7 cm column). The two analytes are eluted from the column with 10 mL of 3 mol/L sodium chloride, and 2 microL of the eluate, injected directly into the liquid chromatograph, is chromatographed at 40 degrees C. This column contains mu Bondapak C18, and the mobile phase is 100 mmol/L potassium phosphate buffer, pH 6.7, containing 0.5 mmol of tetrabutylammonium phosphate per liter. Detector sensitivity is 50 nA full scale. Analytical recoveries of I and II are 80--84% and 48--49%, respectively; the coefficients of variation for various concentrations in urine are about 10%.
A lyophilized hemoglobin control prepared from stroma-free hemolysates.
Authors: Bonderman D P , Proksch G J , Haskins S
Published: February 2020

We prepared a stable lyophilized hemoglobin control from human erythrocytes by removing stroma with calcium and Ficoll. Addition of polyhydroxy compounds enhanced reconstitution and stability. The lyophilized product was stable during one year of use in a service laboratory. Accelerated aging studies demonstrated the potential of up to two years of stability, with methemoglobin increasing at a projected rate of approximately 6% per year. Reconstituted, the control gave reproducible values for at least five days when refrigerated.
Evaluation of an immobilized-enzyme analyzer for measuring galactose in serum.
Authors: Buffone G J , Johnson J M , Lewis S A , Sparks J W
Published: February 2020

Reportedly, galactose provides an alternative carbohydrate source and improved homeostatic regulation of glucose in the premature infant. Because of its potentially toxic effects, sensitive methods are needed for monitoring its concentration during therapy. We evaluated an immobilized galactose oxidase/hydrogen peroxide electrode system and a modified homogeneous enzymic method. Both methods are suitable for measuring galactose in a small sample and are comparably precise. The latter method gives superior analytical recoveries below 100 mg/L, but is linear in absorbance response to only 300 mg/L. We find the immobilized-enzyme method superior for monitoring treatment of neonates with galactose, because it requires only a few minutes and 25 microL of serum, and the analytical procedure is simpler.
Taurine transport in epilepsy.
Authors: Goodman H O , Connolly B M , McLean W , Resnick M
Published: February 2020

Previous studies of plasma taurine concentrations in epileptics have yielded equivocal results. We measured plasma and urinary taurine in 41 epileptic and 68 control subjects and found plasma concentrations among epileptics to be comparable in general to those of controls, but that two or three classes of plasma taurine concentrations, possibly genetically regulated, occur in both epileptic and control subjects. Our previous studies and data from the present study on taurine excretion revealed three excretion classes under genetic control. The principal finding is that epileptics include disproportionate numbers of low excretors (high reabsorbers), who are presumptive homozygotes for the allele effecting higher reabsorption. If confirmed, these findings suggest that the transport of taurine, rather than absolute taurine concentration, may explain the efficacy of taurine administration in some epileptics but not in others. The locus involved may be one component in the polygenic diathesis to the idiopathic epilepsies.
A simplified assay for dihydroxylated vitamin D metabolites in human serum: application to hyper- and hypovitaminosis D.
Authors: Mason R S , Lissner D , Grunstein H S , Posen S
Published: February 2020

We describe a simplified assay for 24,25-and 1.25-dihydroxyvitamin D in human serum. It involves two preparative steps, and normal chick intestine is used in preparing cytosol-binding protein. Our results for 24,25-dihydroxyvitamin D include a reference interval of 2.9—16 nmol/L (1.2—6.7 microgram/L), a mean of 6.7 nmol/L (2.8 microgram/L), an intra-assay CV of 11%, and an interassay CV of 22%. For 1,25-dihydroxyvitamin D, these data were 29—168 pmol/L (12—70 ng/L), 86 pmol/L (36 ng/L), 12%, and 22%, respectively. In hypoparathyroid patients with vitamin D intoxication, mean concentrations of 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D in serum were significantly above normal; the 1,25-dihydroxyvitamin D concentrations were significantly below normal. Patients with malabsorption and/or post-gastrectomy states had significantly subnormal values for both 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D in serum, and there was a significantly negative correlation between each of these biochemical values and the severity of osteomalacia. We also discuss cost effectiveness of assaying vitamin D metabolites in human serum.
Kinetic serum creatinine assays I. The role of various factors in determining specificity.
Authors: Bowers L D
Published: February 2020

We studied the specificity of kinetic methods of analysis, with emphasis on creatinine determination. The error contributed by an interferent that reacts with the analytical reagent and absorbs at the wavelength of analysis is shown to be related to the ratio of the equilibrium absorbances of the analyte and interferent, the ratio of the rate constants, the extent of the analytical reaction, and the duration of the measurement. To assess the potential diminution of the interference with kinetic methods, we determined the rate constants of several alpha-keto acids in the Jaffé reaction. Evaluation of the advantages of various measuring techniques with respect to specificity showed the main factors to be the extent of the analytical reaction and the relative value of the rate constants. Total specificity for creatine appears to be unattainable with currently used kinetic techniques.
Effects of sample aging on total cholesterol values determined by the automated ferric chloride-sulfuric acid and Liebermann-Burchard procedures.
Authors: Wood P D , Bachorik P S , Albers J J , Stewart C C , Winn C , Lippel K
Published: February 2020

To investigate the comparability of three commonly used methods for determination of total cholesterol in plasma in several studies, we used fresh plasma samples as well as plasmas and reference sera that had been stored frozen at −15 degrees C for as long as several years. Duplicate determinations by the manual method of Abell et al. (J. Biol. Chem. 195: 357, 1952) were compared with estimates from one to five continuous-flow analyzers by the ferric chloride-sulfuric acid procedure and also with estimates from five to 13 continuous-flow analyzers by the Liebermann-Burchard procedure with calibrator, as part of the laboratory standardization activities of the Lipid Research Clinics. The agreement among all three procedures was generally within acceptable limits (within 5% of the manual method) when plasmas or sera were fresh or had been frozen for less than one month. Results by the manual method of Abell et al. agreed well with those by the automated Liebermann-Burchard method for samples that had been stored at −15 degrees C for as long as two years. However, the automated ferric chloride-sulfuric acid procedure often showed unacceptably high values (as compared with those from the manual method) for samples that had been stored frozen for a year or more. With the ferric chloride-sulfuric acid method, measured cholesterol concentration increased about 2.5% per year of storage for at least two years. We conclude that reference sera of plasmas that have been kept in long-term frozen storage (−15 degrees C) are not suitable for ongoing standardization of the automated ferric chloride-sulfuric acid assay for cholesterol.
Fluorometric and colorimetric enzymic determination of triglycerides (triacylglycerols) in serum.
Authors: Winartasaputra H , Mallet V N , Kuan S S , Guilbault G G
Published: February 2020

We describe two fully enzymic methods, fluorometric and colorimetric, for determination of triglycerides (triacylglycerols) in serum. Samples are incubated with microbial lipase for 10 min, and the glycerol released from the triglycerides is oxidized by NAD+ in the presence of glycerol dehydrogenase. In the fluorometric method, the resulting NADH is in turn oxidized by resazurin as catalyzed by diaphorase to form resorufin, a highly fluorescent compound. In the colorimetric method, the NADH is oxidized by coupling with a tetrazolium salt/diaphorase system to form formazan, a highly colored compound. Calibration curves, constructed by plotting change in fluorescence or absorbance vs concentration of triglycerides, were linear up to 6 and 5 g of triglycerides per liter of serum for the fluorometric and colorimetric methods, respectively. The assays require only 5 and 15 microL of serum for fluorometry and colorimetry, respectively. The CV was 0.59% for the fluorometric method, 0.91% for the colorimetric procedure. The time for analysis for either method is less than 15 min. The results correlate well with those obtained by the Dow Diagnostic Kit method, a colorimetric method in which glycerol kinase and glycerol-1-phosphate dehydrogenase form NADH from ATP and NAD+ in the presence of glycerol and glycerol 1-phosphate.
Evaluation of standard curves in the graded hemagglutination-inhibition method applied to quantitation of human immunoglobulins.
Authors: Wolk M
Published: February 2020

For accurate quantitation of human immunoglobulins A and B by graded hemagglutination inhibition, I have established standard curves. For IgA, plotting the inner diameter of the ring formed by sedimented erythrocytes vs the log of the antigen concentrations gives a straight line. Plotting the same parameters for IgG gives a hyperbolic line. These ratios between antigen concentration and ring diameter were constant for at least one year. Both undiluted and 10,000-fold diluted human serum may be quantitated by this method, depending only on immunoglobulin concentrations. Precision (CV) of the system, assessed in 35 patients’ sera over the period of one year, ranged from 0.5 to 15.2% (mean 10%) for IgA and from 1.4 to 14.9% (mean 7.3%) for IgG.
Method for determination of hydrogen peroxide, with its application illustrated by glucose assay.
Authors: Graf E , Penniston J T
Published: February 2020

We describe a simple colorimetric method for determining micromolar quantities of hydrogen peroxide, based on the oxidation of iodide in the presence of ammonium molybdate and photometry of the resulting blue starch-iodine complex. Color development is linearly dependent on analyte concentration, but only slightly time dependent, and the color of the complex formed is stable for several hours. In the range of wavelengths that may be used (570 to 630 nm), lack of interference from other biological compounds makes this method seem suitable for routine analyses. As one illustrative application of the method we quantitated glucose by measuring hydrogen peroxide produced from it by glucose oxidase catalysis. This method of quantitating glucose is more than five times as sensitive as the commonly used dianisidine method. With the appropriate hydrogen peroxide-producing oxidases, this method may be used to directly measure amino acids, purines, uric acid, xanthine, and hypoxanthine.
The contribution of assays for lymphocyte capping and creatine kinase to detection of the Becker-type dystrophy trait.
Authors: Goldsmith B M , Gruemer H D , Hawley R J , Pickard N A , Verrill H L , Nance W E , Miller G , Crawford R G
Published: February 2020

Members of three unrelated families with the mild Becker type of muscular dystrophy were subjected to lymphocyte capping tests and measurements of serum creatine kinase activity. Both tests correctly identified all nine affected males, but only the capping test was abnormal in seven of eight obligate carriers. The number of capped cells in carriers and affected persons with the Becker-type dystrophy was generally intermediate between those observed for individuals with the Duchenne trait and normal controls, thus potentially aiding in the differential diagnosis between the two myopathies. The lack of sensitivity of measurements of serum creatine kinase activity in identifying carriers is further complicated by the difficulty of establishing reliable reference intervals for this enzyme in 204 healthy controls. Detailed directions for the performance of the capping test are presented.
The coefficient of analysis, a new figure of merit for laboratory performance.
Authors: Louderback A L , Szatkowski P R
Published: February 2020

A simple statistic has been developed to determine a figure of merit for overall laboratory performance. This simple statistic, the coefficient of analysis, relates for the first time both the imprecision and the inaccuracy of a laboratory analysis to a single value that clinical chemists will easily understand. In the derivation of the coefficient of analysis, we also define two secondary statistics: the coefficient of bias, which is mathematically similar to the CV and represents the inaccuracy of an analysis, and the coefficient of accuracy, which is mathematically represented as 100 minus the coefficient of bias and is a measure of the accuracy of the analysis.
Continuous-flow enzymatic determination of total serum cholesterol and method standardization with CDC-calibrated pooled sera.
Authors: MacAulay M A , Jacklyn C L , Mathers J M , Storm V A
Published: February 2020

We compared Boehringer Mannheim's enzymatic kit for the continuous-flow (AutoAnalyzer II) determination of serum cholesterol with Technicon's N-24a extraction method. Results for patients' samples analyzed by the enzymatic method were higher than those by the comparison method. To evaluate accuracy in the cholesterol determinations, we enrolled the enzymatic method into the Center for Disease Control's (CDC) Lipid Standardization program. We calibrated the method by use of a pooled sera for which cholesterol content was assigned by CDC after analysis by their reference Abell-Kendall procedure. We discuss the difficulties with available calibration material and limitations in the application of some commercial control materials to the enzymatic cholesterol method. The continuous-flow variables, Michaelis-Menton constants, percent ester-hydrolase activity, and other factors affecting the performance of the enzyme-linked cholesterol method are evaluated. We believe pooled sera with an assigned value for cholesterol content is the best calibrator material.
Liquid-chromatographic separation of urinary 5-hydroxy-3-indoleacetic acid, with measurement at 254 nm.
Authors: Draganac P S , Steindel S J , Trawick W G
Published: February 2020

A "high-performance" liquid-chromatographic procedure for 5-hydroxy-3-indoleacetic acid is described and compared with a colorimetric method in which 1-nitroso-2-naphthol is used. The analyte and an internal standard, p-nitrobenzoic acid, were extracted into diethyl ether from urine at pH 4.0 (acidified with HCl) to which sodium chloride had been added, and the ether was back-extracted with acetate buffer, pH 9.2. Aliquots of this extract were injected into a reversed-phase liquid-chromatographic column and eluted with pH 3.5 acetate buffer/methanol (95/5 by vol); the effluent was monitored at 254 nm. The precision (CV) of the method was 11.8% at 1.8 mg/L, 5.5% at 92 mg/L. Analytical recovery averaged 84%. The colorimetric method gave higher values for the analyte than did the chromatographic method for all patients' urines.
A Method for Reconstructing the Past Soil Temperature Based on Tree-Ring Widths
Authors: Yuan Shuai , Zheng Yonghong , Qi Yongdong , Kong Fanxi , Wang Dan , Zhang Fangfang
Published: February 2020

Soil temperature can affect tree growth and is one of the most important types of basic data for forest cultivation and management. To obtain a long-term time series of soil temperatures, we explored the utility of dendroclimatology in a subtropical area of China. In this study, the relations between tree-ring-width chronologies and climate factors were explored by correlation analysis. The results indicated that the limiting climatic factors for the radial growth of Huangshan pine were elevation-specific. Further investigation found that chronology at high elevations was significantly correlated with soil temperature. Then, we described a reconstruction of the soil temperatures of the Dabie Mountains area using the tree-ring width chronology from 1869 to 2015 and showed that the reconstruction explained 42.9 percent of the instrumental soil temperature variation in the common years. We found that the 1970s and 2000s were the coldest and warmest decades since 1884, respectively. The results of the reconstruction method for describing past soil temperatures can provide a reference for other subtropical forests. Furthermore, the results of our research also have a certain significance for guiding policymaking related to forest cultivation and management.
Darwin’s Fancy Revised: An Updated Understanding of the Genomic Constitution of Pigeon Breeds
Authors: Pacheco George , van Grouw Hein , Shapiro Michael D , Gilbert Marcus Thomas P , Vieira Filipe Garrett
Published: February 2020

Through its long history of artificial selection, the rock pigeon (Columba livia Gmelin 1789) was forged into a large number of domestic breeds. The incredible amount of phenotypic diversity exhibited in these breeds has long held the fascination of scholars, particularly those interested in biological inheritance and evolution. However, exploiting them as a model system is challenging, as unlike with many other domestic species, few reliable records exist about the origins of, and relationships between, each of the breeds. Therefore, in order to broaden our understanding of the complex evolutionary relationships among pigeon breeds, we generated genome-wide data by performing the genotyping-by-sequencing (GBS) method on close to 200 domestic individuals representing over 60 breeds. We analyzed these GBS data alongside previously published whole-genome sequencing data, and this combined analysis allowed us to conduct the most extensive phylogenetic analysis of the group, including two feral pigeons and one outgroup. We improve previous phylogenies, find considerable population structure across the different breeds, and identify unreported interbreed admixture events. Despite the reduced number of loci relative to whole-genome sequencing, we demonstrate that GBS data provide sufficient analytical power to investigate intertwined evolutionary relationships, such as those that are characteristic of animal domestic breeds. Thus, we argue that future studies should consider sequencing methods akin to the GBS approach as an optimal cost-effective approach for addressing complex phylogenies.
Pictorial Cigarette Pack Warnings Increase Some Risk Appraisals But Not Risk Beliefs: A Meta-Analysis
Authors: Noar Seth M , Rohde Jacob A , Barker Joshua O , Hall Marissa G , Brewer Noel T
Published: February 2020

Pictorial warnings on cigarette packs motivate smokers to quit, and yet the warnings’ theoretical mechanisms are not clearly understood. To clarify the role that risk appraisals play in pictorial warnings’ impacts, we conducted a meta-analysis of the experimental literature. We meta-analyzed 57 studies, conducted in 13 countries, with a cumulative N of 42,854. Pictorial warnings elicited greater cognitive elaboration (e.g., thinking about the risks of smoking; d = 1.27; p < .001) than text-only warnings. Pictorial warnings also elicited more fear and other negative affect (d = .60; p < .001). In contrast, pictorial warnings had no impact on perceived likelihood of harm (d = .03; p = .064), perceived severity (d = .16; p = .244), or experiential risk (d = .06; p = .449). Thus, while pictorial warnings increase affective and some cognitive risk appraisals, they do not increase beliefs about disease risk. We discuss the role of negative affect in warning effectiveness and the implications for image selection and warning implementation.
Comparison of two multiplex immunochromatographic assays for the rapid detection of major carbapenemases in Enterobacterales
Authors: Bogaerts Pierre , Berger Anne-Sophie , Evrard Stéphanie , Huang Te-Din
Published: February 2020

Objectives

Two commercially available lateral flow immunochromatographic assays (ICAs) for detection of the major carbapenemases were prospectively assessed for the detection of carbapenemases in Enterobacterales: RESIST-4 O.K.N.V. (Coris BioConcept) and NG-Test CARBA 5 (NG Biotech).

Methods

These two assays were performed prospectively on consecutive Enterobacterales suspected of producing a carbapenemase that were referred to the Belgian National Reference Center for Monitoring Antimicrobial Resistance in Gram-Negative Bacteria between March and June 2018. The intensity of the band corresponding to a carbapenemase for each test was compared using ImageJ software.

Results

Of the 161 isolates tested, a carbapenemase was detected in 91 (60 OXA-48-like, 15 VIM, 9 KPC, 5 NDM, 1 IMP and 1 IMP + OXA-48); in the remaining 70, no carbapenemases were detected. For both tests, the results were 100% concordant with the results of the PCR-sequencing reference method. Two IMP producers were only detected by NG-Test CARBA 5 as IMP is not targeted by RESIST-4 O.K.N.V. The mean intensity of the OXA-48, VIM and NDM bands displayed by NG-Test CARBA 5 was 3 to 3.7 times higher than for RESIST-4 O.K.N.V., while the KPC band was on average 1.7 times more intense with RESIST-4 O.K.N.V.

Conclusions

RESIST-4 O.K.N.V. and NG-Test CARBA 5 are two efficient assays for identification of the major carbapenemases. NG-Test CARBA 5 offers the advantage of detecting IMP, which remains rare in Western countries.
Postburn Nasal Reconstruction With Distally Based Radial Artery Perforator Flap: A Novel Technique
Authors: Karki Durga , Muthukumar Vamseedharan
Published: February 2020

Postburn total nasal reconstruction associated with face burns is challenge to all reconstructive surgeons. The local tissue flaps for reconstruction is virtually out of options, forcing surgeons to opt for distant tissues for nasal reconstruction. Here in, we have described the use of distally based radial artery perforator flap for total postburn nasal reconstruction which has not been described for nasal reconstruction. The anatomy and technique of the flap and case series is presented in this report. Two cases of total nasal reconstruction using the distally based radial artery perforator flap are presented, one case post thermal burn and another post chemical burn. Radial artery distal perforator-based pedicled flap is a versatile option for nasal reconstruction especially when there is a paucity of unscarred skin in loco regional options.
An iterative method of statistical tolerancing based on the unified Jacobian–Torsor model and Monte Carlo simulation
Authors: Peng Heping , Peng Zhuoqun
Published: February 2020

This paper focuses on exploring an iterative method of statistical tolerance design to guide designers to select tolerances more economically and effectively. After having identified the assembly functional requirement (FR) and the functional elements (FEs) of corresponding tolerance chain, the expression of a unified Jacobian–Torsor model can be derived. Monte Carlo simulation is employed to generate random variables simulating the variations of small displacement torsor associated with the FE pairs with all the generated random values being within the intervals constrained by the corresponding tolerance zones. Then, the real multiplication operations are repeatedly executed to this model, a large number of real torsor component values of FR will be obtained and we can perform statistical analysis for these simulated data to get the statistical limits of the assembly FR in the desired direction. The tolerances of critical FEs may need to be adjusted to satisfy the assembly FR imposed by the designer, and the percentage contribution of each FE to the assembly FR can help determine these critical tolerances that need to be tightened or loosened. Once the calculated FR is in close agreement with the imposed FR, the iterative process can be stopped, and the statistical tolerance redesign is achieved. The effectiveness of the proposed method is illustrated with a case study. Compared with the deterministic tolerancing method, the results show that the proposed method is more economical and that can relax significantly the precision required, manufacturing and inspection costs can then be reduced considerably.
Health-related quality of life in Japanese patients with prostate cancer following proton beam therapy: an institutional cohort study
Authors: Matsukawa Kyoko , Arimura Takeshi , Orita Makiko , Kondo Hisayoshi , Chuman Ikuko , Ogino Takashi , Taira Yasuyuki , Kudo Takashi , Takamura Noboru
Published: February 2020

Objective

Many treatment options have guaranteed long-term survival in patients with localized prostate cancer and health-related quality of life has become a greater concern for those patients. The purpose of this study was to reveal the health-related quality of life after proton beam therapy and to clarify the differences from other treatment modalities for prostate cancer.

Methods

Between January 2011 and April 2016, 583 patients were enrolled in the study and health-related quality of life outcomes using the Expanded Prostate Cancer Index Composite questionnaire were evaluated and compared with previous research targeted at Japanese patients.

Results

We found a significant decrease in the least square mean scores for urinary and bowel domains excluding the incontinence subscale after proton beam therapy (P < 0.0001) and recovery at a year following treatment. The scores for sexual function in patients without androgen deprivation therapy decreased each year after proton beam therapy (P < 0.0001). The scores for hormones in patients without androgen deprivation therapy remained high and those of patients with androgen deprivation therapy were lower before treatment but were comparable to those of non-androgen deprivation therapy patients at 2 years post-treatment. We found that the impact of radiotherapy including proton beam therapy on urinary condition and sexual function was lower than that of surgery.

Conclusions

For the first time in Japan, we investigated health-related quality of life using Expanded Prostate Cancer Index Composite questionnaires in patients with prostate cancer after proton beam therapy and compared it with other treatment modalities.
Rethinking Northern Hardwood Forest Management Paradigms with Silvicultural Systems Research: Research–Management Partnerships Ensure Relevance and Application
Authors: Walters Michael B , Roloff Gary J , Henry Catherine R , Hartman Jason P , Donovan Michael L , Farinosi Evan J , Starking Melissa D
Published: February 2020

Well-designed, robust partnerships are important for addressing forest resource problems that intersect diverse ownerships, management, and research expertise. Here, we describe a case study of a research–management partnership. First, we describe the rationale and design of a large-scale, long-term experiment focused on increasing the sustainability and resilience of managed northern hardwoods. With the experiment as context, we next discuss details of the partnership contributing to its success, as well as some challenges. The experiment is a Michigan-wide evaluation of silvicultural alternatives to the current paradigm of selection silviculture. Our goal is to identify combinations of silvicultural treatments that increase the diversity and density of sapling recruits over forested landscapes where deer-browsing pressure and other limiting factors are at play. Pretreatment data from our 140-site study bolstered justification for the research, with sapling and pole classes generally lacking adequate stocking and diversity of desirable species over large geographic extents. We anticipate that the wildlife and forestry research–management model used to develop this project will be useful for other rapidly developing challenges that cannot wait decades to be addressed without potentially catastrophic losses to forest function. Key beneficial elements of our partnership include: (1) sensitivity to information needs at all management levels (i.e., policy to practice), (2) capitalizing on differences in strengths and reward systems of managers and scientists, (3) structured, frequent scientist–manager meetings to maintain focus on research and management application outcomes, (4) long-term relations and support that build trust, and (5) explicit wildlife and forestry collaboration on problems requiring joint expertise. Challenges to our partnership generally revolved around communication, workload, and implementation issues, and were partially alleviated by planning.
Virtual Length and the Two I's of Qaraqosh Neo-Aramaic
Authors: Faust Noam , Lampitelli Nicola
Published: February 2020

This paper examines the differences in form between weak-final (III-j) verbs and strong verbs in the Neo-Aramaic dialect of Qaraqosh (Khan 2002). The analysis, conducted in the autosegmental theory of Strict CV (Lowenstamm 1996, Scheer 2004), derives these differences from the interaction of the common template with the weak radical of weak verbs. In addition, it accounts for two surprising facts about this lan-guage: (i) the distribution of the vowel [I], which only contrasts with other relevant vowels in the final unstressed position; and (ii) the marking, unique among Semitic languages, of a gender distinction in the imperative only on weak verbs. The analysis suggests that both these facts follow from the assumption that [I] is a phonologically short /i/, while a phonologically long /i/ is realized with the quality [i]. It thus argues for non-surface-true ‘virtual’ length.
Students Exposed to Community Violence
Authors: Rohde-Collins Dorothy
Published: February 2020

Exposure to community violence has a detrimental effect on the academic, social-emotional, and physical functioning of children, adolescents, and their families. Schools and educators are instrumental in enabling children and adults to process violence and trauma in order to develop a healthy worldview. Schools can counter the effects of community violence by emphasizing the development of sincere relationships between staff, students, and families; offering a warm, welcoming atmosphere; and providing a safe school environment conducive to learning. Educators can embed writing prompts and other opportunities for self-reflection within the academic curriculum as well as teach stress management, coping mechanisms, mindfulness, and relaxation techniques which can be used when a demanding situation arises. Educators and administrators are uniquely positioned to offer supports and opportunities within the school context to substantially improve the outcome for students, families, and communities experiencing community violence.
Research and Best Practices to Support Students with Incarcerated Parents
Authors: Sullivan Megan
Published: February 2020

The understanding of the relationship between a parent’s incarceration and a child’s outcomes has continued to evolve since the 1950s. Until very recently, however, most researchers have undertaken small-scale studies focused on the period when the parent is imprisoned, and most advocates and practitioners have had few resources at their disposal. All educators benefit from understanding how and why children of incarcerated parents may need support and from recognizing gaps in research. This chapter addresses developmental and other associated outcomes of parental incarceration and offers concrete practices schools can use to support children. In order to most effectively help students, school-based professionals should recognize the myriad ways parental incarceration impacts children’s emotional, physical, social and academic well-being.
Students with Parents Involved in Substance Abuse or Dependence
Authors: Malone Celeste M. , Ellis Tierra T. , Isom DeLon
Published: February 2020

Substance use affects more than the individual user; all those who have relationships with the person using are impacted and suffer the consequences of substance use. Parental substance use places children at risk for a wide range of adverse physical, psychological, social-emotional, and behavioral outcomes at all stages of the developmental continuum. However, schools can help mitigate those adverse outcomes by providing children with access to social support and helping them to develop coping skills. This chapter provides an overview of the short- and long-term effects of parental substance use and its impact on youth functioning and provides educators with strategies and resources to support these students and meet their needs.
Talking About Epilepsy
Authors: Lowenberg Kenneth
Published: February 2020

Epilepsy education and awareness are brought to the forefront in the following stories through innovative outreach, research, and marketing efforts.
In Honor of Carolina
Authors: Miller Eric
Published: February 2020

Epilepsy education and awareness are brought to the forefront in the following stories through innovative outreach, research, and marketing efforts.
Purple Day®
Authors: Megan Cassidy
Published: February 2020

Epilepsy education and awareness are brought to the forefront in the following stories through innovative outreach, research, and marketing efforts.
My Epilepsy Story
Authors: Parker-McFadden Brandy
Published: February 2020

Epilepsy education and awareness are brought to the forefront in the following stories through innovative outreach, research, and marketing efforts.
Athetosis and Dystonia
Authors: Shibasaki Hiroshi , Hallett Mark , Bhatia Kailash P. , Reich Stephen G. , Balint Bettina
Published: February 2020

Athetosis is characterized by irregular, slow, writhing, bizarre movements seen in hands and feet. Athetosis is classified as minor athetosis and major athetosis based on its magnitude. Minor athetosis is seen in patients with mild cerebral palsy. Major athetosis is caused by organic lesions of the striatum, including cerebral palsy, as a residual state of encephalitis, and after anoxic encephalopathy. In these conditions, athetosis is commonly seen in combination with dystonia. Dystonia is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements or postures or both. In many cases of dystonia, the affected part of the body shows an abnormal writhing posture in the resting condition, and slow, writhing involuntary movements are superimposed on the abnormal posture with voluntary movement. For childhood-onset patients, dystonia is most commonly generalized; in adults, typically there is focal dystonia. Focal dystonia includes blepharospasm, cervical dystonia, writer’s cramp, and musician’s cramp. It is often task-specific and can be treated with local botulinum toxin injection. Generalized dystonia is caused by long use of neuroleptic drugs (tardive dystonia) and a variety of neurodegenerative diseases.
Concussion One Hour Later
Authors: Hainline Brian , Gurin Lindsey J. , Torres Daniel M.
Published: February 2020

Concussion is not a singular event, but rather a neurological process that may evolve over minutes to hours. Individuals with uncomplicated concussion may develop either increased or new symptoms during the first several hours following the initial injury, yet such symptoms do not result from progressive brain damage but rather a functional cascade of metabolic dysfunction. Any individual with suspected concussion should be monitored serially, as symptoms may evolve over time. When worsening symptoms do not manifest with worrisome neurologic signs, the individual does not require urgent transfer to a hospital and does not need urgent brain imaging studies. Therefore, concussion symptom evolution should be anticipated and distinguished from more severe traumatic brain injury.
Objective Biomarkers and Concussion
Authors: Hainline Brian , Gurin Lindsey J. , Torres Daniel M.
Published: February 2020

Concussion is diagnosed clinically, and the diagnosis relies primarily on subjective symptoms. Currently there are no objective biomarkers to diagnose concussion, although promising ones are emerging. Without objective biomarkers, concussion must be diagnosed clinically, and the symptoms that clinicians rely on are non-specific and may result from non-concussion disorders. The push to develop objective biomarkers has accelerated during the past several years. Objective biomarkers include evaluations of blood products that indicate nervous system injury or inflammation, brain imaging studies, and head accelerometry. At present, there is no identified correlation between measured head impact and development of a concussion.
What patients wish you understood
Authors: Snow Rosamund
Published: February 2020

Learning medicine has traditionally meant a strong focus on acute medicine—diagnosing, treating, curing, and concentrating on one part of the body at a time. Traditionally, the doctor has always been the expert, the person we come to when something is wrong, to help make our bodies healthy again. Those skills are still vital, but things are changing in several key ways. This chapter is written from a personal viewpoint on how helping patients manage chronic conditions requires a different set of skills from those used in acute medicine. Diagnosis becomes only a tiny part of the story, because people can live with a long-term condition for a lifetime, and restoring people to full health is often impossible. Dividing the body up into textbook chapters becomes less and less relevant because chronic illnesses can impact on many body parts at once.
Principles of clinical pharmacology and drug therapy
Authors: O’Shaughnessy Kevin
Published: February 2020

In its widest sense, a drug is any chemical entity that can perturb a biological system. For the purposes of drug therapy, the biological system is the human body and the perturbation is exploited to aid the diagnosis, treatment, or even cure of a disease process. When prescribing for the individual patient, guidelines, formularies, and other prescribing aids are not a substitute for an intelligent clinical approach. The prescriber needs to establish what the patient’s experience and expectations of drug therapy are, and the patient needs to know the likely consequences—both good and bad—of taking any drug that is prescribed. This dialogue is important, since it will often decide whether the patient actually takes the drug as prescribed. Patient compliance is a key variable in the prescribing process, and one over which the doctor often has least control.
Engaging patients in therapeutic development
Authors: Kakkis Emil , Bronstein Max
Published: February 2020

Engagement of patients during the development of new treatments has evolved rapidly in the last decade. No longer should patients be viewed as passive subjects of research: they should be active participants in a more open and ambitious ecosystem of academic investigators, companies, and government entities. Enhanced engagement of patients throughout the development process provides important benefits for the introduction of useful and effective drugs by changing the understanding of the disease, the measurement of the disease during treatment, and the interpretation of benefit-risk. This system is critical for the discovery, study, development, regulation, delivery, and use of innovative therapies.
Preventive medicine
Authors: Mant David
Published: February 2020

Deaths from infectious diseases and trauma usually reflect poverty and political instability. Prevention requires political action to reduce the risk of war and improve the supply of food, clean water, sanitation, and shelter. Preventive medicine can help by controlling spread of infection through vaccination, health education, control of insect vectors, and treatment of disease carriers to prevent onward transmission.

Many effective preventive interventions such as legislation to make seatbelts compulsory or tax tobacco should be targeted at the whole population, whereas preventive medicine provided by clinicians must target individuals. This often requires screening to detect early signs of disease (e.g. HIV infection, cancer) or markers of risk of disease (e.g. high blood pressure, intrauterine growth delay), but clinicians must be clear that something effective can be done to ameliorate the condition detected before any screening is undertaken.
Medical screening
Authors: Wald Nicholas , Law Malcolm
Published: February 2020

Medical screening is the systematic application of a test or inquiry to identify individuals at sufficient risk of a specific disorder to benefit from further investigation or direct preventive action (these individuals not having sought medical attention on account of symptoms of that disorder). Key to this definition is that the early detection of disease is not an end in itself; bringing forward a diagnosis without altering the prognosis is useless and may be harmful. Before a potential screening test is introduced into practice it must be shown to prevent death or serious disability from the disease to an extent sufficient to justify the human and financial costs. Where a detection rate cannot be directly determined (e.g. in cancer screening, or if the efficacy of the intervention is uncertain), a randomized trial is needed to show that screening and subsequent treatment reduce disease-specific mortality.
Health promotion
Authors: de Leeuw Evelyne
Published: February 2020

The ‘Ottawa Charter for Health Promotion’ (1986) remains a benchmark for the global health promotion community, but the context for health promotion has changed with increasing recognition of the significance of inequalities in health. Health promotion is a key strategy to deal with the social determinants of health that create these inequities. Attention has shifted from the mere recognition that all public policies may impact on health to active strategies and actions to move health concerns into all policies. Clinicians are key actors in shaping social and cultural priorities and beliefs: they should be committed to the reduction of health inequity, with health promotion as a core commitment and responsibility.
Deprivation and health
Authors: Burns Harry
Published: February 2020

The health of an individual is influenced by the circumstances in which he or she lives. Individuals who live in poverty are more likely to be unhealthy and die younger than individuals who are wealthy. The mechanism by which complex social circumstances cause health inequalities might be a failure to create capacity to manage life’s challenges. Most agree that well-being is created where individuals have an optimistic outlook, a sense that they are in control of their own lives, a sense of purpose and meaning in life, confidence in their ability to deal with problems, a supportive network of friends, and a nurturing family. If society is serious about tackling health inequalities, action needs to happen across the life course.
How much should rich countries’ governments spend on healthcare?
Authors: Pollock Allyson M. , Price David
Published: February 2020

The argument commonly made by politicians in richer countries is that a universal health system is unaffordable because of the enormous gains in life expectancy leading to an ageing population, and that market-driven competition and choice is preferred because it increases efficiency. There is no evidence to support these claims, and evidence to the contrary on both counts. The ageing of the population contributes little to the overall growth in expenditure, which is largely attributable to increasing marketization of health systems and costs of medicines and technologies. Many countries have decided that universal healthcare is the hallmark of a civilized society and that it is both necessary and affordable for governments to legislate for its citizens to that end.
Regulation versus innovation in medicine
Authors: Rawlins Michael
Published: February 2020

Two tragedies created drug regulatory authorities in the form they exist today. The marketing in 1937 of an elixir of sulphanilamide using diethyl alcohol as the solvent led to over 100 children dying from acute kidney injury. The use from 1957 of thalidomide as a treatment for morning sickness led to the development of phocomelia (and other abnormalities) in the fetuses of about 10 000 mothers who had been given it during their pregnancies. Drug regulatory authorities initially tended to be risk averse, but now recognize concern that the process of drug regulation might inhibit the development and licensing of novel products. They now pursue a more risk-based approach to regulation and seek to support safe innovation, with arrangements including scientific advice programmes, orphan drug approval processes, and expedited approval processes, although these are not without their critics.