bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival and prognostic factors in cats with restrictive cardiomyopathy: a review of 90 cases
Authors: Locatelli Chiara , Pradelli Danitza , Campo Giulia , Spalla Ilaria , Savarese Alice , Brambilla Paola G , Bussadori Claudio
Published: February 2018

Objectives

Large studies focusing on restrictive cardiomyopathy (RCM) in the cat are scarce. The aims of this retrospective study were to describe epidemiological characteristics and to analyse prognostic factors affecting survival in cats with RCM.

Methods

The clinical archives of the Gran Sasso Veterinary Clinic (Milan, Italy) and of the cardiology unit of the Department of Veterinary Medicine (University of Milan, Italy) from 1997–2015 were reviewed for all cats diagnosed with RCM based on an echocardiographic examination (left atrial/biatrial enlargement, normal left ventricle wall thickness, normal or mildly decreased systolic function and restrictive left ventricle filling pattern with pulsed Doppler echocardiography).

Results

The study population comprised 90 cats (53 male, 37 female) with an echocardiographic diagnosis of RCM. Most were domestic shorthairs (n = 60) with a mean ± SD age of 10.0 ± 4.3 years and a median weight of 3.8 kg (interquartile range 3.2–5 kg). Most cats were symptomatic (n = 87). The most common clinical sign was respiratory distress (n = 75). Follow-up was available for 60 cats and the median survival time (MST) was 69 days (95% confidence interval [CI] 0–175 days). Cardiac-related death occurred in 50 cats. In the multivariate Cox analysis only respiratory distress showed a statistically significant effect on survival. The cats without respiratory distress showed an MST of 466 days (95% CI 0–1208); cats with respiratory distress showing an MST of 64 days (95% CI 8–120; P = 0.011).

Conclusions and relevance

RCM can be considered an end-stage condition associated with a poor prognosis, with few cats not showing clinical signs and surviving >1 year. Most cats died of cardiac disease within a very short time.
Retrospective study of 152 feline cytological bone marrow examinations: preliminary classification and ranges
Authors: Turinelli Vanessa , Gavazza Alessandra
Published: February 2018

Objectives

Cytological assessment of the bone marrow is an essential tool for understanding and investigating haematological abnormalities. Sometimes it represents the only way to reach a definitive diagnosis. The purpose of this study was to provide a general overview regarding the prevalence of feline bone marrow disorders encountered in a private European laboratory setting, to classify them and to assess the differential cell counts related to such disorders.

Methods

In total, 152 bone marrow samples were classified using cytological and numerical criteria. The bone marrow cytological examinations were performed after the identification of haematological alterations, such as cytopenias, increased number of cells or suspicion of malignant blood disorders.

Results

Of the 152 bone marrow samples evaluated, 71 (46.7%) were classified as hyperplastic, primarily granulocytic and erythroid hyperplasia (50.7% and 45.1%, respectively, of the total hyperplasia); 23 (15.1%) showed dysmyelopoiesis, mainly in the form of myelodysplastic syndrome (39.1% of the total dysmyelopoiesis); 21 (13.8%) had no cytological abnormalities; 17 (11.2%) were malignant blood disorders; 15 (9.9%) had hypoplastic conditions; and two (1.3%) were miscellaneous diseases. Metastatic disease was detected in only two cases (1.3%). Differential cell counts and myeloid-to-erythroid (M:E) ratios were reported for normal, erythroid hypoplastic, erythroid and granulocytic hyperplastic and dysplastic conditions.

Conclusions and relevance

This study provides a general overview of the prevalence and incidence of feline bone marrow disorders together with ranges for differential nucleated cell counts and M:E ratios for the various conditions reported.
Thermal analysis of twin-disc machine for traction tests and scuffing experiments
Authors: Isaac G , Changenet C , Ville F , Cavoret J , Becquerelle S
Published: February 2018

Literature agrees that thermal effects have a great influence on friction. However, the heat flows and the thermal behaviour of test rigs used to characterize friction coefficient are largely dependent on their architecture. As a consequence, some discrepancies can be noted between the frictional responses measured by different test benches. Therefore, a thermal model of a twin-disc machine has been developed using the thermal network methodology. This model allows thermal analyses of the traction tests performed with this twin-disc machine. The results reveal that the disc bulk temperature has a significant impact on friction coefficient. Some scuffing experiments are also studied thanks to this numerical model, and a thermal interpretation of classical scuffing criteria is proposed.
Comparative research on the effect of an oxide coating and a tribo-oxide layer on dry sliding wear of Ti–6Al–4V alloy
Authors: Zhou Yin , Wang Shuqi , Chen Wei , Jiang Wei , Wang Lan , Chen Kangmin , Cui Xianghong
Published: February 2018

The effect of an oxide coating and a tribo-oxide layer on dry sliding wear of Ti–6Al–4V alloy was comparatively studied. The oxide coating was prepared on Ti–6Al–4V alloy by a thermal oxidation/diffusion process; the tribo-layer was an in situ produced mechanically mixed layer during dry sliding. The oxide coating markedly improved the wear performance of Ti–6Al–4V alloy at room and elevated temperatures. Tribo-layers were classified into three types: no-oxide tribo-layer, porous, and dense tribo-oxide layers. Both porous and dense tribo-oxide layer presented protective function, thus significantly improving wear performance of Ti–6Al–4V alloy. However, no other than dense tribo-oxide layer was qualified to be comparable to the oxide coating, which almost possessed the same wear-reduced function as the oxide coating. Even when the oxide coating was severely delaminated, the tribo-oxide layer would replace the oxide coating and took effect to protect from wear.
A parametric study of the combined effects of window property and air vent placement
Authors: Duan Qiuhua , Wang Julian (Jialiang)
Published: February 2018

The creation of energy-efficient buildings that maintain thermal comfort is a major goal of architectural design. The study on the interrelation of vent location and window properties on indoor thermal conditions and energy performance is still needed. With the rapid development of building window technologies, such combined effects have become more complex. This work using computational fluid dynamics examines airflow patterns, temperature distributions, thermal comfort indices and corresponding heat transfers through exterior windows in an office unit during summer and winter seasons. Our results indicate that, buildings with low-insulated windows, above-the-window air register and under-the-window air register, have obvious advantages in forming comfortable conditions in summer and winter, respectively. Building with highly insulated windows, the central-ceiling placement of air supply vents is capable of merging airflows for the entire room, providing appropriate indoor thermal conditions and significant savings in energy use. The percentage of occupants dissatisfied with the thermal conditions achieved is slightly higher than best performances achieved in other reference models but still within recommended limits. The findings from this research provide an improved understanding of how thermal comfort and energy issues could change in response to different vent locations and types of building windows.
Human rights or security? Positions on asylum in European Parliament speeches
Authors: Frid-Nielsen Snorre Sylvester
Published: February 2018

This study examines speeches in the European Parliament relating to asylum. Conceptually, it tests hypotheses concerning the relation between national parties and Members of European Parliament. The computer-based content analysis method Wordfish is used to examine 876 speeches from 2004 to 2014, scaling Members of European Parliament along a unidimensional policy space. Debates on asylum predominantly concern positions for or against European Union security measures. Surprisingly, national party preferences for European Union integration were not the dominant factor. The strongest predictors of Members of European Parliament's positions are their national parties’ general ‘right-left’ preferences, and duration of European Union membership. Generally, Members of European Parliament from Central and Eastern Europe and the European People's Party take up pro-security stances. Wordfish was effective and valid, confirming the relevance of automated content analysis for studying the European Union.
Legislative Participation in the EU: An analysis of questions, speeches, motions and declarations in the 7th European Parliament
Authors: Sorace Miriam
Published: February 2018

Which legislative activities in the European Parliament are ‘pluralistic’ – i.e. undertaken by all Members of the European Parliament, irrespective of legislative and electoral status? What type of parliamentary activity – if any – is dominated by party leaderships or vote-seekers in the European Union? This study will advance our knowledge of legislative politics in the EU by determining whether its legislature conforms to expectations from the legislative behaviour literature. This study compares the participation patterns in the EP7 (2009–2014) parliamentary questions, speeches, motions and written declarations via multilevel negative binomial regression. It makes use of a dataset on activity levels and demographics of 842 individual Members of the European Parliament serving between 2009 and 2014. The findings highlight that highly procedurally constrained activities, such as speeches and oral questions, are dominated by frontbenchers and vote-seekers, while procedurally ‘freer’ activities – written questions in particular – are very representative of the population of Members of the European Parliament. The analysis finds that there are both ‘pluralistic’ and vote-seeking activities in the ‘second order’ EU legislature, and that participation patterns broadly conform to patterns found in other established representative democracies.
A Qualitative Examination of Parent Engagement in a Family-Based Childhood Obesity Program
Authors: Schmied Emily A. , Chuang Emmeline , Madanat Hala , Moody Jamie , Ibarra Leticia , Ortiz Kenia , Macias Karla , Ayala Guadalupe X.
Published: February 2018

Low parent engagement is frequently identified as a barrier to effective implementation of family-based childhood obesity prevention and control programs. A more nuanced understanding of factors affecting parent engagement is important for improving implementation and, ultimately, program efficacy. This qualitative study examined factors influencing parent engagement in a family-based childhood obesity prevention and control program. Semistructured interviews informed by the health belief model and the transtheoretical model were conducted with 22 predominantly Latina mothers following the scheduled conclusion of program activities. Spanish- and English-language interviews were transcribed, translated into English (if Spanish), coded, and summarized using established protocols. Differences between parents who attended at least two thirds of program activities and those who did not were examined. There were no significant demographic differences between parents who did and did not complete two thirds of program activities. Findings indicated that differences in parent engagement may be at least partially explained by differences in parental motivations for participating and in barriers and facilitators, such as children’s level of support and enthusiasm for the program. Parents were highly satisfied with the program content and the community health workers who delivered the program. This study adds to emergent literature regarding parents’ experiences in family-based childhood obesity prevention and control programs. Potential targets for improving program engagement are discussed.
Is This Social TV 3.0? On Funk and Social Media Policy in German Public Post-television Content Production
Authors: Stollfuß Sven
Published: February 2018

This article investigates how social media affects German public television. Due to recent dynamics in the field of social TV, notions of social TV as basically “tweeting while watching TV,” or as an “additional function” of television, need to be revised. As an addition to existing ideas of “Social TV 1.0” and “Social TV 2.0” and other characterizations, I refer here to “Social TV 3.0.” Current social TV features need to be characterized in the light of a “network of content” that combines the “media logic of television” and the “logic of social media” by means of their dynamic, flexible, and horizontal integration into the “matrix-media strategy” of TV executives impelled by a social media policy. By taking the content network funk (“a consortium of public broadcasters” [ARD] and “Second German Television” [ZDF]) as a prime example of social TV 3.0 in Germany, I analyze the merging of television and social media.
Quantitative evaluation to efficacy and safety of therapies for psoriasis: A network meta-analysis
Authors: Lv Jingjing , Zhou Dongmei , Wang Yan , Zhao Jingxia , Chen Zhaoxia , Zhang Jinchao , Di Tingting , Hu Jing , Li Bo , Li Ping , Huang Feng
Published: February 2018

Therapies treating psoriasis can be categorized into five classes according to their mechanism: anti-metabolites (AM), anti-interleukin-12/23 agents (anti-IL12/23), anti-interleukin-17 agents (anti-IL17), anti-T-cell agent (ANT), and anti-tumor necrosis factor-α agent (anti-TNF-α). This network meta-analysis (NMA) aimed to give a quantitative and systemic evaluation of safety and efficacy for the five kinds of therapies mentioned above. Odds ratios and mean differences were calculated to evaluate binary and continuous outcomes, respectively. Forest plots were conducted to show the performance of pair-wise comparison of above therapies in each outcome, and surface under the cumulative ranking curves was given to evaluate the relative ranking of above therapies in each outcome. Node splitting was conducted to evaluate the consistency between direct and indirect evidence. Direct comparisons from 65 studies (32,352 patients) were included in this NMA. Our results showed an excellent efficacy of anti-IL12/23 and anti-IL17. However, these two therapies and anti-TNF-α were revealed to have a high possibility to cause adverse effects (AEs) such as infections. Additionally, node splitting showed that no inconsistency appeared between the direct and indirect comparisons. Anti-IL12/23 was the most recommended therapy according to this NMA. Anti-IL17 had similar efficacy to anti-IL12/23 but should be applied with caution since it has poor performance in safety outcomes.
Role of medullary astroglial glutamine synthesis in tooth pulp hypersensitivity associated with frequent masseter muscle contraction
Authors: Watase Tetsuro , Shimizu Kohei , Ohara Kinuyo , Komiya Hiroki , Kanno Kohei , Hatori Keisuke , Noma Noboru , Honda Kuniya , Tsuboi Yoshiyuki , Katagiri Ayano , Shinoda Masamichi , Ogiso Bunnai , Iwata Koichi
Published: February 2018

Background

The mechanisms underlying tooth pulp hypersensitivity associated with masseter muscle hyperalgesia remain largely underinvestigated. In the present study, we aimed to determine whether masseter muscle contraction induced by daily electrical stimulation influences the mechanical head-withdrawal threshold and genioglossus electromyography activity caused by the application of capsaicin to the upper first molar tooth pulp. We further investigated whether astroglial glutamine synthesis is involved in first molar tooth pulp hypersensitivity associated with masseter muscle contraction.

Methods

The first molar tooth pulp was treated with capsaicin or vehicle in masseter muscle contraction or sham rats, following which the astroglial glutamine synthetase inhibitor methionine sulfoximine or Phosphate buffered saline (PBS) was applied. Astroglial activation was assessed via immunohistochemistry.

Results

The mechanical head-withdrawal threshold of the ipsilateral masseter muscle was significantly decreased in masseter muscle contraction rats than in sham rats. Genioglossus electromyography activity was significantly higher in masseter muscle contraction rats than sham rats. Glial fibrillary acidic protein-immunoreactive cell density was significantly higher in masseter muscle contraction rats than in sham rats. Administration of methionine sulfoximine induced no significant changes in the density of glial fibrillary acidic protein-immunoreactive cells relative to PBS treatment. However, mechanical head-withdrawal threshold was significantly higher in masseter muscle contraction rats than PBS-treated rats after methionine sulfoximine administration. Genioglossus electromyography activity following first molar tooth pulp capsaicin treatment was significantly lower in methionine sulfoximine-treated rats than in PBS-treated rats. In the ipsilateral region, the total number of phosphorylated extracellular signal-regulated protein kinase immunoreactive cells in the medullary dorsal horn was significantly smaller upon first molar tooth pulp capsaicin application in methionine sulfoximine-treated rats than in PBS-treated rats.

Conclusions

Our results suggest that masseter muscle contraction induces astroglial activation, and that this activation spreads from caudal to the obex in the medullary dorsal horn, resulting in enhanced neuronal excitability associated with astroglial glutamine synthesis in medullary dorsal horn neurons receiving inputs from the tooth pulp. These findings provide significant insight into the mechanisms underlying tooth pulp hypersensitivity associated with masseter muscle contraction.
A variant in the SCN10A enhancer may affect human mechanical pain sensitivity
Authors: Duan Guangyou , Sun Jiaoli , Li Ningbo , Zheng Hua , Guo Shanna , Zhang Yuhao , Wang Qingli , Ying Ying , Zhang Mi , Huang Penghao , Zhang Xianwei
Published: February 2018

Expression of Nav1.8, encoded by SCN10A, can affect pain transmission and thus mediate the human pain phenotype. In the current study, we assessed whether the variant rs6801957, located in the SCN10A enhancer region, may have the potential to affect human pain. Through dual-luciferase reporter assays in 293T cells, we found that the SCN10A enhancer A (Enh-A) increased the activity of the SCN10A promoter ( P < 0.05). Additionally, in a cohort of 309 healthy women, mutant rs6801957 A/A was found to have a significant association with decreased human experimental mechanical pain sensitivity ( P < 0.05). We then found that mutant genotype A/A suppressed the increased effect of Enh-A compared with wild-type G/G ( P < 0.05). The association between rs6801957 and human experimental mechanical pain sensitivity was further validated in a larger cohort of 1005 women ( P < 0.05). In conclusion, these results demonstrated that the variant rs6801957 and Enh-A may affect SCN10A gene expression and play an important role in human mechanical pain sensitivity.
Similarity and decision time in preferential choice
Authors: Bhatia Sudeep , Mullett Timothy L
Published: February 2018

Choice option similarity is a key contextual variable in multiattribute choice. Based on theories of preference accumulation, we predicted that decision times would be longer when the available choice options were similar compared with when they were dissimilar, controlling for the relative desirabilities of the options. We tested for the relationship between similarity and decision time in an experiment involving incentivised binary choices between items of equivalent desirability and found that our predictions were confirmed. Our results show how the effects of contextual factors on key decision variables can be accurately predicted by existing computational theories of decision-making.
Towards a universal declaration on internet rights and freedoms?
Authors: Pettrachin Andrea
Published: February 2018

This article, conceived as a mainly empirically based contribution, analyses a discursive context composed of 58 documents proclaiming Internet-related human rights drafted and launched by different actors between 1997 and 2015. The article hypothesises that a discourse on Internet-related human rights is being shaped, autonomous from the broader discourse on Internet governance. Therefore, differently from other scholarly works, it does not focus on the many initiatives aimed at defining principles for the governance of the Internet but only on those documents that specifically aim to proclaim Internet-related rights and freedoms. The article, first, analyses the findings of a software-enabled content analysis aimed at (1) identifying the key issues that dominate the discourse, (2) assessing the evolution of the discourse in the last two decades and (3) identifying the thematic priorities of different types of drafting entities. Second, it discusses possible research, policy and legal developments.
Tensioning of the radioscaphocapitate and long radio-lunate ligaments for dynamic radiocarpal instability
Authors: Rubensson Carin , Johansson Torsten , Adolfsson Lars
Published: February 2018

During 1994–2003, we treated 20 patients with post-traumatic radial-sided wrist pain and dynamic radiocarpal instability. After arthroscopy confirmed no disruption of the radioscaphocapitate ligament and an increased laxity of the ligament, we passed a strip of the radioscaphocapitate ligament through the long radio-lunate ligament. The rationale of this procedure was to increase tension of the two ligaments and to close the space of Poirier. Eighteen patients were assessed after 1–3.7 years (mean 2.5 years). Four patients were symptom-free and 11 patients were markedly improved. Fourteen patients were followed for 11–15 years; four patients were symptom-free and eight patients were markedly improved. Two reported unchanged symptoms and none was worse in the follow-up. Based on our findings, we suggest a cause of post-traumatic radial-sided wrist pain is laxity of the radiocarpal joint. We conclude that our surgical procedure increases tension in the radioscaphocapitate and long radio-lunate ligaments and decreases wrist pain at rest and during activity.

Level of Evidence: IV
The association between preaxial polydactyly and radial longitudinal deficiency in syndromic cases: a report on nine families
Authors: Al-Qattan Mohammad M.
Published: February 2018

Preaxial polydactyly and radial longitudinal deficiency are usually viewed as two different entities. We present nine families with different disorders in which both preaxial polydactyly and radial longitudinal deficiency were seen in the phenotype. This indicates that both entities may be caused by the same developmental error or insult. The pathogenesis is complex and may be related to the interactions of two signalling loops: the first loop (named as the radial longitudinal deficiency loop) contains genes/proteins responsible for the development of the radial ray; and the second loop (named as the preaxial polydactyly loop) contains the Sonic Hedgehog involved in the pathogenesis of preaxial polydactyly. This entity is named as the preaxial polydactyly–radial longitudinal deficiency association and should be included in the description of the preaxial polydactyly spectrum.

Level of evidence: IV
Efficacy and safety of pasireotide-LAR for the treatment of refractory bleeding due to gastrointestinal angiodysplasias: results of the ANGIOPAS multicenter phase II noncomparative prospective double-blinded randomized study
Authors: Benamouzig Robert , Benallaoua Mourad , Saurin Jean-Christophe , Boubaya Marouane , Cellier Christophe , Laugier René , Vincent Magalie , Boustière Christian , Gincul Rodica , Samaha Elia , Grandval Philippe , Aparicio Thomas , Airinei Gheorghe , Bejou Bakhtiar , Bon Cyriaque , Raynaud Jean-Jacques , Levy Vincent , Sautereau Denis
Published: February 2018

Background:

Gastrointestinal angiodysplasias (GIADs) could be responsible for recurrent bleeding and severe anemia. Somatostatin analogs could reduce transfusion requirements in these patients but no randomized controlled study is available. The main objective of the ANGIOPAS phase II double-blinded randomized, noncomparative study was to assess the effectiveness of pasireotide-LAR in reducing transfusion requirements in patients with refractory GIADs bleeding.

Methods:

A total of 22 patients with transfusion requirements ⩾6 units of packed red blood cells (pRBCs) during the 6 months prior to inclusion were randomized to receive pasireotide-LAR 60 mg ( n = 10) or placebo ( n = 12) every 28 days for 6 months. Patients were then followed for an additional 6 months after stopping treatment.

Results:

The pasireotide-LAR and placebo groups were equivalent for age, sex, comorbidities and transfusion requirement during the reference period (median 13 and 9.5 pRBCs). A 50 and 83% success rate (success defined as a decrease of at least 30% of transfused pRBCs) was observed in the pasireotide-LAR arm in the Intent to Treat (ITT) and per protocol (PP) analysis respectively. The need for transfusion during the intervention period was 3 pRBC units in the pasireotide-LAR group (range 0–26) and 11.5 pRBC units in the placebo group (range 0–23). Overall, three cases with glycemic control impairment were observed in the pasireotide-LAR group including one de novo diabetes.

Conclusion:

This double-blinded noncomparative randomized phase II study suggests, for the first time, the effectiveness of pasireotide-LAR 60 mg every 28 days to decrease the transfusion requirement in patients with recurrent bleeding due to GIADs.
Impact of Clostridium difficile toxin gene PCR result on decisions to de-isolate patients: Do the ends justify the means?
Authors: Morris Kirsti A , Davies Kerrie , Wilcox Mark H
Published: February 2018

We aimed to determine how often Clostridium difficile toxin gene PCR assay (CDPCR)-negative patients were appropriately removed from single room contact isolation. Hospital databases were used to collect information on glutamate dehydrogenase (GDH)-positive, toxin-negative inpatients (February–April 2015). Of 60 CDPCR-negative patients, only two (3%) were removed from single room isolation. At least 36% of 53 CDPCR-positive results did not influence bed management. In conclusion, identification of C. difficile toxigenic status did not impact significantly on decisions whether to continue single room isolation. Cost-benefit analysis should be undertaken before CDPCR testing is introduced.
A comparison of the minimum data sets for primary shoulder arthroplasty between national shoulder arthroplasty registries. Is international harmonization feasible?
Authors: Aveledo Ricardo , Holland Phillip , Thomas Michael , Ashton Fiona , Rangan Amar
Published: February 2018

The aims of this study were to identify the common components of the Minimum Data Set (MDS) of current national shoulder arthroplasty registries that could be pooled for analysis; and to determine whether further harmonisation of data collection across these registries would be feasible. Copies of primary shoulder arthroplasty MDS forms, annual reports, and other publications from national shoulder arthroplasty registries were identified using internet search engines up to November 2016. Data relating to local or regional registries was excluded. There were nine national shoulder arthroplasty registries reporting a total of 97,388 primary shoulder replacements. All minimum data sets included patient identifiers, date of surgery, implant identification, laterality of surgery, indication and mode of implant fixation. At least 6 registries had common options within the categories of indication, implant fixation and previous operations. Most discrepancies were seen in categories for additional interventions, outcome measures, and intra-operative complications. As numbers within individual registries are relatively small, international collaboration would harness the global strength of knowledge and experience in shoulder replacement. Several similarities were identified between the current national registries that could become unified with only minor changes by a few registries, highlighting the potential feasibility of MDS harmonisat.
Single-Occupancy Patient Rooms: A Systematic Review of the Literature Since 2006
Authors: Taylor Ellen , Card Alan J. , Piatkowski Melissa
Published: February 2018

Aim:

Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs.

Background:

In 2006, a requirement for SPRs in hospitals was instituted in the United States. This systematic literature review evaluates research published since that time to evaluate the impact of SPRs.

Methods:

The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched included MEDLINE, CINAHL, and Scopus. Supplemental searches were performed. We included studies reporting patient outcomes or user opinion related to SPRs. Appraisal was conducted using a dual appraisal system of evidence levels and methodological quality.

Results:

Forty-three studies qualified for appraisal. Three were excluded due to methodological quality (no appraisal score). One study was appraised for three individual outcomes (i.e., falls, infections, and user opinion). Eleven studies with low methodological quality scores were not included in the narrative synthesis. Overall, 87% of studies reported advantages associated with SPRs (some a combination of advantages and disadvantages or a combination of advantages and neutral results). Outcomes with the best evidence of benefit include communication, infection control, noise reduction/perceived sleep quality, and preference/perception.

Conclusion:

SPRs seem to result in more advantages than disadvantages. However, healthcare is a complex adaptive system, and decisions for 100% SPRs should be reviewed alongside related issues, such as necessary workflow modifications, unit configuration and other room layout decisions, patient populations, staffing models, and inherent trade-offs (e.g., the advantages of privacy compared to disadvantage of isolation).
Treating Severe Knee Osteoarthritis with Combination of Intra-Osseous and Intra-Articular Infiltrations of Platelet-Rich Plasma: An Observational Study
Authors: Sánchez Mikel , Delgado Diego , Pompei Orlando , Pérez Juan Carlos , Sánchez Pello , Garate Ane , Bilbao Ane Miren , Fiz Nicolás , Padilla Sabino
Published: February 2018

Objective

Assessing the therapeutic effects of a combination of intra-articular and intra-osseous infiltrations of platelet-rich plasma (PRP) to treat severe knee osteoarthritis (KOA) using intra-articular injections of PRP as the control group.

Design

In this observational study, 60 patients suffering from severe KOA were treated with intra-articular infiltrations of PRP (IA group) or with a combination of intra-osseous and intra-articular infiltrations of PRP (IO group). Both groups were matched for sex, age, body mass index, and radiographic severity (III and IV degree according to Ahlbäck scale). Clinical outcome was evaluated at 2, 6, and 12 months, using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires.

Results

At 2, 6 and 12 months after treatment, IO group had a significant improvement in all KOOS and WOMAC subscales ( P < 0.05). On the contrary, patients of the IA group did not improve in any of the scores. Sixteen out of 30 IO group patients showed minimal clinically important improvement (MCII) whereas 8 out of 30 IA group patients showed this response at 6 months (26.7%; 95% CI −0.4 to 49.9; P = 0.037). At 12 months, 14 patients of IO group and 5 patients of the IA group showed MCII (30%; 95% CI 4.3 to 51.9; P = 0.013). No differences between groups were observed at 2 months.

Conclusions

PRP intra-articular injections in severe KOA were not effective and did not provide any benefit. Combination of intra-articular and intra-osseous infiltrations of PRP was not clinically superior at 2 months, but it showed superior clinical outcomes at 6 and 12 months when compared with intra-articular injections of PRP.
Clarifying Gender Differences in Moral Dilemma Judgments: The Complementary Roles of Harm Aversion and Action Aversion
Authors: Armstrong Joel , Friesdorf Rebecca , Conway Paul
Published: February 2018

Moral dilemmas entail situations where decisions consistent with deontological principles (following moral rules) conflict with decisions consistent with utilitarian principles (maximizing overall outcomes). Past work employing process dissociation (PD) clarified that gender differences in utilitarianism are modest, but women are substantially more deontological than men. However, deontological judgments confound two motivations: harm aversion and action aversion. The current work presents a mega-analysis of eight studies ( N = 1,965) using PD to assess utilitarian and deontological response tendencies both when deontology entails inaction and when it requires action, to assess the independent contributions of harm aversion and action aversion. Results replicate and clarify past findings: Women scored higher than men on deontological tendencies, and this difference was enhanced when the deontological choice required refraining from harmful action rather than acting to prevent harm. That is, gender differences in deontological inclinations are caused by both harm aversion and action aversion.
Erectile dysfunction: A hidden epidemic
Authors: Yap Jonathan , Tan Francine Chiu Lan , Shen Tong , Teo Tse Yean , Yeo Khung Keong
Published: February 2018

Erectile dysfunction is commonly faced by men with cardiovascular disease. We aimed to determine the prevalence of erectile dysfunction in patients with cardiovascular disease risk factors in Singapore. We conducted a cross-sectional survey on patients with cardiovascular disease risk factors from June 2014 to July 2014 at the outpatient cardiology clinics of our tertiary institution. The survey included patient demographics, comorbidities and an abridged version of the International Index of Erectile Function (IIEF-5). Erectile dysfunction severity was categorized as absent (IIEF-5 score: 22–25), mild (IIEF-5 score: 17–21), moderate (IIEF-5 score: 8–16) and severe (IIEF-5 score: <8). Independent variables were demographic factors (i.e. age, race, occupation, etc.) and comorbidities (i.e. diabetes, hypertension, etc.). Primary dependent variable was the presence of erectile dysfunction and secondary dependent variable was the severity of erectile dysfunction. A total of 468 male respondents (mean age 57±11.2 years) were included. Sixty-nine per cent of respondents reported the presence of erectile dysfunction, with further breakdown into 29% with mild, 30% with moderate and 10% with severe erectile dysfunction. Multivariate analysis revealed that significant predictive risk factors of erectile dysfunction were old age (odds ratio (OR) 1.073, 95% confidence interval (CI) 1.050–1.097, p<0.001), the presence of diabetes (OR 2.127, 95% CI 1.186–3.81, p=0.001) and a lower level of education (OR 2.392, 95% CI 1.387–4.125, p=0.002). These three factors were significant predictors for severity of erectile dysfunction ( p-values of 0.000). Prevalence of erectile dysfunction is high in patients with cardiovascular disease risk factors. Cardiologists should screen for erectile dysfunction particularly in patients with older age, diabetes and lower education levels.
Study on shock resistance of steel plate reinforced with polyurea–woven fiberglass mesh composite under shock wave
Authors: Liao Yu , Shi Shaoqing , Liu Zhaohui , Liang Caoke
Published: February 2018

To study the dynamic mechanical properties of polyurea–woven fiberglass mesh composite material as a reinforcing layer, the shock resistance tests on plain steel plate, polyurea-reinforced steel plate, and polyurea–woven fiberglass mesh composite–reinforced steel plate were carried out using the large shock tube device. Finite element method simulation was also carried out. The results of experimental and numerical simulation show that the deformation of polyurea–woven fiberglass mesh composite reinforcing layer is smaller than that of pure polyurea reinforcing layer, and the overall deformation of steel plate reinforced by polyurea–woven fiberglass mesh composite is minimal among all the three specimens. With the same polyurea consumption in reinforcing layer, the mass of the 3.5-mm-thick polyurea–woven fiberglass mesh composite–reinforced steel plate is only 2.92% larger than that of the 3.2-mm-thick pure polyurea–reinforced steel plate, but it can reduce the residual displacement of steel plate center by additional 13.03%. The work in this article has some reference value to improve the shock resistance of polyurea-reinforced structure in engineering.
Understanding the link between feelings of mental defeat, self-efficacy and the experience of chronic pain
Authors: Hazeldine-Baker Charlotte E , Salkovskis Paul M , Osborn Mike , Gauntlett-Gilbert Jeremy
Published: February 2018

Objectives:

‘Mental defeat’ (MD) has been identified among people with chronic pain as a type of self-processing related to social role and rank. Research has linked it to anxiety, pain interference and functional disability. The relationship between MD and other cognitive constructs, such as hopelessness and depression, remains poorly understood. This study considers the association between MD, pain symptomatology and self-efficacy in the context of other cognitive factors.

Methods:

In total, 59 participants completed a questionnaire pack assessing anxiety, depression, hopelessness, pain catastrophising and MD in order to examine the relationship with pain symptomatology and self-efficacy.

Results:

Linear multiple regression analyses showed that anxiety was most strongly associated with pain symptomatology, accounting for 26% of the variance, while catastrophising showed the strongest association with sensory pain and MD the strongest association with affective pain. Finally, MD was found to be strongly associated with pain-related self-efficacy, accounting for 47% of the variance.

Conclusion:

This research has demonstrated the potential importance of assessing MD in chronic pain patients, suggesting that targeting these cognitions during interventions and therapy could be valuable. Furthermore, the study indicates that MD differs from related cognitive constructs involved in pain, such as depression, hopelessness and catastrophising.
Giant Condylomata Acuminata of Buschke-Lowenstein Associated With Paraneoplastic Hypercalcemia
Authors: Venter Fredrick , Heidari Arash , Viehweg Macsen , Rivera Mark , Natarajan Piruthiviraj , Cobos Everardo
Published: February 2018

Low-risk human papillomavirus types 6 and 11 can manifest as giant condylomata acuminata (GCA) of Buschke-Lowenstein. Up to 50% of GCA can slowly progress over years to fungating, invasive tumors. The malignant potential is attributed to unique immune evading abilities of the human papillomavirus. A 42-year-old male presented with pain and foul-smelling discharge from his genital warts. The histopathological examination of the mass showed invasive squamous cell carcinoma, and it was associated with paraneoplastic hypercalcemia. The timely removal of long-standing GCA in order to prevent a carcinomatous transition is a priority.
Āwhina Revolution: A Bayesian Analysis of Undergraduate and Postgraduate Completion Rates from a Program for Māori and Pacific Success in STEM Disciplines
Authors: Richardson Ken , Clark Zaramasina , Gaines Michael , Kingi Hautahi , Miller Sonja , Pearson Willie , Richardson Liz
Published: February 2018

Māori and Pacific students generally do not attain the same levels of tertiary success as New Zealanders of European descent, particularly in science, technology, engineering, and mathematics (STEM) subjects. Te Rōpū Āwhina (Āwhina), an equity initiative at Victoria University of Wellington in New Zealand between 1999 and 2015, aimed to produce Māori and Pacific professionals in STEM disciplines who contribute to Māori and Pacific community development and leadership. A hierarchical Bayesian approach was used to estimate posterior standardized completion rates for 3-year undergraduate and 2-year postgraduate degrees undertaken by non–Māori-Pacific and Māori-Pacific students. Results were consistent with an Āwhina effect, that is, Āwhina’s positive influence on (combined) Māori and Pacific success.
Internship Experiences Contribute to Confident Career Decision Making for Doctoral Students in the Life Sciences
Authors: Schnoes Alexandra M. , Caliendo Anne , Morand Janice , Dillinger Teresa , Naffziger-Hirsch Michelle , Moses Bruce , Gibeling Jeffery C. , Yamamoto Keith R. , Lindstaedt Bill , McGee Richard , O’Brien Theresa C.
Published: February 2018

The Graduate Student Internships for Career Exploration (GSICE) program at the University of California, San Francisco (UCSF), offers structured training and hands-on experience through internships for a broad range of PhD-level careers. The GSICE program model was successfully replicated at the University of California, Davis (UC Davis). Here, we present outcome data for a total of 217 PhD students participating in the UCSF and UC Davis programs from 2010 to 2015 and 2014 to 2015, respectively. The internship programs at the two sites demonstrated comparable participation, internship completion rates, and overall outcomes. Using survey, focus group, and individual interview data, we find that the programs provide students with career development skills, while increasing students’ confidence in career exploration and decision making. Internships, in particular, were perceived by students to increase their ability to discern a career area of choice and to increase confidence in pursuing that career. We present data showing that program participation does not change median time to degree and may help some trainees avoid “default postdocs.” Our findings suggest important strategies for institutions developing internship programs for PhD students, namely: including a structured training component, allowing postgraduation internships, and providing a central organization point for internship programs.
CancerLinQ: Origins, Implementation, and Future Directions
Authors: Rubinstein Samuel M. , Warner Jeremy L.
Published: February 2018

Rapid-learning health systems have been proposed as a potential solution to the problem of quality in medicine, by leveraging data generated from electronic health systems in near-real time to improve quality and reduce cost. Given the complex, dynamic nature of cancer care, a rapid-learning health system offers large potential benefits to oncology practice. In this article, we review the rationale for developing a rapid-learning health system for oncology and describe the sequence of events that led to the development of ASCO’s CancerLinQ (Cancer Learning Intelligence Network for Quality) initiative, as well as the current state of CancerLinQ, including its importance to efforts such as the Beau Biden Cancer Moonshot. We then review the considerable challenges facing optimal implementation of a rapid-learning health system such as CancerLinQ, including integration of rapidly expanding multiomic data, capturing big data from a variety of sources, an evolving competitive landscape, and implementing a rapid-learning health system in a way that satisfies many stakeholders, including patients, providers, researchers, and administrators.
Development and validation of a radiomic signature to predict HPV (p16) status from standard CT imaging: a multicenter study
Authors: Leijenaar Ralph TH , Bogowicz Marta , Jochems Arthur , Hoebers Frank JP , Wesseling Frederik WR , Huang Sophie H , Chan Biu , Waldron John N , O'Sullivan Brian , Rietveld Derek , Leemans C Rene , Brakenhoff Ruud H , Riesterer Oliver , Tanadini-Lang Stephanie , Guckenberger Matthias , Ikenberg Kristian , Lambin Philippe
Published: February 2018

Objectives:

Human papillomavirus (HPV) positive oropharyngeal cancer (oropharyngeal squamous cell carcinoma, OPSCC) is biologically and clinically different from HPV negative OPSCC. Here, we evaluate the use of a radiomic approach to identify the HPV status of OPSCC.

Methods:

Four independent cohorts, totaling 778 OPSCC patients with HPV determined by p16 were collected. We randomly assigned 80% of all data for model training (N = 628) and 20% for validation (N = 150). On the pre-treatment CT images, 902 radiomic features were calculated from the gross tumor volume. Multivariable modeling was performed using least absolute shrinkage and selection operator. To assess the impact of CT artifacts in predicting HPV (p16), a model was developed on all training data (Mall) and on the artifact-free subset of training data (Mno art). Models were validated on all validation data (Vall), and the subgroups with (Vart) and without (Vno art) artifacts. Kaplan–Meier survival analysis was performed to compare HPV status based on p16 and radiomic model predictions.

Results:

The area under the receiver operator curve for Mall and Mno art ranged between 0.70 and 0.80 and was not significantly different for all validation data sets. There was a consistent and significant split between survival curves with HPV status determined by p16 [p = 0.007; hazard ratio (HR): 0.46], Mall (p = 0.036; HR: 0.55) and Mno art (p = 0.027; HR: 0.49).

Conclusion:

This study provides proof of concept that molecular information can be derived from standard medical images and shows potential for radiomics as imaging biomarker of HPV status.

Advances in knowledge:

Radiomics has the potential to identify clinically relevant molecular phenotypes.
Vacuum assisted breast biopsy (VAB) excision of subcentimeter microcalcifications as an alternative to open biopsy for atypical ductal hyperplasia
Authors: Schiaffino Simone , Massone Elena , Gristina Licia , Fregatti Piero , Rescinito Giuseppe , Villa Alessandro , Friedman Daniele , Calabrese Massimo
Published: February 2018

Objective:

Atypical ductal hyperplasia (ADH) is a proliferative lesion associated with a variable increased risk of breast malignancy, but the management of the patients is still not completely defined, with mandatory surgical excision in most cases. To report the results of the conservative management with mammographic checks of patients with ADH diagnosed by vacuum assisted breast biopsy (VAB), without residual calcifications.

Methods:

The authors accessed the institutional database of radiological, surgical and pathological anatomy. Inclusion criteria were: ADH diagnosed by VAB on a single group of microcalcifications, without residual post-procedure; follow-up at least of 12 months. Exclusion criteria were the presence of personal history of breast cancer or other high-risk lesions; association with other synchronous lesions, both more and less advanced proliferative lesions.

Results:

The 65 included patients were all females, with age range of 40–79 years (mean 54 years). The maximum diameter range of the groups of microcalcifications was 4–11 mm (mean 6.2 mm), all classified as BI-RADS 4b (Breast Imaging Reporting and Data System 4b) and defined as fine pleomorphic in 29 cases (45%) or amorphous in 36 cases (55%). The range of follow-up length was 12–156 months (mean 67 months). Only one patients developed new microcalcifications, in the same breast, 48 months after and 15 mm from the first VAB, interpreted as low-grade ductal carcinoma in situ (DCIS) at surgical excision.

Conclusion:

These results could justify the conservative management, in a selected group of patients, being the malignancy rate lower than 2%, considered in the literature as the “probably benign” definition.

Advances in knowledge:

Increasing the length of follow-up of selected patients conservatively managed can improve the management of ADH cases.