bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of serum biomarkers in staging of canine hepatic fibrosis
Authors: Menard Maud , Lecoindre Alexis , Cadoré Jean-Luc , Chevallier Michèle , Pagnon Aurélie , Hernandez Juan , Oliveira Leal Rodolpho , Hugonnard Marine , Miette Véronique , Destro Marie , Rannou Benoît , Benchekroun Ghita , Lecoindre Patrick
Published: July 2019

Accurate staging of hepatic fibrosis (HF) is important for treatment and prognosis of canine chronic hepatitis. HF scores are used in human medicine to indirectly stage and monitor HF, decreasing the need for liver biopsy. We developed a canine HF score to screen for moderate or greater HF. We included 96 dogs in our study, including 5 healthy dogs. A liver biopsy for histologic examination and a biochemistry profile were performed on all dogs. The dogs were randomly split into a training set of 58 dogs and a validation set of 38 dogs. A HF score that included alanine aminotransferase, alkaline phosphatase, total bilirubin, potassium, and gamma-glutamyl transferase was developed in the training set. Model performance was confirmed using the internal validation set, and was similar to the performance in the training set. The overall sensitivity and specificity for the study group were 80% and 70% respectively, with an area under the curve of 0.80 (0.71–0.90). This HF score could be used for indirect diagnosis of canine HF when biochemistry panels are performed on the Konelab 30i (Thermo Scientific), using reagents as in our study. External validation is required to determine if the score is sufficiently robust to utilize biochemical results measured in other laboratories with different instruments and methodologies.
Equine urinary N-acetyl-β-D-glucosaminidase assay validation and correlation with other markers of kidney injury
Authors: Bayless Rosemary L. , Moore A Russell , Hassel Diana M. , Byer Brittney J. , Landolt Gabriele A. , Nout-Lomas Yvette S.
Published: July 2019

Detection of equine acute kidney injury (AKI) is hindered by limited markers of early renal damage in horses. N-acetyl-β-D-glucosaminidase (NAG), a lysosomal enzyme in renal tubular epithelium released into urine during tubular insult, has shown promise for early identification of AKI in humans and other species. We validated an assay for NAG in equine urine and measured urinary NAG in 7 azotemic and 7 non-azotemic client-owned adult horses. The enzymatic NAG assay was validated using within- and between-run coefficients of variation (CVs), recovery following standard addition, and linearity of dilution. Intra- and inter-run CVs (21% and 3.2%, respectively), average recovery following standard addition (99–109%), and linearity under serial dilution ( R2 = 0.997) were satisfactory. Urine NAG index was significantly correlated with urinary fractional excretion of sodium (FENa; ρ = 0.76, p < 0.001) and plasma creatinine (ρ = 0.74, p = 0.001). Median urine NAG indices were higher in azotemic horses ( p = 0.006), in horses with increased urinary FENa ( p = 0.006), and in horses with increased urine gamma-glutamyl transferase index ( p = 0.032). Urine NAG can be measured in horses and shows positive correlation with 2 current renal biomarkers. Additional work is needed to establish normal equine reference intervals and characterize the increase of urine NAG index in horses in relation to tubular injury.
What Caused My Cancer? Cancer Patients’ Perceptions on What May Have Contributed to the Development of Their Cancer: A Cross-Sectional, Cross-Country Comparison Study
Authors: Hall Alix , Nguyen Sang Minh , Mackenzie Lisa , Sanson-Fisher Rob , Olver Ian , Thuan Tran Van , Huong Tran Thanh
Published: July 2019

Accurate public perceptions on the risk factors associated with cancer are important in promoting primary, secondary, and tertiary prevention. Limited studies have explored this topic among patients with cancer in non-western, low-to-middle-income countries. A cross-sectional survey to compare Australian and Vietnamese cancer patients’ perceptions of what caused their cancer was undertaken. Adult, patients with cancer from both countries, receiving radiotherapy treatment completed a standardized survey, which included a 25-item module assessing their beliefs on the causes of their cancer. Items ranged from known evidence-based causes (eg, smoking, sun exposure) to non-evidence-based beliefs (eg, stress or anxiety, physical injury, or trauma). Country-specific logistic regression analyses were conducted to identify differences in the determinants of patients’ top perceived causes. A total of 585 patient surveys were completed (75% response rate; 285 from Australia, and 300 from Vietnam). Most patients were male (58%) and aged 60 years and older (55%). The most frequently reported risk factor overall and for the Australian sample was “getting older” (overall = 42%, Australia = 49%, and Vietnam = 35%). While the most frequently reported risk factor for the Vietnamese sample was “poor diet” (overall = 39%, Australia = 11%, and Vietnam = 64%). There were differences in the characteristics associated with the top causes of cancer identified by Australian and Vietnamese patients. Patients’ beliefs about what may have caused their cancer are complex and likely to be impacted by multiple factors, including the country from which they reside. Developing public awareness campaigns that are accurate and tailored to address the specific beliefs and possible misconceptions held by the target community are needed.
The entrepreneur of the self beyond Foucault’s neoliberal homo oeconomicus
Authors: Christiaens Tim
Published: July 2019

In his lectures on neoliberalism, Michel Foucault argues that neoliberalism produces subjects as ‘entrepreneurs of themselves’. He bases this claim on Gary Becker’s conception of the utility-maximizing agent who solely acts upon cost/benefit-calculations. Not all neoliberalized subjects, however, are encouraged to maximize their utility through mere calculation. This article argues that Foucault’s description of neoliberal subjectivity obscures a non-calculative, more audacious side to neoliberal subjectivity. Precarious workers in the creative industries, for example, are encouraged not merely to rationally manage their human capital, but also to take a leap of faith to acquire unpredictable successes. It is this latter risk-loving, extra-calculative side to neoliberal subjectivity that economists usually designate as ‘entrepreneurial’. By confronting Foucault with the theories of entrepreneurship of the Austrian School of Economics, Frank Knight, and Joseph Schumpeter, the Foucauldian analytical framework is enriched. Neoliberal subjectivation is not the monolithic promotion of utility-maximizing agents, but the generation of a multiplicity of modes for entrepreneurs to relate to oneself and the market.
Tweeting Grenfell: Discourse and networks in critical constructions of British Muslim social boundaries on social media
Authors: Downing Joseph , Dron Richard
Published: July 2019

The Grenfell fire has yet to be analysed to understand the event’s implications in relation to construction of social boundaries for British Muslims. In this current research, two methodological approaches are applied to gain understandings of social boundary construction on twitter: thematic analysis of the content of tweets and social network analysis (SNA) of how messages are diffused and contested. Twitter is shown to be an important platform in spreading positive narratives about Muslims during the fire, enabling individuals to spontaneously contest fake news and hate narratives. Social media acts counter to established knowledge, demonstrating that it is not, per se, a conduit for fake news and hate speech. Furthermore, it demonstrates how twitter offers Muslims an international space to voice and articulate themselves where they can be influential in debates that effect Muslim diasporas in other national contexts.
The Deconsolidation of Democracy: Is It New and What Can Be Done About It?
Authors: Corbett Jack
Published: July 2019

Democracy in the United States and Europe is said to be at the crossroads. I review five recent books that seek to diagnose and cure this ‘crisis’. Explanations range from institutional dysfunction and elite maleficence to technological change and rising economic inequality. Remedies include everything from institutional engineering to moral persuasion. Collectively, the books raise two important questions: is this really a crisis and if it is, can democratisation theory, the branch of political science dedicated to explaining why regimes rise and fall, tell us why? I conclude that if we are to explain the deconsolidation of well-established democracies in which all of the usual pre-conditions had been met, then we must first question the linear narrative about democracy being a naturally legitimate form of regime.
Identification of wool and cashmere SEM images based on SURF features
Authors: Lu Kai , Luo Junli , Zhong Yueqi , Chai Xinyu
Published: July 2019

Pattern recognition and feature extraction methods are applied to identify cashmere and wool fibers, which are two kinds of very similar animal fibers. In this article, we proposed a new identification method based on Speed Up Robust Features of fiber images. The images of wool and cashmere fibers are obtained by scanning electron microscopy. Speed Up Robust Features of fiber images are extracted, and each fiber image is regarded as a collection of feature vectors in our logic. The vectors are fed into a support vector machine for supervised learning. The findings from scanning electron microscope images indicate that this method is effective; the recognition rate is higher than 93% for a broad range of blend proportions of the two fibers.
Influence of silica aerogels on fabric structural feature for thermal isolation properties of weft-knitted spacer fabrics
Authors: Islam Syed Rashedul , Yu Weidong , Naveed Tayyab
Published: July 2019

Textile clothing coated with silica aerogels has the potential of thermal insulation performance for heating and cooling. This work investigated the thermal isolation properties of untreated and treated three-layered weft-knitted spacer fabrics with different thicknesses (2 mm, 3 mm, and 4 mm) by using silica aerogels. Three samples of spacer fabrics (300GSM, 350GSM, 540GSM) were coated with nanoporous silica aerogel at a 26°C temperature and then kept for aging, exchanging the solvent, surface modification. The characteristics, for example, thermal resistance, thermal conductivity, yarn arrangement angle, porosity, and air permeability of spacer fabric samples, were investigated. Scanning electron microscopy analysis and Fourier transform infrared spectroscopy–attenuated total reflection test were conducted to explore the surface morphology and surface changes initiated by the silica coating. The experimental results indicated that the treated weft-knitted spacer fabrics with 350GSM have a higher thermal resistance of 0.09131 m2 K W−1, higher porosity ratio, higher air permeability, higher arrangement angle, and lower density. The statistical analysis also verified the significant performance (p = 0.000) of treated fabric samples at the 0.05 level.
Re-tangling the concept of coercive control: A view from the margins and a response to Walby and Towers (2018)
Authors: Donovan Catherine , Barnes Rebecca
Published: July 2019

This article responds to Walby and Towers’ article, in which they propose a quantitative methodology that evidences gender asymmetry in ‘domestic violence crime’. Through examining core issues including harm, severity and repetition of domestic violence crime victimisation, they argue that Stark’s concept of ‘coercive control’ is obsolete and refute Johnson’s typology of intimate partner violence. However, their conclusions are based on problematic assumptions about, for example, the relative impacts of physical and non-physical violence; the usefulness of incident- rather than relationship-based understandings of domestic violence and abuse and a focus on victim/survivors’ ‘resilience’ and ‘vulnerability’ over perpetrators’ motives. Moreover, their cisnormative operationalisation of sex and gender and neglect of sexuality overlooks important evidence about lesbian, gay, bisexual and/or transgender people’s victimisation. This reinforces a limited ‘public story’ of domestic violence and abuse and arguably creates weaknesses in feminist analyses of domestic violence that could further fuel anti-feminist, gender-neutral approaches.
Dual-Energy X-Ray Absorptiometry Body Composition in NCAA Division I Athletes: Exploration of Mass Distribution
Authors: Sanfilippo Jennifer , Krueger Diane , Heiderscheit Bryan , Binkley Neil
Published: July 2019

Background:

Body composition assessment is frequently used in sports medicine and athletic performance environments to assess change in response to strength training and nutrition programs. However, to effectively do so requires knowledge regarding expected body composition values relative to sport and sex. Dual-energy x-ray absorptiometry (DXA) is widely used to evaluate body composition, although its utility in relationship to specific sports, performance, or rehabilitation is not clearly defined.

Hypothesis:

Body composition metrics and distribution of National Collegiate Athletic Association Division I collegiate athletes will vary based on sport and sex.

Level of Evidence:

Level 4.

Study Design:

Cross-sectional study.

Methods:

A convenience sample of 337 athletes (229 men and 108 women) participating in football, wrestling, soccer, hockey, basketball, golf, softball, or volleyball was evaluated. DXA-measured total body composition, including bone mineral density (BMD), % lean mass, % fat, and regional distribution, were compared by sex, sport, and with an age-matched National Health and Nutrition Examination Survey (NHANES) population.

Results:

Men had higher BMD, lower % fat (16.4% vs 25.2%) and higher % lean mass (79.2% vs 70.6%) ( P < 0.001). Regional composition varied by sport and sex, with women having a greater proportion of lean mass at the trunk and men in their arms ( P < 0.0001). Leg lean mass was distributed similarly between sexes (35%). Overall, the normative group (NHANES) had lower BMD and higher percentage fat.

Conclusion:

DXA-measured body composition and lean mass distribution varies by sport and sex in Division I athletes. The observed difference to the NHANES population emphasizes challenges in identifying appropriate comparison populations, reinforcing the need to compare athletes with their own baseline.

Clinical Relevance:

These findings establish a framework to investigate the relevance of these variances and determine the utility of body composition analysis in elite athletes.
Process-Based Evaluation of the Potential Affectiveness of Futures Studies as a Profession
Authors: Spies Philip H.
Published: July 2019

This article argues that futures studies practice must have relevance and meaning for society and organizations—that is, it should be affective—and that it should be evaluated as such. Evaluation should be process-based, specifically by observing the way futures studies as a profession is managed and interacts with society. Within this context, “evaluation” is defined as merit determination through process review, using as central norm the raison d’être for futures studies, namely, it must enhance better long-term decision making in organizations and in society. Affectiveness is an emergent quality. Emergence is a property that a whole (such as the subject area of futures studies) displays which is not apparent in its parts. In other words, it is a property that emerges from the interactions between the parts of the whole. With this in mind, futures studies can be visualized as an “application system” comprising of various specialized subsystems such as conceptual development, methodological development, scanning and trend research, scenario development, and idealized planning. The article defends and proposes a process-based approach to the evaluation of affectiveness: one that is based on a heuristic learning and dialogue design in the practice of futures studies. The quest for affectiveness is a journey toward an ideal, perhaps never to be reached but forever a guide toward improving the relevance and meaning of an important profession.
Eligibility for cardiovascular risk screening among different ethnic groups: The HELIUS study
Authors: Perini Wilco , Snijder Marieke B , Agyemang Charles , Peters Ron JG , Kunst Anton E , van Valkengoed Irene GM
Published: July 2019

Background

Ethnic differences in the age-of-onset of cardiovascular risk factors may necessitate ethnic-specific age thresholds to initiate cardiovascular risk screening. Recent European recommendations to modify cardiovascular risk estimates among certain ethnic groups may further increase this necessity.

Aims

To determine ethnic differences in the age to initiate cardiovascular risk screening, with and without implementation of ethnic-specific modification of estimated cardiovascular risk.

Methods

We included 18,031 participants of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan background from the HELIUS study (Amsterdam). Eligibility for cardiovascular risk screening was defined as being eligible for blood pressure-lowering treatment, based on a combination of systolic blood pressure, estimated cardiovascular risk, and ethnic-specific conversion of estimated cardiovascular risk as recommended by European cardiovascular disease prevention guidelines. Age-specific proportions of eligibility were determined and compared between ethnic groups via logistic regression analyses.

Results

Dutch men reached the specified threshold to initiate cardiovascular risk screening (according to Dutch guidelines) at an average age of 51.5 years. Among ethnic minority men, this age ranged from 39.8 to 52.4. Among Dutch women, the average age threshold was 53.4. Among ethnic minority women, this age ranged from 36.8 to 49.1. Age-adjusted odds of eligibility were significantly higher than in the Dutch among all subgroups, except among Moroccan men. Applying ethnic-specific conversion factors had minimal effect on the age to initiate screening in all subgroups.

Conclusions

Most ethnic minority groups become eligible for blood pressure-lowering treatment at a lower age and may therefore benefit from lower age-thresholds to initiate cardiovascular risk screening.
Technocolonialism: Digital Innovation and Data Practices in the Humanitarian Response to Refugee Crises
Authors: Madianou Mirca
Published: July 2019

Digital innovation and data practices are increasingly central to the humanitarian response to recent refugee and migration crises. In this article, I introduce the concept of technocolonialism to capture how the convergence of digital developments with humanitarian structures and market forces reinvigorates and reshapes colonial relationships of dependency. Technocolonialism shifts the attention to the constitutive role that data and digital innovation play in entrenching power asymmetries between refugees and aid agencies and ultimately inequalities in the global context. This occurs through a number of interconnected processes: by extracting value from refugee data and innovation practices for the benefit of various stakeholders; by materializing discrimination associated with colonial legacies; by contributing to the production of social orders that entrench the “coloniality of power”; and by justifying some of these practices under the context of “emergencies.” By reproducing the power asymmetries of humanitarianism, data and innovation practices become constitutive of humanitarian crises themselves.
Pre-Service Teachers’ Attitudes Toward Inclusive Education During Their Studies in Bahrain Teachers College
Authors: AlMahdi Osama , Bukamal Hanin
Published: July 2019

This study explored pre-service teachers’ attitudes toward inclusive education. The Sentiments, Attitudes, and Concerns about Inclusive Education–Revised (SACIE-R) scale was completed by 138 teacher candidates in a teacher preparation program in Bahrain Teachers College. The findings revealed that candidate teachers needed more opportunities to interact with and teach children with disabilities during their school practicum; they also needed more preparation and knowledge about the educational policies related to these children. Not all the candidate teachers felt confident in their knowledge and skills when dealing with these children. The sentiments of the candidate teachers were generally positive and compassionate to children with disabilities. The attitudes of the candidate teachers were generally positive as well, but there were some apprehensions in regard to including children who show aggressive behavior toward others or those who require communicative technologies in regular classes. The participants had many concerns related to certain aspects of including students with disabilities in the regular classrooms. The findings indicated that there is no significant difference among the study sample in terms of their attitudes, concerns, or sentiments toward inclusion according to the academic year variable (orientation, Year 1, Year 2, Year 3, and Year 4) and the specialization variable (no specialization, Cycle 1). There was also a significant negative relationship between level of confidence in teaching students with disabilities and the sentiment aspect, and also with the concerns. There was a significant negative relationship between knowledge of the local policy that relates to children with disabilities and the sentiment aspect.
Screw Loosening in Posterior Spine Fusion: Prevalence and Risk Factors
Authors: Marie-Hardy Laura , Pascal-Moussellard Hugues , Barnaba Anne , Bonaccorsi Raphael , Scemama Caroline
Published: July 2019

Study Design:

Retrospective cohort study.

Objective:

Screw loosening in spinal fusion is poorly defined. Accordingly, its prevalence rates range from 1% to 60%, and its risk factors remain undefined. The goal of this study was to assess the prevalence of screw loosening, according to precise definitions, and to identify factors associated with it.

Methods:

We retrospectively reviewed records for 166 patients who underwent a posterior spinal fusion in our institution between 2011 and 2016. We recorded demographic data, osteoporosis, pelvic balance, surgery-related information, and postoperative radiographic data at a minimum follow-up of 6 months. Univariable and multivariable logistic regression models were used. Significance was defined by P < .05.

Results:

When loosening was defined by partial pull-out, its prevalence was 9.6% (95% CI 5.6-15); thoracic localization, the use of CrCo (chromium-cobalt) rods, osteoporosis, PI/LL (pelvic incidence/lumbar lordosis) mismatch (preoperative), and frontal imbalance (preoperative) were significant risk factors. When loosening was defined by osteolysis (radiolucent rim) >1 mm around at least 1 screw, its prevalence was 40.4% (95% CI 33-48) and age, scoliosis as indication for fusion, ASA (American Society of Anesthesiologists) 2 or 3, the use of CrCo rods, more than 5 levels fused, no circumferential arthrodesis, postoperative bracing, and sacrum or ilium as the inferior level of instrumentation were also significant risk factors.

Conclusions:

A clear definition of screw loosening seems essential for a useful analysis of the literature. Osteoporosis, sagittal imbalance, and rigid material appear to be risk factors, regardless of the definition.
Post-Endovascular Abdominal Aortic Aneurysm Repair Abdominal Pain: A Learning Experience
Authors: Kichloo Asim , Khan M. Zatmar , Zain El-Amir , Vipparla Navya Sree , Wani Farah
Published: July 2019

Abdominal aortic aneurysm (AAA) is one of the important pathologies involving the abdominal aorta, as it can have adverse consequences if it goes unnoticed or untreated. AAA is defined as an abnormal dilation of the abdominal aorta 3 cm or greater. Endovascular abdominal aortic aneurysm repair (EVAR) has recently emerged as a treatment modality for AAA. It does have a few inherent complications that include endoleak, endograft migration, bleeding, ischemia, and compartment syndrome. This case report discusses a patient who came in with abdominal pain and a pulsatile mass, which raised concerns regarding endoleak. The patient had a 9.9-cm AAA, which was repaired in the past, as was made evident by computed tomography findings of the stent graft in the aneurysmal segment. This case stands out because it highlights the importance of comparing the size of the AAA at the time of the EVAR to the current scenario where the patient presents with abdominal pain of unknown etiology. Also, this case report highlights the importance of computed tomography and other imaging forms in following-up with patients who have EVAR for AAAs.
“What Will I Be Doing There Among So Many Women?”: Perceptions on Male Support in Prevention of Mother to Child Services in Lilongwe, Malawi
Authors: Nkhoma Nicola , Nyondo-Mipando Linda Alinane , Makanjee Chandra , Myburgh Nellie Dominica , Nyasulu Peter Suwirakwenda
Published: July 2019

Participation of males in the prevention of mother-to-child transmission (PMTCT) programs remains a challenge despite the implementation of guidelines. The study aimed at exploring male involvement in the PMTCT program at a primary health facility in Lilongwe, Malawi. Focus group discussions and in-depth individual interviews were used to collect data from health care workers, men, and women who were attending PMTCT services. Snowball sampling was used to recruit participants who were purposively identified. Alcohol consumption, pressure from work places, stigma, role conflict, denial or nondisclosure of HIV status among women, and lack of awareness were among factors found to hinder male participation in PMTCT services. Therefore, to have an effective PMTCT program, male involvement is needed as this could positively influence the delivery of interventions including antiretroviral treatment among HIV-infected pregnant women. As such, health education awareness campaigns emphasizing the value of men in PMTCT services should be reinforced.
Inherited genetic susceptibility to acute lymphoblastic leukemia in Down syndrome
Authors: Brown Austin L. , de Smith Adam J. , Gant Vincent U. , Yang Wenjian , Scheurer Michael E. , Walsh Kyle M. , Chernus Jonathan M. , Kallsen Noah A. , Peyton Shanna A. , Davies Gareth E. , Ehli Erik A. , Winick Naomi , Heerema Nyla A. , Carroll Andrew J. , Borowitz Michael J. , Wood Brent L. , Carroll William L. , Raetz Elizabeth A. , Feingold Eleanor , Devidas Meenakshi , Barcellos Lisa F. , Hansen Helen M. , Morimoto Libby , Kang Alice Y. , Smirnov Ivan , Healy Jasmine , Laverdière Caroline , Sinnett Daniel , Taub Jeffrey W. , Birch Jillian M. , Thompson Pamela , Spector Logan G. , Pombo-de-Oliveira Maria S. , DeWan Andrew T. , Mullighan Charles G. , Hunger Stephen P. , Pui Ching-Hon , Loh Mignon L. , Zwick Michael E. , Metayer Catherine , Ma Xiaomei , Mueller Beth A. , Sherman Stephanie L. , Wiemels Joseph L. , Relling Mary V. , Yang Jun J. , Lupo Philip J. , Rabin Karen R.
Published: July 2019

The authors report the interaction between Down syndrome, a major genetic leukemia predisposition condition, and inherited genetic alleles associated with increased susceptibility to childhood acute lymphoblastic leukemia.
Effect of donor, component, and recipient characteristics on hemoglobin increments following red blood cell transfusion
Authors: Roubinian Nareg H. , Plimier Colleen , Woo Jennifer P. , Lee Catherine , Bruhn Roberta , Liu Vincent X. , Escobar Gabriel J. , Kleinman Steven H. , Triulzi Darrell J. , Murphy Edward L. , Busch Michael P.
Published: July 2019

This study furnishes evidence that both confirms and refutes a long-standing maxim that a one-unit transfusion of red blood cells should yield a posttransfusion hemoglobin increment of 1 g/dL.
Study protocol and rationale of the “Cogni-action project” a cross-sectional and randomized controlled trial about physical activity, brain health, cognition, and educational achievement in schoolchildren
Authors: Solis-Urra Patricio , Olivares-Arancibia Jorge , Suarez-Cadenas Ernesto , Sanchez-Martinez Javier , Rodríguez-Rodríguez Fernando , Ortega Francisco B. , Esteban-Cornejo Irene , Cadenas-Sanchez Cristina , Castro-Piñero Jose , Veloz Alejandro , Chabert Steren , Sadarangani Kabir P. , Zavala-Crichton Juan Pablo , Migueles Jairo H. , Mora-Gonzalez Jose , Quiroz-Escobar Milton , Almonte-Espinoza Diego , Urzúa Alfonso , Dragicevic Constantino D. , Astudillo Aland , Méndez-Gassibe Eduardo , Riquelme-Uribe Daniel , Azagra Marcela Jarpa , Cristi-Montero Carlos
Published: July 2019

Background

Education and health are crucial topics for public policies as both largely determine the future wellbeing of the society. Currently, several studies recognize that physical activity (PA) benefits brain health in children. However, most of these studies have not been carried out in developing countries or lack the transference into the education field. The Cogni-Action Project is divided into two stages, a cross-sectional study and a crossover-randomized trial. The aim of the first part is to establish the associations of PA, sedentarism, and physical fitness with brain structure and function, cognitive performance and academic achievement in Chilean schoolchildren (10–14 years-old). The aim of the second part is to determinate the acute effects of three PA protocols on neuroelectric indices during a working memory and a reading task.

Methods

PA and sedentarism will be self-reported and objectively-assessed with accelerometers in a representative subsample, whilst physical fitness will be evaluated through the ALPHA fitness test battery. Brain structure and function will be assessed by magnetic resonance imaging (MRI) in a randomized subsample. Cognitive performance will be assessed through the NeuroCognitive Performance Test, and academic achievement by school grades. In the second part 32 adolescents (12–13 year-old) will be cross-over randomized to these condition (i) “Moderate-Intensity Continuous Training” (MICT), (ii) “Cooperative High-Intensity Interval Training” (C-HIIT), and (iii) Sedentary condition. Neuroelectric indices will be measures by electroencephalogram (EEG) and eye-tracking, working memory by n-back task and reading comprehension by a reading task.

Discussion

The main strength of this project is that, to our knowledge, this is the first study analysing the potential association of PA, sedentarism, and physical fitness on brain structure and function, cognitive performance, and academic achievement in a developing country, which presents an important sociocultural gap. For this purpose, this project will use advanced technologies in neuroimaging (MRI), electrophysiology (EEG), and eye-tracking, as well as objective and quality measurements of several physical and cognitive health outcomes.

Trial registration

ClinicalTrials.gov identifier: NCT03894241 Date of register: March 28, 2019. Retrospectively Registered.
Effects of micro-porosity and local BMP-2 administration on bioresorption of β-TCP and new bone formation
Authors: Kakuta Atsuhito , Tanaka Takaaki , Chazono Masaaki , Komaki Hirokazu , Kitasato Seiichiro , Inagaki Naoya , Akiyama Shoshi , Marumo Keishi
Published: July 2019

Background

It has been reported that the microporous structure of calcium phosphate (CaP) ceramics is important to osteoconduction. Bone morphogenetic protein-2 (BMP-2) has been shown to be a promising alternative to bone grafting and a therapeutic agent promoting bone regeneration when delivered locally. The aim of this study was to evaluate the effects of micro-porosity within beta-tricalcium phosphate (β-TCP) cylinders and local BMP-2 administration on β-TCP resorption and new bone formation.

Methods

Bilateral cylindrical bone defects were created in rabbit distal femora, and the defects were filled with β-TCP. Rabbits were divided into 3 groups; defects were filled with a β-TCP cylinder with a total of approximately 60% porosity (Group A: 13.4% micro- and 46.9% macropore, Group B: 38.5% micro- and 20.3% macropore, Group C: the same micro- and macro-porosity as in group B supplemented with BMP-2). Rabbits were sacrificed 4, 8, 12, and 24 weeks postoperatively.

Results

The number of TRAP-positive cells and new bone formation in group B were significantly greater than those in group A at every period. The amount of residual β-TCP in group C was less than that in group B at all time periods, resulting in significantly more new bone formation in group C at 8 and 12 weeks. The number of TRAP-positive cells in group C was maximum at 4 weeks.

Conclusions

These results suggest that the amount of submicron microporous structure and local BMP-2 administration accelerated both osteoclastic resorption of β-TCP and new bone formation, probably through a coupling-like phenomenon between resorption and new bone formation.
Addressing shame: what role does shame play in the formation of a modern medical professional identity?
Authors: Miles Sandy
Published: July 2019

Shame is a highly prevalent, though rarely discussed, emotion experienced by trainee doctors. Seeking to avoid the pain of shame can cause significant distress and maladaptive behaviours. However, it plays a key role in helping doctors identify their moral values which, in turn, form the basis of their medical professional identity. This article uses personal doctors’ narratives together with sources from sociology, psychology and medical education to address shame as experienced by medical trainees – its causes, effects and remedies that doctors and medical educators can use to neutralise its malign effects.
Reversal of Vasodilatory Shock: Current Perspectives on Conventional, Rescue, and Emerging Vasoactive Agents for the Treatment of Shock
Authors: Chow Jonathan H. , Abuelkasem Ezeldeen , Sankova Susan , Henderson Reney A. , Mazzeffi Michael A. , Tanaka Kenichi A.
Published: July 2019

Understanding the different mechanisms of vasoconstrictors is crucial to their optimal application to clinically diverse shock states. We present a comprehensive review of conventional, rescue, and novel vasoactive agents including their pharmacology and evidence supporting their use in vasodilatory shock. The role of each drug in relation to the Surviving Sepsis Guidelines is discussed to provide a context of how each one fits into the algorithm for treating vasodilatory shock. Rescue agents can be utilized when conventional medications fail, although there are varying levels of evidence on their clinical effectiveness. In addition, novel agents for the treatment of vasodilatory shock have recently emerged such as ascorbic acid and angiotensin II. Ascorbic acid has been used with some success in vasoplegia and is currently undergoing a more rigorous evaluation of its utility. Angiotensin II (Ang-2) is the newest available vasopressor for the treatment of vasodilatory shock. In addition to its catecholamine-sparing properties, it has been shown to hold promising mortality benefits in certain subsets of critically ill patients.
Comparison of Macintosh Laryngoscopy in Bed-up-Head–Elevated Position With GlideScope Laryngoscopy: A Randomized, Controlled, Noninferiority Trial
Authors: Tsan Samuel E. H. , Lim Siu M. , Abidin Mohd F. Z. , Ganesh Shahmini , Wang Chew Y.
Published: July 2019

BACKGROUND:

Approximately half of all difficult tracheal intubations (DTIs) are unanticipated; hence, proper positioning during intubation is critical to increase the likelihood of success. The bed-up-head–elevated (BUHE) intubation position has been shown to improve laryngeal view, reduce airway complications, and prolong safe apneic time during intubation. In this study, we sought to determine whether the BUHE intubation position is noninferior to Glidescope (GLSC)-assisted intubation with regard to laryngeal exposure.

METHODS:

A total of 138 American Society of Anesthesiologists (ASA) I to III patients were randomly assigned into 2 groups and underwent baseline laryngoscopy in the sniffing position. Group BUHE patients (n = 69) were then intubated in the BUHE position, while group GLSC patients (n = 69) were intubated using GLSC laryngoscopy. Laryngeal exposure was measured using Percentage of Glottic Opening (POGO) score and Cormack–Lehane (CL) grading, and noninferiority will be declared if the difference in mean POGO scores between both groups do not exceed −15% at the lower limit of a 98% confidence interval (CI). Secondary outcomes measured included time required for intubation (TRI), number of intubation attempts, use of airway adjuncts, effort during laryngoscopy, and complications during intubation.

RESULTS:

Mean POGO score in group BUHE was 80.14% ± 22.03%, while in group GLSC it was 86.45% ± 18.83%, with a mean difference of −6.3% (98% CI, −13.2% to 0.6%). In both groups, there was a significant improvement in mean POGO scores when compared to baseline laryngoscopy in the sniffing position (group BUHE, 25.8% ± 4.7%; group GLSC, 30.7% ± 6.8%) (P < .0001). The mean TRI was 36.23 ± 14.41 seconds in group BUHE, while group GLSC had a mean TRI of 44.33 ± 11.53 seconds (P < .0001). In patients with baseline CL 3 grading, there was no significant difference between mean POGO scores in both groups (group BUHE, 49.2% ± 19.6% versus group GLSC, 70.5% ± 29.7%; P = .054).

CONCLUSIONS:

In the general population, BUHE intubation position provides a noninferior laryngeal view to GLSC intubation. The laryngeal views obtained in both approaches were superior to the laryngeal view obtained in the sniffing position. In view of the many advantages of the BUHE position for intubation, the lack of proven adverse effects, the simplicity, and the cost-effectiveness, we propose that clinicians should consider the BUHE position as the standard intubation position for the general population.
Exploring Structures and Properties through Anion Chemistry
Authors: Kageyama Hiroshi , Yajima Takeshi , Tsujimoto Yoshihiro , Yamamoto Takafumi , Tassel Cedric , Kobayashi Yoji
Published: July 2019

The discovery of new extended structures has often led to the development of new fields in chemistry and physics. However, the numerous combinations of metals (or cations) to yield new materials have been largely exhausted. Materials development based on the anion-centered strategy allows us to access several new classes of materials, such as iron oxides with square-planar coordination and mixed-anion oxides including oxyhydrides.
Association analysis between quantitative MRI features and hypoxia-related genetic profiles in prostate cancer: a pilot study
Authors: Sun Yu , Williams Scott , Byrne David , Keam Simon , Reynolds Hayley M. , Mitchell Catherine , Wraith Darren , Murphy Declan , Haworth Annette
Published: July 2019

Objective:

To investigate the association between multiparametric MRI (mpMRI) imaging features and hypoxia-related genetic profiles in prostate cancer.

Methods:

In vivo mpMRI was acquired from six patients prior to radical prostatectomy. Sequences included T  2 weighted (T2W) imaging, diffusion-weighted imaging, dynamic contrast enhanced MRI and blood oxygen-level dependent imaging. Imaging data were co-registered with histology using three-dimensional deformable registration methods. Texture features were extracted from T  2W images and parametric maps from functional MRI. Full transcriptome genetic profiles were obtained using next generation sequencing from the prostate specimens. Pearson correlation coefficients were calculated between mpMRI data and hypoxia-related gene expression levels. Results were validated using glucose transporter one immunohistochemistry (IHC).

Results:

Correlation analysis identified 34 candidate imaging features (six from the mpMRI data and 28 from T  2W texture features). The IHC validation showed that 16 out of the 28 T  2W texture features achieved weak but significant correlations (p < 0.05).

Conclusions:

Weak associations between mpMRI features and hypoxia gene expressions were found. This indicates the potential use of MRI in assessing hypoxia status in prostate cancer. Further validation is required due to the low correlation levels.

Advances in knowledge:

This is a pilot study using radiogenomics approaches to address hypoxia within the prostate, which provides an opportunity for hypoxia-guided selective treatment techniques.
Impact of malaria on haematological parameters of urban, peri-urban and rural patients in the Ashanti region of Ghana: a cross-sectional study
Authors: Mutala Abdul-Hakim , Badu Kingsley , Owusu Christian , Agordzo Samuel Kekeli , Tweneboah Austine , Ackom Abbas Dawood , Addo Matthew Glover
Published: July 2019

Background: This study aimed at investigating haematological changes in malaria patients across different demographic settlements. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements, may also influence these changes, but this has rarely been studied.

Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Giemsa-stained blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser.

Results: The rural settlement had the highest malaria prevalence compared to the other study communities (p=0.009). The difference in parasite densities across the three communities was also significant (p=0.0149). When the malaria-infected population was compared to the uninfected, there were differences in red blood cell count (p=0.0170), haemoglobin levels (p=0.0165), mean corpuscular volume (p=0.0139) and platelet counts (p<0.0001). The difference in median white blood cell (p-value <0.0001), neutrophil (p-value <0.0001) and lymphocyte (p-value <0.0269) count were significantly higher in infected patients from the peri-urban area compared to malaria patients from the rural and urban areas. There were also significant differences in platelet (p=0.0002), plateletcrit (p=0.0041), mean platelet volume (p=0.0009) and platelet large cell ratio (p=0.0046) levels between patients from the urban, peri-urban and rural areas.

Conclusions: Patients infected with malaria generally had low red blood cell, haemoglobin and platelets in comparison to uninfected patients. There were also significant differences in several haematological parameters between malaria-infected patients from the three demographic settlements. Atypical results from routine haematological assays, especially findings of anaemia and thrombocytopenia, may be indicative of malaria and, in cases where the infection is asymptomatic, may improve diagnosis by prompting a more thorough search for the parasite in the peripheral circulation.
Evolution of late steps in exocytosis: conservation, specialization
Authors: Boehm Cordula , Field Mark C.
Published: July 2019

Background:The eukaryotic endomembrane system likely aroseviaparalogous expansion of genes encoding proteins specifying organelle identity, coat complexes and government of fusion specificity. While the majority of these gene families were established by the time of the last eukaryotic common ancestor (LECA), subsequent evolutionary events molded these systems, likely reflecting adaptations retained for increased fitness. As well as sequence evolution, these adaptations include loss of otherwise canonical subunits, emergence of lineage-specific proteins and paralog expansion. The exocyst complex is involved in late exocytosis, and possibly additional pathways, and is a member of the complexes associated with tethering containing helical rods (CATCHR) tethering complex family, which includes conserved oligomeric Golgi (COG), homotypic fusion and vacuole protein sorting (HOPS), class C core vacuole/endosome tethering (CORVET) and others. The exocyst is integrated into a complex GTPase signaling network in animals, fungi and other lineages. Prompted by discovery of Exo99, a non-canonical subunit in the excavate protistTrypanosoma brucei,and significantly increased genome sequence data, we examined evolution of the exocyst.

Methods:We examined evolution of the exocyst by comparative genomics, phylogenetics and structure prediction.

Results:The exocyst is highly conserved, but with substantial losses of subunits in the Apicomplexa and expansions in Streptophyta plants and Metazoa. Significantly, few taxa retain a partial complex, suggesting that, in the main, all subunits are required for functionality. Further, the ninth exocyst subunit Exo99 is specific to the Euglenozoa with a distinct architecture compared to the other subunits and which possibly represents a coat system.

Conclusions:These data reveal a remarkable degree of evolutionary flexibility within the exocyst complex, suggesting significant diversity in exocytosis mechanisms.
Padre José Maurício Nunes Garcia e o hábito da purificação: Sociabilidade e música no Rio de Janeiro dos oitocentos
Authors: Henrique Artur Rômulo Batista
Published: July 2019

Almejamos com esse artigo fazer uma breve análise sobre a chegada da corte portuguesa no Rio de Janeiro e o impacto transformador no ambiente artístico da cidade. Utilizaremos a trajetória do padre José Maurício Nunes Garcia e a sua titulação do Hábito de Cristo, para demonstrar como ocorreu sua ascensão pelo reconhecimento de seus serviços prestados. Traçaremos ainda uma análise sobre os hábitos de corte e a edificação da capela real no século XIX no Rio de Janeiro.
Apresentação
Authors: Nemi Ana , Abreu Mirhiane Mendes de
Published: July 2019

História e literatura: diálogos possíveis
Reflecting on the communication process in health care. Part 2: the management of complaints
Authors: Anderson Beverley
Published: July 2019

This is Part 2 of a two-part article on the communication process in healthcare practice. Part 1 focused on clinical practice in relation to breaking bad news. In Part 2, the focus is on the management of complaints, including the communication process, and the subsequent emotional impact on the health professional. Efficient management of complaints is vital to ensure positive outcomes for all stakeholders—patients, health professionals and the organisation. Reflection is a highly beneficial tool and this process is used to acknowledge the impact of a complaint on the author, other health professionals and the health organisation, and propose ways in which management of this highly sensitive issue could be improved in the future
Non-medical practitioner roles in the UK: who, where, and what factors influence their development?
Authors: Abraham Jenny , Bailey Liz , Coad Jane , Whiteman Becky , Kneafsey Rosie
Published: July 2019

Background:

traditional health workforce roles are changing, with existing roles being extended and advanced, while new roles are being created, often undertaking duties previously completed by doctors, sometimes referred to as non-medical practitioners (NMPs).

Aim:

to investigate which NMP roles exist within the UK, mapping distribution, and explore factors influencing their development and recruitment.

Methods:

two descriptive, exploratory, online self-completed semi-structured questionnaires were used. One was sent to all NHS acute healthcare providers (n=156) and private/independent healthcare providers in England (n=90). A separate questionnaire collected data, using convenience and snowballing approaches, from NMPs across the UK. Quantitative data were analysed using descriptive and frequency statistics. Qualitative data derived from open questions and comments were analysed using content and thematic analysis.

Results:

healthcare organisations in England returned 23/246 useable questionnaires; 115 NMPs returned responses, 19 did not meet the criteria, leaving 96 useable responses.

Conclusion:

seven NMP roles were identified, throughout the UK, with regional variation. Several factors influence the development and recruitment of NMP roles in England such as service delivery and national policies. Inconsistencies were noted in Agenda for Change pay banding. Many practitioners undertook NMP roles to progress their career clinically.