bluuebunny/crossref_metadata_2025 huggingface dataset:
Trafficking Experiences and Psychosocial Features of Domestic Minor Sex Trafficking Victims
Authors: Moore Jessica L. , Houck Christopher , Hirway Priyadarshini , Barron Christine E. , Goldberg Amy P.
Published: April 2017

Domestic minor sex trafficking (DMST) is an increasingly recognized traumatic crime premised upon the control, abuse, and exploitation of youth. By definition, DMST is the “recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act” within domestic borders, in which the person is a U.S. citizen or lawful permanent resident under the age of 18 years. The present study described the demographics, psychosocial features, and trafficking experiences (e.g., environments of recruitment, relationship to trafficker, solicitation) of DMST victims. A total of 25 medical records of patients under the age of 18 who disclosed their involvement in DMST to medical providers between August 1, 2013, and November 30, 2015, were retrospectively reviewed. The majority of patients were female, and the mean age was 15.4 years old. Most patients lived at home and/or were accompanied at the evaluation by a parent/guardian. High rates of alcohol or substance use/abuse (92%), being placed in a group home or child protective services (CPS) custody (28%), a history of runaway behavior (60%), and/or exposure to other child maltreatment (88%) were identified. Our data indicated variation in reported trafficking experiences; however, patients commonly reported an established relationship with their trafficker (60%) and recruitment occurred primarily as a result of financial motivation (52%). Patients were prevalently recruited in settings where there were face-to-face interactions (56%), whereas the solicitation of sex-buyers occurred primarily online (92%). Victims who disclosed involvement in DMST had complicated psychosocial histories that may have rendered them susceptible to their exploitation, and reported a variety of DMST experiences perpetuated by traffickers. Although preliminary in nature, this study provided empirical evidence of the predisposing factors, motivations, and experiences of victimized youth uniquely from the perspective of patients who sought medical care.
Capturing complexity in pulmonary system modelling
Authors: Clark Alys R , Kumar Haribalan , Burrowes Kelly
Published: April 2017

Respiratory disease is a significant problem worldwide, and it is a problem with increasing prevalence. Pathology in the upper airways and lung is very difficult to diagnose and treat, as response to disease is often heterogeneous across patients. Computational models have long been used to help understand respiratory function, and these models have evolved alongside increases in the resolution of medical imaging and increased capability of functional imaging, advances in biological knowledge, mathematical techniques and computational power. The benefits of increasingly complex and realistic geometric and biophysical models of the respiratory system are that they are able to capture heterogeneity in patient response to disease and predict emergent function across spatial scales from the delicate alveolar structures to the whole organ level. However, with increasing complexity, models become harder to solve and in some cases harder to validate, which can reduce their impact clinically. Here, we review the evolution of complexity in computational models of the respiratory system, including successes in translation of models into the clinical arena. We also highlight major challenges in modelling the respiratory system, while making use of the evolving functional data that are available for model parameterisation and testing.
Computational modeling of long-term effects of prophylactic vertebroplasty on bone adaptation
Authors: Badilatti Sandro D , Christen Patrik , Ferguson Stephen J , Müller Ralph
Published: April 2017

Cement augmentation in vertebrae (vertebroplasty) is usually used to restore mechanical strength after spinal fracture but could also be used as a prophylactic treatment. So far, the mechanical competence has been determined immediately post-treatment, without considering long-term effects of bone adaptation. In this work, we investigated such long-term effects of vertebroplasty on the stiffness of the augmented bone by means of computational simulation of bone adaptation. Using micro-finite element analysis, we determined sites of increased mechanical stress (stress raisers) and stress shielding and, based on the simulations, regions with increased or decreased bone loss due to augmentation. Cement volumes connecting the end plates led to increased stress shielding and bone loss. The increased stiffness due to the augmentation, however, remained constant over the simulation time of 30 years. If the intervention was performed at an earlier time point, it did lead to more bone loss, but again, it did not affect long-term stability as this loss was compensated by bone gains in other areas. In particular, around the augmentation cement, bone structures were preserved, suggesting a long-term integration of the cement in the augmented bone. We conclude that, from a biomechanical perspective, the impact of vertebroplasty on the bone at the microstructural level is less detrimental than previously thought.
The role of inelastic deformations in the mechanical response of endovascular shape memory alloy devices
Authors: Petrini Lorenza , Bertini Alessandro , Berti Francesca , Pennati Giancarlo , Migliavacca Francesco
Published: April 2017

Nickel–titanium alloys are commonly adopted for producing cardiovascular minimally invasive devices such as self-expandable stents, aortic valves and stent-grafts. These devices are subjected to cyclic loads (due to blood pulsatility, leg or heart movements), that can induce fatigue fracture, and may also be subjected to very large deformations (due to crimping procedure, a tortuous physiological path or overloads), that can induce material yield. Recently, the authors developed a new constitutive model that considers inelastic strains due to not-completed reverse phase transformation (not all the stress-induced martensite turns back to austenite) or/and plasticity and their accumulation during cyclic loads. In this article, the model is implemented in the finite element code ABAQUS/Standard and it is used to investigate the effects of inelastic strain accumulation on endovascular nickel–titanium devices. In particular, the behavior of a transcatheter aortic valve is studied considering the following steps: (1) crimping, (2) expansion in a tube resembling a durability test chamber and (3) cyclic loads due to pressure variation applied on the inner surface of the tube. The analyses are performed twice, activating and not activating that part of the new model which describes the development of irreversible strain. From the results, it is interesting to note that plasticity has a very significant effect on the local material response, inducing stress modification from compression to tension. However, permanent deformations are concentrated in few zones of the stent frame and their presence does not affect the global behavior of the device that maintains its capability of recovering the original shape. In conclusion, this work suggests that at least for cardiovascular devices where the crimping is high (local strain may reach values of 8%–9%), taking into account inelastic effects due to plasticity and not-completed reverse phase transformation can be important, and hence using a suitable constitutive model is recommended.
Analysis of rotation angles and motions of the flexible mechanisms in bifurcated blood vessels
Authors: He Bin , Xu Shoulin , Ding An , Zhou Yanmin
Published: April 2017

This article investigates the relationship of rotation angle of two ends of elastic guidewires, and motion method of guidewires and catheters in bifurcated blood vessels. The relationship of rotation angles of the two ends of the guidewire has first been studied by mathematical reasoning, indicating that the rotation angle of the front end of guidewire can be precisely described by that of the rear end. In order to satisfy the requirements of different vascular interventional surgeries, we further investigated a general model of bifurcated human blood vessels. Based on this model, a new motion method, which ensures the guidewire and catheter move cooperatively along center lines of blood vessels to the final target point, has been introduced. Rotation angles of the guidewire in this model were then analyzed. By experiments to verify the functional relationship between rotation angles of two ends of guidewire, the motion method and algorithm of guidewire and catheter are correct. Our study provides references for future studies in fully automated vascular interventional surgeries.
Global mental health, autonomy and medical paternalism: reconstructing the ‘French ethical tradition’ in psychiatry
Authors: Pires Marques Tiago
Published: April 2017

In the last few decades, the definition of deontological ethics, a well-identified ethical territory in psychiatry, has been the object of increasing concerns. This has been the case in France, where claims of a specific ethical tradition in psychiatry have accompanied the institutionalization of psychiatric ethics and the perceived globalization of an Anglo-American model of mental health care. This study traces the history of the ‘French ethical tradition in psychiatry’ and its relationship with establishing institutional spaces for ethical decision-making. The ‘ethical tradition’ thus conceived proves to be functional in terms of preserving the threatened identity of French psychiatry. Nevertheless, this movement also pinpoints impasses that transcend the French context and may provide valuable resources for ethical reflections on mental health on a global scale.
Analysis of decay characteristics of an accumulator in an open-circuit hydrostatic system with pump loading
Authors: Kumar Ajit , Dasgupta K , Das J
Published: April 2017

The effects of the decay characteristics of a hydraulic accumulator on the responses of the hydrostatic drive system used in mining vehicles are studied in this article. The system considered for the analysis basically consists of a hydraulic pump, hydro-motor, accumulator and a loading circuit. The studies have been carried out with respect to two different sizes of accumulators. The system model has been made in MATLAB/Simulink® environment. The simulation test results are obtained with respect to the hydro-motor speeds and the system pressure at different resistive loads and capacities of the accumulator and they are verified with the experimental test data. Using the validated model, the parametric studies are also made on the speed responses of the hydrostatic drive for different precharge pressures of the accumulator and inertial load on the motor shaft. The studies made in this article may be useful for the selection of proper capacity of accumulators incorporated in the hydrostatic drive system in mining vehicles.
Theoretical analysis of a resistance adjusting type piezoelectric cylindrical transducer
Authors: Wang Jianjun , Wei Peijun , Ji Jianlong
Published: April 2017

A resistance adjusting type piezoelectric cylindrical transducer is studied in this work. The transducer’s functional components are two radially polarized piezoelectric short tubes. One of them is utilized to actuate the transducer, while the other is used to adjust its electromechanical characteristics, such as resonance and anti-resonance frequencies as well as the corresponding electromechanical coupling factor, through changing a connecting resistance. Based on the plane stress assumption, the electromechanical characteristics of this transducer in radial vibration are studied, and the expressions of input electric impedance are derived analytically. The theoretical solution is validated by comparing the results with a special case in a previous work. Furthermore, numerical analysis is conducted to study the effects of resistance and electrode on the transducer’s electromechanical characteristics. The results indicate that adjusting the resistance enables the transducer’s multi-frequency characteristics, and furthermore, there exists a special matching resistance that results in the transducer’s optimal electromechanical coupling factor. This study provides a theoretical guide for designing and optimizing the resistance adjusting type piezoelectric cylindrical transducer, which has a potential application in the underwater sound and ultrasonic fields, among others.
Mobile Learning Game Effectiveness in Cognitive Learning by Adults: A Comparative Study
Authors: Wardaszko Marcin , Podgórski Błażej
Published: April 2017

Background. The effectiveness of digital game-based learning is an important issue. Mobile learning games (MLG) are rapidly growing trends among the digital game-based learning genre. Although many studies have been conducted and mobile games have been shown to have an unquestionable potential as a learning method, their effectiveness has not been fully proven, and the positive impacts and outcomes of mobile learning games with respect to learning have yet to be investigated.

Aim. The study aimed at capturing the cognitive learning outcomes and the process of knowledge acquisition. The study has demonstrated both positive and negative cognitive learning effects of using mobile learning game in comparison with the textbook learning process.

Methodology. This article presents a comparative study conducted on a group of 160 freshman students majoring in management and finance. The participants of the study, divided into subgroups, were taught using either textbook-based learning or a mobile learning game. Three tests were applied to measure their performance: a pre-test at the beginning of the experiment, and two post-tests, the first administered directly after the learning process and the second 2-3 weeks after the initial learning.

Results and recommendations. MLG have been proven to create many positive effect for learning. It is as effective in transferring factual knowledge as textbook learning, when measured directly after the learning process. In longer term, the effects are blurred because the affective effects interfere with the measurement.
The Double-Edged Sword of Gender Equality
Authors: Lo Celia C. , Ash-Houchen William , Gerling Heather M.
Published: April 2017

Objectives:

While the literature confirms the applicability of routine activity/lifestyle theory in studying individual crime victimization, this study asks whether neighborhood disorganization as well as—on the level of the nation—income inequality, attitudes about gender equality, and the meeting of citizens’ basic human needs are associated with opportunity for crime and so might contribute to the explanation of victimization. The study measures demographic variables that could indicate the presence of motivated offenders and likely crime targets, as well as the absence of effective guardians.

Methods:

The data come from the sixth wave of the World Values Survey (collected 2010–2014), from the Social Progress Index Report, and from information compiled by the World Bank. The present sample numbers 64,861 respondents, representing 46 countries.

Results:

The data analysis suggests that risk of victimization increases in the presence of income inequality and gender equality, and decreases where people’s basic human needs are met. The relationship between neighborhood disorganization and one employed victimization measure was found to be moderated by attitudes about gender equality.

Conclusions:

Further investigation of the role of opportunity and routine activity/lifestyle factors (macro- and individual-level) could improve understanding of victimization, particularly related to the complex interplay between structural and cultural predictors of victimization.
On the homogenization of a new class of locally periodic microstructures in linear elasticity with residual stress
Authors: Seguin Brian
Published: April 2017

Many biological and engineering materials have nonperiodic microstructures for which classical periodic homogenization results do not apply. Certain nonperiodic microstructures may be approximated by locally periodic microstructures for which homogenization techniques are available. Motivated by the consideration that such materials are often anisotropic and can possess residual stresses, a broad class of locally periodic microstructures are considered and the resulting effective macroscopic equations are derived. The effective residual stress and effective elasticity tensor are determined by solving unit cell problems at each point in the domain. However, it is found that for a certain class of locally periodic microstructures, solving the unit cell problems at only one point in the domain completely determines the effective elasticity tensor.
Chemical evaluation of the Rhynchophorus ferrugineus larvae fed on different substrates as human food source
Authors: Cito Annarita , Longo Santi , Mazza Giuseppe , Dreassi Elena , Francardi Valeria
Published: April 2017

We investigated the chemical composition of the weevil Rhynchophorus ferrugineus larvae, traditionally used as human food in Asia and known worldwide as one of the most significant pest for palm trees. Total fat content and fatty acid composition were analyzed using standard methodologies in (1) weevil larvae reared on apple fruit slices and wild specimens collected from attacked (2) Phoenix canariensis and (3) Syagrus romanzoffiana palm trees. Total fat content was extremely high in all the specimens (ranged between 57.62 and 60.03% based on dry weight). Despite sharing the same prevalent fatty acids (myristic acid, palmitic acid, stearic acid, palmitoleic acid, oleic acid, α-linoleic acid, and α-linolenic acid), fatty acid composition of the wild weevil larvae significantly differed from that of the specimens raised on apple fruit, due to the presence of other minor compounds. In general, a good balance between unsaturated fatty acids (∼53.68% of total fatty acids) and saturated fatty acids (∼43.41% of total fatty acids) and a low cholesterol content (74.61–152.32 mg/kg based on dry matter) were detected in all the specimens. Conversely, the weevil larvae did not represent a good source of α-tocopherol (14.17–26.22 mg/kg based on dry matter). The ability of the protein extracts obtained from the weevil larvae to inhibit in vitro the angiotensin-converting enzyme, the main enzyme involved in blood pressure regulation, was also investigated. To simulate gastrointestinal digestion process, protein extracts were hydrolyzed by the gastrointestinal enzymes. A significantly lower IC50 (0.588–0.623 mg/ml) was measured in all the protein extracts after enzymatic hydrolysis versus the corresponding crude protein extracts (3.270–3.752 mg/ml). Given that the weevil larvae are able to provide interesting benefits for human health, this study supports their use as human food not just in the native countries where they are traditionally consumed and farmed but also throughout the world.
Performance portability in reverse time migration and seismic modelling via OpenACC
Authors: Qawasmeh Ahmad , Hugues Maxime R , Calandra Henri , Chapman Barbara M
Published: April 2017

Heterogeneity among the computational resources within a single machine has significantly increased in high performance computing to exploit the tremendous potential of graphics processing units (GPUs). Portability in terms of code development and performance has been a challenge due to major differences between GPU programming and memory models from one side and conventional central processing units (CPUs) from another side. Performance characteristics of compilers and processors also vary between machines. Emerging high-level directive-based programming models such as OpenACC has been proposed to target this challenge. In this work, we develop OpenACC implementations for both seismic modelling and reverse time migration algorithms that solve the isotropic, acoustic, and elastic wave equations. We employ OpenACC to take advantage of the computational power of two Nvidia GPU cards: (1) M2090 and (2) K40, residing in IBM and CRAY XC30 clusters respectively. We also explore the main aspects of hybridization seismic modelling and reverse time migration by implementing an Message Passing Interface (MPI)+OpenACC approach. We expose various mapping techniques to develop a portable code that maximizes performance regardless of compiler or platform. Depending on the intensity of the computations, different propagators exhibited different speedup behaviours against a full socket CPU MPI implementation. A performance enhancement of ~10× was obtained, when the acoustic model was ported to a single GPU, compared with a 1.7× speedup obtained using the isotropic model. Our MPI+OpenACC implementation of reverse time migration and seismic modelling shows promising scaling when multiple GPUs were used.
Association of Exclusive Breastfeeding Duration With Systemic Inflammation Markers in Adolescents: A Cross-Sectional Study
Authors: González-Jiménez Emilio , Schmidt-RioValle Jacqueline , Sinausía Laura , Perona Javier S.
Published: April 2017

Background:

Breastfeeding duration has been associated with less low-grade inflammation in healthy adolescents, but there is scarce information regarding obese subjects. This study aimed to evaluate whether exclusive breastfeeding is related to serum concentrations of inflammatory markers in a population of Spanish adolescents.

Method:

A cross-sectional study was performed on 1,001 adolescents (13.2 ± 1.2 years) randomly recruited from schools in southeast Spain. Data on breastfeeding duration were collected via a parental questionnaire. Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined by enzyme-linked immunosorbent assay. C-reactive protein (CRP) was determined by solid-phase chemiluminescent immunometric assay.

Results:

Nonadjusted and adjusted multivariate correlation analyses confirmed a strong association ( p < .001, 95% confidence interval) between the three markers of inflammation and exclusive breastfeeding duration. No significant differences were observed for IL-6, TNF-α, and CRP serum concentrations among normal weight, overweight, and obese adolescents, except for IL-6 between normal weight and obese subjects. Likewise, no significant association was found between these markers of inflammation and body mass index (BMI) z-score.

Conclusions:

We found a possible association between inflammatory markers and exclusive breastfeeding duration in adolescents, regardless of their BMI. This finding suggests that increased body weight or obesity might not mediate the association between breastfeeding and inflammation. These results contribute to the understanding of the relationship between breastfeeding and inflammatory markers in adolescents.
Are mothers’ protective attachment strategies related to their children’s strategies?
Authors: Crittenden Patricia M , Robson Katrina , Tooby Alison , Fleming Charles
Published: April 2017

Aims:

We explored the relation between mothers’ protective attachment strategies and those of their school-age children.

Methods:

In total, 49 child–mother dyads participated in a short longitudinal study when the children were 5.5 and 6.0 years old. Their strategies were first assessed with the Preschool Assessment of Attachment (PAA) and then with the School-age Assessment of Attachment (SAA). Mothers were assessed with the Adult Attachment Interview (AAI). The Dynamic-Maturational Model of Attachment and Adaptation (DMM) was used to classify the assessments.

Results:

The validity and precision of the DMM-AAI were supported: Mothers’ AAI classifications were related to their referral group (normative or clinical) and measures of stress and distress. The DMM categories were more associated with risk than the Ainsworth categories. Types A, C and A/C were differentiated by trauma, triangulation and depression. Mothers’ and children’s protective attachment strategies were related, with B mothers having B children and A or C mothers having children using the same or opposite strategy. Children whose classification changed from the PAA to the SAA had mothers with complex traumas.

Conclusion:

When psychosocial treatment is needed, knowing whether mother and child use the same or different strategies and whether mothers have complex trauma can affect treatment success.
The clinician perspective on sex differences in autism spectrum disorders
Authors: Jamison Rene , Bishop Somer L , Huerta Marisela , Halladay Alycia K
Published: April 2017

Research studies using existing samples of individuals with autism spectrum disorders have identified differences in symptoms between males and females. Differences are typically reported in school age and adolescence, with similarities in symptom presentation at earlier ages. However, existing studies on sex differences are significantly limited, making it challenging to discern if, how, and at what point in development females with autism spectrum disorder actually exhibit a different behavioral presentation than males. The purpose of this study was to gather impressions from a large group of clinicians to isolate specific areas for future study of sex differences. Clinicians were surveyed about their opinions and perceptions of symptom severity in females, as compared to males, at different points during development. They were also asked to provide open-ended responses about female symptom presentation. Consistent with previous literature, clinicians noted more sex-related differences in restricted and repetitive behaviors and fewer differences for social communication features. Differences were most commonly observed in school age and adolescence, suggesting this time period as a critical and particularly vulnerable window for females with autism spectrum disorder. The results are discussed in the context of other male/female differences across development so that more targeted investigations of autism spectrum disorder sex differences across development.
Four cases of corneal thermal injury from incense burning in paediatric patients in Hong Kong
Authors: Li Anita LW , Kwok Rachel PW , Young Alvin L
Published: April 2017

The ritual burning of incense in the form of joss sticks is a common Chinese cultural practice, especially during Chinese festivals for paying respect to ancestors or religious figures. We report four consecutive cases of ocular and corneal thermal injury by burning joss sticks, in paediatric patients who presented to our centre from March 2015 to October 2015. Given that incense burning is so commonly practiced in Hong Kong, there is a need to educate and raise awareness in order to prevent similar ocular and corneal injuries in future.
Indoor Air Temperature and Agitation of Nursing Home Residents With Dementia
Authors: Tartarini Federico , Cooper Paul , Fleming Richard , Batterham Marijka
Published: April 2017

This study aimed to determine the specific correlation between indoor air temperature and agitation of nursing home residents with dementia. Agitated behaviors of 21 residents, living in 1 nursing home, were assessed for a 10-month period using the Cohen-Mansfield Agitation Inventory (CMAI). The CMAI Total Frequency scores were found to increase significantly when indoor average temperatures deviated from 22.6°C. In addition, cumulative exposure to temperatures higher than 26°C and lower than 20°C was linearly correlated with CMAI Total Frequency scores. Results showed that agitated behaviors not only affected the person manifesting them but were found to be disruptive for other residents and the delivery of care. Agitation can, therefore, be potentially reduced by limiting the range of indoor air temperature variations, and aged care providers should ensure that a thermally comfortable environment is provided in nursing homes to enhance comfort and well-being of all occupants.
A residual-energy-activated forwarding protocol using relay ordering and finite field network coding for multiple-source multiple-relay wireless sensor networks
Authors: Cheng Yulun , Yang Longxiang , Zhu Hongbo
Published: April 2017

Combining with finite field network coding, relay ordering is significant for the transmission reliability of multiple-source multiple-relay wireless sensor networks. However, it leads to severe energy consumption and is harmful to the lifetime of the network. To overcome the drawback of relay ordering and achieve desired trade-off between energy efficiency and transmission reliability, a residual energy-activated forwarding protocol is proposed in this article. In the protocol, by considering the unique characteristics of relay ordering–finite field network coding, a novel metric is proposed to jointly formulate both energy consumption and transmission reliability into one optimization problem. Based on this, the appropriate numbers of cooperative relays are selected to reduce energy consumption. Furthermore, by solving the proposed optimization problem in various cases, the optimization process is transferred to three sub-problems, and the corresponding strategy is developed to maximize the proposed metric accordingly. Extensive simulation results verify the superiority of the proposed protocol in both energy efficiency and transmission reliability.
Ultrasound-guided removal of hypopharyngeal foreign body in the emergency department
Authors: Shaukat Nadia Maria , Lenz Alexis , Desai Poonam
Published: April 2017

Foreign body impaction at the cricopharyngeal level can be a life-threatening emergency. While traditionally, removal of these is performed in the operating room setting, patients with relatively unstable airways or significant discomfort may require immediate extraction to prevent further injury. This is the case of an 85-year-old man who presented to the emergency department in significant discomfort following aspiration of a large partial denture. We report here the first known use of ultrasound in an emergent airway situation to rapidly localize and retrieve an aspirated foreign body.
Predisposing Customers to Be More Satisfied by Inducing Empathy in Them
Authors: Davis Cassandra , Jiang Li , Williams Patti , Drolet Aimee , Gibbs Brian J.
Published: April 2017

The present research demonstrates that increasing a consumer’s empathy with a service provider can increase that consumer’s satisfaction with the service. In Study 1, customers at a café who were induced to empathize with the clerk felt more satisfied with the service, and in Study 2, such empathizing customers were better tippers. Study 3 corroborated this finding of an empathy–satisfaction relation using dispositional empathy, showing that naturally occurring levels of empathy were positively related to consumers’ feelings of satisfaction in a long-term service relationship (personal fitness training). Study 4 found that the positive effect of empathy on consumer satisfaction held true for a negative service situation (for female but not for male consumers), indicating that the effect was not the result of consumers becoming more sensitive to the valence of the service situation. In addition, the overall results suggest that the effect was not mediated by more favorable attitudes toward the service provider or by more favorable attributions of responsibility to the service provider. Instead, we suggest that empathy may make consumers more cooperative and that being satisfied is one way consumers “cooperate” with a service provider. These findings exemplify how responses to a marketing situation can be managed by manipulating the mental state of consumers rather than by altering the attributes of the goods or services being offered.
Nasogastric tube placement confirmation: where we are and where we should be heading
Authors: Fan Esther Monica Peijin , Tan Siok Bee , Ang Shin Yuh
Published: April 2017

Background:

Insertion of a tube via the nasal passage is a common procedure which has been practiced for many years. There are various ways to assess the position of the nasogastric tube (NGT).

Objectives:

The objective of this study was to discuss the advantages and limitations of each method of NGT placement confirmation, to identify gaps in literature, and provide suggestions for future research.

Methods:

A search was performed with Pubmed, CINAHL, and Embase. The following keywords were used: “nasogastric,” “tube,” “placement,” “insertion,” and “measurement.” The results were narrowed down to those with full text available, published in the English language, those published within the last 10 years, and those studies done in the adult population. The reference lists of those articles were also referred to and relevant articles were retrieved. A final 26 relevant articles were included in this review, including six that were published more than 10 years ago but still relevant in this review.

Results:

A method to confirm NGT placement that is accurate, affordable, does not require gastric aspirates, and is able to be used not only upon insertion but also at regular intervals is lacking.

Conclusions:

This article provides a summary of the different methods of NGT placement confirmation and discusses their advantages and limitations. Gaps in literature and suggestions for future research were also deliberated.
Antipsychotic-induced hyperprolactinemia in Tourette syndrome
Authors: Rath Judith J. G. , Deen Marlies E. J. , van Houten Hessel , de Bruijn Sebastiaan F. T. M. , van Gerven Joop , Mul Dick
Published: April 2017

For many years, Tourette syndrome (TS) was considered to be a rare disorder, but tics and TS are now recognized as fairly common childhood-onset conditions. Children and adolescents with TS are frequently treated with antipsychotics, either as monotherapy or in combination with psychostimulants, melatonin and selective serotonin reuptake inhibitors (SSRIs). Antipsychotics are most often used in schizophrenia and related psychotic disorders, and in these conditions hyperprolactinemia is one of the most common adverse effects associated with antipsychotics, occurring in 40–50% of patients. We describe two patients with TS who experienced antipsychotic-induced hyperprolactinemia. Treatment options generally consist of dose reduction or switching from typical to atypical antipsychotics. However, diminishing dosages can lead to exacerbations of tics. Also, not all atypical antipsychotics have the same pharmacologic properties required to normalize prolactin levels. The choice of treatment may also be affected by the patient’s age and sex. These factors are discussed in relation to these cases, and illustrated by the results of therapeutic interventions over the years.
MicroCT analysis of vascular morphometry: a comparison of right lung lobes in the SUGEN/hypoxic rat model of pulmonary arterial hypertension
Authors: Faight Erin M. , Verdelis Kostas , Zourelias Lee , Chong Rong , Benza Raymond L. , Shields Kelly J.
Published: April 2017

Pulmonary arterial hypertension (PAH) is a rare disease characterized by significant vascular remodeling within the lung. Clinical computed tomography (CT) scans are routinely used to aid in PAH diagnosis. Animal models, including the Sugen‐hypoxic rat model (SU/hyp), of PAH closely mimic human PAH development. We have previously used micro‐computed tomography (microCT) to find extensive right lung vascular remodeling in the SU/hyp. We hypothesized that the individual right lung lobes may not contribute equally to overall lung vascular remodeling. Sprague‐Dawley rats were subjected to a subcutaneous injection of vascular endothelial growth factor receptor blocker (Sugen 5416) and subsequently exposed to chronic hypoxic conditions (10% O2) for three weeks. Following perfusion of the lung vasculature with an opaque resin (Microfil), the right lung lobes were microCT‐imaged with a 10‐µm voxel resolution and 3D morphometry analysis was performed separately on each lobe. As expected, we found a significantly lower ratio of vascular volume to total lobe volume in the SU/hyp compared with the control, but only in the distal lobes (inferior: 0.23 [0.21–0.30] versus 0.35 [0.27–0.43], P = 0.02; accessory: 0.27 [0.25–0.33] versus 0.37 [0.29–0.43], P = 0.06). Overall, we observed significantly fewer continuous blood vessels and reduced vascular density while having greater vascular lumen diameters in the distal lobes of both groups (P < 0.05). In addition, the vascular separation within the SU/hyp lobes and the vascular surface area to volume ratio were significantly greater in the SU/hyp lobes compared with controls (P < 0.03). Results for the examined parameters support the overall extensive vascular remodeling in the SU/hyp model and suggest this may be lobe‐dependent.
Open label study of ambrisentan in patients with exercise pulmonary hypertension
Authors: Segrera Sergio A. , Lawler Laurie , Opotowsky Alexander R. , Systrom David , Waxman Aaron B.
Published: April 2017

A growing body of evidence suggests that exercise pulmonary hypertension (ePH) is an early form of pulmonary arterial hypertension (PAH). Identifying the disease at an early, potentially more responsive phase, and initiating treatment may improve functional status and prevent progression to severe forms of PAH. This was a single‐center, open‐label six‐month treatment trial to evaluate the effect of ambrisentan on pulmonary hemodynamics and exercise capacity in ePH utilizing invasive cardiopulmonary exercise testing (iCPET). After six months of treatment with ambrisentan, patients repeated iCPET; exercise capacity, symptoms, and pulmonary hemodynamics were reassessed. Twenty‐two of 30 patients completed the treatment phase and repeat iCPET. After six months of treatment there was a significant decline in peak exercise mPAP (−5.2 ± 5.6 mmHg, P = 0.001), TPG (−7.1 ± 8.0 mmHg, P = 0.001), PVR (−0.9 ± 0.7 Woods units, P = 0.0002), and Ca‐vO2 (−1.8 ± 2.3 mL/dL, P = 0.0002), with significant increases in peak PCWP (+2.9 ± 5.6 mmHg, P = 0.02), PVC (+0.8 ± 1.4 mL/mmHg, P = 0.03), and CO (+2.3 ± 1.4 L/min, P = 0.0001). A trend toward increased VO2max (+4.4 ± 2.6% predicted, P = 0.07) was observed. In addition, there were improvements in 6MWD and WHO FC after 24 weeks. Our findings suggest that treatment of ePH with ambrisentan results in improved pulmonary hemodynamics and functional status over a six‐month period. Treatment of ePH may prevent the progression of vascular remodeling and development of established PAH.
Macroscopic lymphovascular invasion visualized on mammogram and magnetic resonance imaging: Initially misidentified as ductal carcinoma in situ but properly diagnosed by immunohistochemistry
Authors: Sanders Linda M , Dardik Michael , Modi Lopa , Sanders Alison Esteva , Schaefer Sarah S , Litvak Anya
Published: April 2017

Objectives:

Lymphovascular invasion (LVI) is a pathologic, microscopic finding associated with invasive cancer, and is a poor prognostic indicator, but has no reported imaging findings. This report presents the first documented case of LVI with seen by imaging. Linear branching microcalcifications were identified on mammography and clumped enhancement was noted on MRI, both imaging findings that are highly predictive of ductal carcinoma in situ (DCIS).

Methods:

Ultrasound guided core biopsy of the dominant mass was performed, confirming invasive ductal malignancy. Stereotactic biopsy performed on the microcalcifications was initially interpreted by pathology as DCIS.

Results:

Patient underwent mastectomy. Pathologic evaluation of the surgical specimen confirmed the invasive ductal malignancy. Microcalcifications were re-evaluated with immunohistochemistry (IHC) and re-classified as LVI. Radiology images and IHC stains are shown.

Conclusion:

This is the first report of LVI identified by imaging with findings that mimicked DCIS and initially mis-identified as DCIS by pathology as well. The implications of this overlap in radiologic appearance are discussed.
Rising incidence and prevalence of adult eosinophilic esophagitis in midwestern Spain (2007–2016)
Authors: Molina-Infante Javier , Gonzalez-Cordero Pedro Luis , Ferreira-Nossa Hal Cliff , Mata-Romero Pilar , Lucendo Alfredo J. , Arias Angel
Published: April 2017

Objectives

Epidemiologic studies on eosinophilic esophagitis (EoE) are scarce and patient responders to proton pump inhibitor (PPI) therapy have usually been excluded. We aimed to evaluate population-based incidence rates, prevalence and trends in adult EoE over the past decade, including responders to PPI therapy.

Methods

We conducted an analysis of a prospectively established case registry in the health area of Cáceres, located in midwestern Spain. From the first EoE case diagnosed in 2007, endoscopy and pathology reports up to December 2016 were manually reviewed. A baseline diagnosis of EoE was confirmed upon symptoms of esophageal dysfunction (dysphagia/food impaction) and esophageal eosinophilia ≥ 15 eos/HPF. All patients were re-evaluated on PPI therapy during follow-up.

Results

A total of 137 patients were diagnosed with EoE during the study period, of whom 63 (46%) achieved clinicohistologic remission on PPI therapy. The prevalence of autoimmune disorders was low. Mean incidence rate was 8.09 new cases/100,000 inhabitants/year, increasing to 9.95 during the last lustrum and peaking in 2016 with 13.7. This trend coincided with late declining of esophageal biopsies rate. Overall prevalence in 2016 was 81.73 patients/100,000 inhabitants, with the highest prevalence in males between age 35 and 44 years (273 cases/100,000). No seasonal variation was observed in the diagnosis of EoE (53% during pollen season vs. 47%, p = 0.4).

Conclusions

In midwestern Spain, incidence (13.7 cases/100,000 inhabitants/year) and prevalence (81.73 patients/100,000 inhabitants) in 2016 have grown remarkably in just one decade, coming closer to those figures recently reported for Crohn’s disease in Spain.
Validation of the Kidney Failure Risk Equation in Manitoba
Authors: Whitlock Reid H. , Chartier Mariette , Komenda Paul , Hingwala Jay , Rigatto Claudio , Walld Randy , Dart Allison , Tangri Navdeep
Published: April 2017

Background:

Patients with chronic kidney disease (CKD) are at risk to progress to kidney failure. We previously developed the Kidney Failure Risk Equation (KFRE) to predict progression to kidney failure in patients referred to nephrologists.

Objective:

The objective of this study was to determine the ability of the KFRE to discriminate which patients will progress to kidney failure in an unreferred population.

Design:

A retrospective cohort study was conducted using administrative databases.

Setting:

This study took place in Manitoba, Canada.

Measurements:

Age, sex, estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (ACR) were measured.

Methods:

We included patients from the Diagnostic Services of Manitoba database with an eGFR <60 mL/min/1.73 m2 and ACR measured between October 2006 and March 2007. Five-year kidney failure risk was predicted using the 4-variable KFRE and compared with treated kidney failure events from the Manitoba Renal Program database. Sensitivity and specificity for KFRE risk thresholds (3% and 10% over 5 years) were compared with eGFR thresholds (30 and 45 mL/min/1.73 m2).

Results:

Of 1512 included patients, 151 developed kidney failure over the 5-year follow-up period. The 4-variable KFRE showed a superior prognostic discrimination compared with eGFR alone (area under the receiver operating characteristic curve [AUROC] values, 0.90 [95% confidence interval {CI}: 0.88-0.92] for KFRE vs 0.78 [95% CI: 0.74-0.83] for eGFR). At a 3% threshold over 5 years, the KFRE had a sensitivity of 97% and a specificity of 62%. At 10% risk, sensitivity was 86%, and specificity was 80%.

Limitations:

Only 11.7% of stage 3-5 CKD patients had simultaneous ACR measurement. The KFRE does not account for other indications for referral such as suspected glomerulonephritis, polycystic kidney disease, and recurrent stone disease.

Conclusions:

The KFRE has been validated in a population with a demographic and referral profile heretofore untested and performs well at predicting 5-year risk of kidney failure in a population-based sample of Manitobans with CKD stages 3 to 5. Thresholds of 3% and 10% over 5 years are sensitive, specific, and can be used in clinical decision making. Further testing of the 4-variable KFRE and these thresholds in clinical practice should be considered.
Digital Genealogies: Understanding Social Mobile Media LINE in the Role of Japanese Families
Authors: Ohashi Kana , Kato Fumitoshi , Hjorth Larissa
Published: April 2017

This article explores the emergence of the dominant mobile social media platform in Japan, LINE. In particular, the article focuses upon its usage to maintain familial ties, especially between matriarchal connections. Drawing upon ethnographic work with 12 families over 3 years, this article seeks to provide a detailed and nuanced sense of how social mobile media is deployed intergenerationally.
Pain in the Chain
Authors: Mehta Nikhil K. , Basu Roy Shreya
Published: April 2017

An iTech company ponders how to price its range of products. A journey to understanding communication differences between various arms of an organization.
Liberatio Communio: The Ecclesiological Identity of Sadrach’s Javanese Community
Authors: Harahap Yoshua Budiman Paramita
Published: April 2017

We tend to view the narrative of a church and its involvement in mission as describing predominately either a social phenomenon or a “divine image.” To do so, however, leaves us with a single-dimensional narrative. Under the term Sanctorum Communio, Bonhoeffer developed an ecclesiology that blends these two narratives into a single, multidimensional entity. Using Bonhoeffer’s perspective, I retell the history of Golongane Wong Kristen kang Mardika, Sadrach’s Javanese nineteenth-century community, not merely as a historical community or a divine “product,” but as a liberatio communio. This ecclesiological identity involves the transformation from a peccatorum communio to a sanctorum communio.
Kruppel-like factor 4 regulates neutrophil activation
Authors: Shen Yuyan , Hong Hong , Sangwung Panjamaporn , Lapping Stephanie , Nayak Lalitha , Zhang Lilei , Jain Mukesh K. , Liao Xudong
Published: April 2017

Key Points

KLF4 deficiency impairs neutrophil function in vitro and in vivo. This is the first demonstration that KLF4 plays a crucial role in neutrophils.
Van Gogh’s Irises and Roses: the contribution of chemical analyses and imaging to the assessment of color changes in the red lake pigments
Authors: Centeno Silvia A. , Hale Charlotte , Carò Federico , Cesaratto Anna , Shibayama Nobuko , Delaney John , Dooley Kathryn , van der Snickt Geert , Janssens Koen , Stein Susan Alyson
Published: April 2017

Vincent van Gogh’s still lifes Irises and Roses were investigated to shed light onto the degree to which the paintings had changed, both individually and in relation to each other since they were painted, particularly in regard to the fading of the red lakes. Non-invasive techniques, including macroscopic X-ray fluorescence mapping, reflectance imaging spectroscopy, and X-radiography, were combined with microanalytical techniques in a select number of samples. The in-depth microchemical analysis was necessary to overcome the complications that arise when evaluating by non-invasive methods alone the compositions of passages with complex layering and mixing of paints. The results obtained by these two approaches were complemented by color measurements performed on paint cross-sections and on protected edges, and with historical information provided by the artist’s own descriptions, early reviews and reproductions, and the data was used to carry out digital color simulations that provided, to a certain extent, a visualization of how the paintings may have originally appeared.