bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the distinctiveness of psychotherapies and examining change over treatment for anorexia nervosa with cognitive‐behavior therapy, interpersonal psychotherapy, and specialist supportive clinical management
Authors: McIntosh Virginia V.W. , Jordan Jennifer , Carter Janet D. , Luty Suzanne E. , Carter Frances A. , McKenzie Janice M. , Frampton Christopher M.A. , Joyce Peter R.
Published: August 2016

Objective

Therapist adherence to cognitive‐behavior therapy (CBT), interpersonal psychotherapy (IPT), and specialist supportive clinical management (SSCM) for anorexia nervosa (AN), was examined across three phases of therapy in a randomized clinical trial.

Method

Adherence in early, middle, and late phase therapy sessions from 53 of 56 participants in the trial was assessed using the CSPRS‐AN by independent raters after listening to complete therapy sessions.

Results

The three forms of psychotherapy were distinguishable by blind raters. Subscale scores were higher for the corresponding therapy than the other therapy modalities. In CBT and SSCM, a phase‐by‐therapy effect was found, with the CBT subscale highest for CBT, intermediate for SSCM, lowest for IPT, and elevated in the middle phase of CBT and SSCM. The SSCM subscale was highest for SSCM, intermediate for CBT, lowest for IPT, and elevated in the middle phase of SSCM. Adherence to activities around normalizing eating, weight gain, and education about anorexia nervosa was higher in SSCM than in either CBT or IPT.

Discussion

Ensuring the distinctiveness of therapies in existing clinical trials with differential treatment outcome is essential. Research on adherence to therapy modalities has the potential to help understanding of the effective components of new and existing treatments for AN. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:958–962).
Appearance evaluation of others' faces and bodies in anorexia nervosa and body dysmorphic disorder
Authors: Moody Teena D. , Shen Vivian W. , Hutcheson Nathan L. , Henretty Jennifer R. , Sheen Courtney L , Strober Michael , Feusner Jamie D.
Published: August 2016

Objective

Individuals with anorexia nervosa (AN) and body dysmorphic disorder (BDD) exhibit distorted perception and negative evaluations of their own appearance; however, little is known about how they perceive others' appearance, and whether or not the conditions share perceptual distortions.

Method

Thirty participants with BDD, 22 with AN, now weight‐restored, and 39 healthy comparison participants (HC) rated photographs of others' faces and bodies on attractiveness, how overweight or underweight they were, and how much photographs triggered thoughts of their own appearance. We compared responses among groups by stimulus type and by level‐of‐detail (spatial frequency).

Results

Compared to HCs, AN and BDD had lower attractiveness ratings for others' bodies and faces for high‐detail and low‐detail images, rated bodies as more overweight, and were more triggered to think of their own appearance for faces and bodies. In AN, symptom severity was associated with greater triggering of thoughts of own appearance and higher endorsement of overweight ratings for bodies. In BDD, symptom severity was associated with greater triggering of thoughts of own appearance for bodies and higher overweight ratings for low‐detail images. BDD was more triggered to think of own facial appearance than AN.

Discussion

AN and BDD show similar behavioral phenotypes of negative appearance evaluations for others' faces and bodies, and have thoughts of their own appearance triggered even for images outside of their primary appearance concerns, suggesting a more complex cross‐disorder body‐image phenotype than previously assumed. Future treatment strategies may benefit from addressing how these individuals evaluate others in addition to themselves. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:127–138)
Impulsivity‐related traits distinguish women with co‐occurring bulimia nervosa in a psychiatric sample
Authors: Reas Deborah L. , Pedersen Geir , Rø Øyvind
Published: August 2016

Objective

This study investigated impulsivity‐related personality traits using the Revised NEO Personality Inventory (NEO PI‐R) in women diagnosed with co‐occurring bulmia nervosa and borderline personality disorder (BN‐BPD), borderline personality disorder (BPD no‐BN), or major depressive disorder (MDD‐only).

Method

The sample included 672 adult female admissions to a psychiatric day hospital treatment program. The NEO PI‐R facets of impulsiveness (N5), excitement‐seeking (E5), self‐discipline (C5), and deliberation (C6) provided a proxy assessment of impulsivity‐related traits tapping negative urgency, sensation‐seeking, lack of perseverance, and lack of premeditation/planning.

Results

After adjusting for age, BN‐BPD displayed significantly higher levels of negative urgency and lack of premeditation than BPD without co‐occurring BN. Women with BN‐BPD also had significantly higher levels of impulsivity traits than MDD across domains, except for lack of perseverance.

Discussion

Impulsivity‐related traits of negative urgency and lack of premeditation significantly differentiated women with versus without co‐occurring BN among women with borderline personality disorder. Lower levels of impulsivity‐related traits in women with MDD indicated that effects were not simply attributable to any form of psychopathology. Of the impulsivity traits, negative urgency demonstrated the strongest effect, providing further evidence of the important relationship between negative urgency and the expression of bulimic symptomology. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1093–1096)
Viability of cyclic populations
Authors: Singer Alexander , Frank Karin
Published: August 2016

Theory on viability of small populations is well developed and has led to the standard methodology of population viability analysis (PVA) to assess vulnerability of single species. However, more complex situations involving community dynamics or environmental change violate theoretical assumptions. Synthesizing concepts from population, community, and conservation ecology, we develop a generic theory on the viability of cyclic populations. The interplay of periodic population decline and demography causes varying risk patterns that aggregate during cycles and modify the temporal structure of viability. This variability is visualized and quantitatively assessed. For two standard viability metrics that summarize immediate extinction risk and the general long‐term conditions of populations, we mathematically describe the impact of population cycles. Finally, we suggest and demonstrate PVA for cyclic populations that respond to, e.g., seasonality, interannual variation, or trophic interactions. Our theoretical and methodological advancement opens a route to viability analysis in food webs and trophic meta‐communities and equips biodiversity conservation with a long‐missing tool.
A bird pollinator shows positive frequency dependence and constancy of species choice in natural plant communities
Authors: Schmid B. , Nottebrock H. , Esler K. J. , Pagel J. , Böhning‐Gaese K. , Schurr F. M. , Mueller T. , Schleuning M.
Published: August 2016

Animal pollinators mediate reproduction of many plant species. Foraging theory suggests that animal pollinators exhibit preferences for common plant species in natural communities (positive frequency‐dependent foraging) and temporary single‐species specialization (flower constancy) during foraging bouts. Positive frequency dependence may favor common plant species; flower constancy may enhance conspecific pollen transfer particularly in rare plant species. Previous experimental studies suggest that avian pollinators are unlikely to exhibit these behaviors. We studied foraging behavior of Cape Sugarbirds (Promerops cafer), the main avian pollinator of many Protea species, using focal‐plant and focal‐bird sampling, assisted by high‐resolution maps of the spatiotemporal distribution of Protea individuals and their flowering status. We found that Sugarbird's visitation preference increased with species' relative floral abundance, and that individual Sugarbirds tended to visit single species in sequence. Flower constancy during foraging bouts was significantly higher than expected from random plant–animal encounters at the scale of pollinator movements. Positive frequency dependence may favor the reproduction of abundant plant species while flower constancy may be particularly important for rare plant species. This first simultaneous study of both behaviors in a natural plant–pollinator system shows that bird pollinators exhibit both types of behavior and, in this way, possibly influence plant community structure.
Seedling performance covaries with dormancy thresholds: maintaining cryptic seed heteromorphism in a fire‐prone system
Authors: Liyanage Ganesha S. , Ayre David J. , Ooi Mark K. J.
Published: August 2016

The production of morphologically different seeds or fruits by the same individual plant is known as seed heteromorphism. Such variation is expected to be selected for in disturbance‐prone environments to allow germination into inherently variable regeneration niches. However, there are few demonstrations that heteromorphic seed characteristics should be favored by selection or how they may be maintained. In fire‐prone ecosystems, seed heteromorphism is found in the temperatures needed to break physical dormancy, with seeds responding to high or low temperatures, ensuring emergence under variable fire‐regime‐related soil heating. Because of the relationship between dormancy‐breaking temperature thresholds and fire severity, we hypothesize that different post‐fire resource conditions have selected for covarying seedling traits, which contribute to maintenance of such heteromorphism. Seeds with low thresholds emerge into competitive conditions, either after low‐severity fire or in vegetation gaps, and are therefore likely to experience selection for seedling characteristics that make them good competitors. On the other hand, high‐temperature‐threshold seeds would emerge into less competitive environments, indicative of stand‐clearing high‐severity fires, and would not experience the same selective forces. We identified high and low‐threshold seed morphs via dormancy‐breaking heat treatments and germination trials for two study species and compared seed mass and other morphological characteristics between morphs. We then grew seedlings from the two different morphs, with and without competition, and measured growth and biomass allocation as indicators of seedling performance. Seedlings from low‐threshold seeds of both species performed better than their high‐threshold counterparts, growing more quickly under competitive conditions, confirming that different performance can result from this seed characteristic. Seed mass or appearance did not differ between morphs, indicating that dormancy‐breaking temperature threshold variation is a form of cryptic heteromorphism. The potential shown for the selective influence of different post‐fire environmental conditions on seedling performance provides evidence of a mechanism for the maintenance of heteromorphic variation in dormancy‐breaking temperature thresholds.
Hunting on a hot day: effects of temperature on interactions between African wild dogs and their prey
Authors: Creel Scott , Creel Nancy M. , Creel Andrea M. , Creel Bridget M.
Published: August 2016

As global temperatures increase, interactions between species are affected by changes in distribution, abundance and phenology, but also by changes in behavior. The heat dissipation limitation hypothesis suggests that the ability to dissipate heat commonly limits the activity of endotherms, a problem that should be particularly acute for cursorial predators and their prey in equatorial ecosystems. Allometric relationships suggest that heat dissipation should be a stronger constraint for larger species, so that (smaller) predators should be less affected than (larger) prey. We used data from 266 complete days of direct observation of African wild dogs (Lycaon pictus) in five packs over a period of 2 yr to test how deviations of temperature from that expected for the time of day affected eight measures of hunting effort and success. We found that higher temperatures disadvantaged the prey of wild dogs more than the dogs themselves, with increased hunting success and shorter pursuits on warmer days. Broadly, our results demonstrate that effects of temperature on behavior can alter interactions between species, exacerbating or offsetting the direct effects of climate change.
A plant growth form dataset for the New World
Authors: Engemann K. , Sandel B. , Boyle B. , Enquist B. J. , Jørgensen P. M. , Kattge J. , McGill B. J. , Morueta‐Holme N. , Peet R. K. , Spencer N. J. , Violle C. , Wiser S. K. , Svenning J.‐C.
Published: August 2016

This dataset provides growth form classifications for 67,413 vascular plant species from North, Central, and South America. The data used to determine growth form were compiled from five major integrated sources and two original publications: the Botanical Information and Ecology Network (BIEN), the Plant Trait Database (TRY), the SALVIAS database, the USDA PLANTS database, Missouri Botanical Garden's Tropicos database, Wright (2010), and Boyle (1996). We defined nine plant growth forms based on woodiness (woody or non‐woody), shoot structure (self‐supporting or not self‐supporting), and root traits (rooted in soil, not rooted in soil, parasitic or aquatic): Epiphyte, Liana, Vine, Herb, Shrub, Tree, Parasite, or Aquatic. Species with multiple growth form classifications were assigned the growth form classification agreed upon by the majority (>2/3) of sources. Species with ambiguous or otherwise not interpretable growth form assignments were excluded from the final dataset but are made available with the original data. Comparisons with independent estimates of species richness for the Western hemisphere suggest that our final dataset includes the majority of New World vascular plant species. Coverage is likely more complete for temperate than for tropical species. In addition, aquatic species are likely under‐represented. Nonetheless, this dataset represents the largest compilation of plant growth forms published to date, and should contribute to new insights across a broad range of research in systematics, ecology, biogeography, conservation, and global change science.
Effects of changing climate on ice cover in three morphometrically different lakes
Authors: Magee Madeline R. , Wu Chin H.
Published: August 2016

A one‐dimensional hydrodynamic lake model (DYRESM‐WQ‐I) is employed to simulate ice cover and water temperatures over the period 1911–2014. The effects of climate changes (air temperature and wind speed) on ice cover (ice‐on, ice‐off, ice cover duration, and maximum ice thickness) are modeled and compared for the three different morphometry lakes: Fish Lake, Lake Wingra, and Lake Mendota, located in Madison, Wisconsin, USA. It is found that the ice cover period has decreased due to later ice‐on dates and earlier ice‐off dates, and the annual maximum ice cover thickness has decreased for the three lakes during the last century. Based upon simulated perturbations of daily mean air temperatures across the range of −10°C to +10°C of historical values, Fish Lake has the most occurrences of no ice cover and Lake Wingra still remains ice covered under extreme conditions (+10°C). Overall, shallower lakes with larger surface areas appear more resilient to ice cover changes caused by climate changes.
Never Too Old: A How‐To Guide for Developing Adult Readers’ Oral Reading Skills
Authors: Ortlieb Evan , Young Chase
Published: August 2016

Despite efforts to promote literacy in the early years, millions of people in the United States and countless more abroad are functionally illiterate. The importance of improving adult literacy proficiency is unquestionable; however, the pedagogical approaches to support this monumental undertaking have been scarcely researched. Moreover, the nature of what constitutes literacy today is ever changing. This article introduces a practical approach for teachers/tutors to support adult literacy improvement through using specific strategies such as Read Two Impress.
Are Computers, Smartphones, and the Internet a Boon or a Barrier for the Weaker Reader?
Authors: Harrison Colin
Published: August 2016

If boys are spending nine hours a day media multitasking and prefer computers to books, shouldn't they be successful at online learning? Yet, it is not so simple. Online learning requires online reading, which means that boys, who are significantly poorer readers than girls in every nation in the world, may well be struggling to keep up. Text‐to‐speech software and many other online tools would seem to offer personalized support for weaker readers, but there is growing evidence that even with multimedia texts, the sheer volume of curricular material can be too great. Add to this the fact that an online student may not have access to the learning that can come from group interaction, nor to the social and emotional support that can come from peers or a teacher, and the online reader could be heading for a learning apocalypse.
Joyful Learning and Letting Stories Breathe
Authors: Newhouse Katherine , Rodriguez Kerr Kristine
Published: August 2016

This forum reviews a mix of resources (written texts, graphic novels, documentaries, and mixed‐media pieces) to inform pedagogy and related educational practices that foreground representations of youths and their literacy practices within and outside of school.
Our Literacies In/Justice
Authors: Zenkov Kristien , Newman Kerry ,   with Northern Virginia Preservice Teachers and High School Students, Zenkov Kristien
Published: August 2016

The Partnerships Literacies column explores the idea that literacies are as much evolving processes as they are static contents. Coauthored by university‐ and school‐based teachers and teacher educators, preservice teachers, and youths, the columns consider how very traditional literacies (e.g., in reading, writing, composing, speaking, and listening) and other notions and concepts of literacy are best developed through context‐crossing partnerships among university, school, and community constituents playing boundary‐spanning roles.
Online Resources About Climate Change
Authors: Golden Barry W.
Published: August 2016

This forum highlights and evaluates apps, computer programs, and websites that teachers, students, and other interested parties can use to explore, research, and engage in content learning and literacy practices.
Challenging Nonfiction
Authors: Garcia Antero
Published: August 2016

This forum reviews high‐interest young adult literature and adult texts. Exploring both print‐based and multimodal works, this column considers all kinds of texts that are encountered by contemporary readers, considering how the texts challenge and are challenged by readers.
Making It Social: Considering the Purpose of Literacy to Support Participation in Making and Engineering
Authors: Tucker‐Raymond Eli , Gravel Brian E. , Wagh Aditi , Wilson Naeem
Published: August 2016

Digital literacies for disciplinary learning explores intersections of digital and disciplinary literacies across learning contexts such as community makerspaces and schools and examines learning across disciplines including the arts, engineering, science, social studies, language arts, and math. Columns will address work with both youth and adults, both in school and out of school. Digital enhancements will encourage interactivity with readers and will provoke questions, comments, and connections.
Optimism, Cynical Hostility, Falls, and Fractures: The Women's Health Initiative Observational Study (WHI-OS)
Authors: Cauley Jane A , Smagula Stephen F , Hovey Kathleen M , Wactawski-Wende Jean , Andrews Christopher A , Crandall Carolyn J , LeBoff Meryl S , Li Wenjun , Coday Mace , Sattari Maryam , Tindle Hilary A
Published: August 2016

Traits of optimism and cynical hostility are features of personality that could influence the risk of falls and fractures by influencing risk-taking behaviors, health behaviors, or inflammation. To test the hypothesis that personality influences falls and fracture risk, we studied 87,342 women enrolled in WHI-OS. Optimism was assessed by the Life Orientation Test–Revised and cynical hostility, the cynicism subscale of the Cook-Medley questionnaire. Higher scores indicate greater optimism and hostility. Optimism and hostility were correlated at r = –0. 31, p < 0.001. Annual self-report of falling ≥2 times in the past year was modeled using repeated measures logistic regression. Cox proportional hazards models were used for the fracture outcomes. We examined the risk of falls and fractures across the quartiles (Q) of optimism and hostility with tests for trends; Q1 formed the referent group. The average follow-up for fractures was 11.4 years and for falls was 7.6 years. In multivariable (MV)-adjusted models, women with the highest optimism scores (Q4) were 11% less likely to report ≥2 falls in the past year (odds ratio [OR] = 0.89; 95% confidence intervals [CI] 0.85–0.90). Women in Q4 for hostility had a 12% higher risk of ≥2 falls (OR = 1.12; 95% CI 1.07–1.17). Higher optimism scores were also associated with a 10% lower risk of fractures, but this association was attenuated in MV models. Women with the greatest hostility (Q4) had a modest increased risk of any fracture (MV-adjusted hazard ratio = 1. 05; 95% CI 1.01–1.09), but there was no association with specific fracture sites. In conclusion, optimism was independently associated with a decreased risk of ≥2 falls, and hostility with an increased risk of ≥2 falls, independent of traditional risk factors. The magnitude of the association was similar to aging 5 years. Whether interventions aimed at attitudes could reduce fall risks remains to be determined. © 2016 American Society for Bone and Mineral Research.
IL-36 Induces Bisphosphonate-Related Osteonecrosis of the Jaw-Like Lesions in Mice by Inhibiting TGF-β-Mediated Collagen Expression
Authors: Kim Sol , Williams Drake W , Lee Cindy , Kim Terresa , Arai Atsushi , Shi Songtao , Li Xinmin , Shin Ki-Hyuk , Kang Mo K , Park No-Hee , Kim Reuben H
Published: August 2016

Long-term administration of nitrogen-containing bisphosphonates can induce detrimental side effects such as bisphosphonate-related osteonecrosis of the jaw (BRONJ) in human. Although inflammation is known to be associated with BRONJ development, the detailed underlying mechanism remains unknown. Here, we report that the pro-inflammatory cytokine IL-36α is, in part, responsible for the BRONJ development. We found a notably higher level of IL-36α and lower level of collagen in the BRONJ lesions in mice. We also found that IL-36α remarkably suppressed TGF-β-mediated expression of Collα1 and α-Sma via the activation of Erk signaling pathway in mouse gingival mesenchymal stem cells. When IL-36 signaling was abrogated in vivo, development of BRONJ lesions was ameliorated in mice. Taken together, we showed the pathologic role of IL-36α in BRONJ development by inhibiting collagen expression and demonstrated that IL-36α could be a potential marker and a therapeutic target for the prevention and treatment of BRONJ. © 2016 American Society for Bone and Mineral Research.
Absence of the Vitamin D Receptor Inhibits Atherosclerotic Plaque Calcification in Female Hypercholesterolemic Mice
Authors: Shamsuzzaman Sohel , Onal Melda , St John Hillary C. , Jeffery Justin J. , Pike John W.
Published: August 2016

Epidemiological and clinical data suggest adverse cardiovascular outcomes with respect to vitamin D deficiency. Here, we explored the effects of vitamin D in atherosclerotic plaque calcification in vivo by utilizing vitamin D receptor (Vdr)‐deficient mice in an Apoe−/− background. Animals were fed a high‐fat diet (HFD) for either 12 or 18 weeks and then examined for atherosclerotic plaque development. In order to prevent calcium deficiency, Vdr−/− and Apoe−/−;Vdr−/− animals were fed a high‐calcium rescue diet prior to initiation of the HFD feeding and supplemented with high‐calcium water during HFD feeding. Although calcium supplementation improved bone mass in Vdr−/− and Apoe−/−;Vdr−/− mice, neither strain was fully rescued. Systemic inflammatory responses observed in the absence of VDR were exaggerated in Apoe−/− mice. Whereas, hyperlipidemic profiles seen in Apoe−/− mice were ameliorated in the absence of VDR. Micro‐computed tomography (µCT) analysis revealed that six out of eight Apoe−/− animals developed atherosclerotic plaque calcification following 12 weeks of HFD feeding and 100% of the mice developed plaque calcification after 18 weeks. In contrast, although atherosclerotic lesions were evident in Apoe−/−;Vdr−/− mice at 12 and 18 weeks of HFD challenge, none of these animals developed plaque calcification at either time point. The active vitamin D hormone, 1,25(OH)2D3 likely increased calcification in aortic smooth muscle cells perhaps by directly modulating expression of Alpl, Rankl, and Opg. Our data suggest that the absence of VDR inhibits atherosclerotic plaque calcification in hypercholesterolemic Apoe−/− mice, providing additional insight into the role of vitamin D in atherosclerotic plaque calcification. J. Cell. Biochem. 118: 1050–1064, 2017. © 2016 Wiley Periodicals, Inc.
CTNND1 755 T>G Promoter Polymorphism and Risk of Pancreatic Carcinoma in Chinese
Authors: Wang Wei , Fei Yang , Liu Sheng‐li
Published: August 2016

Objective

To investigate the relationship between 755 T>G polymorphisms in the CTNND1 gene, which is associated with the risk of pancreatic carcinoma in Chinese.

Methods

CTNND1 755 T>G genotypes were determined by PCR‐RFLP in 122 pancreatic carcinoma patients and 180 healthy controls matched for age and sex, who did not receive radiotherapy or chemotherapy for newly diagnosed and histopathologically confirmed pancreatic carcinoma.

Results

In control subjects, the frequency of T/T and G/T genotypes, and T and G alleles was 79.4%, 17.2%, 88.1%, and 11.9%, respectively. The distribution of genotypes and allelotypes in the pancreatic carcinoma patients was significantly different from that in the controls (P = 0.007, P = 0.012). Combined GG and GT genotypes were found to have a higher OR in male pancreatic carcinoma patients and the group under the age of 70 years (males: OR, 1.409; 95%CI, 0.912~1.921; under 70 years: OR 1.626; 95% CI, 0.878~2.312). This study also showed a distinct difference in the distribution of P120ctn and single nucleotide polymorphisms (SNPs) between Chinese and Canadian (11.9% vs. 3.9%, P = 0.008).

Conclusion

CTNND1 755 T>G polymorphism may be a stratification marker to predict the susceptibility to pancreatic carcinoma, at least in Chinese. CTNND1 promoter SNPs is diverse in ethnic populations.
An alternative approach to calculating Area‐Under‐the‐Curve (AUC) in delay discounting research
Authors: Borges Allison M. , Kuang Jinyi , Milhorn Hannah , Yi Richard
Published: August 2016

Applied to delay discounting data, Area‐Under‐the‐Curve (AUC) provides an atheoretical index of the rate of delay discounting. The conventional method of calculating AUC, by summing the areas of the trapezoids formed by successive delay‐indifference point pairings, does not account for the fact that most delay discounting tasks scale delay pseudoexponentially, that is, time intervals between delays typically get larger as delays get longer. This results in a disproportionate contribution of indifference points at long delays to the total AUC, with minimal contribution from indifference points at short delays. We propose two modifications that correct for this imbalance via a base‐10 logarithmic transformation and an ordinal scaling transformation of delays. These newly proposed indices of discounting, AUClog

d
and AUCor

d,
address the limitation of AUC while preserving a primary strength (remaining atheoretical). Re‐examination of previously published data provides empirical support for both AUClog

d
and AUCor

d
. Thus, we believe theoretical and empirical arguments favor these methods as the preferred atheoretical indices of delay discounting.
Pathophysiology of lymphedema—Is there a chance for medication treatment?
Authors: Hespe Geoffrey E. , Nores Gabriela Garcia , Huang Jung‐Ju , Mehrara Babak J.
Published: August 2016

Lymphedema is a common morbid after cancer treatment. The disease characterizes with progressive inflammatory process that result in irreversible fibrosis. Its chronology and progressive disease character often impacts the quality of life of cancer survivors. The pathophysiology of lymphedema remains unclear and the disease remains non‐curable. In this article, we reviewed available studies of lymphedema and concluded possible treatment strategies for lymphedema. J. Surg. Oncol. 2017;115:96–98. © 2016 Wiley Periodicals, Inc.
Successful treatment of recurrent CNS disease post‐bone marrow transplant in children with familial hemophagocytic lymphohistiocytosis
Authors: Bock Allison M. , LeVeque Michelle , Camitta Bruce , Talano Julie‐An
Published: August 2016

Background

Central nervous system (CNS) involvement is a major cause of morbidity and mortality in patients with hemophagocytic lymphohistiocytosis (HLH). Current standard of care for CNS disease utilizes high‐dose systemic dexamethasone plus intrathecal methotrexate and hydrocortisone prior to transplantation. However, the morbidity and mortality remains high and there are no clear guidelines posttransplantation for screening and treatment of CNS disease.

Procedure

We report a single‐center retrospective case series of five patients with familial HLH (FHLH) who had CNS involvement post‐bone marrow transplantation (BMT). All patients were monitored with monthly lumbar punctures (LPs) prior to developing neurologic symptoms. Treatment utilized systemic dexamethasone for CNS disease control.

Results

Five patients were monitored with monthly or bimonthly surveillance LPs and treated with systemic dexamethasone to control CNS relapse post‐BMT. All patients are alive, a median of 34 months posttransplant (range 14–66 months). Four patients have mild neurological deficits, including mild speech delay (3) and one patient who exhibited brainstem herniation on day 0, due to CNS HLH, has made a substantial recovery of function with residual deficits of focal weakness on the right side. One patient has no deficits.

Conclusion

Our data support vigilant screening posttransplant for occult CNS disease prior to the development of symptoms and the use of systemic dexamethasone to reverse disease progression. Future prospective trials are needed to evaluate this treatment strategy.
Pencil beam scanning proton therapy for treatment of the retroperitoneum after nephrectomy for Wilms tumor: A dosimetric comparison study
Authors: Vogel Jennifer , Lin Haibo , Both Stefan , Tochner Zelig , Balis Frank , Hill‐Kayser Christine
Published: August 2016

Background

Multimodality treatment for patients with Wilms tumor has improved patient survival, but is associated with acute and long‐term toxicity, partially due to irradiation. Proton therapy using pencil beam scanning (PBS) is a promising technique to reduce dose to organs at risk (OAR). In this study, we evaluate PBS plans for postoperative irradiation in patients with Wilms tumor.

Procedure

Patients were treated with anterior‐posterior–posterior‐anterior (AP–PA) photon fields encompassing the preoperative tumor volume. Patients requiring whole lung irradiation were treated with AP–PA photon fields covering the bilateral lungs. Prescription doses were generally 1,080 and 1,200 cGy, respectively. Flank PBS plans encompassing the ipsilateral retroperitoneum and para‐arotic nodes were generated for dosimetric evaluation.

Results

Treatment records and comparison plans of 11 patients were reviewed. Mean dose and median dose to 50% or more of the contralateral kidney (D50) were 135 cGy and 139 cGy with photons and 52 cGy relative biological effectiveness (RBE) (P = 0.009) and 5 cGy RBE (P = 0.000001) with PBS. Mean dose and median D50 to bowel was 639 cGy and 979 cGy with photons and 379 cGy RBE (P = 0.001) and 47 cGy RBE (P = 0.004) with PBS. Mean dose and median D50 to the liver were 755 cGy and 1,013 cGy with photons and 411 cGy RBE (P = 0.02) and 132 cGy RBE (P = 0.02) with PBS. For patients with right‐sided tumors, mean liver dose following sequential whole lung irradiation was 1,252 cGy with photons and 845 cGy RBE (P = 0.04) with PBS.

Discussions

PBS proton therapy is a feasible method for irradiating the retroperitoneum and provides significant sparing of dose to critical OAR. This may translate to improved long‐term health outcomes for patients and warrants further clinical investigation.
Incidence of second cancers after radiotherapy and systemic chemotherapy in heritable retinoblastoma survivors: A report from the German reference center
Authors: Temming Petra , Arendt Marina , Viehmann Anja , Eisele Lewin , Le Guin Claudia H. D. , Schündeln Michael M. , Biewald Eva , Astrahantseff Kathy , Wieland Regina , Bornfeld Norbert , Sauerwein Wolfgang , Eggert Angelika , Jöckel Karl‐Heinz , Lohmann Dietmar R.
Published: August 2016

Background

Survivors of heritable retinoblastoma carry a high risk to develop second cancers. Eye‐preserving radiotherapy raises this risk, while the impact of chemotherapy remains less defined.

Procedure

This population‐based study characterizes the impact of all treatment modalities on second cancers incidence and type after retinoblastoma treatment in Germany. Data on second cancer incidence in 648 patients with heritable retinoblastoma treated between 1940 and 2008 at the German national reference center for retinoblastoma were analyzed to identify associations with treatment.

Results

The cumulative incidence ratio (per 1,000 person years) of second cancers was 8.6 (95% confidence interval 7.0–10.4). Second cancer incidence was influenced by type of retinoblastoma treatment but not by the year of diagnosis or by sex. Radiotherapy and systemic chemotherapy increased the incidence of second cancers (by 3.0‐ and 1.8‐fold, respectively). While radiotherapy was specifically associated with second cancers arising within the periorbital region in the previously irradiated field, chemotherapy was the strongest risk factor for second cancers in other localizations. Soft tissue sarcomas and osteosarcomas were the most prevalent second cancers (standardized incidence ratio 179.35 compared to the German population).

Conclusions

Second cancers remain a major concern in heritable retinoblastoma survivors. Consistent with previous reports, radiotherapy increased second cancer incidence and influenced type and localization. However, chemotherapy was the strongest risk factor for second malignancies outside the periorbital region. Our results provide screening priorities during life‐long oncological follow‐up based on the curative therapy the patient has received and emphasize the need for less‐detrimental therapies for children with heritable retinoblastoma.
Sclerosing cholangitis and intracranial lymphoma in a child with classical Wiskott–Aldrich syndrome
Authors: Vignesh Pandiarajan , Suri Deepti , Rawat Amit , Lau Yu Lung , Bhatia Anmol , Das Ashim , Srinivasan Anirudh , Dhandapani Sivashanmugam
Published: August 2016

Patients with Wiskott–Aldrich syndrome (WAS) are predisposed to malignancy and autoimmunity in addition to infections. We report a male child with WAS, who had presented with recurrent pneumonia, eczema, thrombocytopenia, autoimmune hemolytic anemia, and vasculitic skin lesions. Genetic analysis revealed a classical genotype WAS 155C>T; R41X. At 2 years of follow‐up, he developed persistent headache and progressive hepatomegaly. Brain imaging showed a mass in the right frontal region, which on histopathology was shown to be high‐grade non‐Hodgkin lymphoma. Magnetic resonance cholangiopancreatography showed features of sclerosing cholangitis. This report extends the clinical spectrum and highlights unusual manifestations of sclerosing cholangitis and intracranial lymphoma in a patient with WAS.
Short‐term recovery of chemotherapy‐induced peripheral neuropathy after treatment for pediatric non‐CNS cancer
Authors: Gilchrist Laura S. , Tanner Lynn R. , Ness Kirsten K.
Published: August 2016

Purpose

Chemotherapy‐induced peripheral neuropathy (CIPN) is a frequent side effect of pediatric cancer treatment. The presentation of CIPN, trajectory and completeness of recovery over the first 6 months postchemotherapy, and the influence of patient and treatment characteristics on recovery are described.

Patients and Methods

Sixty‐seven children and adolescents treated for non‐CNS cancers were evaluated for CIPN using the pediatric modified total neuropathy score (ped‐mTNS) while on treatment and 3 and 6 months postchemotherapy. Differences between diagnostic groups and treatment type were evaluated as well as change in scores over time. Risk factors for on‐treatment and persistent CIPN at 6 months were identified.

Results

Overall, ped‐mTNSs were in the abnormal range for 86.5% during treatment and scores decreased over time (initial 9.3 ± 0.6, 6 months 4.3 ± 0.4; F = 38.14, P < 0.001). By 6 months posttreatment, mean scores and percentage of children with abnormal scores were reduced to 2.4 ± 0.3 and 11.5%, respectively, in the ALL group, but remained higher at 5.7 ± 0.7 and 57%, respectively, for lymphoma, and 5.2 ± 1.0 and 60%, respectively, for other solid tumors. At 6 months posttreatment, light touch deficits and foot strength deficits remained in 19.4 and 59.7%, respectively, compared with only 4.9 and 9.8% of the control population. Subjects who were older at exposure, female, or who received etoposide in addition to vincristine were at higher risk for on‐treatment CIPN. On‐treatment sensory abnormalities were associated with increased risk of persistent CIPN.

Conclusion

While CIPN improves in most pediatric patients, significant numbers, especially those treated for lymphoma or other solid tumors, have remaining neuropathic signs and symptoms 6 months posttreatment.
TMSEG: Novel prediction of transmembrane helices
Authors: Bernhofer Michael , Kloppmann Edda , Reeb Jonas , Rost Burkhard
Published: August 2016

Transmembrane proteins (TMPs) are important drug targets because they are essential for signaling, regulation, and transport. Despite important breakthroughs, experimental structure determination remains challenging for TMPs. Various methods have bridged the gap by predicting transmembrane helices (TMHs), but room for improvement remains. Here, we present TMSEG, a novel method identifying TMPs and accurately predicting their TMHs and their topology. The method combines machine learning with empirical filters. Testing it on a non‐redundant dataset of 41 TMPs and 285 soluble proteins, and applying strict performance measures, TMSEG outperformed the state‐of‐the‐art in our hands. TMSEG correctly distinguished helical TMPs from other proteins with a sensitivity of 98 ± 2% and a false positive rate as low as 3 ± 1%. Individual TMHs were predicted with a precision of 87 ± 3% and recall of 84 ± 3%. Furthermore, in 63 ± 6% of helical TMPs the placement of all TMHs and their inside/outside topology was correctly predicted. There are two main features that distinguish TMSEG from other methods. First, the errors in finding all helical TMPs in an organism are significantly reduced. For example, in human this leads to 200 and 1600 fewer misclassifications compared to the second and third best method available, and 4400 fewer mistakes than by a simple hydrophobicity‐based method. Second, TMSEG provides an add‐on improvement for any existing method to benefit from. Proteins 2016; 84:1706–1716. © 2016 Wiley Periodicals, Inc.
Predictive Performance of Physiologically Based Pharmacokinetic and Population Pharmacokinetic Modeling of Renally Cleared Drugs in Children
Authors: Zhou W , Johnson TN , Xu H , Cheung SYA , Bui KH , Li J , Al‐Huniti N , Zhou D
Published: August 2016

Predictive performance of physiologically based pharmacokinetic (PBPK) and population pharmacokinetic (PopPK) models of drugs predominantly eliminated through kidney in the pediatric population was evaluated. After optimization using adult clinical data, the verified PBPK models can predict 33 of 34 drug clearance within twofold of the observed values in children 1 month and older. More specifically, 10 of 11 of predicted clearance values were within 1.5‐fold of those observed in children between 1 month and 2 years old. The PopPK approach also predicted 19 of 21 drug clearance within twofold of the observed values in children. In summary, our analysis demonstrated both PBPK and PopPK adult models, after verification with additional adult pharmacokinetic (PK) studies and incorporation of known ontogeny of renal filtration, could be applied for dosing regimen recommendation in children 1 month and older for renally eliminated drugs in a first‐in‐pediatric study.
Lactate dehydrogenase downregulation mediates the inhibitory effect of diallyl trisulfide on proliferation, metastasis, and invasion in triple‐negative breast cancer
Authors: Cheng Shi‐Yann , Yang Yao‐Chih , Ting Kuan‐lun , Wen Su-Ying , Viswanadha Vijaya Padma , Huang Chih‐Yang , Kuo Wei‐Wen
Published: August 2016

The Warburg effect plays a critical role in tumorigenesis, suggesting that specific agents targeting Warburg effect key proteins may be a promising strategy for cancer therapy. Previous studies have shown that diallyl trisulfide (DATS) inhibits proliferation of breast cancer cells by inducing apoptosis in vitro and in vivo. However, whether the Warburg effect is involved with the apoptosis‐promoting action of DATS is unclear. Here, we show that the action of DATS is associated with downregulation of lactate dehydrogenase A (LDHA), an essential protein of the Warburg effect whose upregulation is closely related to tumorigenesis. Interestingly, inhibition of the Warburg effect by DATS in breast cancer cells did not greatly affect normal cells. Furthermore, DATS inhibited growth of breast cancer cells, particularly in MDA‐MB‐231, a triple‐negative breast cancer (TNBC) cell, and reduced proliferation and migration; invasion was reversed by over‐expression of LDHA. These data suggest that DATS inhibits breast cancer growth and aggressiveness through a novel pathway targeting the key enzyme of the Warburg effect. Our study shows that LDHA downregulation is involved in the apoptotic effect of DATS on TNBC. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1390–1398, 2017.
Collaborating With Music Therapists to Improve Patient Care
Authors: Palmer Jaclyn Bradley , Lane Deforia , Mayo Diane
Published: August 2016

Collaboration between perioperative nurses and music therapists can be beneficial in providing a safe, cost‐effective means of managing patients’ anxiety and pain and reducing the need for pharmacologic intervention in the perioperative setting. The use of a board‐certified music therapist may help to improve patient outcomes, ease nurse workload, and serve as an adjunct therapeutic modality that is enjoyable for both patients and staff members. We conducted a two‐year, randomized controlled trial to determine how to best implement a music therapy program, navigate its challenges, and collaborate with nurse colleagues to bring its benefits to surgical patients. This article offers suggestions for alliances between perioperative nursing and music therapy staff members and describes the potential of music therapists to help provide optimal patient care.
Outcome Management in Cardiac Surgery Using the Society of Thoracic Surgeons National Database
Authors: Halpin Linda S. , Gallardo Bret E. , Speir Alan M. , Ad Niv
Published: August 2016

Health care reform has helped streamline patient care and reimbursement by encouraging providers to provide the best outcome for the best value. Institutions with cardiac surgery programs need a methodology to monitor and improve outcomes linked to reimbursement. The Society of Thoracic Surgeons National Database (STSND) is a tool for monitoring outcomes and improving care. This article identifies the purpose, goals, and reporting system of the STSND and ways these data can be used for benchmarking, linking outcomes to the effectiveness of treatment, and identifying factors associated with mortality and complications. We explain the methodology used at Inova Heart and Vascular Institute, Falls Church, Virginia, to perform outcome management by using the STSND and address our performance‐improvement cycle through discussion of data collection, analysis, and outcome reporting. We focus on the revision of clinical practice and offer examples of how patient outcomes have been improved using this methodology.
Guideline Implementation: Processing Flexible Endoscopes
Authors: Bashaw Marie A.
Published: August 2016

The updated AORN “Guideline for processing flexible endoscopes” provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.
Use of a Surgical Safety Checklist to Improve Team Communication
Authors: Cabral Richard A. , Eggenberger Terry , Keller Kathryn , Gallison Barry S. , Newman David
Published: August 2016

To improve surgical team communication, a team at Broward Health Imperial Point Hospital, Ft Lauderdale, Florida, implemented a program for process improvement using a locally adapted World Health Organization Surgical Safety Checklist. This program included a standardized, comprehensive time out and a briefing/debriefing process. Postimplementation responses to the Safety Attitudes Questionnaire revealed a significant increase in the surgical team's perception of communication compared with that reported on the pretest (6% improvement resulting in t79 = –1.72, P < .05, d = 0.39). Perceptions of communication increased significantly for nurses (12% increase, P = .002), although the increase for surgeons and surgical technologists was lower (4% for surgeons, P = .15 and 2.3% for surgical technologists, P = .06). As a result of this program, we have observed improved surgical teamwork behaviors and an enhanced culture of safety in the OR.
Back to Basics: Preventing Surgical Fires
Authors: Spruce Lisa
Published: August 2016

When fires occur in the OR, they are devastating and potentially fatal to both patients and health care workers. Fires can be prevented by understanding the fire triangle and methods of reducing fire risk, conducting fire risk assessments, and knowing how to respond if a fire occurs. This Back to Basics article addresses the basics of fire prevention and the steps that can be taken to prevent fires from occurring.
Clinical Issues‐September 2016
Authors: Van Wicklin Sharon A.
Published: August 2016

This Month

Packaging multiple items in a single peel pouch

Key words: peel pouch, packaging, low profile items.

Closed instruments found in instrument trays

Key words: closed instruments, instrument trays.

Organic and inorganic material found in instrument trays

Key words: organic material, inorganic material, instrument trays.

Processed endoscopes touching each other

Key words: endoscope storage, endoscopes touching, endoscope storage cabinet, endoscope damage, endoscope coiling.

Maximum safe storage time for processed flexible endoscopes

Key words: endoscope storage, endoscope storage time, risk assessment, multidisciplinary team.