bluuebunny/crossref_metadata_2025 huggingface dataset:
Percutaneous Sclerotherapy of Varicocele: Personal Experience
Authors: Broggini P. , Puricelli G.P. , Goddi A. , Belli L. , Pozzi E. , Malvestiti G.M. , Leoni O. , Marandola P. , Roggia A. , Jallous M.
Published: October 2018

The Authors describe their experience regarding 80 cases of selective phlebography of the spermatic vein in men with varicocele. Percutaneous transvenous retrograde sclerotherapy of the internal spermatic vein was performed in 78 patients (type 1 and type 3 according to Coolsaet). Follow-up colour-doppler 1 month after sclerotherapy revealed a persistent varicocele in only 3% of cases. The Authors present the advantages of percutaneous sclerotherapy.
Andrologic Evaluation in Kidney Transplant Patient
Authors: Ferrando U. , Morabito F. , Pagliano G.L. , Arena G. , Paradiso M. , Pigato M. , Cucchiarale G.
Published: October 2018

The Authors report their personal experience from ten years activity at the kidney transplant center in S. Giovanni Battista Hospital - Turin. 189 male patients, submitted to kidney transplant at least 1 year ago, have been evaluated. The protocol of investigation included: general medical history based on a self-completed questionnaire with special emphasis on sexual history, routine blood chemistry and hormonal profile, doppler study, nocturnal penile tumescence monitoring, sacral evoked potential, intracavernous injection of vasoactive drug. 41.3% of patients showed various degrees of erectile dysfunction. Treatment was according to dysfunction aetiology and gravity.
Benign Prostatic Hyperplasia (BPH): Therapeutic Options
Authors: Caruso N.
Published: October 2018

Researchers' interest in the last few years has been concentrated on finding a medical, if possible, or at least “mini-invasive” therapy for benign prostatic hypertrophy (BPH), which can be used for the symptomatic form instead of open or endoscopic surgery. The various therapeutic options are reviewed, underlining their advantages and disadvantages.
Benign Prostatic Hyperplasia: Diagnostic and Therapeutic Problems
Authors: Fiaccavento G.
Published: October 2018

The reliability and importance of diagnostic ultrasound and urodynamics in benign prostatic hyperplasia is emphasised, while pointing out the limits of medical treatment. Surgery is still the golden standard, despite a high percentage of patients who are “unsatisfied” even though the obstruction has been removed. These cases always present hyperreflexia and alterations of detrusor normal anatomy.
Cryptorchidism: Prevalence at Birth and Testicular Post-Natal Descent
Authors: Zanon A.
Published: October 2018

This works gives the results of an epidemiological survey on the frequency of cryptorchidism carried out from 1988–1994 in the Hospital of Cittadella (Padua) on 3185 newborn. These babies were examined again by the same operator at 3-6-12 months. Standard criteria were used in defining cryptorchidism. Fifty-seven newborn (1.79%) were cryptorchid. The rate was much higher at birth for hypodystrophic and pre-term infants. The frequency descended to 1.17% and 1.15% respectively at 6 and 12 months, when the difference between the frequency of cryptorchidism in pre-term and underweight infants was no longer statistically significant compared to eutrophic and full-term babies. In conclusion, it may be confirmed that the incidence of this malformation is around 1% at one year old, as reported in literature. The spontaneous complete descent of the cryptorchid testis occurred before the 3rd-6th month and the descents recorded after that date are not significant.
The Contralateral Testis in Cryptorchid Patients
Authors: Foresta C. , Ferlin A. , Bettella A. , Garolla A. , Milani C. , Oliva G. , Rossato M.
Published: October 2018

We performed bilateral testicular Fine Needle Aspiration Cytology (FNAC) in a large group of unilateral cryptorchid subjects to characterize the tubular status related to the seminal pattern. In azoospermic and in severe oligozoospermic subjects the cytological picture of the contralateral testis showed similar lesions to those observed in the cryptorchid testis, while in moderate oligozoospermic subjects this analysis revealed the presence of a normal spermatogenic line and in normospermic subjects the presence of a compensatory activity of the tubular function. In conclusion, in unilateral cryptorchidism a frequent testicular damage in the orchidopexied testis and a concomitant tubular alteration in the contralateral scrotal testis exist, suggesting that cryptorchidism is the end point of different pathological conditions, including intrinsic (congenital) and extrinsic (anatomical) causes. FNAC of both testes could represent a tool for the clinician in the assessment of the tubular status in cryptorchid subjects, above all in presence of azoospermia or severe oligozoospermia. In these cases the existence of intratesticular spermatids or mature spermatozoa allows new assisted reproduction techniques using intratesticular germ cells to be used.
Histological Findings in Cryptorchidism
Authors: Cassaro M.
Published: October 2018

Cryptorchidism is an anomaly in the migration of the testis. Although frequent (1% of the population), the causes are still not fully clear. The associated histological lesions are constant and are worse the longer the testis remains in an anomalous position and the higher this position. Alterations in the maturation of the germinal cells appear very early at about the 7th month of life, gradually becoming more severe until there is complete atrophy of the seminiferous tubules in post-puberty. With histological lesions in the cryptorchid testis there is a risk of seminomatous cancer developing in the undescended testis and of a mixed or non-seminomatous type in the descended testis. Orchiopexy does not reduce the risk of cancer in the cryptorchid testis, but it does eliminate the hyperthermic state in the gonad and allows a simpler, more reliable clinical and biopsy assessment of the testis after surgery.
Latest Developments in Cryptorchidism: Therapy
Authors: Ferrarese P. , Santacatterina U. , Bragato F. , Serra F. , Bargelloni U.
Published: October 2018

The Authors analyse the possible therapies for cryptorchidism on the basis of current knowledge and with the aim of being able to choose the age in which to act. The latest laparoscopic therapeutic method is reported by the few authors who are using it, although its real advantages have still to be confirmed.
Urological Emergencies in Patients with Multiple Traumas: Our Experience
Authors: Meneguolo M. , Faccioli F. , Bertoldin R. , D'incà G. , Guazzieri S.
Published: October 2018

The Authors describe their limited but significant experience (101 cases) regarding the diagnostic and therapeutic approach to patients with multiple traumas with involvement of the urogenital tract. Approach to the renal trauma in these patients appears to be highly controversial. Experience has shown that in cases of severe renal trauma, when the urologist is called immediately to visit the patient so that a complete and correct urological diagnostic procedure can be planned, the possibilities of conservative treatment to save the kidney are greater.
The Ballistic Lithotrite in Ureteral Calculosis
Authors: Badiali G. , Fornetti F.
Published: October 2018

The Authors describe their experience regarding 120 cases of ureteral calculosis treated with the ballistic lithotrite. Fragmentation of the stones proved effective in all cases, the ureter being freed of obstruction in only one session. The ballistic lithotrite may therefore be considered a valid alternative to electrohydraulic lithotripsy and laser, or even the best choice in terms of effectiveness, easy application and reduced purchasing and maintenance costs for the endourological treatment of ureteral calculosis.
Radical Prostatectomies in 1995 in Emilia Romagna with Related Diagnostic Evaluation
Authors: Simone M. , Romano A. , Carluccio G. , Gigante L. , Ughi G. , Spisani L , Daniele C.
Published: October 2018

Fifteen hospital departments of Urology in Emilia Romagna took part in this study, which had two aims: to record the different approaches to clinically localised prostate cancer and make an overall assessment of the single series of radical prostatectomy. Multiple ultrasound-guided biopsy is performed in 13 departments, CT scan in 7, bone scan in 10 and laparoscopic lymphnode staging in 2. During 1995, 263 radical prostatectomies were performed, 233 being evaluable for this study. Mean age was 65.2 years. 107 cases (45.9%) proved to be organ-confined. Another 107 had locally advanced disease. 19 (8.1%) revealed node metastases. Post-operative incontinence rate was 5.5%. Radical prostatectomy is the first choice treatment for clinically localised prostate cancer at all the hospital departments participating in this study. In 1995, 28.3% of newly diagnosed patients underwent this operation. Clinical understaging is still a major issue, particularly in patients with high PSA.
Critical Evaluation of Prostate Carcinoma Imaging
Authors: Monica B. , Barbieri A. , Incarbone P. , Sebastio N. , Di Stefano C.
Published: October 2018

Since accurate clinical staging is the ideal presupposition for any therapeutic decision in prostate cancer (PC), the aim of this paper is to review sensitivity, specificity and accuracy of the imaging techniques routinely used to diagnose and stage PC. They are highly important parameters for selecting patients in whom the disease is confined to the prostate and who may benefit from radical surgery. This is particularly important when considering the high incidence of progression in patients with extracapsular disease or positive surgical margins and that 40–60% of patients with a clinically confined disease have extracapsular involvement shown at the histological examination.
Measurement of Cultured Mesangial Matrix Protein Production by the Bradford Technique
Authors: Mukhtar A.
Published: October 2018

It has been suggested that mesangial cell contraction can adapt the glomerular tuft in response to variations in extracellular volume, although the relevance of mesangial cell contraction for the regulation of glomerular haemodynamics appeared to be small. Mesangial matrix is an intercellular substance morphologically similar to but biochemically distinct from glomerular basement membrane. This study measures the amount of stimulated and non-stimulated mesangial cell protein production in culture using the Bradford technique. This study shows the effect of cytokines in altering extracellular matrix proteins produced by mesangial cells and it shows that IL-1 increases the amount of matrix proteins while PMA decreases them compared to the non-stimulated cells. These in turn could lead to the alteration of pore size, matrix properties and filtration, and thus influence the development and progression of glomerular diseases.
Bladder Carcinosarcoma: Case Report and Literature Review
Authors: Lusuardi L. , Signorello D. , Galantini A. , Gerstner D. , Pisetta F.
Published: October 2018

The authors report a case of bladder carcinosarcoma, a highly malignant tumour rarely reported in literature. Therapy is purely surgical, since radiation and chemotherapy do not resolve the situation.
Urethral Diverticulum in Women with Neurologic Bladder
Authors: Menchinelli P. , De Giovanni L , Manca A. , Weir J.M. , Ronzoni G.
Published: October 2018

Female urethral diverticulum is a rather rare pathology, often ignored, which affects from 1 to 4% of the white population. In this study we report our series, limited to a selected population of women affected by neurologic bladder (6 paraplegic patients; 2 patients with multiple sclerosis) who were referred to our Urosurgical Unit within the space of four years. The diagnostic work-up relevant to these patients is discussed, together with the therapeutic strategies carried out and the long-term results obtained.
A Truly “Complex” Case of Urethral Stricture
Authors: Pizzorno R. , Parodi G. , Romagnoli A. , Simonato A. , Stubinski R. , Di Marco A. , Carmignani G.
Published: October 2018

Diagnosis of pseudohermaphroditism (gonads and secondary characteristics of the opposite sex) after puberty is rare. We observed a mis-diagnosed case of pseudohermaphroditism caused by the persistence of Mullerian ducts (vagina, uterus and Fallopian tubes) in a 72-year-old patient, who had previously undergone several operations for urethral stenosis and bilateral criptorchidism.
Stenting versus Splinting of Uretero-Intestinal Anastomoses: Our Experience
Authors: Simonato A. , Bonini F. , Zaninetta G. , Caviglia C. , De Rose A.F. , Galli S. , Corbu C. , Carmignani G.
Published: October 2018

The role and type of temporary ureteral splints to be used for uretero-intestinal anastomoses is not yet clear, especially regarding whether they help prevent stenoses or fistulas, which are complications that can affect the successful outcome of the actual operation. The aim of this study is to assess the results using the double J ureteral stent and the splint in patients subjected to radical cystectomy and urinary diversion using the intestine.

Material and methods

From November ‘94 to December ‘97, 109 patients underwent radical cystectomy: 60 orthotopic neobladders were created (53 VIP, 4 Reddy 2, 2 Studer, 1 Carney 2), 42 ileal conduits, 4 heterotopic diversions (2 Indiana, 1 Mainz1, 1 Mainz2), 3 USS and 216 u-i anastomoses (93 Le Duc, 6 Leadbetter, 4 Goodwin, 2 Split-cuff, 2 Main, 2 Ghoneim, 41 Nesbit, 35 Wallace1, 13 Bricker, 12 Polsino, 6 Wallace2). 115 splints were used (in orthotopic and heterotopic diversions the counter-opening was through the abdominal wall) and 101 double J stents. A check by neocystography/Brikergraph and transplintgraph (with possible removal of the splint) was carried out on the 15th day, while the double J stent was removed on the 30th day by flexible cystoscopy.

Results

18 stenoses occurred, of which 7/115 patients subjected to splinting and 11/101 patients subjected to stenting. Fistulas occurred in 6 patients: 5/6 with stent, 1/6 with splint (5 VIP with 5 Le Duc, 1 Bricker with Nesbit): these resolved spontaneously keeping the ureteral splint in situ for a longer period (average 20 days, range 15–32). These is consequently no statistically significant difference between the two groups of patients (p = 0,09 for stenoses and p = 0,11 for fistulas).

Conclusions

The importance of the temporary ureteral splint in u-i anastomoses in order to prevent stenoses or fistulas seems to be recognised in literature, but the type of splint is not clarified. Our study does not seem to indicate a substantial preference. The choice of splint depends on the personal preference of the surgeon, also taking into account that although the splint allows radiological (also serial) control of the upper urinary tracts (important with urinary fistulas), the stent is perhaps easier to handle and better tolerated by the patient.
Bilateral Testis Germ Cell Tumours: Two Case Reports
Authors: Porcaro A.B. , Curti P. , Isgro’ A. , Mofferdin A. , Malossini G. , Migliorini F. , Tallarigo C.
Published: October 2018

The authors present 2 cases of bilateral testicular germ cell tumours occuring metachronously and synchronously. The usefulness of testicular contralateral biopsy at the time of inguinal orchiectomy is discussed. Advantages and problems concerning the new therapeutic approach of organ-sparing surgery for testicular bilateral germ cell tumours are reported.
The Utility of Autophotography in the Diagnosis and Follow-Up of Penile Deviation
Authors: Liguori G. , Trombetta C. , Buttazzi L. , Belgrano E.
Published: October 2018

Congenital and acquired penile deviation may be classified using autophotography. Angle and different types of deviation can be documented using the new method of documentation. It's also useful for follow-up and to compare results after surgical correction.
A New Fibre (Quadralase) for Treating BPH with Laser ND:YAG
Authors: Monica B. , Barbieri A. , Ziveri M. , Sebastio N. , Incarbone G.P.
Published: October 2018

Laser photocoagulation, due to simplicity and good results, is the main alternative to TURP in BPH. The technical evolution of materials and procedures has favoured vaporisation of the prostate instead of simple coagulation. More energy has thus been required for the treatment, leading to fibre damage or malfunctioning and increasing cost for single treatment. We report our initial experience with the Quadralase fibre that has a specially designed distal cap, which always allows the laser beam to be transmitted through a clean surface. We believe this is a further technical improvement in prostatic vaporisation with Nd:YAG laser, which may reduce operating times and fibre damage.
The energy absorption enhancement in aramid fiber-reinforced poly(benzoxazine-co-urethane) composite armors under ballistic impacts
Authors: Okhawilai Manunya , Parnklang Tewarak , Mora Phattarin , Hiziroglu Salim , Rimdusit Sarawut
Published: October 2018

Energy absorptions under ballistic impacts of aramid fiber-reinforced poly(benzoxazine-co-urethane) composites at urethane mass concentrations of 0, 10, 20, 30, and 40 wt.% were investigated. The energy absorption of the composite was investigated by subjecting eight plies of the specimen with 9 mm and .44 Magnum according to levels II and IIIA of the National Institute of Justice standard-0101.04. The composite having the urethane mass concentration of 20 wt.% exhibited the synergistic behavior in energy absorption at both levels II and IIIA. The 20 wt.% of PU composite also possessed the greatest tensile strength and modulus. The numerical prediction revealed that the ballistic limit of aramid fiber-reinforced poly(benzoxazine-co-urethane) ballistic panel was as high as 690 m s−1. High energy absorption capabilities of the composites can be tailored for fabricating the ballistic panels in soft armor applications.
Safety and Efficacy of Intermittent Bolus and Continuous Infusion Neostigmine for Acute Colonic Pseudo-Obstruction
Authors: Smedley Lucas W. , Foster Dana B. , Barthol Colleen A. , Hall Reed , Gutierrez G. Christina
Published: October 2018

Purpose:

To compare clinical response of intermittent bolus versus continuous infusion neostigmine for acute colonic pseudo-obstruction (ACPO). Acute colonic pseudo-obstruction occurs due to reduced colonic parasympathetic activity. Neostigmine is an acetylcholinesterase inhibitor that increases frequency of smooth muscle contraction by increasing acetylcholine at autonomic nervous system synapses. Although these administration modalities have been studied separately, they have never been compared.

Methods:

This retrospective study compared bolus versus continuous infusion neostigmine for ACPO. The primary outcome was initial clinical response, defined as bowel movement (BM) within 4 hours of bolus dose or 24 hours of initiation of continuous infusion. Secondary outcomes included time to BM, bowel diameter reduction at 24 hours, incidence of bradycardia, additional neostigmine requirements, and need for colonic decompression or surgical intervention.

Results:

Seventy-five patients were included (bolus n = 37; infusion n = 38). Median total 24-hour neostigmine dose was 2.0 mg (interquartile range [IQR]: 2.0-2.6) with bolus and 9.6 mg (IQR: 6.3-9.6) with continuous infusion. Initial clinical response was similar (infusion 81.6% vs bolus 62.2%, P = .06), but continuous infusion was associated with greater bowel diameter reduction (73.7% vs 40.5%, P = .004). Bolus administration had shorter time to BM (1.4 vs 3.5 hours, P = .0478) and increased need for colonic decompression (67.6% vs 39.5%, P = .0148). Bolus dosing was associated with less bradycardia (13.5% vs 39.5%, P = 0.011), with no difference in atropine usage (10.8% vs 5.3%, P = .43).

Conclusion:

Initial clinical response was similar between groups; however, continuous infusion neostigmine was associated with greater bowel diameter reduction at 24 hours. Bolus administration resulted in less bradycardia; however, given the lack of difference in atropine use, clinical significance is unknown. This study is the first to compare bolus versus continuous infusion neostigmine for ACPO. Further studies are needed to confirm findings.
Modelling Waiting Times in an Emergency Department in Greece During the Economic Crisis
Authors: Manolitzas Panagiotis , Stylianou Neophytos
Published: October 2018

Overcrowding is one of the most common phenomenon at the emergency departments of the hospitals across the world. The aforementioned phenomenon causes many problems such as long waiting times for patients, increasing length of stay, patient dissatisfaction, ambulance diversions in some cities, prolonged pain and suffering, violence and miscommunication between the medical staff and the patients, patients leaving the emergency department without been seen and decreased physician productivity. This article analyses the problem of the increased waiting times in a Greek emergency department during the economic crisis. We use statistical models in order to reveal the factors that can lead to a decrease in waiting times. Our findings suggest that Greece’s Department of Health should standardize an uppermost waiting time for emergency departments which could help improve health care.
The State of Development in Villages of India: An Analysis of the 2011 Census Data
Authors: Chaurasia Aalok Ranjan
Published: October 2018

The present article uses data available through the 2011 population census to analyze the state of development in the villages of India on the basis of a village development index that has been constructed for the purpose following the capabilities expansion as development approach. The analysis reveals that the state of development in the villages of the country varies widely and there is only a small proportion of the villages where the state of development can be termed as satisfactory. The analysis also reveals that the state of development in the village is influenced by its selected defining characteristics. The article calls for a village-based planning and programming approach for meeting the development and welfare needs of the village people.
Limitations of personal information in an online environment
Authors: Shailer Gabriella
Published: October 2018

This Brief will demonstrate the provisions of the Privacy Act 1988 (Cth) that govern the usage of personal information can create substantial risk to the individual. It will accomplish this by setting out how the provisions of the Privacy Act 1988 (Cth) would not have prevented the sharing of the fitness data sourced from corporate servers in January 2018. It will explain how that published information would be classified as ‘de-identified’ data under Privacy Act 1988 (Cth). It will conclude by describing how the collection and collation of the data could form a risk to the individual.
All Families Are Special: Experiences of Lesbian-Parented Families
Authors: Gall Rachel T. , Softas-Nall Lia , Eberle Kiersten M.
Published: October 2018

This study explores the lived experiences of members of lesbian-parented families incorporating a systemic perspective to include both the voices of mothers and their young children. Eight whole-family interviews were conducted with lesbian couples with at least one child in elementary school (aged 5–11). Six themes emerged from the study: intentionality in finding places to live and travel, having children, and having discussions with their children; views of themselves as advocates and being “out” in their communities; noticing how times are changing; identifying assumptions as a two-way street; perceptions of gender surrounding parenting and the salience of various identities; and the dialectical tension between wanting to be perceived as normal and wanting to acknowledge their uniqueness. Clinical implications and suggestions for future research are discussed.
Long-Term Systemic Treatment With Methamphetamine Causes Retinal Damage in CD1 Mice
Authors: Yang Haojiang , Tao Liming , Li Lin
Published: October 2018

As a powerful psychostimulant with high potential for abuse, methamphetamine (Meth) could cause long-lasting abnormalities in retinas. The purpose of this study was to investigate the effects of systemic administration of Meth at low dose on retinal damage and understand the underlying mechanisms of pathology. CD1 mice were treated with 0.5 mg/kg or 1 mg/kg Meth by intraperitoneal injection daily for 2 months, mice treated with saline were used as negative control. Electroretinography (ERG) reflects the mass response of photoreceptor cells and was used to test the outer retinal function after Meth treatment. Toluidine blue staining was used to show the retinal morphology and evaluate the photoreceptor cell loss. Inflammatory factors were measured by enzyme-linked immunosorbent assay to show the inflammatory response. Terminal deoxynucleotidyl transferase dUTP Nick end labeling assay was used to detect the apoptosis-positive cells. Real-time polymerase chain reaction and Western blot were applied to measure the gene and protein change to explore the underlying mechanisms. Results demonstrated that retinal damage was caused by Meth treatment after 2 months, evidenced by loss of rod photoreceptor cells; decreased ERG amplitude; increased apoptotic photoreceptor cells, cytochrome-c release, caspase-3 activity, caspase-9 activity, and apoptosis-related protein expression; increased malondialdehyde level as well as nicotinamide adenine dinucleotide phosphate oxidase 4 protein expression; decreased anti-oxidative agents glutathione as well as superoxide dismutase levels; and increased production and gene expression of inflammatory factors. Our study indicated that systemic administration of Meth caused neurotoxic effects on CD1 mouse retinas, providing the potential mechanisms for the retina damage caused by Meth abuse.
Tools for managing feline problem behaviours: Psychoactive medications
Authors: Denenberg Sagi , Dubé Maya Bräm
Published: October 2018

Practical relevance:

When a cat is presented for evaluation of a problem behaviour, it is likely that the cat’s wellbeing is negatively affected by the condition. In addition, the owners and any other animals around the cat may also be experiencing negative consequences. When managing these cases, it is important to consider all options (including behaviour modification, environmental changes, medications) that can help to reach an optimal solution. Medication cannot teach the cat how to behave or change a particular behaviour; it can, however, reduce arousal, excitability, reactivity and anxiety.

Rationale:

The rationale for using psychoactive medications in behavioural medicine, or veterinary psychiatry, is to increase the wellbeing of the animal and to aid the owner and practitioner in managing problem behaviours. Medications should always be used as an adjunct to behavioural and environmental modification.

Clinical challenges:

Many psychoactive medications cannot be used in the face of certain physical illnesses or concurrently with other medications. Some medications may also have side effects, not be effective at the recommended dose or have a paradoxical effect. Furthermore, success is reliant on the owner being able to administer the medication.

Aims:

This article aims to guide practitioners by discussing questions such as how to choose the appropriate medication, how to dose it and how long to use it. The psychoactive medications most commonly used in feline medicine are reviewed, as well as some that are newer or less common.

Evidence base:

Data for the use of medications in cats is limited, with just a small number of clinical-, species- and problem-directed studies available, and a few more case series and case reports. Where feline-specific research is not available, the authors have drawn upon research published in other species, such as humans, dogs and rats, as well as anecdotal reports and expert opinions.
Unconventional Practitioners’ Causal Beliefs and Treatment Strategies for Chronic Low Back Pain in Rural Nigeria
Authors: Igwesi-Chidobe Chinonso N , Sorinola Isaac O , Kitchen Sheila , Godfrey Emma L
Published: October 2018

Chronic low back pain (CLBP) is highly prevalent and CLBP disability reinforces poverty and Nigerian rural-urban inequality. Most rural Nigerian dwellers with CLBP consult unconventional practitioners due to difficulty in accessing conventional health care. This interaction may influence back pain beliefs and behaviours, and health outcomes including disability. In line with the recent Lancet Low Back Pain series call to address widespread misconceptions in the population and among health practitioners about low back pain, this study explored the beliefs and management strategies of unconventional practitioners consulted by people living with CLBP in rural Nigeria. Qualitative semi-structured face-to-face individual interviews. Thematic analysis of transcripts was performed using the Framework approach. Nine unconventional practitioners consented to participate in this study. Patent medicine sellers and herbalists had biomedical beliefs about CLBP and encouraged passivity and drug dependence in patients. Pastors adopted spiritual or biopsychosocial-spiritual management models and either encouraged spiritual CLBP causal beliefs and spiritual healing expectations; or patients’ resilience and acceptance, respectively. Unconventional practitioners’ CLBP beliefs and management strategies aligned with the beliefs and coping strategies of patients who consulted them. Unconventional practitioners’ beliefs and management strategies may therefore contribute to the adverse impact of CLBP in rural Nigeria.
Skeletal Muscle Modulates Huntington’s Disease Pathogenesis in Mice: Role of Physical Exercise
Authors: Corrochano Silvia , Blanco Gonzalo , Acevedo-Arozena Abraham
Published: October 2018

Huntington’s disease (HD) is a monogenic fatal neurodegenerative disorder. However, there is increasing evidence that HD is a pleiotropic systemic disorder. In particular, skeletal muscle metabolism is greatly affected in HD, which in turn can have a major impact on whole-body metabolism and energetic balance. Throughout an unbiased mutagenesis approach in HD mice, we have found that Scn4a, a skeletal muscle–specific sodium channel gene, is a modifier of the disease. Mutations in Scn4a enhance HD disease progression and weight loss by accelerating muscle waste and cachexia, increasing skeletal muscle activity and energy demands. At the molecular level, Scn4a mutations activate AMP-activated protein kinase (AMPK), leading to a fibre switch towards more oxidative types. These adaptations seen in HD; Scn4a double mutant muscles are similar to those observed in healthy individuals after endurance exercise training regimes. This prompted us to assess the effects of an endurance exercise regime in HD mice, independently showing that skeletal muscle adaptations leading to the activation of AMPK are detrimental for HD pathogenesis. Although it is undeniable that physical exercise can lead to many health benefits, our work shows that, at least under certain situations such as in HD, an endurance exercise routine could be a detrimental therapeutic option.
‘Press play for pride’: The cultural logics of LGBTQ-themed playlists on Spotify
Authors: Dhaenens Frederik , Burgess Jean
Published: October 2018

This article explores the cultural practice of creating lesbian, gay, bisexual, transgender, and queer (LGBTQ)-themed playlists on music streaming services. It aims to understand how LGBTQ identities and cultures are represented and negotiated through the use of, and shaped by, digital media platforms. Through the textual analysis of 37 LGBTQ-themed Spotify playlists, we identified four cultural logics that structure the practice of playlist curation, each of which demonstrates the significance of music consumption to individual identity work and collective belonging. We conclude that the practice of playlist curation engages with LGBTQ culture in three productive ways: first, the curators contribute to a library of libraries by sharing their diverse perspectives on what constitutes LGBTQ music culture; second, the Spotify platform engages in community-building through enabling the sharing of tastes, pleasures, and experiences; and third, the curation of playlists brings diverse identity politics to the table, resulting in playlists that are politically queer, heteronormative, or ideologically ambiguous.
Involving minority ethnic communities and diverse experts by experience in dementia research: The Caregiving HOPE Study
Authors: Parveen Sahdia , Barker Sandra , Kaur Ripaljeet , Kerry Fionnuala , Mitchell Wendy , Happs Alex , Fry Gary , Morrison Val , Fortinsky Richard , Oyebode Jan R
Published: October 2018

Patient and public involvement is imperative to ensure relevance of research. There is a growing literature on the theoretical underpinning on patient and public involvement including level and processes of involvement. The aim of this paper is to describe a person-centred and culturally sensitive approach to working with minority ethnic communities, involving carers, people living with dementia, members of the public and carer support workers, as used in the Caregiving HOPE study; and the influence of the approach on the study’s research processes and outcomes. Patient and public involvement members were considered experts by experience and involved with study conception, design, conduct and dissemination. The perspective of the experts by experience is also presented in this article. The level and nature of involvement was influenced by each individual’s needs and desires which changed over the course of the study. The approach had a significant impact on study outcomes as evidenced by successful recruitment and engagement at a national level, but was not without challenges with greater flexibility required and fuller consideration of financial and time costs required. Benefits of the approach included strong engagement, improved outcomes (successful recruitment of seldom heard groups) and meaningful relationships between researchers and experts by experience. A person-centred and culturally sensitive approach is required with patient and public involvement to ensure involvement is not detrimental to those involved, is meaningful and enjoyable and has a positive impact on the research.
‘Of Mice and Dementia’: A filmed conversation on the use of animals in dementia research
Authors: Tamagnini Francesco , Cotton Mark , Goodall Olwen , Harrison Gillian , Jeynes Charlie , Palombo Francesca , Tomkow Jean , Tomkow Terry , Wedgwood Kyle , Welsman Jo
Published: October 2018

Preclinical science research focuses on the study of physiological systems regulating body functions, and how they are dysregulated in disease, in a non-human setting. For example, cells in a dish, computer simulations or animals. Scientific procedures traditionally involve a specialist scientist developing a hypothesis and subsequently testing it using an experimental set-up. The results are then disseminated to the wider scientific community, following peer review and only at the last stage the news will reach the general, lay public. In the last few years, some research funding institutions have promoted a different model, with the direct involvement of members of the public in the research co-creation, from the hypothesis development, to the grant revision, project monitoring and results communication. We personally experienced this model and brought it to a further level by producing a movie. Animal research is a very controversial topic as, while still being necessary for the investigation of body functions, it brings about issues related to the ethics, the regulation and the practical execution of experimental procedures on animals. Here we discuss the different stages of the ideation, production and outcomes of the movie ‘Of Mice and Dementia’, a filmed conversation on animal experimentation in dementia research. The conversation was between scientists and lay people with a direct experience of dementia.
The Influence-Network Model of the Photojournalistic Icon
Authors: Dahmen Nicole Smith , Mielczarek Natalia , Perlmutter David D.
Published: October 2018

Iconic images are those that rise to the forefront of our collective, visual public consciousness to become the defining, enduring image of an event: a naked Vietnamese girl screaming out in pain following a napalm attack, U.S. Marines raising the American flag at Iwo Jima, and a German dirigible engulfed in flames and falling to the ground. Iconic images have a discursive value that helps citizens navigate and understand the political and social contexts of complex events. Traditionally, news photographs became iconic largely through their prominent placement on the front pages of elite newspapers across the globe. But, undeniably, in the age of digital news, mobile phones/tablets, and social media, the media component has changed the equation for the formation of iconic imagery and collective visual consciousness. With the speed, ease of access, and abundance of information sources available in the current age, a volume of images can now represent a significant (or not so significant) event. This monograph traces the development of iconic image literature and then proposes a model termed the “influence-network model of the photojournalistic icon,” which predicts how photographs of events become iconic (or not).
Darcy–Forchheimer flow of micropolar nanofluid between two plates in the rotating frame with non-uniform heat generation/absorption
Authors: Khan Arshad , Shah Zahir , Islam Saeed , Khan Sajad , Khan Waris , Khan Aurang Zeb
Published: October 2018

This article studies the Darcy–Forchheimer flow of three-dimensional micropolar nanofluid between parallel and horizontal plates in a rotating system. The micropolar nanofluid in permeable media is described by assuming the Darcy–Forchheimer model, where drenching the permeable space obeys the Darcy–Forchheimer expression. The significant influence of Brownian motion and thermophoresis has been taken in the nanofluids model. The thermal radiation impact is taken to be varying in terms of non-uniform absorption/generation for the purpose to see the concentration as well as the temperature modifications between the nanofluid and the surfaces. The leading equations are converted into a system of differential nonlinear equations and then homotopic method is used for solving the modeled equations. The other physical impacts, that is, skin friction, heat flux, and mass flux, have been studied through tables. The impacts of the porosity, rotation, and inertia coefficient analysis have been mainly focused in this research. It is observed that the higher value of Fr decay the velocity profile, while it increases the transverse velocity, and the increase in the porosity parameter [Formula: see text] increases the porous space, which creates resistance in the flow path and reduces the flow motion. Skin friction coefficient is observed to be larger for the strong concentration [Formula: see text], as compared to the case of weak concentration [Formula: see text]. Impact of strong and weak concentrations on Nusselt and Sherwood numbers seems to be similar in a quantitative sense.
Dealing with climate change: A European centre–right perspective
Authors: Lilkov Dimitar
Published: October 2018

The fight against climate change is sometimes inaccurately perceived as a topic which inherently belongs to those on the left of the political spectrum. This article maps out the most important aspects of climate change and its prevention from a centre–right perspective, and ventures to show that a both sensible and successful approach to this problem is entirely consistent with centre–right tenets and values. It starts by discussing the principle of stewardship and how to address this issue on the individual level. It then argues that the involvement of local and regional actors is of great importance when it comes to the implementation of internationally set climate goals or specific commitments. The article proceeds with a brief overview of how the private sector and emerging technologies can play their part in the fight against climate change. Lastly, it makes the case for the reinforced engagement of the EU through coordinated investment, an improved emissions trading scheme and global leadership.
Beyond emergency measures: The need for a holistic and truly European approach to migration
Authors: Teodorescu Loredana
Published: October 2018

Since mid-2017 there has been a reduction in irregular migrant arrivals, and this has partially been attributed to the various initiatives undertaken by the EU. However, migration remains a controversial and pressing issue for which the EU is still struggling to find an adequate and shared response. Migration has become a divisive issue among EU member states, calling into question the meaning of solidarity within the EU and within the member states themselves. This article argues that it is time to move beyond short-term emergency measures and work on a long-term, holistic and truly European approach to migration, combining internal and external policies. Reinforcing control of the European borders will not be enough. While it is necessary to reduce the number of irregular arrivals, the EU needs to equip itself with a future-proof, efficient migration policy that also addresses the Union’s internal weaknesses, as the challenge is not only to reduce the number of arrivals, but also to increase the capacity to manage the flows.
Auditory disorders and future therapies with delivery systems
Authors: Lee Jung-Hwan , Lee Min Young , Lim Yohan , Knowles Jonathan , Kim Hae-Won
Published: October 2018

Auditory function takes a major part in human life. While sensorineural hearing loss is related with many factors including genetic disorders, age and noise, the clear causes are not well understood. Even more, the currently available treatments with drugs cause side effects, which thus are considered suboptimal. Here, we communicate the delivery systems with biomaterials that can be possible therapeutic options to restore hearing and vestibular functions. We introduce briefly the various pathological factors related with hearing loss and the limitation of current therapies, detail the recent studies on delivery systems including nanoparticles and hydrogels and discuss future clinical availability.
Diabetes: the place of new therapies
Authors: Dhatariya Ketan
Published: October 2018

Until the discovery of insulin in 1921 there were no effective treatments for diabetes mellitus. After the advent of long-acting insulin, the first oral agents, sulfonylureas became available in the mid-1950s, quickly followed (outside of the United States) by metformin. It was then another three decades before newer agents became available, with alpha glucosidase inhibitors, thiazolidinediones and meglitinides following in the 1990s. Since the turn of the century, several new classes have also been launched. But how do these agents fit into the management of type 2 diabetes? How does one choose which drug class to use after metformin? This review looks at the agents launched since 2000 and how and when they can be used. It also deals with some of the controversies that have arisen and how decisions have changed as a result, in particular moving away from the use of HbA1c as the driver for decision, but rather the cardiovascular safety of these agents and their use in the prevention of premature cardiovascular morbidity and mortality. Now that some of these agents have shown cardiovascular benefit, will this lead to a change in the treatment paradigm?
Association between serum vitamin D levels and cardiorespiratory fitness in the adult population of the USA
Authors: Marawan Amr , Kurbanova Nargiza , Qayyum Rehan
Published: October 2018

Aims

The small number of studies that have investigated the relationship between serum vitamin D levels and cardiorespiratory fitness (CRF) have reported conflicting results. We investigated the association between vitamin D levels and CRF in a representative sample of the US population using data from the National Health and Nutrition Survey (2001–2004).

Methods

We included participants between the ages of 20 and 49 years and excluded those with vitamin D levels at the 5% extremes of the distribution. We used survey-weighted linear regression without and with adjustment for age, sex, race, body mass index, hypertension, diabetes, smoking, C-reactive protein, hemoglobin, and glomerular filtration rate to examine the relationship between the maximal oxygen consumption (VO2 max) (as a surrogate for CRF) and vitamin D levels.

Results

Of the 1995 participants, 45.2% were women, 49.1% were white, 13% had hypertension, and 4% had diabetes. The mean ± SD age was 33 ± 8.6 years, with a mean ± SD vitamin D level of 58 ± 5.3 nmol/L and a mean ± SD VO2 max of 40 ± 9.7 ml/kg/min. Participants in the highest quartile of vitamin D levels had a significantly higher CRF than participants in the lowest quartile (difference 4.3, 95% confidence interval (CI) 3.0–5.5; P < 0.001). After adjustment for potential confounders, the difference between the highest and lowest vitamin D quartiles remained significant (difference 2.9, 95% CI 1.6–4.1; P < 0.001). In unadjusted and adjusted linear regression, each 10 nmol/L increase in vitamin D level was associated with a significant increase in VO2 max (β = 0.78 ml/kg/min, 95% CI 0.55–1.01; P < 0.001; β = 0.51 ml/kg/min, 95% CI 0.23–0.79; P = 0.001, respectively).

Conclusions

We found an independent and robust association between serum vitamin D levels and CRF, but our results need to be validated with clinical trials examining the effect of vitamin D supplementation on CRF.
Exercise as a diagnostic and therapeutic tool for the prevention of cardiovascular dysfunction in breast cancer patients
Authors: Howden Erin J , Bigaran Ashley , Beaudry Rhys , Fraser Steve , Selig Steve , Foulkes Steve , Antill Yoland , Nightingale Sophie , Loi Sherene , Haykowsky Mark J , La Gerche André
Published: October 2018

Background

Anthracycline chemotherapy may be associated with decreased cardiac function and functional capacity measured as the peak oxygen uptake during exercise ([Formula: see text] peak). We sought to determine (a) whether a structured exercise training program would attenuate reductions in [Formula: see text] peak and (b) whether exercise cardiac imaging is a more sensitive marker of cardiac injury than the current standard of care resting left ventricular ejection fraction (LVEF).

Methods

Twenty-eight patients with early stage breast cancer undergoing anthracycline chemotherapy were able to choose between exercise training (mean ± SD age 47 ± 9 years, n = 14) or usual care (mean ± SD age 53 ± 9 years, n = 14). Measurements performed before and after anthracycline chemotherapy included cardiopulmonary exercise testing to determine [Formula: see text] peak and functional disability ([Formula: see text] peak < 18 ml/min/kg), resting echocardiography (LVEF and global longitudinal strain), cardiac biomarkers (troponin and B-type natriuretic peptide) and exercise cardiac magnetic resonance imaging to determine stroke volume and peak cardiac output. The exercise training group completed 2 × 60 minute supervised exercise sessions per week.

Results

Decreases in [Formula: see text] peak during chemotherapy were attenuated with exercise training (15 vs. 4% reduction, P = 0.010) and fewer participants in the exercise training group met the functional disability criteria after anthracycline chemotherapy compared with those in the usual care group (7 vs. 50%, P = 0.01). Compared with the baseline, the peak exercise heart rate was higher and the stroke volume was lower after chemotherapy ( P = 0.003 and P = 0.06, respectively). There was a reduction in resting LVEF (from 63 ± 5 to 60 ± 5%, P = 0.002) and an increase in troponin (from 2.9 ± 1.3 to 28.5 ± 22.4 ng/mL, P < 0.0001), but no difference was observed between the usual care and exercise training group. The baseline peak cardiac output was the strongest predictor of functional capacity after anthracycline chemotherapy in a model containing age and resting cardiac function (LVEF and global longitudinal strain).

Conclusions

The peak exercise cardiac output can identify patients at risk of chemotherapy-induced functional disability, whereas current clinical standards are unhelpful. Functional disability can be prevented with exercise training.