bluuebunny/crossref_metadata_2025 huggingface dataset:
Fable
Authors: Ossher Harold L. , Reid Brian K.
Published: November 2016

The Stanford University Center for Integrated Systems is embarking on an ambitious project to formally characterize integrated circuit fabrication processes, and to provide a degree of automation of research and prototyping activities in the IC fabrication facility. A crucial component of this project is the ability to represent an IC fabrication “recipe” in a repeatable, transportable, device-independent fashion. We have designed the language Fable for this purpose: it offers some novel approaches to abstraction and modularity. We describe the problem, explain why we were forced to devise a new language rather than use an existing language, describe important properties of the Fable language, and give several examples.
Data abstraction in GLISP
Authors: Novak Gordon S.
Published: November 2016

GLISP is a high-level language that is based on Lisp and is compiled into Lisp. It provides a versatile abstract-data-type facility with hierarchical inheritance of properties and object-centered programming. The object code produced by GLISP is optimized, so that it is about as efficient as handwritten Lisp. An integrated programming environment is provided, including editors for programs and data-type descriptions, interpretive programming features, and a display-based inspector/editor for data. GLISP is fully implemented.
Extensions to static scoping
Authors: Cormack G. V.
Published: November 2016

Scope rules are presented as they appear in the language L, which is currently under development at McGill. These rules permit a programmer to specify explicitly the duration and visibility of all objects. Such specification can be used to declare variables or to create data structures which persist from one invocation of a block to the next. In addition, the data may be caused to persist from one run of the program to the next, obviating temporary files which are outside the scope and control of the programming language. The visibility of an object may also be specified to be larger than the block that contains its declaration. This facility allows the programmer to export some objects, yet keep others private. Finally, a facility for call-site visibility is presented that provides some of the expressive power of dynamic scoping and macros without their inherent type insecurity.
A functional shell
Authors: Shultis Jon
Published: November 2016

One of the best features of the standard UNIX shell is the use of pipes to compose programs. A C language derivative is used for more complex program combinations involving looping or branching. This paper presents an alternative shell language based on natural extensions of the pipe concept.

“Structured data streams” are introduced as a means of expressing potentially concurrent processing, and “labelled data streams” serve to route data to one of a pool of programs. These complex data streams are hooked together with functional operators much as simple data streams are hooked together with pipes. A generalized notion of “powers” provides for repetition of programs and also for systems that take an arbitrary number of input streams. This provides a uniform way of building complex tools from simple ones, as advocated by Kernighan and Plauger [8]. A major advantage of this new shell language is its program algebra, which facilitates system verification and analysis.
Medical students’ perceptions of the effectiveness of integrated clinical skills sessions using different simulation adjuncts
Authors: Zafar Muhammad
Published: November 2016

Simulation-based integrated clinical skills sessions have great potential for use in medical curricula. Integration is central to simulation efficacy. The aim of this study was to obtain medical students' perceptions toward effectiveness of integrated clinical skills sessions by using different simulation adjuncts and to know the challenges/obstacles encountered toward the implementation of such sessions. A study was conducted to obtain anonymous feedback from male ( n = 156) and female ( n = 179) medical students in years 2 and 3 during the 2014–2015 academic sessions at Alfaisal University about their perceptions of the effectiveness of integrated clinical skills sessions, uses of simulation adjuncts, and obstacles encountered toward the effective implementation of such sessions. The response rate was 93.4. Factor analysis showed data being valid and reliable. Cronbach’s α-values for effectiveness of sessions, use of simulation adjunct, and obstacles encountered were 0.97, 0.95, and 0.95, respectively. We conclude that students perceived positively the effectiveness of integrated clinical skills sessions as well as the use of simulation adjuncts, especially SPs. They suggested overcoming the obstacles and limitations of simulation. They highly valued the role of the facilitators in achieving effective sessions.
Disseminated Cryptococcal Disease in Non-HIV, Nontransplant Patient
Authors: AlMutawa F. , Leto D. , Chagla Z.
Published: November 2016

Disseminated cryptococcal infection carries a high risk of morbidity and mortality. Typical patients include HIV individuals with advanced immunosuppression or solid organ or hematopoietic transplant recipients. We report a case of disseminated cryptococcal disease in a 72-year-old male who was immunocompromised with chronic lymphocytic leukemia and ongoing chemotherapy. The patient presented with a subacute history of constitutional symptoms and headache after he received five cycles of FCR chemotherapy (fludarabine/cyclophosphamide/rituximab). Diagnosis of disseminated cryptococcal disease was made based on fungemia in peripheral blood cultures with subsequent involvement of the brain, lungs, and eyes. Treatment was started with liposomal amphotericin, flucytosine, and fluconazole as induction. He was discharged after 4 weeks of hospitalization on high dose fluconazole for consolidation for 2 months, followed by maintenance therapy.
Gap Filling of the CALYPSO HF Radar Sea Surface Current Data through Past Measurements and Satellite Wind Observations
Authors: Gauci Adam , Drago Aldo , Abela John
Published: November 2016

High frequency (HF) radar installations are becoming essential components of operational real-time marine monitoring systems. The underlying technology is being further enhanced to fully exploit the potential of mapping sea surface currents and wave fields over wide areas with high spatial and temporal resolution, even in adverse meteo-marine conditions. Data applications are opening to many different sectors, reaching out beyond research and monitoring, targeting downstream services in support to key national and regional stakeholders. In the CALYPSO project, the HF radar system composed of CODAR SeaSonde stations installed in the Malta Channel is specifically serving to assist in the response against marine oil spills and to support search and rescue at sea. One key drawback concerns the sporadic inconsistency in the spatial coverage of radar data which is dictated by the sea state as well as by interference from unknown sources that may be competing with transmissions in the same frequency band. This work investigates the use of Machine Learning techniques to fill in missing data in a high resolution grid. Past radar data and wind vectors obtained from satellites are used to predict missing information and provide a more consistent dataset.
Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen
Authors: O’Leary Michael P. , Ashman Zane W. , Plurad David S. , Kim Dennis Y.
Published: November 2016

Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery.Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia. On exam, he had evidence of small bowel obstruction. Computed tomography revealed high-grade small bowel obstruction secondary to presumed ruptured appendicitis. In the operating room, an infected urachal cyst was identified with adhesions to the proximal ileum. After lysis of adhesions and resection of the cyst, the patient was subsequently discharged without further issues.Conclusion. Although rare, urachal pathology should be considered in the differential diagnosis when evaluating a patient with small bowel obstruction without prior intraabdominal surgery, hernia, or malignancy.
Common Arterial Trunk in a 3-Day-Old Alpaca Cria
Authors: Kurosawa Tsumugi Anne , Gunasekaran Tamilselvam , Sanders Robert , Carr Elizabeth
Published: November 2016

A 3-day-old alpaca cria presented for progressive weakness and dyspnea since birth. Complete bloodwork, thoracic radiographs, and endoscopic examination of the nasal passages and distal trachea revealed no significant findings. Echocardiogram and contrast study revealed a single artery overriding a large ventricular septal defect (VSD). A small atrial septal defect or patent foramen ovale was also noted. Color flow Doppler and an agitated saline contrast study revealed bidirectional but primarily right to left flow through the VSD and bidirectional shunting through the atrial defect. Differential diagnosis based on echocardiographic findings included common arterial trunk, Tetralogy of Fallot, and pulmonary atresia with a VSD. Postmortem examination revealed a large common arterial trunk with a quadricuspid valve overriding a VSD. Additionally, defect in the atrial septum was determined to be a patent foramen ovale. A single pulmonary trunk arose from the common arterial trunk and bifurcated to the left and right pulmonary artery, consistent with a Collet and Edwards’ type I common arterial trunk with aortic predominance. Although uncommon, congenital cardiac defects should be considered in animals presenting with clinical signs of hypoxemia, dyspnea, or failure to thrive.
A Computational Model for Investigating Tumor Apoptosis Induced by Mesenchymal Stem Cell-Derived Secretome
Authors: Hendrata Melisa , Sudiono Janti
Published: November 2016

Apoptosis is a programmed cell death that occurs naturally in physiological and pathological conditions. Defective apoptosis can trigger the development and progression of cancer. Experiments suggest the ability of secretome derived from mesenchymal stem cells (MSC) to induce apoptosis in cancer cells. We develop a hybrid discrete-continuous multiscale model to further investigate the effect of MSC-derived secretome in tumor growth. The model encompasses three biological scales. At the molecular scale, a system of ordinary differential equations regulate the expression of proteins involved in apoptosis signaling pathways. At the cellular scale, discrete equations control cellular migration, phenotypic switching, and proliferation. At the extracellular scale, a system of partial differential equations are employed to describe the dynamics of microenvironmental chemicals concentrations. The simulation is able to produce both avascular tumor growth rate and phenotypic patterns as observed in the experiments. In addition, we obtain good quantitative agreements with the experimental data on the apoptosis of HeLa cancer cells treated with MSC-derived secretome. We use this model to predict the growth of avascular tumor under various secretome concentrations over time.
A Rare Case Report of Thoracic Ectopia Cordis: An Obstetrician’s Point of View in Multidisciplinary Approach
Authors: Ramasauskaite Diana , Snieckuviene Vilija , Zitkute Viktorija , Vankeviciene Ramune , Lauzikiene Dalia , Drasutiene Grazina
Published: November 2016

Ectopia cordis is a rare congenital anomaly associated with the heart positioned outside of the thoracic cavity either partially or completely. It can be associated with other congenital abnormalities. Overall, the prognosis for infants with ectopia cordis is very poor but depends greatly on the type and severity of ectopia cordis and intracardiac and associated malformations. We present one case of a fetus with prenatally diagnosed thoracic ectopia cordis with intracardiac defects and omphalocele, all the abnormalities seen in pentalogy of Cantrell except a diaphragmatic defect. Considering poor prognosis for fetus, conservative management of prenatal care has been chosen. At the 42nd gestational week, during the active stage of labor, due to fetal distress, cesarean section was performed at a tertiary level hospital. The condition of the infant was impairing rapidly and the newborn succumbed within 24 hours. We discuss the perinatal care concerning this rare anomaly.
Perioperative Severe Hypotension in a Patient with Multiple Endocrine Neoplasia Type IIb and Bilateral Adrenalectomies: Time to Review the Evidence for Stress Dose Steroids
Authors: Tan Jens , Zavala Acsa , Hagan Katherine B. , Van Meter Antoinette , Williams Uduak Ursula , Zhang Wei , Owusu-Agyemang Pascal
Published: November 2016

Multiple endocrine neoplasia type IIb (MEN IIb) is an endocrine disorder which can manifest with tumors such as pheochromocytomas and neuromas. We present the case of a patient with MEN IIb, after bilateral adrenalectomies, on maintenance steroid replacement, who underwent a neuroma resection and developed severe hypotension. There is persistent controversy regarding the general administration of perioperative “stress dose” steroids for patients with adrenal insufficiency. While the most recent literature suggests that stress dose steroids are unnecessary for secondary adrenal insufficiency, the rarer form of primary adrenal insufficiency always requires supplemental steroids, specifically hydrocortisone, when undergoing surgical procedures.
Xiphoidectomy: A Surgical Intervention for an Underdocumented Disorder
Authors: Hogerzeil Dirk Pieter , Hartholt Klaas Albert , de Vries Mark Rem
Published: November 2016

Two patients who presented with nonspecific thoracic and upper abdominal symptoms and tenderness of the xiphoid process are discussed. Both patients had undergone extensive examinations, but no source for their symptoms could be found. Plain chest radiographs revealed an anterior displacement of the xiphoid process in both patients. Physical examination confirmed this to be the primary source of discomfort. Anterior displacement of the xiphoid process may be the result of significant weight gain. Repeated trauma of the afflicted area, unaccustomed heavy lifting, exercise, and perichondritis are, amongst other causes, believed to contribute to the development of xiphodynia. Both patients were treated by performing a xiphoidectomy, resulting in disappearance of the symptoms.
Cholesterol Efflux Capacity of Apolipoprotein A-I Varies with the Extent of Differentiation and Foam Cell Formation of THP-1 Cells
Authors: Yano Kouji , Ohkawa Ryunosuke , Sato Megumi , Yoshimoto Akira , Ichimura Naoya , Kameda Takahiro , Kubota Tetsuo , Tozuka Minoru
Published: November 2016

Apolipoprotein A-I (apoA-I), the main protein component of high-density lipoprotein (HDL), has many protective functions against atherosclerosis, one of them being cholesterol efflux capacity. Although cholesterol efflux capacity measurement is suggested to be a key biomarker for evaluating the risk of development of atherosclerosis, the assay has not been optimized till date. This study aims at investigating the effect of different states of cells on the cholesterol efflux capacity. We also studied the effect of apoA-I modification by homocysteine, a risk factor for atherosclerosis, on cholesterol efflux capacity in different states of cells. The cholesterol efflux capacity of apoA-I was greatly influenced by the extent of differentiation of THP-1 cells and attenuated by excessive foam cell formation.N-Homocysteinylated apoA-I indicated a lower cholesterol efflux capacity than normal apoA-I in the optimized condition, whereas no significant difference was observed in the cholesterol efflux capacity between apoA-I in the excessive cell differentiation or foam cell formation states. These results suggest that cholesterol efflux capacity of apoA-I varies depending on the state of cells. Therefore, the cholesterol efflux assay should be performed using protocols optimized according to the objective of the experiment.
DcR3, TFF3, and Midkine Are Novel Serum Biomarkers in Small Intestinal Neuroendocrine Tumors
Authors: Edfeldt Katarina , Daskalakis Kosmas , Bäcklin Christofer , Norlén Olov , Tiensuu Janson Eva , Westin Gunnar , Hellman Per , Stålberg Peter
Published: November 2016

Small intestinal neuroendocrine tumors (SI-NETs) are amine- and peptide-producing neoplasms. Most patients display metastases at the time of diagnosis; they have an unpredictable individual disease course and the tumors are often therapy resistant. Chromogranin A and 5-hydroxyindoleacetic acid are the biomarkers clinically used most often today, but there is a great need for novel diagnostic and prognostic biomarkers and new therapeutic targets. Sixty-nine biomarkers were screened in serum from 23 SI-NET patients and 23 healthy controls using the multiplex proximity ligation assay (PLA). A refined method, the proximity extension assay (PEA), was used to analyze 76 additional biomarkers. Statistical testing and multivariate classification were performed. Immunohistochemistry and ELISA were performed in an extended cohort. Using PLA, 19 biomarkers showed a significant difference in serum concentrations between patients and controls, and PEA revealed a difference in the concentrations of 17 proteins. Multivariate classification analysis revealed decoy receptor 3 (DcR3), trefoil factor 3 (TFF3), and midkine to be good biomarkers for the disease, which was confirmed by ELISA analysis. All 3 biomarkers were expressed in tumor tissue. DcR3 concentrations were elevated in patients with stage IV disease. High concentrations of DcR3 and TFF3 were correlated to poor survival. DcR3, TFF3, and midkine exhibited elevated serum concentrations in SI-NET patients compared to healthy controls, and DcR3 and TFF3 were associated with poor survival. DcR3 seems to be a marker for liver metastases, while TFF3 and midkine may be new diagnostic biomarkers for SI-NETs.
Characterizing Teamwork in Cardiovascular Care Outcomes
Authors: Carson Matthew B. , Scholtens Denise M. , Frailey Conor N. , Gravenor Stephanie J. , Powell Emilie S. , Wang Amy Y. , Kricke Gayle Shier , Ahmad Faraz S. , Mutharasan R. Kannan , Soulakis Nicholas D.
Published: November 2016

Background—

The nature of teamwork in healthcare is complex and interdisciplinary, and provider collaboration based on shared patient encounters is crucial to its success. Characterizing the intensity of working relationships with risk-adjusted patient outcomes supplies insight into provider interactions in a hospital environment.

Methods and Results—

We extracted 4 years of patient, provider, and activity data for encounters in an inpatient cardiology unit from Northwestern Medicine’s Enterprise Data Warehouse. We then created a provider–patient network to identify healthcare providers who jointly participated in patient encounters and calculated satisfaction rates for provider–provider pairs. We demonstrated the application of a novel parameter, the shared positive outcome ratio, a measure that assesses the strength of a patient-sharing relationship between 2 providers based on risk-adjusted encounter outcomes. We compared an observed collaboration network of 334 providers and 3453 relationships to 1000 networks with shared positive outcome ratio scores based on randomized outcomes and found 188 collaborative relationships between pairs of providers that showed significantly higher than expected patient satisfaction ratings. A group of 22 providers performed exceptionally in terms of patient satisfaction. Our results indicate high variability in collaboration scores across the network and highlight our ability to identify relationships with both higher and lower than expected scores across a set of shared patient encounters.

Conclusions—

Satisfaction rates seem to vary across different teams of providers. Team collaboration can be quantified using a composite measure of collaboration across provider pairs. Tracking provider pair outcomes over a sufficient set of shared encounters may inform quality improvement strategies such as optimizing team staffing, identifying characteristics and practices of high-performing teams, developing evidence-based team guidelines, and redesigning inpatient care processes.
Dissociation of Early and Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage
Authors: Ayling Oliver G.S. , Ibrahim George M. , Alotaibi Naif M. , Gooderham Peter A. , Macdonald R. Loch
Published: November 2016

Background and Purpose—

Cerebral infarction after aneurysmal subarachnoid hemorrhage is a significant cause of substantial morbidity and mortality. Because early and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage may be mediated by different processes, we evaluated whether aneurysm-securing methods contributed to infarcts and whether long-term outcomes differ between early and delayed infarcts.

Methods—

A post hoc analysis of the CONSCIOUS-1 study (Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage) was performed. Using multivariate logistic regression analysis and propensity matching, independent clinical risk factors associated with infarctions were identified, and the contribution of cerebral infarcts to long-term outcomes was evaluated.

Results—

Within the cohort of 413 subjects, early infarcts were present in 76 subjects (18%), whereas delayed infarcts occurred in 79 subjects (19%), and 36 subjects (9%) had new infarctions that were present on both early and delayed imaging. Propensity score matching revealed a significantly higher proportion of early infarcts after clipping (odds ratio, 4.62; 95% confidence interval, 1.99–11.57;
P
=0.00012). Multivariate logistic regressions identified clipping as an independent risk factor for early cerebral infarction (odds ratio, 0.26; 95% confidence interval, 0.15–0.48;
P
<0.001), and angiographic vasospasm was an independent risk factor for delayed cerebral infarction (odds ratio, 1.79; 95% confidence interval, 1.03–3.13;
P
=0.039). Early infarcts were a significant independent risk factor for poor long-term outcomes at 3 months (odds ratio, 2.34; 95% confidence interval, 1.18–4.67;
P
=0.015).

Conclusions—

Clipping is an independent risk factor for the development of early cerebral infarcts, whereas delayed cerebral infarcts are associated with angiographic vasospasm. Early cerebral infarcts are stronger predictors of worse outcome than delayed infarction.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00111085.
Victim or Villain: Exploring the Possible Bases of a Defence in the Ongwen Case at the International Criminal Court
Authors: Nortje Windell
Published: November 2016

The reality of child soldiers who join rebel forces once they reach adulthood presents complex legal questions in the face of contemporary international criminal law principles which, on the one hand, afford protection to all children, and on the other, unequivocally call for the prosecution and punishment of those who are guilty of committing serious crimes. Currently, the case of Dominic Ongwen before the icc raises contentious issues, including whether or not international criminal law permits the consideration of factors, such as the impact of the experiences as a child soldier on future conduct, when he is prosecuted for allegedly committing crimes during adulthood. This article specifically examines whether Ongwen’s experiences as a child soldier could serve as a possible defence and/or as a mitigating factor.
Incomplete Forgetting: Race and Slavery in Morocco
Authors: Marouan Maha
Published: November 2016

The systemic silence surrounding the legacy of the trans-Saharan Slave trade in Morocco and the power of personal narratives in dismantling this silence.
Applying Population Genetic Approaches within Languages
Authors: Syrjänen Kaj , Honkola Terhi , Lehtinen Jyri , Leino Antti , Vesakoski Outi
Published: November 2016

The adoption of evolutionary approaches to study language change as a type of non-biological evolution has gained increasing interest and introduced a variety of quantitative tools to linguistics. The focus has thus far mainly been on language families, or ‘linguistic macroevolution,’ and taken the shape of linguistic phylogenetics. Here we explore whether evolutionary methods could be applicable for studying intra-lingual variation (‘linguistic microevolution’) by testing a population genetic clustering method for analyzing the ‘population structure’ of Finnish dialects. We compare the results with traditional dialect divisions established in the literature and with K-medoids clustering, which is free from biological assumptions. The results are encouragingly similar to each other and agree with traditional views, suggesting that population genetic tools could be a useful addition to the dialectological toolkit. We also show how the results of the model-based clustering could serve as a basis for further study.
The Diachronic Development of French -age between Usage-Related Shifts and Grammatical Change
Authors: Uth Melanie
Published: November 2016

French -age developed from Latin relational adjectives in -aticus that were by and by nominalized, thereby incorporating the former head noun as a semantic constituent. In this article, it is argued that the Modern French -age derivation originated from the (re-)association of a semantically vacuous formative and an abstract semantic feature. This semantic feature gradually emerged through abstraction from the existing concrete derivatives and, once established, has determined the range of possible interpretations of newly coined formations up to this day. The most important result of the analysis is that, apart from a structural reanalysis of the Latin nominalized relational -aticus adjectives, French -age did not undergo any meaning change at all, the stability of its meaning being due to the abovementioned continuous interplay between the abstract semantic feature and the usage of the various concrete -age nominalizations.
Lectotypification of Trapella weylandii (Plantaginaceae s.l.) from European Pliocene
Authors: HARTKOPF-FRÖDER CHRISTOPH , WINTERSCHEID HEINRICH
Published: November 2016

The genus Trapella Oliver in Hooker (1887: pl. 1595) with one living species Trapella sinensis Oliver in Hooker (1887: pl. 1595) is endemic to the eastern Asia, including China (Anhui, Fujian, Guangxi, Hebei, Heilongjiang, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning), Japan (Honshu, Shikoku, Kyushu), Republic of Korea (South Korea) and Russian Federation (Russia Far East, Ussuri) as aquatic perennial herbs in ponds and lakes up to an elevation of 300 m (Wu & Raven 1998, Manchester et al. 2009). A second extant species T. antennifera (Léveillé 1899: 229) Glück (1939: 149) and a variety T. sinensis var. antennifera (Léveillé) Hara (1941: 380) are now regarded to be synonyms of Trapella sinensis (Hassler 2016). Trapella was assigned to the Trapellaceae or Pedaliaceae but recently Gormley et al. (2015) placed the isolated genus in the tribe Gratioleae of Plantaginaceae.
The Salivary Microbiome and Oral Cancer Risk: A Pilot Study in Fanconi Anemia
Authors: Furquim C.P. , Soares G.M.S. , Ribeiro L.L. , Azcarate-Peril M.A. , Butz N. , Roach J. , Moss K. , Bonfim C. , Torres-Pereira C.C. , Teles F.R.F.
Published: November 2016

Fanconi anemia (FA) is a rare genetic disease characterized by chromosomal instability and impaired DNA damage repair. FA patients develop oral squamous cell carcinoma (OSCC) earlier and more frequently than the general population, especially after hematopoietic stem cell transplantation (HSCT). Although evidence of an etiological role of the local microbiome and carcinogenesis has been mounting, no information exists regarding the oral microbiome of FA patients. The aim of this study was to explore the salivary microbiome of 61 FA patients regarding their oral health status and OSCC risk factors. After answering a questionnaire and receiving clinical examination, saliva samples were collected and analyzed using 16S rRNA sequencing of the V3-V4 hypervariable region. The microbial profiles associated with medical and clinical parameters were analyzed using general linear models. Patients were young (mean age, 22 y) and most had received HSCT ( n = 53). The most abundant phyla were Firmicutes [mean relative abundance (SD), 42.1% (10.1%)] and Bacteroidetes [(25.4% (11.4%)]. A history of graft-versus-host disease (GVHD) ( n = 27) was associated with higher proportions of Firmicutes (43.8% × 38.5%, P = 0.05). High levels of gingival bleeding were associated with the genera Prevotella (22.25% × 20%), Streptococcus (19.83% × 17.61%), Porphyromonas (3.63% × 1.42%, P = 0.03), Treponema (1.02% × 0.28%, P = 0.009), Parvimonas (0.28% × 0.07%, P = 0.02) and Dialister (0.27% × 0.10%, P = 0.04). Finally, participants transplanted over 11 y ago showed the highest levels of Streptococcus (18.4%), Haemophilus (12.7%) and Neisseria (6.8%). In conclusion, FA patients that showed poor oral hygiene harbored higher proportions of the genera of bacteria compatible with gingival disease. Specific microbial differences were associated with a history of oral GVHD and a history of oral mucositis.
A retrospective study describing the characteristics of one Mental Health Trust’s admissions under sections 47 and 48 of the Mental Health Act 1983
Authors: Neeilan Ravindran , O’Brien Aileen
Published: November 2016

Sections 47 and 48 of the Mental Health Act 1983 allow prisoners to be transferred from prison to an appropriate health-care setting in order to be treated. There is an awareness that delays exist when transferring prisoners to hospital. However, literature regarding the delay in returning these patients from hospital is limited. The admissions from prison to a Psychiatric Intensive Care Unit (PICU) in South West London were compared to non-offenders on the PICU in order to compare the average length of stay for both groups and the time taken for the discharge from PICU once felt clinically appropriate. The study also compared demographic profiles, reason for admissions, psychiatric diagnosis and index offences. Over six years, there were 18 admissions from prison to a PICU. The control group comprised 37 non-offenders admitted to the same PICU. On average the prison group took longer to be deemed clinically ready for discharge and, even once clinically ready, then took longer to be discharged. The average length of stay in PICU was 77.83 days for prisoners, and 16.46 days for non-offenders. All 55 admissions were between 1 January 2008 and 31 December 2014. The offender pathway and the difference in the length of stay between prisoners and non-offenders in a PICU warrants further exploration. Possible recommendations to reduce the length of stay of prisoners include improved information sharing between prisons and hospital, and clearer guidelines regarding the level of security required.
Framing in criminal investigation
Authors: Salet Renze
Published: November 2016

Failures in criminal investigation may lead to wrongful convictions. Insight in the criminal investigation process is needed to understand how these investigative failures may rise and how measures can contribute to the prevention of this kind of failures. Some of the main findings of an empirical study of the criminal investigation process in four cases of major investigations are presented here. This criminal investigation process is analyzed as a process of framing, using Goffman's framing (Goffman, 1975) and interaction theories (Goffman, 1990). It shows that in addition to framing, other substantive and social factors affect the criminal investigation.
Predictors of Depression Among Adult Women With Diabetes in the United States
Authors: Strauss Shiela M. , Rosedale Mary T. , Rindskopf David M.
Published: November 2016

Purpose

The purpose of the study was to identify the sex-specific characteristics that predict depression among adult women with diabetes.

Methods

Data from the 2007-2012 National Health and Nutrition Examination Survey in the United States were used to identify the predictors of depression in a large sample of women ages 20 years and older with diabetes (n = 946).

Results

When extrapolated to almost 9 million women in the United States ≥ 20 years of age with diabetes, 19.0% had depression. Female-specific significant predictors of depression included younger age (< 65 years old), less than high school graduation, self-rated fair or poor health, inactivity due to poor health, and pain that interferes with usual activities. Marital status and diabetes-related factors (years living with diabetes, use of insulin, parent or sibling with diabetes) were not significant predictors of depression in adult women with diabetes.

Conclusion

When educating and counseling women with diabetes, diabetes educators should be aware that some of the predictors of depression in women with diabetes differ from those of populations that include both sexes. Depression screening, although important for all women with diabetes, should especially be performed among women with female-specific depression predictors.
Evaluation of a Web‐Based Module and an Otoscopy Simulator in Teaching Ear Disease
Authors: Wu Vincent , Beyea Jason A.
Published: November 2016

Objective

To determine which teaching method—otoscopy simulation (OS), web‐based module (WM), or standard classroom instruction (SI)—produced the best improvement in the diagnosis of middle/external ear pathologies and the development of otoscopy clinical skills.

Study Design

Prospective randomized controlled nonclinical trial.

Setting

Preclerkship undergraduate medical education.

Subjects and Methods

Fifty‐four medical students (first year, 26; second year, 28) were randomized to receive 1 of the 3 interventions: OS, WM, or SI. All students underwent baseline testing of diagnostic accuracy (25 ear pathologies) and otoscopy skills. Immediately following each intervention and 3 months later, testing was repeated.

Results

Baseline scores for diagnostic accuracy and otoscopy skills did not differ across intervention groups. Immediately postintervention, all groups showed an improvement in diagnostic accuracy (P <. 001). OS scored significantly higher than SI (P <. 001), as did WM (P =. 003). At 3‐month follow‐up, all groups continued to demonstrate improved diagnostic accuracy as compared with baseline. Again, OS showed improvement over SI (P =. 031). For otoscopy clinical skills, only OS improved immediately postintervention (P <. 001). OS had significantly higher scores than WM and SI (P <. 001). At 3‐month follow‐up, OS again showed improvement over WM (P <. 001) and SI (P =. 009).

Conclusion

All groups showed an improvement in diagnostic accuracy immediately postintervention, with the largest increases coming from OS and WM. Otoscopy clinical skills increased and were retained only in OS. Preclerkship medical student acquisition and retention of otolaryngology diagnostic skills can be greatly improved through web‐based teaching modules and otoscopy simulation.
CDX2 immunostaining in primary and metastatic germ cell tumours of the testis
Authors: Oz Atalay Fatma , Aytac Vuruskan Berna , Vuruskan Hakan
Published: November 2016

Objective

To evaluate the immunohistochemical staining pattern of caudal type homeobox 2 (CDX2) protein in germ cell tumours (GCTs) of the testis.

Methods

This study reassessed archival tissue samples collected from patients diagnosed with primary and metastatic testicular GCTs for CDX2 immunoreactivity using standard immunohistochemical techniques. Positive nuclear immunostaining was evaluated with regard to both the staining intensity and the extent of the staining.

Results

Tissue sections from primary and metastatic testicular GCTs ( n = 104), germ cell neoplasia in situ (GCNis) ( n = 5) and benign testicles ( n = 15) were analysed. The GCNis and benign testicular tissues showed no immunoreactivity for CDX2. Strong and diffuse staining of CDX2 was demonstrated only in the mature colonic epithelium of teratomas in both primary and metastatic GCTs. CDX2 positivity in other tumours (one pure yolk sac tumour, one yolk sac component of a mixed GCT and one pure seminoma) was infrequent, and was only weak and focal.

Conclusions

CDX2 immunostaining should be interpreted based on both the staining intensity and the extent of staining so as not to cause misdiagnosis. Teratomas with colonic-type epithelium should be considered in the differential diagnosis if a metastatic tumour with an unknown primary shows prominent CDX2 immunostaining.
Clinical features of patients who died within 24 h after admission to a stroke care center
Authors: Sasaki Masahiro , Okudera Hiroshi , Nakase Taizen , Suzuki Akifumi
Published: November 2016

Objective

In Japan, stroke care is provided through medical cooperation and standardized treatment. However, various factors affect mortality in the hyperacute phase. The present study investigated factors associated with death within 24 h after admission for acute stroke.

Methods

Among 2335 patients admitted within 24 h after stroke onset from 1 January 2007 to 31 December 2012, a total of 139 deaths occurred. Forty-eight deaths occurred within 24 h after admission. We retrospectively examined the clinical features of these 48 patients.

Results

The overall mortality rate was 6.0%. When the initial 72-h period was divided into ≤24 h (Period I), >24 to 48 h (Period II), and >48 to 72 h (Period III), deaths were significantly more frequent in Period I than in the other two periods. The frequency of intracerebral haemorrhage (ICH) was also significantly higher in Period I than in the other two periods. Factors significantly associated with death from ICH were systolic blood pressure, hematoma volume, and surgery.

Conclusion

The mortality rate was low among patients with stroke transported to the authors’ medical center within 24 h of onset. Blood pressure management and the timing of determining indications for surgery are important factors in acute haemorrhagic stroke care.
Feasibility of laparoscopic abdominal wall reconstruction in an outpatient community-hospital setting using cPTFE prosthetic mesh: a prospective, multicenter case series
Authors: Unruh Terry , Boachie Joseph Adjei , Smith-Singares Eduardo
Published: November 2016

Objective

This study investigated the use of prosthetic condensed polytetrafluoroethylene (cPTFE) for laparoscopic ventral hernia repair (LVHR) in an outpatient community-hospital setting.

Methods

Patients underwent LVHR with cPTFE at one of three community hospitals. Primary endpoint was hernia recurrence at 1-year postoperatively. Secondary endpoints included pain, surgical site infection, medical/surgical complications, and patient-reported outcomes.

Results

This study included 65 females and 52 males, aged 46.6 ± 13.2 years (mean ± SD; range 18–84 years). Mean prosthetic size was 413.8 ± 336.11 cm2 (range 165–936 cm2). Mean follow-up was 30 months (range 12–46 months). Hernia recurrence rate was 4.3%. Rate of hospitalization in the first postoperative week was 2.6%. Early and late secondary endpoint complication rates were 24.8% and 27.4%, respectively; pain was the most common complication, followed by seroma (8.5%).

Conclusions

Outpatient LVHR using cPTFE is feasible in community hospitals. Complication rates were similar to previous reports, and the seroma rate was markedly lower.
A novel SCN1A mutation identified in a Chinese family with familial hemiplegic migraine: A case report
Authors: Zhang Yang , Chen Ning , Zhou Muke , Guo Jian , Guo Jiang , He Li
Published: November 2016

Background

Familial hemiplegic migraine (FHM) is a rare type of migraine with aura that is characterized by transient hemiparesis. Mutations in three genes (CACNA1A, ATP1A2, and SCN1A) have been found to cause FHM. Among these, nine SCN1A gene mutations were reported to cause familial hemiplegic migraine type 3 (FHM3). However, none of them was reported in China.

Method

The clinical manifestations of a Chinese FHM family were recorded and all coding exons and flanking intronic regions of the CACNA1A, ATP1A2, and SCN1A genes were tested for mutations.

Results

All FHM patients in the investigated family have typical hemiplegic migraine attacks characteristic of FHM. We identified a novel mutation (p.Leu1670Trp) of the SCN1A gene. The affected amino acid is highly conserved across different species and therefore likely plays an important role in SCN1A gene function.

Conclusion

The identification of a novel mutation in the SCN1A gene in the Chinese population may further aid in the understanding of FHM genetics.
Psychosocial factors associated with migraine and tension-type headache in medical students
Authors: Lebedeva Elena R , Kobzeva Natalia R , Gilev Denis V , Kislyak Nadezhda V , Olesen Jes
Published: November 2016

Background

In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity. The hypothesis of this study was therefore that a number of psychosocial factors relating to the personal sphere would better explain the high prevalence of migraine and TTH in students.

Methods

The study population consisted of 1042 students (719 females, 323 males, mean age 20.6, range 17–40). Headache diagnoses and associated factors were identified by direct professional semi-structured interview. We also interviewed about the following psychosocial factors: dissatisfaction with study, dissatisfaction with family life, dissatisfaction for personal reasons, bad financial situation, overwork, stress, not enough sleep, insomnia, depressed mood, anxiety, irritability, tendency towards conflicts and not being married. We report psychosocial factors associated with headache according to diagnosis and sex using univariate and multivariate logistic regression analyses.

Results

Several factors were significantly associated with migraine and TTH in the univariate analysis. In the multivariate analysis, two psychosocial factors were statistically significantly associated with migraine in all students: irritability (OR 2.2, 95% CI 1.4–3.6) and overwork (OR 2.2, 95% CI 1.4–3.5). Insomnia (2.7, 95% CI 1.1–6.9) and depressed mood (OR 2.1, 95% CI 1.1–4.2) were associated with migraine only in females. Two psychosocial factors were associated with TTH: dissatisfaction with study in males (OR 2.0, 95% CI 1.0–3.8) and depressed mood in females (OR 1.8, 95% CI 1.0–3.5).

Conclusion

Psychosocial factors from the personal sphere showed significant association with migraine and TTH in students. Such factors should therefore be major targets for preventive efforts to reduce the prevalence of primary headache disorders in students.
Employer Choice and Job Quality
Authors: Findlay Patricia , Lindsay Colin , McQuarrie Jo , Bennie Marion , Corcoran Emma D. , Van Der Meer Robert
Published: November 2016

This article examines employer choice in relation to job quality (JQ). Acknowledging the important role of market, institutional, and technological constraints, the authors highlight the role of employer agency in shaping JQ by reporting on an employer-led service redesign initiative in hospital pharmacy services in Scotland. This redesign initiative aimed at upskilling employees and redirecting their work effort toward high value-added, patient-facing work using robotics implementation. The article provides a critical assessment of the success of the initiative in enhancing JQ and explores a range of factors constraining and shaping employers’ JQ choices.
Utility of the Personality Inventory for DSM-5–Brief Form (PID-5-BF) in the Measurement of Maladaptive Personality and Psychopathology
Authors: Anderson Jaime L. , Sellbom Martin , Salekin Randall T.
Published: November 2016

The Diagnostic and Statistical Manual of Mental Disorders–Fifth edition ( DSM-5) Personality and Personality Disorders workgroup developed the Personality Inventory for the DSM-5 (PID-5) for the assessment of the alternative trait model for DSM-5. Along with this measure, the American Psychiatric Association published an abbreviated version, the PID-5–Brief form (PID-5-BF). Although this measure is available on the DSM-5 website for use, only two studies have evaluated its psychometric properties and validity and no studies have examined the U.S. version of this measure. The current study evaluated the reliability, factor structure, and construct validity of PID-5-BF scale scores. This included an evaluation of the scales’ associations with Section II PDs, a well-validated dimensional measure of personality psychopathology, and broad externalizing and internalizing psychopathology measures. We found support for the reliability of PID-5-BF scales as well as for the factor structure of the measure. Furthermore, a series of correlation and regression analyses showed conceptually expected associations between PID-5-BF and external criterion variables. Finally, we compared the correlations with external criterion measures to those of the full-length PID-5 and PID-5–Short form. Intraclass correlation analyses revealed a comparable pattern of correlations across all three measures, thereby supporting the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits.
Eye-tracking study on facial emotion recognition tasks in individuals with high-functioning autism spectrum disorders
Authors: Tsang Vicky
Published: November 2016

The eye-tracking experiment was carried out to assess fixation duration and scan paths that individuals with and without high-functioning autism spectrum disorders employed when identifying simple and complex emotions. Participants viewed human photos of facial expressions and decided on the identification of emotion, the negative–positive emotion orientation, and the degree of emotion intensity. Results showed that there was an atypical emotional processing in the high-functioning autism spectrum disorder group to identify facial emotions when eye-tracking data were compared between groups. We suggest that the high-functioning autism spectrum disorder group prefers to use a rule-bound categorical approach as well as featured processing strategy in the facial emotion recognition tasks. Therefore, the high-functioning autism spectrum disorder group more readily distinguishes overt emotions such as happiness and sadness. However, they perform more inconsistently in covert emotions such as disgust and angry, which demand more cognitive strategy employment during emotional perception. Their fixation time in eye-tracking data demonstrated a significant difference from that of their controls when judging complex emotions, showing reduced “in” gazes and increased “out” gazes. The data were in compliance with the findings in their emotion intensity ratings which showed individuals with autism spectrum disorder misjudge the intensity of complex emotions especially the emotion of fear.