bluuebunny/crossref_metadata_2025 huggingface dataset:
Making Sense of One’s Place in an Educational Opportunity Program
Authors: Todorova Ralitsa
Published: June 2017

A college degree has been shown to decrease the income gap, but disadvantaged students are at a greater risk of dropping out of college. This study explores meaning-making of students in an educational opportunity program (EOP), the Search for Education Elevation and Knowledge (SEEK) in the City University of New York system. It is important to examine the experiences of students who are receiving additional support to understand how they develop through this complex transition process. Forty-six first-year SEEK students and 38 upperclassmen responded to a set of five narrative prompts of different genres. Using values analysis, the data showed that over half of the values guiding participants’ narratives (53.30%) discussed the many benefits of SEEK and the sources of support youth rely on. Participants used the genres to express the complexities of transitioning to college as freshman, along with a settling in the later years. The findings of this study demonstrate youth perspectives on the ways in which EOPs can significantly contribute to student retention.
Integrating Research and Practice: Looking Forward
Authors: Wang Jia
Published: June 2017

The Problem

The diversity of issues illuminated in this collection of six articles is just another reminder that we still have a long way to go in our endeavor to cross between the worlds of research and practice. Recognizing why the research–practice tension persists is critical, yet awareness without action will lead us to nowhere.

The Solution

To move us from the stage of knowing to the next level of doing calls for a carefully crafted action plan. This article synthesizes actionable strategies recommended by the issue contributors. It is hoped that multilevel stakeholders will be inspired to take some of the suggested actions to innovate their professional practices.

The Stakeholders

Multiple stakeholders will benefit from the knowledge created in this issue. They include academic researchers, practitioners, scholar–practitioners, organizations, and intermediaries who desire to make a meaningful impact on bridging the great divide between research and practice.
Early Results of the Bolton Treovance Endograft in the Treatment of Abdominal Aortic Aneurysms
Authors: Georgakarakos Efstratios , Pitoulias George , Schoretsanitis Nikolaos , Argyriou Christos , Mavros Dimitrios M. , Lazarides Miltos K. , Georgiadis George S.
Published: June 2017

Purpose: To present early results with the Treovance aortic stent-graft in the treatment of abdominal aortic aneurysms (AAAs). Methods: Between October 2013 and January 2016, 35 consecutive AAA patients (mean age 74±7.7 years; 32 men) were treated with Treovance. The maximum diameter of the treated AAA was 60±9 cm. Nine (25%) patients presented with concomitant iliac aneurysms. Seven (20%) AAAs had infrarenal neck angulation >60°. The infrarenal neck length and diameter were 21.6±12.6 mm and 25.7±4.6 mm, respectively. Sixteen (45%) AAAs had a reversed tapered neck contour. Six (17%) and 9 (25%) patients showed severe or moderate iliac tortuosity, respectively. Primary endpoints were endoleak, reintervention, and aneurysm-related death. Results: Primary technical success was 94% due to 2 intraoperative type Ia endoleaks, which were successfully treated with a proximal aortic extension (100% assisted primary technical success). Local dissection was encountered in 5 (7%) of 70 femoral artery access sites in 4 patients. During a mean 12-month follow-up (range 6–24), clinical success was 97%. No type I or III endoleak, death, AAA rupture, open conversion, or device-related serious adverse events were documented. Four type II endoleaks were detected; one resolved spontaneously at 12 months and 2 remained stable, while one associated with AAA sac enlargement was treated successfully with embolization of the lumbar arteries (3% reintervention rate). Conclusion: Treovance shows accurate deployment even through angulated and tortuous iliac vessels and presents satisfactory conformability in highly angulated necks with acceptable clinical results. Future development to lower the profile and increase the flexibility of its delivery system will enhance its applicability in cases of narrow access vessels.
Total Endovascular Treatment of Aortic Arch Disease Using an Arch Endograft With 3 Inner Branches
Authors: Spear Rafaëlle , Clough Rachel E. , Fabre Dominique , Roeder Blayne , Hertault Adrien , Martin Gonzalez Teresa , Azzaoui Richard , Sobocinski Jonathan , Haulon Stéphan
Published: June 2017

Purpose: To report early experience with a new endovascular graft developed for aortic arch aneurysm repair in patients unfit for open surgery. Case Report: Three consecutive men (62, 74, and 69 years old) at high risk for open repair were treated for postdissection aortic arch aneurysms using a custom-made 3 inner branched endovascular graft. The 2 proximal branches are antegrade and perfuse the innominate artery and the left common carotid artery; the third branch is retrograde and perfuses the left subclavian artery. The latter is preloaded with a catheter and wire to aid cannulation. Technical success was achieved in each case. The mean procedure time, fluoroscopy duration, and contrast volume were 180 minutes, 35 minutes, and 145 mL, respectively. The perioperative period was uneventful. All branches were patent on 6-month computed tomography and duplex ultrasound imaging. Conclusion: This new patient-specific device allows total endovascular revascularization of the supra-aortic trunks during arch repair. These encouraging results support its more widespread use.
Literal Media Ecology: Crisis in the Conditions of Production
Authors: Caraway Brett R.
Published: June 2017

This article outlines a socio-political theory appropriate for the study of the ecological repercussions of contemporary media technologies. More specifically, this approach provides a means of assessing the material impacts of media technologies and the representations of capitalist ecological crises. This approach builds on the work of ecological economists, ecosocialist scholars, and Marx’s writings on the conditions of production to argue that capitalism necessarily results in ecological destabilization. Taking Apple’s 2016 Environmental Responsibility Report as a case study, the article uses the theory to analyze Apple’s responses to ecological crises. The article asserts that Apple’s reactions are emblematic of the capitalist compulsion for increasing rates of productivity. However, unless the matter/energy savings achieved through higher rates of productivity surpass the overall increase in the flow of matter/energy in production, ecological crises will continue. Ultimately, capital accumulation ensures continued ecological destabilization.
Rehabilitation for Individuals With Genetic Degenerative Ataxia: A Systematic Review
Authors: Milne Sarah C. , Corben Louise A. , Georgiou-Karistianis Nellie , Delatycki Martin B. , Yiu Eppie M.
Published: June 2017

Background. Treatment of genetic degenerative ataxia is currently based on symptom management and maintenance of function. However, utilization of rehabilitation is limited due to a lack of evidence supporting its efficacy. Objective. This systematic review evaluated rehabilitation interventions for individuals with genetic degenerative ataxia. In addition, long-term outcomes from rehabilitation and optimal duration and intensity of rehabilitation were examined. Methods. A comprehensive search of 4 databases (MEDLINE, CINAHL, PEDro, and Cochrane) identified randomized, nonrandomized controlled, and cohort studies published from inception through to January 2016. The studies included at least one measure examining function, ataxia, balance, or gait. Methodological quality was assessed with the Australian National Health and Medical Research Council (NHMRC) Hierarchy of Evidence and the randomized controlled trials were rated according to the PEDro scale. Results. Seventeen studies met eligibility criteria. Five randomized controlled trials were included; however, the majority were classified as level III-3 and IV studies. Of 292 participants included, 148 had autosomal dominant ataxia, and 85 had autosomal recessive ataxia. Rehabilitation interventions included coordination and balance training, multifaceted inpatient rehabilitation, a cycling regime, balance exercises with technology assisted biofeedback, respiratory muscle training, and treadmill training. Two studies examined adjuncts to rehabilitation. Fifteen of the 17 studies demonstrated a statistically significant improvement in at least 1 outcome measuring ataxia, function, gait, or balance. Less than half of the studies included assessment of long-term outcomes and follow-up time frames varied considerably. Conclusion. There is consistent evidence that rehabilitation improves function, mobility, ataxia, and balance in genetic degenerative ataxia.
Mixed Methods Sampling
Authors: Teddlie Charles , Yu Fen
Published: June 2017

WITHDRAWN: Teddlie, C., & Yu, F. (2007). Mixed methods sampling: A typology with examples. Journal of Mixed Methods Research, 1(1), 77-100. DOI 10.1177/1558689806292430

Article withdrawn by publisher.

Due to an administrative error, this article was accidentally published OnlineFirst and in Volume 1 Issue 1 of publishing year 2007 with different DOIs and different page numbers.

The incorrect version of the article with DOI: 10.1177/2345678906292430 has been replaced with this correction notice.

The correct and citable version of the article remains:

Teddlie, C., & Yu, F. (2007). Mixed methods sampling: A typology with examples. Journal of Mixed Methods Research, 1(1), 77-100. DOI 10.1177/1558689806292430
Active authority or latent legitimacy? The institutional visibility of the university governing body amongst staff as a factor in its effectiveness
Authors: Dawkins Adam Peter
Published: June 2017

This study examines the institutional visibility of the university governing body amongst staff, as an unexplored factor influencing the effectiveness of the body in performing stewardship and strategic responsibilities on behalf of the university. A constructionist view of governance is taken in order to examine the enactment of governing body institutional visibility within the spaces of the university, from the formal projection of its legal and constitutional duties, to communication of the decisions made at governing body meetings, through to governors’ informal encounters and engagement with staff. An institutional visibility spectrum was developed based on governing body ‘apparency’, ‘transparency’ and ‘engagement’, prior to interviewing secretaries and clerks as key actors in the governance system. It was found that governor visibility through engagement and interaction with a range of staff outside the ‘boardroom’ was perceived as a contributor to governing body effectiveness, including governors’ knowledge-building and ability to contribute to strategic initiatives in the host university.
Primary sensory neuron-specific interference of TRPV1 signaling by adeno-associated virus-encoded TRPV1 peptide aptamer attenuates neuropathic pain
Authors: Xiang Hongfei , Liu Zhen , Wang Fei , Xu Hao , Roberts Christopher , Fischer Gregory , Stucky Cheryl L , Dean Caron , Pan Bin , Hogan Quinn H , Yu Hongwei
Published: June 2017

Background

TRPV1 (transient receptor potential vanilloid subfamily member 1) is a pain signaling channel highly expressed in primary sensory neurons. Attempts for analgesia by systemic TRPV1 blockade produce undesirable side effects, such as hyperthermia and impaired heat pain sensation. One approach for TRPV1 analgesia is to target TRPV1 along the peripheral sensory pathway.

Results

For functional blockade of TRPV1 signaling, we constructed an adeno-associated virus (AAV) vector expressing a recombinant TRPV1 interfering peptide aptamer, derived from a 38mer tetrameric assembly domain (TAD), encompassing residues 735 to 772 of rat TRPV1, fused to the C-terminus of enhanced green fluorescent protein (EGFP). AAV-targeted sensory neurons expressing EGFP-TAD after vector injection into the dorsal root ganglia (DRG) revealed decreased inward calcium current and diminished intracellular calcium accumulation in response to capsaicin, compared to neurons of naïve or expressing EGFP alone. To examine the potential for treating neuropathic pain, AAV-EGFP-TAD was injected into fourth and fifth lumbar (L) DRGs of rats subjected to neuropathic pain by tibial nerve injury (TNI). Results showed that AAV-directed selective expression of EGFP-TAD in L4/L5 DRG neuron somata, and their peripheral and central axonal projections can limit TNI-induced neuropathic pain behavior, including hypersensitivity to heat and, to a less extent, mechanical stimulation.

Conclusion

Selective inhibition of TRPV1 activity in primary sensory neurons by DRG delivery of AAV-encoded analgesic interfering peptide aptamers is efficacious in attenuation of neuropathic pain. With further improvements of vector constructs and in vivo application, this approach might have the potential to develop as an alternative gene therapy strategy to treat chronic pain, especially heat hypersensitivity, without complications due to systemic TRPV1 blockade.
Crying Is in the Eyes of the Beholder: An Attribution Theory Framework of Crying at Work
Authors: Becker William , Conroy Samantha , Djurdjevic Emilija , Gross Michael
Published: June 2017

This article contributes to research on emotion expression, attributions, and discrete work emotions by developing an observer-focused model to explain the outcomes of crying at work. Our model is focused on crying as a form of emotion expression because crying may be driven by different felt emotions or be used as a means of manipulation. In addition, the model focuses on observers, who must form perceptions of the emotion expression in order to determine an appropriate response. This model is particularly valuable because it addresses the reality that an observer will develop an impression of another person’s emotion and intention, and that this impression may not always align with the reality of the emotion being experienced by the expresser.
Comparison of Calcaneal Exposure Through the Extensile Lateral and Sinus Tarsi Approaches
Authors: Bedigrew Katherine M. , Blair James A. , Possley Daniel R. , Kirk Kevin L. , Hsu Joseph R.
Published: June 2017

The purpose of this study was to compare the exposure of the posterior facet with the extensile lateral (EL) approach compared with the sinus tarsi (ST) approach. We hypothesized that the ST approach will provide a similar exposure of the posterior calcaneal facet. A total of 8 sequential ST then EL approaches were performed on cadavers. Calcaneal landmarks were identified by visualization or palpation. Calibrated digital photographs of the posterior facet and lateral calcaneal body were obtained from standardized positions and used to calculate the exposed surface area. No significant difference was found in the average square area of the posterior facet exposed with the 2 approaches. Significantly more of the lateral calcaneal body was seen with the EL approach. Excluding the posterior facet superomedial quadrant, all the landmarks were visualized in 100% of approaches. The superomedial corner was visualized in significantly more of the cadavers with the EL approach and was palpable in 12.5% of the remaining cadavers in both approaches. Whereas the ST approach exposes less of the lateral wall of the calcaneus, it exposes similar amounts of the posterior facet when compared with the EL approach.

Levels of Evidence: Therapeutic, Level V
A Research-Based Evidence of the Effect of Graphic Organizers on the Understanding of Prose Fiction in ESL Classroom
Authors: Uba Emmanuel , Oteikwu Emmanuel Agbo , Onwuka Edwin , Abiodun-Eniayekan Eugenia
Published: June 2017

Graphic organizers (GOs) are fast becoming acceptable standard instructional tools across subjects in the education arena globally. However, this visual representation of information is yet to be recognized and integrated into the teaching methods in Nigerian schools. This study, therefore, presents a research-based investigation of the usefulness of GOs in the appreciation of prose literature in Nigeria, with a view to foregrounding their use in Nigerian schools. Specifically, the study seeks to find out whether senior secondary students in prose literature-in-English in Nigeria who are taught with GOs perform better in prose and comprehension assessments. Four project secondary schools with total of 100 students were purposively selected for the study. The schools were grouped into two: graphic-based schools (GBS) and non-graphic-based schools (NGBS). Whereas the GBS was exposed to instruction via eight graphic organizers, the NGBS served as control. Subjected to descriptive statistics and one-sample t test analysis, the investigation reveals that graphic organizers make students take charge of the learning process in prose literature classes, and it concludes that these visual instructional elements guarantee student understanding and achievement. The study, thus, recommends the incorporation of graphic organizers in the teaching and learning processes across subjects in Nigerian schools.
What Role Did Rising Demand Play in Driving Food Prices Up?
Authors: Bhattacharya Rudrani , Gupta Abhijit Sen
Published: June 2017

Average food inflation in India during the period 2006–2013 was one of the highest among emerging market economies and nearly double the inflation witnessed in India during the previous decade. An often-cited hypothesis argues that the surge in food inflation during this period was driven by rising demand for high-value food products due to higher per capita income and diversification of Indian diets. In this article, we test the validity of this hypothesis by estimating the expenditure elasticity and then calculating the aggregate demand using data from household survey conducted by the National Sample Survey Organisation (NSSO). Our results show that in recent years, estimated demand has exceeded supply of all major food products, barring fruits. Moreover, empirical estimates indicate that the demand–supply gap is an important driver of rise in food prices, along with other factors such as minimum support prices, global prices, fiscal deficit and agricultural wages.

JEL Classification: E31, E37, Q11
DON and Shapley Value for Allocation among Cooperating Agents in a Network: Conditions for Equivalence
Authors: Mandyam Sridhar , Sridhar Usha
Published: June 2017

In a paper appearing in a recent issue of this journal ( Studies in Microeconomics), the authors explored a new method to allocate a divisible resource efficiently among cooperating agents located at the vertices of a connected undirected network. It was shown in that article that maximizing social welfare of the agents produces Pareto optimal allocations, referred to as dominance over neighbourhood (DON), capturing the notion of dominance over neighbourhood in terms of network degree. In this article, we show that the allocation suggested by the method competes well with current cooperative game-theoretic power centrality measures. We discuss the conditions under which DON turns exactly equivalent to a recent ‘fringe-based’ Shapley Value formulation for fixed networks, raising the possibility of such solutions being both Pareto optimal in a utilitarian social welfare maximization sense as well as fair in the Shapley value sense.
Carcinoid Heart Disease: Starting From Heart Failure
Authors: Bertin Nicole , Favretto Serena , Pelizzo Francesco , Mos Lucio , Pertoldi Franco , Vriz Olga
Published: June 2017

Carcinoid syndrome is the constellation of symptoms mediated by humoral factors produced by some carcinoid tumors. It consists primarily of vasomotor symptoms, gastrointestinal hypermotility, hypotension, and bronchospasm, due to the production and release of vasoactive substances. Carcinoid heart disease occurs in more than 50% of patients with carcinoid syndrome; in some cases, it represents the initial manifestation of the disease. We report the case of a 75-year-old woman with a metastatic neuroendocrine tumor admitted to the emergency room for fatigue and heart failure. Transthoracic echocardiography showed severe tricuspid and pulmonic regurgitation suggesting carcinoid heart disease. A hypervascular retroperitoneal mass was found on abdominal computed tomography, which seemed to arise from the mesenteric artery, anteriorly to the abdominal aorta. Unfortunately, our patient was neither a candidate for mass resection nor for cardiac surgery due to advanced metastatic disease and poor clinical condition. Additionally, we performed a systematic literature review of carcinoid heart disease focusing on typical echocardiographic findings.
What’s Your “Street Race”? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status among Latinxs
Authors: López Nancy , Vargas Edward , Juarez Melina , Cacari-Stone Lisa , Bettez Sonia
Published: June 2017

Using the 2015 Latino National Health and Immigration Survey (N = 1,197), we examine the relationship between physical and mental health status and three multidimensional measures of race: (1) street race, or how you believe other “Americans” perceive your race at the level of the street; (2) socially assigned race, or what we call ascribed race, which refers to how you believe others usually classify your race in the United States; and (3) self-perceived race, or how you usually self-classify your race on questionnaires. We engage in intersectional inquiry by combining street race and gender. We find that only self-perceived race correlates with physical health and that street race is associated with mental health. We also find that men reporting their street race as Latinx or Arab were associated with higher odds of reporting worse mental health outcomes. One surprising finding was that for physical health, men reporting their street race as Latinx were associated with higher odds of reporting optimal physical health. Among women, those reporting their street race as Mexican were associated with lower odds of reporting optimal physical health when compared to all other women; for mental health status, however, we found no differences among women. We argue that street race is a promising multidimensional measure of race for exploring inequality among Latinxs.
Muslim Belonging in Hindu South Asia: Ambivalence and Difference in Nepali Public Discourses
Authors: Sijapati Megan Adamson
Published: June 2017

The role of Islam and Muslims in secular Hindu South Asia is central to debates about who belongs and what constitutes national identity. This article examines the symbolic and abstract dimensions of the representations of Muslim minority belonging in the secular but Hindu majority state of Nepal. Through analysis of discourses in Nepal (English, Urdu and Nepali) about Muslims, I argue there is an underlying narrative representing Muslims as either cooperative supporters of Hindu religious life in a Hindu majority culture or as dangerous non-patriots with proclivities to violence. I argue that both representations are problematic, as neither correspond with the lived realities of this internally diverse and increasingly globalised religious minority. I also attempt to demonstrate that these narrative tropes bring into view important distinctions between religion as an abstract category and religion as a lived reality for Muslims in contemporary South Asia.
High-throughput sequencing for noninvasive disease detection in hematologic malignancies
Authors: Scherer Florian , Kurtz David M. , Diehn Maximilian , Alizadeh Ash A.
Published: June 2017

Noninvasive monitoring of minimal residual disease (MRD) has led to significant advances in personalized management of patients with hematologic malignancies. Improved therapeutic options and prolonged survival have further increased the need for sensitive tumor assessment that can inform treatment decisions and patient outcomes. At diagnosis or relapse of most hematologic neoplasms, malignant cells are often easily accessible in the blood as circulating tumor cells (CTCs), making them ideal targets to noninvasively profile the molecular features of each patient. In other cancer types, CTCs are generally rare and noninvasive molecular detection relies on circulating tumor DNA (ctDNA) shed from tumor deposits into circulation. The ability to precisely detect and quantify CTCs and ctDNA could minimize invasive procedures and improve prediction of clinical outcomes. Technical advances in MRD detection methods in recent years have led to reduced costs and increased sensitivity, specificity, and applicability. Among currently available tests, high-throughput sequencing (HTS)–based approaches are increasingly attractive for noninvasive molecular testing. HTS-based methods can simultaneously identify multiple genetic markers with high sensitivity and specificity without individual optimization. In this review, we present an overview of techniques used for noninvasive molecular disease detection in selected myeloid and lymphoid neoplasms, with a focus on the current and future role of HTS-based assays.
How I use laboratory monitoring of antiplatelet therapy
Authors: Michelson Alan D. , Bhatt Deepak L.
Published: June 2017

Antiplatelet therapy is of proven benefit in coronary artery disease and a number of other clinical settings. This article reviews platelet function, molecular targets of antiplatelet agents, and clinical indications for antiplatelet therapy before focusing on a frequent question to hematologists about the 2 most commonly used antiplatelet therapies: Could the patient be aspirin “resistant” or clopidogrel “resistant”? If so, should results of a platelet function test be used to guide the dose or type of antiplatelet therapy? Whether such guided therapy is of clinical benefit to patients has been a source of controversy. The present article reviews this subject in the context of 2 prototypical clinical cases. Available evidence does not support the use of laboratory tests to guide the dose of aspirin or clopidogrel in patients with so-called aspirin or clopidogrel “resistance.”
Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research
Authors: Hill Adam T. , Haworth Charles S. , Aliberti Stefano , Barker Alan , Blasi Francesco , Boersma Wim , Chalmers James D. , De Soyza Anthony , Dimakou Katerina , Elborn J. Stuart , Feldman Charles , Flume Patrick , Goeminne Pieter C. , Loebinger Michael R. , Menendez Rosario , Morgan Lucy , Murris Marlene , Polverino Eva , Quittner Alexandra , Ringshausen Felix C. , Tino Gregory , Torres Antoni , Vendrell Montserrat , Welte Tobias , Wilson Rob , Wong Conroy , O'Donnell Anne , Aksamit Timothy
Published: June 2017

There is a need for a clear definition of exacerbations used in clinical trials in patients with bronchiectasis. An expert conference was convened to develop a consensus definition of an exacerbation for use in clinical research.

A systematic review of exacerbation definitions used in clinical trials from January 2000 until December 2015 and involving adults with bronchiectasis was conducted. A Delphi process followed by a round-table meeting involving bronchiectasis experts was organised to reach a consensus definition. These experts came from Europe (representing the European Multicentre Bronchiectasis Research Collaboration), North America (representing the US Bronchiectasis Research Registry/COPD Foundation), Australasia and South Africa.

The definition was unanimously approved by the working group as: a person with bronchiectasis with a deterioration in three or more of the following key symptoms for at least 48 h: cough; sputum volume and/or consistency; sputum purulence; breathlessness and/or exercise tolerance; fatigue and/or malaise; haemoptysis AND a clinician determines that a change in bronchiectasis treatment is required.

The working group proposes the use of this consensus-based definition for bronchiectasis exacerbation in future clinical research involving adults with bronchiectasis.
Obstructive sleep apnoea and related comorbidities in incident idiopathic pulmonary fibrosis
Authors: Gille Thomas , Didier Morgane , Boubaya Marouane , Moya Loris , Sutton Angela , Carton Zohra , Baran-Marszak Fanny , Sadoun-Danino Danielle , Israël-Biet Dominique , Cottin Vincent , Gagnadoux Frederic , Crestani Bruno , d'Ortho Marie-Pia , Brillet Pierre-Yves , Valeyre Dominique , Nunes Hilario , Planès Carole ,   collaborators
Published: June 2017

The objectives of this prospective study were: 1) to determine the prevalence and determinants of obstructive sleep apnoea (OSA) in patients with newly diagnosed idiopathic pulmonary fibrosis (IPF); 2) to determine whether OSA was associated with cardiovascular disease (CVD) as well as increased oxidative stress and levels of IPF biomarkers in the blood.

A group of 45 patients with newly diagnosed IPF attended polysomnography. The prevalence of CVD and the severity of coronary artery calcification were investigated by high-resolution computed tomography. The levels of 8-hydroxydeoxyguanosine (8-OH-DG) and various IPF biomarkers in the blood were compared between patients with no or mild OSA (apnoea–hypopnoea index (AHI) <15 events·h−1), with moderate OSA (15 ≤AHI <30 events·h−1) and with severe OSA (AHI ≥30 events·h−1).

The prevalence of moderate-to-severe OSA and severe OSA was 62% and 40%, respectively. AHI did not correlate with demographic or physiological data. All patients with severe OSA had a medical history of CVD,versus41.2% and 40% of those with no or mild OSA, or with moderate OSA, respectively (p<0.0001). Ischaemic heart disease (IHD) and moderate-to-severe coronary artery calcifications were strongly associated with severe OSA. The 8-OH-DG and matrix metalloproteinase-7 serum levels were significantly increased in the severe OSA group.

Moderate-to-severe OSA is highly prevalent in incident IPF and severe OSA is strongly associated with the presence of CVD, particularly IHD.
Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension: the initial German experience
Authors: Olsson Karen M. , Wiedenroth Christoph B. , Kamp Jan-Christopher , Breithecker Andreas , Fuge Jan , Krombach Gabriele A. , Haas Moritz , Hamm Christian , Kramm Thorsten , Guth Stefan , Ghofrani Hossein Ardeschir , Hinrichs Jan B. , Cebotari Serghei , Meyer Katrin , Hoeper Marius M. , Mayer Eckhard , Liebetrau Christoph , Meyer Bernhard C.
Published: June 2017

Balloon pulmonary angioplasty (BPA) is an emerging treatment for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH).

We report on a prospective series of 56 consecutive patients who underwent 266 BPA interventions (median, five per patient) at two German institutions. All patients underwent a comprehensive diagnostic work-up including right heart catheterisation at baseline and 24 weeks after their last intervention.

BPA resulted in improvements in WHO functional class, 6 min walk distance (mean change, +33 m), right ventricular function and haemodynamics, including a decline in mean pulmonary artery pressure by 18% and in pulmonary vascular resistance by 26%. Procedure-related adverse events occurred in 9.4% of the interventions. The most common complications were related to pulmonary vascular injury and consecutive pulmonary bleeding. Most of these events were asymptomatic and self-limiting, but one patient died from pulmonary bleeding, resulting in a mortality rate of 1.8%.

BPA resulted in haemodynamic and clinical improvements but was also associated with a considerable number of complications, including one fatal pulmonary bleeding. As the effects of BPA on survival are unknown, randomised controlled outcome trials comparing BPA with approved medical therapies in patients with inoperable CTEPH are required to allow for appropriate risk–benefit assessments.
Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes
Authors: Sardu Celestino , Barbieri Michelangela , Santamaria Matteo , Giordano Valerio , Sacra Cosimo , Paolisso Pasquale , Spirito Alessandro , Marfella Raffaele , Paolisso Giuseppe , Rizzo Maria Rosaria
Published: June 2017

Background

Type 2 diabetes mellitus (T2DM) is a multi factorial disease, affecting clinical outcomes in failing heart patients treated by cardiac resynchronization therapy with a defibrillator (CRT-d).

Methods

One hundred and ninety-five T2DM patients received a CRT-d treatment. Randomly the study population received a CRT-d via multipolar left ventricle (LV) lead pacing (n 99, multipolar group), vs a CRT-d via bipolar LV pacing (n 96, bipolar group). These patients were followed by clinical, and instrumental assessment, and telemetric device control at follow up. In this study we evaluated, in a population of failing heart T2DM patients, cardiac deaths, all cause deaths, arrhythmic events, CRT-d responders rate, hospitalizations for HF worsening, phrenic nerve stimulation (PNS), and LV catheter dislodgment events (and re-intervention for LV catheter re-positioning), comparing multipolar CRT-d vs bipolar CRT-d group of patients at follow up.

Results

At follow up there was a statistical significant difference about atrial arrhythmic events [7 (7%) vs 16 (16.7%), p value 0.019], hospitalizations for HF worsening [15 (15.2% vs 24 (25%), p value 0.046], LV catheter dislodgments [1 (1%) vs 9 (9.4%), p value 0018], PNS [5 (5%) vs 18 (18.7%), p value 0.007], and LV re-positioning [1 (1%) vs 9 (9.4%), p value 0.018], comparing multipolar CRT-d vs bipolar CRT-d group of patients. Multipolar pacing was an independent predictor of all these events.

Conclusions

CRT-d pacing via multipolar LV lead vs bipolar LV lead may reduce arrhythmic burden, hospitalization rate, PNS, LV catheters dislodgments, and re-interventions in T2DM failing heart patients.

Clinical trial number NCT03095196
Success in bone marrow failure? Novel therapeutic directions based on the immune environment of myelodysplastic syndromes
Authors: Cull Alyssa H , Rauh Michael J
Published: June 2017

Myelodysplastic syndromes (MDS) are clonal neoplasms of aging that are associated with BM failure, related cytopenias, fatigue, susceptibility to infections, bruising, bleeding, a shortened lifespan, and a propensity for leukemic transformation. Most frail, elderly patients are not candidates for curative allogeneic BM transplantations and instead receive expectant management, supportive blood transfusions, or empirical, nontargeted therapy. It has been known for some time that MDS arises in an abnormal BM immune environment; however, connections have only recently been established with recurring MDS-associated mutations. Understanding how mutant clones alter and thrive in the immune environment of marrow failure at the expense of normal hematopoiesis opens the door to novel therapeutic strategies that are aimed at restoring immune and hematopoietic balance. Several examples are highlighted in this review. Haploinsufficiency of microRNAs 145 and 146a in MDS with chromosome 5q deletions leads to derepression of TLR4 signaling, dysplasia, and suppression of normal hematopoiesis. Moreover, mutations of TET2 or DNMT3A—regulators of cytosine methylation—are among the earliest in myeloid cancers and are even found in healthy adults with cryptic clonal hematopoiesis. In innate immune cells, TET2 and DNMT3A mutations impair the resolution of inflammation and production of type I IFNs, respectively. Finally, a common result of MDS-associated mutations is the inappropriate activation of the NLRP3 inflammasome, with resultant pyroptotic cell death, which favors mutant clone expansion. In summary, MDS-associated mutations alter the BM immune environment, which provides a milieu that is conducive to clonal expansion and leukemic progression. Restoring this balance may offer new therapeutic avenues for patients with MDS.
Anesthetic and Obstetric Management of Syringomyelia During Labor and Delivery: A Case Series and Systematic Review
Authors: Garvey Gráinne Patricia , Wasade Vibhangini S. , Murphy Kellie E. , Balki Mrinalini
Published: June 2017

BACKGROUND:

Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management.

METHODS:

A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken. Hospital records and electronic databases were interrogated usingInternational Classification of Diseases, 10th Revisioncodes and the keywords “syringomyelia,” “syringobulbia,” and “pregnancy.” Data regarding demographics, diagnosis, radiology reports, neurological symptoms, mode of delivery, anesthetic management, and maternal-fetal outcomes were collected.

RESULTS:

We collected and analyzed data on a total of 43 pregnancies in 39 patients. The most common location for syrinx was in the cervicothoracic region (41.9%). The large majority of patients (n = 34; 87%) demonstrated signs and symptoms associated with syringomyelia before delivery. Syringomyelia associated with Arnold Chiari malformation was documented in 49% (n = 21) cases. General anesthesia was the most commonly used (n = 21/30, 70%) anesthetic technique for cesarean delivery. The majority (n = 9/13, 69%) of patients had an epidural sited for labor analgesia. There were no maternal or neonatal complications associated with neuraxial anesthesia; however, 3 cases (14%) raised concerns regarding general anesthesia including difficult intubation, transient worsening of neurological symptoms postpartum, and prolonged muscle paralysis after atracurium.

CONCLUSIONS:

Despite concerns regarding aggravation of the syrinx with vaginal delivery, this mode of delivery has never caused any documented long-term worsening of neurological condition. All techniques of anesthesia have been performed successfully without major lasting complications. All cases necessitate patient counseling and individualized multidisciplinary involvement to ensure maternal safety.
Perioperative Temperature Measurement Considerations Relevant to Reporting Requirements for National Quality Programs Using Data From Anesthesia Information Management Systems
Authors: Epstein Richard H. , Dexter Franklin , Hofer Ira S. , Rodriguez Luis I. , Schwenk Eric S. , Maga Joni M. , Hindman Bradley J.
Published: June 2017

BACKGROUND:

Perioperative hypothermia may increase the incidences of wound infection, blood loss, transfusion, and cardiac morbidity. US national quality programs for perioperative normothermia specify the presence of at least 1 “body temperature” ≥35.5°C during the interval from 30 minutes before to 15 minutes after the anesthesia end time. Using data from 4 academic hospitals, we evaluated timing and measurement considerations relevant to the current requirements to guide hospitals wishing to report perioperative temperature measures using electronic data sources.

METHODS:

Anesthesia information management system databases from 4 hospitals were queried to obtain intraoperative temperatures and intervals to the anesthesia end time from discontinuation of temperature monitoring, end of surgery, and extubation. Inclusion criteria included age >16 years, use of a tracheal tube or supraglottic airway, and case duration ≥60 minutes. The end-of-case temperature was determined as the maximum intraoperative temperature recorded within 30 minutes before the anesthesia end time (ie, the temperature that would be used for reporting purposes). The fractions of cases with intervals >30 minutes between the last intraoperative temperature and the anesthesia end time were determined.

RESULTS:

Among the hospitals, averages (binned by quarters) of 34.5% to 59.5% of cases had intraoperative temperature monitoring discontinued >30 minutes before the anesthesia end time. Even if temperature measurement had been continued until extubation, averages of 5.9% to 20.8% of cases would have exceeded the allowed 30-minute window. Averages of 8.9% to 21.3% of cases had end-of-case intraoperative temperatures <35.5°C (ie, a quality measure failure).

CONCLUSIONS:

Because of timing considerations, a substantial fraction of cases would have been ineligible to use the end-of-case intraoperative temperature for national quality program reporting. Thus, retrieval of postanesthesia care unit temperatures would have been necessary. A substantive percentage of cases had end-of-case intraoperative temperatures below the 35.5°C threshold, also requiring postoperative measurement to determine whether the quality measure was satisfied. Institutions considering reporting national quality measures for perioperative normothermia should consider the technical and logistical issues identified to achieve a high level of compliance based on the specified regulatory language.
Dietary saccharides and sweet tastants have differential effects on colonization ofDrosophilaoocytes byWolbachiaendosymbionts
Authors: Camacho Moises , Oliva Mailin , Serbus Laura R.
Published: June 2017

Wolbachia bacteria are widespread, maternally transmitted endosymbionts of insects. Maintenance of sufficient Wolbachia titer in maternal germline cells is required for transmission efficacy. The mechanisms that regulate Wolbachia titer are not well understood; however, dietary sucrose was reported to elevate oocyte Wolbachia titer in D. melanogaster whereas dietary yeast decreased oocyte titer. To further investigate how oocyte Wolbachia titer is controlled, this study analyzed the response of wMel Wolbachia to diets enriched in an array of natural sugars and other sweet tastants. Confocal imaging of D. melanogaster oocytes showed that food enriched in dietary galactose, lactose, maltose and trehalose elevated Wolbachia titer. However, oocyte Wolbachia titers were unaffected by exposure to the sweet tastants lactulose, erythritol, xylitol, aspartame and saccharin as compared to the control. Oocyte size was generally non-responsive to the nutrient-altered diets. Ovary size, however, was consistently smaller in response to all sugar- and sweetener-enriched diets. Furthermore, most dietary sugars administered in tandem with dietary yeast conferred complete rescue of oocyte titer suppression by yeast. All diets dually enriched in yeast and sugar also rescued yeast-associated ovary volume changes. This indicates oocyte colonization by Wolbachia to be a nutritionally sensitive process regulated by multiple mechanistic inputs.
Rapid growth causes abnormal vaterite formation in farmed fish otoliths
Authors: Reimer T. , Dempster T. , Wargelius A. , Fjelldal P. G. , Hansen T. , Glover K. A. , Solberg M. F. , Swearer S. E.
Published: June 2017

Sagittal otoliths are essential components of the sensory organs that enable all teleost fish to hear and maintain balance, and are primarily composed of calcium carbonate. A deformity, where aragonite (the normal crystal form) is replaced with vaterite, was first noted over 50 years ago but its underlying cause is unresolved. We evaluated the prevalence of vateritic otoliths from two captive rearing studies which suggested that fast growth, due to environmental rather than genetic control, led to vaterite development. We then tested this by varying light and temperature to create phenotypes with different growth rates, which resulted in fast growers (5x larger) having 3 times more vaterite than slow growers. A decrease in either the ratio of otolith matrix proteins (otolin-1/OMM-64) or [Ca2+]/[CO32–] may explain why fast growth causes vaterite deposition. As vaterite decreases hearing sensitivity, reducing growth rates in hatcheries may improve the welfare of farmed fish and increase the success of conservation efforts.
Changes in mechanical work during neural adaptation to asymmetric locomotion
Authors: Selgrade Brian P. , Thajchayapong Montakan , Lee Gloria E. , Toney Megan E. , Chang Young-Hui
Published: June 2017

Minimizing whole body metabolic cost has been suggested to drive the neural processes of locomotor adaptation. Mechanical work performed by the legs should dictate the major changes in whole body metabolic cost of walking while providing greater insight into temporal and spatial mechanisms of adaptation. We hypothesized changes in mechanical work by the legs during an asymmetric split-belt walking adaptation task could explain previously observed changes in whole body metabolic cost. We predicted subjects would immediately increase mechanical work performed by the legs when first exposed to split-belt walking, followed by a gradual decrease throughout adaptation. Fourteen subjects walked on a dual-belt, instrumented treadmill. Baseline trials were followed by a ten-minute split-belt adaptation condition with one belt running three times faster than the other. A post-adaptation trial with both belts moving at 0.5m/s demonstrated neural adaptation. As predicted, summed mechanical work from both legs initially increased abruptly and gradually decreased over the adaptation period. The initial increase in work was primarily due to increased positive work by the leg on the fast belt during the pendular phase of the gait cycle. Neural adaptation in asymmetric split-belt walking reflected the reduction of pendular phase work in favor of more economical step-to-step transition work. This may represent a generalizable framework for how humans initially and chronically learn new walking patterns.
Low levels of extracellular glucose limit cardiac anaerobic metabolism in some species of fish
Authors: Clow Kathy A. , Short Connie E. , Driedzic William R.
Published: June 2017

There is a wide interspecific range in plasma glucose levels in teleosts from less than 0.5 to greater than 10 mmol l−1. Here it is assessed how glucose availability influences glucose metabolism in hearts of Atlantic cod (Gadus morhua), rainbow trout (Oncorhynchus mykiss), lumpfish (Cyclopterus lumpus) and short-horned sculpin (Myoxocephalus scorpius) under normoxic and hypoxic conditions. These species had plasma glucose levels of 5.1, 4.8, 0.9 and 0.5 mmol l−1, respectively. Rates of glucose metabolism and lactate production were determined in isolated hearts perfused with media containing physiological levels of glucose. Under normoxic conditions there was no significant difference in rates of either glucose metabolism (average 15 nmol g−1 min−1) or lactate production (average 30 nmol g−1 min−1) across species. Under hypoxia (12% of air saturation) there were significant increases in rates of glucose metabolism and lactate production in hearts from Atlantic cod (glucose - 130; lactate - 663 nmol g−1 min−1) and rainbow trout (glucose - 103; lactate - 774 nmol g−1 min−1); however, there was no change in rate of glucose metabolism in hearts from either lumpfish or short-horned sculpin and only increases in lactate production to rates much lower than the other species. Furthermore, Atlantic cod hearts perfused with medium containing low non-physiological levels of glucose (0.5 mmol l−1) had the same rates of glucose metabolism under normoxic and hypoxic treatment. Anaerobic metabolism supported by extracellular glucose is compromised in fish with low levels of plasma glucose which in turn may decrease performance under oxygen limiting conditions at the whole animal level.