bluuebunny/crossref_metadata_2025 huggingface dataset:
An Experimental Investigation of the Refrigerant Adsorption Performance of Carbon Nanotube-Activated Carbon Mixtures
Authors: Anas N. S. , Thomas Shijo , Sobhan C. B. , Peterson G. P.
Published: April 2017

The research reported here presents the results of an experimental investigation of the adsorption performance of different combinations of activated carbon and multi-walled carbon nanotubes mixtures (7.5–25%), as an adsorbent material for refrigerant R-134a, with the application potential in vapor adsorption refrigeration systems. The specific adsorbance was found to increase with the addition of carbon nanotubes to activated carbon. The experimental data were used to calculate the isosteric heat of adsorption using the Clausius–Clapeyron equation, and study its variation with the specific adsorbance for the mixture with the highest percentage of carbon nanotubes, and compare the results with that for activated carbon. The increase in the specific adsorption capacity upon addition of carbon nanotubes was interpreted as due to an increase in the pore volume, which in turn increases the specific surface area of the adsorbent material.
Loss and recovery of functional connectivity in cultured cortical networks exposed to hypoxia
Authors: le Feber Joost , Erkamp Niels , van Putten Michel J. A. M. , Hofmeijer Jeannette
Published: April 2017

In the core of a brain infarct, loss of neuronal function is followed by neuronal death within minutes. In an area surrounding the core (penumbra), some perfusion remains. Here, neurons initially remain structurally intact, but massive synaptic failure strongly reduces neural activity. Activity in the penumbra may eventually recover or further deteriorate toward massive cell death. Besides activity recovery, return of brain functioning requires restoration of connectivity. However, low activity has been shown to initiate compensatory mechanisms that affect network connectivity. We investigated the effect of transient hypoxia and compensatory mechanisms on activity and functional connectivity using cultured cortical networks on multielectrode arrays. Networks were exposed to hypoxia of controlled depth (10–90% of normoxia) and duration (6–48 h). First, we determined how hypoxic depth and duration govern activity recovery. Then, we investigated connectivity changes during and after hypoxic incidents, mild enough for activity to recover. Shortly after hypoxia onset, activity and connectivity decreased. Following 4–6 h of ongoing hypoxia, we observed partial recovery. Only if the hypoxic burden was limited did connectivity show further recovery upon return to normoxia. Partial recovery during hypoxia was dominated by restored baseline connections, rather than newly formed ones. Baseline strengths of surviving (persisting or recovered) and lost connections did not differ nor did baseline activity at their “presynaptic” electrodes. However, “postsynaptic” electrodes of surviving connections were significantly more active during baseline than those of lost connections. This implies that recovery during hypoxia reflects an effective mechanism to restore network activity, which does not necessarily conserve prehypoxia connectivity.

NEW & NOTEWORTHY Hypoxia reduced the firing rates of cultured neurons. Depending on hypoxic depth and duration, activity recovered during hypoxia and upon return to normoxia. Recovery (partial) during hypoxia was associated with restored baseline connections rather than newly formed ones. Predominantly, baseline connections with most active postsynaptic electrodes recovered, supporting the notion of effective activity homeostasis. This compensatory mechanism remained effective during ~20 h of hypoxia. Beyond 20 h of compensation, loss of activity and connectivity became irreversible.
Primary Villoglandular Mucinous Adenocarcinoma of the Vulva
Authors: Matsuzaki Akiko , Saio Masanao , Kosuge Noritake , Aoyama Hajime , Tamaki Tomoko , Matsumoto Hirofumi , Yoshimi Naoki
Published: April 2017

Primary villoglandular mucinous adenocarcinoma of the vulva is rare tumor. We report a case of 68-year-old woman who developed this very uncommon malignant tumor. Immunohistochemical examination of this tumor revealed positive staining for Cytokeratin 20, Mucin 2, and CDX2, although Cytokeratin 7 and Mucin 6 were negative. This positive staining indicated the tumor enteric type characters. In order to exclude the possibility of the metastasis from another site, we thoroughly evaluated clinical data and extensively investigated the whole body. However, we could not detect any other tumors. The patient was treated by tumor resection. The patient remains free of disease 5 years after surgery.
Complete Ectopia Cordis: A Case Report and Literature Review
Authors: Pius Simon , Abubakar Ibrahim Halima , Bello Mustapha , Bashir Tahir Mohammed
Published: April 2017

Ectopia cordis is a congenital heart exposure defined as complete or partial protrusion of heart through ventral defect in the thoracoabdominal wall alone or with other viscera in cases of pentalogy of Cantrell. This condition was first described by Haller et al. in 1706; since then many advances have been made. Diagnosis of ectopia cordis is done prenatally in well-equipped health facility by antenatal ultrasound scan so that early diagnosis and management plan can be initiated. The index case was delivered to uneducated rural family and admitted at 3 days of life and survived for seven days, even though most literatures state that majority died within four days even with surgery. So, in view of this, we presented this case report to deliberately draw the attention of paediatrician/obstetrician to the fact that even though this condition is rare, proactive search and diagnosis should be made and early treatment should be instituted, so that such a child may be salvaged.
A Frailty Index from Next-of-Kin Data: A Cross-Sectional Analysis from the Mexican Health and Aging Study
Authors: Pérez-Zepeda Mario Ulises , Cesari Matteo , Carrillo-Vega María Fernanda , Salinas-Escudero Guillermo , Tella-Vega Pamela , García-Peña Carmen
Published: April 2017

Objectives. To construct a frailty index from next-of-kin information of the last year of life of community-dwelling 50 years old or older adults and test its association with health services utilization. Methods. Cross-sectional analysis from next-of-kin data available from the last wave of the Mexican Health and Aging Study (MHAS). Measurements. Along with descriptive statistics, the frailty index (FI) was tested in regression models to assess its association with adverse outcomes previous to death: number of hospitalized days in the previous year and number of visits to a physician in the previous year, in unadjusted and adjusted models. Results. From a total of 2,649 individuals the mean of age was 74.8 (±11.4) and 56.3% (n = 1,183) were women. The mean of the FI was of 0.279 (±SD 0.131, R = 0.0–0.738) and distribution was biased to the right. There was a significant association (p < 0.001) between the FI and number of hospitalized days (β = 45.7, 95% CI 36.1–55.4, p < 0.001) and for the number of visits to a physician (β = 25.93, 95% CI 19.27–32.6, p < 0.001) both models adjusted for age and sex. Conclusion. The FI constructed with next-of-kin data showed similar characteristics to similar indexes of older adults. It was independently associated with health care use.
Therapeutic Effects of Phytochemicals and Medicinal Herbs on Depression
Authors: Lee Gihyun , Bae Hyunsu
Published: April 2017

Background. Depression is a recurrent, common, and potentially life-threatening psychiatric disease related to multiple assignable causes. Although conventional antidepressant therapy can help relieve symptoms of depression and prevent relapse of the illness, complementary therapies are required due to disadvantage of the current therapy such as adverse effects. Moreover, a number of studies have researched adjunctive therapeutic approaches to improve outcomes for depression patients. Purpose. One potential complementary method with conventional antidepressants involves the use of medicinal herbs and phytochemicals that provide therapeutic benefits. Studies have revealed beneficial effects of medical herbs and phytochemicals on depression and their central nervous system mechanism. Here, we summarize the current knowledge of the therapeutic benefits of phytochemicals and medicinal herbs against depression and describe their detailed mechanisms. Sections. There are two sections, phytochemicals against depression and medical herbs against depression, in this review. Conclusion. Use of phytomedicine may be an alternative option for the treatment of depression in case conventional drugs are not applicable due to their side effects, low effectiveness, or inaccessibility. However, the efficacy and safety of these phytomedicine treatments for depression have to be supported by clinical studies.
Collagen External Scaffolds Mitigate Intimal Hyperplasia and Improve Remodeling of Vein Grafts in a Rabbit Arteriovenous Graft Model
Authors: Li Haiming , Chai Shoudong , Dai Longsheng , Gu Chengxiong
Published: April 2017

Objectives. The aim of this study was to test the effects of collagen external scaffold (CES) in intimal hyperplasia of vein grafts and explore its underlying mechanisms. Methods. Thirty-six New Zealand white rabbits were randomized into no-graft group, graft group, and CES group. The rabbit arteriovenous graft model was established. In CES group, the vein graft was wrapped around with CES. The hemodynamic parameters of vein grafts were measured intraoperatively and 4 weeks after operation by ultrasonic examination. Histological characteristics of vein grafts were also evaluated 4 weeks later. The mRNA and protein levels of proliferating cell nuclear antigen (PCNA), active cleaved-caspase-3 (ClvCasp-3), and smooth muscle 22 alpha (SM22α) were measured 4 weeks later by quantitative real-time PCR and western blot. Results. CES significantly improved the hemodynamic stability of vein grafts, with higher blood velocity and blood flow. Similarly, CES also markedly mitigated intimal hyperplasia and inhibited dilatation of vein grafts. In CES group, the upexpression of PCNA and ClvCasp-3 and the downexpression of SM22α were inhibited. Conclusion. CES exerts beneficial effects in mitigating intimal hyperplasia and improving remodeling of autogenous vein grafts, which may be associated with reducing the proliferation and apoptosis and preserving the phenotype of VSMCs.
Games Based Study of Nonblind Confrontation
Authors: Yang Yixian , Niu Xinxin , Peng Haipeng
Published: April 2017

Security confrontation is the second cornerstone of the General Theory of Security. And it can be divided into two categories: blind confrontation and nonblind confrontation between attackers and defenders. In this paper, we study the nonblind confrontation by some well‐known games. We show the probability of winning and losing between the attackers and defenders from the perspective of channel capacity. We establish channel models and find that the attacker or the defender wining one time is equivalent to one bit transmitted successfully in the channel. This paper also gives unified solutions for all the nonblind confrontations.
A Phase I Study of ABC294640, a First-in-Class Sphingosine Kinase-2 Inhibitor, in Patients with Advanced Solid Tumors
Authors: Britten Carolyn D. , Garrett-Mayer Elizabeth , Chin Steven H. , Shirai Keisuke , Ogretmen Besim , Bentz Tricia A. , Brisendine Alan , Anderton Kate , Cusack Susan L. , Maines Lynn W. , Zhuang Yan , Smith Charles D. , Thomas Melanie B.
Published: April 2017

Purpose: Sphingosine kinases (SK1 and SK2) regulate tumor growth by generating the mitogenic and proinflammatory lipid sphingosine 1-phosphate (S1P). This phase I study investigated the safety, pharmacokinetics, pharmacodynamics, and antitumor activity of ABC294640, a first-in-class orally available inhibitor of SK2.

Experimental Design: Escalating doses of ABC294640 were administered orally to patients with advanced solid tumors in sequential cohorts at the following dose levels: 250 mg qd, 250 mg bid, 500 mg bid, and 750 mg bid, continuously in cycles of 28 days. Serial blood samples were obtained to measure ABC294640 concentrations and sphingolipid profiles.

Results: Twenty-two patients were enrolled, and 21 received ABC294640. The most common drug-related toxicities were nausea, vomiting, and fatigue. Among the 4 patients at 750 mg bid, one had dose-limiting grade 3 nausea and vomiting, and 2 were unable to complete cycle 1 due to diverse drug-related toxicities. The 500 mg bid dose level was established as the recommended phase II dose. ABC294640 administration resulted in decreases in S1P levels over the first 12 hours, with return to baseline at 24 hours. The best response was a partial response in a patient with cholangiocarcinoma at 250 mg qd, and stable disease was observed in 6 patients with various solid tumors across dose levels.

Conclusions: At 500 mg bid, ABC294640 is well tolerated and achieves biologically relevant plasma concentrations. Changes in plasma sphingolipid levels may provide a useful pharmacodynamic biomarker for ABC294640. Clin Cancer Res; 23(16); 4642–50. ©2017 AACR.
Food Intake, Diet Quality and Behavioral Problems in Children: Results from the GINI-plus/LISA-plus Studies
Authors: Kohlboeck Gabriele , Sausenthaler Stefanie , Standl Marie , Koletzko Sibylle , Bauer Carl-Peter , von Berg Andrea , Berdel Dietrich , Krämer Ursula , Schaaf Beate , Lehmann Irina , Herbarth Olf , Heinrich Joachim ,   for the GINI-plus and LISA-plus Study Groups
Published: April 2017

Background/Aims: To assess the association between food intake and diet quality and behavioral problems at the 10-year follow-up of the two population-based birth cohorts of the studies German Infant Nutritional Intervention and ‘Influences of lifestyle-related factors on the immune system and the development of allergies in childhood’. Methods: Cross-sectional data on food intake over the past year were collected by a parent-reported food frequency questionnaire. Diet quality was based on reference values of food amounts of the optimized mixed diet. Behavioral problems were assessed by a parent-reported Strengths and Difficulties Questionnaire. Relationships between food category intake, diet quality and behavior problems were examined using multivariable regression modeling adjusted for gender, sociodemographic characteristics, body mass index, physical exercise, television viewing/PC use and total energy intake. A total of 3,361 children with complete data were analyzed. Results: Children with increased intake of confectionery had increased odds of having emotional symptoms [adjusted odds ratio (ORadj) 1.19, 95% confidence interval (CI) 1.08–1.32] compared to children with low intake. A higher diet quality score was associated with lower likelihood of emotional symptoms (ORadj 0.89, 95% CI 0.80–0.98). The unadjusted significant relationship between diet quality and hyperactivity/inattention was attenuated by adjusting for several confounders to an ORadj of 0.92 (95% CI 0.82–1.03). Conclusions: Increased consumption of high-sugar products and lower diet quality are associated with a higher likelihood of emotional symptoms in children.
The Role of Behaviour in Inequality in Increments of Dental Caries among Finnish Adults
Authors: Sabbah Wael , Suominen Anna L. , Vehkalahti Miira M. , Aromaa Arpo , Bernabé Eduardo
Published: April 2017

Background: Evidence from cross-sectional studies implies that dental behaviours partially explain inequalities in oral health. Objective: To assess whether dental behaviours completely eliminate inequality in increments of dental caries in a sample of Finnish adults. Methods: The baseline data were collected from the Health 2000 survey, a nationally representative survey of 8,028 individuals aged 30 years or older living in mainland Finland. Four years later, 1,248 subjects were invited for oral re-examination, and 1,049 agreed to participate (84% response rate). At baseline, participants provided information on demographics, education and dental behaviours (dental attendance, tooth brushing with fluoride toothpaste, sugar consumption and daily smoking). Oral examinations at baseline and follow-up were identical. Results: Adults with basic education had significantly greater increments of DMFT (incidence rate ratio 1.41, 95% CI 1.07-1.85) and DT (incidence rate ratio 2.23, 95% CI 1.27-3.90) than those with high education. Adjusting for single behaviours attenuated but did not eliminate education inequality in DMFT and DT increments, tooth brushing having the greatest impact on inequality. Simultaneous adjustment for all behaviours eliminated the significant relationship between education and caries increment. Conclusions: Accounting for important dental behaviours appears to explain all education inequality in dental caries in Finnish adults. The results should be interpreted with caution when applied to less egalitarian populations.
Laparoscopic Lysis of the Ligament of Treitz for Superior Mesenteric Artery Syndrome
Authors: Fang Jia-feng , Wei Bo , Zheng Zong-heng , Lei Pu-run , Chen Tu-feng , Wei Hong-bo
Published: April 2017

Background: Superior mesenteric artery (SMA) syndrome (SMAS) is a rare condition caused by compression of the third portion of the duodenum by the SMA. The effect of the laparoscopic management of SMAS remains poorly understood. This study aimed to investigate the feasibility and effect of the laparoscopic management for SMAS. Methods: We retrospectively reviewed 19 cases of SMAS who underwent surgical interventions in The Third Affiliated Hospital of Sun Yat-sen University between June 2006 and October 2013, consisting of 8 cases of duodenojejunostomy (DJ) and 11 cases of laparoscopic lysis of the ligament of Treitz (LL-LOT). A telephone survey was conducted to collect the follow-up status. Results: Either DJ or LL-LOT was performed smoothly. The median operative time of the laparoscopic procedure and DJ was 56 and 95 min, respectively. Median blood loss was 10 versus 35 ml. Median postoperative hospital stays in both were 8 days. Ten cases of the laparoscopic group recovered uneventfully, while 1 case still presented symptoms of abdominal distention. Upper gastrointestinal fluoroscopy showed marked ‘to-and-fro' peristalsis. An additional DJ was performed 35 days later to resolve her symptoms. Conclusions: LL-LOT is simple, feasible, minimally invasive and effective for SMAS with no severe duodenum ‘to-and-fro' peristalsis. i 2014 S. Karger AG, Basel
Combining Virtual Touch Tissue Imaging and BI-RADS May Improve Solid Breast Lesion Evaluation
Authors: Wu Size , Cui Xiaojing , Huang Li , Bai Xuefei
Published: April 2017

Background: Ultrasound elastography (UE) is a novel imaging method. The purpose of this study was to determine the utility of Virtual Touch tissue imaging in the evaluation of solid breast lesions. Patients and Methods: 209 breast solid lesions in 192 patients that had been evaluated using ultrasound (US) and UE were reviewed and analyzed. Results: The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for UE, US, and US plus UE in the differentiation of malignant from benign breast lesions were 80.8, 75.6, 77.9, 73.1, and 82.8% for UE, 87.2, 86.1, 86.6, 83.7, and 89.2% for US, and 92.5, 86.9, 89.5, 85.3, and 93.4% for US plus UE. There were significant differences between UE and US plus UE (all p < 0.05). Except for accuracy, there were no significant differences between UE and US or US and US plus UE (all p > 0.05). The area under the curve obtained from the ROC curve for UE, US, and US plus UE in differentiating malignant from benign lesions was 0.845, 0.884, and 0.922, respectively. Conclusion: The UE scoring system is not superior to BI-RADS in the sonographic evaluation of solid breast lesions. Combined use may improve the performance.
Evaluating Weight Status and Sex as Moderators of the Association of Serum Leptin with Bone Mineral Density in Children and Adolescents
Authors: Armaiz-Flores Sara A. , Kelly Nichole R. , Galescu Ovidiu A. , Demidowich Andrew P. , Altschul Anne M. , Brady Sheila M. , Hubbard Van S. , Pickworth Courtney K. , Tanofsky-Kraff Marian , Shomaker Lauren B. , Reynolds James C. , Yanovski Jack A.
Published: April 2017

Background/Aims: Animal studies suggest that leptin may adversely affect bone mineral density (BMD). Clinical studies have yielded conflicting results. We therefore investigated associations between leptin and bone parameters in children. Methods: 830 healthy children (age = 11.4 ± 3.1 years; 75% female; BMI standard deviation score [BMIz] = 1.5 ± 1.1) had fasting serum leptin measured with ELISA and body composition by dual-energy X-ray absorptiometry. The main effects for leptin and BMIz plus leptin’s interactions with sex and BMIz were examined using hierarchical linear regressions for appendicular, pelvis, and lumbar spine BMD as well as bone mineral content (BMC), and bone area (BA). Results: Accounting for demographic, pubertal development, and anthropometric variables, leptin was negatively and independently associated with lumbar spine BMC and BA, pelvis BA, and leg BA (p < 0.05 for all). Sex, but not BMIz, moderated the associations of leptin with bone parameters. In boys, leptin was negatively correlated with leg and arm BMD, BMC at all bone sites, and BA at the subtotal and lumbar spine (p < 0.01 for all). In girls, leptin was positively correlated with leg and arm BMD (p < 0.05 for both). Conclusion: Independent of body size, leptin is negatively associated with bone measures; however, these associations are moderated by sex: boys, but not girls, have a negative independent association between leptin and BMD.
Expanding Genetic and Functional Diagnoses of IGF1R Haploinsufficiencies
Authors: Ocaranza Paula , Golekoh Marjorie C. , Andrew Shayne F. , Guo Michael H. , Kaplowitz Paul , Saal Howard , Rosenfeld Ron G. , Dauber Andrew , Cassorla Fernando , Backeljauw Philippe F. , Hwa Vivian
Published: April 2017

Background: The growth-promoting effects of IGF-I is mediated through the IGF-I receptor (IGF1R), a widely expressed cell-surface tyrosine kinase receptor. IGF1R copy number variants (CNV) can cause pre- and postnatal growth restriction or overgrowth. Methods: Whole exome sequence (WES), chromosomal microarray, and targeted IGF1R gene analyses were performed on 3 unrelated children who share features of small for gestational age, short stature, and elevated serum IGF-I, but otherwise had clinical heterogeneity. Fluorescence-activated cell sorting (FACS) analysis of cell-surface IGF1R was performed on live primary cells derived from the patients. Results: Two novel IGF1R CNV and a heterozygous IGF1R nonsense variant were identified in the 3 patients. One CNV (4.492 Mb) was successfully called from WES, utilizing eXome-Hidden Markov Model (XHMM) analysis. FACS analysis of cell-surface IGF1R on live primary cells derived from the patients demonstrated a ∼50% reduction in IGF1R availability associated with the haploinsufficiency state. Conclusion: In addition to conventional methods, IGF1R CNV can be identified from WES data. FACS analysis of live primary cells is a promising method for efficiently evaluating and screening for IGF1R haploinsufficiency. Further investigations are necessary to delineate how comparable IGF1R availability leads to the wide spectrum of clinical phenotypes and variable responsiveness to rhGH therapy.
Excessive Weight Favours Skin Physiology - Up to a Point: Another Expression of the Obesity Paradox
Authors: Monteiro Rodrigues Luís Monteiro , Palma Lídia , Santos Osvaldo , Almeida Maria Angélica , Bujan Julia , Tavares Liliana
Published: April 2017

Background/Aims: Recently classified as an epidemic by the WHO, obesity (as well as the state of being overweight) clearly affects significant populations across all ages. The relationship between obesity and some diseases (e.g. cardiovascular ones) is known, although many paradoxes remain to be explained. Very little information is available, however, regarding its impact on skin physiology and skin disease. This study aims to examine the influence of excessive weight on epidermal hydration and transepidermal water loss, key variables of skin water balance and skin biomechanics. Methods: A convenience sample of 89 healthy female volunteers was selected and divided into 4 groups, according to their BMI (body mass index), as normal (control), overweight, obese (I and II), and morbid. Skin physiology was quantitatively assessed in all individuals in 4 anatomical areas using non-invasive biometrical analysis by reference instrumentation. Descriptive and comparative statistics were applied, adopting a confidence level of 95%. Results: A non-linear alteration for all variables was detected as a function of BMI. Conclusion: Results suggest that excessive weight might favour skin performance within certain limits, reflecting a particular adaptation of the skin to the weight gain and body contour.
Determinants of Advanced Bone Age in Childhood Obesity
Authors: de Groot Cornelis J. , van den Berg Adriaan , Ballieux Bart E.P.B. , Kroon Herman M. , Rings Edmond H.H.M. , Wit Jan M. , van den Akker Erica L.T.
Published: April 2017

Background: Childhood obesity is associated with advanced bone age (BA). Previous studies suggest that androgens, oestrogens, sex hormone-binding globulin, and insulin are responsible for this phenomenon, but results are contradictory and might be biased by confounders. We aim to elucidate this matter by applying a multivariate approach. Method: We performed a correlation analysis of BA standard deviation score (SDS) with age- and sex-specific SDS for androgens, oestrogens, and with indicators of insulin secretion derived from oral glucose tolerance testing, in a group of obese children. A multivariate analysis was performed to investigate which parameters were independently predictive of BA SDS. Results: In this cohort (n = 101; mean age 10.9 years; mean BA 11.8 years; mean BMI SDS 3.3), BMI SDS was significantly correlated to BA SDS (r = 0.55, p < 0.001). In a regression analysis in the total cohort (B = 0.27, p < 0.001) as well as in females (B = 0.34, p = 0.042), males (B = 0.31, p = 0.006), and pubertal children (B = 0.32, p = 0.046), dehydroepiandrosterone sulphate (DHEAS) showed a positive, independent association with BA SDS. No association with indicators of insulin secretion was found. Conclusion: BMI SDS is highly correlated to BA SDS in obese children. Increased DHEAS has a central role in advanced BA in obese children.
Pancreatitis Induced by Cocaine
Authors: Chapela Sebastián Pablo , Paz Silvina de los Angeles , Ballestero Florencia Maria
Published: April 2017

Pancreatitis is one of the commonest diseases of the gastrointestinal tract, characterized by epigastric pain of moderate to severe intensity, which radiates to the back, elevation of pancreatic lipase and amylase enzymes, and changes in pancreatic parenchyma in imaging methods. The most common etiologies vary, generally the most frequent being biliary lithiasis and alcohol, followed by hypertriglyceridemia. Among the less frequent causes is drug-induced pancreatitis. We report a case of acute pancreatitis caused by cocaine, rarely described in literature.
Cholecystoparietal Fistula Revealed by an Epigastric Abscess
Authors: Kassi Assamoi Brou Fulgence , Koffi Eric , Yénon Kacou Sébastien , Bombet-Kouamé Cynthia
Published: April 2017

Cholecystocutaneous fistula, the ultimate complication of abscessed or overlooked acute cholecystitis, is due to perforation of the gallbladder in the abdominal wall. The authors report an unusual case of cholecystoparietal fistula revealed by an epigastric abscess. Fistulography and modern imaging tools make the diagnosis easier. Surgery is the best available treatment.
Pharmacokinetic and Pharmacodynamic Modeling of MOD-4023, a Long-Acting Human Growth Hormone, in Growth Hormone Deficiency Children
Authors: Fisher Dennis M. , Rosenfeld Ron G. , Jaron-Mendelson Michal , Amitzi Leanne , Koren Ronit , Hart Gili
Published: April 2017

Background/Aims: MOD-4023 is a long-acting human growth hormone (hGH) in clinical trials for the treatment of growth hormone deficiency (GHD). A key goal is maintenance of serum concentrations of insulin-like growth factor (IGF) 1 within normal range throughout GH dosing. The study aimed to develop a pharmacokinetic model for MOD-4023 and a pharmacodynamic model for the effect of MOD-4023 on IGF-1 to allow estimation of peak and mean IGF-1 and to identify the optimal IGF-1 sampling day. Methods: MOD-4023 (0.25, 0.48, or 0.66 mg/kg) was administered weekly for 12 months to 41 GH-naive GHD children (age 3–11 years). The control group (n = 11, age 4–9 years) received daily recombinant human growth hormone (r-hGH; 34 µg/kg). Sparse samples (4/subject) were obtained to determine serum concentrations of MOD-4023 or r-hGH and IGF-1. Results: A 2-compartment pharmacokinetic model with first-order absorption fit MOD-4023 data well; a 1-compartment model was appropriate for r-hGH. For both, weight-normalized systemic parameters were preferred over allometric scaling. For MOD-4023, an indirect model fit IGF-1 SDS data well; baseline IGF-1 increased over time. At steady state, samples obtained 4 days following dose administration predicted mean IGF-1 SDS during the dosing interval well. Conclusion: The IGF-1 profile is consistent with the weekly dosing interval. Sampling 4 days following dose administration allows estimation of mean IGF-1 SDS during the dosing interval in GHD patients.
Subjective Technology Adaptivity Predicts Technology Use in Old Age
Authors: Kamin Stefan T. , Lang Frieder R. , Beyer Anja
Published: April 2017

Background: To date, not much is known about the psychological and motivational factors underlying technology use in late life. What are the interindividual determinants that lead older adults to invest in using technological innovations despite the age-related physiological changes that impose challenges on behavioral plasticity in everyday life? Objective: This research explores interindividual differences in subjective technology adaptivity - a general technology-related motivational resource that accounts for technology use in late life. More specifically, we investigate the influence of this factor relative to demographic characteristics, personality traits, and functional limitations in a longitudinal sample of community-dwelling older adults. Methods: We report results from a paper-and-pencil survey with 136 older adults between 59 and 92 years of age (mean = 71.4, SD = 7.4). Of those participants, 77 participated in a 2-year follow-up. We assessed self-reports of technology use, subjective technology adaptivity, functional limitations, and the personality traits openness to new experiences and neuroticism. Results: Higher levels of subjective technology adaptivity were associated with technology use at the first measurement as well as increased use over the course of 2 years. Conclusions: Subjective technology adaptivity is a significant predictor of technology use in old age. Our findings contribute to improving the understanding of interindividual differences when using technological innovation in late life. Moreover, our findings have implications in the context of user involvement and may contribute to the successful development of innovative technology for older adults.
A Systematic Review of Symptoms and Quality of Life Issues in Pancreatic Neuroendocrine Tumours
Authors: Topping Megan , Gray Debra , Friend Elizabeth , Davies Albert , Ramage John K.
Published: April 2017

Purpose: Pancreatic neuroendocrine tumours (pNETs) are rare neoplasms, in that they may only present symptoms of the hormone secreted, without any generic cancer issues. It is thus important to measure quality of life (QoL) in these patients by evaluating issues relevant and important to them, as opposed to general cancer issues. This paper systematically reviews papers addressing the symptoms and QoL implications of pNETs, and evaluates each subtype separately, with the aim to create a list of QoL issues relevant to these patient groups. Methods: Medline, EMBASE, CINAHL, PsycInfo, Web of Science, Scopus, OpenGrey, and the Cochrane Library were searched for publications (1990-2016) reporting symptoms and QoL issues in pNETs. Results: Following screening of 2,797 papers, 69 articles were eligible for data extraction. From these papers, 84 different symptoms or QoL issues were extracted: 21 for gastrinoma, 18 for glucagonoma, 50 for insulinoma, 10 for VIPoma and 15 for non-functioning pNETs. No issues were reported for somatostatinoma, PPoma or ACTHoma. The most frequently reported symptoms vary by subtype. Conclusions: This review emphasises the need to develop a QoL measure for pNETs with specific items relevant to the different subtypes, due to the distinct symptoms reported. Following from this review, patient and healthcare professional interviews will be conducted in large cohorts across many different countries to collect more data on QoL issues specific to pNETs. This data will all be collated with the aim to create a QoL measure for pNETs.
The teacher at the end of elementary school towards students with learning difficulties: psychic questions and defense mechanisms
Authors: Luce Catherine
Published: April 2017

Este artigo visa apresentar tensões e questões psíquicas ligadas à confrontação do professor do fim do Ensino Fundamental I com alunos com dificuldade de aprendizagem e com “necessidades educativas especiais”, de acordo com as normas institucionais. Esse profissional realiza seu trabalho no colégio em um entre-deux. Foi escolhido um método de pesquisa clínico de orientação psicanalítica. Ele permite apreender os movimentos psíquicos conscientes e inconscientes mobilizados na “personalidade profissional” e a relação específica estabelecida entre o professor de 5º ano e tais alunos ditos com necessidades especiais. A análise de entrevistas clínicas de pesquisa conduzidas com professores na França e em países francófonos valoriza modos de defesa específicos
Ortognaisse Morro do Resende: mineralogia, petrografia, geoquímica e geocronologia
Authors: Vasconcelos Fabiana Franco de , Ávila Ciro Alexandre , Neumann Reiner , Teixeira Wilson , Bongiolo Everton Marques , Barbosa Natali , Camara Beatriz de Oliveira , Menezes Victor Hugo Riboura , Cunha Fernanda Caetano de Mattos
Published: April 2017

O ortognaisse Morro do Resende aflora próximo à mina da Volta Grande, no município de Nazareno, estado de Minas Gerais, e corresponde a um corpo hololeucocrático a leucocrático, fino e de composição monzogranítica a granodiorítica. Apresenta xenólitos de rochas metamáficas da sequência metavulcano-sedimentar Rio das Mortes e possui idade de cristalização U-Pb SHRIMP de 2174 ± 4 Ma, possibilitando sua correlação a um dos pulsos magmáticos do cinturão Mineiro. Sua mineralogia primária é representada por quartzo, albita, microclínio, biotita, allanita, zircão, magnetita, titanita e apatita, enquanto os minerais metamórficos correspondem a sericita, epidoto, zoisita, clinozoisita, carbonato e clorita. Maghemita, barita, fluorita, monazita, xenotímio, granada e fluoretos de elementos de terras raras (ETR) (possivelmente gagarinita) são minerais de origem hidrotermal, pois ocorrem preenchendo fraturas, intercrescidos ou substituindo os minerais primários e metamórficos, sendo que a percolação desse fluido não ocorreu de forma homogênea ao longo de todo o corpo. A paragênese metamórfica indica condições de fácies xisto verde, que pode estar correlacionada ao evento paleproterozoico II do cinturão Mineiro, com idade entre 2131 e 2101 Ma. Esse corpo apresenta acentuado enriquecimento no conteúdo de ETR, anomalia negativa de Eu associada ao processo de cristalização magmática e anomalia negativa de Ce correlacionada à circulação de fluidos hidrotermais oxidantes.
Association Between Chronic Kidney Disease and Rates of Transfusion and Progression to End‐Stage Renal Disease in Patients Undergoing Transradial Versus Transfemoral Cardiac Catheterization—An Analysis From the Veterans Affairs Clinical Assessment Reporting and Tracking (CART) Program
Authors: Vora Amit N. , Stanislawski Maggie , Grunwald Gary K. , Plomondon Mary E. , Rumsfeld John S. , Maddox Thomas M. , Vidovich Mladen I. , Woody Walter , Nallamothu Brahmajee K. , Gurm Hitinder S. , Rao Sunil V.
Published: April 2017

Background

Patients with chronic kidney disease (
CKD
) are at increased risk for bleeding, transfusion, and dialysis after cardiac catheterization. Whether rates of these complications are increased in this high‐risk population undergoing transradial access compared with transfemoral access is unknown.

Methods and Results

From the Veterans Affairs (VA) Clinical Assessment Reporting and Tracking program, we identified 229 108 patients undergoing cardiac catheterization between 2007 and 2014, of which 48 155 (21.0%) had baseline glomerular filtration rate (
GFR
) between 15 and 59 mL/min. We used multivariable Cox modeling to determine the independent association between transradial access and postprocedure transfusion as well as progression to new dialysis by degree of renal dysfunction. Overall, 35 979 (15.7%) of patients underwent Transradial access. Transradial patients tended to be slightly younger, but, overall, had similar rates of
CKD
compared to transfemoral patients (24.3% vs 27.1%). Transradial patients had longer fluoroscopy times (7.2 vs 6.0 minutes;
P
<0.001), but lower contrast use (85.0 vs 100.0 mL;
P
<0.001). The estimated rate of blood transfusion within 48 hours was lower among transradial patients (0.85% vs 1.01%) as were rates of new dialysis at 1 year (0.58% vs 0.71%). After multivariable adjustment, transradial access was associated with lower rates of progression to dialysis at 1 year overall (hazard ratio [
HR],
0.83; 95%
CI,
0.70–0.98), with no trend of increased risk for dialysis by degree of
CKD
compared with transfemoral access. Transradial access was associated with greater reduction in transfusion rates with increasing degree of
CKD
(
P
value for trend=0.04: non‐
CKD
:
HR,
0.99; 95%
CI,
0.73–1.34;
GFR
45–59 mL/min:
HR,
0.93; 95%
CI,
0.70–1.23;
GFR
30–44 mL/min:
HR,
0.73; 95%
CI,
0.51–1.03;
GFR
15–29 mL/min:
HR,
0.43; 95%
CI,
0.20–0.90).

Conclusions

Among patients undergoing cardiac catheterization in the
VA
health system, transradial access was associated with lower risk for postprocedure transfusion within 48 hours among patients with more‐severe
CKD
, and with lower risk of progression to end‐stage renal disease at 1 year compared with transfemoral access. These data provide additional evidence that transradial access may provide significant benefit in this high‐risk population.
Association of Magnet Status With Hospitalization Outcomes for Ischemic Stroke Patients
Authors: Bekelis Kimon , Missios Symeon , MacKenzie Todd A.
Published: April 2017

Background

It is not clear whether Magnet recognition by the American Nurses Credentialing Center (nursing excellence program) is associated with improved patient outcomes. We investigated whether hospitalization in a Magnet hospital is associated with improved outcomes for patients with ischemic stroke.

Methods and Results

We performed a cohort study of patients with ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database. Propensity‐score‐adjusted multivariable regression models were used to adjust for known confounders, with mixed effects methods to control for clustering at the facility level. An instrumental variable analysis was used to control for unmeasured confounding and simulate the effect of a randomized trial. During the study period, 176 557 patients were admitted for ischemic stroke, and met the inclusion criteria. Of these, 32 092 (18.2%) were hospitalized in Magnet hospitals, and 144 465 (81.8%) in non‐Magnet institutions. Instrumental variable analysis demonstrated that hospitalization in Magnet hospitals was associated with lower case‐fatality (adjusted difference, −23.9%; 95%
CI
, −29.0% to −18.7%), length of stay (adjusted difference, −0.4; 95%
CI
, −0.8 to −0.1), and rate of discharge to a facility (adjusted difference, −16.5%; 95%
CI
, −20.0% to −13.0%) in comparison to non‐Magnet hospitals. The same associations were present in propensity‐score‐adjusted mixed effects models.

Conclusions

Using a comprehensive all‐payer cohort of patients with ischemic stroke in New York State, we identified an association of treatment in Magnet hospitals with lower case‐fatality, discharge to a facility, and length of stay. Further research into the factors contributing to the superiority of Magnet hospitals in stroke care is warranted.
Perilous Interventions and the Responsibility to Protect
Authors: Hall Ian
Published: April 2017

This article analyses Perilous Interventions: The Security Council and the Politics of Chaos by Hardeep Singh Puri, a retired senior diplomat and India’s former Permanent Representative to the United Nations in New York. It outlines the structure and argument of the book, which addresses foreign interventions in various conflicts over the past three decades, including those in Libya, Syria, Yemen, Ukraine, and Sri Lanka, and the emergence of the concept of Responsibility to Protect. It argues that Perilous Interventions is a significant, if problematic, book insofar as it signals that deep scepticism about r2p persists in important sections of the policymaking elite in New Delhi, despite India’s rising power, growing capabilities, and changing relationships with major powers, including the United States. It also introduces the remaining three articles in this special section.
India’s Reluctant Approach to r2p: Lessons from Perilous Interventions
Authors: Destradi Sandra
Published: April 2017

This contribution uses the analytical lens of ‘reluctance’ to assess some of the broader implications of the arguments made by Hardeep Singh Puri in Perilous Interventions. Based on a conceptualization of reluctance that entails the two constitutive dimensions of ‘hesitation’ and ‘recalcitrance’, the article finds that India was only moderately reluctant when it came to unscr 1973, but grew increasingly reluctant vis-à-vis r2p after military operations in Libya. Puri’s book reveals how India’s growing reluctance on r2p was shaped by the perception that the West was driven by an appetite for interventionism and regime change. These insights are helpful to make sense of the broader phenomenon of India’s and other rising powers’ reluctant approach to world politics. Reluctance can result from efforts to deal with either competing expectations articulated by different actors, or with competing norms (e.g., protection of civilians and sovereignty; status recognition as a responsible country and autonomy).
An Unusual Cause of Frequent, Sudden, Transient, Unexplained Falls and New-Onset Status Epilepticus: Case Report and Mini-Review
Authors: Singh Dinesh , Dyer Alford , Gu Sherry , McCarville Patrick , Hess Annie , Akingbola Olugbenga , El-Dahr Jane , Nelson Stephen
Published: April 2017

We report a 14-year old adolescent Caucasian female, who presented with frequent, sudden, transient, and unexplained falls leading to multiple serious injuries to her head and extremities requiring several visits to the emergency department. She was evaluated numerous times and imaging studies, echocardiogram, electrocardiogram, and electroencephalogram studies were all normal. She eventually presented to outside emergency department with dystonic posturing and status epilepticus and was transferred to our pediatric intensive care unit for further management. She was diagnosed with an uncommon, underrecognized and underdiagnosed condition. To our knowledge there is no such previous report in a pediatric patient.
The Rate of Sepsis in a National Pediatric Population, 2006 to 2012
Authors: Schuller Kristin A. , Hsu Benson S. , Thompson Allyson B.
Published: April 2017

Introduction: The rate of pediatric severe sepsis is reported to be on the rise in the United States, increasing by approximately 6000 cases annually. The goal of this study was to determine the rate of pediatric sepsis per 100 000 inpatient discharges over time. Methods: The 2006, 2009, and 2012 Agency for Healthcare Research and Quality Healthcare Cost Utilization Project Kid’s Inpatient Databases were used to analyze the rate of sepsis in children over time. Results: The rate of pediatric sepsis has increased over time from 92.8 per 100 000 in 2006 to 158.7 per 100 000 in 2012. Children less than a year old with Medicaid coverage and 3 or more procedures during hospitalization have significantly higher rates than their counterparts. Conclusions: This study helps clarify the population demographics that are at greater risk for sepsis infections. Understanding the at-risk population aids policymakers and care providers in targeting these populations and make drastic changes to sepsis policies.
Chemical and Common Burns in Children
Authors: Yin Shan
Published: April 2017

Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals—most commonly acids and alkalis—that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.
College Women’s Subjective Femininity Stress, Gender Solidarity, and Psychological Help-Seeking Intentions
Authors: Shea Munyi , Wong Y. Joel , Nguyen Kimmy K. , Baghdasarian Serani
Published: April 2017

Female gender has been consistently associated with positive psychological help-seeking attitudes and behaviors; however, surprisingly few empirical studies have examined how femininity-related variables impact women’s help-seeking decision making. Informed by the theory of reasoned action (Ajzen & Fishbein, 1980), the purpose of this study was (a) to investigate the associations between two femininity constructs—subjective femininity stress and gender solidarity—and psychological help-seeking intention, and (b) to explore the mediating roles of help-seeking attitudes and social stigma using structural equation modeling. Participants were 451 college-enrolled women in Southern California. Results revealed that all the mediation relationships involving help-seeking attitudes and stigma were significant. Subjective femininity stress was positively related to help-seeking intention via help-seeking attitudes, but was negatively related to intention via social stigma. Gender solidarity was positively related to help-seeking intention via positive attitudes and reduced social stigma. Implications for future research, prevention programs, and practice are discussed.