bluuebunny/crossref_metadata_2025 huggingface dataset:
The long-term (24-month) effect on health and well-being of the Lifestyle Matters community-based intervention in people aged 65 years and over: a qualitative study
Authors: Chatters Robin , Roberts Jennifer , Mountain Gail , Cook Sarah , Windle Gill , Craig Claire , Sprange Kirsty
Published: September 2017

Objectives

To assess the long-term effect on health and well-being of the Lifestyle Matters programme.

Design

Qualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT).

Setting

The intervention took place at community venues within two sites in the UK.

Participants

A purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2 years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being.

Intervention

Lifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy.

Results

Interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed.

Conclusion

The majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained.

Trial registration

ISRCTN,ISRCTN67209155, post results.
Use pattern and predictors of use of highly caffeinated energy drinks among South Korean adolescents: a study using the Health Belief Model
Authors: Ha Dongmun , Song Inmyung , Jang Gyeongil , Lee Eui-Kyung , Shin Ju-Young
Published: September 2017

Objectives

Concerns about the use of highly caffeinated energy drinks among Korean adolescents remains. We compared adolescents’ perceptions regarding the use of drinks to their behaviours and factors.

Design

A structured questionnaire based on the Health Belief Model was administered to 850 freshmen and sophomores at three high schools in Bucheon, South Korea. Benefits were defined as beneficial effects from the use of highly caffeinated energy drinks (eg, awakening from sleepiness) and harms as adverse effects of the drinks (eg, cardiac palpitation). Likelihood of action represents the likelihood of taking actions that are perceived to be more beneficial after comparison of the benefits and harms of caffeine use. Descriptive analysis was used to quantify the relationship between their beliefs about highly caffeinated energy drinks and their use. We conducted hierarchical logistic regression to compute ORs and 95% CIs for: (1) demographic factors, (2) health threat, (3) likelihood of action and (4) cues to act.

Results

Altogether, 833 students responded to the questionnaire (effective response rate=98.0%). About 63.0% reported use of highly caffeinated energy drinks and 35.2% had used them as needed and habitually. The more susceptible the respondents perceived themselves to be to the risk of using these drinks, the less likely they were to use them (OR: 0.73, 95% CI 0.50 to 1.06). The more severe the perception of a health threat, the less that perception was associated with use (OR: 0.44, 95% CI 0.29 to 0.67). Likelihood of action was the strongest predictor of use, explaining 12.5% in use. Benefits and harms (OR: 4.43, 95% CI 2.77 to 7.09; OR: 1.86, 95% CI 1.16 to 2.99) also were significant predictors.

Conclusions

Enhancing adolescents’ perceptions of benefits and harms regarding using highly caffeinated energy drinks could be an effective way to influence the use of these drinks.
What are the essential features of a successful surgical registry? a systematic review
Authors: Mandavia Rishi , Knight Alec , Phillips John , Mossialos Elias , Littlejohns Peter , Schilder Anne
Published: September 2017

Objective

The regulation of surgical implants is vital to patient safety, and there is an international drive to establish registries for all implants. Hearing loss is an area of unmet need, and industry is targeting this field with a growing range of surgically implanted hearing devices. Currently, there is no comprehensive UK registry capturing data on these devices; in its absence, it is difficult to monitor safety, practices and effectiveness. A solution is developing a national registry of all auditory implants. However, developing and maintaining a registry faces considerable challenges. In this systematic review, we aimed to identify the essential features of a successful surgical registry.

Methods

A systematic literature review was performed adhering to Preferred Reporting Items for Systematic Review and Meta-Analysis recommendations. A comprehensive search of the Medline and Embase databases was conducted in November 2016 using the Ovid Portal. Inclusion criteria were: publications describing the design, development, critical analysis or current status of a national surgical registry. All registry names identified in the screening process were noted and searched in the grey literature. Available national registry reports were reviewed from registry websites. Data were extracted using a data extraction table developed by thematic analysis. Extracted data were synthesised into a structured narrative.

Results

Sixty-nine publications were included. The fundamentals to successful registry development include: steering committee to lead and oversee the registry; clear registry objectives; planning for initial and long-term funding; strategic national collaborations among key stakeholders; dedicated registry management team; consensus meetings to agree registry dataset; established data processing systems; anticipating challenges; and implementing strategies to increase data completion. Patient involvement and awareness of legal factors should occur throughout the development process.

Conclusions

This systematic review provides robust knowledge that can be used to inform the successful development of any UK surgical registry. It also provides a methodological framework for international surgical registry development.
Randomised controlled trial ofLactobacillus rhamnosus(LGG) versus placebo in children presenting to the emergency department with acute gastroenteritis: the PECARN probiotic study protocol
Authors: Schnadower David , Tarr Phillip I , Casper T Charles , Gorelick Marc H , Dean Michael J , O’Connell Karen J , Mahajan Prashant , Chun Thomas H , Bhatt Seema R , Roskind Cindy G , Powell Elizabeth C , Rogers Alexander J , Vance Cheryl , Sapien Robert E , Gao Feng , Freedman Stephen B
Published: September 2017

Introduction

Acute gastroenteritis (AGE) is a common and burdensome condition that affects millions of children worldwide each year. Currently available strategies are limited to symptomatic management, treatment and prevention of dehydration and infection control; no disease-modifying interventions exist. Probiotics, defined as live microorganisms beneficial to the host, have shown promise in improving AGE outcomes, but existing studies have sufficient limitations such that the use of probiotics cannot currently be recommended with confidence. Here we present the methods of a large, rigorous, randomised, double-blind placebo-controlled study to assess the effectiveness and side effect profile ofLactobacillus rhamnosusGG (LGG) (ATCC 53103) in children with AGE.

Methods and analysis

The study is being conducted in 10 US paediatric emergency departments (EDs) within the federally funded Pediatric Emergency Care Applied Research Network, in accordance with current SPIRIT and CONSORT statement recommendations. We will randomise 970 children presenting to participating EDs with AGE to either 5 days of treatment with LGG (1010colony-forming unit twice a day) or placebo between July 2014 to December 2017. The main outcome is the occurrence of moderate-to-severe disease over time, as defined by the Modified Vesikari Scale. We also record adverse events and side effects related to the intervention. We will conduct intention-to-treat analyses and use an enrichment design to restore the statistical power in case the presence of a subpopulation with a substantially low treatment effect is identified.

Ethics and dissemination

Institutional review board approval has been obtained at all sites, and data and material use agreements have been established between the participating sites. The results of the trial will be published in peer-reviewed journals. A deidentified public data set will be made available after the completion of all study procedures.

Trial registration number

NCT01773967.
Comparison of control charts for monitoring clinical performance using binary data
Authors: Neuburger Jenny , Walker Kate , Sherlaw-Johnson Chris , van der Meulen Jan , Cromwell David A
Published: September 2017

Background

Time series charts are increasingly used by clinical teams to monitor their performance, but statistical control charts are not widely used, partly due to uncertainty about which chart to use. Although there is a large literature on methods, there are few systematic comparisons of charts for detecting changes in rates of binary clinical performance data.

Methods

We compared four control charts for binary data: the Shewhart p-chart; the exponentially weighted moving average (EWMA) chart; the cumulative sum (CUSUM) chart; and the g-chart. Charts were set up to have the same long-term false signal rate. Chart performance was then judged according to the expected number of patients treated until a change in rate was detected.

Results

For large absolute increases in rates (>10%), the Shewhart p-chart and EWMA both had good performance, although not quite as good as the CUSUM. For small absolute increases (<10%), the CUSUM detected changes more rapidly. The g-chart is designed to efficiently detect decreases in low event rates, but it again had less good performance than the CUSUM.

Implications

The Shewhart p-chart is the simplest chart to implement and interpret, and performs well for detecting large changes, which may be useful for monitoring processes of care. The g-chart is a useful complement for determining the success of initiatives to reduce low-event rates (eg, adverse events). The CUSUM may be particularly useful for faster detection of problems with patient safety leading to increases in adverse event rates.
Medical and bioethical considerations in elective cochlear implant array removal
Authors: Owoc Maryanna S , Kozin Elliott D , Remenschneider Aaron , Duarte Maria J , Hight Ariel Edward , Clay Marjorie , Meyer Susanna E , Lee Daniel J , Briggs Selena
Published: September 2017

Objective

Cochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation.

Data sources

We address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community.

Review methods

A systematic review using three scientific online databases was performed. Included articles addressed the benefits and/or complications of cochlear implantation in young children, CI explantation with or without revision surgery and the ethical debate between the medical and Deaf communities on cochlear implantation and explantation.

Conclusions

The medical and audiological perspectives identify a host of risks related to implant removal without reimplantation, including risk from surgery, general anaesthesia, cochlear ossification and poor audiometric outcomes. The member of the deaf community and bioethicist argue that physicians need to guide the principles of beneficence, non-maleficence and patient autonomy. Taken together, patient desires should be seen as paramount, if the patient is otherwise fit for surgery and well informed.

Implications for practice

Similar to the case of device implantation, device explantation should be a multidisciplinary and collaborative decision with the patient and the family’s desires at the centre. While every case is different, we offer a CI explantation discussion to assist in clinical decision-making, patient counselling and education.
Vitamin D supplementation
Authors: Dobson Ruth , Cock Hannah R , Brex Peter , Giovannoni Gavin
Published: September 2017

Vitamin D testing and supplementation is of great interest to neurologists and their patients. Recommended nutritional intakes of vitamin D in the UK remain focused on bone health, despite increasing evidence for a role outside this area. Here we discuss how neurologists might approach vitamin D testing and supplementation, focusing on two conditions associated with vitamin D deficiency that have an increased risk of downstream complications resulting from these: multiple sclerosis and epilepsy. We set out a rationale for testing serum 25-hydroxyvitamin D concentrations and discuss our personal practice in terms of supplementation, with evidence where available.
Lactobacillus iners-dominated vaginal microbiota is associated with increased susceptibility to Chlamydia trachomatis infection in Dutch women: a case–control study
Authors: van Houdt Robin , Ma Bing , Bruisten Sylvia M , Speksnijder Arjen G C L , Ravel Jacques , de Vries Henry J C
Published: September 2017

Introduction

This prospective study aimed to study the composition and structure of the vaginal microbiota prior to Chlamydia trachomatis infection.

Methods

A nested case–control study was performed in 122 women, half of which acquired C. trachomatis within a year after their first visit. At the first visit, the composition and structure of vaginal microbial communities were analysed using 16S rRNA sequencing in the context of the sociodemographic and sexual risk behaviour information using logistic regression.

Results

Five vaginal community state types (CSTs) were identified. Four CSTs were dominated by Lactobacillus spp., of which L. crispatus (37%) and L. iners (33%) were the most common. One CST was characterised by the absence of Lactobacillus spp. (25%) and the presence of an array of strict and facultative anaerobes. Multivariate logistic regression analysis revealed that women with a L. iners-dominated CST had an increased risk of C. trachomatis infection (p=0.04; OR: 2.6, 95% CI 1.0 to 6.6).

Conclusions

The distribution of CSTs dominated by Lactobacillus spp. agreed with previous studies. However, the frequency of dysbiosis among Caucasian women was relatively high (24%). Having vaginal microbiota dominated by L. iners was associated with an increased risk for C. trachomatis infection. Therefore, we hypothesise that specific signatures of vaginal microbiota are indicative of increased host predisposition to acquiring STIs.
Scimitar cat (Homotherium serum Cope) from southwestern Alberta, Canada
Authors: Ewald Tatyanna , Hills L.V. , Tolman Shayne , Kooyman Brian
Published: September 2017

Skull and tooth fragments of Homotherium serum recently recovered from the Wally’s Beach site (DhPg-8) in southwestern Alberta provide the first indications that scimitar cat populated the area of the St. Mary Reservoir. Accelerator mass spectrometry radiocarbon dating provides a calibrated age (2σ) of 12 715 – 12 655 cal. years BP. This is the fourth known occurrence of the species in Canada, the first outside of Yukon, and currently the youngest precisely dated occurrence of the species in North America. Well-preserved dentition combined with the temporal and geographic context allows the sample to be identified as H. serum. The specimen is significant as it represents an extension of the geographic and chronological range of the species.
Salvia miltiorrhizaLipophilic Fraction Attenuates Oxidative Stress in Diabetic Nephropathy through Activation of Nuclear Factor Erythroid 2-Related Factor 2
Authors: An Lin , Zhou Mei , Marikar Faiz M. M. T. , Hu Xue-Wen , Miao Qiu-Yun , Li Ping , Chen Jun
Published: September 2017

Diabetic nephropathy (DN) is a common cause of chronic kidney disease and end-stage renal disease, which can be triggered by oxidative stress. In this study, we investigated the renoprotective effect of the ethyl acetate extract of Salvia miltiorrhiza (EASM) on DN and examined the underlying molecular mechanism. We observed that EASM treatment attenuated metabolic abnormalities associated with hyperglycemic conditions in the experimental DN model. In streptozotocin (STZ)-induced mice, EASM treatment reduced albuminuria, improved renal function and alleviated the pathological alterations within the glomerulus. To mimic the hyperglycemic conditions in DN patients, we used high glucose (25[Formula: see text]mmol/L) media to stimulate mouse mesangial cells (MMCs), and EASM inhibited high glucose-induced reactive oxygen species. We also observed that EASM enhanced the expression of nuclear factor erythroid-2-related factor 2 (Nrf2), which mediated the anti-oxidant response, and its downstream gene heme oxygenase-1 (HO-1) and NAD(P)H quinone dehydrogenase 1 (NQO1) with concomitant decrease of expression of kelch-like ECH-associated protein 1 (keap1) both in vitro and in vivo. Taken together, these results suggest that EASM alleviates the progression of DN and this might be associated with activation of Nrf2.
EXTRACTION OF CO-BEHAVING GENES BY SIMILARITY ENSEMBLES
Authors: MOHAMMADI-JENGHARA MOSLEM , EBRAHIMPOUR-KOMLEH HOSSEIN
Published: September 2017

Microarray technology is used as a source of data for a wide range of biology studies. Useful biological information can be extracted from the analysis of microarray data, namely, the impact of a particular gene expression on the expression of other genes or the determination of expressed genes under different conditions. The purpose of this paper is to find co-behavioral genes in different data sets for different times and conditions. In other words, genes with similar behavior, same increase or decrease, under different medical, stress, and time conditions in terms of expression are determined. Multi-valued discretization of expression data was used for extracting genes with identical behavior. The algorithm proposed in this study is based on data and methods ensemble. The data ensemble technique was used to extract candidate genes with identical behavior. Other methods were also applied on all the data sets; as a result, many co-behavioral candidate genes with different similarity and correlation values were identified. Finally, the ultimate output was created from the ensemble of different methods. By applying the algorithm on yeast gene expression data, meaningful relations among genes were extracted.
CRISPR System: From Adaptive Immunity to Genome Editing
Authors: Doudna Jennifer
Published: September 2017

CRISPR-Cas9 is a revolutionary genome-editing tool. Understanding how Cas9 recognizes DNA and how to control its function will be critical in improving the system. We used single-molecule FRET to elucidate a key validation step during DNA target recognition. We also used X-ray crystallography to show how a Cas9 inhibitor is able to permit DNA binding but prevent cleavage. Finally, CRISPR research is notable not just for the exciting applications, but also for its profound ethical implications.
Inflammatory and Anti-Inflammatory Equilibrium, Proliferative and Antiproliferative Balance: The Role of Cytokines in Multiple Myeloma
Authors: Musolino Caterina , Allegra Alessandro , Innao Vanessa , Allegra Andrea Gaetano , Pioggia Giovanni , Gangemi Sebastiano
Published: September 2017

Multiple myeloma (MM) is typically exemplified by a desynchronized cytokine system with increased levels of inflammatory cytokines. We focused on the contrast between inflammatory and anti-inflammatory systems by assessing the role of cytokines and their influence on MM. The aim of this review is to summarize the available information to date concerning this equilibrium to provide an overview of the research exploring the roles of serum cytokines in MM. However, the association between MM and inflammatory cytokines appears to be inadequate, and other functions, such as pro-proliferative or antiproliferative effects, can assume the role of cytokines in the genesis and progression of MM. It is possible that inflammation, when guided by cancer-specific Th1 cells, may inhibit tumour onset and progression. In a Th1 microenvironment, proinflammatory cytokines (e.g., IL-6 and IL-1) may contribute to tumour eradication by attracting leucocytes from the circulation and by increasing CD4+T cell activity. Hence, caution should be used when considering therapies that target factors with pro- or anti-inflammatory activity. Drugs that may reduce the tumour-suppressive Th1-driven inflammatory immune response should be avoided. A better understanding of the relationship between inflammation and myeloma will ensure more effective therapeutic interventions.
Life-Threatening Irinotecan-Induced Toxicity in an Adult Patient with Alveolar Rhabdomyosarcoma: The Role of a UGT1A1 Polymorphism
Authors: Jannin Arnaud , Hennart Benjamin , Adenis Antoine , Chauffert Bruno , Penel Nicolas
Published: September 2017

Alveolar rhabdomyosarcoma (AR) in adult patients is an exceptional malignancy. Management of AR is based on (neo)adjuvant chemotherapy combining ifosfamide, vincristine, and actinomycin D and local curative-intent surgery/radiotherapy. In cases of relapsing AR, the combination of temozolomide/irinotecan is regarded as a possible option. Here we describe life-threatening long-lasting toxicity related to the 1st cycle of irinotecan-based chemotherapy in a 56-year-old woman suffering from locally advanced and metastatic head and neck AR. The patient experienced grade 4 vomiting and diarrheas resulting in acute functional renal failure, associated with grade 4 neutropenia complicated by severe septic shock. The hospital stay duration was 40 days. The analysis of the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene revealed homozygous UGT1A1 ⁎28 polymorphism with an associated homozygous mutation c.-3275T>G; the latter is associated with a decrease of about 80% of UGT1A1 transcription explaining this irinotecan induced toxicity. Physician must be aware of the potential hematological (mainly neutropenia and infectious disease) and digestive (mainly diarrhea) toxicities caused by irinotecan and especially when the patient presents a UGT1A1 ⁎28 homozygous allele. UGT1A genotyping performed before initiating treatment is useful to anticipate severe toxic reaction to irinotecan and improve the benefit/risk ratio of its use.
Glycemic Control, Hand Activity, and Complexity of Biological Signals in Diabetes Mellitus
Authors: Wu Hsien-Tsai , Lin Gen-Min , Haryadi Bagus , Yang Chieh-Ming , Chu Hsiao-Chiang
Published: September 2017

Both glycemic control and handgrip strength affect microvascular function. Multiscale entropy (MSE) of photoplethysmographic (PPG) pulse amplitudes may differ by diabetes status and hand activity. Of a middle-to-old aged and right-handed cohort without clinical cardiovascular disease, we controlled age, sex, and weight to select the unaffected (no type 2 diabetes,n=36),the well-controlled diabetes (HbA1c < 8%,n=22), and the poorly controlled diabetes (HbA1c ≥ 8%,n=22) groups. MSEs were calculated from consecutive 1,500 PPG pulse amplitudes of bilateral index fingertips. Thesmall-,  medium-,and large-scale MSEs were defined as the average of scale 1 (MSE1), scales 2–4 (MSE2–4), and scales 5–10 (MSE5–10), respectively. Intra- and intergroups were compared by one- and two-samplet-tests, respectively. The dominant handMSE5–10was lower in the poorly controlled diabetes group than the well-controlled diabetes and the unaffected (1.28 versus 1.52 and 1.56,p=0.019and 0.001, resp.) groups, whereas the nondominant handMSE5–10was lower in the well- and poorly controlled diabetes groups than the unaffected group (1.35 and 1.29 versus 1.58,p=0.008and 0.005, resp.). TheMSE1of dominant hand was higher than that of nondominant hand in the well-controlled diabetes (1.35 versus 1.10,p=0.048). In conclusion, diabetes status and hand dominance may affect the MSE of PPG pulse amplitudes.
Neural Vascular Mechanism for the Cerebral Blood Flow Autoregulation after Hemorrhagic Stroke
Authors: Xiao Ming , Li Qiang , Feng Hua , Zhang Le , Chen Yujie
Published: September 2017

During the initial stages of hemorrhagic stroke, including intracerebral hemorrhage and subarachnoid hemorrhage, the reflex mechanisms are activated to protect cerebral perfusion, but secondary dysfunction of cerebral flow autoregulation will eventually reduce global cerebral blood flow and the delivery of metabolic substrates, leading to generalized cerebral ischemia, hypoxia, and ultimately, neuronal cell death. Cerebral blood flow is controlled by various regulatory mechanisms, including prevailing arterial pressure, intracranial pressure, arterial blood gases, neural activity, and metabolic demand. Evoked by the concept of vascular neural network, the unveiled neural vascular mechanism gains more and more attentions. Astrocyte, neuron, pericyte, endothelium, and so forth are formed as a communicate network to regulate with each other as well as the cerebral blood flow. However, the signaling molecules responsible for this communication between these new players and blood vessels are yet to be definitively confirmed. Recent evidence suggested the pivotal role of transcriptional mechanism, including but not limited to miRNA, lncRNA, exosome, and so forth, for the cerebral blood flow autoregulation. In the present review, we sought to summarize the hemodynamic changes and underline neural vascular mechanism for cerebral blood flow autoregulation in stroke-prone state and after hemorrhagic stroke and hopefully provide more systematic and innovative research interests for the pathophysiology and therapeutic strategies of hemorrhagic stroke.
School Anxiety in Children and Adolescents with Chronic Pain
Authors: Jastrowski Mano K. E.
Published: September 2017

Anxiety is highly prevalent in pediatric chronic pain. This comorbidity has been explained by the presence of shared mechanisms underlying the development and maintenance of chronic pain and anxiety. Accumulating evidence demonstrates that school is a significant source of anxiety among youth with chronic pain and that anxiety contributes to school-related functional impairment in this population. This article reviews the cooccurrence of pediatric chronic pain and anxiety, identifies unique sources of heightened school anxiety among youth with chronic pain, and describes current approaches for assessing anxiety in pediatric pain settings. Highlighted by this review is the absence of a comprehensive evidence-based approach for assessing school anxiety in pediatric chronic pain. Given the psychometric limitations inherent to gathering data from a single source, recommendations for advancing measurement methods are provided. Novel approaches may be needed to shed more light on the way in which school anxiety is experienced in pediatric chronic pain.
Primary Cutaneous Follicle Centre Lymphoma with Hodgkin and Reed-Sternberg Like Cells: A Case Report and Review of the Literature
Authors: Aldarweesh Fatima A. , Treaba Diana O.
Published: September 2017

An elderly woman with a complex medical history presented with a left forearm mass that slowly developed for several months. The excisional biopsy of this skin mass was remarkable for involvement by a follicle centre cell derived lymphoma with a nodular and diffuse pattern associated with a subset of scattered Hodgkin and Reed-Sternberg like cells. Fluorescence in situ hybridization studies did not detect the presence of IgH-bcl2 fusion transcript, and molecular studies were negative for immunoglobulin heavy chain gene rearrangements and EBV DNA sequences. Hodgkin and Reed-Sternberg like cells are rarely reported in FLs, and the association with primary cutaneous follicle centre lymphoma is extremely rarely seen. To our knowledge, our case is the second case of primary cutaneous follicle centre lymphoma with Hodgkin and Reed-Sternberg like cells.
Cytoplasmic Cyclin E Mediates Resistance to Aromatase Inhibitors in Breast Cancer
Authors: Doostan Iman , Karakas Cansu , Kohansal Mehrnoosh , Low Kwang-Hui , Ellis Matthew J. , Olson John A. , Suman Vera J. , Hunt Kelly K. , Moulder Stacy L. , Keyomarsi Khandan
Published: September 2017

Purpose: Preoperative aromatase inhibitor (AI) therapy has demonstrated efficacy in hormone receptor (HR)-positive postmenopausal breast cancer. However, many patients have disease that is either intrinsically resistant to AIs or that responds initially but develops resistance after prolonged exposure. We have shown that patients with breast tumors expressing the deregulated forms of cyclin E [low molecular weight forms (LMW-E)] have poor overall survival. Herein, we hypothesize that LMW-E expression can identify HR-positive tumors that are unresponsive to neoadjuvant AI therapy due to the inability of AIs to induce a cytostatic effect.

Experimental Design: LMW-E was examined in breast cancer specimens from 58 patients enrolled in the American College of Surgeons Oncology Group Z1031, a neoadjuvant AI clinical trial. The mechanisms of LMW-E–mediated resistance to AI were evaluated in vitro and in vivo using an inducible model system of cyclin E (full-length and LMW-E) in aromatase-overexpressing MCF7 cells.

Results: Breast cancer recurrence-free interval was significantly worse in patients with LMW-E–positive tumors who received AI neoadjuvant therapy, compared with those with LMW-E negative tumors. Upon LMW-E induction, MCF7 xenografts were unresponsive to letrozole in vivo, resulting in increased tumor volume after treatment with AIs. LMW-E expression overcame cell-cycle inhibition by AIs in a CDK2/Rb-dependent manner, and inhibition of CDK2 by dinaciclib reversed LMW-E–mediated resistance, whereas treatment with palbociclib, a CDK4/6 inhibitor, did not.

Conclusions: Collectively, these findings suggest that cell-cycle deregulation by LMW-E mediates resistance to AIs and a combination of CDK2 inhibitors and AIs may be an effective treatment in patients with HR-positive tumors that express LMW-E. Clin Cancer Res; 23(23); 7288–300. ©2017 AACR.
Implementing Case Management in Portuguese Mental Health Services: Conceptual Background
Authors: Mateus Pedro , Caldas de Almeida José M. , de Carvalho Álvaro , Xavier Miguel
Published: September 2017

Case management implementation processes are one of the best examples on how an evidence-based practice can influence health services organisation. This practice helped shaping mental health teams, increasing their multidisciplinarity and interdisciplinary work in the last decades. Examples from several countries show how effectiveness research blends into health policy development to meet different needs in each health system, thus influencing case management inception and improvement of care. Portugal followed its own path in case management implementation, determined mostly by mental health services organisation and closely linked with the capacity to implement a national mental health policy in the last years.
Bacterial Translocation from the Gut to the Distant Organs: An Overview
Authors: Nagpal Ravinder , Yadav Hariom
Published: September 2017

Background: The intestinal epithelial layer is the chief barricade between the luminal contents and the host. A healthy homeostatic intestinal barrier is pivotal for maintaining gastrointestinal health, which impacts the overall health as it safeguards the gut-blood axis and checks gut microbes including potential pathogens from entering into the circulation. Summary: Under healthy milieus, the intestinal barrier is generally very dynamic and effective, with luminal side being heavily infested with a wide variety of gut microbes while the basolateral side remains virtually sterile. However, certain conditions such as abnormal exposure to toxins, drugs, pathogens etc. or a state of hyper-inflammation due to disease conditions may weaken or destabilize the integrity of gut epithelia. A perturbed gut integrity and permeability (“leaky gut”) may lead to microbial (bacterial) translocation, and the eventual leakage of bacteria or their metabolites into the circulation can make the host susceptible to various types of diseases via inducing chronic or acute inflammatory response. Key Message: Given a close association with gut integrity, bacterial translocation and inflammatory responses have recently emerged as a clinically important research field and have unveiled novel aspects of gut microbial ecology and various gastrointestinal, metabolic, and lifestyle diseases. This review aims to describe the significance of a healthy gut barrier integrity and permeability, as well as the factors and consequences associated with a compromised gut barrier, while discussing briefly the dietary approaches including probiotics and prebiotics that could ameliorate gut health by restoring gut environment and barrier integrity, thereby preventing bacterial translocation.
Beyond Human Leukocyte Antigen Class I Antigens: Hereditary Hemochromatosis Gene Mutations in Recurrent Aphthous Oral Ulcers and Behçet Disease in the South of Tunisia
Authors: ElAoud Sahar , Kamoun Arwa , Mahfoudh Nadia , Charfi Aida , Snoussi Mouna , Hachicha Hend , Jerbi Ameni , Dammak Chifa , Frikha Feten , Hakim Faiza , Gaddour Lilia , Bahloul Zouheir , Makni Hafedh
Published: September 2017

Objective: The aim of this work was to establish human leukocyte antigen (HLA) class I and hereditary hemochromatosis gene (HFE) mutation associations with recurrent aphthous oral ulcers (RAOU) and Behçet disease (BD) in a cohort of Southern Tunisian patients. Subjects and Methods: A total of 232 patients with RAOU and 123 healthy controls (HCs) were enrolled in this study. The patients were divided into 2 groups based on the presence (BD+: n = 62) or absence of BD (BD−, n = 170). In the BD+ group, 28 patients had severe manifestations of BD. In the BD- group, RAOU was isolated in 81 patients, associated with mucocutaneous manifestations in 58 and with joint symptoms in 25. Complement-dependent microlymphocytotoxicity assay and polymerase chain reaction-restriction fragment length polymorphism were used to study HLA class I polymorphism and HFE mutations, respectively. Results: HLA-B51 was positively associated with BD, particularly in those with severe manifestations. No association was detected with HLA class I polymorphism among the BD group. Based on stratification to clinical manifestations, the isolated RAOU was negatively associated with HLA-A1 with a difference close to significance (12 [14.81%] vs. 32 [26.02%] in HCs; p = 0.06). Furthermore, patients with mucocutaneous features had a higher frequency of HLA-B51 (14, 24.14%) than patients without mucocutaneous involvement (11, 11.37%). Considering HFE mutations, patients with isolated RAOU had a higher frequency of H63D when compared with other subgroups, especially after limiting the comparison to 27 patients of at least 5 years of follow-up. Conclusion: This study showed that, unlike BD, RAOU were not associated with HLA-B51. Moreover, we suggest that H63D mutation was positively associated with isolated RAOU.
ГІПЕРПЛАСТИЧНІ ПРОЦЕСИ ЕНДОМЕТРІЯ У ЖІНОК В ПІЗНЬОМУ РЕПРОДУКТИВНОМУ І ПРЕМЕНОПАУЗАЛЬНОМУ ПЕРІОДІ: ЩО ВПЛИВАЄ НА РЕЦИДИВИ
Authors: Korniyenko S. M.
Published: September 2017

Резюме. Гіперпластичні процеси ендометрія (ГПЕ) займають значне місце в структурі гінекологічної захворюваності і є однією з найчастіших причин госпіталізації в гінекологічному стаціонарі. Дана патологія викликає порушення менструального циклу, дисфункціональні маткові кровотечі і анемію, однак особлива увага до ГПЕ пов'язана з високим ризиком злоякісної трансформації ендометрія. Пізній репродуктивний вік і період пременопаузи пов'язані з високою частотою рецидивів ГПЕ, соматичної патології та гінекологічних оперативних втручань.            Мета дослідження – виявити фактори, що впливають на рецидиви ГПЕ у жінок пізнього репродуктивного та пременопаузального віку.            Матеріали і методи. Були вивчені клініко-анамнестичні дані, особистісні особливості, якість життя і віддалені результати гістероскопії у 255 жінок, які страждають ГПЕ у віці 35–54 років. У 72 жінок протягом 1,5–2,5 років після лікування спостерігалися рецидиви ГПЕ. Ці пацієнтки склали групу Р, решта 183 жінки увійшли до групи К. Окремий аналіз був проведений в групах з поліпами і в групах з гіперплазією ендометрія.Результати. Рецидиви поліпів спостерігалися в 49 (25,5 %) випадках, гіперплазії ендометрія – в 25 (25,3 %). У двох пацієнток відзначалися рецидиви обох форм ГПЕ. Рівень гінекологічної захворюваності в анамнезі пацієнток з рецидивами ГПЕ істотно перевищував референтні значення. Урогенітальні інфекції не чинили статистично значущого впливу на рецидивність гіперплазії ендометрія. Ефективність лікування поліпів, навпаки, істотно залежала від генітальних інфекцій. Соматичні захворювання більш виражено погіршували перспективи лікування ГПЕ, ніж генітальна патологія. В якості особистісних предикторів рецидивуючої гіперплазії ендометрія відзначалися невротичність, спонтанна агресивність, депресивність і емоційна лабільність.            Висновки. У пізньому репродуктивному і пременопаузальному віці рецидиви ГПЕ спостерігаються в кожному четвертому випадку. Ризики рецидування поліпів ендометрія найтісніше асоціюються з аномаліями розвитку матки, маскулінним психотипом, хронічним ендометритом, інсомнією, цитомегаловірусною генітальною інфекцією, гіпертонічною хворобою і ожирінням. Шанси рецидивів гіперплазії ендометрія найбільш значимо підвищують захворювання печінки і щитоподібної залози, емоційна лабільність, індекс маси тіла понад 27 кг/м2, невротичність, інсомнія, депресивність і синдром вегетативної дисфункції.
ЧАСОВО-ПРОСТОРОВИЙ АСПЕКТ НАВЧАЛЬНО-ПЕДАГОГІЧНОЇ ТА НАУКОВОЇ ДІЯЛЬНОСТІ ПРОФЕСОРСЬКО-ВИКЛАДАЦЬКОГО СКЛАДУ КАФЕДРИ ЦИВІЛЬНОГО ЗАХИСТУ ТА МЕДИЦИНИ КАТАСТРОФ ЗА 1967-2017 РОКИ: РОЗШИРЕННЯ КОНТИНУУМУ
Authors: Kochin I. V.
Published: September 2017

Мета роботи - дослідити і узагальнити досвід роботи професорсько-викладацького складу кафедри ЦЗ та МК за 50 років (1967–2017 рр.), відслідкувати динаміку змін навчально-педагогічної та наукової роботи, дати оцінку напрацюванням, зробити висновки для подальшого удосконалення навчального процесу, підготовки медичних кадрів та наукової діяльності.Матеріали і методи. Проведення дослідження архівних і поточних матеріалів організації та діяльності ДЗ «Запорізька медична академія післядипломної освіти МОЗ України» та кафедри ЦЗ та МК за 1926–2017 рр. Проаналізовано та узагальнено матеріали навчально-методичної, педагогічної та наукової діяльності професорсько-викладацького складу кафедри з використанням компаративного методу та контент-аналізу.Результати. Дано оцінку в часово-просторовому аспекті розвитку навчально-педагогічної, навчально-методичної та наукової діяльності кафедри ЦЗ та МК 1967–2017 рр., виокремлено досягнення та накреслено шляхи подальшого удосконалення навчальної та наукової роботи.Висновки. Минуле медицини, розглянуте у компарації з її сучасним станом, дає змогу простежити й оцінити в історичній послідовності зміни у медичній освіті, навчальному процесі, змісті медичних знань, підготовці медичних кадрів, проблематиці науки, пануючих теоріях й парадигмах, організаційних формах надання екстреної медичної допомоги при НС техногенного, природного, соціального та воєнного характерів.
Best protocols for cycad propagation require more research
Authors: Marler Thomas Edward , Cruz Gil Naputi
Published: September 2017

Best protocols for cycad propagation require more research
Logical and Methodological Issues Affecting Genetic Studies of Humans Reported in Top Neuroscience Journals
Authors: Grabitz Clara R. , Button Katherine S. , Munafò Marcus R. , Newbury Dianne F. , Pernet Cyril R. , Thompson Paul A. , Bishop Dorothy V. M.
Published: September 2017

Genetics and neuroscience are two areas of science that pose particular methodological problems because they involve detecting weak signals (i.e., small effects) in noisy data. In recent years, increasing numbers of studies have attempted to bridge these disciplines by looking for genetic factors associated with individual differences in behavior, cognition, and brain structure or function. However, different methodological approaches to guarding against false positives have evolved in the two disciplines. To explore methodological issues affecting neurogenetic studies, we conducted an in-depth analysis of 30 consecutive articles in 12 top neuroscience journals that reported on genetic associations in nonclinical human samples. It was often difficult to estimate effect sizes in neuroimaging paradigms. Where effect sizes could be calculated, the studies reporting the largest effect sizes tended to have two features: (i) they had the smallest samples and were generally underpowered to detect genetic effects, and (ii) they did not fully correct for multiple comparisons. Furthermore, only a minority of studies used statistical methods for multiple comparisons that took into account correlations between phenotypes or genotypes, and only nine studies included a replication sample or explicitly set out to replicate a prior finding. Finally, presentation of methodological information was not standardized and was often distributed across Methods sections and Supplementary Material, making it challenging to assemble basic information from many studies. Space limits imposed by journals could mean that highly complex statistical methods were described in only a superficial fashion. In summary, methods that have become standard in the genetics literature—stringent statistical standards, use of large samples, and replication of findings—are not always adopted when behavioral, cognitive, or neuroimaging phenotypes are used, leading to an increased risk of false-positive findings. Studies need to correct not just for the number of phenotypes collected but also for the number of genotypes examined, genetic models tested, and subsamples investigated. The field would benefit from more widespread use of methods that take into account correlations between the factors corrected for, such as spectral decomposition, or permutation approaches. Replication should become standard practice; this, together with the need for larger sample sizes, will entail greater emphasis on collaboration between research groups. We conclude with some specific suggestions for standardized reporting in this area.
Assessing the Role of Resolutions in the ilc Draft Conclusions on Identification of Customary International Law
Authors: Deplano, PhD Rossana
Published: September 2017

On 30 May 2016, the International Law Commission (‘ilc’) adopted a set of 16 Draft Conclusions providing a methodology on how to identify customary international law. Although largely based on the two elements approach set forth in article 38(1)(b) of the Statute of the International Court of Justice, the ilc study pushes the boundaries of the formal sources of international law beyond the realm of state practice by recognising that the practice of international organizations (‘ios’) as such may be constitutive of custom. This article critically examines the ilc Draft Conclusions concerning the role of ios in the process of custom creation. It examines the concept of resolution adopted by the ilc and assesses the coherence of the interpretive methodology devised by the ilc using the un General Assembly resolutions as a case study. The findings show that the Draft Conclusions fall short of expectation in providing authoritative guidance to scholars and practitioners alike.
Moving Along the Belt and Road: Implications of China’s “One Belt, One Road” Strategies on Chinese Migration (沿“一帶一路”的移動：“一帶一路”戰略對中國人口遷移影響)
Authors: Muttarak (Raya Muttarak) Raya
Published: September 2017

Along with the flows of China’s foreign direct investment following the newly implemented “One Belt, One Road” strategy by the Chinese government comes movement of state employees, entrepreneurs, workers and accompanying family members to respective countries along the Belt and Road. It is not clear how large the Chinese migration flows into these countries will be, who they will be comprised of, how the public reception of the host society will be and how well the migrants will be integrated in the destination country. Based on extant data and literature on current Chinese migration, this paper describes trends and patterns of recent Chinese migration in Africa and Asia, analyzes host country public perceptions on China, and investigates integration patterns of Chinese migrants. Given that the “One Belt, One Road” strategy was officially endorsed in 2015, it is still early to analyze its impacts on Chinese migration in the respective countries. Considering earlier Chinese overseas migration of the past decades, this paper presents potential migration and integration patterns one may expect following the Belt and Road initiative.

中國政府提出的「一帶一路」戰略帶來大量的對外直接投資，隨之形成了沿「一帶一路」的人口遷移流，這些遷移人口包括雇員、企業家、勞動力及其家庭成員等。來自中國的大量遷移人口將在沿「一帶一路」國家形成怎樣的遷移格局？誰會成為這些遷移者？沿「一帶一路」國家的主流社會對這些遷移者的剬眾反應會是怎樣？遷移者怎樣才能很好地融入遷入地國家？這些問題都有待回答。根據中國當前人口遷移的相關數據和文獻，本研究分析了中國在亞洲、非洲的人口遷移趨勢和格局，以及沿“一帶一路”國家對中國的剬眾感知和中國遷移者的融入情況。由於中國官方自2015年才正式推動“一帶一路”戰略，因此這方面的研究也才剛起步。但是過去關於海外華人的研究，為未來的發展提供了可能的參考模式。 (This article is in English).
Restoration of Suaeda sect. Helicilla (Chenopodiaceae) and typification of its related taxa
Authors: FREITAG HELMUT , LOMONOSOVA MARIA N.
Published: September 2017

Suaeda glauca is separated off from sect. Schanginia and classified in the revived monotypic sect. Helicilla. Morphologically it is characterized by dimorphic fruits and seeds, with the fruits bearing flat seeds being strongly carinate and obconical, and the sub-spherical seeds of the globular fruits having a prominent honeycomb-like pattern caused by sunken lines above the anticlinal cell walls of the testa which are bordered by distinct narrow ridges that are unique in Suaeda. The separate position of S. glauca is also clearly confirmed in the ITS and the combined atpB-rbcL / psbB-psbH trees. For nomenclatural purposes, the synonymous names S. stauntonii and Helicilla altissima are lectotypified, while the typification of Salsola asparagoides is corrected. Finally the inclusion of sect. Macrosuaeda into sect. Salsina is advocated.
Critical study of the Cohniella (Oncidiinae, Orchidaceae) of French Guiana
Authors: SAMBIN AURÉLIEN , CHIRON GUY R.
Published: September 2017

The detailed study of several Cohniella specimens observed and/or collected in French Guiana shows that they all belong to a single entity and that it is different from the two species previously cited for this country, Cohniella cebolleta and C. ultrajectina, by a set of significant vegetative and floral characters. This entity is here described as a new species, illustrated and compared with the two taxa mentioned. A distribution map of the hitherto known specimens and/or populations is proposed, as well as an identification key.