bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulating hatred: Of devils and demons?
Authors: Alkiviadou Natalie
Published: September 2018

Hate speech and hate crime are an anathema to any society. On a United Nations level, the central tools to tackle such hatred are Article 20(2) of the International Covenant on Civil and Political Rights and Article 4 of the International Convention on the Elimination of All Forms of Racial Discrimination. On a Council of Europe level, the Additional Protocol to the Cybercrime Convention tackles racist and xenophobic material, threats and insults as well as revisionist rhetoric transmitted and disseminated through computer systems. On a European Union level, there is the Framework Decision on Racism and Xenophobia. In none of the above-mentioned instruments do we find provisions on homophobic and transphobic speech and crime, nor are there equivalents of documents such as the Framework Decision with the thematic of homophobia and transphobia. This creates a hierarchy of hate, with some forms of hate considered more important than others by the aforementioned institutions, a reality that goes against the very essence of international human rights law.
When culture is content: Applications for content-based instruction in the world language classroom
Authors: Spenader Allison J. , Wesely Pamela M. , Glynn Cassandra
Published: September 2018

Content-based instruction (CBI) is a pedagogical approach used in the second/other language classroom that commits to addressing both language- and content-learning objectives. Scholars have found that, particularly in the planning stages, teachers struggle with achieving that balance (Donato, 2016; Lyster, 2007). This study examines world language (WL) teachers’ planning for CBI via these research questions: (1) When experienced teachers from traditional WL classroom contexts design CBI unit plans, what do these plans reveal about the pathways they take towards CBI in a traditional WL settings? (2) What broader challenges and opportunities related to using CBI in the traditional WL context are revealed? The data sources in this qualitative lesson analysis study are 36 unit plans developed as the final project for a graduate-level course on CBI in one US institution. The three investigators examined the content–language dichotomy and the academic content-cultural content dichotomy in each lesson and identified patterns. The findings reveal that teachers often chose content that was more cultural than academic in nature, and they were challenged by several aspects of relating the language and content objectives. Implications for researchers, teacher educators, and teachers present a broader discussion of CBI as a viable curricular option in WL classrooms.
No exchange, same pain, no gain: Risk–reward of wearable healthcare disclosure of health personally identifiable information for enhanced pain treatment
Authors: Robinson Stephen Cory
Published: September 2018

Wearable technologies have created fascinating opportunities for patients to treat chronic pain in a discreet, mobile fashion. However, many of these health wearables require patients to disclose sensitive information, including health information (e.g., heart rate, glucose levels) and personal information (location, email, name, etc.). Individuals using wearables for treatment of chronic pain may sacrifice social health elements, including their privacy, in exchange for better physical and mental health. Utilizing communication privacy management, a popular disclosure theory, this article explores the policy and ethical ramifications of patients disclosing sensitive health information in exchange for better health treatment and relief of chronic pain. The article identifies scenarios where a user must disclose information, and what factors motivate or dissuade disclosure, and ultimately the use of a health wearable. Practical implications of this conceptual article include an improved understanding of how and why consumers may disclose personal data to health wearables, and potential impacts for public policy and ethics regarding how wearables and their manufacturers entice disclosure of private health information.
Bad debt and green issues
Authors: Brown Lloyd A.
Published: September 2018

This article uses interview data, collected from ‘elite’ banking respondents, to examine how secured lenders use insolvency practitioners as a form of post-loan due diligence. It is concerned with how effective insolvency practitioners are at obviating the risks that may be incurred where insolvency proceedings are caused or impeded by environment-related issues. It shows how the unique relationship between lenders and insolvency practitioners greatly reduces the likelihood of direct liability from environmental regulations transferring to the lender during the liquidation process. Two regimes are analysed in this article: the contaminated land regime, and the waste licensing system. Statutory provisions and judicial decisions have limited the power of environmental regulators. At the same time, however, this is good for secured lenders who are principally concerned with repaying the debt that is owed to them by a defaulting borrower. A more significant concern for lenders during borrowers’ insolvencies are the indirect risks (that is, credit and security risks). Environmental issues arising during a borrower’s insolvency may reduce the likelihood of the lender being repaid and, in the case of contaminated land, could severely limit the lender’s ability to exercise its security.
Psychotic, acritical and precarious? A Lacanian exploration of the neoliberal consumer subject
Authors: Lambert Aliette
Published: September 2018

Extending the critical project of interrogating the consumer subject form, in this study, the consumer subject is read as potentially acritical, precarious and psychotic through Dufour’s Lacanian-inspired analysis of neoliberal subjectivity. Reflecting on two case studies from an ethnographic-type study of young women, identity and consumer culture, I demonstrate how participants attempt to fulfil neoliberal ideals related to agency, productivity and creativity. Relying on commodities for symbolic anchoring in doing so, a ‘psychotic’ and precarious subject position is evidenced. While the findings could certainly be interpreted as productive, tendencies toward materialism, uncertainty and anxiety, along with pervasive mental health issues, provided the impetus to further problematise dominant understandings of the consumer. Neoliberal consumer culture is evidenced as a harmful, dehumanising ideology that fosters competitiveness, individuality and meritocratic tendencies, encouraging a reliance on ever-changing, transient commodities to (in)form the self. This occurs at the expense of compromise, communality and social welfare, through which subjects may find more stable and emancipatory symbolic anchors. Only by recognising critical theorisations of the consumer as dominant subject positions of neoliberalism can cultural consumer researchers begin to imagine opportunities for resistance and emancipatory change.
Impact of Prolonged Inflation Times During Plain Balloon Angioplasty on Angiographic Dissection in Femoropopliteal Lesions
Authors: Horie Kazunori , Tanaka Akiko , Taguri Masataka , Kato Shigeaki , Inoue Naoto
Published: September 2018

Purpose: To investigate if balloon angioplasty with a prolonged inflation time (>3 minutes) can prevent postdilation dissection in femoropopliteal lesions. Methods: A retrospective single-center analysis examined 294 consecutive patients (mean age 74.1±8.7 years; 215 men) with de novo femoropopliteal lesions treated with balloon angioplasty between 2013 and 2018. The patients were classified into 2 groups to compare angiographic dissection patterns: 175 patients treated with balloon angioplasty for 3 minutes (3-minute group) and 119 treated for >3 minutes (>3-minute group). Results: Mean balloon inflation time was 7.8±2.7 minutes in the >3-minute group. Severe dissections (type C or higher) were observed less frequently after balloon dilation in the >3-minute group (22.7% vs 50.9%, p<0.001); therefore, significantly more patients in the >3-minute group had successful endovascular treatment after initial balloon angioplasty (57.1% vs 38.3%, p=0.001). Additional balloon dilation was attempted more frequently in the 3-minute group (30.9% vs 14.3%, p=0.001); as a result, there were more patients in whom additional balloon dilation repaired severe dissection that occurred after the initial dilation (25.1% vs 10.9%, p=0.001). Multivariate analysis revealed that chronic total occlusion (p<0.001) and longer lesion (p<0.001) were independent predictors of severe dissection, and prolonged dilation time was independently related to preventing severe dissection (p<0.001). Among 171 patients undergoing successful balloon angioplasty without stent implantation, the Kaplan-Meier estimates of primary patency within 1 year did not differ significantly according to inflation time. Conclusion: Balloon dilation with prolonged inflation time (>3 minutes) may be effective as an initial strategy to prevent severe dissection in femoropopliteal lesions compared to inflation for 3 minutes.
The Molecular Imaging of Natural Killer Cells
Authors: Shapovalova Mariya , Pyper Sean R. , Moriarity Branden S. , LeBeau Aaron M.
Published: September 2018

The recent success of autologous T cell-based therapies in hematological malignancies has spurred interest in applying similar immunotherapy strategies to the treatment of solid tumors. Identified nearly 4 decades ago, natural killer (NK) cells represent an arguably better cell type for immunotherapy development. Natural killer cells are cytotoxic lymphocytes that mediate the direct killing of transformed cells with reduced or absent major histocompatibility complex (MHC) and are the effector cells in antibody-dependent cell-mediated cytotoxicity. Unlike T cells, they do not require human leukocyte antigen (HLA) matching allowing for the adoptive transfer of allogeneic NK cells in the clinic. The development of NK cell-based therapies for solid tumors is complicated by the presence of an immunosuppressive tumor microenvironment that can potentially disarm NK cells rendering them inactive. The molecular imaging of NK cells in vivo will be crucial for the development of new therapies allowing for the immediate assessment of therapeutic response and off-target effects. A number of groups have investigated methods for detecting NK cells by optical, nuclear, and magnetic resonance imaging. In this review, we will provide an overview of the advances made in imaging NK cells in both preclinical and clinical studies.
Prediction of preload attenuation of ball screw based on support vector machine
Authors: Chen Kai , Zu Li , Wang Li
Published: September 2018

Ball screw is a mechanical device widely used in mechanical field. The reverse clearance of ball screw will reduce its precision. In order to eliminate the reverse clearance, it is necessary to apply preload to the ball screw. It is very difficult to measure the preload in real time, and the data are large and time-consuming. By using machine learning method to predict and supervise preload, the changing trend of working condition of ball screw can be evaluated in advance, and the working precision of screw is controlled, which has important engineering significance. In this article, the relationship between the preload and the friction torque is obtained through theoretical derivation and experimental verification. Then, the support vector machine is used as a tool to model the friction torque of ball screw with the parameters of material, lubrication, and revolution, and predict the value and trend of preload to complete the supervision and prediction of the preload of the ball screw. By comparing the experimental results, it is proved that the support vector machine is feasible in predicting and supervising the attenuation of the preload of ball screw.
Adaptive hierarchical sliding mode control based on fuzzy neural network for an underactuated system
Authors: Huang Xiaorong , Gao Hongli , Ralescu Anca L , Huang Haibo
Published: September 2018

We present an adaptive hierarchical sliding mode control based on fuzzy neural network for a class of underactuated systems to solve the problem of high-precision trajectory tracking. This system is viewed as several subsystems. One subsystem is used to design the first-layer sliding surface, which constructs the second-layer sliding surface with another subsystem. When the top layer includes all the subsystems, the design process is finished. Meanwhile, the equivalent control law and the switching control law are achieved at every layer. Because the hierarchical sliding mode control law relies excessively on the requirement of detailed information of the underactuated dynamic system, and because that method causes an inevitable chattering phenomenon, an online fuzzy neural network system is applied to mimic the hierarchical sliding mode control law. Moreover, the bounds of system uncertainties and modeling error caused by the fuzzy neural network system are estimated online by a robust term. The stability of the closed-loop system is guaranteed based on the Lyapunov theory and Barbalat’s Lemma. Finally, the examples, a single-pendulum-type overhead crane system and an inverted pendulum system, are simulated to verify the effectiveness and robustness of the proposed method compared with some conventional methods.
Dynamics and effective distance of gas–liquid two-phase swirling flow induced by vortex tools
Authors: Zhang Zhao , Liao Ruiquan , Liu Jie
Published: September 2018

Based on the mechanistic model of the two-phase swirling annular flow behavior, a calculation method for the effective distance of vortex tool is obtained by taking Kelvin–Helmholtz instability into account. The rationality of the proposed method is validated by comparing the predicted liquid film thickness and pressure under non-swirling flow with the commonly used correlations. Then, the influences of gas–liquid ratio, helix angle, and hub diameter of vortex tool on the liquid film thickness, pressure drop, and effective distance have been analyzed. Results show that the presence of the vortex tool causes the decrease in the liquid film thickness and increase in the pressure drop. The liquid film thickness increases gradually as the helix angle and the hub diameter increase, and the larger helix angle results in smaller pressure drop. The effective distance increases with an increase in the gas–liquid ratio and decreases with an increase in helix angle and hub diameter. A sudden decrease occurs when the helix angle exceeds 60°. The gas–liquid ratio and helix angle are more dominant factors than the hub diameter on the liquid film thickness, pressure drop, and effective distance.
The effect of mean annual temperature on the incidence of distal radial fractures
Authors: Johnson Nick A. , Stirling Euan , Dias Joseph J.
Published: September 2018

We investigated the relationship between the incidence of distal radial fractures and mean annual temperature. Data for all adult patients presenting to our unit with a distal radial fracture from 2007–2014 were analysed. Incidence rates were compared with meteorological records. A Poisson regression model was used to analyse trends. Distal radial fractures were sustained by 8831 adults. The only significant change in fracture incidence occurred in 2010, in women only. This was the coldest year in the United Kingdom for over 20 years. Analysis by age bands during 2010 showed fracture incidences were significantly higher for women aged 40–69 with a higher percentage of injuries occurring in the street. These women are likely to remain mobile during bad weather but frequently have underlying osteoporosis. Falls prevention programmes should address this group with specific strategies. Simple measures, such as walking aids, appropriate footwear and avoidance of non-essential travel in slippery conditions, may reduce risk.

Level of evidence: IV
Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
Authors: Kister Ilya , Bacon Tamar E. , Cutter Gary R.
Published: September 2018

Background:

Short-term disease progression is well documented in clinical trials, but there are limited published data on disease course in real-life practice.

Methods:

Patient-derived Multiple Sclerosis Severity Score (PMSSS), a disease severity rank score, was computed at each visit for consecutive MS patients attending two large, ethnically diverse MS centers in New York metropolitan area. Disability was assessed via Patient-Determined Disease Steps (PDDS). Clinicians recorded disease subtype and relapse status at each visit, but did not rate disability. PMSSS change from the first to the last visit was calculated for the cohort as a whole and for subgroups of interest. Multivariable regression models were constructed for predicting final PMSSS based on readily available predictor variables collected at the initial visit and relapse history during follow up.

Results:

A total of 1740 consecutive patients from New York University ( n = 1079) and Barnabas ( n = 661) MS Care Centers were included. During follow up (mean 2.4 ± 0.82  years, range 1–4  years), mean PDDS score increased from 1.9 ± 2.2 to 2.3 ± 2.2 ( p < 0.0001), while PMSSS remained roughly unchanged (initial PMSSS = 3.71 ± 2.73, last PMSSS = 3.81 ± 2.76, paired t test, p = 0.28). The only major predictor of final PMSSS was the initial PMSSS. Demographic variables (age, sex, race) or relapse status did not predict final severity score.

Conclusions:

Baseline disability in two MS clinics was much lower than in the reference population from which PMSSS was derived. We observed no discernable slowing of disability accumulation during the short-term follow up in our cohort compared with the reference cohort. Overwhelmingly the most important predictor of final disease severity rank score was the initial disease severity rank score.
In situ identification strategy of thermoacoustic stability in annular combustors
Authors: Rouwenhorst Driek , Hermann Jakob , Polifke Wolfgang
Published: September 2018

In annular combustion systems, thermoacoustic eigenmodes can manifest as standing waves, traveling waves or some form in between. Which dynamic solution appears in a combustor depends on details, regarding the flow field and (unintentional) breaking of the cylindrical symmetry of the annular combustion system. When these details are unknown, the specific behavior cannot be predicted from the characteristics of a single burner. Due to the (nearly) degenerate nature of the acoustic solution, annular eigenmodes come in pairs with practically the same eigenfrequency. In order to identify the thermoacoustic modes, conventional analysis of a spectral peak from a measurement does not suffice, because the peak is a superposition of the two eigenmodes. A method has been proposed to identify the two eigenmodes of given azimuthal mode order from multiple simultaneous measurements around the circumference of the combustion system. Using output-only identification on the acoustic signals, it is possible to estimate the individual mode shapes, frequencies and growth rates of the co-existing eigenmode pair. In this work, the strategy is applied to experimental data from an annular combustor. A split in the growth rate pair is observed during stable operation, depending on the equivalence ratio and flame-to-flame distance. It shows that in situ identification of annular thermoacoustics can reveal subtle dynamic effects, which is useful for testing and online monitoring of annular combustors. The moment when instability occurs can be foreseen under prevailing conditions, with simultaneous identification of the azimuthal mode structure.
Survival After Exercise-Related Sudden Cardiac Arrest in Young Athletes: Can We Do Better?
Authors: Drezner Jonathan A. , Peterson Danielle F. , Siebert David M. , Thomas Leah Cox , Lopez-Anderson Martha , Suchsland Monica Z. , Harmon Kimberly G. , Kucera Kristen L.
Published: September 2018

Background:

Sudden cardiac arrest (SCA) is the leading cause of death in young athletes during sports.

Hypothesis:

Survival after SCA in young athletes is variable.

Study Design:

Prospective, active surveillance study.

Level of Evidence:

Level 3.

Methods:

From July 1, 2014, to June 30, 2016, exercise-related SCA in competitive young athletes was identified through a systematic search of traditional and social media sources, direct reporting to the National Center for Catastrophic Sports Injury Research, searching of the National Collegiate Athletic Association Resolutions List, regular communication with national and state high school athletic associations, and review of cases in the Parent Heart Watch database.

Results:

A total of 132 cases were identified during the 2-year study period (mean patient age, 16 years; age range, 11-27 years; 84% male; 51% white non-Hispanic/Latino, 30% black/African American, and 11% white Hispanic/Latino). High school athletes accounted for 78 (59%) cases, with 28 (21%) in middle school and 15 (11%) in college athletes. Overall survival was 48% (95% CI, 40%-57%; 64 survivors, 68 deaths). Survival was similar in male versus female athletes but higher in white non-Hispanic/Latino (40/67; 60%) versus black/African American (13/39; 33%) athletes (difference, 27%; 95% CI, 7%-45%; P = 0.008) and white non-Hispanic/Latino versus all minority (18/59; 31%) athletes (difference, 29%; 95% CI, 13%-46%; P = 0.001). Basketball accounted for 30% of cases, followed by football (25%), track/cross-country (12%), and soccer (11%). The majority (93%) of cases were witnessed. If a certified athletic trainer was on-site and involved in the resuscitation, 83% of athletes survived. If an on-site automated external defibrillator was used in the resuscitation, 89% of athletes survived.

Conclusion:

Exercise-related SCA in young, competitive athletes is typically witnessed, providing an opportunity for rapid resuscitation. Additional research is needed to identify factors that affect survival in different athlete populations.

Clinical Relevance:

Public access defibrillator programs should be universal in schools and youth sporting venues and have the potential to increase survival after SCA in young athletes.
Case series of seven women with uterine fibroids associated with venous thromboembolism and chronic thromboembolic disease
Authors: Lacharite‐Roberge Anne‐Sophie , Raza Farhan , Bashir Riyaz , Dass Chandra A. , Moser G. William , Auger William R. , Toyoda Yoshiya , Forfia Paul R. , Vaidya Anjali
Published: September 2018

Uterine fibroids have been described as an associate to acute venous thromboembolism (VTE), with case reports showing an association between large uterine fibroids, acute deep venous thrombosis (DVT), and acute pulmonary embolism (PE). However, there is little known about the association or causation between uterine fibroids, chronic thromboembolic disease (CTED), and chronic thromboembolic pulmonary hypertension (CTEPH). We report on six women with uterine fibroids and CTEPH, as well as one woman with CTED, all of whom presented with exertional dyspnea, lower extremity swelling, and in the cases of CTEPH, clinical, echocardiographic, and hemodynamic evidence of pulmonary hypertension and right heart failure. Compression of the pelvic veins by fibroids was directly observed with invasive venography or contrast‐enhanced computed tomography in five cases. All seven women underwent pulmonary thromboendarterectomy (PTE) followed by marked improvement in functional, clinical, and hemodynamic status.
A fatal case of Ortner’s syndrome and dysphagia aortica secondary to rapidly expanding mycotic thoracic aortic aneurysm in a chronic kidney disease patient
Authors: Kyaw Wynn Aung , Lim Chiao Yuen , Khalil Muhammad Abdul Mabood , Lim Kian Chai , Chong Vui Heng , Tan Jackson
Published: September 2018

Ortner’s syndrome or cardiovocal syndrome is a rare condition and refers to the association between cardiovascular conditions, usually cardiac enlargement from mitral stenosis, and recurrent laryngeal nerve palsy. We reported an interesting case of a patient with end-stage renal disease on regular dialysis who developed both Ortner’s syndrome and dysphagia aortica as a result of an aortic arch aneurysm. The aneurysm underwent a rapid increase in size, likely as a result of Staphylococcus aureus infection (mycotic aneurysm) from an internal jugular dialysis catheter. This case highlighted the importance of cardiovascular conditions as rarer causes of dysphonia and dysphagia, particularly with the existence of an extrinsic infective source.
A meta‐analysis on the cardiac safety profile of domperidone compared to metoclopramide
Authors: Bor Serhat , Demir Mesut , Ozdemir Oktay , Yuksel Kivanc
Published: September 2018

Background

This meta‐analysis aimed to assess the cardiac safety profile of domperidone treatment for the risk of cardiovascular (CV) event and QT prolongation.

Methods

Data from nine studies involving 101,155 patients were used for the analysis of CV event risk, while data from eight studies involving 390 patients were used for the analysis of QT prolongation risk.

Results

Meta‐analysis findings suggested a significant increase in CV risk under domperidone as compared to no treatment for domperidone doses of >30 mg/day (OR: 3.14, 95% CI, 1.191 to 8.304, p = 0.021), no significant increase in QT prolongation event rates with domperidone (3.54%, 95% CI, 1.73% to 7.10%) and a significantly lower CV risk for domperidone than for metoclopramide (OR: 0.63, 95% CI, 0.58 to 0.70, p < 0.001).

Conclusions

The present meta‐analysis indicates that domperidone treatment may not be associated with an overall CV event risk increase at doses ≤30 mg/day and does not result in QT prolongation.
Determinants of Corporate Environmental Disclosure from an Asian Perspective
Authors: Roy Abhijit , Ghosh Santanu Kumar
Published: September 2018

The present study attempts to address the inconclusive outcomes of the existing literature on the determinants of corporate environmental disclosure. It reports that country level factors like national cultural dimensions, political rights, civil liberties, freedom of expression and the prevailing legal system can explain the corporate environmental disclosure decisions in that particular country. Existing studies on the determinants of corporate environmental disclosure mostly focus on accounting based and stock market based variables at the firm level and report fairly inconclusive outcomes. Literature on the determinants of corporate environmental disclosure using country level variables is limited but more consistent. The country level cultural, political and legal phenomena have good potential for extensive research in explaining corporate governance and corporate social responsibility issues.
Left Atrial Appendage Occlusion Complicated by Appendage Perforation Rescued by Device Deployment
Authors: Sarcon Anna , Roy Dipayon , Laughrun David , Huntsinger Mary , Schwartz Jacqueline , Sohn Jina , Doshi Rahul N.
Published: September 2018

The Watchman device is a transcatheter left atrial appendage (LAA) occluding device used in patients with nonvalvular atrial fibrillation (NVAF) and a high CHADS2-VA2SC score who are poor long-term anticoagulation candidates. Pericardial effusion related to device deployment and perforation can be a life-threatening complication. While not common in hands of experienced operators, management may require surgical intervention. Here we present a rare case of LAA perforation, which was corrected by successful repositioning of the device foregoing the need for surgical management.
The Economization of Diversity
Authors: Thomas James M.
Published: September 2018

Through a case study of an ongoing diversity initiative at Diversity University (DU), a public, flagship university in the U.S. South, the author’s research advances understanding of the discursive relationship between neoliberalism and contemporary racial ideology. As part of a larger ethnographic project, the author draws on more than ten years worth of diversity discourse at DU to illuminate diversity’s economization: the process whereby specific formations of economic values, practices, and metrics are extended toward diversity as justification for DU’s efforts. The analysis responds to three questions: (1) How is diversity economized by the organization? (2) How is this economization articulated through organizational discourse on diversity? and (3) How does the economization of diversity potentially reconfigure race and racial subjectivities? The findings reveal three interrelated processes that facilitate diversity’s economization: diversity as investment, diversity metrics, and diversity as affective labor. Together these processes congeal and convert multicultural principles and practices into economic ones. Consequently, diversity’s economization recasts nonwhite racial subjectivity as human capital for DU and its white publics, minimizing and entrenching existing racial inequality in the process.
The interrelationships among job satisfaction, work–home interference and psychological contract breach
Authors: Abdelmoteleb Samir A
Published: September 2018

This study aims to expand the literature on work–home interference, job satisfaction and psychological contracts. Using a two-wave panel survey, this study tests an explanatory model using data collected from 414 employees of three Egypt-based organizations. Consistent with the developed hypotheses, the results indicate a reciprocal negative relationship between employees’ work–home interference and job satisfaction. Moreover, psychological contract breach is negatively associated with job satisfaction. Furthermore, a moderating role of psychological contract breach in the relationship between work–home interference and job satisfaction is supported. In other words, a higher level of psychological contract breach intensifies the negative impact of work–home interference on job satisfaction. Implications for theory, research and practice and directions for future research with cultural emphasis are discussed.
Sonography Simulators: Use and Opportunities in CAAHEP-Accredited Programs
Authors: Pessin Yosefa J. , Tang-Simmons Jason
Published: September 2018

Concern for patient safety and increased demands on health professionals have resulted in challenges for the clinical training of sonography students. The purpose of this study was to examine simulation use in Commission on Accreditation of Allied Health Education Programs (CAAHEP)–accredited sonography programs. A prospective cross-sectional study was conducted. Program directors were sent a survey that addressed the use of simulation and the perception of simulation’s educational value. Of the 230 sonography programs identified, 137 responded, for a response rate of 60%. Of the respondents, 75% indicated they used simulation and 89% reported that it was a good teaching tool. The programs indicated that 81% recorded a positive student experience using simulation. Simulation was rated most useful for improved anatomic identification (55%) and transducer manipulation (64%). Simulation is commonly used for educational training in CAAHEP-accredited sonography programs and is perceived as a positive tool to enhance education of students. More research is needed to establish best use and educational practice.
How I manage medical complications of β-thalassemia in adults
Authors: Taher Ali T. , Cappellini Maria Domenica
Published: September 2018

The complex pathophysiology in β-thalassemia can translate to multiple morbidities that affect every organ system. Improved survival due to advances in management means that patients are exposed to the harmful effects of ineffective erythropoiesis, anemia, and iron overload for a longer duration, and we started seeing new or more frequent complications in adult compared with younger patients. In this article, we highlight particular aspects of managing adult patients with β-thalassemia, using our own experience in treating such patients. We cover both transfusion-dependent and nontransfusion-dependent forms of the disease and tackle specific morbidities of highest interest.
Is a matched unrelated donor search needed for all allogeneic transplant candidates?
Authors: Ciurea Stefan O. , Bittencourt Maria Cecilia Borges , Milton Denái R. , Cao Kai , Kongtim Piyanuch , Rondon Gabriela , Chen Julianne , Konopleva Marina , Perez Jorge M. Ramos , El Shazly Mohammed F. , Aljadayeh Majdi , Alvarez Michele , Im Jin , Al-Atrash Gheath , Mehta Rohtesh , Popat Uday , Bashir Qaiser , Oran Betul , Hosing Chitra M. , Khouri Issa F. , Kebriaei Partow , Champlin Richard E.
Published: September 2018

Donor availability for allogeneic transplantation remains an important factor in determining outcomes of a successful transplant. We examined outcomes of 242 patients treated over 3 years who had a matched unrelated donor (MUD) search at our institution. One hundred sixty patients (66%) had a 10 of 10 MUD identified, and 85 (53%) proceeded to MUD transplantation. White patients and those with common haplotypes were more likely to have a MUD identified (odds ratio [OR], 7.4 [P < .0001]; OR, 41.6 [P < .0001]), and were more likely to proceed to transplantation with a MUD (OR, 11.2 [P < .0001]; OR, 85.1 [P = .002]). In addition, patients who were newly diagnosed/in remission at the time of MUD search had a higher probability of receiving a transplant (OR, 2.01 [P = .013]) and better progression-free survival (PFS; P < .0001). In multivariate analysis for patients who received a transplant, donor type did not influence PFS at 3 years, which was 40% for MUD and 57% for haploidentical transplants, respectively (hazard ratio, 1.2 [P = .50]). In conclusion, race, haplotype frequency, and disease status at the time of MUD search influence the probability of identifying a MUD and receiving a transplant. Patients with a low likelihood of receiving a MUD transplant may proceed to a haploidentical transplant as soon as indicated, as this approach does not appear to compromise transplant outcomes.
RETRACTED ARTICLE: Pluronic-based nano-self-assemblies of bacitracin A with a new mechanism of action for an efficient in vivo therapeutic effect against bacterial peritonitis
Authors: Hong Wei , Liu Lipeng , Zhao Yining , Liu Yinghui , Zhang Dexian , Liu Mingchun
Published: September 2018

Background

Although assemblies of hydrophobic-modified bacitracin A with PLGA (Nano-BAPLGA) have demonstrated promising antibacterial activities against both Gram-positive and Gram-negative bacteria, the desirable antibacterial potency has remained challenging due to the low solubility of Nano-BAPLGA. To address this tissue, a series of Pluronic copolymers (Pluronic® F127, Pluronic® P123 and Pluronic® P85) were selected to link the N-terminus of bacitracin A to construct Pluronic-based nano-self assemblies (Nano-BAF127, Nano-BAP123 and Nano-BAP85).

Results

Impressively, all the newly designed Pluronic-based Nano-BAs possessed higher solubility and stronger effectiveness against both Gram-positive and Gram-negative bacteria compared with Nano-BAPLGA, especially the modification with Pluronic® P85. Surface tension measurements indicated that Nano-BAP85 was much more tensioactive than Nano-BAPLGA, which usually translated into a good membranolytic effect. Fluorescence spectroscopy and electron microscopy analyses confirmed the speculation that the cell wall/membrane might be the main action target of Nano-BAP85 by permeabilizing the cell membrane and damaging the membrane integrity. In vivo results further demonstrated that Nano-BAP85 significantly suppressed bacterial growth and prolonged survival time in the bacterial peritonitis mouse model with negligible toxicity.

Conclusions

Collectively, the membrane targeting mechanism of action is entirely distinct from those of clinically used antibacterial agents. Furthermore, the new approach of construction nanoantibiotics based on the modification of commercially available antibiotics with Pluronic copolymers is demonstrated to have an efficient therapeutic effect against bacterial infection.
Feasibility of Implementing the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events in a Multicenter Trial: NCCTG N1048
Authors: Basch Ethan , Dueck Amylou C. , Rogak Lauren J. , Mitchell Sandra A. , Minasian Lori M. , Denicoff Andrea M. , Wind Jennifer K. , Shaw Mary C. , Heon Narre , Shi Qian , Ginos Brenda , Nelson Garth D. , Meyers Jeffrey P. , Chang George J. , Mamon Harvey J. , Weiser Martin R. , Kolevska Tatjana , Reeve Bryce B. , Bruner Deborah Watkins , Schrag Deborah
Published: September 2018

Purpose

The US National Cancer Institute (NCI) Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was developed to enable patient reporting of symptomatic adverse events in oncology clinical research. This study was designed to assess the feasibility and resource requirements associated with implementing PRO-CTCAE in a multicenter trial.

Methods

Patients with locally advanced rectal cancer enrolled in the National Cancer Institute–sponsored North Central Cancer Treatment Group (Alliance) Preoperative Radiation or Selective Preoperative Radiation and Evaluation before Chemotherapy and Total Mesorectal Excision trial were asked to self-report 30 PRO-CTCAE items weekly from home during preoperative therapy, and every 6 months after surgery, via either the Web or an automated telephone system. If participants did not self-report within 3 days, a central coordinator called them to complete the items. Compliance was defined as the proportion of participants who completed PRO-CTCAE assessments at expected time points.

Results

The prespecified PRO-CTCAE analysis was conducted after the 500th patient completed the 6-month follow-up (median age, 56 years; 33% female; 12% nonwhite; 43% high school education or less; 5% Spanish speaking), across 165 sites. PRO-CTCAE was reported by participants at 4,491 of 4,882 expected preoperative time points (92.0% compliance), of which 3,771 (77.2%) were self-reported by participants and 720 (14.7%) were collected via central coordinator backup. Compliance at 6-month post-treatment follow-up was 333 of 468 (71.2%), with 122 (26.1%) via backup. Site research associates spent a median of 15 minutes on PRO-CTCAE work for each patient visit. Work by a central coordinator required a 50% time commitment.

Conclusion

Home-based reporting of PRO-CTCAE in a multicenter trial is feasible, with high patient compliance and low site administrative requirements. PRO-CTCAE data capture is improved through centralized backup calls.
Impacts of differences in nutritional quality of wingless and winged aphids on parasitoid fitness
Authors: Pirotte Jennifer A.-L. M. , Lorenzi Ange , Foray Vincent , Hance Thierry
Published: September 2018

Winged aphids are described as hosts of lesser quality for parasitoids because a part of their resources is used to produce wings and associated muscles during their development. Host lipid content is particularly important for parasitoid larvae as they lack lipogenesis, therefore, they rely entirely on the host for this resource. The goal of this study is to determine in what extent winged and wingless aphids differ from the nutritional point of view and if these differences impact the parasitoid fitness notably the lipid content. We analysed the energetic budget (proteins, lipids and carbohydrates) of aphids of different ages (third, fourth instars and adults) according to the morph (winged or wingless). We also compared fitness indicators for parasitoids emerging from winged and wingless aphids (third and fourth instars). We found that in third instars, parasitoids are able to inhibit wing development whereas not in fourth instars. Both winged instars allow the production of heavier and fattier parasitoids. The presence of wings in aphids seems to have little effect on the fitness of emerging parasitoids and did not modify female choice for oviposition. Finally, we demonstrate that Aphidius colemani, used as a biological control agent is able to parasite wingless as well as winged Myzus persicae at least the juvenile stages. If the parasitism occurs in third instars, the parasitoid will prevent the aphid from flying, which could in turn reduce the virus transmission.
Interaction between a Single-Stranded DNA and a Binding Protein Viewed by the Fragment Molecular Orbital Method
Authors: Komeiji Yuto , Okiyama Yoshio , Mochizuki Yuji , Fukuzawa Kaori
Published: September 2018

The interaction between a single-stranded DNA (ssDNA) and a binding protein (Sulfolobus solfataricus ssDNA binding protein, SSB) were investigated by the ab initio fragment molecular orbital (FMO) method in explicit solvent. The calculated overall energy change upon complexation suggested that the ssDNA/SSB association is not strong. Nonetheless, more detailed analysis of interfragment interaction energy (IFIE) and pair interaction energy decomposition analysis (PIEDA) indicated that the ssDNA/SSB association is based upon a minute balance of various contributions of local structural parts of the molecules. The most stabilizing contribution was that by the electrostatic interaction between the sugar–phosphate backbone of ssDNA and charged side chains of SSB, and the second was that by the stacking interaction between bases of ssDNA and aromatic side chains of SSB. Thus, though the overall association energy change was small, the local interactions were suggested to contribute to the association.
Taxa: An R package implementing data standards and methods for taxonomic data
Authors: Foster Zachary S.L. , Chamberlain Scott , Grünwald Niklaus J.
Published: September 2018

The taxa R package provides a set of tools for defining and manipulating taxonomic data. The recent and widespread application of DNA sequencing to community composition studies is making large data sets with taxonomic information commonplace. However, compared to typical tabular data, this information is encoded in many different ways and the hierarchical nature of taxonomic classifications makes it difficult to work with. There are many R packages that use taxonomic data to varying degrees but there is currently no cross-package standard for how this information is encoded and manipulated. We developed the R package taxa to provide a robust and flexible solution to storing and manipulating taxonomic data in R and any application-specific information associated with it. Taxa provides parsers that can read common sources of taxonomic information (taxon IDs, sequence IDs, taxon names, and classifications) from nearly any format while preserving associated data. Once parsed, the taxonomic data and any associated data can be manipulated using a cohesive set of functions modeled after the popular R package dplyr. These functions take into account the hierarchical nature of taxa and can modify the taxonomy or associated data in such a way that both are kept in sync. Taxa is currently being used by the metacoder and taxize packages, which provide broadly useful functionality that we hope will speed adoption by users and developers.
The destruction of the ‘Windrush’ disembarkation cards: a lost opportunity and the (re)emergence of Data Protection regulation as a threat to longitudinal research
Authors: Boyd Andy , Woollard Matthew , Macleod John , Park Alison
Published: September 2018

Historical records and the research databases of completed studies have the potential either to establish new research studies or to inform follow-up studies assessing long-term health and social outcomes. Yet, such records are at risk of destruction resulting from misconceptions about data protection legislation and research ethics. The recent destruction of the Windrush disembarkation cards, which potentially could have formed the basis of a retrospective cohort study, illustrates this risk. As organisations across Europe transition to the EU General Data Protection Regulation (GDPR), this risk is being amplified due to uncertainty as to how to comply with complex new rules, and the requirement under GDPR that data owners catalogue their data and set data retention and destruction rules. The combination of these factors suggests there is a new meaningful risk that scientifically important historical records will be destroyed, despite the fact that GDPR provides a clear legal basis to hold historical records and to repurpose them for research for the public good. This letter describes this risk; details the legal basis enabling the retention and repurposing of these data; makes recommendations as to how to alleviate this risk; and finally encourages the research and research-active clinical community to contact their ‘Data Protection Officers’ to promote safe-keeping of historical records.
MYCOPLASMAS: BIOLOGY, DISTRIBUTION AND ROLE IN PATHOLOGY
Authors: Катола Виктор , Katola Viktor
Published: September 2018

The general characteristics of the Mollicutes class of the family Mycoplasmataceae, the distribution and sources of mycoplasma infection, its clinical features and diagnostic methods are given. In scanning electron microscopy of blood plasma in patients with severe fibrous cavernous pulmonary tuberculosis in the phase of infiltration and seeding, elementary bodies of unidentified L-forms of bacteria and filamentous branching forms with various structures on the surface, presumably cells of mycoplasmas, were identified. All these formations together with mycobacterium tuberculosis form superinfection, which is the cause of the progression and outcome of the tuberculosis process.
Cardiac catheterisation: the healthcare assistant and assistant practitioner's role
Authors: Flatman Lewis
Published: September 2018

Coronary heart disease (CHD) is the leading cause of death in the UK. Cardiac catheterisation is used to provide access to the coronary arteries, allowing cardiologists to take images and treat heart disease.

This article aims to provide a brief overview of the arterial system and reasons for cardiac catheterisation. How healthcare assistants and assistant practitioners can support senior staff in preparation and post-procedural care is also explored throughout the article.