bluuebunny/crossref_metadata_2025 huggingface dataset:
Ensuring Capability to Provide Safe Patient Care Prior to Occupying Renovated Clinical Area
Authors: West Gordon F. , Rose Traceee J.
Published: June 2018

Objective:

To determine the effectiveness of simulation in improving staff confidence to provide safe patient care in a new or unfamiliar patient care area.

Background:

Hospitals undergo constant renovation to meet the needs of the populations they serve. Relocating to a newly renovated care area can potentially impact patient safety through workflow process changes.

Method:

Simulated patient care scenarios were used to assess functionality of equipment and staff orientation to a newly renovated ward. Additionally, staff confidence to provide safe patient care was assessed prior to patient relocation.

Results:

All participating staff reported feeling confident in their ability to provide safe patient care within the newly renovated ward at the conclusion of the exercise.

Conclusions:

In this case study, the use of simulated patient care scenarios was successful to orientate staff to a new clinical space. Additionally, staff were able to identify workflow changes and access the functionality of newly installed equipment. This exercise allowed staff to gain confidence in their ability to provide safe patient care in a newly renovated area.
Monitoring Young Tropical Forest Restoration Sites: How Much to Measure?
Authors: Viani Ricardo A. G. , Barreto Tiago E. , Farah Fabiano T. , Rodrigues Ricardo R. , Brancalion Pedro H. S.
Published: June 2018

Monitoring is a key step for achieving restoration success. Despite increasing advances for selecting ecological indicators, monitoring sampling designs are not always available. We investigated how tree richness and the most used forest structure indicators vary spatially in restoration sites, aiming to provide evidence-based guidance for future monitoring protocols. We collected data from eight forest restoration sites covering overall 1,000 ha in four Brazilian Atlantic Forest regions. Canopy cover, tree density, vegetation height, and species richness were assessed in 18.2 ha of plots ranging from 60 to 300 m2 in size, in restoration sites aged 1 to 5 years old. Using resampling techniques, we calculated the sampling error for the indicators and compared them with original sampling results, and then estimated the number of plots needed to reach a 20% sampling error. The ecological indicators assessed showed high variability among restoration sites. Canopy cover and height required less plots to reach the targeted sampling error than density of trees. The number of species does not stabilize even when more than 90% of the total number of plots was resampled, indicating high spatial variation. The use of the sampling error approach for defining how much to monitor, associated to appropriate sampling methods, could increase the reliability of monitoring. In addition, they will reduce operational costs, thus providing a key contribution to the effectiveness of large-scale restoration programs expected to be implemented globally in the coming years. Thus, we recommend the incorporation of this in the forest restoration monitoring protocols being discussed worldwide.
Crosstalk signaling between alveoli and capillaries
Authors: Hough Rebecca F. , Bhattacharya Sunita , Bhattacharya Jahar
Published: June 2018

Crosstalk signaling between the closely juxtaposed epithelial and endothelial membranes of pulmonary alveoli establishes the lung’s immune defense against inhaled and blood‐borne pathogens. The crosstalk can occur in a forward direction, as from alveolus to capillary, or in a reverse direction, as from capillary to alveolus. The crosstalk direction likely depends on the site at which pathogens first initiate signaling. Thus, forward crosstalk may occur when inhaled pathogens encounter the alveolar epithelium, while reverse crosstalk may result from interactions of blood‐borne pathogens with the endothelium. Here, we review the factors that regulate these two directions of signaling.
Expression and clinical significance of SERPINA3 and EFEMP2 in endometrial carcinoma
Authors: Wang Shaoguang , Dong Yaozong , Meng Xiaomei
Published: June 2018

Our study aimed to investigate expression and clinical significance of serpin peptidase inhibitor clade A member 3 (SERPINA3) and epidermal growth factor (EGF) containing fibulin-like extracellular matrix protein 2 (EFEMP2) in endometrial carcinoma. A total of 180 patients treated in our hospital from January 2015 to April 2017 were selected as subjects. Positive expression of SERPINA3 was found in 48 cases (80%) in the cancer group, in 6 cases (10%) in the hyperplasia group, and in no case in the control group. The expression of SERPINA3 in the cancer group was significantly higher than that in the hyperplasia group and control group ( P < 0.05). Positive expression of EFEMP2 was found in 10 cases (16.7%) in the cancer group, in 27 cases (45%) in the hyperplasia group, and in 42 cases (70%) in the control group. The expression of EFEMP2 in the cancer group was significantly lower than that in the hyperplasia and control groups ( P < 0.05). The protein expression of SERPINA3 in the cancer group was significantly higher than that in the hyperplasia and control groups ( P < 0.05). The protein expression of EFEMP2 in the cancer group was significantly lower than that in the hyperplasia and control groups ( P < 0.05). The expression of SERPINA3 and EFEMP2 in cancer tissues was related to the degree of tumor differentiation, clinical classification, and lymph node metastasis ( P < 0.05), but not related to age and tumor size ( P > 0.05). SERPINA3 was highly expressed while EFEMP2 was low expressed in endometrial cancer patients. The expression of SERPINA3 and EFEMP2 in cancer tissues was related to the degree of tumor differentiation, clinical classification, and lymph node metastasis and was hopeful to be one of the detection indexes of endometrial carcinoma.
I Am Nobody Here: Institutional Humanism and the Discourse of Disposability in the Lives of Criminalized Refugee Youth in Canada
Authors: Francis Jenny
Published: June 2018

This article uses the concept of “institutional humanism” to explicate how the ideology of humanism is deployed through a biopolitical “discourse of disposability” to dehumanize, objectify, and animalize racialized and criminalized refugee youth in Canada, setting them in opposition to mainstream Whites who are deemed normal, rational, and autonomous—in essence, human. This article identifies four mechanisms of disposability: the expulsion of criminalized refugee youth from school and the labor market, the “revolving door” of the criminal justice system, the creation of deportability, and disinvestment in programs for youth. The treatment of criminalized refugee youth as disposable is part of an epistemological and ontological exercise that creates and enforces a boundary between those defined as human and those who are excluded from the set of “bodies that matter.” The study was conducted through qualitative interviews with criminalized refugee youth and professional adults who work with them. The interview data are set within the web of theoretical relationships among humanism, posthumanism, animalization, institutional policy, and categorizations based on race, gender, class, ability, age, and immigration status, demonstrating how these theoretical nodes attain bolder relief when operationalized under performativity.
Introduction to the Special Issue
Authors: Young Anita A. , Dollarhide Colette T.
Published: June 2018

In this introduction article to the special issue of Professional School Counseling on “School Counseling Leadership in Practice,” the guest editors advance the next evolution of school counseling leadership by presenting a compilation of research, conceptual, and practitioner articles. The special issue emphasizes how school counselors can lead efforts endorsed by the American School Counselor Association Mindsets & Behaviors, examines ways social justice leadership is manifested in school counseling programs, and explores new leadership paradigms.
School Counselors’ Emotional Intelligence and Its Relationship to Leadership
Authors: Mullen Patrick R. , Gutierrez Daniel , Newhart Sean
Published: June 2018

In this investigation, we examined the relationship between emotional intelligence, leadership self-efficacy (LSE), self-leadership, and leadership experiences among a sample of practicing school counselors. School counselors who reported higher levels of emotional intelligence also reported greater LSE, self-leadership, and leadership experiences. We discuss the implications of these findings for the practice of school counseling and potential future research on school counselor leadership.
A Social-Emotional Leadership Framework for School Counselors
Authors: Bowers Hannah , Lemberger-Truelove Matthew E. , Brigman Greg
Published: June 2018

Social-emotional learning (SEL) is an effective intervention focus associated with personal growth, student achievement, and behavioral regulation. The authors suggest that school counselors extend SEL practices into their leadership dispositions and behaviors. The authors offer implications for socially just school counseling practice, scholarship, and program evaluation.
School Counselors as Curricular Leaders
Authors: Lopez Caroline J. , Mason Erin C. M.
Published: June 2018

The authors examined school counselors design of classroom curriculum lessons through a content analysis of lesson plans located on the American School Counselor Association (ASCA) Scene website. The analysis coded 139 lesson plans based on 12 lesson plan component categories and types of instructional strategies used. Findings address the frequency of topics related to the three ASCA domains, grade levels, and scores on 12 lesson components including overall total score. The article includes implications for school counselor leadership and training.
Transformative Leadership in School Counseling
Authors: Shields Carolyn M. , Dollarhide Colette T. , Young Anita A.
Published: June 2018

Transformative leadership is a leadership paradigm that addresses the need for systemic, equitable change in education. We propose eight tenets within this paradigm that support equity, inclusion, excellence, and social justice. We then apply these tenets to the American School Counselor Association’s ASCA National Model to demonstrate how a comprehensive school counseling program would be designed using transformative leadership, improving learning environments for all students.
Black Male School Counselor Educator Contextual Explorations in Leadership
Authors: Henfield Malik S. , Washington Ahmad R. , Rue Lisa De La , Byrd Janice A.
Published: June 2018

The counseling profession has seen an increase in research exploring counselor educators’ professional identity development. Leadership skills are noted in the Council for Accreditation of Counseling and Related Educational Programs standards as an important part of a school counselor’s identity, but scholars have paid less attention to leadership identity development for counselor educators. This lack of emphasis in the literature is even more evident when considering the leadership development of racial and ethnic minority counselor educators in school counseling programs. This article explores and critiques noted leadership approaches and provides firsthand accounts of two Black male counselor educators’ experiences leading school counseling programs.
Promoting STEM Career Development Among Students and Parents of Color
Authors: Shillingford M. Ann , Oh Seungbin , Finnell Laura Rendell
Published: June 2018

To date, millions of dollars have been spent in hopes of bolstering an increase among students of color pursuing science, technology, engineering, and math (STEM) professions. School counselors are uniquely positioned to contribute to this increase; however, they often miss the significance of their leadership role in improving STEM opportunities, particularly for students of color. The results from this qualitative study point to systemic variables that hinder such engagements and provide implications for school counselors and counselor education programs.
Robotic rehabilitation training with a newly developed upper limb single-joint Hybrid Assistive Limb (HAL-SJ) for elbow flexor reconstruction after brachial plexus injury: A report of two cases
Authors: Kubota Shigeki , Kadone Hideki , Shimizu Yukiyo , Hara Yuki , Kubo Tadashi , Watanabe Hiroki , Hada Yasushi , Ochiai Naoyuki , Sankai Yoshiyuki , Yamazaki Masashi
Published: June 2018

This study aimed to evaluate the effectiveness and safety of using the upper limb single-joint Hybrid Assistive Limb (upper limb HAL-SJ) during elbow flexion training following elbow flexor reconstruction for brachial plexus injury (BPI). We present the cases of two patients in whom the upper limb HAL-SJ was implemented 5 and 7 months postoperatively following elbow flexor reconstruction for BPI. They underwent elbow flexor reconstruction with intercostal nerve crossing-to-musculocutaneous nerve (ICN-MCN crossing) after BPI. Postoperative training using the upper limb HAL-SJ was started from the Medical Research Council (MRC) grade 1 elbow flexion power to MRC grade 3 once every week or every 2 weeks. Both patients could implement elbow training using the upper limb HAL-SJ even in MRC grade 1 of their elbow flexion power. Training with the upper limb HAL-SJ was performed safely and effectively in two patients with elbow flexor reconstruction with ICN crossing after BPI.
Adapting Hearing Devices to the Individual Ear Acoustics: Database and Target Response Correction Functions for Various Device Styles
Authors: Denk Florian , Ernst Stephan M. A. , Ewert Stephan D. , Kollmeier Birger
Published: June 2018

To achieve a natural sound quality when listening through hearing devices, the sound pressure at the eardrum should replicate that of the open ear, modified only by an insertion gain if desired. A target approximating this reference condition can be computed by applying an appropriate correction function to the pressure observed at the device microphone. Such Target Response Correction Functions (TRCF) can be defined based on the directionally dependent relative transfer function between the location of the hearing device microphone and the eardrum of the open ear. However, it is unclear how exactly the TRCF should be derived, and how large the benefit of individual, versus generic, correction is. We present measurements of Head-Related Transfer Functions (HRTF) at the eardrum and at 9 microphone locations of a comprehensive set of 5 hearing device styles, including 91 incidence directions, and recorded in 16 subjects and 2 dummy heads. Based on these HRTFs, individualized and generic TRCF were computed for frontal (referred to as free-field) and diffuse-field sound incidence. Spectral deviations between the computed target and listening with the open ear were evaluated using an auditory model and virtual acoustic scenes. Results indicate that a correction for diffuse-field incidence should be preferred over the free field, and individual correction functions result in notably reduced spectral deviations to open-ear listening, as compared with generic correction functions. These outcomes depend substantially on the specific device style. The HRTF database and derived TRCFs are publicly available.
A cost-effective method for tranquility mapping using open environmental data
Authors: Pafi Maria , Chalkias Christos , Stathakis Demetris
Published: June 2018

In this study, we propose a cost-effective method for tranquillity mapping using multi-criteria analysis and open geospatial data. We apply this method in an extended zone around a major Greek highway trespassing areas of high natural value. Composite criteria are developed through analytic functions and geostatistical methods to reflect either barriers or enablers of tranquillity. The results indicate that it is possible to identify tranquility zones which are spatially plausible. To verify the validity of the results, we calculate the Kappa coefficient (0.71) and the overall accuracy (80%) using preference data obtained from non-specialized photo-interpreters in a sample of places on Google Earth. We believe that this method can inform planning, especially in countries with a weak landscape policy.
Leveraging Policies for Self Sufficiency in Pulses in India
Authors: Kumar Ranjit , Raju K. V.
Published: June 2018

Although pulses are a major source of protein integral to the Indian diet, there has been a consistent demand–supply gap. Barring the last five years, total production of pulses remained stagnant at 12–14 million tonnes (mt) over the past five decades. Over the last 20 years, more than 550 improved varieties of different maturity periods and for different regions have been released by public research organisations, but the availability of quality seeds remained a serious concern, thereby resulting in yield uncertainty. The domestic supply fell short by 3–4 mt every year. Also, owing to increased consumption by the diet-conscious growing urban population in India, prices rose by 150 per cent to 200 per cent in recent years. The supportive trade policy has cooled down the pulses price during the deficit year, while encouraging price support policy and good monsoon helped in a big way to allocate 20 per cent more area to the crop, which resulted in record pulses production of 23 mt in 2016–2017. This article captures the influence of government policy on pulses production and suggests paradigm shift in strategy through short-, medium- and long-term plans to achieve self-sufficiency in pulses production and ensure nutritional security for population.
Renal Echogenicity as a Predictor of Human Immunodeficiency Virus–Associated Nephropathy: A Cross-Sectional Study at a Tertiary Hospital in Lagos, Southwest Nigeria
Authors: Eze Cletus Uche , Eze Charles Ugwoke , Adeyomoye Adekunle A. O.
Published: June 2018

The objective of this study was to determine the accuracy of sonography in a human immunodeficiency virus–associated nephropathy (HIVAN) diagnosis. A sample of 340 HIVAN patients underwent laboratory CD4+ count, serum creatinine/glomerular filtration rate (GFR) estimation, and sonographic echogenicity grading. The accuracy of sonography in predicting an HIVAN diagnosis was calculated. Mean CD4+ count, serum creatinine, and GFR for male and female HIVAN patients was 153.1 ± 103.2 cells/mm3 and 121.9 ± 91.0 cells/mm3, 218.4 ± 147.4 mmol/L and 222.0 ± 150.4 mmol/L, and 50.1 ± 23.6 mL/min/1.73 m2 and 39.3 ± 20.6 mL/min/1.73 m2, respectively; 56.9% of patients had echogenicity grade 3. On the basis of CD4+ count, serum creatinine, and GFR, the area under the curve was 0.76 and ≈ 1, respectively; the area under the curve was 0.63, 0.79, 0.70, 0.79 and 0.91, 0.99, 1, 1 for grades 0, 1, 2, and 3 echogenicity, respectively. With a high level of apathy to voluntary HIV/AIDS screening and late patient presentation, sonography (grade 3 renal echogenicity) can assist in predicting an HIVAN diagnosis.
Immunological corollary of the pulmonary mycobiome in bronchiectasis: the CAMEB study
Authors: Mac Aogáin Micheál , Chandrasekaran Ravishankar , Lim Albert Yick Hou , Low Teck Boon , Tan Gan Liang , Hassan Tidi , Ong Thun How , Hui Qi Ng Amanda , Bertrand Denis , Koh Jia Yu , Pang Sze Lei , Lee Zi Yang , Gwee Xiao Wei , Martinus Christopher , Sio Yang Yie , Matta Sri Anusha , Chew Fook Tim , Keir Holly R. , Connolly John E. , Abisheganaden John Arputhan , Koh Mariko Siyue , Nagarajan Niranjan , Chalmers James D. , Chotirmall Sanjay H.
Published: June 2018

Understanding the composition and clinical importance of the fungal mycobiome was recently identified as a key topic in a “research priorities” consensus statement for bronchiectasis.

Patients were recruited as part of the CAMEB study: an international multicentre cross-sectional Cohort of Asian and Matched European Bronchiectasis patients. The mycobiome was determined in 238 patients by targeted amplicon shotgun sequencing of the 18S–28S rRNA internally transcribed spacer regions ITS1 and ITS2. Specific quantitative PCR for detection of and conidial quantification for a range of airwayAspergillusspecies was performed. Sputum galactomannan,Aspergillusspecific IgE, IgG and TARC (thymus and activation regulated chemokine) levels were measured systemically and associated to clinical outcomes.

The bronchiectasis mycobiome is distinct and characterised by specific fungal genera, includingAspergillus,CryptococcusandClavispora.Aspergillus fumigatus(in Singapore/Kuala Lumpur) andAspergillus terreus(in Dundee) dominated profiles, the latter associating with exacerbations. High frequencies ofAspergillus-associated disease including sensitisation and allergic bronchopulmonary aspergillosis were detected. Each revealed distinct mycobiome profiles, and associated with more severe disease, poorer pulmonary function and increased exacerbations.

The pulmonary mycobiome is of clinical relevance in bronchiectasis. Screening forAspergillus-associated disease should be considered even in apparently stable patients.
Maternal age at delivery, lung function and asthma in offspring: a population-based survey
Authors: Gómez Real Francisco , Burgess John A. , Villani Simona , Dratva Julia , Heinrich Joachim , Janson Christer , Jarvis Debbie , Koplin Jennifer , Leynaert Bénédicte , Lodge Caroline , Lærum Birger N. , Matheson Melanie C. , Norbäck Dan , Omenaas Ernst R. , Skulstad Svein M. , Sunyer Jordi , Dharmage Shyamali C. , Svanes Cecilie
Published: June 2018

There is limited information about potential impact of maternal age on the respiratory health of offspring. We investigated the association of maternal age at delivery with adult offspring's lung function, respiratory symptoms and asthma, and potential differences according to offspring sex.

10 692 adults from 13 countries participating in the European Community Respiratory Health Survey (ECRHS) II responded to standardised interviews and provided lung function measurements and serum for IgE measurements at age 25–55 years. In logistic and linear multilevel mixed models we adjusted for participants’ characteristics (age, education, centre, number of older siblings) and maternal characteristics (smoking in pregnancy, education) while investigating for differential effects by sex. Maternal age was validated in a subsample using data from the Norwegian birth registry.

Increasing maternal age was associated with increasing forced expiratory volume in 1 s (2.33 mL per year, 95% CI 0.34–4.32 mL per year), more consistent in females (ptrend0.025) than in males (ptrend0.14). Asthma (OR 0.85, 95% CI 0.79–0.92) and respiratory symptoms (OR 0.87, 95% CI 0.82–0.92) decreased with increasing maternal age (per 5 years) in females, but not in males (pinteraction0.05 and 0.001, respectively). The results were consistent across centres and not explained by confounding factors.

Maternal ageing was related to higher adult lung function and less asthma/symptoms in females. Biological characteristics in offspring related to maternal ageing are plausible and need further investigation.
Maintenance low-dose chemotherapy in patients with high-risk (HR) rhabdomyosarcoma (RMS): A report from the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG).
Authors: Bisogno Gianni , De Salvo Gian Luca , Bergeron Christophe , Jenney Meriel , Merks Johannes H.M. , Minard-Colin Veronique , Orbach Daniel , Glosli Heidi , Chisholm Julia , Casanova Michela , Gallego Melcon Soledad , Ferrari Andrea ,   European Paediatric Soft Tissue Sarcoma Study Group (EpSSG)
Published: June 2018

LBA2

Background:
Most patients with localized RMS achieve complete remission during standard (std) treatment but approximately 20-30% of them relapse and chance of salvage is poor. We tested whether adding maintenance metronomic chemotherapy after std chemotherapy would improve survival for patients with non metastatic RMS defined as HR according to EpSSG stratification.
Methods:
Patients (pts) age >6 months <21 years, with N0 alveolar (A)RMS or incompletely resected (Group II or III) embryonal (E)RMS arising in an unfavorable primary site and/or N1 in complete remission after std treatment including 9 cycles of ifosfamide, vincristine and actinomycin D +/- doxorubicin, surgery and/or radiotherapy were eligible for randomization to stop treatment (Std-arm) or receive maintenance chemotherapy (M-arm) with 6 28-day cycles of iv vinorelbine 25 mg/m
2
on day 1,8,15 of each cycle and continuous daily oral cyclophosphamide 25 mg/m
2
. The study was initially designed with 80% power (5% 2-sided alpha level) to detect an increase in 3 yr Event Free Survival (EFS) from 55% to 67%, a Hazard Ratio of 0.67, but was successively amended to allow a detection of a relative reduction in the relapse rate of 50% in the M-arm, with 80% power, testing at the 5% significance level (2-sided).
Results:
670 pts were entered between 4/2006-12/2016, with 371 confirmed eligible and 186 assigned to the std-arm and 185 to M-arm. Clinical features were well balanced in the two arms and included ERMS 67%, ARMS 33%, age 10+ years 21%; IRS Group III 86%; N1 16%. Most common primary tumor sites were parameningeal (32%) and “other” sites (23%). With median follow up of 5 years in surviving pts, 3 yr EFS and overall survival (OS) in M-arm vs Std-arm were respectively: EFS 78.4% (95% IC -71.5-83.8) vs 72.3% (95% IC -65.0-78.3) (p 0.061) and OS 87.3% (95% IC 81.2-91.6) vs 77.4 (95% IC 70.1-83.1) (p = 0.011). Toxicity in the M-arm was manageable: grade 3/4 febrile neutropenia in 25% of pts, grade 4 neurotoxicity in 1.1%.
Conclusions:
The addition of maintenance after std treatment significantly improves OS in HR RMS patients and support its inclusion in future EpSSG trials.
Clinical trial information: 2005-000217-35.
Precision medicine: Clinical outcomes including long-term survival according to the pathway targeted and treatment period–The IMPACT study.
Authors: Tsimberidou Apostolia Maria , Hong David S. , Wheler Jennifer J. , Falchook Gerald Steven , Naing Aung , Fu Siqing , Piha-Paul Sarina Anne , Janku Filip , Cartwright Carrie , Broaddus Russell , Nogueras-Gonzalez Graciela M. , Hwu Patrick , Kurzrock Razelle
Published: June 2018

LBA2553

Background: We evaluated the impact of pathway targeted and long-term follow-up of patients (pts) with refractory cancers referred to phase I trials. Methods: Pts referred to our program (2007-2013) had CLIA molecular testing. Pts treated with matched targeted therapy (MTT) vs. non-matched therapy (NMT) were analyzed. Results: Of 3,743 pts who had testing, 1,307 had ≥1 alteration and received therapy (MTT 711, NMT 596): med. age 57 yrs, range 16-86; 39% men; med. no. of prior therapies 4, range 0-16. The most common tumors were gastrointestinal 24.2%, gynecologic 19.4%, breast 13.5%, melanoma 11.9%, and lung 8.7%. Targeting MEK/RAF and RET pathways correlated with higher rates of CR/PR/SD≥6 months (mos), PFS and OS compared to others (all P < .001) (Table). Plateau was noted in OS (start, 38 mos): 74 of 711 (10.4%) in the MTT (max 10.7+ yrs) vs. 24 of 596 (4%) in the NMT (max 6 yrs) group were alive (p < .0001). In the MTT group, factors predicting longer PFS were non-PI3K pathway MTT (p < .001), no liver metastases (p < .001), PS < 2 (p = .006), normal LDH (p < .001) and albumin (p = .01) levels, and non-single agent therapy (p = .02). Factors predicting longer OS were non-PI3K pathway MTT (p < .001), no liver metastases (p < .001), PS < 2 (p < .001), normal LDH (p < .001) and albumin (p = .001) levels, and normal PLT counts (p = .03). Conclusions: Outcomes were superior in pts matched to RET and MEK/RAF inhibitors. Factors predicting longer PFS and OS were identified. In the MTT group, 10.4% of patients had OS ≥ 38 mos, the plateau starting point. Clinical trial information: NCT00851032. [Table: see text]
A UNICANCER phase III trial of hyperthermic intra-peritoneal chemotherapy (HIPEC) for colorectal peritoneal carcinomatosis (PC): PRODIGE 7.
Authors: Quenet François , Elias Dominique , Roca Lise , Goere Diane , Ghouti Laurent , Pocard Marc , Facy Olivier , Arvieux Catherine , Lorimier Gerard , Pezet Denis , Marchal Frederic , Loi Valeria , Meeus Pierre , De Forges Hélène , Stanbury Trevor , Paineau Jacques , Glehen Olivier ,   UNICANCER-GI Group and the French BIG-Renape Group
Published: June 2018

LBA3503

Background: Promising results have been obtained during the last decade using cytoreductive surgery (CRS) plus HIPEC for selected patients with colorectal PC who are amenable to complete macroscopic resection. This is the first trial to evaluate the specific role of HIPEC, after CRS, for the treatment of PC of colorectal origin. Methods: Prodige 7 is a randomized phase III, multicenter trial. Patients with histologically proven and isolated PC, peritoneal cancer index (PCI) ≤25 were eligible. Randomization (1:1) was stratified by center, complete macroscopic resection (R0/1 vs R2), and neoadjuvant systemic chemotherapy. Patients were treated with CRS plus HIPEC with oxaliplatin or CRS alone, in association with systemic chemotherapy. The primary endpoint was the overall survival (OS). Secondary endpoints were relapse-free survival (RFS) and toxicity. 264 patients were required to show a gain in median OS from 30 to 48 months (HR = 0.625) with a two-sided α = 0,046 and 80% power. Results: 265 patients from 17 centers were included between February 2008 and January 2014: 132 in Arm without HIPEC and 133 in Arm with HIPEC. The median age was 60 years (range: 30-74). Baseline characteristics were well balanced. The overall post-operative mortality rate was 1.5% and was not different between the two arms. The morbidity rates did not differ statistically at 30 days. At 60 days, the grade 3-5 morbidity rate was significantly higher with HIPEC (24.1% vs. 13.6%, p= 0.030). After a median follow up of 63.8 months (95% CI: 58.9-69.8), the median OS was 41.2 months (95% CI 35.1-49.7) in the non-HIPEC Arm and 41.7 months (95% CI: 36.2-52.8) in the HIPEC Arm, HR = 1.00 (95% CI: 0.73-1.37) p = 0.995. The median RFS was 11.1 months (95% CI: 9-12.7) in non-HIPEC Arm and 13.1 months (95% CI: 12.1-15.7) in HIPEC Arm, HR = 0.90 (95% CI: 0.69-1.90) (p = 0.486), whilst the 1-year RFS rates were 46.1% in non-HIPEC Arm and 59 % in the HIPEC Arm. Conclusions: The therapeutic curative management of PC from colorectal cancer by CRS shows satisfactory survival results. While the addition of HIPEC with oxaliplatin does not influence the OS. Clinical trial information: NCT00769405.
Pembrolizumab (pembro) versus platinum-based chemotherapy (chemo) as first-line therapy for advanced/metastatic NSCLC with a PD-L1 tumor proportion score (TPS) ≥ 1%: Open-label, phase 3 KEYNOTE-042 study.
Authors: Lopes Gilberto , Wu Yi-Long , Kudaba Iveta , Kowalski Dariusz , Cho Byoung Chul , Castro Gilberto , Srimuninnimit Vichien , Bondarenko Igor , Kubota Kaoru , Lubiniecki Gregory M. , Zhang Jin , Kush Debra A. , Mok Tony
Published: June 2018

LBA4

Background: In KEYNOTE-024, pembro significantly improved PFS (primary end point) and OS (secondary end-point) over chemo as first-line therapy for metastatic NSCLC without targetable alterations and PD-L1 TPS ≥50%. In KEYNOTE-042, we compared pembro with chemo at the lower TPS of ≥1% (NCT02220894). Methods: Eligible patients (pts) were randomized 1:1 to ≤35 cycles of pembro 200 mg Q3W or investigator’s choice of ≤6 cycles of paclitaxel + carboplatin or pemetrexed (peme) + carboplatin with optional peme maintenance (nonsquamous only). Randomization was stratified by region (east Asia vs non-east Asia), ECOG PS (0 vs 1), histology (squamous vs nonsquamous), and TPS (≥50% vs 1-49%). Primary end-points were OS in pts with TPS ≥50%, ≥20%, and ≥1%. OS differences were assessed sequentially using the stratified log-rank test. Efficacy boundaries at the prespecified second interim analysis were one-sided P = .0122, .01198, and .01238, respectively. Results: 1274 pts were randomized: 637 to each arm. 599 pts (47.0%) had TPS ≥50%, 818 (64.2%) had TPS ≥20%. After 12.8-mo median follow-up, 13.7% were still on pembro and 4.9% were receiving peme maintenance. Pembro significantly improved OS in pts with TPS ≥50% (HR 0.69), TPS ≥20% (HR 0.77), and TPS ≥1% (HR 0.81) (Table). Grade 3-5 drug-related AEs were less frequent with pembro (17.8% vs 41.0%). The external DMC recommended continuing the trial to evaluate PFS (secondary end-point). Conclusion: KEYNOTE-042 is the first study with a primary end-point of OS to demonstrate superiority of pembro over platinum-based chemo in pts with previously untreated advanced/metastatic NSCLC without sensitizing EGFR or ALK alterations and a PD-L1 TPS ≥1%. These data confirm and potentially extend the role of pembro monotherapy as a standard first-line treatment for PD-L1-expressing advanced/metastatic NSCLC. Clinical trial information: NCT02220894. [Table: see text]
IMpower131: Primary PFS and safety analysis of a randomized phase III study of atezolizumab + carboplatin + paclitaxel or nab-paclitaxel vs carboplatin + nab-paclitaxel as 1L therapy in advanced squamous NSCLC.
Authors: Jotte Robert M. , Cappuzzo Federico , Vynnychenko Ihor , Stroyakovskiy Daniil , Rodriguez Abreu Delvys , Hussein Maen A. , Soo Ross A. , Conter Henry Jacob , Kozuki Toshiyuki , Silva Carlos , Graupner Vilma , Sun Shawn , Lin Ray S , Kelsch Claudia , Kowanetz Marcin , Hoang Tien , Sandler Alan , Socinski Mark A.
Published: June 2018

LBA9000

Background: Atezolizumab (atezo; anti–PD-L1) demonstrated OS benefit vs docetaxel in 2L+ NSCLC regardless of PD-L1 status or tumor histology. Because cytotoxic agents can exhibit positive immunomodulatory effects, combining atezo with chemotherapy may further improve outcomes. IMpower131 (NCT02367794) was designed to evaluate atezo + carboplatin (carbo) + paclitaxel (pac) or nab-paclitaxel (nab-pac) in 1L stage IV squamous NSCLC. Methods: Patients (pts) were randomized 1:1:1 to Arm A (atezo 1200 mg q3w + carbo AUC 6 q3w + pac 200 mg/m2 q3w), Arm B (atezo + carbo + nab-pac 100 mg/m2 weekly) or Arm C (carbo + nab-pac). Pts received chemotherapy for 4 or 6 cycles and atezo until loss of clinical benefit. We present the primary analysis of investigator (INV)-assessed PFS per RECIST v1.1 in the ITT population for Arm B vs Arm C. Data cutoff: 22 January 2018. Results: 338 pts (Arm A), 343 pts (Arm B) and 340 pts (Arm C) were enrolled. Minimum follow-up was 9.8 mo. INV-assessed median PFS was 6.3 mo in Arm B vs 5.6 mo in Arm C (HR, 0.715; 95% CI: 0.603, 0.848; P = 0.0001). PFS benefit was enriched in all PD-L1–positive IHC subgroups and was most pronounced in TC3 or IC3. AEs related to any treatment (TRAEs) were 91.3% (Arm A), 94.6% (Arm B) and 90.7% (Arm C); Grade 3-4 TRAEs were 42.8% (Arm A), 68.0% (Arm B) and 56.9% (Arm C); serious TRAEs were 22.3% (Arm A), 20.4% (Arm B) and 10.5% (Arm C). Preliminary OS data will be presented. Conclusions: IMpower131 met its co-primary endpoint of INV-assessed PFS in the ITT population in Arm B vs Arm C. The safety profile of atezo + carbo + nab-pac or pac was consistent with the known risks of the individual treatment components; no new safety signals were identified. Clinical trial information: NCT02367794. [Table: see text]
A Longitudinal Study of Thyroid Markers Across Pregnancy and the Risk of Gestational Diabetes
Authors: Rawal Shristi , Tsai Michael Y , Hinkle Stefanie N , Zhu Yeyi , Bao Wei , Lin Yuan , Panuganti Pranati , Albert Paul S , Ma Ronald C W , Zhang Cuilin
Published: June 2018

Context

T3 is the biologically active thyroid hormone involved in glucose metabolism. The free T3 (fT3)/free T4 (fT4) ratio, a marker indicating conversion of fT4 to fT3, is also implicated in glucose homeostasis.

Objective

To examine associations of fT3 and the fT3/fT4 ratio with gestational diabetes mellitus (GDM).

Design

In a case-control study, thyroid markers (fT3, fT4, TSH) were measured and the fT3/fT4 ratio was derived across four visits in pregnancy, including first (gestational weeks 10 to 14) and second (weeks 15 to 26) trimester. Conditional logistic regression adjusting for thyroid autoimmunity status and major GDM risk factors estimated trimester-specific associations of thyroid markers with subsequent GDM risk.

Setting

Twelve US clinical centers.

Participants

One hundred seven GDM cases and 214 non-GDM controls from a multiracial pregnancy cohort of 2802 women.

Main Outcome Measures

GDM diagnosis ascertained from medical records.

Results

Both fT3 and the fT3/fT4 ratio were positively associated with GDM: adjusted OR (95% CI) comparing the highest vs lowest fT3 quartile was 4.25 (1.67, 10.80) at the first trimester and 3.89 (1.50, 10.10) at the second trimester. Similarly, the corresponding risk estimates for the fT3/fT4 ratio were 8.63 (2.87, 26.00) and 13.60 (3.97, 46.30) at the first and second trimester, respectively. Neither TSH nor fT4 was significantly associated with GDM.

Conclusions

Higher fT3 levels, potentially resulting from de novo synthesis or increased fT4 to fT3 conversion, may be an indicator of GDM risk starting early in pregnancy.
Ectopic Lipid Deposition Is Associated With Insulin Resistance in Postmenopausal Women
Authors: Abildgaard Julie , Danielsen Else Rubaek , Dorph Emma , Thomsen Carsten , Juul Anders , Ewertsen Caroline , Pedersen Bente Klarlund , Pedersen Anette Tønnes , Ploug Thorkil , Lindegaard Birgitte
Published: June 2018

Context

Menopause is associated with an increased incidence of insulin resistance and diabetes.

Objective

The aim of this study was to explore the lipid deposition in liver and skeletal muscle and investigate the association with insulin sensitivity in postmenopausal and premenopausal women.

Design and Setting

Single-center cross-sectional study of 55 healthy women between 45 and 60 years of age. We measured lipid deposition in the liver with magnetic resonance spectroscopy, intramuscular and intra-abdominal lipid deposition with MRI, body composition with a dual-energy X-ray absorptiometry scan, and insulin sensitivity with the composite Matsuda Index.

Outcome Measures

We studied the association between fat distribution, ectopic lipid deposition, and insulin sensitivity in pre- and postmenopausal women.

Results

Postmenopausal women had an increased lipid deposition in the liver [0.68% (0.44 to 0.99) vs 0.49% (0.38 to 0.64), P = 0.01] and skeletal muscle [3% (2 to 4) vs 2% (1 to 3), P = 0.001] and had a 28% lower Matsuda insulin sensitivity index during an oral glucose tolerance test (6.31 ± 3.48 vs 8.78 ± 4.67, P = 0.05) compared with premenopausal women. Total fat mass and leg fat mass were stronger predictors of ectopic lipid deposition, and visceral fat mass was a stronger predictor of both ectopic lipid deposition and insulin resistance in postmenopausal women compared with premenopausal women.

Conclusions

For a given subcutaneous and visceral fat depot size, postmenopausal women show increased ectopic lipid deposition and insulin resistance compared with premenopausal women. It is suggested that lipid deposition in liver and skeletal muscle may represent important mechanistic links between the changes in fat depots and the increased incidence of insulin resistance seen after menopause.
Intraoperative Hemodynamic and Echocardiographic Measurements Associated With Severe Right Ventricular Failure After Left Ventricular Assist Device Implantation
Authors: Gudejko Michael D. , Gebhardt Brian R. , Zahedi Farhad , Jain Ankit , Breeze Janis L. , Lawrence Matthew R. , Shernan Stanton K. , Kapur Navin K. , Kiernan Michael S. , Couper Greg , Cobey Frederick C.
Published: June 2018

BACKGROUND:

Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF.

METHODS:

A review of LVAD patients between March 2013 and March 2016 was performed. Severe RVF was defined by the need for a right ventricular mechanical support device, inotropic, and/or inhaled pulmonary vasodilator requirements for >14 days. From a chart review, the right ventricular failure risk score was calculated and right heart hemodynamic data were collected. Pulmonary artery pulsatility index (PAPi) [(pulmonary artery systolic pressure − pulmonary artery diastolic pressure)/central venous pressure (CVP)] was calculated for 2 periods: (1) 30 minutes before cardiopulmonary bypass (CPB) and (2) after chest closure. Echocardiographic data were recorded pre-CPB and post-CPB by a blinded reviewer. Univariate logistic regression models were used to examine the performance of hemodynamic and echocardiographic metrics.

RESULTS:

A total of 110 LVAD patients were identified. Twenty-five did not meet criteria for RVF. Of the remaining 85 patients, 28 (33%) met criteria for severe RVF. Hemodynamic factors associated with severe RVF included: higher CVP values after chest closure (18 ± 9 vs 13 ± 5 mm Hg; P = .0008) in addition to lower PAPi pre-CPB (1.2 ± 0.6 vs 1.7 ± 1.0; P = .04) and after chest closure (0.9 ± 0.5 vs 1.5 ± 0.8; P = .0008). Post-CPB echocardiographic findings associated with severe RVF included: larger right atrial diameter major axis (5.4 ± 0.9 vs 4.9 ± 1.0 cm; P = .03), larger right ventricle end-systolic area (22.6 ± 8.4 vs 18.5 ± 7.9 cm2; P = .03), lower fractional area of change (20.2 ± 10.8 vs 25.9 ± 12.6; P = .04), and lower tricuspid annular plane systolic excursion (0.9 ± 0.2 vs 1.1 ± 0.3 cm; P = .008). Right ventricular failure risk score was not a significant predictor of severe RVF. Post-chest closure CVP and post-chest closure PAPi discriminated severe from nonsevere RVF better than other variables measured, each with an area under the curve of 0.75 (95% CI, 0.64–0.86).

CONCLUSIONS:

Post-chest closure values of CVP and PAPi were significantly associated with severe RVF. Echocardiographic assessment of RV function post-CPB was weakly associated with severe RVF.
“Flesh-to-Flesh Contact”: Marvel Comics’ Rogue and the Queer Feminist Imagination
Authors: D’Agostino Anthony Michael
Published: June 2018

The X-Men’s Rogue’s ability to absorb the powers and personality of others through “flesh-to-flesh contact” presents an affective figure for the queer potential of the X-Men’s metaphor of mutancy as difference. Close readings of Rogue’s first appearance, Avengers Annual #10, and the end of her first major character arc, Uncanny X-Men #185, reveal that this affective figure for queerness is variable and derived from X-Men writer Chris Claremont’s ongoing engagement with feminist politics and theory.
“The Lesbian Norman Rockwell”: Alison Bechdel and Queer Grassroots Networks
Authors: Galvan Margaret
Published: June 2018

Alison Bechdel’s renown has been building since the success of Fun Home (2006). While scholars have focused on her contemporary production, her comics work within grassroots periodicals, including her long-running strip, Dykes to Watch Out For (1983–2008), has received comparatively little attention. By focusing on the grassroots context of DTWOF, this essay demonstrates how Bechdel’s participation in grassroots periodicals shaped her work. Through the development of new reading practices and the notion of queer comics archives, I show how queer communities influenced Bechdel’s visual rhetoric in the pages of WomaNews, the grassroots periodical where Bechdel first published her work and participated as a member of the collective. Informed by archival research, this analysis embraces grassroots contexts as an overlooked venue for exploring queer histories and tracing the development of queer comics.
Plasmodesmata at a glance
Authors: Sager Ross E. , Lee Jung-Youn
Published: June 2018

Plasmodesmata are cytoplasmic communication channels that are vital for the physiology and development of all plants. They facilitate the intercellular movement of various cargos – ranging from small molecules, such as sugars, ions and other essential nutrients and chemicals, to large complex molecules, such as proteins and different types of RNA species – by bridging neighboring cells across their cell walls. Structurally, an individual channel consists of the cytoplasmic sleeve that is formed between the endoplasmic reticulum and the plasma membrane leaflets. Plasmodesmata are highly versatile channels; they vary in number and structure, and undergo constant adjustments to their permeability in response to many internal and external cues. In this Cell Science at a Glance article and accompanying poster, we provide an overview of plasmodesmata form and function, with highlights on their development and variation, associated components and mobile factors. In addition, we present methodologies that are currently used to study plasmodesmata-mediated intercellular communication.
Volitional control of social vocalisations and vocal usage learning in bats
Authors: Lattenkamp Ella Z. , Vernes Sonja C. , Wiegrebe Lutz
Published: June 2018

Bats are gregarious, highly vocal animals that possess a broad repertoire of social vocalisations. For in-depth studies of their vocal behaviours, including vocal flexibility and vocal learning, it is necessary to gather repeatable evidence from controlled laboratory experiments on isolated individuals. However, such studies are rare for one simple reason: eliciting social calls in isolation and under operant control is challenging and has rarely been achieved. To overcome this limitation, we designed an automated setup that allows conditioning of social vocalisations in a new context, and tracks spectro-temporal changes in the recorded calls over time. Using this setup, we were able to reliably evoke social calls from temporarily isolated lesser spear-nosed bats (Phyllostomus discolor). When we adjusted the call criteria that could result in food reward, bats responded by adjusting temporal and spectral call parameters. This was achieved without the help of an auditory template or social context to direct the bats. Our results demonstrate vocal flexibility and vocal usage learning in bats. Our setup provides a new paradigm that allows the controlled study of the production and learning of social vocalisations in isolated bats, overcoming limitations that have, until now, prevented in-depth studies of these behaviours.
Skin glands of an aquatic salamander vary in size and distribution and release antimicrobial secretions effective against chytrid fungal pathogens
Authors: Pereira Kenzie E. , Crother Brian I. , Sever David M. , Fontenot Clifford L. , Pojman John A. , Wilburn Damien B. , Woodley Sarah K.
Published: June 2018

Amphibian skin is unique among vertebrate classes, containing a large number of multicellular exocrine glands that vary among species and have diverse functions. The secretions of skin glands contain a rich array of bioactive compounds including antimicrobial peptides (AMPs). Such compounds are important for amphibian innate immune responses and may protect some species from chytridiomycosis, a lethal skin disease caused by the fungal pathogens, Batrachochytrium dendrobatidis (Bd) and B. salamandrivorans (Bsal). While the bioactivity of skin secretions against Bd has been assessed for many amphibian taxa, similar studies are lacking for Bsal, a chytrid fungus that is especially pathogenic for salamanders. We studied the skin glands and their potential functions in the aquatic salamander, Three-toed Amphiuma (Amphiuma tridactylum). Skin secretions of captive adult salamanders were analyzed by RP-HPLC and tested against the growth of Bd and Bsal using in-vitro assays. We found that compounds within collected skin secretions were similar between male and female salamanders and inhibited the growth of Bd and Bsal. Thus, skin secretions that protect against Bd may also provide protection against Bsal. Histological examination of the skin glands of preserved salamanders revealed the presence of enlarged granular glands concentrated within caudal body regions. A site of potential gland specialization was identified at the tail base and may indicate specialized granular glands related to courtship and communication.