bluuebunny/crossref_metadata_2025 huggingface dataset:
Carotid Intima-Media Thickness: A Surrogate Marker for Cardiovascular Disease in Chronic Kidney Disease Patients
Authors: Lawal Olutoyin Morenike , Balogun Michael Olabode , Akintomide Anthony Olubunmi , Ayoola Oluwagbemiga Oluwole , Mene-Afejuku Tuoyo Omasan , Ogunlade Oluwadare , Okunola Oluyomi Oluseun , Lawal Adekunle Oyeyemi , Akinsola Adewale
Published: June 2019

Background:

Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD). Carotid intima-media thickness (CIMT) is a measure of atherosclerotic vascular disease and considered a comprehensive picture of all alterations caused by multiple cardiovascular risk factors over time on the arterial walls. We therefore sought to determine the CIMT of the common carotid artery in patients with CKD and to evaluate the clinical pattern and prevalence of CVD in CKD patients.

Methods:

A case-control study involving 100 subjects made of 50 patients with CKD stages 2 to 4 and 50 age and sex matched apparently normal individuals. Carotid intima-media thickness of the common carotid artery was considered thickened if it measured greater than 0.8 mm. All subjects had laboratory investigations, 12-lead electrocardiogram, transthoracic echocardiography, and ankle-brachial index.

Results:

The mean CIMT was higher in CKD population compared with controls ( P < .001). Eighty-four percent of the study population was found to have thickened CIMT compared with 18% of controls ( P < .001). Patients with CKD had significantly higher blood pressure and heart rate than controls. Cardiovascular disease was also more prevalent among patients with CKD as compared with controls. Carotid intima-media thickness positively correlated with age, blood pressure, and random blood sugar.

Conclusions:

As CIMT was well correlated with many cardiovascular risk factors among CKD patients, it may serve as a surrogate marker for CVD and its early assessment may target patients who may need more aggressive therapy to retard the progression of kidney disease and improve outcome.
Organization, atmosphere, and digital technologies: Designing sensory order
Authors: Jørgensen Lydia , Holt Robin
Published: June 2019

We argue technology and organization are inherently spatial phenomenon. We conceptualize this conjunction as atmosphere: a gathering of mood, human practice, material and environmental conditions, and values that has sufficient coherence and distinction to constitute a distinct interior. Atmospheres, however, are not entirely stable and present: the interior is porous to outside influence, and the interior is never wholly ordered. We show this through the study of digitally mediated architectural design practice. We find the technological mediation of atmospheres is constituted in sensory and affective spatial arrangements, and not in rationally calculated configurations of assets and goals. An atmosphere is inherently aesthetic. This allows us to gesture toward a definition of organization as technologically mediated spatial struggle to reconcile interior coherence with outward exposure.
All in the game: Effects of opinion polls on party coverage in the 2013 German election campaign
Authors: Stolwijk Sjoerd B , Schuck Andreas RT
Published: June 2019

Opinion polls form an important part of modern election coverage but might also shape amount and tone of other subsequent coverage about political parties. We propose to use and elaborate on Patterson’s generic storylines to help account for different findings in prior research, by pointing to the importance of race context. A manual content analysis (N = 3755) of the 2013 German Bundestag election campaign is used to empirically test our framework, using a multilevel model that separates effects of 36 polls on coverage of five different parties in 11 different outlets. Results show that the amount of party coverage for the front runner party increased after drops in its ratings, and the challenger party received more negative coverage after increases in its poll ratings. Media coverage did not follow a bandwagon trend but played an independent and counteracting role within the election campaign.
Elastodontic appliance assisted fixed appliance treatment: A new two-phase protocol for extraction cases
Authors: Chen Yong , Hagg Urban , McGrath Colman
Published: June 2019

Elastodontic appliance (EA) is a type of removable appliance that has been widely used in interceptive orthodontics. The present case report describes a severe crowding case treated with a new two-phase protocol by using an EA and a fixed appliance. A 13-year-old patient with severe dental crowding, increased overjet and overbite on a skeletal Class II base was selected. The patient had four bicuspids extracted; during the first phase of treatment, she wore the EA for 2 h during the daytime plus overnight, combined with a myofunctional exercise. During the second phase of treatment, a fixed appliance was employed to close residual space and improve the teeth angulations. The total treatment time was 14 months, of which the second phase with fixed appliance lasted 10 months. Satisfactory improvements of the overjet and teeth alignment were achieved. This case report used a new two-phase treatment protocol which resulted in a favourable outcome after comparatively short treatment.
Using affinity diagramming to generate a codebook: a case study on young military veterans and community reintegration
Authors: Haskins Lisle Ali , Merenda Coleman , Gabbard Joseph
Published: June 2019

Use of a codebook to categorize meaning units is a well-known research strategy in qualitative inquiry. However, methodology for the creation of a codebook in practice is not standardized, and specific guidance for codebook ideation is sometimes unclear, especially to novice qualitative researchers. This article describes the procedure that was utilized to create a codebook, which adapted an affinity diagram methodology (Scupin, 1997), an approach used in user-centered design. For this research, affinity diagramming was applied to a method outlined by Kurasaki (2000) for codebook ideation. Annotations of a subset of military veterans’ transcripts were utilized in congruence with affinity diagramming to create a codebook to categorize the phenomenon of reintegration into the civilian community after service (Haskins Lisle, 2017). This method could be useful in exploratory research that utilizes a codebook generated in vivo from annotations, especially for novice researchers who are overwhelmed by the codebook creation phase.
Anti-identity strategizing: The dynamic interplay of “who we are” and “who we are not”
Authors: Stanske Sarah , Rauch Madeleine , Canato Anna
Published: June 2019

In this article, we investigate the strategy–identity nexus by illustrating the interaction between organizational identity, anti-identity, and strategy. While extant research illustrates the potentially constraining role of organizational identity on change trajectories, less is known about the role of organizational anti-identity. Drawing on a qualitative case study of a leading German distributor’s 32-year history, we highlight the importance of organizational anti-identity for both continuous and discontinuous change initiatives, and illustrate how organizational members can overcome identity ambiguity by referring to “who we are not as an organization” rather than to “who we are as an organization.” We further show how managers who draw on identity reservoirs may have greater leeway when exploiting anti-identity, and how ambiguity and resistance may be overcome by referring to “who we are not” as an organization. Our findings broaden our understanding of the role of anti-identity for strategy selection and contribute to the burgeoning literature on the strategy–identity nexus.
Local governance in the new Police Scotland: Renegotiating power, recognition and responsiveness
Authors: Henry Alistair , Malik Ali , Aydın-Aitchison Andy
Published: June 2019

A marked, but by no means universal, trend in Europe over the last decade or so has been the centralization or amalgamation of regional police organizations into larger or single units. Scotland is a case in point, its eight regional services becoming one Police Scotland in April 2013. Although the reform process was relatively consensual, the new organization has been the subject of numerous controversies, some of which reflect an actual or perceived loss of the local in Scottish policing. Drawing on a qualitative study of the emerging local governance arrangements, we explore the negotiated character of large-scale organizational reform, demonstrating that it is best understood as a process not an event. We also argue that appeals to localism are not mere expressions of sentiment and resistance to change. They reflect the particular historical development of policing and public service delivery in Scotland at the level of municipal government, but also strong convictions that policing should be subject to democratic deliberation and should recognize and be responsive to those subject to it – what we argue here are necessary functions of police governance in general.
Perceptions of Chronic Illnesses and Preventive Behaviors Among Hispanic/Latino men
Authors: Luquis Raffy R.
Published: June 2019

Introduction:

Although Latinos represent the largest minority group, their health needs continue to be poorly understood, especially regarding Latino men. The purpose of this study was to assess perceptions of chronic illnesses and preventing behaviors among Latino men residing in Pennsylvania.

Method:

Qualitative in-depth interviews were conducted with 30 men, older than 40 years.

Results:

Findings from the content analysis were that several factors influenced these men, including their perceptions about the severity of chronic illnesses, their level of concerns, views about health and prevention, and when to go to see a primary care provider. In addition, cultural factors such as family, machismo, lack of preventive culture, religious beliefs, present time orientation, and sympathy and respect influence whether these men engage in preventive behaviors. Most men would like to receive information about chronic illnesses, risk factors, and screenings.

Conclusion:

The results provide some insight into the perceptions about chronic illnesses, health screening, and preventive behaviors, and could help in the development of a health promotion and disease prevention programs targeting Latino men.
All in the Family: An Examination of the Predictors of Visitation Among Committed Juvenile Offenders
Authors: Young Brae Campion , Hay Carter
Published: June 2019

Scholarship highlights the importance of visitation in improving the lives of prisoners across numerous domains including mental health, adjustment to confinement, and postrelease success. Although research on adult inmates has examined factors that predict visitation, no such study exists for juvenile offenders. Moreover, because this existing research has relied largely on administrative data, no study has examined how family and social contexts affect visitation. Using data collected on 2,345 youth who completed residential placement in Florida, the current study examined how qualities and histories of offenders and their families affect the likelihood, consistency, and sequencing of visits for juvenile offenders. The results suggest that youth’s demographics and offending histories, as well as their family backgrounds and relationships, affect visitation. Directions for future research and implications for policy and practice are discussed.
Advantages of Damage Control Strategy With Abdominal Negative Pressure and Instillation in Patients With Diffuse Peritonitis From Perforated Diverticular Disease
Authors: Brillantino Antonio , Andreano Mauro , Lanza Michele , D’Ambrosio Vito , Fusco Ferdinando , Antropoli Massimo , Lucia Antonella , Zito Enzo Saverio , Forner Anna , Ambrosino Francesco , Monte Giovanni , Cricrì Antonio Maria , Robustelli Umberto , De Masi Alessandro , Calce Rosario , Ciardiello Giovanna , Renzi Adolfo , Castriconi Maurizio
Published: June 2019

Purpose. To evaluate the results of Damage Control Strategy (DCS) in the treatment of generalized peritonitis from perforated diverticular disease in patients with preoperative severe systemic diseases. Methods. All the patients with diffuse peritonitis (Hinchey 3 and 4) and the American Society of Anesthesiologists (ASA) score ≥3 were included and underwent DCS consisting of a 2-step procedure. The first was peritoneal lavage, perforated colon-stapled resection, and temporary abdominal closure with negative pressure wound therapy combined with instillation. The second step, 48 hours later, included the possibility of restoring intestinal continuity basing on local and general patients’ conditions. Results. Thirty patients (18 [60%] women and 12 [40%] men, median age 68.5 [range = 35-84] years) were included (18 [60%] ASA III, 11 [36.7%] ASA IV, and 1 [0.03%] ASA V). Seven patients (23.3%) showed sepsis and 1 (3.33%) septic shock. At second surgery, 24 patients (80%) received a colorectal anastomosis and 6 patients (20%) underwent a Hartmann’s procedure. Median hospital stay was 18 days (range = 12-62). Postoperative morbidity rate was 23.3% (7/30) and included 1 anastomotic leak treated with Hartmann’s procedure. Consequently, at discharge from hospital, 23 patients (76.6%) were free of stoma. Primary fascial closure was possible in all patients. Conclusions. DCS with temporary abdominal closure by negative pressure wound therapy combined with instillation in patients with diffuse peritonitis from complicated diverticulitis could represent a feasible surgical option both in hemodynamically stable and no stable patients, showing encouraging results including a low stoma rate and an acceptable morbidity rate.
Games as (Not) Culture: A Critical Policy Analysis of the Economic Agenda of Horizon 2020
Authors: Perrotta Carlo , Bailey Chris , Ryder Jim , Haggis-Burridge Mata , Persico Donatella
Published: June 2019

This article presents a critical examination of European policy in relation to gamification. We begin by describing how gamification “traveled” as an idea, evolving from controversial yet persuasive buzzword to legitimate policy priority. We then focus on how gamification was represented in Horizon 2020: the flagship European Research & Development program from 2014 to 2020, worth nearly €80 billion of funding. The article argues that the ethically problematic aspects of gamification were removed through a process of policy capture that involved its assimilation in an established European network of research and small and medium enterprise (SME) actors. This process of “ethical neutering” is also observable in the actual funding calls, where the problematic assumptions of gamification around agency and manipulation are made invisible through a superficial commitment to vague and ill-defined criteria of responsible research and innovation.
Strength Abilities in Men 50+ as an Effect of Long-Distance Run Training
Authors: Iwańska Dagmara , Mróz Anna , Wójcik Agnieszka , Witek Katarzyna , Czajkowska Anna , Kusztelak Małgorzata
Published: June 2019

The aim of this study was to evaluate the effect of long-term running training on muscle strength of men aged 50 and above. The study involved two groups of men aged 50 and above: physically active (E, n = 34) and inactive (NE, n = 20). Body composition was assessed with the electrical bioimpedance method. The isometric maximum voluntary contraction (MVC) was the main measurement. The value of muscle torque achieved by a group of synergists (operating in the given joint) during a short isometric contraction was evaluated. Ten groups of flexor and extensor muscles of the elbow, shoulder, hip, knee, and torso joints were measured. In addition, a 3 s measurement of grip strength of the right (Fr) and left (Fl) hand was taken using a hand dynamometer. The obtained values enabled to calculate the symmetry index (SI).

Men who had been running regularly were characterized by a significantly lower strength level ( p < .05). Results in the NE group were determined to a great extent by significantly different body weights ( p < .001) and a significantly higher body fat mass (FAT) content ( p < .001). SI was statistically higher in the reference group ( p < .05).

Long-distance run training reduces FAT while maintaining a high level of muscle strength. These studies indirectly confirm the effect of strengthening slow-twitch motor units in men aged 50 (Doherty & Brown 1993; Kanda & Hashizume 1989). In addition, stimulating the body through physical effort helps it also to maintain a high level of strength symmetry, which is a preventive factor in reducing the number of injuries.
Using Mixed Methods Research as a Tool for Developing an Indigenous Cultural Values Instrument in Malaysia
Authors: Taghipoorreyneh Mehdi , de Run Ernest C.
Published: June 2019

The purpose of this article is to illustrate how mixed methods research can be applied as a rigorous method for developing a quantitative instrument responsive to an indigenous culture in Malaysia. In a sequential research design, a three-round Delphi study was conducted to integrate open-ended and free-listing data, and to generate a list of items. The items were subjected to a field test to ensure reliability. A correspondence analysis of scale was employed to examine the validity of the instrument. This research contributes to mixed methods by illustrating the value of Delphi groups as part of a mixed methods research design and the utility of mixed methods research in advancing the validity and reliability of an indigenous cultural values instrument.
Autoignition of diesel-like fuels under dual operation with H2
Authors: Hernández Juan J , Salvador Javier Barba , Cova-Bonillo Alexis
Published: June 2019

The partial replacement of diesel fuel with gaseous fuels in diesel engines allows for reducing soot, increasing the renewable fraction of the fuel and decreasing CO2 emissions. Hydrogen is a promising alternative; since it is a non-carbon compound, it can be produced from renewable sources and it has suitable combustion properties. However, the use of hydrogen in diesel engines could require some modifications on the engine calibration. Among the different phenomena involved in diesel combustion, autoignition significantly affects the engine efficiency. This work analyzes the autoignition behavior of diesel and biodiesel fuels under a H2-rich ambient. Two different liquid fuel replacements (10% and 20% by energy) have been tested in a constant-volume combustion chamber. Three different chamber temperatures (535°C, 602°C, and 650°C) and equivalence ratios (0.4, 0.6, and 0.8) have been checked. Results show that, in the case of diesel fuel, hydrogen delays autoignition and reduces the combustion rate, the latter caused by a higher fuel dilution with air. The influence of H2 in the autoignition of biodiesel is less significant. A reduction in the OH radicals pool appears as the main reason for retarding ignition. The lower pressure peaks with hydrogen suggest unburnt hydrogen to be relevant.
Brachial flow-mediated dilation by continuous monitoring of arterial cross-section with ultrasound imaging
Authors: Chen Zhen , Sultan Laith R , Schultz Susan M , Cary Theodore W , Sehgal Chandra M
Published: June 2019

Objective

Impairment of flow-mediated dilation of the brachial artery is a marker of endothelial dysfunction and often predisposes atherosclerosis and cardiovascular events. In this study, we propose a user-guided automated approach for monitoring arterial cross-section during hyperemic response to improve reproducibility and sensitivity of flow-mediated dilation.

Material and methods

Ultrasound imaging of the brachial artery was performed in 11 volunteers in cross-sectional and in 5 volunteers in longitudinal view. During each examination, images were recorded continuously before and after inducing ischemia. Time-dilation curves of the brachial lumen cross-section were measured by user-guided automated segmentation of brachial images with the feed-forward active contour (FFAC) algorithm. %FMD was determined by the ratio of peak dilation to the baseline value. Each measurement was repeated twice in two sessions 1 h apart on the same arm to evaluate the reproducibility of the measurements. The intra-subject variation in flow-mediated dilation between two sessions (subject-specific) and inter-group variation in flow-mediated dilation with all the subjects within a session grouped together (group-specific) were measured for FFAC. The FFAC measurements were compared with the conventional diameter measurements made using echo tracking in longitudinal views.

Results

Flow-mediated dilation values for cross-sectional area were greater than those measured by diameter dilation: 33.1% for cross-sectional area compared to 22.5% for diameter. Group-specific flow-mediated dilation measurements for cross-sectional area were highly reproducible: 33.2% vs. 33.0% ( p > 0.05) with coefficient of variation CV of 0.4%. The group-specific flow-mediated dilations measured by echo tracking for the two sessions were 21.1 vs. 23.9% with CV of 9%. Subject-specific CV for cross-sectional area by FFAC was 10% ± 2% versus 24% ± 10% for the conventional approach. Using correlation as a metric of evaluation also showed better performance for cross-sectional imaging: correlation coefficient, R, between two sessions for cross-sectional area was 0.92 versus 0.72 for the conventional approach based on diameter measurements.

Conclusion

Peak dilation area measured by continuous automated monitoring of cross-sectional area of the brachial artery provides more reproducible and higher-sensitivity measurement of flow-mediated dilation compared to the conventional approach of using vascular diameter measured using longitudinal imaging.
Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue following Stroke, 6th edition update 2019
Authors: Lanctôt Krista L , Lindsay M Patrice , Smith Eric E , Sahlas Demetrios J , Foley Norine , Gubitz Gord , Austin Melissa , Ball Kristyn , Bhogal Sanjit , Blake Treena , Herrmann Nathan , Hogan David , Khan Aisha , Longman Stewart , King Andrea , Leonard Carol , Shoniker Tricia , Taylor Trudy , Teed Moira , de Jong Andrea , Mountain Anita , Casaubon Leanne K , Dowlatshahi Dar , Swartz Richard H ,   on behalf of the Management of Mood, Cognition and Fatigue Following Stroke Best Practice Writing Group, the Heart & Stroke Canadian Stroke Best Practices and Quality Advisory Committee; in collaboration with the Canadian Stroke Consortium
Published: June 2019

The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for Mood, Cognition and Fatigue following Stroke is a comprehensive set of evidence-based guidelines addressing three important issues that can negatively impact the lives of people who have had a stroke. These include post-stroke depression and anxiety, vascular cognitive impairment, and post-stroke fatigue. Following stroke, approximately 20% to 50% of all persons may be affected by at least one of these conditions. There may also be overlap between conditions, particularly fatigue and depression. If not recognized and treated in a timely matter, these conditions can lead to worse long-term outcomes. The theme of this edition of the CSBPR is Partnerships and Collaborations, which stresses the importance of integration and coordination across the healthcare system to ensure timely and seamless care to optimize recovery and outcomes. Accordingly, these recommendations place strong emphasis on the importance of timely screening and assessments, and timely and adequate initiation of treatment across care settings. Ideally, when screening is suggestive of a mood or cognition issue, patients and families should be referred for in-depth assessment by healthcare providers with expertise in these areas. As the complexity of patients treated for stroke increases, continuity of care and strong communication among healthcare professionals, and between members of the healthcare team and the patient and their family is an even bigger imperative, as stressed throughout the recommendations, as they are critical elements to ensure smooth transitions from acute care to active rehabilitation and reintegration into their community.
Muslim minorities as Germany’s past future: Islam critics, Holocaust memory, and immigrant integration
Authors: Özyürek Esra
Published: June 2019

A new cohort of Turkish- and Arab-background public intellectuals in Germany locate the root of problems of migrant communities in a resemblance between Islamic culture and Nazi ideology. Islam critics promote the idea that if, like the children of Nazis before them, children of Muslims can rebel against their fathers sexually liberate themselves, they will also be able to embrace the democratic values of German society. In their best-seller books, Islam critics aim to include migrants in the German national temporal framework and also enable a new interpretation of German history not as an anomaly, an evolutionary modernization story gone terribly wrong, but as an historical model that other nationalities should also pass through and come out of. By studying how highly popular Islam critics position Muslims in relation to memory of National Socialism in Germany, this article asks what kind of transformation (and reproduction) is German Holocaust memory and public political culture is undergoing in its perception of its relationship with its Nazi past on one hand and its multi-ethnic present and future on the other hand. It also asks what role Muslims and other minorities play in shaping, reacting to, and corresponding with these transformations. By focusing on the unlikely promise of inclusion of the Muslim minority in the German national temporality through path-dependent repetition, it argues that national memory cultures are formed in relation to and with the help of minorities who are being simultaneously incorporated and excluded from the present at once.
Non-invasive ventilation in amyotrophic lateral sclerosis
Authors: Dorst Johannes , Ludolph Albert C.
Published: June 2019

Non-invasive ventilation (NIV) has become an important cornerstone of symptomatic treatment in amyotrophic lateral sclerosis (ALS), improving survival and quality of life.

In this review, we summarize the most important recent developments and insights, including evidence of efficacy, indication criteria and time of initiation, ventilation parameters and adaptation strategies, treatment of complicating factors, transition from NIV to invasive ventilation, termination of NIV and end-of-life management. Recent publications have questioned former conventions and guideline recommendations, especially with regard to timing and prognostic factors; therefore, a fresh look and re-evaluation of current evidence is needed.
Social Media for Political Campaigns: An Examination of Trump’s and Clinton’s Frame Building and Its Effect on Audience Engagement
Authors: Sahly Abdulsamad , Shao Chun , Kwon K. Hazel
Published: June 2019

This study investigates cross-platform differences in social media by analyzing the contending candidates who represent different political ideology during the 2016 presidential election. Borrowing the frame-building and frame-effect perspectives, it examines the ways in which the two contending candidates (Donald Trump and Hillary Clinton) built their message frames in two different social platforms—Twitter ( N = 3,805) and Facebook ( N = 655)—and how the frame differences affected audience engagement in each platform. The results showed that Trump’s messages presented more variety in frame selection than Clinton’s, focusing on conflict and negative emotional frames on Twitter while displaying frequent positive emotional frames on Facebook. Clinton’s strategy relied heavily on conflict and positive emotional frames on both Twitter and Facebook. The results also suggested that for both Trump and Clinton followers on Twitter, conflict and morality frames consistently attracted retweeting behaviors and emotional frames attracted favoriting behaviors. However, Facebook engagement behaviors did not show a consistent pattern between the followers of the two candidates.
District nurses' experiences of providing palliative care in the home: An interview study
Authors: Midlöv Elina Mikaelsson , Lindberg Terese
Published: June 2019

The trend shows that more people are choosing to die at home. Since at home palliative care is often provided by district nurses, their work will be affected, and the burden will increase. The aim of this study was to illuminate district nurses' experiences of providing palliative care in the home. Qualitative semi-structured interviews were conducted with 12 district nurses. The interviews were analyzed according to the qualitative content analysis methods that Graneheim and Lundman describe. Findings consist of three main categories with nine subcategories. The conclusion is that collaboration with others is essential. Providing palliative care in the home is both emotionally rewarding and demanding, and the work is additionally time and expertise consuming. District nurses want more resources and organizational changes, such as access to doctors and a palliative home care team who only work with these patients. This would be an advantage both for district nurses and the patients.
Effect of stress on learning and motivation-relevance to autism spectrum disorder
Authors: Theoharides Theoharis C , Kavalioti Maria
Published: June 2019

Learning and motivation are critical in the development of children, and to their acquisition of knowledge and skills. A case in point is autism spectrum disorder (ASD), a neurodevelopmental condition characterized by impaired social interactions and communication, as well as by stereotypic movements. Maternal stress has been strongly associated with increased risk of developing ASD. Children experience multiple stressors such as separation anxiety, fear of the unknown, physical and/or emotional trauma, bullying, as well as environmental exposures. Stress is well known to affect learning and motivation. However, patients with ASD have aggrevated tresponses to stress, especially fear response. There is extensive literature connecting the amygdala to social behavior and to pathophysiologic responses to stress. The amygdala regulate the responses to stress, and anatomical changes in amygdala have been reported in ASD. In particular, corticotropin-releasing hormone (CRH), which is secreted under stress, is high in children with ASD and stimulates both mast cells and microglia, thus providing possible targets for therapy. Factors and/or circumstances that could interfere with the neurodevelopmental pathways involved in learning and motivation are clearly important and should be recognized early.
Expression of S100 calcium-binding protein A8 in peripheral blood of patients with preeclampsia during pregnancy
Authors: Li Xiaoyun , Cheng Fangzheng , Cao Guangchao
Published: June 2019

A total of 30 late onset severe preeclampsia (LS-PE) patients and 30 early onset severe preeclampsia (ES-PE) patients were selected as Experimental group, and 30 normal pregnant were selected as Control group. Expression of S100 calcium-binding protein A8 (S100A8) mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). Enzyme-linked immunosorbent assay (ELISA) was used to detect expression of S100A8 protein and inflammatory factors. Levels of uric acid (UA) and creatinine (CRE) were measured using an automatic biochemical analyzer. Urinary protein (UPRO) content was measured using biuret colorimetry. S100A8 levels were significantly higher in experimental groups than in control groups at mRNA and protein levels ( P < 0.05). Significantly increased contents of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-12, UA, CRE, and UPRO, and decreased level of IL-10 were found in experimental groups than in control groups ( P < 0.05). Compared with patients with ES-PE, significantly higher levels of TNF-α, IL-12, IL-6, UA, CRE, and UPRO, and lower level of IL-10 were found in patients with LS-PE. S100A8 plays pivotal roles in the development of preeclampsia through the interactions with other inflammatory factors.
Improving Workplace-Based Intervention in Indonesia to Prevent and Control Anemia
Authors: Mansyur Muchtaruddin , Khoe Levina Chandra , Karman Michelle Marcella , Ilyas Mohammad
Published: June 2019

Purpose: The present study determined female workers’ experiences and preferences to improve the workplace anemia prevention program in Indonesia by studying their perception of anemia, as well as its risk factors and control. Methods: This qualitative study was conducted using focus group discussions (FGDs) to assess female workers’ understanding about anemia and possible improvements for workplace-based intervention in a factory located in East Jakarta, Indonesia. Participants were consisted of 14 FGD groups according to anemia status and potential affecting characteristics, including marital status, ethnicity, religion, and frequency of medical consultations. A semistructured questionnaire was used to determine participants’ ideas and experiences of anemia control. Results: A total of 14 FGDs were conducted including 105 female workers who participated in this study. More than half of the participants showed a good understanding of the signs and symptoms of anemia. They expected the company to improve the factory health service by improving accessibility and affordability of food and controlling hazardous substances considered risk factors of anemia in the workplace. Conclusion: Female workers have valuable experience and ideas that should be considered to improve workplace-based anemia intervention. They proposed improvement of workplace-based health services such as improving factory canteen and clinics services and controlling potential anemia risk hazards in the workplace.
Development of a Model on Determinants of Malnutrition in Aged Persons: A MaNuEL Project
Authors: Volkert Dorothee , Kiesswetter Eva , Cederholm Tommy , Donini Lorenzo M. , Eglseer Doris , Norman Kristina , Schneider Stéphane M. , Ströbele-Benschop Nanette , Torbahn Gabriel , Wirth Rainer , Visser Marjolein
Published: June 2019

In older persons, the origin of malnutrition is often multifactorial with a multitude of factors involved. Presently, a common understanding about potential causes and their mode of action is lacking, and a consensus on the theoretical framework on the etiology of malnutrition does not exist. Within the European Knowledge Hub “Malnutrition in the Elderly (MaNuEL),” a model of “ Determinants of Malnutrition in Aged Persons” (DoMAP) was developed in a multistage consensus process with live meetings and written feedback (modified Delphi process) by a multiprofessional group of 33 experts in geriatric nutrition. DoMAP consists of three triangle-shaped levels with malnutrition in the center, surrounded by the three principal conditions through which malnutrition develops in the innermost level: low intake, high requirements, and impaired nutrient bioavailability. The middle level consists of factors directly causing one of these conditions, and the outermost level contains factors indirectly causing one of the three conditions through the direct factors. The DoMAP model may contribute to a common understanding about the multitude of factors involved in the etiology of malnutrition, and about potential causative mechanisms. It may serve as basis for future research and may also be helpful in clinical routine to identify persons at increased risk of malnutrition.
Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
Authors: Saha Sumit , DiRusso Stephen M. , Welle Scott , Lieberman Benjamin , Sender Joel , Shabsigh Ridwan , Baltazar Gerard A.
Published: June 2019

Objective: Geriatric admissions to trauma centers have increased, and in 2013, our center integrated geriatrician consultation with the management of admitted patients. Our goal is to describe our experience with increasing geriatric fall volume to help inform organized geriatric trauma programs. Method: We retrospectively analyzed admitted trauma patients ≥65 years old, suffering falls from January 1, 2006, to December 31, 2017. We examined descriptive statistics and changes in outcomes after integration. Results: A total of 1,335 geriatric trauma patients were admitted, of which 1,054 (79%) had suffered falls. Falls increased disproportionately (+280%) compared with other mechanisms of injury (+97%). After 2013, patient discharge disposition to skilled nursing facility decreased significantly (–67%, p < .001), with a concomitant increase in safe discharges home with outpatient services. Regression analysis revealed association between integration of geriatrician consultation and outcomes. Discussion: Geriatrician consultation is associated with optimized discharge disposition of trauma patients. We recommend geriatrician consultation for all geriatric trauma activations.
Inhibition of EZH2 and immune signaling exerts synergistic antitumor effects in chronic lymphocytic leukemia
Authors: Chartomatsidou Elisavet , Ntoufa Stavroula , Kotta Konstantia , Rovida Alessandra , Akritidou Maria Anna , Belloni Daniela , Ferrero Elisabetta , Trangas Theoni , Stavroyianni Niki , Anagnostopoulos Achilles , Rosenquist Richard , Ghia Paolo , Papakonstantinou Nikos , Stamatopoulos Kostas
Published: June 2019

Key Points

Microenvironmental stimuli affect EZH2 expression and function in CLL. Combined B-cell signaling and EZH2 inhibition showed synergistic effects on primary CLL cells.
The psychosis risk timeline: can we improve our preventive strategies? Part 1: early life
Authors: Romain Karen , Eriksson Alexandra , Onyon Richard , Kumar Manoj
Published: June 2019

Psychosis is a complex presentation with a wide range of factors contributing to its development, biological and environmental. Psychosis is a feature present in a variety of psychiatric disorders. It is important for clinicians to keep up to date with evidence regarding current understanding of the reasons psychosis may occur. Furthermore, it is necessary to find clinical utility from this knowledge so that effective primary, secondary and tertiary preventative strategies can be considered. This article is the first of a three-part series that examines contemporary knowledge of risk factors for psychosis and presents an overview of current explanations. The articles focus on the psychosis risk timeline, which gives a structure within which to consider key aspects of risk likely to affect people at different stages of life. In this first article, early life is discussed. It covers elements that contribute in the prenatal and early childhood period and includes genetic, nutritional and infective risk factors.

LEARNING OBJECTIVES

After reading this article you will be able to:

•

give an up-to-date overview of psychosis risk factors that can affect early life

•

describe some important genetic risk factors

•

understand more about the role of environmental factors such as nutrition and infection.

DECLARATION OF INTEREST

None.
Conceptual Framework to Support Clinical Trial Optimization and End-to-End Enrollment Workflow
Authors: Jain Neha M. , Culley Alison , Knoop Teresa , Micheel Christine , Osterman Travis , Levy Mia
Published: June 2019

In this work, we present a conceptual framework to support clinical trial optimization and enrollment workflows and review the current state, limitations, and future trends in this space. This framework includes knowledge representation of clinical trials, clinical trial optimization, clinical trial design, enrollment workflows for prospective clinical trial matching, waitlist management, and, finally, evaluation strategies for assessing improvement.
Atg7 Knockdown Reduces Chemerin Secretion in Murine Adipocytes
Authors: Heinitz Sascha , Gebhardt Claudia , Piaggi Paolo , Krüger Jacqueline , Heyne Henrike , Weiner Juliane , Heiker John T , Stumvoll Michael , Blüher Matthias , Baier Leslie , Rudich Assaf , Kovacs Peter , Tönjes Anke
Published: June 2019

Context

In individuals with obesity, adipocyte endocrine function is affected by altered autophagy. Genetic variants in autophagy-related gene 7 (ATG7) correlated with serum chemerin (RARRES2) concentrations.

Objectives

To investigate a functional interplay between chemerin and ATG7, how it may relate to autophagy-mediated adipocyte dysfunction in obesity, and the relevance of genetic ATG7 variants in chemerin physiology.

Design

Adipose ATG7 mRNA expression and adiposity measures were available in two human study cohorts. The effect of a high-calorie diet on adipose Rarres2 and Atg7 expression was investigated in mice. In 3T3-L1 adipocytes, the effect of Atg7 knockdown on chemerin expression and secretion was studied. The influence of single nucleotide polymorphisms on ATG7 transcription and chemerin physiology was investigated using a luciferase assay.

Setting

Mouse model, clinical trials, in vitro studies.

Participants

Native American (n = 83) and white (n = 100) cohorts.

Main outcome measure

Adipocyte chemerin expression and secretion.

Results

In mice fed a high-calorie diet, adipose Atg7 mRNA expression did not parallel an increase in Rarres2 mRNA expression. ATG7 mRNA expression in human subcutaneous adipose tissue correlated with body mass index, fat mass (r > 0.27; P < 0.01), and adipocyte cell size (r > 0.24; P < 0.02). Atg7 knockdown in 3T3-L1 adipocytes decreased chemerin secretion by 22% (P < 0.04). Rs2606729 in ATG7 was predicted to alter ATG7 transcription and induced higher luciferase activity in vitro (P < 0.0001).

Conclusions

Human adipose ATG7 mRNA expression relates to measures of adiposity. Atg7 knockdown reduces chemerin secretion from adipocytes in vitro, supportive of a functional interplay between ATG7 and chemerin in autophagy-mediated adipocyte dysfunction.
Clinical Importance of Free Thyroxine Concentration Decline After Radiotherapy for Pediatric and Adolescent Brain Tumors
Authors: van Iersel Laura , Xu Jiahui , Potter Brian S , Conklin Heather M , Zhang Hui , Chemaitilly Wassim , van Santen Hanneke M , Merchant Thomas E
Published: June 2019

Context

Clinical significance of a decline in free T4 (FT4) concentrations across the reference range in children with brain tumors treated with radiation therapy (RT) is uncertain.

Objectives

To study trends in FT4 in children after RT and risk factors and health outcomes associated with plasma FT4 concentrations.

Design and Setting

Longitudinal, single-center retrospective cohort study.

Patients

Low-grade glioma or ependymoma patients (n = 267; age ≤25 years) who received RT (50.4 to 59.4 Gy) at a single institution (1996 to 2016) and followed with serial FT4 measurements.

Main Outcome Measure

A linear mixed-effects model with a random intercept was used to investigate risk factors for longitudinal changes in FT4 concentrations. A two-stage mixed-effects model examined associations between clinical outcomes and plasma FT4 concentrations.

Results

FT4 concentrations declined over time after RT (P < 0.001). Females (P < 0.001) and younger patients (P < 0.001) demonstrated greater declines in FT4 concentrations over time. The rate of weight gain, but not of height loss, increased with a higher FT4 decline rate (P < 0.001). At last follow-up, patients with lower baseline FT4 concentrations had increased risk of glucose disorder (OR, 19.73; P = 0.002) or dyslipidemia (OR, 19.40; P = 0.003) but not high fat mass (P = 0.18). Lower baseline FT4 concentrations were not associated with impaired scores for intelligence, attention, memory, or psychosocial functioning.

Conclusions

FT4 concentrations significantly decline in children with brain tumor after RT. Variation and trends in FT4 concentration are associated with physical health outcomes. Future studies should assess whether continuous FT4 concentrations and trends, rather than population-based cut-off values, can distinguish between euthyroid and hypothyroid states.
Adrenal Insufficiency After Unilateral Adrenalectomy in Primary Aldosteronism: Long-Term Outcome and Clinical Impact
Authors: Heinrich Daniel A , Adolf Christian , Holler Finn , Lechner Benjamin , Schneider Holger , Riester Anna , Nirschl Nina , Sturm Lisa , Wang Xiao , Ladurner Roland , Seidensticker Max , Bidlingmaier Martin , Beuschlein Felix , Reincke Martin
Published: June 2019

Context

Primary aldosteronism (PA) represents a secondary form of arterial hypertension that can be cured by surgery. Evidence of adrenal insufficiency (AI) was recently found in patients with PA who had undergone unilateral adrenalectomy (uADX).

Objective

To study the incidence and long-term outcome of postoperative AI after uADX for PA.

Design

Prospective registry study (August 2014 until the end of 2018).

Setting

Tertiary referral center.

Patients

One hundred consecutive patients undergoing uADX for PA were included. All patients underwent postoperative ACTH stimulation testing.

Intervention

Postoperative ACTH stimulation testing to identify patients with AI.

Main Outcome Measures

Incidence of patients with postoperative AI and definition of long-term outcome.

Results

Twenty-seven percent of patients developed postoperative AI. Of these, 48% had postoperative ACTH stimulation serum cortisol levels ≤13.5 µg/dL (severe AI); 52% were classified into the group with moderate AI (stimulated serum cortisol levels: 13.5 to 17 µg/dL). Patients with severe AI required significantly longer hydrocortisone replacement therapy than the moderate group (median [25th, 75th percentiles]: 353 [294, 476] days; 95% CI: 284 to 322 days; vs 74 [32, 293] days; 95% CI: 11 to 137 days; P = 0.016). One patient with severe AI was hospitalized for an acute adrenal crisis. With a cumulative follow-up of 14.5 years, this produced an incidence rate of 6.9 adrenal crises per 100 patient-years.

Conclusion

We suggest performing postoperative ACTH stimulation tests in all patients who undergo uADX for PA.
Compensation, Productivity, and Other Demographics of Academic Divisions of Endocrinology, Diabetes, and Metabolism
Authors: Ringel Matthew D , Murphy Elizabeth J , Hammes Stephen R
Published: June 2019

The landscape for academic endocrinology divisions has continued to evolve rapidly;thus, finding reliable data that can be used as benchmarks has become more difficult. Resources are available for salary and relative value units, with the Association of American Medical Colleges, Medical Group Management Association, and Faculty Practice Solutions Center the most commonly used databases. However, details regarding how these data are collected and what they include are unclear. For example, does the income include bonus and/or incentive payments? How are work relative value units defined (individual rendering vs supervising advanced practitioners or fellows or residents)? How is a clinical full-time equivalent defined? In addition, other important data that would be relevant to running an academic division of endocrinology are not available from these, or any other resources, including support staff numbers and compensation or fellowship funding and training information. Therefore, an unmet need exists for reliable data that divisions can use to help shape their visions and goals. To address this demand, the Association of Endocrine Chiefs and Directors, in collaboration with the Endocrine Society, developed a detailed survey for members to address the financial, productivity, composition, and educational issues that they regularly face. Twenty academic institutions throughout the United States completed in the survey in 2018. In the present report, we have provided the results of the survey and some initial interpretations of the findings. Our hope is that the information presented will prove useful as academic endocrinology divisions continue to evolve.