bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrafamilial and extrafamilial sexual assault and its association with alcohol consumption
Authors: Valle Rubén , Bernabé-Ortiz Antonio , Gálvez-Buccollini Juan Antonio , Gutiérrez César , Martins Silvia S
Published: April 2019

OBJECTIVE: Analyze the prevalence of intrafamilial and extrafamilial sexual assault in adolescents of Peru and its association with alcohol consumption. METHODS: We used a two-step and stratified probabilistic sampling to select male and female students in secondary education from all over Peru. The study included data from 54,756 students with information on demographics, alcohol and drug use, and sexual assault. The statistical analysis considered the complex sampling and we conducted two independent analyses by type of sexual assault (intrafamilial and extrafamilial), stratified by the sex of the victim. RESULTS: The prevalence of life of intrafamilial sexual assaults (5.4%, 95%CI 5.0–5.8) was similar to that of extrafamilial sexual assaults (6.1%, 95%CI 5.6–6.6). Alcohol consumption in the past year was associated with intrafamilial and extrafamilial sexual assaults that occurred in the same period after adjusting for confounders. Alcohol consumption in the past year was associated with non-physical and physical forms of intrafamilial and extrafamilial sexual assaults in the disaggregated analysis by type of assault. Alcohol consumption in the past year was associated with extrafamilial rape only among females (ORa = 2.8; 95%CI 1.3–5.9). CONCLUSIONS: Sexual assault against adolescent males and females by family members is a frequent form of victimization that is associated with alcohol consumption in Peru. It is important to examine this form of victimization among adolescents, especially those who consume alcohol.
Impact of Platelet Endothelial Aggregation Receptor-1 Genotypes on Platelet Reactivity and Early Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention and Treated With Aspirin and Clopidogrel
Authors: Xu Ke , Ye Sen , Zhang Shuhua , Yang Mingwen , Zhu Tiantian , Kong Deyu , Chen Jun , Xu Lei , Li Jimin , Zhu Hui , Wang Fei , Yang Lu , Zhang Jing , Fan Yuansheng , Ying Lianghong , Hu Xianqing , Zhang Xiaofeng , Chan Noel C. , Li Chunjian
Published: April 2019

Background:

The genetic determinants of response to clopidogrel and aspirin are incompletely characterized. Recently,
PEAR1
(platelet endothelial aggregation receptor-1) rs12041331 polymorphism has been shown to influence the platelet reactivity, but its impact on cardiovascular outcomes remains unclear in patients treated with antiplatelet agents.

Methods and Results:

In this prospective cohort study, 2439 Chinese patients with acute coronary syndrome or stable coronary artery disease undergoing coronary stent implantation and receiving clopidogrel and aspirin were consecutively recruited. Their platelet reactivity was determined by light transmission aggregometry at 5 and 30 days after coronary intervention. Genotyping was performed using an improved multiplex ligation detection reaction technique. All patients completed a 30-day follow-up for clinical outcomes. Genotyping for
PEAR1
showed 768 (38.3%) GG homozygotes, 941 (46.9%) GA heterozygotes, and 298 (14.8%) AA homozygotes. The 30-day incidence of major adverse cardiovascular events, the composite of cardiovascular death, nonfatal myocardial infarction, and ischemic stroke were significantly higher in AA homozygotes than in non-AA homozygotes (adjusted hazard ratio, 2.78; 95% CI, 1.13–6.82;
P
=0.026), irrespective of
CYP2C19*2
loss-of-function polymorphism and known outcome predictors including age, sex, smoking, and diabetes mellitus. The ADP-induced platelet aggregation was significantly lower in AA homozygotes than that in GG homozygotes at both time points, although no significant difference was found for the arachidonic acid–induced platelet aggregation among the 3 groups.

Conclusions:

About 15% of Chinese patients undergoing coronary stent implantation were AA homozygotes for
PEAR1
rs12041331. These patients had ≈3-fold increase in short-term major adverse cardiovascular events risk compared with non-AA homozygotes, and the adverse clinical outcome is unlikely to be mediated by suboptimal pharmacological response to aspirin or clopidogrel.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01968499.
Routine Fractional Flow Reserve Measurement After Percutaneous Coronary Intervention
Authors: van Bommel Rutger J. , Masdjedi Kaneshka , Diletti Roberto , Lemmert Miguel E. , van Zandvoort Laurens , Wilschut Jeroen , Zijlstra Felix , de Jaegere Peter , Daemen Joost , van Mieghem Nicolas M.
Published: April 2019

Background:

Fractional flow reserve (FFR) is the current gold standard to determine hemodynamic severity of angiographically intermediate coronary lesions. Much less is known about the prognostic effects of FFR measured directly after percutaneous coronary intervention (PCI). The aims of this study were to evaluate post-PCI FFR values, identify predictors for a low post-PCI FFR, and to investigate whether a relationship between postprocedural FFR and outcome during 30-day follow-up exists.

Methods and Results:

The FFR-SEARCH (Fractional Flow Reserve—Stent Evaluated at Rotterdam Cardiology Hospital) is a prospective registry in which FFR measurements were performed after PCI in 1000 consecutive patients. All FFR measurements were performed under maximum hyperemia with intravenous adenosine with the Navvus RXi system (ACIST Medical Systems, Eden Prairie, MN). The clinical end point was defined as a composite of death, target vessel revascularization, or nonfatal myocardial infarction at 30-day follow-up. Measurement of post-PCI FFR was successful in 959 patients (96%), and a total of 1165 lesions were assessed. There were no complications related to the microcatheter. A total of 322 ST-segment–elevation myocardial infarction patients with 371 measured lesions were excluded leaving 637 patients with 794 measured lesions for the final analysis. Overall post-PCI FFR was 0.90±0.07. In 396 lesions (50%), post-PCI FFR was >0.90. A total of 357 patients (56%) had ≥1 lesion(s) with a post-PCI FFR ≤0.90, and 73 patients (11%) had ≥1 lesion(s) with a post-PCI FFR ≤0.80 with post-PCI FFR ≤0.80 in 78 lesions (9.8%). Complex lesion characteristics, use of multiple stents and smaller reference vessel diameter was associated with post-PCI FFR ≤0.90. During follow-up, 11 patients (1.8%) reached the clinical end point. There was no significant relationship between post-PCI FFR and the clinical end point at 30-day follow-up (
P
=0.636).

Conclusions:

Routine measurement of post-PCI FFR using a monorail microcatheter is safe and feasible. Several lesion and patient characteristics were associated with a low post-PCI FFR. Post-PCI FFR did not correlate with clinical events at 30 days.
Atorvastatin Has a Dose‐Dependent Beneficial Effect on Kidney Function and Associated Cardiovascular Outcomes: Post Hoc Analysis of 6 Double‐Blind Randomized Controlled Trials
Authors: Vogt Liffert , Bangalore Sripal , Fayyad Rana , Melamed Shari , Hovingh G. Kees , DeMicco David A. , Waters David D.
Published: April 2019

Background

Kidney function decreases during the lifetime, and this decline is a powerful predictor of both kidney and cardiovascular outcomes. Statins lower cardiovascular risk, which may relate to beneficial effects on kidney function. We studied whether atorvastatin influences kidney function decline and assessed the association between individual kidney function slopes and cardiovascular outcome.

Methods and Results

Data were collected from 6 large atorvastatin cardiovascular outcome trials conducted in patients not selected for having kidney disease. Slopes of serum creatinine reciprocals representing measures of kidney function change ([mg/dL]
−1
/y), were analyzed in 30 621 patients. Based on treatment arms, patients were categorized into 3 groups: placebo (n=10 057), atorvastatin 10 mg daily (n=12 763), and 80 mg daily (n=7801). To assess slopes, mixed‐model analyses were performed for each treatment separately, including time in years and adjustment for study. These slopes displayed linear improvement over time in all 3 groups. Slope estimates for patients randomized to placebo or atorvastatin 10 mg and 80 mg were 0.009 (0.0008), 0.011 (0.0006), and 0.014 (0.0006) (mg/dL)
−1
/y, respectively. A head‐to‐head comparison of atorvastatin 10 and 80 mg based on data from 1 study (
TNT
[Treating to New Targets]; n=10 001) showed a statistically significant difference in slope between the 2 doses (
P
=0.0009). From a Cox proportional hazards model using slope as a predictor, a significant (
P
<0.0001) negative association between kidney function and cardiovascular outcomes was found.

Conclusions

In patients at risk of or with cardiovascular disease, atorvastatin improved kidney function over time in a dose‐dependent manner. In the 3 treatment groups, kidney function improvement was strongly associated with lower cardiovascular risk.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifiers:
NCT
00327418;
NCT
00147602;
NCT
00327691.
Low‐Carbohydrate Diets and Risk of Incident Atrial Fibrillation: A Prospective Cohort Study
Authors: Zhang Shaozhao , Zhuang Xiaodong , Lin Xiaoyu , Zhong Xiangbin , Zhou Huimin , Sun Xiuting , Xiong Zhenyu , Huang Yiquan , Fan Yongqiang , Guo Yue , Du Zhimin , Liao Xinxue
Published: April 2019

Background

The influences of low‐carbohydrate diets in cardiovascular disease are controversial. Few studies have examined the relationship of carbohydrate intake and risk of incident atrial fibrillation (
AF
). We aimed to evaluate the association between carbohydrate intake and the risk of incident
AF
in the ARIC (Atherosclerosis Risk in Communities) Study.

Methods and Results

We included 13 385 participants (age, 54.2±5.8 years; 45.1% men and 74.7% white) who completed a dietary questionnaire at baseline (1987–1989) in the
ARIC
Study. The primary outcome was incident
AF
, which was identified by ECG performed during study examinations, hospital discharge codes, and death certificates. We used multivariable Cox hazard regression models to assess the association between carbohydrate intake and incident
AF
. We further explored the effects of specific food source (animal versus plant based) used to replace carbohydrate intake in the low‐carbohydrate intake setting. During a median follow‐up of 22.4 years, 1808 cases (13.5%) of
AF
occurred. The hazard ratio for incident
AF
associated with a 1‐
SD
(9.4%) increase in carbohydrate intake as a percentage of energy intake was 0.82 (95%
CI
, 0.72–0.94), after adjustment for traditional
AF
risk factors and other diets factors. Results were similar when individuals were categorized by carbohydrate intake quartiles (hazard ratio, 0.64; 95%
CI
, 0.49–0.84; comparing extreme quartiles). No association was found between the type of protein or fat used to replace the carbohydrate and risk of incident
AF
.

Conclusions

Low‐carbohydrate diets were associated with increased risk of incident
AF
, regardless of the type of protein or fat used to replace the carbohydrate.
The Baptist Followers of Mani: Reframing the Cologne Mani Codex
Authors: Han Jae Hee
Published: April 2019

For decades, scholars of religious studies have questioned the anachronism of the category of “religion” for discussing the historical emergence of Judaism, Christianity, Buddhism, and Hinduism. Beginning already with Wilfred Cantwell Smith in the 1960s, however, Manichaeism was heralded as an exception to this pattern, and Mani has been understood as perhaps the first to found a new “religion.” This article considers how this model shaped the interpretation of the Cologne Mani Codex (CMC) and offers a fresh reading of its rhetoric of differentiation and identification. It attends to how the CMC frames Mani as a reformer among the Baptists and in continuity with this Baptist past. It ultimately argues that the creators of the CMC did not think of “Manichaeism” as a distinct “religion.” Finally, it aims to recalibrate the study of the Cologne Mani Codex towards broader attempts at situating it within a Syro-Mesopotamian milieu.
Breaking the Rules: Considerations on Zoroastrian Terminology Related to the Idea of Heresy
Authors: Timuş Mihaela
Published: April 2019

The present article is a part of a wider project devoted to the Zoroastrian Middle Persian terminology often translated in European languages as “heresy” or “heretic.” I offer here an analysis of the Middle Persian ahlomōγ according to only one text of the exegetical literature of this religious tradition, written down after the Arab conquest of Iran, namely Dēnkard 7. I propose a hypothesis according to which the majority of the contexts in which this term is used refers to Mazdak and the Mazdakites, suggesting that the author of Dēnkard 7 here draws a historical scheme of this sectarian movement. Other meanings, though not so many, can be found, such as “apostasy.” Among the methodological considerations, one finds that the same notion may have slightly changed meaning from one text to another, from one period to another. The Avestan ašǝmaoγa, for which the Middle Persian ahlomōγ is a translation, does not clearly lead to the idea of heresy, understood as schism or sect.
US Public Diplomacy and the Terrorism Challenge
Authors: Seib Philip
Published: April 2019

Public diplomacy can be one element of multifaceted counter-terrorism strategy, but to be successful it must be used in timely fashion as a preventive tool. One key to reducing the threat posed by terrorism is to turn off terror groups’ recruiting faucets, and public diplomacy can play an important role in doing this. This article explores the vulnerability of certain populations and how they might be reached and strengthened in ways that undercut terrorist recruitment. This includes recognizing the importance of religion in terrorist recruiting and how it may be addressed constructively. Further, traditional pubic diplomacy programmes such as educational and cultural exchanges have been underestimated as a mean of counteracting the ‘othering’ that increases vulnerable populations’ susceptibility to terrorist recruitment.
Political Leaders and Public Diplomacy in the Contested Indo-Pacific
Authors: Byrne Caitlin
Published: April 2019

Public diplomacy practice is intensifying across the Indo-Pacific as global actors compete to keep pace with the emerging geopolitical realities of a contested world order. China’s rise is the dominant feature. It comes as the United States retreats from global leadership, further heightening the sense of uncertainty in the region. Amid this strategic re-ordering, competition to influence narratives, set political agendas and frame the rules of a changing order is intense. The stakes for public diplomacy could not be higher and the implications for political leaders are significant. This article examines the role of Indo-Pacific political leaders through the lens of public diplomacy. While there are significant differences in approach, findings suggest that the imperative for political leaders to inform, engage and influence public audiences increasingly lies in the desire to shape the narrative and thus the nature of a regional order that will be favourable for their national interests.
Soft Power and Public Diplomacy Revisited
Authors: Nye Joseph S.
Published: April 2019

Soft power is the ability to affect others to obtain the outcomes one wants through attraction and persuasion rather than coercion or payment. A country’s soft power rests on its resources of culture, values and policies. A smart-power strategy combines hard- and soft-power resources. Public diplomacy has a long history as a means of promoting a country’s soft power, and soft power was essential in winning the Cold War. Smart public diplomacy requires an understanding of the roles of credibility, self-criticism and civil society in generating soft power. As authoritarian states today use new cyber technologies and other means to disrupt political processes in democracies, questions arise about the boundaries of soft power and the appropriate policies for public diplomacy.
The Understanding of dharmanirapekṣa (“secular”) in the Nepali Online Newspaper Nagarik
Authors: Buss Johanna
Published: April 2019

The term “secular” has long been interpreted in academia either as opposition towards religion or as a neutral position. As a Western concept deeply entangled with Christianity, its application to non-Christian and non-Western societies is highly contested. In our second case study, we focus on media discourse around Nepali democracy as a secular (dharmanirapekṣa) state. The discourse understands dharmanirapekṣa as neutrality or indifference towards all religions, but the idea of opposition is lacking. Secularism is attacked as a Western concept threatening Nepali culture or welcomed as a tool in the fight for recognition of different groups after centuries of domination under high-caste Hindu rule.
The Father Said Goodbye: The German Press’ Reactions to the Resignation of Pope Benedict xvi and the Conclave
Authors: Grünenthal Hannah
Published: April 2019

This paper analyzes the different constructions, interpretations and understandings of authority in the German journalistic press coverage in spring 2013, when Benedict xvi declared his resignation from the papal office, and the following time until his successor – Pope Francis – was elected. Pope Benedict’s resignation was an occasion that caused a stir in the journalistic field. The pope, the highest religious authority of the Roman Catholic Church, had brought his own power up to discussion. The opportunity was favourable for the journalistic, secular media to start an extensive critique and deconstruction of the Pope’s religious authority – but surprisingly enough, this did not happen. So, how and to whom is religious authority ascribed in the German press discourse? In this article I argue that the secular German press discourse not only refrains from deconstructing traditional religious authority, but reinforces it on various levels.
From xylogenesis to tree rings: wood traits to investigate tree response to environmental changes
Authors: De Micco Veronica , Carrer Marco , Rathgeber Cyrille B.K. , Julio Camarero J. , Voltas Jordi , Cherubini Paolo , Battipaglia Giovanna
Published: April 2019

It is noteworthy that the largest part of global vegetation biomass depends on a thin layer of cells: the vascular cambium. Understanding the wood formation processes and relationships with environmental factors is a crucial and timely research question requiring interdisciplinary efforts, also to upscale the information gained and to evaluate implications for tree growth and forest productivity.

We provide an overview of wood formation processes up to tree-ring development, bearing in mind that the combined action of intrinsic factors and environmental drivers determines the anatomical traits of a tree ring formed at a specific time and position within the tree’s architecture. After briefly reviewing intrinsic factors, we focus attention on environmental drivers highlighting how a correct interpretation of environmental signals in tree rings must be grounded in a deep knowledge of xylogenesis and consequent wood anatomical traits. We provide guidelines on novel methods and approaches recently developed to study xylem formation. We refer to existing literature on established techniques for retrospective analyses in tree-ring series of anatomical and isotopic traits, to assess long-term ecophysiological responses to environmental variations, also giving advice on possible bias because of interand within-tree variability.

Finally, we highlight that, once the temporal axis of intra-annual tree-ring variability of xylem traits is established by xylogenesis analysis, a multidisciplinary approach linking classical dendro-ecology, wood functional traits (dendro-anatomy) and eco-physiology (here focusing on dendro-isotopes) allows a better interpretation of past environmental events hidden in tree rings, and more reliable forecasts of wood growth in response to climate change.
“Drafting,” “Copying,” and “Adding Notes”: On the Semantic Field of “Writing” as Reflected by Qin and Early Han Legal and Administrative Documents
Authors: Staack Thies
Published: April 2019

The present paper investigates three terms that were all used to refer to acts of writing in the early imperial administration: shu 書, xie 寫, and shu 署. Based on an analysis of their usage in administrative and legal texts, it illustrates the semantic differences of these terms, which also bear implications for our understanding of the production and use of administrative documents.
On the Moisture Origins of Tornadic Thunderstorms
Authors: Molina Maria J. , Allen John T.
Published: April 2019

Tornadic thunderstorms rely on the availability of sufficient low-level moisture, but the source regions of that moisture have not been explicitly demarcated. Using the NOAA Air Resources Laboratory HYSPLIT model and a Lagrangian-based diagnostic, moisture attribution was conducted to identify the moisture source regions of tornadic convection. This study reveals a seasonal cycle in the origins and advection patterns of water vapor contributing to winter and spring tornado-producing storms (1981–2017). The Gulf of Mexico is shown to be the predominant source of moisture during both winter and spring, making up more than 50% of all contributions. During winter, substantial moisture contributions for tornadic convection also emanate from the western Caribbean Sea (>19%) and North Atlantic Ocean (>12%). During late spring, land areas (e.g., soil and vegetation) of the contiguous United States (CONUS) play a more influential role (>24%). Moisture attribution was also conducted for nontornadic cases and tornado outbreaks. Findings show that moisture sources of nontornadic events are more proximal to the CONUS than moisture sources of tornado outbreaks. Oceanic influences on the water vapor content of air parcels were also explored to determine if they can increase the likelihood of an air mass attaining moisture that will eventually contribute to severe thunderstorms. Warmer sea surface temperatures were generally found to enhance evaporative fluxes of overlying air parcels. The influence of atmospheric features on synoptic-scale moisture advection was also analyzed; stronger extratropical cyclones and Great Plains low-level jet occurrences lead to increased meridional moisture flux.
Deconstructing Victim-Blaming, Dehumanization, and Othering: Using Empathy to Develop a Sociological Imagination
Authors: Ghidina Marcia
Published: April 2019

The sociological imagination is a core component of all introductory sociology courses. A main focus of this perspective is how social forces are related to individual lives. Undergraduates are often socialized to rely on individualistic explanations of public issues. These explanations often blame, dehumanize, and other the victim, thereby inhibiting the understanding and application of structural analyses. A classroom activity that sought to increase empathy by showing video clips of individuals affected by the issues followed by a focused discussion of their experience was developed, implemented, and assessed. Results comparing pretests and posttests of students who engaged in the activity and those who were taught via more traditional methods indicate the exercise reduced victim-blaming and increased understanding of the sociological imagination. The pedagogical implications of these results for teaching introductory sociology are discussed along with the promise of sociology in the current socio-political context.
Pressure ulcers in patients receiving palliative care: A systematic review
Authors: Ferris Amy , Price Annie , Harding Keith
Published: April 2019

Background:

Pressure ulcers are associated with significant morbidity and mortality as well as high cost to the health service. Although often linked with inadequate care, in some patients, they may be unavoidable.

Aim:

This systematic review aims to quantify the prevalence and incidence of pressure ulcers in patients receiving palliative care and identify the risk factors for pressure ulcer development in these patients as well as the temporal relationship between pressure ulcer development and death.

Design:

The systematic review is registered in the PROSPERO database (CRD42017078211) and conducted in accordance with the ‘PRISMA’ pro forma. Articles were reviewed by two independent authors.

Data sources:

MEDLINE (1946–22 September 2017), EMBASE (1996–22 September 2017), CINAHL (1937–22 September 2017) and Cochrane Library databases were searched. In all, 1037 articles were identified and 12 selected for analysis based on pre-defined inclusion and exclusion criteria.

Results:

Overall pressure ulcer prevalence and incidence were found to be 12.4% and 11.7%, respectively. The most frequently identified risk factors were decreased mobility, increased age, high Waterlow score and long duration of stay.

Conclusion:

The prevalence of pressure ulcers is higher in patients receiving palliative care than the general population. While this should not be an excuse for poor care, it does not necessarily mean that inadequate care has been provided. Skin failure, as with other organ failures, may be an inevitable part of the dying process for some patients.
Ovarian preservation for premenopausal women with early-stage endometrial cancer: a Chinese retrospective study
Authors: Lyu Tianjiao , Guo Lu , Chen Xiaojun , Jia Nan , Gu Chao , Zhu Menghan , Zhao Yuqing , Liu Xiaoxia , Feng Weiwei
Published: April 2019

Objective

This study aimed to retrospectively investigate the safety of ovarian preservation of premenopausal women with stage 1a endometrial carcinoma.

Methods

We performed a population-based study to identify surgically treated stage Ia endometrial cancer of premenopausal women who were diagnosed between August 1989 and December 2015 in our center. Survival outcomes and recurrence rate were examined for premenopausal women who underwent ovarian preservation. Recurrence-free survival rates were calculated following generation of Kaplan–Meier curves and were compared with the log-rank test. Cox regression analysis was performed to identify the independent factors affecting the recurrence rate.

Results

Patients with ovarian preservation tended to be significantly younger at diagnosis, have less myometrial invasion, and were less likely to undergo lymphadenectomy compared with women treated with bilateral salpingo-oophorectomy. There was no significant difference in recurrence-free survival between the two groups. In the Cox regression model, ovarian preservation remained an independent prognostic factor for improved overall survival.

Conclusion

Ovarian preservation does not have a negative effect on oncological outcomes. Ovarian preservation can be applied to premenopausal women with stage Ia endometrial carcinoma.
Angiocentric astrocytoma in a cat
Authors: Rissi Daniel R. , McHale Brittany J. , Armién Anibal G.
Published: April 2019

Gliomas are common primary central nervous system neoplasms of dogs and cats, but atypical glioma subtypes are rare. Herein we report an angiocentric astrocytoma in a 15-y-old spayed female domestic shorthaired cat that was euthanized after therapy-resistant seizures. Gross anatomic changes consisted of swelling of the rostral leptomeninges over the olfactory bulbs and rostral telencephalon. Histologically, polygonal-to-elongate atypical neoplastic cells were arranged along perivascular spaces within these areas. Neoplastic cells were positive for glial fibrillary acidic protein, S100 protein, and vimentin. Ultrastructurally, round-to-elongate neoplastic cells emitting long processes with aggregates of intermediary filaments expanded and occupied the spaces between the vascular basement membrane and the glia limitans; nuclei had marginal and central heterochromatin. Tight junctions connected the plasma membrane of neighboring cells. The cell morphology, immunohistochemistry, and ultrastructural findings were consistent with an astrocytoma; the exclusive perivascular arrangement of neoplastic cells with no parenchymal mass warranted the diagnosis of angiocentric astrocytoma.
Perceptions of Digital Assistants From Early Adopters Aged 55+
Authors: Koon Lyndsie M. , McGlynn Sean A. , Blocker Kenneth A. , Rogers Wendy A.
Published: April 2019

Voice-activated digital assistants have the potential to assist adults aging-in-place with a variety of everyday tasks and leisure activities. To understand this potential, semi-structured interviews were conducted to explore perceptions and attitudes from current adult users based on the models of the unified theory of acceptance and use of technology model. Several model factors were identified as influential in the initial and continued use of the digital assistants. Results indicate the need for an effective instructional protocol to promote successful interactions during the learning phase and for continued engagement with novel abilities of the digital assistants.
Anthracofibrotic Lymph Node of Neck Mimicking Metastatic Malignant Melanoma in a Patient With Gastric Cancer
Authors: Lee Dong Hoon , Kim Jo Heon , Cho Sang Hee , Yoon Tae Mi , Lee Joon Kyoo , Lim Sang Chul
Published: April 2019

Extrathoracic anthracofibrosis in head and neck region is of extremely rare occurrence and can be confused with malignancy. In this article, we report an unusual case of an anthracofibrotic lymph node of neck that was mistaken for metastatic malignant melanoma in a gastric cancer patient. Because the incidence of an anthracofibrotic lymph node of the neck is very low, it is important to distinguish it from other diseases, including malignancy or metastasis, especially in patients with a cancer history. Thus, pathological diagnosis of anthracofibrosis is necessary to make an accurate diagnosis and find appropriate treatment.
3D Talar Kinematics During External Rotation Stress Testing in Hindfoot Varus and Valgus Using a Model of Syndesmotic and Deep Deltoid Instability
Authors: Goetz Jessica E. , Vaseenon Tanawat , Tochigi Yuki , Amendola Annunziato , Femino John E.
Published: April 2019

Background:

External rotation stress (ERS) identifies ankle instability after fibular reduction of rotational ankle injuries. Combined hindfoot and ankle motions and an inconsistent starting position could mask differing degrees of instability resulting from syndesmotic and/or deltoid ligament disruption. The goal of this work was to use full 3D talar kinematics to evaluate the effects of hindfoot orientation and foot starting position during ERS on the ability to detect instability caused by ligament disruptions.

Methods:

Six cadaveric ankles with metallic fiducial markers were CT scanned in neutral and 3 stress positions: varus hindfoot internal rotation stress (IRS-var), valgus hindfoot ERS (ERS-val), and varus hindfoot ERS (ERS-var). Scans were obtained in stress positions after transecting the deep deltoid ligament (tDDL) and then the syndesmotic ligaments (tDDL+Syn). Talar rotations and translations were computed in the axial, coronal, and sagittal planes in each stress position. Changes in a fixed center of rotation (CoR) relative to the intact sequence were calculated.

Results:

Axial plane rotation beginning from IRS-var increased significantly for each level of ligamentous instability ( P < .05 for all conditions) (10.9 degrees, intact; 14.1 degrees, tDDL; 22.7 degrees, tDDL+Syn during ERS-val; and 16.4 degrees, intact; 23.1 degrees, tDDL; 29.9 degrees, tDDL+Syn during ERS-var). With ERS-val, the talar CoR moved medially (3.6-5.4 mm) and posteriorly (0.5-5.2 mm); ERS-var moved anterior/laterally or posterior/medially depending on the specific ligamentous instability. With tDDL+Syn the ankle became grossly unstable and there were no clear trends in sagittal/coronal rotation or translation.

Conclusion:

An ERS test from internal to external rotation consistently differentiates between normal, tDDL, and tDDL+Syn. Talar CoR moved outside the mortise with ligamentous instability.

Clinical Relevance:

Significant residual deep deltoid instability is likely underrecognized with current practice. The most discriminatory test for detecting such instability in our laboratory was an ERS test performed by internally rotating the foot to a hard, bony endpoint, positioning the hindfoot in varus, and then performing the entire external rotation maneuver while maintaining the varus hindfoot position.
Optimization of plastic analysis of moment frames using modified dolphin echolocation algorithm
Authors: Daryan Amir Saedi , Palizi Soheil , Farhoudi Neda
Published: April 2019

The analysis of structures and, in particular, the determination of their failure mode are the basic requirements in the field of civil engineering. Obtaining this information in high-rise structures or structures with complex irregular layouts is a difficult process, which even with the use of specialized computer software is very time-consuming. In recent years, meta-heuristic algorithms have been used extensively in engineering optimization problems. This research presents an automated approach to assess plastic loads and failure modes of two-dimensional frames, in which the plastic analysis of moment frames has been optimized using the modified dolphin echolocation optimization algorithm. This method is based on the creation of the basic collapse mechanisms, which, following their combination, should reach the minimum coefficient of plastic collapse loads using virtual work theory. The efficiency of this algorithm is verified using four sample frames, which, their exact solution including minimum load factor and the corresponding critical failure mode of the structure, exit in other research. Comparison of the results shows that the proposed method provides very good results with high precision and speed and also demonstrates the failure mechanism of the structure. Meanwhile, the modifications made in this method have greatly reduced the volume of calculations. Moreover, applying changes to the dolphin echolocation optimization algorithm led to the use of this optimization algorithm for binary problems for the first time, which ultimately resulted in a good convergence rate.
Congenital Cytomegalovirus Infection Masquerading as Antenatal Ventriculomegaly With Intraventricular Hemorrhage in a Term Neonate
Authors: Bhattacharya Deepanjan , Anil Kumar B. N. , Panigrahi Inusha , Kaur Anupriya
Published: April 2019

Intraventricular hemorrhage is an uncommon manifestation of congenital cytomegalovirus (CMV) infection and has been described in preterm neonates. We discuss a term neonate, who was referred because of intracranial hemorrhage and hydrocephalous detected in the antenatal ultrasound. She had cholestatic jaundice, hepatitis, and thrombocytopenia, with positive polymerase chain reaction for CMV. Neuroimaging revealed reduced sulcation, mildly enlarged ventricles, and multiple periventricular cysts, along with residual hemorrhage in occipital horn of left lateral ventricle. She was started on ganciclovir, following which there was improvement in platelet count, jaundice, as well as transaminase levels.
Myocardial Ischemia and Anomalous Origin of the Right Coronary Artery From the Pulmonary Artery in the Adult: Management Implications and Follow-Up
Authors: VanLoozen Dennis , Bykhovsky Michael R. , Kapoor Deepak , Bates William B. , Murdison Kenneth A. , Polimenakos Anastasios C.
Published: April 2019

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare and potentially fatal congenital heart defect due to myocardial ischemia secondary to coronary steal phenomenon. We present a case of an adult presenting with a myocardial infarction who was found to have ARCAPA. Three-dimensional (3D) reconstructed computed tomography angiography (CTA) was utilized preoperatively for surgical planning. Surgical technique as well as pre- and postoperative 3D CTA are described and literature reviewed.
Matrix-Associated Autologous Chondrocyte Implantation Is an Effective Treatment at Midterm Follow-up in Adolescents and Young Adults
Authors: Hoburg Arnd , Löer Ingo , Körsmeier Konrad , Siebold Rainer , Niemeyer Philipp , Fickert Stefan , Ruhnau Klaus
Published: April 2019

Background:

Autologous chondrocyte implantation (ACI) is an established method for treating cartilage defects in the knee of adult patients. However, less is known about its effectiveness in adolescents.

Hypothesis:

Third-generation matrix-associated ACI (MACI) using spheroids (co.don chondrosphere/Spherox) is an effective and safe treatment for articular cartilage defects in adolescents aged 15 to 17 years, with outcomes comparable with those for young adults aged 18 to 34 years.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 71 patients (29 adolescents, 42 young adults) who had undergone ACI using spheroids were evaluated retrospectively in this multicenter study. For adolescents, the mean defect size was 4.6 ± 2.4 cm2, and the follow-up range was 3.5 to 8.0 years (mean, 63.3 months). For young adults, the mean defect size was 4.7 ± 1.2 cm2, and the follow-up range was 3.8 to 4.3 years (mean, 48.4 months). At the follow-up assessment, outcomes were assessed by using validated questionnaires (Knee injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee [IKDC] subjective knee evaluation form and current health assessment form, and modified Lysholm score), the magnetic resonance observation of cartilage repair tissue (MOCART) score, and if relevant, time to treatment failure. Safety was assessed by the treatment failure rate.

Results:

No significant difference between the 2 study groups was found for KOOS, IKDC, or MOCART scores, with all patients achieving high functional values. A significant difference was found in the modified Lysholm score, favoring the young adult group over the adolescent group (22.3 ± 1.9 vs 21.0 ± 2.4, respectively; P = .0123). There were no differences between the rates of treatment failure, with 3% in the adolescent group and 5% in the young adult group.

Conclusion:

Third-generation MACI using spheroids is a safe and effective treatment for large cartilage defects of the knee in adolescents at midterm follow-up. Outcomes are comparable with those for young adults after ACI.
Impact of a Cancer Urgent Care Clinic on Regional Emergency Department Visits
Authors: Hong Arthur S. , Froehlich Thomas , Clayton Hobbs Stephanie , Lee Simon J. Craddock , Halm Ethan A.
Published: April 2019

PURPOSE:

Did the creation of an urgent care clinic specifically for patients with cancer affect emergency department visits among adults newly diagnosed with cancer?

PATIENTS AND METHODS:

We applied an interrupted time series analysis to adjusted monthly emergency department visits made by adults age 18 years or older who were diagnosed with cancer between 2009 and 2016 at a comprehensive cancer center. Cancer registry patients were linked to a longitudinal regional database of emergency department and hospital visits. Because the urgent care clinic was closed on weekends, we took advantage of the natural experiment by comparing weekend visits as a control group. Our primary outcome was emergency department visits within 180 days after a cancer diagnosis, compiled as adjusted monthly rates of emergency department visits per 1,000 patient-months. We analyzed subsequent hospitalizations as a secondary outcome.

RESULTS:

The rate of weekday emergency department visits was increasing at a rate of 0.43 visits (95% CI, 0.29 to 0.57 visits) per month before May 2012, then fell in half to a rate of 0.19 visits (95% CI, 0.11 to 0.28 visits) per month ( P = .007) after the urgent care clinic was established. In contrast, the weekend visit rate was growing at a rate of 0.08 visits (95% CI, −0.03 to 0.19 visits) per month before May 2012 and 0.05 (95% CI, −0.02 to 0.13 visits; P = .533) afterward. By the end of 2016, there were 15.3 fewer monthly weekday emergency department visits than expected ( P = .005). Trends in weekday hospitalizations were not significantly changed.

CONCLUSION:

Although only one in eight emergency department–visiting patients also used the urgent care clinic, the growth rate of emergency department visits fell by half after the urgent care clinic was established.
CRISPR/Cas9-generated mouse model of Duchenne muscular dystrophy recapitulating a newly identified large 430 kb deletion in the human DMD gene
Authors: Egorova Tatiana V. , Zotova Evgenia D. , Reshetov Denis A. , Polikarpova Anna V. , Vassilieva Svetlana G. , Vlodavets Dmitry V. , Gavrilov Alexey A. , Ulianov Sergey V. , Buchman Vladimir L. , Deykin Alexei V.
Published: April 2019

Exon skipping is a promising strategy for Duchenne muscular dystrophy (DMD) disease-modifying therapy. To make this approach safe, ensuring that excluding one or more exons will restore the reading frame and that the resulting protein will retain critical functions of the full-length dystrophin protein is necessary. However, in vivo testing of the consequences of skipping exons that encode the N-terminal actin-binding domain (ABD) has been confounded by the absence of a relevant animal model. We created a mouse model of the disease recapitulating a novel human mutation, a large de novo deletion of exons 8-34 of the DMD gene, found in a Russian DMD patient. This mutation was achieved by deleting exons 8-34 of the X-linked mouse Dmd gene using CRISPR/Cas9 genome editing, which led to a reading frame shift and the absence of functional dystrophin production. Male mice carrying this deletion display several important signs of muscular dystrophy, including a gradual age-dependent decrease in muscle strength, increased creatine kinase, muscle fibrosis and central nucleation. The degrees of these changes are comparable to those observed in mdx mice, a standard laboratory model of DMD. This new model of DMD will be useful for validating therapies based on skipping exons that encode the N-terminal ABD and for improving our understanding of the role of the N-terminal domain and central rod domain in the biological function of dystrophin. Simultaneous skipping of exons 6 and 7 should restore the gene reading frame and lead to the production of a protein that might retain functionality despite the partial deletion of the ABD.
Li-Ion Conductive Li3PO4-Li3BO3-Li2SO4 Mixture: Prevision through Density Functional Molecular Dynamics and Machine Learning
Authors: Sumita Masato , Tamura Ryo , Homma Kenji , Kaneta Chioko , Tsuda Koji
Published: April 2019

The development of high Li-ion conductive solid electrolytes is crucial for the practical use of all solid-state Li-ion batteries. The mixing of hetero Li-ion conductive substances is a known method for enhancing the Li-ion conductivity more than in the original substances. In this study, using computer simulations, we proved that a ternary Li3PO4-Li3BO3-Li2SO4 system has the potential to indicate improved Li-ion conductivity based on the introduction of a pseudo-Li-ion/oxygen vacancy. The Li-ion conductivities of this ternary system were calculated using several model systems based on the density functional molecular dynamics under an isothermal-isobaric ensemble. However, an exploration using the density functional molecular dynamics cannot cover the entire combinatorial space owing to a lack of computational capability. To search through a vast combinatorial space, we conducted analyses using a machine learning technique. The analysis results clarify the relationship between Li-ion conductivity and phonon free energy, and allow the optimum composition ratio with the highest Li-ion conductivity to be predicted.
Molecular detection and phylogenetic tree of infectious laryngotracheitis virus in layers in Al-Diwaniyah province, Iraq
Authors: Alaraji Furkan , Hammadi Hasan , Abed Alaa Abdulaziz , Khudhair Yahia Ismail
Published: April 2019

Background and Aim: Infectious laryngotracheitis (ILT) of chickens is a substantial issue to be studied in Iraq because this disease is one of the most highly contagious respiratory diseases in the world caused by a herpesvirus. However, in Iraq, the ILT virus (ILTV) infection and disease have yet not been confirmed in layers, so farm owners do not vaccinate these layers. The current study aimed to document the detection and characterization of ILTV in layer hens from Al-Diwaniyah city, for the first time in Iraq, using molecular techniques like polymerase chain reaction (PCR) and sequencing.

Materials and Methods: Four layer farms (15,000 unvaccinated layers/farm) in Al-Diwaniyah province, Iraq, suffered a severe ILT outbreak, was diagnosed and reported by clinical and PCR tests. This disease has been reported in Iraq, and more recently, it began to show outbreaks in Al-Diwaniyah city. The current work opted to investigate the ILTV using PCR and DNA sequencing techniques. The study targeted the p32 gene of ILTV using pooled tracheal swabs and organs including the trachea, lung, and kidneys which were collected from dead and clinically infected chickens.

Results: The analyses revealed that four of six suspected field samples showed positive results by PCR. The DNA sequencing results showed the homology of the amplified fragments with the studied gene.

Conclusion: This study confirmed the presence of ILTV in hens with respiratory signs during the outbreak.
Carriage of Class 1 integrons and molecular characterization of intI1 gene in multidrug-resistant Salmonella spp. isolates from broilers
Authors: Gupta Renu , Chauhan Sneh Lata , Kumar Sunil , Jindal Naresh , Mahajan N. K. , Joshi V. G.
Published: April 2019

Aim: The present study was conducted with the following aims: (i) To screen the Salmonella spp. isolates recovered from suspected cases of fowl typhoid for carriage of Class 1 integrons and analyze their association with antimicrobial resistance and (ii) to carry out molecular characterization and phylogenetic analysis of Class 1 integron-integrase (intI1) gene.

Materials and Methods: A total of 43 Salmonella isolates were subjected to polymerase chain reaction (PCR) assay to determine the presence of Class1 intI1. Differences between different serotypes in relation to their carriage of integrons and the differences between strains containing or not containing an integron and being resistant to different antimicrobials were analyzed by Fisher exact test using STATA™ (StataCorp, College Station, TX). Phylogenetic analysis was carried out using MEGA6 software.

Results: Out of 43 isolates, 40 (93.02%) were found positive for Class 1 integrons. 35/40 (87.5%) intI1-positive isolates were multidrug resistance (MDR) (resistant to ≥4 antibiotics), which support the hypothesis of an association between the presence of Class 1 integrons and emerging MDR in Salmonella. There was no significant difference among isolates resistant to different antimicrobials in Class 1 integron carrying isolates and the Class 1 integron negative isolates (p<0.05). Further, there was no significant difference among different serotypes in respect of their carriage of Class 1 integrons.

Conclusion: It can be concluded that the high prevalence of Class 1 integrons indicates a high potential of Salmonella isolates for horizontal transmission of antimicrobial genes, especially among Gram-negative organisms.
ANALYSIS OF THE SENSITIVITY OF VISCOELASTIC PARAMETERS AT THE STRAIN-RATE OF A THERMOPLASTIC
Authors: Saadallah Younès , Derfouf Semcheddine , Guerira Belhi
Published: April 2019

The behavior of thermoplastics depends on several factors, mainly time and temperature. The present work is the subject of a study of the dependence of these materials on time. The material considered in this study is a polyamide 6. The applied behavior model is represented by the Kelvin-Voigt viscoelastic mechanism with instant elasticity. Following the mathematical formulation of the equations of the model, tensile tests at different strain rates are conducted. The model parameters are then identified. These being sensitive to the strain-rate, the relation which links them with it is established by means of an exponential regression. The experimental results and those obtained by the model are presented, compared and interpreted. Their relevance and coherence validates both the model and the approach adopted.