bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of prenatal exposure to bisphenol A on pregnant rats: Fetal bone development and immunohistochemistry implications
Authors: Atay Emre , Ertekin Tolga , Yılmaz Halil , Güler Hatice Susar , Al Özge , Nisari Mehtap , Yay Arzu , Unur Erdoğan , Özdamar Saim , Yalçın Betül
Published: February 2019

Background:

Bisphenol A (BPA) is one of the most commonly produced chemicals in the world. BPA is used in products such as food packaging, personal care products, detergents, and plastic bottles. This study was conducted to determine the effect of BPA on fetal bone development.

Material and methods:

In this study, 16 pregnant female Sprague-Dawley rats were used. The rats were divided into four groups: the control group and 0.5 mg/kg/day, 5 mg/kg/day, and 50 mg/kg/day dose BPA groups. The skeletal system development of fetuses was examined with double skeletal and immunohistochemistry (IHC) staining (tartrate resistant acid phosphatase (TRAP) and the alkaline phosphatase (AP) expressions) methods.

Results:

The highest ossification rates in the humerus, radius, and ulna were detected as 41.05%, 39.25%, and 37.26% in the control group, respectively. The highest ossification rates in the femur, tibia, and fibula were detected as 23.04%, 30.73%, and 32.78% in the control group, respectively. Statistically significant differences were found between control and experimental groups in the TRAP and AP expression of the femur by IHC staining ( p < 0.001).

Conclusion:

Exposure to BPA during pregnancy adversely affected ossification and bone growth. A dose-dependent decrease was observed in the rate of ossification.
Usability Testing of the Teacher Help for Learning Disabilities Program: An eHealth Intervention for Teachers
Authors: Parker Ashton , Brine Sarah , McGonnell Melissa , Baert Annie , Corkum Penny
Published: February 2019

Use of evidence-based interventions for learning disabilities (LDs) in the classroom is limited by several factors such as teachers’ knowledge of LDs and access to interventions. eHealth interventions (i.e., interventions delivered via the Internet) have the potential to be a powerful tool in overcoming barriers to implementing evidence-based strategies within the classroom. The current article describes the development and usability testing of Teacher Help for LD, an eHealth professional development program that assists classroom teachers in providing evidence-based interventions to students with LDs. Specialists in LDs ( n = 18), consisting of individuals within the educational and health systems, were asked to evaluate the usability of the Teacher Help for LD intervention and provide their feedback. Results from both quantitative and qualitative data suggest that participants were very satisfied with the program and found the program highly usable. Results will help to prepare and modify the program for use with regular classroom teachers in an upcoming cluster randomized controlled trial across Canada.
After Child Maltreatment: The Importance of Voice for Youth in Foster Care
Authors: Goldfarb Deborah , Tashjian Sarah M. , Goodman Gail S. , Bederian-Gardner Daniel , Hobbs Sue D. , Cordón Ingrid M. , Ogle Christin M. , Bakanosky Sarah , Narr Rachel K. , Chae Yoojin ,   the NYTD/CYTD Research Group
Published: February 2019

Once social services steps in to protect children from violence and neglect in their homes, many youth become wards of the specialized juvenile or family court that assists in child protection (e.g., the dependency court). Some of these children will be ordered into foster care. Within this “dependency system,” such children often feel a lack of voice. This study tests the prediction that foster youth who perceive having more opportunity for voice, even indirectly via a representative, more favorably rate the dependency system. Adolescents ( n = 110), aged 17 years, involved in foster care and age-matched nonfoster youth rated “how good or bad the foster care/dependency court is for foster youth.” The foster youth were also asked about their interactions with the court and with their attorney representatives. Foster and nonfoster youth did not significantly differ in dependency system ratings when considered at the overall group level. However, foster and nonfoster youth ratings significantly differed when foster youth’s views of relevant prior legal experiences (e.g., frequency of child–attorney contact, quality of attorney representation) were taken into account: Youth with the highest perceived quality of experiences indicated more positive views than any other group. The importance of perceived quality of experience adds insight into mechanisms for improving adolescents’ feelings of voice in the legal system.
Development of a Novel Tool to Assess Intimate Partner Violence Against Transgender Individuals
Authors: Peitzmeier Sarah M. , Hughto Jaclyn M. W. , Potter Jennifer , Deutsch Madeline B. , Reisner Sari L.
Published: February 2019

Intimate partner violence (IPV) takes on unique dimensions when directed against transgender individuals, with perpetrators leveraging transphobia to assert power and control. Standard IPV measurement tools do not assess this type of IPV. Four questions to assess transgender-related IPV (T-IPV) were developed: (a) being forced to conform to an undesired gender presentation or to stop pursuing gender transition; (b) being pressured to remain in a relationship by being told no one would date a transgender person; (c) being “outed” as a form of blackmail; and (d) having transition-related hormones, prosthetics, or clothing hidden or destroyed. The T-IPV tool was administered to 150 female-to-male transmasculine individuals completing a study of cervical cancer screening in Boston from March 2015-September 2016. Construct validity was assessed by examining correlations between T-IPV and two validated screeners of other forms of IPV (convergent) and employment status and fruit consumption (divergent). The association between T-IPV and negative health outcomes (posttraumatic stress disorder [PTSD], depression, psychological symptoms, binge drinking, number of sexual partners, and sexually transmitted infection [STI] diagnosis) were also calculated. Lifetime T-IPV was reported by 38.9%, and 10.1% reported past-year T-IPV. T-IPV was more prevalent among those who reported lifetime physical (51.7% vs. 31.7%, p = .01) and sexual (58.7% vs. 19.4%, p < .001) IPV than those who did not. Lifetime T-IPV was associated with PTSD (adjusted odds ratio [AOR] = 2.23, 95% confidence interval [CI] = [1.04, 4.80]), depression (AOR = 2.70, 95% CI = [1.22, 5.96]), and psychological distress (AOR = 2.82, 95% CI = [1.10, 7.26]). The T-IPV assessment tool demonstrated adequate reliability and validity and measures a novel type of abuse that is prevalent and associated with significant mental health burden. Future work should further validate the measure and pilot it with male-to-female transfeminine individuals.
Building on Strengths While Addressing Barriers: Career Interventions in Rural Appalachian Communities
Authors: Gibbons Melinda M. , Brown Emily C. , Daniels Stephanie , Rosecrance Pamela , Hardin Erin E. , Farrell Isabel
Published: February 2019

This article describes a model for developing culturally sensitive career education programs, framed from an ecological contextual understanding. This framework allows career practitioners to build on cultural strengths and values to meet the career education needs of diverse communities. To illustrate the application of this model, we describe the cultural context of rural Appalachia and offer theoretically framed ideas of how to meet the population’s career education needs.
Two time domain models for fatigue life prediction under multiaxial random vibrations
Authors: Luo Zhengbo , Chen Huaihai , He Xudong , Zheng Ronghui
Published: February 2019

Two time domain models for fatigue life prediction under multiaxial random vibrations are developed on the basis of the critical plane approach. Firstly, the stress power spectral density matrix of each node at the notch root of the test specimen is obtained by the random vibration analysis with finite element method, and the stress time-histories are generated from the stress power spectral density matrix by the time domain randomization approach. Then, the fatigue life of each node is predicted based on the damage on the critical plane, where the cumulative damage value is the greatest. The minimum fatigue life of all nodes at the notch root is considered as the fatigue life of the test specimen. Finally, the proposed models are validated by the multiaxial random vibration fatigue test with the 6061-T4 aluminum alloy. The results show that the predicted fatigue lives and predicted crack orientation angles are in good agreement with the experimental fatigue lives and experimentally observed crack orientation angles, respectively.
Development of the active disturbance rejection control method for increasing the stability of the long articulated vehicle
Authors: Esmaeili Naser , Kazemi Reza
Published: February 2019

Today, with the increasing growth in road traffic, many countries are welcoming long articulated vehicles because of their economic and environmental benefits and the positive effects on the problem of traffic congestion and the reduction in fuel consumption and environmental pollutants. The major problem with such vehicles is poor maneuverability at low speeds and inappropriate lateral performance at high speeds, resulting in accidents and financial losses. Therefore, in order to improve their safety, they need a control system that can improve the performance of the long articulated vehicles. In this article, a 19-degree of freedom dynamic model of the long articulated vehicle has been developed in MATLAB software. This vehicle consists of a tractor and two semi-trailer units. To adjust the articulated vehicle lateral dynamics, a robust control method based on the combination of active disturbance rejection control and back-stepping sliding mode control is introduced. Four control variables such as yaw rate and lateral velocity of the tractor and also first and second articulation angles are regulated by steering the axles of the tractor and two trailers. Furthermore, in order to measure the state variables of the long articulated vehicle, the extended Kalman filter is used. The results of the simulation in high-speed lane change and low-speed steep steer maneuvers indicate the superiority of this method over linear-quadratic regulator and sliding mode controllers. Finally, the robustness of this controller than conventional sliding mode and active disturbance rejection sliding mode controllers have been shown in the presence of noises.
Computational Models of Anxiety: Nascent Efforts and Future Directions
Authors: Sharp Paul B. , Eldar Eran
Published: February 2019

Computational approaches to understanding the algorithms of the mind are just beginning to pervade the field of clinical psychology. In the present article, we seek to explain in simple terms why this approach is indispensable to pursuing explanations of psychological phenomena broadly, and we review nascent efforts to use this lens to understand anxiety. We conclude with future directions that will be required to advance algorithmic accounts of anxiety. Ultimately, the surplus explanatory value of computational models of anxiety, above and beyond existing neurobiological models of anxiety, impugns the naively reductionist claim that neurobiological models are sufficient to explain anxiety.
Taking justice to people in crisis: Mobile legal clinics
Authors: Hubbard Britane , Saladen Mallory , Tushaus David W , Upreti Nirmal K
Published: February 2019

Mobile legal clinics can be used to provide better access to justice in many different ways. The Nepal projects discussed and evaluated here used law students and private lawyer volunteers to conduct legal education programs, give counsel and advice, and provide legal representation. Mobile legal clinics like these can be replicated for people in personal crises or natural disasters anywhere. The goal of this article is to provide information the reader can use to create mobile clinics to meet the needs of people in crisis in any situation. Assessing these programs is also discussed.
The rule of law, arbitrariness and institutional virtue
Authors: Thompson Keith
Published: February 2019

This article summarises Professor Martin Krygier's work on the rule of law and his view that arbitrariness is its core and is under-theorised. From ancient philosophy, the author suggests that our rule of law settlement feels tentative because arbitrariness is a human characteristic that cannot be completely fixed with institutional checks and balances. The author observes that a variety of rule of law virtues are already expected of judicial decision-makers and suggests that these institutional virtues should be transferred into the administrative, executive and corporate decision-making space to advance the rule of law project.
Investigation of the potential for sera from cattle persistently infected with bovine viral diarrhea virus to generate false-negative antibody ELISA results in pooled serum from seropositive and seronegative cattle
Authors: Graham David A. , King Deirdre , Clegg Tracy A. , O’Neill Ronan G.
Published: February 2019

We investigated the potential for viremic sera from cattle persistently infected with bovine viral diarrhea virus to create false-negative antibody results when testing pools of 10 sera by indirect or blocking ELISAs. Seronegative viremic sera ( n = 23) were each added to a series of artificially constructed pools containing various percentages (0–90%) of antibody-positive sera, and the resulting pools were assayed for antibody. In all 23 cases, a negative antibody result was obtained in the pool containing no seropositive sera. In contrast, all pools containing ≥10% seropositive serum, representing a single seropositive animal in a pool of 10 samples, returned a positive result in both antibody ELISAs. We concluded that the likelihood of a false-negative antibody result occurring as a result of the presence of serum from a viremic animal was low, and therefore did not preclude the use of pooled sera for serosurveillance.
Interethnic Conflict and Genocide in Myanmar
Authors: Anwary Afroza
Published: February 2019

This article, based on event history and a narrative analysis of reports produced by human rights groups, reveals that the genocide of Rohingyas of the Rakhine state of Myanmar is the result of the Myanmar military government’s deliberate policies and unpremeditated consequences that have led to the higher level of conflict among groups in Myanmar. It examines the processes by which the Myanmar government has constructed the collective identity of Rohingya as illegal immigrants. It focuses on the role of the sustained historical and conflictual relationships among the Myanmar government, Rohingyas, and the Rakhine Buddhists that contributed to the Rohingya genocide.
Effect of solar temperature field on a sea-crossing cable-stayed bridge tower
Authors: Li Yuan , He Shuanhai , Liu Peng
Published: February 2019

Based on the transient temperature field theory of heat conduction, the solar temperature field calculation model of a sea-cross cable-stayed bridge tower was established and calculated through transient heat transfer analysis, with the largest sea-cross construction project of Kong–Zhuhai–Macao Bridge as an example. The main parameters, including the solar elevation angle, azimuth angle, radiation absorption coefficient, and length of overhang, were incorporated. The proposed model was verified by comparing the measured data with the predicted values of both the temperature field and temperature deformation. The analysis results and monitoring data achieved a good agreement, which reveals that integrating numerical analysis with field monitoring data can be utilized to thoroughly understand the effects of a solar temperature field on a sea-crossing cable-stayed bridge tower. The research results guide the construction of the bridge.
I have most of my asthma under control and I know how my asthma acts: Users’ perceptions of asthma self-management mobile app tailored for adolescents
Authors: Schneider Tali , Baum Laura , Amy Alman , Marisa Couluris
Published: February 2019

Asthma continues to be the leading chronic condition among US adolescents. Despite medical advances, many adolescents face uncontrolled asthma mainly due to insufficient self-management skills. Mobile apps pose a promising adjunct to in-clinic asthma care. However, little is known about the usability and effectiveness of such technology. In all, 20 adolescents participated in a 3-month trial to test an asthma app tailored to their age. Qualitative data on adolescents’ experience with the app were inquired. Overall, participants thought the app was functional and user-friendly. The majority expressed that the app assisted them with asthma self-management through tracking of asthma status and text reminders to test their peak flow regularly. They indicated external factors that limited app use and suggested improvements to make the app more engaging and appealing to adolescents. The tested app provides a feasible means to assist adolescent in developing self-management skills, tracking disease status, and communicating with healthcare providers.
The effect of fuel composition and additive packages on deposit properties and homogeneous charge compression ignition combustion
Authors: Lacey Joshua , Kameshwaran Karthik , Filipi Zoran , Fuentes-Afflick Peter , Cannella William
Published: February 2019

Homogeneous charge compression ignition combustion is highly dependent on in-cylinder thermal conditions that are favorable to auto-ignition, and the presence of deposits can dramatically impact the in-cylinder environment. Because fuels available at the pump can differ considerably in composition, and fuel composition and the included additive package directly affect how deposits accumulate in a homogeneous charge compression ignition engine, strategies intended to bring homogeneous charge compression ignition to market must account for this fuel and additive variability. In order to investigate this impact, two oxygenated refinery stream test fuels with two different additives were run in a single cylinder homogeneous charge compression ignition engine. The two fuels had varying chemical composition; one represents a “dirty” fuel with high aromatic content that was intended to simulate a worst-case scenario for deposit growth, while the other represents a California Reformulated Gasoline Blendstock for Oxygenate Blending fuel, which is the primary constituent of pump gasoline at fueling stations across the state of California. The additive packages are typical of technologies that are commercially available to treat engine deposits. Both fuels were run in an experimental, single-cylinder homogeneous charge compression ignition engine in a passive conditioning study, during which the engine was run at steady state over a period of time in order to track changes in the homogeneous charge compression ignition combustion event as deposits accumulated in-cylinder. Both the composition and the additive influenced the structure of the combustion chamber deposit layer, but more importantly, both the rate at which the layer developed and the equilibrium thickness it achieved. The overall thickness of the combustion chamber deposit layer was found to have a significant impact on homogeneous charge compression ignition combustion phasing.
The Emergence of transnational awareness among children in immigrant families
Authors: Compton-Lilly Catherine , Kim Jieun , Quast Erin , Tran Sarah , Shedrow Stephanie
Published: February 2019

In the past, physical barriers such as geography and distance limited global communication. In this paper, we explore how young children in immigrant families engage in transnational literacy practices. Specifically, we explore the transnational funds of knowledge that result from those experiences. This three-year longitudinal collective case study involves ten children from immigrant families who have come to the United States from around the world. The students entered the study in four-year-old kindergarten, grade 1 or grade 2. Each year, we collected observations, spoken data and student-created artefacts (e.g. writing samples, maps, photographs). Data sources were designed to highlight the various spaces that the immigrant families occupy or have occupied over time (i.e. home/neighbourhood/ school; native country/country of residence). Our reading and rereading of coded data across the sample led us to focus on families’ digital transnational practices and children’s transnational awareness. We argue that these funds of knowledge should be recognized in classrooms and schools and that they have the potential to contribute to the nurturing of cosmopolitan perspectives for all children.
Should campaign finance reform aim to level the playing field?
Authors: Pevnick Ryan
Published: February 2019

Many argue that an important goal of campaign finance reform should be to ensure that competing candidates have roughly equal financial resources with which to contest campaigns. Although there are very important reasons to worry about the role that money has come to play in many democracies, this article argues in three main steps that this particular position lacks compelling justification. First, while advocates of such positions often rely on an analogy with much smaller deliberative settings to defend the view that advocates of competing perspectives should be given equal resources, there are differences between such settings and campaigns that undermine the analogy’s appeal. Second, independent arguments – connected to the importance of ensuring that the wealthy do not dominate public debate and preventing corruption – may speak strongly in favor of a generous system of public funding, but fail to provide reason to ensure that advocates of competing positions have access to equal resources. Third, it is impossible to meaningfully level the playing field without objectionably restricting civil liberties. An implication of these arguments is that common criticisms of voucher-based systems of public funding, which hinge on an implicit commitment to the importance of a level playing field, fail.
Real-Time Visualization of Ureters Using Indocyanine Green During Laparoscopic Surgeries: Can We Make Surgery Safer?
Authors: Mandovra Pranav , Kalikar Vishaka , Patankar Roy V.
Published: February 2019

Background. Intraoperative ureteral injury is rare, but a grave complication during laparoscopic surgery. Several methods for intraoperative localization of ureters are described with their own pitfalls. Intraoperative localization using near-infrared (NIR) fluorescence with indocyanine green (ICG) is an easier and assured method during laparoscopic pelvic surgeries. Method. From September 2017 to December 2017, patients undergoing laparoscopic pelvic surgeries were administered cystoscopic-guided intraureteral ICG immediately preoperatively with tip of a 6-Fr ureteral catheter. The fluorescence of ureters was visualized in the NIR mode of the camera system, localizing the ureters precisely and in real time. Results. This technique was used to visualize ureters in 30 surgeries. Median age of the patients was 46.7 years with median body mass index of 23.2 kg/m2. Mean duration between administration of dye and insertion of trocar was 10 minutes. Mean duration for insertion of cystoscopically guided intraureteral ICG was 7 minutes. Ureteral fluorescence was visualized in all cases with some variation in intensity of the brightness perceived depending on surrounding fat. Duration of the lengthiest surgery was 240 minutes, and fluorescence was appreciated till the end. There were no intraoperative or postoperative complications attributed to ICG administration. In 10 patients (33%), there was difficulty in identifying the ureters on conventional white light mode, in which ICG localization was extremely helpful. Conclusion. ICG-stained ureteral visualization under NIR light is a safe and feasible method that provides real-time ureteral demarcation. This easily replicable, sensitive, and specific method of ureteral visualization can make complex laparoscopic pelvic surgeries safer.
Minimally Invasive Multidisciplinary Approach to Chronic Giant Inguinoscrotal Hernias
Authors: Sanford Zachary , Weltz Adam S. , Singh Devinder , Hanley Robert , Todd David , Belyansky Igor
Published: February 2019

Background. Giant inguinoscrotal hernias (GIH) are defined as groin hernias extending below the mid-thigh when standing, often significantly encumbering activities of daily living. To date, there are no reports utilizing the combination of progressive pneumoperitoneum (PPP), botulinum toxin A injection (BTI), and enhanced view-totally extraperitoneal (eTEP) technique for GIH repair. In this report, we present 2 such cases of this unique minimally invasive multidisciplinary approach to address GIH. Series Presentation. Two individuals with lifelong complaints of GIH presented for elective hernia repair, each with significant morbidity relating to their pathology and profound loss of abdominal domain. Four weeks prior to surgery, BTI was administered to the lateral abdominal compartment muscles to facilitate regional paralysis, followed by PPP to develop larger intraabdominal domain. Utilizing the eTEP access technique and transversus abdominis release, a wide retromuscular dissection was performed to aid in the increase of intraabdominal domain and to develop a large space for mesh placement. Reconstruction including partial scrotectomy and scrotoplasty using adjacent tissue transfer technique was completed. Both patients tolerated the procedures well without recurrence in the first postoperative year. Conclusion. In this article, we present the first series of GIH patients undergoing combined PPP, BTI, and eTEP access approach to retromuscular dissection. This multidisciplinary approach to patient care has proven both safe and effective.
The Use of Botulinum Toxin in Flap Surgery: A Review of the Literature
Authors: Segreto Francesco , Marangi Giovanni Francesco , Signoretti Matteo , Cazzato Vito , Giorgino Riccardo , Alessandri-Bonetti Mario , Persichetti Paolo
Published: February 2019

Botulinum neurotoxin-A and botulinum neurotoxin-B have been shown to play a potential role in improving flap survival in animal models. The aim of this study is to review indications as well as to study injection timing, technique, and doses of botulinum neurotoxin-A and botulinum neurotoxin-B in animal models. Seventeen articles describe a total of 266 animals that underwent botulinum toxin injections before or during flap harvesting or vascular anastomosis procedure. All the studies demonstrated a beneficial effect of botulinum toxin administration in flap surgery or vascular anastomosis. Botulinum neurotoxin-A injection was shown to be a reliable approach in reducing vascular complications rate and increasing survival of flaps in animal models. The main conclusions drawn from the study include the following: perivascular injections targeting each vascular pedicle are preferred in cases of free flaps or axial flaps; subdermal injections are favorable in cases of random pattern skin flaps; and injections should be performed 7 days before flap elevation.
Opportunities for use of radiation therapy in penile cancer based on patterns of care in the United States from 2007 to 2013
Authors: Shen Xinglei , Parker William , Miller Leah , TenNapel Mindi
Published: February 2019

Background:

Radiation therapy (RT) is an effective modality for the treatment of squamous cell carcinomas of the penis. The National Comprehensive Cancer Network recommends consideration of primary radiation for penile preservation, in surgically unresectable tumors, and as adjuvant therapy for positive margins, bulky groin nodes or pelvic nodes. We performed a population-based analysis to evaluate the usage of RT in penile cancer from 2007 to 2013.

Methods:

We used the Surveillance, Epidemiology and End Results ( SEER) database to identify men diagnosed with squamous cell carcinoma of the penis from 2007 to 2013. Patients were grouped as early stage (T1–T2N0), locally advanced (T3–T4N0), node-positive (T1xN1–3) and metastatic. We used linear regression model to test for factors associated with adjuvant radiation in node-positive patients.

Results:

We identified 2200 men diagnosed with penile cancer between 2007 and 2013. Of these, 66.4% had early stage, 10.7% had locally advanced, 15.5% had node-positive, 3.2% had metastatic cancer. Among patient with early stage cancer, RT was used in 14 patients (1.0%) and postoperative radiation in an additional 45 patients (3.1%). Among 340 patients with node-positive cancer, 62.1% received surgery alone, 5.6% radiation alone, 21.8% surgery with adjuvant radiation, and 10.6% neither surgery nor radiation. Of patients who had surgery, 26.0% had adjuvant radiation. On univariate analysis, higher nodal stage (N2–3 versus N1) was associated with adjuvant radiation ( p = 0.02), while there was a trend for higher T-stage (T3/T4 versus T1/T2) ( p = 0.08) and history of prior malignancy ( p = 0.06). On multivariate analysis, only higher nodal stage (N2–3 versus N1) was associated with use of adjuvant radiation [hazard ratio (HR) 1.94, p = 0.03].

Conclusions:

A small percentage of patient who are eligible for primary or adjuvant RT in the United States receive this treatment. Further work should be done to assess barriers to use of radiation in patients with penile cancer.
Preoperative Management of Chronic Rhinosinusitis Prior to Office Balloon Sinus Dilation: A 2011–2014 MarketScan® Analysis
Authors: Jang David W. , Abraham Cecily , Cyr Derek D. , Schulz Kristine , Abi Hachem Ralph , Witsell David L.
Published: February 2019

Background

In-office balloon sinus dilation (BSD) has recently gained popularity as a surgical treatment option for chronic rhinosinusitis (CRS). However, utilization, indications, and practice patterns surrounding in-office BSD remain unclear.

Objective

The purpose of this study was to use a large national administrative database to assess preoperative management of CRS prior to in-office BSD.

Methods

Patients undergoing standalone in-office BSD from 2011 to 2014 were identified on MarketScan and compared to a control group undergoing functional endoscopic sinus surgery (FESS). Visits to the otolaryngologist, number of computed tomography (CT) scans, number of antibiotic and steroid prescriptions, and duration of time from first visit to procedure were compared.

Results

When compared to the FESS group, the in-office BSD group overall had fewer office visits (2.0 vs 2.2), CT scans (1.0 vs 1.1), prescriptions for antibiotics (2.0 vs 2.2), prescriptions for systemic steroids (1.5 vs 1.8), and topical steroids (1.4 vs 1.5) in the preoperative period. They also had a shorter mean duration of time between first visit and CT scan (17.5 vs 21.4 days) as well as between first visit and procedure (55.0 vs 67.8 days). All of these findings were statistically significant.

Conclusion

In-office BSD for CRS was overall associated with less intense management in the preoperative period when compared to FESS. Such differences may reflect ongoing shifts in practice patterns and need to be further investigated.
Intravenous tissue plasminogen activator for ischemic stroke in early pregnancy dosed by actual body weight
Authors: Peksa Gary D , Ostrem Jamie , Davis Teresa
Published: February 2019

Introduction:

Few published reports highlight intravenous tissue plasminogen activator use during the first trimester of pregnancy and provide outcomes for mother and fetus. Little guidance is available regarding body weight dosing of intravenous tissue plasminogen activator during pregnancy.

Methods:

Here, we present a patient who received intravenous tissue plasminogen activator in the emergency department during her first trimester of pregnancy for the treatment of an acute ischemic stroke. Outcomes are presented for mother and fetus, as well as discussion about the dosing weight utilized for the intravenous tissue plasminogen activator dose calculation.

Results:

A 35-year-old, Gravida 7 Para 6, presented to the emergency department at 9 weeks gestation with acute stroke symptoms. Her initial National Institutes of Health Stroke Scale was 7. Imaging revealed a hyperdense right middle cerebral artery sign. Intravenous tissue plasminogen activator was administered 57 min after her arrival and based on her actual body weight during pregnancy. Post tissue plasminogen activator imaging revealed recanalization of the vessel and the patient’s National Institutes of Health Stroke Scale was 0. The patient progressed to delivery of a healthy female infant. The patient did not experience any bleeding complications throughout pregnancy.

Conclusion:

We present positive outcomes of a mother and fetus after receipt of intravenous tissue plasminogen activator using actual body weight during the first trimester of pregnancy for an acute ischemic stroke. Additional information is necessary to provide recommendations for the application to future patients in early pregnancy.
Gastric mixed adenoneuroendocrine carcinoma case report
Authors: Moyón Constante Miguel Angel , Moyón Constante Fernando Xavier , Tufiño Jorge Fernando , Cárdenas Patiño Andres , Molina Gabriel Alejandro , Gutierrez Bernardo Miguel
Published: February 2019

Mixed adenoneuroendocrine carcinomas are rare tumors that contain both an exocrine and an endocrine component. Since the latest classification by the World Health Organization and with the aid of immunostaining, more mixed adenoneuroendocrine carcinomas are now identified and diagnosed. Nonetheless, our knowledge of these tumors is still limited, notably concerning gastric variants, as the cases reported in the literature are very limited. The clinical and surgical treatment, including the chemotherapy schemes, the prognosis, and recurrence still represent challenges for the medical teams. We present the case of a 62-year-old woman. After an upper endoscopy revealed multiple polyps and a low-grade neuroendocrine tumor, a D2 radical gastrectomy was performed. A low output esophageal anastomotic leak was discovered in the postoperative period and successfully managed. Pathology revealed a gastric mixed adenoneuroendocrine carcinoma, the first case of this kind reported in Ecuador. Patient is doing well and under constant surveillance up until her 13th postoperative month.
Poverty and Agriculture in Southern Africa Revisited: A Panel Causality Perspective
Authors: Victor Bekun Festus , Akadiri Seyi Saint
Published: February 2019

Agricultural advancement is considered a panacea for poverty reduction, particularly, in developing countries. This study empirically investigates the dynamic linkage between agricultural value added (AVA) and poverty reduction for a panel of nine countries in Southern Africa using a second-generation panel approach for the period 1990 to 2015. Empirical results show that agricultural development is necessary but not a sufficient policy to combat poverty as it is only viable in the short run. Thus, we suggest long-run economic programs and/or strategies that will complement agricultural development toward poverty alleviation to spur economic growth in the sampled region.
Suicidal Behavior and Stress Generation in Adolescents
Authors: Liu Richard T. , Spirito Anthony
Published: February 2019

Stress generation has potential to account for recurrent suicidal behavior. The current study represents a first step toward evaluating this possibility in a sample of adolescent psychiatric inpatients ( n = 99; 79.80% female) followed over 6 months. At index admission, participants completed baseline measures of depressive symptom severity, suicidal ideation, lifetime history of suicide attempts, and negative life events using a contextual threat life stress interview. Negative life events since baseline were assessed at the follow-up assessment. Consistent with the stress generation hypothesis, lifetime number of suicide attempts prospectively predicted higher rates of dependent but not independent stress. Bayesian analyses also yielded substantial support for an association with overall dependent stress but provided more modest support for specificity to this form of life stress relative to independent stress. Implications of these findings and directions for future research further clarifying the role of stress generation in suicidal behavior are discussed.
Anti–BAFF-R antibody VAY-736 demonstrates promising preclinical activity in CLL and enhances effectiveness of ibrutinib
Authors: McWilliams Emily M. , Lucas Christopher R. , Chen Timothy , Harrington Bonnie K. , Wasmuth Ronni , Campbell Amanda , Rogers Kerry A. , Cheney Carolyn M. , Mo Xiaokui , Andritsos Leslie A. , Awan Farrukh T. , Woyach Jennifer , Carson William E. , Butchar Jonathan , Tridandapani Susheela , Hertlein Erin , Castro Carlos E. , Muthusamy Natarajan , Byrd John C.
Published: February 2019

The Bruton tyrosine kinase inhibitor (BTKi) ibrutinib has transformed chronic lymphocytic leukemia (CLL) therapy but requires continuous administration. These factors have spurred interest in combination treatments. Unlike with chemotherapy, CD20-directed antibody therapy has not improved the outcome of BTKi treatment. Whereas CD20 antigen density on CLL cells decreases during ibrutinib treatment, the B-cell activating factor (BAFF) and its receptor (BAFF-R) remain elevated. Furthermore, BAFF signaling via noncanonical NF-κB remains elevated with BTKi treatment. Blocking BAFF interaction with BAFF-R by using VAY-736, a humanized defucosylated engineered antibody directed against BAFF-R, antagonized BAFF-mediated apoptosis protection and signaling at the population and single-cell levels in CLL cells. Furthermore, VAY-736 showed superior antibody-dependent cellular cytotoxicity compared with CD20- and CD52-directed antibodies used in CLL. VAY-736 exhibited in vivo activity as a monotherapy and, when combined with ibrutinib, produced prolonged survival compared with either therapy alone. The in vivo activity of VAY-736 is dependent upon immunoreceptor tyrosine–based activation motif (ITAM)–mediated activation of effector cells as shown by using an ITAM-deficient mouse model. Collectively, our findings support targeting the BAFF signaling pathway with VAY-736 to more effectively treat CLL as a single agent and in combination with ibrutinib.
Epidermal growth factor receptor (EGFR) overexpression in triple-negative breast cancer: association with clinicopathologic features and prognostic parameters
Authors: Hashmi Atif Ali , Naz Samreen , Hashmi Shumaila Kanwal , Irfan Muhammad , Hussain Zubaida Fida , Khan Erum Yousuf , Asif Huda , Faridi Naveen
Published: February 2019

Introduction

Triple-negative breast cancers are a poor prognostic group of breast cancers that don’t respond to conventional hormonal and her2neu targeted therapy. A subset of triple-negative breast cancer is known to overexpress epidermal growth factor receptor (EGFR); however prognostic significance of this biomarker has not been widely studied in our population. Therefore, we aimed to evaluate the frequency of EGFR overexpression in triple-negative breast cancer in our setup and its association with prognostic and predictive factors.

Methods

We performed EGFR immunohistochemistry on 150 cases of triple-negative breast cancers. Intensity and percentage of EGFR expression were combined to formulate an EGFR score, that was compared with prognostic features of breast cancer and recurrence status of patients.

Results

Positive EGFR expression was noted in 18.7% ( 28 cases); out of which 16% (24 cases) showed low EGFR expression, whereas high EGFR expression was seen in 2.7% ( 4 cases). No significant association of EGFR expression was noted when compared with various clinicopathological parameters and recurrence status of the patients.

Conclusion

We found EGFR protein expression in 18.7% of cases while high expression was seen in only 2.7 % cases of triple-negative breast cancer which may harbor underlying genetic alterations like altered EGFR gene copy number, chromosome 7 copy number or average EGFR gene: chromosome 7 ratio; therefore we suggest that molecular tests like FISH to evaluate these EGFR molecular alterations should be performed in EGFR over expressing triple negative breast cancers in our setup to identify patients that can benefit from anti-EGFR targeted therapy. Moreover, regional difference in EGFR expression (high expression in chinese population compared to our population) are may be due to different underlying genetic alterations in triple-negative breast cancers, further necessitating a need of devising personalized therapeutic protocols for locoregional population.
Assisting salt model building with reflection full-waveform inversion
Authors: Gomes Adriano , Peterson Joe , Bitlis Serife , Fan Chengliang , Buehring Robert
Published: February 2019

Inverting for salt geometry using full-waveform inversion (FWI) is a challenging task, mostly due to the lack of extremely low-frequency signal in the seismic data, the limited penetration depth of diving waves using typical acquisition offsets, and the difficulty in correctly modeling the amplitude (and kinematics) of reflection events associated with the salt boundary. However, recent advances in reflection FWI (RFWI) have allowed it to use deep reflection data, beyond the diving-wave limit, by extracting the tomographic term of the FWI reflection update, the so-called rabbit ears. Though lacking the resolution to fully resolve salt geometry, we can use RFWI updates as a guide for refinements in the salt interpretation, adding a partially data-driven element to salt velocity model building. In addition, we can use RFWI to update sediment velocities in complex regions surrounding salt, where ray-based approaches typically struggle. In reality, separating the effects of sediment velocity errors from salt geometry errors is not straightforward in many locations. Therefore, iterations of RFWI plus salt scenario tests may be necessary. Although it is still not the fully automatic method that has been envisioned for FWI, this combined approach can bring significant improvement to the subsalt image, as we examine on field data examples from the Gulf of Mexico.
Cost per insertion and couple year of protection for postpartum intrauterine devices and implants provided during service scale-up in Kigali, Rwanda
Authors: Wall Kristin M. , Ingabire Rosine , Allen Susan , Karita Etienne
Published: February 2019

Introduction: In two high-volume government hospitals, their two affiliated health facilities, and two additional health facilities, we developed and implemented postpartum intrauterine device (PPIUD) and postpartum (PP) implant promotional counseling and service delivery procedures between May-July 2017 in Kigali, Rwanda. Between August 2017 and July 2018, 9,073 pregnant women received PPIUD/PP implant promotions who later delivered in one of our selected facilities. Of those, 2,633 had PPIUDs inserted, and 955 had PP implants inserted. The goal of the present analysis is to detail implementation expenditures and estimate incremental costs per insertion and couple years of protection (CYP) for PPIUD and PP implant users.

Methods: We detail the incremental costs during the implementation from the health system perspective (including both the implementation costs and the cost of contraceptive methods) and use of standard methods to estimate the cost per insertion and CYP for PPIUD and PP implant users. In addition to the incremental costs of labor and supplies, the costs of promotional activities are included. Research costs for formative work were excluded.

Results: A total of $74,147 USD was spent on the implementation between August 2017 and July 2018. The largest expense (34% of total expenses) went toward personnel, including doctoral-level, administrative, data management and nurse counseling staff. Training for PPIUD and implant providers and promoters comprised 8% of total expenses. Recruitment and reimbursements comprised 6% of expenses. Costs of implants to the government comprised 12% of the expenses, much higher than the cost of IUDs (1%). Costs per insertion were $25/PPIUDs and $77/PP implant. Costs per CYP were $5/PPIUDs and $20/PP implant.

Conclusion: Understanding the cost per PPIUD/PP implant inserted and CYP can help to inform the cost of scaling up PPIUD/PP implant service implementation activities and resource allocation decision-making by the Rwandan Ministry of Health.
Optimisation and standardisation of a multiplex immunoassay of diverse Plasmodium falciparum antigens to assess changes in malaria transmission using sero-epidemiology
Authors: Wu Lindsey , Hall Tom , Ssewanyana Isaac , Oulton Tate , Patterson Catriona , Vasileva Hristina , Singh Susheel , Affara Muna , Mwesigwa Julia , Correa Simon , Bah Mamadou , D'Alessandro Umberto , Sepúlveda Nuno , Drakeley Chris , Tetteh Kevin K A
Published: February 2019

Background: Antibody responses have been used to characterise transmission and exposure history in malaria-endemic settings for over a decade. Such studies have typically been conducted on well-standardised enzyme-linked immunosorbent assays (ELISAs). However, recently developed quantitative suspension array technologies (qSAT) are now capable of high-throughput and multiplexed screening of up to hundreds of analytes at a time. This study presents a customised protocol for the Luminex MAGPIX© qSAT using a diverse set of malaria antigens. The aim is to develop a standardised assay for routine serological surveillance that is implementable across laboratories and epidemiological settings.

Methods: A panel of eight Plasmodium falciparum recombinant antigens, associated with long- and short-lived antibody responses, was designed for the Luminex MAGPIX© platform. The assay was optimised for key steps in the protocol: antigen-bead coupling concentration, buffer composition, serum sample dilution, and bead storage conditions. Quality control procedures and data normalisation methods were developed to address high-throughput assay processing.  Antigen-specific limits of quantification (LOQs) were also estimated using both in-house and WHO reference serum as positive controls.

Results: Antigen-specific bead coupling was optimised across five serum dilutions and two positive controls, resulting in concentrations operational within stable analytical ranges. Coupled beads were stable after storage at room temperature (22⁰C) for up to eight weeks. High sensitivity and specificity for distinguishing positive and negative controls at serum sample dilutions of 1:500 (AUC 0.94 95%CI 0.91-0.96) and 1:1000 (AUC 0.96 95%CI 0.94-0.98) were observed. LOQs were also successfully estimated for all analytes but varied by antigen and positive control.

Conclusions: This study demonstrates that developing a standardised malaria-specific qSAT protocol for a diverse set of antigens is achievable, though further optimisations may be required. Quality control and data standardisation methods may also be useful for future analysis of large sero-epidemiological surveys.
Counseling psychology
Authors: Сапогова Елена , Sapogova Elena
Published: February 2019

The textbook is designed to study the discipline " Fundamentals of counseling psychology "("Psychological counseling") in the professional training of bachelors in the direction of 37.03.01 - "Psychology" and contains systematic information about the history, types and types of psychological counseling, the characteristics of the personality of the consultant and the nature of its interaction with customers, the basic techniques and techniques of modern consulting work, as well as the actual areas of counseling psychology and the specifics of counseling activities in relation to the most common problems that clients turn to a psychologist.
The manual corresponds to the GEF IN 3++ and is aimed at undergraduate and graduate students –psychological faculties of classical and pedagogical universities, humanitarian and medical universities, as well as graduate students, teachers of psychology and practical psychologists who improve their skills in the field of counseling psychology.