bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoking Exposure in Early Pregnancy and Adverse Pregnancy Outcomes: Usefulness of Urinary Tobacco-Specific Nitrosamine Metabolite 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol Levels
Authors: Lee Si Won , Han You Jung , Cho Dong Hee , Kwak Ho-Seok , Ko Kinarm , Park Mi Hye , Han Jung Yeol
Published: May 2018

Objectives: The aim was to investigate the effect of ­maternal smoking exposure assessed by urinary tobacco-specific nitrosamine metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-a1-butanol (NNAL) with adverse pregnancy outcomes. Methods: A total of 251 pregnant women were recruited. Urinary cotinine and NNAL were measured. Participants’ sociodemographics were obtained by questionnaire and pregnancy outcomes were collected by charts review after delivery. Results: The prevalence of smoking was 8.4% (21 of 249), 1.2% (3 of 241), and 3.7% (9 of 241) in pregnant women according to questionnaire, cotinine, and NNAL, respectively. As compared with questionnaire positivity and cotinine levels, women with positive NNAL were independent determinants for spontaneous abortion (adjusted OR 12.357, 95% CI 2.053–74.368), preterm birth (adjusted OR 22.239, 95% CI 3.737–132.357), and small for gestational age (adjusted OR 6.915, 95% CI 1.385–34.524). Conclusions: Urinary NNAL might be a useful biomarker in detection of maternal smoking status in association with adverse pregnancy outcomes. Use of this marker in preconception and pregnancy counselling before planning pregnancy may allow prevention of several adverse pregnancy outcomes.
The COL4A3 and COL4A4 Digenic Mutations in cis Result in Benign Familial Hematuria in a Large Chinese Family
Authors: Li Ang , Cui Ying-Xia , Lv Xing , Liu Jian-Hong , Gao Er-Zhi , Wei Xiu-Xiu , Xia Xin-Yi , Gao Chun-Lin , Liu Feng-Xia , Xia Zheng-Kun , Asan  , Liu Zhi-Hong , Li Xiao-Jun
Published: May 2018

Mutations in the COL4A5 gene result in X-linked Alport syndrome, homozygous or compound heterozygous mutations in COL4A3 or COL4A4 are responsible for autosomal recessive Alport syndrome, and heterozygous mutations in COL4A3 or COL4A4 cause autosomal dominant Alport syndrome or benign familial hematuria. Recently, the existence of a digenic inheritance in Alport syndrome has been demonstrated. We here report heterozygous COL4A3 and COL4A4 digenic mutations in cis responsible for benign familial hematuria. Using bioinformatics analyses and pedigree verification, we showed that COL4A4 c.1471C>T and COL4A3 c.3418 + 1G>T variants in cis are pathogenic and co-segregate with the benign familial hematuria. This result suggests that COL4A3 and COL4A4 digenic mutations in cis mimicking an autosomal dominant inheritance should be considered as a novel inheritance pattern of benign familial hematuria, although the disease-causing mechanism remains unknown.
Muscle Mass Depletion Associated with Poor Outcome of Sepsis in the Emergency Department
Authors: Lee YoonJe , Park Hyun Kyung , Kim Won Young , Kim Myung Chun , Jung Woong , Ko Byuk Sung
Published: May 2018

Background/Aims: Muscle mass depletion has been suggested to predict morbidity and mortality in various diseases. However, it is not well known whether muscle mass depletion is associated with poor outcome in sepsis. We hypothesized that muscle mass depletion is associated with poor outcome in sepsis. Methods: Retrospective observational study was conducted in an emergency department during a 9-year period. Medical records of 627 patients with sepsis were reviewed. We divided the patients into 2 groups according to 28-day mortality and compared the presence of muscle mass depletion assessed by the cross-sectional area of the psoas muscle at the level of the third lumbar vertebra on abdomen CT scans. Univariate and multivariate logistic regression analyses were conducted to examine the association of scarcopenia on the outcome of sepsis. Results: A total of 274 patients with sepsis were finally included in the study: 45 (16.4%) did not survive on 28 days and 77 patients (28.1%) were identified as having muscle mass depletion. The presence of muscle mass depletion was independently associated with 28-day mortality on multivariate logistic analysis (OR 2.79; 95% CI 1.35–5.74, p = 0.01). Conclusions: Muscle mass depletion evaluated by CT scan was associated with poor outcome of sepsis patients. Further studies on the appropriateness of specific treatment for muscle mass depletion with sepsis are needed.
Клініко-лабораторні, прогностичні критерії моніторингу перебігу гострого панкреатиту
Authors: Banadyga А. І.
Published: May 2018

Мета роботи: розробити прогностичні критерії моніторингу перебігу гострого панкреатиту.Матеріали і методи. Дослідження тривали із 2014 до 2018 р. ; за ступенем тяжкості ГП 167 пацієнтів були розділені на дві групи відповідно до Міжнародної консультації (2012 р.). Проведено комплекс клінічних, загальних лабораторних обстежень та спеціальних, зокрема визначення рівня прокальцитоніну імунохроматографічним методом, інструментальні методи обстеження: комп’ютерна томографія (КТ), ультразвукова діагностика (УЗД), магнітно-резонансна панкреатохолангіографія. Проведено програмний аналіз отриманих даних в програмі StatisticaSoft 13.0., використано метод побудови нейронних мереж.Результати досліджень та їх обговорення. Встановлено, що рівень амілази понад 185 ОД / л і рівень АЛТ >34 – це показник, який вказує на ризик розвитку в пацієнта тяжкого або критичного панкреатиту. Прокальцитонін слід використовувати як маркер інфікованого гострого некротичного панкреатиту в комплексі з іншими параметрами запалення, що дозволяє вибирати правильне хірургічне лікування.
Морфологія колото-різаних ран серця, завданих національними узбецькими ножами
Authors: Indiaminov S. I. , Boymanov F. H.
Published: May 2018

Мета роботи: вивчення особливостей морфології колото-різаних ран серця, завданих національними узбецькими ножами.Матеріали і методи. Досліджено матеріал, представлений 30 спостереженнями загиблих в результаті заподіяння проникаючих колото-різаних поранень з пошкодженням серця, завданих національними узбецькими ножами. Таким чином, колото-різані рани зустрічалися частіше у чоловіків, рани в основному були в ділянці шлуночків і рідше в ділянці передсердь. Колото-різані рани, завдані узбецькими національними ножами, мають кутоподібну, овальну, лінійну форми. Обушкові кінці мають П-, Г-, Т- подібну форми, лезові кінці гострі.Результати досліджень та їх обговорення. Виявлено, що стінки серця, порівняно зі шкірними ранами, мають вищу морфологічну ідентифікаційну значимість. Серце після відновлення в розчині Ратнівського деформувалося менше, ніж шкірні рани, і довжина колото-різаних ран серця більш точно відповідає ширині клинка колото-ріжучої зброї. Це може бути пов’язано з особливостями структури епікарда і міокарда, які менш схильні до процесу ретракції. На тканинах серця досить повно визначаються конструктивні особливості обуха і леза клинків ножів, тому їх можна використовувати для групової ідентифікації травмуючого знаряддя.
Стан системної мікроциркуляції у хворих із спайковою кишковою непрохідністю залежно від виду операційних втручань
Authors: Bukata V. V. , Deykalo I. M.
Published: May 2018

Мета роботи: оцінка стану системної мікроциркуляції після різних видів хірургічних втручань при гострій спайковій кишковій непрохідності.Матеріали і методи. Отримано результати лікування 57 хворих на гостру спайкову кишкову непрохідність. Для аналізу стану мікроциркуляторного каналу та механізмів регуляції використовували лазерну доплерівську флоуметрію у хворих залежно від виду операційного втручання.Результати досліджень та їх обговорення. Встановлено, що незалежно від типу хірургічного втручання в післяопераційному періоді проявляються зміни кровотоку в периферичних тканинах, а також порушення взаємозв'язку між основними регуляторними механізмами, які можуть впливати на системну перфузію. Найбільш глибокі зміни виявлено при зростанні тяжкості захворювання. Ці зміни можуть впливати на розвиток ускладнень у післяопераційному періоді, ускладнюючи перебіг захворювання. Враховуючи отримані дані, необхідно включити в комплексне лікування хворих із гострою спайковою кишковою непрохідністю препарати, які здатні нормалізувати зміни в мікроциркуляторному руслі.
Вплив модифікованої плікації шлунка та рукавної резекції шлунка у щурів із глутамат-індукованим ожирінням та стрептозотоцин- індукованим діабетом на динаміку зниження маси тіла та вуглеводний обмін
Authors: Kozakov K. H.
Published: May 2018

Мета роботи: порівняти вплив модифікованої плікації шлунка та рукавної резекції шлунка у щурів із глутамат-індукованим ожирінням та стрептозотоцин-індукованим діабетом на динаміку зниження маси тіла та вуглеводний обмін.Матеріали і методи.  Дослідження проводили на 45 білих безпородних щурах-самках з вихідною масою тіла 150–180 грам. На тваринах було змодельовано глутамат-індуковане ожиріння та стрептозотоцин-індукований діабет 2-го типу. Тварини було розділено на групи по 15 тварин: контрольну та дві експериментальні. В першій експериментальній групі було виконано рукавну резекцію шлунка, другій експериментальній групі було виконано плікацію шлунка по великій кривині з формуванням 3-ох складок і першому ряді швів та другим рядом неприривних швів. Після чого визначали масу тварин та глюкоза натще на 14-ту, 28-му, 42-гу та 60-ту доби.Результати досліджень та їх обговорення. Рівень глюкози натще в контрольній групі на 60-ту післяопераційну добу становив (18,405±1,2) ммоль/л, в першій групі, де було виконано рукавну резекція шлунка, він склав (9,539±1,14) ммоль/л, в другій групі, де виконано модифіковану плікацію шлунка, він склав (10,39±1,49) ммоль/л. Визначення глюкози в сироватці крові на 60-ту – післяопераційну добу встановило високо достовірне зниження показників глюкози сироватки крові між контрольною та першою експериментальною групою, де було виконано рукавну резекцію (p<0,01) та високо достовірне зниження глюкози сироватки крові між контрольною групою та другою експериментальною групою, де було виконано модифіковану методику плікації шлунка (p<0.01). Проте статистичнозначимої різниці між першою та другою експериментальними групами не виявлено (p>0.05). Маса тіла тварин контрольної групи на 60-ту добу становила (335±17,32) г, в першої експериментальної групи на 60-ту добу склала (260±12,96) г та в другій експериментальній групі – (258,33±11,44) г. Визначення маси тіла щурів встановило статистично достовірне зниження маси тіла на 60-ту післяопераційну добу в щурів, яким було виконано рукавну резекцію шлунка, порівняно з контрольною групою (p<0,01) та статистично достовірне зниження маси тіла в щурів на 60-ту післяопераційну добу після модифікованої плікації шлунка порівняно з контрольною групою (p<0,01).  Проте статистично значущої різниці між масою тіла у щурів першої та другої експериментальних груп на 60-ту післяопераційну добу не виявлено (p>0.05).
Вплив величини внутрішньочеревного тиску на динаміку ішемічно-реперфузійних порушень в експерименті
Authors: Melnik O. I.
Published: May 2018

Мета роботи: з’ясувати вплив ішемічно-реперфузійних порушень на інтенсивність процесів ліпідної пероксидації сироватки крові, печінки та стінки тонкої кишки залежно від величини внутрішньочеревного тиску в експерименті.Матеріали і методи. В експерименті використано 78 статевозрілих білих щурів-самців лінії Wistar масою 200–250 г, які знаходилися на стандартному раціоні віварію. Усіх піддослідних тварин наркотизували (тіопентал-натрію 40 мг·кг-1 внутрішньоочеревинно) та в порожнину живота вводили катетер розміром 20 G. У першій дослідній групі (24 тварини) ручним інсуфлятором нагнітали атмосферне повітря до величини внутрішньочеревного тиску 10 мм рт.ст., у другій дослідній групі (24 тварини) – 20 мм рт. ст., у третій дослідній групі (24 тварини) – 30 мм рт. ст. У контрольній групі (6 тварин) повітря не нагнітали. Час експозиції становив 90 хв, після чого контрольних тварин та по 6 тварин кожної дослідної групи відразу виводили з експерименту шляхом тотального кровопускання з серця. Інших тварин кожної дослідної групи (по 6 особин) в умовах анестезії (тіопентал натрію 40 мг·кг-1 внутрішньоочеревинно) виводили з експерименту через 1, 3 і 7 діб після періоду підвищеного внутрішньочеревного тиску. У сироватці крові, печінці та стінці тонкої кишки піддослідних тварин визначали вміст реагентів до тіобарбітурової кислоти (ТБК-активних продуктів), які належать до індикаторних показників інтенсивності пероксидного окиснення ліпідів.Результати досліджень та їх обговорення. Встановлено, що на висоті підвищеного внутрішньочеревного тиску – через 90 хв має місце суттєве зростання інтенсивності процесів ліпідної пероксидації у сироватці крові, печінці та стінці тонкої кишки, яке найбільше виражено при величині внутрішньочеревного тиску 20 і 30 мм рт. ст.Виявлені процеси значно посилюються після зниження внутрішньочеревного тиску до норми. Наші дослідження виявили розвиток ішемічно-реперфузійного синдрому, який супроводжується значним зростанням вмісту ТБК-активних продуктів, інтенсивність якого зростає із збільшенням рівня вихідного внутрішньочеревного тиску. Найбільше зростання вмісту ТБК- активних продуктів ПОЛ спостерігали через 3 доби після реперфузії у печінці піддослідних тварин (більш ніж у 5 разів при ВЧТ 30 мм рт. ст.), порівняно з кишкою (у 2,7 раза) та сироваткою крові (у 2,1 раза), що пов’язано з посиленням метаболічної, детоксикаційної та імунної функції органа внаслідок надходження токсинів кишкового походження. Все це сприяє активації ПОЛ, є свідченням вторинного ураження органа за типом реактивного гепатиту і вимагає розробки засобів профілактики.
Cost-Effectiveness of Left Atrial Appendage Closure With the WATCHMAN Device Compared With Warfarin or Non–Vitamin K Antagonist Oral Anticoagulants for Secondary Prevention in Nonvalvular Atrial Fibrillation
Authors: Reddy Vivek Y. , Akehurst Ronald L. , Amorosi Stacey L. , Gavaghan Meghan B. , Hertz Deanna S. , Holmes David R.
Published: May 2018

Background and Purpose—

Once a patient with atrial fibrillation experiences an embolic event, the risk of a recurrent event increases 2.6-fold. New treatments have emerged as viable treatment alternatives to warfarin for stroke risk reduction in secondary prevention populations. This analysis sought to assess the cost-effectiveness of left atrial appendage closure (LAAC) compared with warfarin and the non–vitamin K antagonist oral anticoagulants dabigatran 150 mg, apixaban and rivaroxaban in the prevention of stroke in nonvalvular atrial fibrillation patients with a prior stroke or transient ischemic attack.

Methods—

A Markov model was constructed using data from the secondary prevention subgroup analyses of the non–vitamin K antagonist oral anticoagulant and LAAC pivotal trials. Costs were from 2016 US Medicare reimbursement rates and the literature. The cost-effectiveness analysis was conducted from a US Medicare perspective over a lifetime (20 years) horizon. The model was populated with a cohort of 10 000 patients aged 70 years with a CHA
2
DS
2
-VASc score of 7 (annual stroke risk=9.60%) and HAS-BLED score of 3 (annual bleeding risk=3.74%).

Results—

LAAC achieved cost-effectiveness relative to dabigatran at year 5 and warfarin and apixaban at year 6. At 10 years, LAAC had more quality-adjusted life years (4.986 versus 4.769, 4.869, 4.888, and 4.810) and lower costs ($42 616 versus $53 770, $58 774, $55 656, and $58 655) than warfarin, dabigatran, apixaban, and rivaroxaban, respectively, making LAAC the dominant (more effective and less costly) stroke risk reduction strategy. LAAC remained the dominant strategy over the lifetime analysis.

Conclusions—

Upfront procedure costs initially make LAAC higher cost than warfarin and the non–vitamin K antagonist oral anticoagulants, but within 10 years, LAAC delivers more quality-adjusted life years and has lower total costs, making LAAC the most cost-effective treatment strategy for secondary prevention of stroke in atrial fibrillation.
Magnetic Resonance Imaging Selection for Endovascular Stroke Therapy
Authors: Simonsen Claus Z. , Yoo Albert J. , Rasmussen Mads , Sørensen Kristina E. , Leslie-Mazwi Thabele , Andersen Grethe , Sørensen Leif H.
Published: May 2018

Background and Purpose—

The GOLIATH trial (General or Local Anesthesia in Intra-Arterial Therapy) compared infarct growth and outcome in patients undergoing endovascular therapy under either general anesthesia or conscious sedation. Magnetic resonance imaging was performed before and after the procedure to study infarct growth. In this post hoc analysis of GOLIATH, we aimed to characterize the workflow of patients undergoing magnetic resonance imaging selection before endovascular therapy.

Methods—

We randomized 128 patients with anterior circulation large vessel occlusion stroke within 6 hours of onset to either general anesthesia or conscious sedation (1:1 allocation). We studied workflow time intervals to examine whether magnetic resonance imaging conferred a time delay in treatment when compared with computed tomography-based studies that emphasized rapid workflow.

Results—

Of 128 patients enrolled between March 2015 and February 2017, 65 were randomized to general anesthesia. Baseline demographic and clinical variables were balanced between the treatment arms. The median interval from scan to groin puncture was 56.5 minutes (interquartile range, 44.5–73.5) for all patients. The median interval from admission to groin puncture was 68 minutes (interquartile range, 54.5–87 minutes). Comparable intervals in recent randomized data were 51 minutes (interquartile range, 39–68) for scan to groin puncture in the ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) and 90 minutes (interquartile range, 69–120 minutes) for door to groin puncture in the SWIFT-PRIME study (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment).

Conclusions—

Workflow in GOLIATH demonstrates that magnetic resonance imaging selection for endovascular therapy can be accomplished rapidly and within a similar time frame as computed tomography-based selection.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02317237.
The Good yet Missing Innkeeper and the Possibility of Open Ecclesiology
Authors: Adiprasetya Joas
Published: May 2018

This article discusses the significant roles of the innkeeper and the inn (pandocheion) in the parable of the Good Samaritan and how contemporary Christians can use the story to construct an open ecclesiology in the midst of global fear of others. The idea of open ecclesiology requires a rethinking of the classical marks of the church as one, holy, catholic, and apostolic in the light of the new marks: diverse, vulnerable, concrete, and friendly. By tracing the root of pondok in Indonesian language back to the Arabic word funduq and the Greek word pandocheion in the Gospel of Luke, the author demonstrates rich intercultural and interreligious negotiations that encourage Indonesian Christians to reclaim their heritage from their Muslim counterparts. The article concludes with the story of GKI Yasmin as a diaclesial and open church that passes-through or crosses-over boundaries amidst violence.
Understanding Climate Change Perception in Community-Based Management Contexts: Perspectives of Two Indigenous Communities
Authors: Ambrosio-Albala Dr. Pepa , Mar Delgado-Serrano Dr. María
Published: May 2018

Many natural resources around the world are managed by indigenous communities that are closely connected to nature and have nature-based livelihoods. These communities are particularly vulnerable to climate change and in need of adaptation strategies. Therefore, understanding how a community that is connected to nature perceives climate change is crucial. Some studies have shown that the capacity to respond to climate change vulnerability might be influenced by the social ties among community members. We used Q methodology to explore and compare climate change perceptions in two indigenous communities in Colombia and Mexico. Both of these communities are characterized by nature-based livelihoods, collective ownership of land, and community-based natural resource management. We analyzed their perception of climate change and nature, their preferred options for adaptation strategies, and the sources of information they trust. The perceptions that emerged were interpreted according to the four worldviews proposed by cultural theory. Overall, this research suggests that perceptions varied across and within local contexts, meaning that different ways of understanding and dealing with climate change coexist within the communities. The results showed that hierarchy and egalitarian worldviews (as described by cultural theory) are more common in both indigenous communities. The history and lived experiences of community-based management for both communities influence preferred adaptation options to cope with climate change.
The Culture of Carbapenem Overconsumption: Where Does It Begin? Results of a Single-Center Survey
Authors: Mogle Bryan T. , Seabury Robert W. , Jones Zachary , Miller Christopher D. , Steele Jeffrey M.
Published: May 2018

Purpose: The United States has seen an increased consumption of carbapenem antibiotics in recent years. The increased utilization of these agents has potential negative consequences, including the increasing incidence of carbapenem-resistant Enterobacteriaceae. Reasons for the rise in carbapenem use among providers in acute care hospitals are not well elucidated in literature. The objectives of this study were to identify factors that influence empiric carbapenem use among providers in a single academic medical center, and to assess therapeutic knowledge pertaining to carbapenem use. Methods: A cross-sectional, single-center, 9-item electronic research survey was developed independently and validated by an infectious diseases pharmacist and infectious diseases physician. The survey was distributed to email accounts of providers at a single academic medical center. Demographic data, factors affecting carbapenem prescription, and baseline therapeutic knowledge were assessed. Results: Ninety-five of 416 providers responded to the survey (response rate of 22.8%). Respondents were well distributed across all levels of training with primary roles in internal medicine and surgery. The most important factors influencing empiric carbapenem use were suspected pathogens at the site of infection, drug allergies, history of multidrug resistant organisms, severity of illness, type of infection, and local resistance rates. A recommendation from a pharmacist was selected as the most likely factor for deterring carbapenem use. Misconceptions pertaining to penicillin drug allergy and beta-lactam cross reactivity, knowledge of local resistance rates according to the institutional antibiogram, and comparative efficacy data for carbapenems were apparent across all levels of training. Conclusions: Provider misconceptions regarding several factors appear to contribute to unnecessary use of carbapenems. An opportunity exists for hospital pharmacists to improve the prescribing patterns of carbapenems by correcting provider misconceptions through education.
Predictors of Urban Principal Turnover
Authors: Beckett Lorna O.
Published: May 2018

Research indicates that principal turnover is increasing and urban districts are struggling to retain their principals. This study used multiple regression analysis to examine seven independent variables and their relationship to principal turnover in Colorado urban schools. This study used longitudinal data from the Colorado Department of Education from 2010-2015. The findings indicate that the percentage of students of color is the only variable predictive of principal turnover, with a higher percentage of students of color in a school resulting in higher principal turnover. In addition, Colorado urban schools experience a change in leadership every 2.5 years and only 23.70% of principals stay at the same school for 5 years. The findings suggest there is an opportunity to reenvision principal retention practices, with an emphasis on schools with a high percentage of students of color.
Squamous Cell Carcinoma of the Soft Palate in the United States: A Population‐Based Study
Authors: Chan Carmen K. , Han Albert Y. , Alonso Jose E. , Xu Mary J. , Mallen‐St Clair Jon , Heaton Chase M. , Ryan William R. , Kuan Edward C. , St John Maie A.
Published: May 2018

Objectives

To describe the incidence and determinants of survival of patients with squamous cell carcinoma of the soft palate (SCCSP) using the Surveillance, Epidemiology, and End Results (SEER) database.

Study Design

Retrospective, population‐based cohort study of patients.

Setting

SEER cancer registry.

Subjects and Methods

Patients from the SEER cancer registry from 1973 to 2015 were used to analyze demographics and survival of SCCSP.

Results

A total of 4366 cases were identified. The average overall survival (OS) and disease‐specific survival (DSS) were 68.7 months and 161.3 months, respectively. Multivariate analysis revealed that male sex, stage, and treatment (hazard ratio [HR] = 0.690, P =. 019; HR = 1.73, P <. 001; HR = 0.64, P <. 001, respectively) were independent determinants of better or worse DSS. Age, stage, and treatment (HR = 1.02, P <. 001; HR = 1.49, P <. 001; HR = 0.66, P <. 001; HR = 0.48, P <. 001, respectively) were independent determinants of better or worse OS. For stages I, II, and III, radiation alone and surgery alone have nearly equivalent OS. Patients with stage IV disease who underwent both surgery and radiation had a significantly higher median OS at 50.0 months.

Conclusion

Radiation alone and surgery alone both have nearly equivalent OS benefit for stages I to III, while surgery and radiation provide the most survival benefit for stage IV disease. The large discrepancy between OS and DSS can be due to significant comorbidities. Future studies should aim to address the determinants of quality‐of‐life variables that help direct treatment decisions and might indirectly affect survival.
Ipsilateral pulmonary infarction after major lung resection
Authors: Kouritas Vasileios K , Kefaloyannis Emmanuel M , Chaudhuri Nilanjan , Milton Richard
Published: May 2018

Background

Lung infarction is a rare complication of lung resection, developing mainly because of technical errors. In some cases, a specific reason cannot be identified. This study aimed to investigate the occurrence, characteristics, and outcome of this pathology in a series of patients.

Methods

The medical records of patients who underwent reoperation for lung infarction without an apparent cause (based on imaging, reoperation findings, and histopathology) after major lung resection at our institution from 2006 to 2015, were investigated.

Results

Seven patients were identified. The mean age was 62.2 years (range 51–75 years), and 5 were male. Copious dissection or adverse events during surgery were recorded in all but 2 cases. The main presenting symptom was unsettling frank hemoptysis (4 cases) with a variable time of onset of symptoms (4–164 h). All reoperations necessitated further lung resection (4 patients had a further lobectomy and 3 had a completion pneumonectomy). During reoperation, all vessels and bronchi were intact. No apparent cause of infarction could be identified according to the histopathology report. Morbidity after reoperation was atrial fibrillation in 3 cases and bronchopleural fistula in 2, one of which required a transsternal pneumonectomy and this was the only mortality. Length of stay ranged from 8 to 90 days.

Conclusion

Ipsilateral lung infarction after lobectomy is a rare complication and the reason may not be identifiable. Treatment usually requires reoperation. Extensive manipulation or adverse events during surgery could induce this rare complication.
The Nitric Oxide Donor SIN-1-Produced Panic-Like Behaviour And Fear-Induced Antinociception Are Modulated By NMDA Receptors In The Anterior Hypothalamus
Authors: Falconi-Sobrinho Luiz Luciano , Coimbra Norberto Cysne
Published: May 2018

Background:

An excitatory imbalance in the hypothalamus of rodents caused by local chemical stimulation elicits fear-related defensive reactions such as escape and freezing. In addition, these panic attack-like defensive reactions induced by hypothalamic neurons may cause antinociception. However, there is a shortage of studies showing the participation of the anterior hypothalamic nucleus in these adaptive defensive mechanisms. Nitric oxide (NO) donors have been shown to evoke fear-related defensive responses when microinjected into paralimbic and limbic structures, and this excitatory neuromodulation can recruit the glutamatergic system.

Aims:

The aim of this work was to investigate the influence of the glutamatergic system in the nitrergic effects on fear-related defensive responses organised by anterior hypothalamic neurons.

Methods:

The present study evaluates the effects of the molsidomine active metabolite SIN-1 NO donor administered into the anterior hypothalamus (AH) of mice at different concentrations (75, 150 and 300 nmol/0.1 μL). Then, we investigated the effects of pre-treatment of the AH with AP-7 (an N-methyl-d-aspartate (NMDA) receptor-selective antagonist; 0.02, 0.2 and 2 nmol/0.1 μL) on the behavioural and antinociceptive effects provoked by AH chemical stimulation with SIN-1 microinjections.

Results:

The 300 nmol dose of SIN-1 was the most effective at causing panic-like defensive behaviours followed by a significant antinociceptive response. In addition, both of these effects were attenuated or inhibited by AH pre-treatment with AP-7.

Conclusions:

These findings suggest that the panicogenic and antinociceptive effects evoked by intra-AH microinjections of SIN-1 depend on NMDA receptor activation.
Brain endothelial cell junctions after cerebral hemorrhage: Changes, mechanisms and therapeutic targets
Authors: Keep Richard F , Andjelkovic Anuska V , Xiang Jianming , Stamatovic Svetlana M , Antonetti David A , Hua Ya , Xi Guohua
Published: May 2018

Vascular disruption is the underlying cause of cerebral hemorrhage, including intracerebral, subarachnoid and intraventricular hemorrhage. The disease etiology also involves cerebral hemorrhage-induced blood–brain barrier (BBB) disruption, which contributes an important component to brain injury after the initial cerebral hemorrhage. BBB loss drives vasogenic edema, allows leukocyte extravasation and may lead to the entry of potentially neurotoxic and vasoactive compounds into brain. This review summarizes current information on changes in brain endothelial junction proteins in response to cerebral hemorrhage (and clot-related factors), the mechanisms underlying junction modification and potential therapeutic targets to limit BBB disruption and, potentially, hemorrhage occurrence. It also addresses advances in the tools that are now available for assessing changes in junctions after cerebral hemorrhage and the potential importance of such junction changes. Recent studies suggest post-translational modification, conformational change and intracellular trafficking of junctional proteins may alter barrier properties. Understanding how cerebral hemorrhage alters BBB properties beyond changes in tight junction protein loss may provide important therapeutic insights to prevent BBB dysfunction and restore normal function.
Icariin influences cardiac remodeling following myocardial infarction by regulating the CD147/MMP-9 pathway
Authors: Shi Yu , Yan Weihong , Lin Qiaoyan , Wang Weimin
Published: May 2018

Objective

We investigated the protective effect of icariin on myocardial infarction-induced cardiac remodeling.

Methods

A cardiac remodeling model was constructed by ligating rats’ coronary artery. Different icariin and CD147 concentrations were administered in the model group, and echocardiography was used to detect systolic function, screening out ideal experimental concentrations. The ventricular systolic function, myocardial apoptosis rate, and expression of collagen type I (Col I), Col III, CD147, matrix metalloproteinase 9 (MMP-9), and tissue inhibitor of metalloproteinase 1 (TIMP-1) were detected by hematoxylin–eosin staining, TUNEL assay, and western blot. MMP-9 activity was evaluated by gelatin zymography.

Results

The expression of Col I, Col III, CD147, and MMP-9 was higher, the expression of TIMP-1 was lower, and the maximal rates of left ventricular pressure rise and fall (+dp/dtmax and −dp/dtmax, respectively) were lower in model than control rats. The expression of CD147, MMP-9, Col I, and Col III was lower, the expression of TIMP-1 was higher, and the +dp/dtmax and −dp/dtmax were higher in the icariin than model group. The apoptosis rate was lower in the icariin and icariin + CD147 groups than control group.

Conclusion

Icariin attenuated myocardial apoptosis following myocardial infarction by apoptosis rate reduction and CD147/MMP-9 pathway inhibition.
Complete contacts in almost conforming sockets
Authors: Balasubramanian Arun , Hills David
Published: May 2018

The behaviour of a contact formed when a flat-faced contact sits in an almost conforming socket is studied. Conditions for the avoidance of all slip are found, and the critical coefficient of friction needed is found. The results derived are of a general nature and apply to many problems of this class, for example, when a dovetail is pulled into a socket having the same angle.
Proposal and Actions to Decrease Malnutrition in Latin America and the Caribbean
Authors:   VII Latin American Workshop on Leadership in Nutrition
Published: May 2018

While some of our countries are still facing nutrition deficiencies (stunting/short stature and micronutrient deficiencies), overweight and obesity are increasing in an alarming way. In addition, a very limited research network and lack of funding make it extremely challenging to foster collaborative efforts to address the complex nutritional problems that Latin America is facing. Therefore, as the future leaders in nutrition, we reinforce our commitment to improve our research capacity to identify opportunities for action to end malnutrition in all its forms in our region to address health disparities and to strengthen the Latin American Society of Nutrition.
Evaluation of potential biomarkers of exposure to crystalline silica: A case study in an insulator manufacturer
Authors: Mohammadi Hamzeh , Farhang Dehghan Somayeh , Tahamtan Alireza , Golbabaei Farideh
Published: May 2018

The purpose of this study was to examine the potential determinants of serum neopterin, malondialdehyde (MDA), and erythrocyte glutathione (GSH) as potential markers of oxidative stress, resulting in cellular immune response to inhaled silica particles. This descriptive analytical study was conducted on two groups of exposed workers ( n = 55) and unexposed office workers ( n = 38) of an insulator manufacturing plant. The sampling of airborne silica in the breathing zone of participants was done on the basis of the National Institute for Occupational Safety and Health Method 7601. The blood samples were analyzed by high performance liquid chromatography to determine the level of serum neopterin. A ZellBio GmbH assay kit was used for the quantitative assays of GSH and MDA on the basis of the colorimetric assay. The results of this study show that the measurements of serum neopterin, MDA, and GSH can be considered as potential biological markers of silica exposure for undertaking further comprehensive studies in this area.
Ethnographies of Therapeutic Governance and Agentic Resistance in Support Groups for Prisoner’s Wives
Authors: Shoshana Avihu
Published: May 2018

This article suggests expanding our understanding about the mundane use of therapeutic governance regarding welfare populations, through ethnographies of support groups for prisoners’ wives in Israel. The findings reveal that although prisoners’ wives meet the neoliberal ideal of financial independence (and therefore it is not possible to regulate them by discourse of need), they are regulated via the discourse of desire. The findings also disclose ethnographies of confrontations within all the meetings, and the agentic transition between resistance strategies (from overt conflict and challenging the psychological discourse, to negotiation and strategic passing). The discussion uncovers the ramifications of therapeutic governance, which defines inter alia therapeutic subjectivity via its requirement for nonpolitical awareness, within a welfare population that experiences daily oppression.
A comparative review of soil charcoal data: Spatiotemporal patterns of origin and long-term dynamics of Western European nutrient-poor grasslands
Authors: Robin Vincent , Nelle Oliver , Talon Brigitte , Poschlod Peter , Schwartz Dominique , Bal Marie-Claude , Allée Philippe , Vernet Jean-Louis , Dutoit Thierry
Published: May 2018

The nutrient-poor grasslands of Western Europe are of major conservation concern because land use changes threaten their high biodiversity. Studies assessing their characteristics show that their past and on-going dynamics are strongly related to human activities. Yet, the initial development patterns of this specific ecosystem remain unclear. Here, we examine findings from previous paleoecological investigations performed at local level on European grassland areas ranging from several hundred square meters to several square kilometers. Comparing data from these locally relevant studies at a regional scale, we investigate these grasslands’ spatiotemporal patterns of origin and long-term dynamics. The study is based on taxonomic identification and radiocarbon AMS dating of charcoal pieces from soil/soil sediment archives of nutrient-poor grasslands in Mediterranean and temperate Western Europe (La Crau plain, Mont Lozère, Grands Causses, Vosges Mountains, Franconian Alb, and Upper-Normandy region). We address the following questions: (1) What are the key determinants of the establishment of these nutrient-poor grasslands? (2) What temporal synchronicities might there be? and (3) What is the spatial scale of these grasslands’ past dynamics? The nutrient-poor grasslands in temperate Western Europe are found to result from the first anthropogenic woodland clearings during the late Neolithic, revealed by fire events in mesophilious mature forests. In contrast, the sites with Mediterranean affinities appear to have developed at earlier plant successional stages (pine forest, matorral), established before the first human impacts in the same period. However, no general pattern of establishment and dynamics of the nutrient-poor grasslands could be identified. Local mechanisms appear to be the key determinants of the dynamics of these ecosystems. Nevertheless, this paleoecological synthesis provides insights into past climate or human impacts on present-day vegetation.
Medication Abuse by Middle–Aged Women
Authors: Borgman Robert D.
Published: May 2018

A three-year study in a community mental health center reveals an intriguing combination of ego maturity and extremely infantile themes in twenty-three patients
Social Work Assistance in Private Pediatric Practice
Authors: Korpela Janet Winn
Published: May 2018

Group and individual family services contribute toward the ultimate goal of providing preventive education and care in the area of improved family mental health
Treating the alcoholic on public assistance
Authors: Morehouse Ellen R.
Published: May 2018

The mandated alcoholic differs from other alcoholic clients in his needs, thus specific treatment issues and intervention methods must be carried out.
Family behavior of urban American Indians
Authors: Horse John G. Red , Lewis Ronald , Feit Marvin , Decker James
Published: May 2018

Effective policy development of human service delivery to American Indians depends on an understanding of cultural characteristics and extended family networks
Issues in the Implementation of the Parent Aide Concept
Authors: Carrol Nancy A. , Reich John W.
Published: May 2018

Empathic paraprofessionals visit problem child-abusing parents and establish close friendship bonds to aid them in their parenting activities
Family Disorganization: A Sociological Perspective
Authors: Geismar Ludwig L.
Published: May 2018

Criteria for defining child neglect are, to some extent, culturally determined and may or may not be related to social class and family malfunction
Training in Family Treatment: Needs and Objectives
Authors: Anderson Linda M. , Amatea Ellen S. , Munson Priscilla A. , Rudner Becki A.
Published: May 2018

An examination of the literature about family-oriented treatment in social work reveals that caseworkers' unfamiliarity with this mode of intervention has limited its use. An assessment of agency, worker, and family needs and resulting service-delivery objectives are presented and an outline for a model training program is given.
The Influence of Parental Attitudes on Psychiatric Treatment Outcome
Authors: Goldstein Eda G.
Published: May 2018

A study of young adult inpatients and their parents sought to find relationships among parental attitudes and characteristics, social work involvement, and the outcome of a psychodynamically oriented treatment program. The strong, positive relationships indicated by the data have significant implications for the field.
Client-Counselor Agreement on Problem and Change
Authors: Sirles Elizabeth A.
Published: May 2018

A relationship exists between the client's and the counselor's perception of the presenting problems and their subsequent agreement on change once treatment begins. Additionally, the type of problem involved has a differential effect on client-counselor congruence, relating to the problem and to change in the problem.
Clients View Outcomes of Child Protective Services
Authors: Magura Stephen
Published: May 2018

Increases in self-confidence and daily coping capacity were improvements most frequently mentioned by parents receiving child protective services for abuse, neglect, and parent-child conflict. Empathy, genuineness, unconditional positive regard, and accessibility were reasons given by clients for satisfaction with their workers.
Dealing with the Process of Change
Authors: Weiss Anschel O.
Published: May 2018

Attitudes toward change and its place in society, interaction of client and change agent, and motivation for and resistance to change significantly influence the effectiveness of professional intervention. Revising the least-necessary-change principle may increase respect for clients and for the changes that they seek.
Funding and the Change Process in Family Service Agencies
Authors: Digiulio Joan Ferry
Published: May 2018

As the programs of family agencies in the past have been shaped by their sources of funding, agencies today are confronted by problems because of lack of money. This analysis of the process of change suggests how administrators may guide agencies in transition.
Social Work Assessment: Route to Clienthood––Part II
Authors: Specht Harry , Specht Riva
Published: May 2018

Applicants for social service agencies should not be designated as “clients” before they have completed the psychosocial assessment process. In Part II of this two-part article, the final decision point in this process––negotiation of a contract––is described and the analytic utility of the model is discussed.
The Empirical Clinical Practice Debate
Authors: Ivanoff André , Blythe Betty J. , Briar Scott
Published: May 2018

Empirically based models of social work practice are derived from research and prescribe ongoing evaluation of practice. Some researchers have argued against this approach to practice. The authors review this debate and propose a view of empirical clinical practice that enhances provision of services.
Adolescent Mothers' Beliefs about Open Adoption
Authors: Barth Richard P.
Published: May 2018

This article assesses pregnant adolescents’ and adolescent mothers’ experience with and expectations about adoption, ratings of social and personal factors in their decision to keep or relinquish a child, and preferences for characteristics of open adoption. Implications for counseling are discussed.
Adolescent Welfare Mothers: Lost Optimism and Lowered Expectations
Authors: Ortiz Elizabeth Thompson , Bassoff Betty Z.
Published: May 2018

Little attention has been paid to the effects of lowered expectations and resignation on adolescent welfare mothers. This study discusses these mothers’ views on career, education, motherhood, and sexuality and contrasts their views with those of their nonparent peers.
Torsional vibration analysis of a rotating tapered sandwich beam with magnetorheological elastomer core
Authors: Bornassi Saeed , Navazi Hossein M
Published: May 2018

In this study, the torsional vibration analysis of a rotating tapered sandwich beam with a magnetorheological elastomer core has been investigated. The magnetorheological elastomer material is used as a constrained damping layer embedded between two elastic constraining skins in order to improve the vibrational behavior of the sandwich beam. The three layers of the sandwich beam have rectangular cross-sections with symmetric arrangement. The problem formulation is set up based on the torsional theory of rectangular laminated plates. The assumed modes method and the Lagrange equations are used to derive the governing equations of motion of the system. The validity of the presented formulation is confirmed through comparison of the obtained results with those available in the literature. A detailed parametric study is carried out to investigate the effects of applied magnetic field, tapering ratios, magnetorheological elastomer layer thickness, rotating speed, hub radius, and setting angle on the free vibration characteristics of the sandwich beam. The results show that magnetic field intensity, magnetorheological elastomer layer thickness, and tapering ratio have significant influences on the torsional vibrating characteristics of the sandwich beam, and the effects of rotating speed and hub radius are considerable. The setting angle has no substantial effect on the torsional vibration characteristics.
A Scientific Foundation of Simulation Games for the Analysis and Design of Complex Systems
Authors: Lukosch Heide K. , Bekebrede Geertje , Kurapati Shalini , Lukosch Stephan G.
Published: May 2018

Background. The use of simulation games for complex systems analysis and design has been acknowledged about 50 years ago. However, articles do not combine all salient factors for successful simulation games, and often stem from a clear view of one particular field of science only. With combining multiple disciplines, connect analysis and design as well as research and practice, we provide deep insights in design and use of simulation games.

Aim. This article analyzes the design and evaluation process of a variety of game-based projects and activities, using existing scientific concepts and approaches, in order to establish games as a valid research tool. Our focus lies on the approach towards the use of games as design instrument; using them as an intervention in a larger, complex context, in order to design this context. With our contribution, we aim at providing insights and recommendations on the design and use of games as valid research tools, the limitations of this use, possible pitfalls, but also best practices.

Method. We carried out a literature review of related work to identify the most important scientific concepts related to our approach of game design. Further use of combined quantitative and qualitative case study analyses highlights the design process and results of our own game studies.

Results. The analyses yielded a consolidated conceptualization of simulation games as research instruments in complex systems analysis and design. The results also include methods for the evaluation of simulation games, additional evaluation methods, and limitations to use simulation games as research instruments.

Conclusions. We propose guidelines for using simulation games as research instruments that may be of value to practitioners and scientists alike.

Recommendation. We recommend practitioners and scientists to apply the guidelines presented here in their efforts to analyze and design complex systems.