bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolutionary Expression of HER2 Conferred by Chromosome Aneuploidy on Circulating Gastric Cancer Cells Contributes to Developing Targeted and Chemotherapeutic Resistance
Authors: Li Yilin , Zhang Xiaotian , Liu Dan , Gong Jifang , Wang Daisy Dandan , Li Shan , Peng Zhi , Li Yanyan , Wang Xiaojuan , Lin Peter Ping , Li Min , Shen Lin
Published: July 2018

Purpose: Previous human epidermal growth factor receptor-2 (HER2)-derived resistance studies were based on ex vivo models, which could not mirror evolutionary expression of HER2 during therapy. To investigate dynamic expression of HER2 and its contribution to developing therapeutic resistance conferred by chromosome aneuploidy, both the HER2 phenotype and chromosome 8 (Chr 8) aneuploidy on circulating tumor cells (CTC) were coexamined in advanced gastric cancer (AGC) patients.

Experimental Design: A total of 115 AGC patients, including 56 of histopathologic HER2+ (hHER2+) subjects who received first-line HER2-targeted therapy plus chemotherapy, and 59 of hHER2− patients who received chemotherapy alone, were prospectively enrolled. Both HER2 phenotype and Chr8 aneuploidy of CTCs in patients were coexamined by HER2-iFISH during therapy.

Results: A fluctuated positive HER2 phenotype on CTCs (cHER2+) was revealed, showing cHER2+ at different time intervals during treatment. Acquisition of the cHER2+ phenotype in 91.0% of hHER2+ and 76.2% hHER2− patients was demonstrated to correlate with development of resistance to trastuzumab-targeted therapy for hHER2+ patients and chemotherapy alone for hHER2− patients. Aneuploid Chr8 was demonstrated to participate in the acquisition of the cHER2+ phenotype, which provides a growth advantage to HER2+ CTCs against therapeutic pressure, leading to the development of therapeutic resistance.

Conclusions: Compared with low positivity of conventional histopathologic hHER2 examination routinely performed once, significant higher positivity of cHER2+ on CTCs was observed. Continuously examining cHER2 shows unique advantages with respect to monitoring therapeutic resistance in real time in carcinoma patients. Moreover, contribution of chromosome aneuploidy to the phenotypic evolution of HER2 expression on CTCs may help elucidate underlying mechanisms of developing therapeutic resistance. Clin Cancer Res; 24(21); 5261–71. ©2018 AACR.
Prognostic Value of Circulating Lipoprotein in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma
Authors: Yao Ji-Jin , He Xiao-Jun , Lawrence Wayne R. , Zhang Wang-Jian , Kou Jia , Zhang Fan , Zhou Guan-Qun , Wang Si-Yang , Sun Ying
Published: July 2018

Background/Aims: Lipoproteins have been reported to be associated with prognosis in various cancers; however, the prognostic value of lipoproteins in patients with nasopharyngeal carcinoma (NPC) remains largely unknown. We aim to asses the role of circulating lipoproteins in locoregionally advanced NPC patients. Methods: Between October 2009 and August 2012, a total of 1,081 patients with stage III-IVB NPC were included in the analysis. Circulating high-density lipoprotein (HDL) and low-density lipoprotein (LDL) are the two key lipoproteins, which were measured at baseline. Receiver operating characteristic (ROC) curve analysis was used to evaluate different cut-off points for lipoproteins. Actuarial rates were performed using Kaplan–Meier methods and the log-rank test. Results: The cutoff points of HDL, LDL, and LDL/HDL ratio were 1.17 mmol/L, 3.75 mmol/L, and 2.73, respectively. At 5 years, high HDL (> 1.17 mmol/L) was significantly associated with better overall survival (OS, 86.6% vs. 78.9%; P=0.004), distant metastasis-free survival (DMFS, 86.9% vs. 80.8%; P=0.004), locoregional relapse-free survival (LRFS, 90.8% vs. 85.4%; P=0.010), and progression-free survival (PFS, 79.1% vs. 70.2%; P= 0.001) than low HDL (≤1.17 mmol/L). In contrast, high LDL (> 3.75 mmol/L) tend to be inferior OS (79.1% vs. 84.9%; P= 0.016) in compassion with low LDL (≤3.75 mmol/L). Likewise, patients with high LDL/HDL ratio (> 2.73) tend to be inferior OS (79.3% vs. 86.9%; P=0.001), DMFS (81.9% vs. 86.5%; P=0.030), and PFS (72.6% vs. 77.8%; P= 0.034) than those of low LDL/HDL ratio (≤2.73). In multivariate analysis, baseline HDL was found to be a significant prognostic factor for LRFS (HR= 0.65; 95% CI, 0.45-0.93; P= 0.019) and PFS (HR=0.75; 95% CI, 0.58-0.98; P= 0.034). Conclusions: Circulating HDL is significantly associated with treatment outcomes in patients with locoregionally advanced NPC. We suggest that HDL measurements will be of great clinical significance in the management of NPC.
Descamuflar a palavra, parir a poesia: a voz de coragem da poeta galega Lupe Gómez
Authors: Escaleira Bruna Renata Bernardo
Published: July 2018

Uma das principais vozes da poesia galega atual, Lupe nos foi apresentada pela Professora Doutora Teresa Bermudez, da Universidade de Vigo, na disciplina “Literatura e Gênero na Literatura Galega Contemporânea”, promovida pelo Programa de Pós-Graduação em Estudos Comparados de Literaturas de Língua Portuguesa no segundo semestre de 2017. A autora insere-se de forma única na “ginealogia” de escritoras galegas incessantemente rebeldes, que têm Rosalía de Castro como “nai (mãe) de tinta”, Xohana Torres como grande referência no século XX e inúmeras “irmãs” na explosão da escrita feminista a partir do final dos anos 1980. Apesar de carregar traços centrais comuns a essa tradição literária, como a escrita do corpo e a subversão, sua obra diferencia-se de suas contemporâneas por reivindicar novos temas e formas poéticas, como se observa em seu mais novo poemário, Camuflaxe (2017).
Uma reflexão sobre os discursos menores ou a escrevivência como narrativa subalterna
Authors: Souza Lívia Natalia
Published: July 2018

Este texto toma para si a tarefa de discutir como o operador teórico “escrevivência”, forjado na escrita de Conceição Evaristo, pode ser acionado para construir uma reflexão sobre o modo como a Literatura Brasileira de Autoria Negra investe numa representação biográfica reescrevendo a experiência singular de cada sujeito como uma travessia de agenciamento coletivo de enunciação.
Indenizações em obstetrícia: estudo das decisões do Superior Tribunal de Justiça do Brasil de 2004 a 2014
Authors: RODRIGUES Thaísa Mara Leal Cintra , NUNES Altacílio Aparecido
Published: July 2018

Este artigo tem por objetivo identificar, nas decisões do Superior Tribunal de Justiça (STJ), as principais causas dos danos decorrentes da prática médica obstétrica no momento do parto. O estudo analisou 21 decisões julgadas pela corte entre 2004 e 2014 relacionadas a indenizações judiciais na obstetrícia. O critério de seleção dos casos utilizou como método a busca de decisões no site do STJ, cujos descritores foram: "parto", "erro médico"; "médico"; "paciente"; "profissional da saúde"; "dano moral"; "dano material"; "SUS"; "responsabilidade civil" e "indenização por erro médico". O Rio de Janeiro foi o estado com maior número de ações indenizatórias (28,6%) apreciadas pelo STJ, seguido de São Paulo e Minas Gerais, com 14,3% cada um. No tocante aos réus que figuraram no polo passivo das demandas, 38,1% eram médicos e hospitais. Verificou-se que 71% das supostas falhas médicas que originaram as ações ocorreram durante a realização do parto natural, contra 29% dos casos de cesariana. A principal causa dos danos relatados foi a demora na realização do parto, seguida dos traumatismos. Apesar de pesquisas demonstrarem que a cesariana oferece maiores riscos para a parturiente e o feto, os resultados obtidos das decisões judiciais analisadas pelo STJ evidenciaram que os danos que resultaram sequelas irreversíveis no nascituro foram recorrentes nos casos relacionados ao parto natural, sugerindo que atenção especial deve ser dada à formação médica obstétrica, bem como à compreensão dos aspectos socioculturais envolvendo a indicação e a escolha pelo tipo de parto.
Impaired Trafficking of β1 Subunits Inhibits BK Channels in Cerebral Arteries of Hypertensive Rats
Authors: Leo M. Dennis , Zhai Xue , Yin Wen , Jaggar Jonathan H.
Published: July 2018

Hypertension is a risk factor for cerebrovascular diseases, including stroke and dementia. During hypertension, arteries become constricted and are less responsive to vasodilators, including nitric oxide (NO). The regulation of arterial contractility by smooth muscle cell (myocyte) large-conductance calcium (Ca
2+
)-activated potassium (BK) channels is altered during hypertension, although mechanisms involved are unclear. We tested the hypothesis that dysfunctional trafficking of pore-forming BK channel (BKα) and auxiliary β1 subunits contributes to changes in cerebral artery contractility of stroke-prone spontaneously hypertensive rats (SP-SHRs). Our data indicate that the amounts of total and surface BKα and β1 proteins are similar in unstimulated arteries of age-matched SP-SHRs and normotensive Wistar-Kyoto rats. In contrast, stimulated surface-trafficking of β1 subunits by NO or membrane depolarization is inhibited in SP-SHR myocytes. PKCα (protein kinase C α) and PKCβII total protein and activity were both higher in SP-SHR than in Wistar-Kyoto rat arteries. NO or depolarization robustly activated Rab11, a small trafficking GTPase, in Wistar-Kyoto rat arteries but weakly activated Rab11 in SP-SHRs. Bisindolylmaleimide, a PKC inhibitor, and overexpression of a PKC phosphorylation-deficient Rab11A mutant (Rab11A S177A) restored stimulated β1 subunit surface-trafficking in SP-SHR myocytes. BK channel activation by NO was inhibited in SP-SHR myocytes and restored by Rab11A S177A expression. Vasodilation to NO and lithocholate, a BKα/β1 channel activator, was inhibited in pressurized SP-SHR arteries and reestablished by bisindolylmaleimide. In summary, data indicate that spontaneously active PKC inhibits Rab11A-mediated β1 subunit trafficking in arterial myocytes of SP-SHRs, leading to dysfunctional NO-induced BK channel activation and vasodilation.
Immunohistopathology and Steroid Profiles Associated With Biochemical Outcomes After Adrenalectomy for Unilateral Primary Aldosteronism
Authors: Meyer Lucie S. , Wang Xiao , Sušnik Eva , Burrello Jacopo , Burrello Alessio , Castellano Isabella , Eisenhofer Graeme , Fallo Francesco , Kline Gregory A. , Knösel Thomas , Kocjan Tomaz , Lenders Jacques W.M. , Mulatero Paolo , Naruse Mitsuhide , Nishikawa Tetsuo , Peitzsch Mirko , Rump Lars C. , Beuschlein Felix , Hahner Stefanie , Gomez-Sanchez Celso E. , Reincke Martin , Williams Tracy Ann
Published: July 2018

Unilateral primary aldosteronism (PA) is the most common surgically curable form of hypertension that must be accurately differentiated from bilateral PA for therapeutic management (surgical versus medical). Adrenalectomy results in biochemical cure (complete biochemical success) in almost all patients diagnosed with unilateral PA; the remaining patients with partial or absent biochemical success comprise those with persisting aldosteronism who were misdiagnosed as unilateral PA preoperatively. To identify determinants of postsurgical biochemical outcomes, we compared the adrenal histopathology and the peripheral venous steroid profiles of patients with partial and absent or complete biochemical success after adrenalectomy for unilateral PA. A large multicenter cohort of adrenals from patients with absent and partial biochemical success (n=43) displayed a higher prevalence of hyperplasia (49% versus 21%;
P
=0.004) and a lower prevalence of solitary functional adenoma (44% versus 79%;
P
<0.001) compared with adrenals from age- and sex-matched patients with PA with complete biochemical success (n=52). We measured the peripheral plasma steroid concentrations in a subgroup of these patients (n=43) and in a group of patients with bilateral PA (n=27). Steroid profiling was associated with histopathologic phenotypes (solitary functional adenoma, hyperplasia, and aldosterone-producing cell clusters) and classified patients according to biochemical outcome or diagnosis of bilateral PA. If validated, peripheral venous steroid profiling may be a useful tool to guide the decision to perform surgery based on expectations of biochemical outcome after the procedure.
Cost-Effectiveness of Quantitative Magnetic Resonance Angiography Screening and Submaximal Angioplasty for Symptomatic Vertebrobasilar Disease
Authors: Esfahani Darian R. , Pandey Dilip , Du Xinjian , Rose-Finnell Linda , Charbel Fady T. , Derdeyn Colin P. , Amin-Hanjani Sepideh ,   on behalf of the VERiTAS Study Group
Published: July 2018

Background and Purpose—

The VERiTAS (Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke) study demonstrated posterior circulation distal flow status, determined by quantitative magnetic resonance angiography, is a robust predictor of vertebrobasilar stroke risk in patients with symptomatic atherosclerotic vertebrobasilar disease. Flow-compromised high-risk patients may benefit from flow-restoring endovascular procedures, such as submaximal angioplasty. In this study, we examine the cost-effectiveness of quantitative magnetic resonance angiography screening to identify patients who may benefit from submaximal angioplasty to restore vertebrobasilar flow.

Methods—

A Markov model was created comparing a no screening strategy with standard medical management alone and a screening strategy involving quantitative magnetic resonance angiography imaging and submaximal angioplasty for treatable patients with low vertebrobasilar flow for a 30-year time horizon. Outcomes included quality-adjusted life years (QALY) and lifetime costs. Rates of stroke and death were obtained from VERiTAS data, and disability rates and costs were derived from VERiTAS and the literature. A sensitivity analysis was performed with periprocedural stroke rate from angioplasty the primary variable of interest.

Results—

At a 6% periprocedural stroke risk, the screening strategy saved an average of 0.364 QALYs per patient and a lifetime cost savings of $7312 versus the no screening strategy. Among patients with low flow suitable for intervention, the benefit was substantially higher, averaging 1.485 QALYs saved and lifetime cost savings of $21 294. Across the entire cohort, QALY savings were observed at the end of the first year and economic savings at year 6. The benefit of screening declined at higher periprocedural risk.

Conclusions—

Quantitative magnetic resonance angiography screening and submaximal angioplasty with 6% periprocedural risk in suitable patients are cost effective both in terms of QALY and lifetime costs for patients with symptomatic vertebrobasilar occlusive disease. With potential health and economic savings, a clinical trial examining the periprocedural risk of submaximal angioplasty is warranted.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00590980.
Inference in Differences-in-Differences with Few Treated Groups and Heteroskedasticity
Authors: Ferman Bruno , Pinto Cristine
Published: July 2018

We derive an inference method that works in differences-in-differences settings with few treated and many control groups in the presence of heteroskedasticity. As a leading example, we provide theoretical justification and empirical evidence that heteroskedasticity generated by variation in group sizes can invalidate existing inference methods, even in data sets with a large number of observations per group. In contrast, our inference method remains valid in this case. Our test can also be combined with feasible generalized least squares, providing a safeguard against misspecification of the serial correlation.
Anatomical and morphological changes of the juniper under the influence of heavy metals in condition of man-induced load
Authors: Mussina Aitzhamal S. , Baitasheva Gaukhar U. , Kurmanbayeva Meruyert S. , Medeuova Galia J. , Mauy Adilhan A. , Imanova Elmira M. , Kurasbaeva Akbota Zh. , Rachimova Zaida S. , Nurkeyev Yerlan S. , Orazbayev Kanat
Published: July 2018

Reaction of the plant body in polluted conditions allows estimating the anthropogenic impact on the environment. The aim of this work is to study anatomical and morphological changes of juniper in terms of the polymetallic pollution of the environment and under the influence of heavy metals. The assessment of some heavy metals impact on juniper was conducted after the planting of seed samples in the soil and obtaining good germination. The juniper has been treated with heavy metal solutions in the lab for 4 months. To determine the anatomical structures of the leaves of the juniper, the samples were fixed by the Strasburger-Fleming method. Under the influence of urban air, negative anatomical and morphological changes of juniper were discovered, the significant increase in the thickness of the needles, the thickness of the conducting bundle and the thickness of the epidermis was noted, that, apparently, provides higher resistance to man-induced pollution. It is shown that the process of environmental restoration can be done due to self-purification by using adsorption properties of leaves of woody plants, for example juniper, that is able to absorb heavy metals (lead, cadmium, cobalt, chromium, nickel, zinc and copper) from urban air. It was first discovered that the effects of heavy metals (lead and nickel) as the nutrient medium leads to the significant changes of the leaves’ anatomical structure (the swelling of the phloem, some decondensation in the mesophyll). The research results allow recommending the juniper for phytoremediation, bioindication and landscape gardening of cities and settlements in different countries.
Affordable Rotating Fluid Demonstrations for Geoscience Education: The DIYnamics Project
Authors: Hill Spencer A. , Lora Juan M. , Khoo Norris , Faulk Sean P. , Aurnou Jonathan M.
Published: July 2018

Demonstrations using rotating tanks of fluid can help demystify otherwise counterintuitive behaviors of atmospheric, oceanic, and planetary interior fluid motions. But the expense and complicated assembly of existing rotating table platforms limit their appeal for many schools, especially those below the university level. Here, we introduce Do-It-Yourself Dynamics (DIYnamics), a project developing extremely low-cost rotating tank platforms and accompanying teaching materials. The devices can be assembled in a few minutes from household items, all available for purchase online. Ordering, assembly, and operation instructions are available on the DIYnamics website. Videos using these and other rotating tables to teach specific concepts such as baroclinic instability are available on the DIYnamics YouTube channel—including some in Spanish. The devices, lesson plans, and demonstrations have been successfully piloted at multiple middle schools, in a university course, and at public science outreach events. These uses to date convince us of the DIYnamics materials’ pedagogical value for instructors from well-versed university professors to K–12 science teachers with little background in fluid dynamics.
Investigating the Relative Contributions of Charge Deposition and Turbulence in Organizing Charge within a Thunderstorm
Authors: Brothers Matthew D. , Bruning Eric C. , Mansell Edward R.
Published: July 2018

Large-eddy-resolving simulations using the Collaborative Model for Multiscale Atmospheric Simulation (COMMAS), which contains microphysical charging and branched-lightning parameterizations, produce much more complex net charge structures than conventionally visualized from previous observations, simulations, and conceptual diagrams. Many processes contribute to the hydrometeor charge budget within a thunderstorm, including advection, hydrometeor differential sedimentation, subgrid turbulent mixing and diffusion, ion drift, microphysical separation, and the attachment of ion charge deposited by the lightning channel. The lightning deposition, sedimentation, and noninductive charging tendencies contribute the most overall charge at relatively large scales, while the advection tendency, from resolved turbulence, provides the most “texture” at small scales to the net charge density near the updraft region of the storm. The scale separation increases for stronger storm simulations. In aggregate, lightning deposition and sedimentation resemble the smoother distribution of the electric potential, while evidence suggests individual flashes could be responding to the fine texture in the net charge. The clear scale separation between the advection and other net charge tendencies suggest the charge advection is most capable of providing net charge texture; however, a clear-cut causality is not obtained from this study.
Subclinical Atherosclerosis in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Wang Peng , Xu Yuan-Yuan , Lv Tian-Tian , Guan Shi-Yang , Li Xiao-Mei , Li Xiang-Pei , Pan Hai-Feng
Published: July 2018

Cardiovascular (CV) risk in type 1 diabetes mellitus (T1DM) is increased. In this study, we evaluated the differences in major markers of CV risk between patients with T1DM and healthy controls by a systematic review and meta-analysis. Literature from PubMed, EMBASE, and The Cochrane Library comparing CV risk markers between patients with T1DM and controls was obtained. The overall standard mean differences (SMDs) of carotid intima–media thickness (cIMT), endothelium-dependent flow-mediated dilation (FMD%), carotid-femoral pulse wave velocity (cf-PWV), and glyceryl trinitrate-mediated dilatation (GTN%) with its 95% confidence interval (CI) between patients with T1DM and control groups were calculated using fixed-effect or random-effect model. Heterogeneity was evaluated using the Cochran Q and I2 statistics. The results showed that patients with T1DM had a significantly greater cIMT (SMD: 0.89; 95% CI, 0.69-1.09; P < .001), significantly lower FMD% (SMD: −1.45%; 95% CI, −1.74 to −1.17; P < .001), significantly increased cf-PWV (SMD: 0.57; 95% CI, 0.03-1.11; P < .001), and significantly decreased GTN% (SMD: −1.11; 95% CI, −1.55 to −0.66; P < .001) than controls. Our results support the current evidence for an elevated CV burden in patients with T1DM and affirm the clinical utility of markers of subclinical atherosclerosis in the management of these patients.
Intrathecal Baclofen Therapy—Practical Approach: Clinical Benefits and Complication Management
Authors: Winter Gidon , Beni-Adani Liana , Ben-Pazi Hilla
Published: July 2018

Intrathecal baclofen is an expanding accepted treatment for children with cerebral palsy and other causes of spasticity and dystonia. The aims of this review are therefore to (1) delineate the clinical benefits of intrathecal baclofen therapy in pediatric spasticity and dystonia and (2) increase awareness of the potential complications and emergency management measures of intrathecal baclofen therapy. A current literature review demonstrates the benefits and complications of this minimally invasive device. Practical guides for recognizing acute conditions and management recommendations are included. Intrathecal baclofen is increasingly being used to help individuals attain realistic functional goals. Therefore, families and health care professionals should be aware of potential complications, symptoms, and emergency management.
Development and Implementation of an End-of-Life Curriculum for Pediatric Residents
Authors: Wilson Paria M. , Herbst Lori A. , Gonzalez-del-Rey Javier
Published: July 2018

Background:

Caring for a child near the end of life (EOL) can be a stressful experience. Resident physicians are often the frontline providers responsible for managing symptoms, communicating difficult information, and pronouncing death, yet they often receive minimal education on EOL care.

Objective:

To develop and implement an EOL curriculum and to study its impact on resident comfort and attitudes surrounding EOL care.

Design:

Kern’s 6-step approach to curriculum development was used as a framework for curriculum design and implementation.

Setting/Participants:

Categorical and combined pediatric residents at a large quaternary care children’s hospital were exposed to the curriculum.

Measurements:

A cross-sectional survey was distributed pre- and postimplementation of the curriculum to evaluate its impact on resident comfort and attitudes surrounding EOL care.

Results:

One-hundred twenty-six (49%) of 258 residents completed the preimplementation survey, and 65 (32%) of 201 residents completed the postimplementation survey. Over 80% of residents reported caring for a dying patient, yet less than half the residents reported receiving prior education on EOL care. Following curriculum implementation, the percentage of residents dissatisfied with their EOL education fell from 36% to 14%, while the percentage of residents satisfied with their education increased from 14% to 29%. The postimplementation survey identified that resident comfort with communication-based topics improved, and they sought additional training in symptom management.

Conclusions:

The implementation of a longitudinal targeted multimodal EOL curriculum improved resident satisfaction with EOL education and highlighted the need for additional EOL education.
Perceptions of Health Care Executives on Leadership Development Skills for Residents After Participating in a Longitudinal Mentorship Program
Authors: Patel Neha , Vemuri Divya , Frasso Rosemary , Myers Jennifer S.
Published: July 2018

Despite the fact that physicians are being asked to lead and enact change to improve a myriad of quality of care measures, there is little focus on leadership skills development during their training. One strategy to address this gap is to focus on trainees during graduate medical education, specifically those residents aspiring to careers as physician leaders in quality. The authors designed a leadership curriculum for self-selected residents who are pursuing a certificate in health care leadership in quality. Residents were surveyed and focus groups were conducted with health system executives who participated in the curriculum as part of an evaluation designed to inform improvements in the program and to provide guidance to others who direct physician leadership training programs. The findings support the need to invest in young physician leaders who are focused on quality with the ultimate goal of improving population health in the ever-changing health care environment.
Design and Implementation of a Depression Registry for Primary Care
Authors: Yang Michael , Loeb Danielle F. , Sprowell Andrew J. , Trinkley Katy E.
Published: July 2018

Registries are fundamental to the success of population health initiatives to improve care and outcomes for patients, including those with depression. The purpose of this article is to describe the design and clinical implementation of a depression registry as part of a collaborative care for depression intervention at 2 large academic outpatient internal medicine practices. The primary objective of the registry was to identify and track patients with depression and monitor antidepressant therapy. Secondary objectives of the registry were to assist in addressing pay-for-performance and value-based reimbursement metrics for depression screening and remission. The registry design and variables for inclusion in the registry were defined with input from clinicians, institutional leadership, and data analysts. For implementation, specific clinical workflows were established and responsible team roles were designated.
AF-CBT for Families Experiencing Physical Aggression or Abuse Served by the Mental Health or Child Welfare System: An Effectiveness Trial
Authors: Kolko David J. , Herschell Amy D. , Baumann Barbara L. , Hart Jonathan A. , Wisniewski Stephen R.
Published: July 2018

The Partnerships for Families project is a randomized clinical trial to evaluate the effectiveness of Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT), an evidence-based treatment (EBT) for families who are at risk of or have histories of child physical abuse. Across 10 agencies whose programs were supported by referrals from the mental health or child welfare system, individual providers were randomized to receive AF-CBT training ( n = 90) in a 6-month learning community or treatment as usual (TAU; n = 92) which provided trainings per agency routine. We recruited families served by providers in the AF-CBT ( n = 122) and TAU ( n = 73) conditions and collected multiple outcomes at up to four time points (0, 6, 12, and 18 months). Using univariate tests and growth curve models, the analyses revealed that AF-CBT (vs. TAU) showed improvements in both service systems (e.g., abuse risk, family dysfunction) or one service system (e.g., threats of force, child to parent minor assault), with some outcomes showing no improvement (e.g., parental anger). These findings are discussed in relation to AF-CBT, service system, provider, and family characteristics, and training/dissemination methods that affect the delivery of an EBT for this population in community settings.
Catecholamine and Indolamine Pathway: A Case–Control Study in Fibromyalgia
Authors: Rus Alma , Molina Francisco , Del Moral María Luisa , Ramírez-Expósito María Jesús , Martínez-Martos José Manuel
Published: July 2018

Objectives:

Fibromyalgia (FM) is a complex syndrome characterized by widespread pain. Its etiology is unclear, and diagnosis is difficult. The aim of this study was to assess plasma levels of monoamine neurotransmitters (catecholamines, indolamines, and intermediate metabolites) in patients with FM and healthy controls to investigate possible alterations in the metabolism of these molecules in FM. We also examined potential relationships between monoamine neurotransmitters and clinical features of FM. The predictive value of these molecules in FM was determined by receiver operating characteristic analysis.

Method:

We measured plasma catecholamines (epinephrine, norepinephrine, and dopamine), as well as indolamines and intermediary metabolites (serotonin or 5-hydroxytryptamine [5-HT], 5-hydroxyindolacetic acid [5-HIAA], 5-hydroxytryptophan [5-HTP], and N-acetyl-5-hydroxytryptamine [Nac-5-HT]) in 35 women with FM and 12 age-matched healthy women.

Results:

Higher levels of norepinephrine and lower levels of dopamine, 5-HT, 5-HIAA, and 5-HTP were found in women with FM in comparison with controls. Epinephrine and Nac-5-HT levels did not differ significantly between groups. Higher norepinephrine levels were associated with worse physical health status in FM patients. Also, plasma norepinephrine levels > 694.69 pg/ml might be an accurate predictor of FM.

Conclusions:

These findings show evidence of the dysregulation of the catecholamine and indolamine pathway in patients with FM, which may contribute to the physiopathology of this syndrome. In addition, the determination of plasma norepinephrine levels could help in the FM diagnosis.
Design of permanent magnetic wheel-type adhesion-locomotion system for water-jetting wall-climbing robot
Authors: Song Wei , Jiang Hongjian , Wang Tao , Ji Daxiong , Zhu Shiqiang
Published: July 2018

Regular surface-maintenances are necessary for high structures to increase service life. The traditional manual operation has shortcomings like limited maneuverability, poor operating quality, low operating efficiency, and high risk of physical harm, which makes it urgent to develop wall-climbing robot for carrying out surface-maintenances of high structures with high efficiency, low cost, and good protection of operators. In this article, we have developed a wheeled wall-climbing robot that uses a permanent magnet adhesion system to climb on large steel surfaces. Wheel traction to avoid slippage is increased by using inflated rubber tire while maintaining a desired air gap for the magnet system. Research is directed at designing a lightweight magnet system to provide an optimum adhesion force and at determining required tire pressures to maintain a specified air gap between the magnets and the surface.
The Role of ECMO in the “At-Risk” Tracheal Extubation: A Case Report
Authors: Phipps Sarah J. , Meisner Jason G. , Watton David E. , Malpas Gemma A. , Hung Orlando R.
Published: July 2018

Tracheal extubation requires careful planning and preparation. We present the extubation of a patient with severe ankylosing spondylitis after cervical spine surgery. We discuss the use of extracorporeal membrane oxygenation (ECMO) in this “at-risk” extubation, where our ability to oxygenate was uncertain and reintubation was predicted to be difficult. To our knowledge, ECMO has not previously been used in this context. We suggest preparing ECMO for rescue oxygenation when all other fundamental oxygenation techniques are predicted to be difficult or impossible. ECMO could be included in airway management and extubation guidelines.
Methylnaltrexone-Associated Bowel Perforation in Postoperative Opioid-Induced Constipation and Ogilvie Syndrome: A Case Report
Authors: Blackney Kevin A. , Kamdar Nirav V. , Liu Chang Amber , Edwards David A.
Published: July 2018

Pain management with opioids is often limited by medication side effects. One of the most common and distressing side effects is opioid-induced constipation (OIC), a syndrome that is now getting significant national attention. We report the case of an opioid-dependent 56-year-old man who underwent lumbar decompression for spinal stenosis. Postoperatively, he developed OIC and Ogilvie syndrome, then following treatment with methylnaltrexone experienced an acute bowel perforation. We briefly review the recommended management of OIC as well as indications and contraindications of methylnaltrexone and similar new medications.
Acute Adrenal Insufficiency in the Perioperative Period: A Case Report
Authors: Karamchandani Kunal , Leathem Jarrett , Sinz Elizabeth H.
Published: July 2018

Acute adrenal insufficiency is a rare but potentially life-threatening event during the perioperative period. The usual manifestations of an acute adrenal crisis can mimic common postoperative complications and a high index of suspicion is required for the diagnosis. Early diagnosis and prompt treatment can be lifesaving. We present the case of a 65-year-old man who, after a partial nephrectomy, developed acute adrenal insufficiency, which remained undiagnosed in the postoperative period, eventually leading to cardiac arrest. This case highlights the need for perioperative physicians to have a watchful eye for diagnosing and treating this uncommon yet lethal condition.
A Langendorff-like system to quantify cardiac pump function in adult zebrafish
Authors: Zhang Hong , Dvornikov Alexey V. , Huttner Inken G. , Ma Xiao , Santiago Celine F. , Fatkin Diane , Xu Xiaolei
Published: July 2018

Zebrafish are increasingly used as a vertebrate model to study human cardiovascular disorders. Although heart structure and function are readily visualized in zebrafish embryos because of their optical transparency, the lack of effective tools for evaluating the hearts of older, nontransparent fish has been a major limiting factor. The recent development of high-frequency echocardiography has been an important advance for in vivo cardiac assessment, but it necessitates anesthesia and has limited ability to study acute interventions. We report the development of an alternative experimental ex vivo technique for quantifying heart size and function that resembles the Langendorff heart preparations that have been widely used in mammalian models. Dissected adult zebrafish hearts were perfused with a calcium-containing buffer, and a beat frequency was maintained with electrical stimulation. The impact of pacing frequency, flow rate and perfusate calcium concentration on ventricular performance (including end-diastolic and end-systolic volumes, ejection fraction, radial strain, and maximal velocities of shortening and relaxation) were evaluated and optimal conditions defined. We determined the effects of age on heart function in wild-type male and female zebrafish, and successfully detected hypercontractile and hypocontractile responses after adrenergic stimulation or doxorubicin treatment, respectively. Good correlations were found between indices of cardiac contractility obtained with high-frequency echocardiography and with the ex vivo technique in a subset of fish studied with both methods. The ex vivo beating heart preparation is a valuable addition to the cardiac function tool kit that will expand the use of adult zebrafish for cardiovascular research.
Independent effects of dietary fat and sucrose content on chondrocyte metabolism and osteoarthritis pathology in mice
Authors: Donovan Elise L. , Lopes Erika Barboza Prado , Batushansky Albert , Kinter Mike , Griffin Timothy M.
Published: July 2018

Obesity is one of the most significant risk factors for knee osteoarthritis. However, therapeutic strategies to prevent or treat obesity-associated osteoarthritis are limited because of uncertainty about the etiology of disease, particularly with regard to metabolic factors. High-fat-diet-induced obese mice have become a widely used model for testing hypotheses about how obesity increases the risk of osteoarthritis, but progress has been limited by variation in disease severity, with some reports concluding that dietary treatment alone is insufficient to induce osteoarthritis in mice. We hypothesized that increased sucrose content of typical low-fat control diets contributes to osteoarthritis pathology and thus alters outcomes when evaluating the effects of a high-fat diet. We tested this hypothesis in male C57BL/6J mice by comparing the effects of purified diets that independently varied sucrose or fat content from 6 to 26 weeks of age. Outcomes included osteoarthritis pathology, serum metabolites, and cartilage gene and protein changes associated with cellular metabolism and stress-response pathways. We found that the relative content of sucrose versus cornstarch in low-fat iso-caloric purified diets caused substantial differences in serum metabolites, joint pathology, and cartilage metabolic and stress-response pathways, despite no differences in body mass or body fat. We also found that higher dietary fat increased fatty acid metabolic enzymes in cartilage. The findings indicate that the choice of control diets should be carefully considered in mouse osteoarthritis studies. Our study also indicates that altered cartilage metabolism might be a contributing factor to how diet and obesity increase the risk of osteoarthritis.
Psicologia, Filosofia e meio ambiente: delineando o conceito de sustentabilidade afetiva
Authors: Mansano Sonia Regina Vargas , Carvalho Paulo Roberto de
Published: July 2018

A preocupação com o meio ambiente e a manutenção de um planeta sustentável, cujos recursos naturais estejam acessíveis às próximas gerações, atravessa diferentes áreas de conhecimento e esferas governamentais. Políticas públicas, projetos de leis, movimentos sociais e iniciativas micropolíticas colocam a questão da sustentabilidade em evidência e procuram chamar a atenção da população para uma dificuldade crescente e urgente: a preservação da vida em nosso planeta. Atentando-se para essa realidade social, o presente artigo teórico tem por objetivo aproximar dois conceitos, estudando-os de maneira aprofundada: sustentabilidade e afeto. Serão duas as principais fontes utilizadas como referência deste estudo: para a noção de sustentabilidade, buscaremos respaldo nas obras de Elkington (2001), Foladori (2002) e Guattari (1997). Já para abordar o conceito de afeto, a obra de referência será a "Ética", de Espinosa (1677/1983), bem como os estudos de dois filósofos: Deleuze (2002, 2009) e Chauí (1995, 1999). Acreditamos que essa aproximação conceitual permitirá elaborar e fundamentar a noção de "sustentabilidade afetiva". Como conclusão parcial, o artigo evidencia que afeto e meio ambiente estão inter-relacionados e, uma vez articulados, podem promover questionamentos sobre a complexa relação que o humano estabelece com a natureza.
Carnaval como instrumento de inclusão social de pessoas com deficiência
Authors: Ribeiro Jussélio Rodrigues , Mourão Luciana
Published: July 2018

A inclusão social vem sendo mais discutida na sociedade e a literatura PSI aponta crescente atuação das empresas em programas voltados a essa temática. O objetivo deste estudo foi avaliar o Projeto Embaixadores da Alegria, que usa o Carnaval como instrumento de inclusão social. A pesquisa multimétodo (pesquisa documental, questionário e entrevistas) contemplou 538 pessoas, incluindo beneficiários, familiares, membros da comunidade, gestores, financiadores e executores do Projeto. O delineamento foi de um quase-experimento que verificou se a participação no programa aumentava a percepção de inclusão social. Os resultados do teste permitem concluir que o Projeto atende apenas parcialmente aos seus objetivos, pois não houve diferenças significativas em relação à favorabilidade à inclusão escolar entre grupo de tratamento e grupo controle. De forma complementar, na análise de conteúdo, foram identificadas cinco categorias relacionadas a aspectos processuais e de resultados do projeto, a saber: (i) participação da família; (ii) formas de comunicação; (iii) mobilidade; (iv) trabalho e geração de renda; e (v) inclusão social. Os achados da pesquisa foram debatidos a partir do referencial teórico. São feitas recomendações para o Projeto e sugestões de novos estudos.
Adolescente em conflito com a lei: revisando as contribuições de variáveis sociais, familiares e individuais
Authors: Costa Lizinara Pereira da , Santos Samara Silva dos
Published: July 2018

O objetivo deste artigo é reunir informações a partir da literatura PSI, a fim de aprofundar o conhecimento sobre os adolescentes em conflito com a lei, tomando como parâmetro o modelo teórico proposto por Shoemaker. O artigo foi dividido em seções de acordo com os três níveis de conceitualização de Shoemaker: nível estrutural, nível individual e nível sociopsicológico. Destacou-se que, para uma melhor compreensão do comportamento infrator, faz-se necessário uma articulação e interação com todos os níveis de compreensão propostos pelo modelo de Shoemaker. Enfatizou-se a importância de pesquisas com dados mais específicos da realidade brasileira.
A Importância da intergeracionalidade para o desenvolvimento de universitários mais velhos
Authors: Leite Soniárlei Vieira , França Lucia Helena de Freitas Pinho
Published: July 2018

O envelhecimento tornou-se preocupação de diversas áreas do conhecimento, dentre elas o ensino-aprendizagem, com foco nas relações intergeracionais. Contudo, há uma carência de pesquisas que demonstrem os benefícios desta intergeracionalidade na educação universitária. Este trabalho teve por objetivo verificar a importância da intergeracionalidade no desenvolvimento dos estudantes mais velhos. A pesquisa teve abordagem qualitativa, por meio de entrevistas semiestruturadas e utilização da análise de conteúdo, baseadas na percepção de diferentes atores acerca da sabedoria, suporte social, habilidades sociais, superação (atitudes resilientes) e o contato intergeracional. Participaram desta pesquisa 20 universitários (10 mais jovens e 10 mais velhos), três professores e dois funcionários de duas universidades do Rio de Janeiro. O contato intergeracional percebido é benéfico aos universitários, independentemente da idade, especialmente para os mais velhos, tanto para o seu desenvolvimento pessoal quanto para o desempenho acadêmico. A idade não é critério definidor do envelhecimento, nem na percepção dos universitários mais velhos, nem na dos mais jovens. As diferenças entre estudantes mais jovens e mais velhos, via de regra, são superadas ao longo do tempo. São recomendadas pesquisas sobre as habilidades sociais, especialmente as desenvolvidas no âmbito acadêmico, como fator de influência no desempenho dos universitários mais velhos.
AUTOMUTILAÇÃO: O ENCONTRO ENTRE O REAL DO SOFRIMENTO E O SOFRIMENTO REAL
Authors: Reis Maurício De Novais
Published: July 2018

Resumo: O presente artigo trata da prática de automutilação na adolescência como reflexo da impossibilidade de estruturação da cadeia significante. Partindo de considerações sobre as origens da terminologia mutilação, aborda-se a incidência de automutilação em adolescentes do sexo feminino, nas escolas dos anos finais do ensino fundamental, baseando as hipóteses levantadas na noção de angústia formulada por Lacan. Como tentativa de resgate genealógico do conceito de automutilação, este artigo reúne as concepções médicas, psiquiátricas e psicanalíticas, fomentando a interdisciplinaridade das investigações epistemológicas. São retomados pressupostos apresentados no DSM-5 e na CID-10, para fundamentar o lugar do Real no sofrimento real da adolescência. Palavras-chave: Automutilação. Psicanálise. Contemporaneidade. Adolescência. Abstract: The present article describes the practice of self cutting in adolescence as a return of the impossibility of structuring of the symbolic chain. On the basis of considerations about the etymological origins mutilation, discusses the incidence of cutting in female adolescents in schools of the basic education, stating the theory raised in the concept of anguish in Lacan. In an attempt to rescue the concept of self cutting, this article brings together the concepts medical, psychiatric and psychoanalytic fostering interdisciplinarity of research epistemological. Resumes premises of the DSM-5 and CID-10 to demonstrate the place of Real in the real suffering of the teenagers. Keywords: Cutting. Psychoanalysis. Modernity. Adolescence.
O PESO QUE NÃO APARECE NA BALANÇA: SOFRIMENTO PSÍQUICO EM UMA SOCIEDADE OBESOGÊNICA E LIPOFÓBICA
Authors: Vianna Monica Vanderlei
Published: July 2018

Resumo: O presente artigo propõe uma reflexão sobre o sofrimento psíquico possivelmente instaurado pelo processo de subjetivação e construção da identidade experimentados em um ambiente sociocultural obesogênico e com valores paradoxalmente lipofóbicos. Partindo do preceito que as psicopatologias trazem em si traços do contexto social e histórico no qual estão inseridas, buscou-se através de um referencial teórico psicanalítico, pensar como um ambiente que promove a obesidade e concomitantemente condena os que sucumbem ao excesso de peso contribui para o aumento de manifestações psíquicas relacionadas ao corpo e a alimentação. Para tanto, abordamos questões referentes aos estigmas arreigados à obesidade, à edificação da lipofobia na contemporaneidade, assim como as relações com declínio dos conflitos psíquicos em detrimento dos sintomas corporais na atualidade.Palavras-chave: Obesidade. Sofrimento Psíquico. Corpo. Abstract: This article proposes a reflection on the psychic suffering possibly established by the process of subjectivation and identity construction experienced in an obesogenic sociocultural environment with paradoxically lipophobic values. Starting from the precept that the psychopathologies bring in themselves traces of the social and historical context in which they are inserted, it was sought through a theoretical reference psychoanalytic, to think like an environment that promotes the obesity and concomitantly condemns those who succumb to the excess weight contributes to the increase of psychic manifestations related to the body and the feeding. In order to do so, we address issues related to the stigmas attached to obesity, the construction of lipophobia in contemporary times, as well as the relationship with the decline of psychic conflicts to the detriment of current bodily symptoms. Keywords: Obesity. Psychological Suffering. Body.