bluuebunny/crossref_metadata_2025 huggingface dataset:
The professional development of counsellors and psychotherapists: Implications of empirical studies for supervision, training and practice
Authors: Rønnestad Michael Helge , Orlinsky David E. , Schröder Thomas A. , Skovholt Thomas M. , Willutzki Ulrike
Published: December 2018

Background

This article presents key findings of two major empirical studies of psychotherapist and counsellor development. Both aimed to advance knowledge of variations in professional development and better understand the complexity of formative influences.

Methodology

The Minnesota Study of Therapist and Counsellor Development and the International Study of Development of Psychotherapists (ISDP) combined qualitative and quantitative research.

Results

In the “Minnesota study,” qualitative analysis of data from 100 psychotherapists (172 interviews) at different experience levels led to formulating five phases of practitioner development: theNovice Student Phase,Experienced Student Phase,Novice Professional Phase,Experienced Professional PhaseandSenior Professional Phase. Results were integrated in a model describing three developmental trajectories—Continued development, Exhaustion and Disengagement—suggesting a developmentally sensitive approach to supervision. In theISDPstudy, theDevelopment of Psychotherapist Common Core Questionnairewas used to survey approximately 5,000 psychotherapists from countries throughout the world from 1991 to 2003 (currently about 12,000 therapists). Multi‐level quantitative analysis yielded two broad dimensions of therapeutic work experience,Healing InvolvementandStressful Involvement, based on therapists’ clinical skills, difficulties in practice, coping strategies, manner of relating to clients and in‐session feelings. Analysis of therapists’ experiences of current professional development showed two dimensions(Currently Experienced GrowthandCurrently Experienced Depletion). These were predicted, respectively, byHealing InvolvementandStressful Involvementand in turn predicted different levels ofOverall Career Development.

Implications

Implications for supervison were drawn from the findings of The Phase Model and the Cyclical Trajectories model of the Minnesota‐study, while the ISDP study results were integrated in a Cyclical‐Sequential Model with implications for clinical training, supervision and practice.
The unsaid: In‐depth accounts of non‐disclosures in supervision from the trainees’ perspective
Authors: Singh‐Pillay Neeshi , Cartwright Duncan
Published: December 2018

Aim

This study explores trainees’ subjective experiences and perceptions of non‐disclosure in clinical supervision, offering a rich, detailed understanding of non‐disclosure from the trainees’ perspective.

Method

Eight trainees were interviewed, and transcripts were analysed using Interpretative Phenomenological Analysis (IPA).

Findings

Four super‐ordinate themes were identified and form the focus of this paper: (a) Purposeful non‐disclosures (b) Factors that prevent and facilitate trainee disclosures (c) Learning from the supervisor and (d) The implications for the trainee's learning and therapy.

Conclusion/Implications

Exploring the issue of non‐disclosures from the trainees’ perspective reveals that the “cycle of non‐disclosure” in clinical supervision can be understood as part of a subversive power dynamic in service of self‐preservation and protection of the vulnerable “trainee self.” The underlying dynamics related to power relations were also strongly associated with perceptions of knowledge and professional identity.
Anticoagulation in patients with atrial fibrillation and heart failure: Insights from the NCDR PINNACLE‐AF registry
Authors: Contreras Johanna P. , Hong Kimberly N. , Castillo Javier , Marzec Lucas N. , Hsu Jonathan C. , Cannon Christopher P. , Yang Song , Maddox Thomas M.
Published: December 2018

Background

In non‐valvular atrial fibrillation (NVAF) patients, congestive heart failure (CHF) confers an increased risk of stroke or systemic thromboembolism. This risk is present in both heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). It is unclear if clinicians account for both types of CHF in their NVAF anticoagulation practices. Accordingly, we characterized current outpatient anticoagulation trends in NVAF patients with HFpEF compared to patients with HFrEF.

Methods

The outpatient NCDR PINNACLE‐AF registry was analyzed to identify patients with NVAF and CHF. The study population was subdivided into HFpEF (ie, LVEF ≥ 40%) and HFrEF (LVEF < 40%). Anticoagulation rates by CHF group were compared and stratified by CHA2DS2‐VASc score.

Results

A total of 340 127 patients with NVAF and CHF were identified, of whom 248 136 (73.0%) were classified as HFpEF and 91 991 (27.0%) as HFrEF. Patients with HFpEF had higher mean CHA2DS2‐VASc scores and were more likely to be female, older, and have hypertension (P < 0.001). Unadjusted anticoagulation rates were significantly lower in patients with HFpEF compared to those with HFrEF (60.6% vs 64.2%, respectively). Lower rates of anticoagulation in the HFpEF group persisted after risk adjustment (RR: 0.93 [95% CI: 0.91, 0.94]). Stratification by CHA2DS2‐VASc score demonstrated that lower rates of anticoagulation in patients with HFpEF persisted until a score of ≥5.

Conclusions

Patients with NVAF and HFpEF have significantly lower anticoagulation rates when compared to their HFrEF counterparts. These findings suggest a potential underappreciation of HFpEF as a risk factor in patients with NVAF.
Disentangling the functional trait correlates of spatial aggregation in tropical forest trees
Authors: McFadden Ian R. , Bartlett Megan K. , Wiegand Thorsten , Turner Benjamin L. , Sack Lawren , Valencia Renato , Kraft Nathan J. B.
Published: December 2018

Environmental filtering and dispersal limitation can both maintain diversity in plant communities by aggregating conspecifics, but parsing the contribution of each process has proven difficult empirically. Here, we assess the contribution of filtering and dispersal limitation to the spatial aggregation patterns of 456 tree species in a hyperdiverse Amazonian forest and find distinct functional trait correlates of interspecific variation in these processes. Spatial point process model analysis revealed that both mechanisms are important drivers of intraspecific aggregation for the majority of species. Leaf drought tolerance was correlated with species topographic distributions in this aseasonal rainforest, showing that future increases in drought severity could significantly impact community structure. In addition, seed mass was associated with the spatial scale and density of dispersal‐related aggregation. Taken together, these results suggest environmental filtering and dispersal limitation act in concert to influence the spatial and functional structure of diverse forest communities.
Sweating disorders in mice with and without nerve lesions
Authors: Guhl Charlotte , Birklein Frank , Hirsch Silke
Published: December 2018

Background

Hypersensitivity and altered sweating are often present in neuropathy patients. Nerve lesions are known to produce sudomotor dysfunctions but also patients suffering from complex regional pain syndrome, CRPS1—a condition without a nerve lesion—present with sweating disorders.

Methods

Using proton nuclear magnetic resonance of sweat water, we quantified sweat output of mice suffering from a nerve lesion or a bone fracture without nerve lesion and correlated their sweating with behavioural paw hypersensitivity accessed in von Frey testings, water applications and weight‐bearing measured with an incapacitance metre.

Results

Lesioned animals sweat less and are hypersensitive compared to healthy controls, as expected. Fractured animals on the injured side sweat less acutely after the injury but more in the chronic phase. They are hypersensitive acutely as well as chronically after the fracture. These findings resemble human bone trauma patients in the acute phase and CRPS patients in the chronic phase.

Conclusions

Sweating disorders are present both in neuropathic animals and in those with a bone fracture without nerve lesions, and autonomic dysfunctions might be considered as an important component in the aetiology of neuropathies.

Significance

Sweat output changes in mice after bone trauma, potentially indicative of posttraumatic processes leading to CRPS in humans.
Developmental changes in functional brain networks from birth through adolescence
Authors: Gozdas Elveda , Holland Scott K. , Altaye Mekibib ,   CMIND Authorship Consortium
Published: December 2018

Investigation of the brain connectome using functional magnetic resonance imaging (fMRI) and measures derived from graph theory analysis has emerged as a new approach to study brain development, cognitive function, and neurophysiological disorders. Here we use graph theory analysis to examine the influence of age, sex, and neurocognitive measures on developmental changes to the global and regional topology of functional brain networks derived from fMRI data recorded in 189 healthy subjects from the age of 0–18 years during rest. We observed that Global Efficiency and Rich‐Club coefficient increased with age and Local Efficiency and Small‐Worldness decreased with age, while Modularity at the global level showed an inverted U‐shaped trajectory during development. Marginally significant differences were observed in Local Efficiency, Small‐Worldness, and Modularity at a global level between boys and girls throughout development. We also examine the effects of neurocognitive measures in boys and girls globally and locally. Our results provide new insight to understand brain maturation of functional brain connectome and its relation to cognitive development from birth through adolescence.
Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer
Authors: Fattouh Michael , Chang Gina Y. , Ow Thomas J. , Shifteh Keivan , Rosenblatt Gregory , Patel Viraj M. , Smith Richard V. , Prystowsky Michael B. , Schlecht Nicolas F.
Published: December 2018

Background

Body mass index (BMI), sarcopenia, and obesity‐related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression.

Methods

We conducted a retrospective analysis of 441 normal‐weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients.

Results

Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3‐0.6) compared to normal‐weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1‐3.9) compared to non‐sarcopenic patients, with the strongest association seen among overweight/obese patients.

Conclusion

Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.
Association between loss of Y chromosome and poor prognosis in male head and neck squamous cell carcinoma
Authors: Hollows Robert , Wei Wenbin , Cazier Jean‐Baptiste , Mehanna Hisham , Parry Gabriella , Halford Graham , Murray Paul
Published: December 2018

Background

Head and neck squamous cell carcinoma (HNSCC) is more prevalent in men than women and this disparity cannot be fully explained by known risk factors. Recent studies have shown that loss of Y chromosome (LoY) confers an increased risk of solid cancer and reduces life expectancy in men.

Methods

Using publicly available data from The Cancer Genome Atlas, we investigated the prevalence of LoY and its association with clinicopathological features in male HNSCC.

Results

LoY was detectable in around 25% of male HNSCC. Men with human papillomavirus‐negative tumors exhibiting LoY experienced significantly worse overall survival than those with no LoY. Moreover, LoY tumors exhibited overexpression of genes involved in redox processes, including genes previously implicated in resistance to both radiotherapy and cisplatin‐based chemotherapeutics.

Conclusion

LoY may be an indicator of poor prognosis in male HNSCC that is linked to the overexpression of genes associated with resistance to standard care therapies.
Prognostic implication of CEACAM1 expression in squamous cell carcinoma of the larynx: Pilot study
Authors: Lucarini Guendalina , Zizzi Antonio , Re Massimo , Sayeed Md. Abu , Di Primio Roberto , Rubini Corrado
Published: December 2018

Background

CEACAM1, a valuable biomarker for several cancers, have remained unexplored up to the present in laryngeal squamous cell carcinoma (LSCC). We aimed to examine CEACAM1 expression and evaluate its combinational clinical significance for the diagnosis or prognosis and treatment decision making in LSCC.

Methods

CEACAM1 expression was assessed by immunohistochemistry in 54 LSCCs and evaluate its correlation with clinical and histopathological features.

Results

CEACAM subtype 1 (CEACAM1) expression was positive in 50% of the cases. No significant difference was observed in relation to age, gender, tumor size, and tumor stage. CEACAM1 expression correlated with tumor grade, development of local recurrence, node and distant metastasis. Kaplan–Meier survival curves showed that CEACAM1 staining was inversely correlated with both overall and disease‐specific 5‐year survival.

Conclusions

Our study is the first to demonstrate that CEACAM1 expression is associated with an adverse prognosis in LSCC. CEACAM1 is a valuable biomarker and a promising therapeutic target in LSCC.
PD‐1 and PD‐L1 in locoregionally advanced nasopharyngeal carcinoma: Substudy of a randomized phase III trial
Authors: Cao Caineng , Wei Qichun , Tang Xiuwen , Jia Yongshi , Sun Xiaonan , Li Wenfeng , Hu Qiaoying , Chen Xiaozhong
Published: December 2018

Background

To evaluate the expression of programmed death‐1 (PD‐1) and programmed death‐ligand 1 (PD‐L1) by using immunohistochemistry analysis in locoregionally advanced nasopharyngeal carcinoma (NPC) patients receiving cisplatin, fluorouracil, and docetaxel followed by concurrent chemoradiotherapy.

Methods

As part of a previously reported trial, 108 patients were enrolled in this study.

Results

We observed that Epstein–Barr Virus (EBV) antibody levels were associated with PD‐1 positive staining in NPC and PD‐1 positive staining was identified as an independent prognostic factor for progression‐free survival (hazard ratio 0.363, 95% confidence interval 0.134‐0.987, P = .047). By contrast, the correlation between the PD‐L1 level and hemoglobin, lactate dehydrogenase and high‐sensitivity C‐reactive protein was not identified. Moreover, high levels of PD‐L1 staining were not significantly associated with clinical outcomes.

Conclusion

NPC patients with negative PD‐1 staining had a significantly reduced survival outcome. Furthermore, patients with positive PD‐1 staining had significantly higher EBV antibody levels.
Numerical simulation to investigate the induced buoyant flow characteristics caused by intensive heat in complex curvilinear geometries
Authors: Savalanpour Hamidreza , Farhanieh Bijan , Afshin Hossein
Published: December 2018

The buoyancy‐induced turbulent flows in complex geometries with internal heat source have important application in enclosure fire dynamics, for example, smoke movement in the situation of fire in tunnels. The majority of computational works studying the fire‐induced hot air movement in such cases use a Cartesian coordinate system. Hence, to simulate curved geometries, the Cartesian grid should be refined so that it comparatively matches the geometry. In the present work, a three‐dimensional numerical method using nonorthogonal curvilinear coordinate system was developed. Numerical simulations were performed to study the flow structures and the heat transfer characteristics of fire‐induced buoyant flow and the effects of using curvilinear coordinates on the result's accuracy and the computational cost. Numerical results were compared with the available experimental data and the results obtained by fire dynamics simulator (FDS) software. The results of the present method showed better agreement with the experimental results when compared with the FDS results.
Dental fluorosis and oral health in the African Esophageal Cancer Corridor: Findings from the Kenya ESCCAPE case–control study and a pan‐African perspective
Authors: Menya Diana , Maina Stephen K. , Kibosia Caroline , Kigen Nicholas , Oduor Margaret , Some Fatma , Chumba David , Ayuo Paul , Middleton Daniel R.S. , Osano Odipo , Abedi‐Ardekani Behnoush , Schüz Joachim , McCormack Valerie A.
Published: December 2018

There are no studies of oral health in relation to esophageal cancer in Africa, or of Eastern Africa's endemic dental fluorosis, an irreversible enamel hypo‐mineralization due to early‐life excessive fluoride intake. During 2014–18, we conducted a case–control study of squamous cell esophageal cancer in Eldoret, western Kenya. Odds ratios (AORs (95% confidence intervals)) were adjusted for design factors, tobacco, alcohol, ethnicity, education, oral hygiene and missing/decayed teeth. Esophageal cancer cases (N = 430) had poorer oral health and hygiene than controls (N = 440). Compared to no dental fluorosis, moderate/severe fluorosis, which affected 44% of cases, had a crude OR of 20.8 (11.6, 37.4) and on full adjustment was associated with 9.4‐fold (4.6, 19.1) increased risk, whilst mild fluorosis (43% of cases) had an AOR of 2.3 (1.3, 4.0). The prevalence of oral leukoplakia and tooth loss/decay increased with fluorosis severity, and increased cancer risks associated with moderate/severe fluorosis were particularly strong in individuals with more tooth loss/decay. Using a mswaki stick (AOR = 1.7 (1.0, 2.9)) rather than a commercial tooth brush and infrequent tooth brushing also independently increased risk. Geographic variations showed that areas of high esophageal cancer incidence and those of high groundwater fluoride levels have remarkably similar locations across Eastern Africa. In conclusion, poor oral health in combination with, or as a result of, high‐altitude susceptibility to hydro‐geologically influenced dental fluorosis may underlie the striking co‐location of Africa's esophageal cancer corridor with the Rift Valley. The findings call for heightened research into primary prevention opportunities of this highly fatal but common cancer.
Smart transport and logistics: A Node‐RED implementation
Authors: Sicari Sabrina , Rizzardi Alessandra , Coen‐Porisini Alberto
Published: December 2018

A clever and efficient management of transport and logistics are fundamental in manufacturer companies, starting to adopt new methodologies, inspired to the emerging industry 4.0 principles. Such a behavior is influenced by the spreading of the Internet of Things (IoT) paradigm, helping to automate a lot of features, if not all, of products' management, from raw materials' purchase order to the final delivery to customers. Small and medium industries must face design issues and noncustomized solutions may not fit with their habitual data flow. Hence, the need of a tool, able to support designers and developers in defining the network architecture and messages' exchange, emerges. To this end, the use of Node‐RED, a flow‐based programming tool for the IoT, is proposed, by providing a comprehensive case study targeted to smart transport and logistics.
Protein changes in gastric epithelial cells RGM‐1 in response to Helicobacter pylori infection
Authors: Lv Zengfa , Zhao Lizhi , Jin Weimin
Published: December 2018

Helicobacter pylori‐induced inflammation significantly increases the risk of gastric cancer. To investigate the role of H. pylori infection in gastric epithelial cell carcinogenesis, flow cytometry was used to analyze the apoptosis of gastric epithelial cells infected by H. pylori. Next, LTQ MS mass spectrometry (MS) was applied to identify protein changes in gastric epithelial cells infected with H. pylori, and then bioinformatics was adopted to analyze the cellular localization and biological function of differential proteins. LTQ MS/MS successfully identified identified 22 differential proteins successfully, including 20 host‐cell proteins and two H. pylori bacterial proteins. Also, human proteins were located in all areas of cells and involved in various cell biological functions. The oncogene proteins p53, p16, and C‐erbB‐2 proteins in H. pylori‐infected RGM‐1 cells were remarkably increased from the analysis by Western blot analysis. H. pylori infection of gastric epithelial cells leads to changes in various protein components in the cell, and enhances the expression of oncogene proteins, thereby increasing the possibility of possibility of carcinogenesis of H. pylori infection.
MicroRNA‐221 regulates osteosarcoma cell proliferation, apoptosis, migration, and invasion by targeting CDKN1B/p27
Authors: Hu Xiao‐Hui , Zhao Ze‐Xue , Dai Jian , Geng De‐Chun , Xu Yao‐Zeng
Published: December 2018

MicroRNAs (miRNAs, miR) are of critical importance in growth and metastasis of cancer cells; however, the underlying functions of miRNAs in osteosarcoma (OS) remain largely unknown. This study was aimed to elucidate the role of miR‐221 in regulating the biological behavior of OS cells. The proliferation ability was examined by cell counting kit‐8 (CCK‐8) and cell cycle assay. The abilities of cell migration, invasion, and apoptosis were monitored by transwell assay and flow cytometry, respectively. The effect of miR‐221 on cyclin‐dependent kinase inhibitor 1B (CDKN1B) expression was evaluated by luciferase assays, real‐time polymerase chain reaction, and Western blot analysis. We found that miR‐221 was elevated in OS cell lines compared with the normal osteoblastic cell line. Transfection of the miR‐221 inhibitor into MG63 and U‐2OS cell lines obviously suppressed cell proliferation, migration, and invasion, which is accompanied with cell cycle arrest in G0/G1 phase. Furthermore, luciferase reporter assays indicated that CDKN1B is directly targeted by miR‐221 in OS cells. Knockdown of CDKN1B inhibited the effects of miR‐221 inhibitor, along with decreased Bax and caspase‐3 and increased cyclin E, cyclin D1, Bcl‐2, Snail, and Twist1 expression. The results suggested that miR‐221 might act as a potentially useful target for treatment of OS.
Long noncoding RNA myocardial infarction–associated transcript regulated the pancreatic stellate cell activation to promote the fibrosis process of chronic pancreatitis
Authors: Liu Hao , Yu Kaihuan , Ma Peng , Xiong Liangkun , Wang Maoming , Wang Weixing
Published: December 2018

Background

Long noncoding RNAs (lncRNAs) play crucial roles in fibrosis process. In our previous RNA‐seq study, we found that lncRNA myocardial infarction–associated transcript (MIAT) was differentially expressed in pancreatic tissues of chronic pancreatitis (CP) patients. However, the function of MIAT in CP remains unknown. This study was aimed to investigate the function and underlying mechanism of MIAT in pancreatic fibrosis.

Materials and Methods

The expression levels of MIAT, miR‐216a‐3p, cyclooxygenase 2 (COX‐2), α‐smooth muscle actin (α‐SMA), and collagen I were estimated by Western blot analysis and qualitative reverse transcription polymerase chain reaction. The relationships between miR‐216a‐3p, MIAT, and COX‐2 were confirmed by luciferase reporter assay. The proliferation of human pancreatic stellate cells (HPaSteCs) was detected by cell counting kit‐8 assay.

Results

We found that MIAT, along with the levels of fibrosis‐related proteins α‐SMA and collagen I, as well as COX‐2 were upregulated, while miR‐216a‐3p was downregulated in transforming growth factor (TGF)‐β1‐stimulated HPaSteCs. Mechanistically, MIAT acted as a molecular sponge for miR‐216a‐3p. Furthermore, we identified COX‐2 as a direct target of miR‐126a‐3p. Additionally, MIAT overturned the inhibitory effect of miR‐216a‐3p overexpression and COX‐2 knockdown on the activation and proliferation of HPaSteCs.

Conclusion

Our study provided mechanistic insights into a critical role for MIAT as a miRNA sponge in CP.
Derivation of preoligodendrocytes from human‐induced pluripotent stem cells through overexpression of microRNA 338
Authors: Nazari Bahareh , Soleimanifar Fatemeh , Kazemi Mansure , Nazari Banafsheh , Enderami Seyed Ehsan , Ai Arman , Sadroddiny Esmaeil , Ebrahimi‐Barough Somayeh , Ai Jafar
Published: December 2018

MicroRNAs (miRNAs) control gene expression at the posttranscriptional level and have a critical role in many biological processes such as oligodendrocyte differentiation. Recent studies have shown that microRNA 338 (miR‐338) is overexpressed during the oligodendrocyte development process in the central nervous system; this finding indicates a potentially important role for miR‐338 in oligodendrocyte development. To evaluate this assumption, we studied the effect of miR‐338 overexpression on promoting the differentiation of oligodendrocyte progenitor cells (OPCs), derived from human‐induced pluripotent stem cells (hiPSC), into preoligodendrocyte. hiPSCs were differentiated into OPCs after treating for 16 days with basic fibroblast growth factor (BFGF), epidermal growth factor (FGF), and platelet‐derived growth factor (PDGF)‐AA. Bipolar OPCs appeared and the expression of OPC‐related markers, including Nestin, Olig2, Sox10, PDGFRα, and A2B5 was confirmed by real‐time polymerase chain reaction (PCR) and immunofluorescence. Then, OPCs were transduced by miR‐338 expressing lentivirus or were treated with triiodothyronine (T3) for 6 days. Data obtained from real‐time PCR and immunofluorescence experiment indicated that preoligodendrocyte markers such as Sox10, O4, and MBP were expressed at higher levels in transduced cells with miR‐338 in comparison with the T3 group. So, the overexpression of miR‐338 in iPSC‐derived OPCs can promote their differentiation into preoligodendrocyte which can be used in cell therapy of myelin‐related diseases.
PI3K‐PKB‐mTOR hyperactivation in relation to nasopharyngeal carcinoma progression and prognosis
Authors: Yu Jian‐Hua , Chen Li , Yu Jian‐Yong , Luo Hong‐Qiang , Wang Ling
Published: December 2018

Nasopharyngeal carcinoma (NPC) has a unique and complex etiology, which is not completely understood. The aim of this study is to investigate the expression patterns of phosphatidylinositol 3‐kinase (PI3K), protein kinase B (PKB), and mammalian target of rapamycin (mTOR) proteins in patients with NPC and their relationship with NPC progression and prognosis. Between January 2008 and March 2010, PI3K, PKB, and mTOR protein expressions were detected using immunohistochemistry among 119 patients with NPC and 30 healthy people. A 5‐year follow‐up was conducted for all patients. Correlations of PI3K, PKB, and mTOR proteins with the clinicopathological features and prognosis of NPC were evaluated using Spearman's rank correlation coefficient and Kaplan‐Meier curve. Cox's regression analysis was performed to analyze the risk factors for the prognosis of NPC. First, PI3K, PKB, and mTOR were highly expressed in patients with NPC. The expressions of PI3K, PKB, and mTOR proteins were associated with T stage, N stage, clinical stage, relapse, and distant metastasis. Meanwhile, PI3K is positively correlated with PKB and PKB is positively correlated with mTOR in NPC. Higher PI3K, PKB, and mTOR protein expressions were related to a shorter survival time and a lower survival rate in NPC. Cox regression analysis revealed that age, T stage, N stage, PI3K, PKB, and mTOR were independent risk factors for NPC patient survival. Altogether, our data suggest that overexpression of PI3K, PKB, and mTOR proteins is an important indicator of poor survival in NPC. In addition, inhibition of PI3K‐PKB‐mTOR signaling may also contribute to the development of new therapeutic strategies for NPC.
The impact of volunteer experience at sport mega‐events on intention to continue volunteering: Multigroup path analysis
Authors: Bang Hyejin , Bravo Gonzalo A. , Mello Figuerôa Katiuscia , Mezzadri Fernando Marinho
Published: December 2018

This study examined the impacts of volunteers’ motivation and satisfaction through Olympic/Paralympic volunteering experiences on their intention to volunteer for future community events and the moderating role of previous volunteering experience in the relationships among motivations, satisfaction, and intention to continue volunteering. A sample of volunteers (N = 4,824) was drawn from the data collected by Nielsen during the Rio 2016 Olympic and Paralympic Games. Responses from a total of 25 items of volunteer motivations, satisfaction, future intention to volunteer, and previous experience status were used for the study's analyses. Path analysis revealed that among the total sample, motivations had direct and indirect (through satisfaction) effects on intention to volunteer. Results of multigroup path analysis showed that the relationships among motivations, satisfaction, and intention vary by returning and first‐time volunteers, supporting the moderating role of prior volunteering experience in the path model. This study provides a systematic examination of how volunteer motivations and satisfaction may operate differently or similarly between returning and first‐time volunteers.
Optimal depth estimation using modified Kalman filter in the presence of non‐Gaussian jitter noise
Authors: Jang Hoon‐Seok , Muhammad Mannan Saeed , Choi Tae‐Sun
Published: December 2018

The consideration of the noise that affects 3D shape recovery is becoming very important for accurate shape reconstruction. In Shape from Focus, when 2D image sequences are obtained, mechanical vibrations, referred as jitter noise, occur randomly along the z‐axis, in each step. To model the noise for real world scenarios, this article uses Lévy distribution for noise profile modeling. Next, focus curves acquired by one of focus measure operators are modeled as Gaussian function to consider the effects of the jitter noise. Finally, since conventional Kalman filter provides good output under Gaussian noise only, a modified Kalman filter, as proposed method, is used to remove the jitter noise. Experiments are carried out using synthetic and real objects to show the effectiveness of the proposed method.
Using Geo‐detector to attribute spatio‐temporal variation of pan evaporation across China in 1961–2001
Authors: Yang Tao , Sun Fubao , Liu Wenbin , Wang Hong , Wang Tingting , Liu Changming
Published: December 2018

Declining pan evaporation (Epan) across many continents in the past decades despite global warming is gaining attention of hydrology and climate science communities. While Geo‐detector is considered useful for attributing the spatio‐temporal variation of a certain geography‐related element, it has not been applied for Epan attribution. Based on the Geo‐detector, we first attribute the spatio‐temporal variation of Epan across China in 1961–2001. The results show that relative humidity is the primary factor influencing the temporal dynamics of Epan, followed by sunshine duration, maximum air temperature and wind speed. In the northwest China (south China and east China), wind speed, air temperature and relative humidity (relative humidity, sunshine duration, wind speed and air temperature) are the dominant factors of Epan variations. The results obtained are comparable to the previous studies using other statistical methods (i.e., the partial differential method, Pearson correlation coefficient and multiple regression), which reveal the usefulness of Geo‐detector for attributing and diagnosing the spatio‐temporal variations of Epan. Moreover, more detailed spatial information and interactions among meteorological elements can be obtained using Geo‐detector. These findings should provide helpful references for understanding the mass and energy budgets at different spatial–temporal scales under global warming.
The spirit of shinise: Lessons from long‐lived Japanese companies
Authors: Krahnke Keiko , Wanasika Isaac , Soltwisch Brandon William
Published: December 2018

Shinise is a Japanese term that refers to a company that has thrived over a long period of time, particularly one that is known and trusted for the quality of its products and unique management practices. A study exploring the main characteristics of three shinise in Kyoto reveals the qualities that have enabled these companies to remain successful over several generations and highlights the differences in values, strategies, and outlook that distinguish them from similar organizations in the United States.
Addressing generational issues in training and development at Aerospace Composites Malaysia
Authors: Bhatti Muhammad Awais , Juhari Ariff Syah , Umrani Waheed Ali
Published: December 2018

The dynamic and hypercompetitive nature of contemporary business has made it more challenging than ever for organizations to design and sustain effective employee training and development programs. A key consideration in preparing these initiatives is the differences in outlook and expectations of the members of Generations X and Y, who tend to be willing to switch jobs more readily than their more senior colleagues. In the case of one Malaysian aircraft parts manufacturer, holding onto skilled workers in all age categories required a reevaluation of traditional methods of employee development. A new emphasis on on‐the‐job instruction featuring the latest technology, complemented with effective coaching and mentoring to facilitate communication and the seamless transfer of knowledge, helped the firm reduce turnover by 10%.
Sentinel lymph node nonvisualization after intratumoral radioisotope tracer injection in breast cancer is not associated with a higher nodal metastasis rate or worse outcomes
Authors: Hellingman Daan , de Wit–van der Veen Berlinda J , Wan Oi Yan , van der Ploeg Iris M , Rutgers Emiel J. Th. , Stokkel Marcel P. M.
Published: December 2018

Background and Objectives

Preoperative lymphoscintigraphy does not always visualize a sentinel lymph node (SLN). The study aim was to investigate whether persistent nonvisualization after additional single‐photon emission computed tomography (SPECT)/CT or a second radiotracer injection in breast cancer patients is associated with nodal metastases or worse outcome due to potential understaging and consequently undertreatment.

Methods

Altogether 2042 consecutive SLN procedures were evaluated. All patients were clinically node‐negative, underwent axillary ultrasound and fine‐needle aspiration cytology (US/FNAC) of suspicious nodes. Lymphoscintigraphy was performed at 3 to 4 hours after intratumoral injection of 99mTc‐nanocolloid. SPECT/CT or a reinjection was performed when initial lymphoscintigraphy showed nonvisualization.

Results

Persistent nonvisualization was seen in 170 of 2042 procedures (8.3%). The nodal metastasis rate was 16.0% vs 18.0% for procedures with nonvisualization vs SLN visualization, respectively (P = 0.593). The regional recurrence rate of tumor‐negative SLN biopsy procedures was equal between the nonvisualization (0.7%, 11 of 1535) vs visualization (0.7%, 1 of 144) group. Median follow‐up was 48 months. Distant–metastasis free interval and overall survival was not significantly different between both groups (
P = 0.164 and 0.208, respectively).

Conclusions

Persistent nonvisualization after lymphoscintigraphy plus SPECT/CT or radiotracer reinjection is not associated with a higher nodal metastasis rate or worse long term outcome when preoperative US/FNAC is performed.
Intracorporeal classic circular‐stapled gastrojejunostomy and jejunojejunostomy during laparoscopic distal gastrectomy: A simple, safe “intraluminal poke technique” for anvil placement
Authors: Du Jianjun , Xue Hongyuan , Hua Jin , Zhao Lizhi , Zhang Ziqiang
Published: December 2018

Background

Totally laparoscopic distal gastrectomy is being increasingly performed. However, an optimal procedure to achieve intracorporeal gastrojejunostomy and jejunojejunostomy for Roux‐en‐Y reconstruction after laparoscopic distal gastrectomy remains to be established. Compared with the simple and preferable circular‐stapled Roux‐en‐Y reconstruction in open gastrectomy, application of intracorporeal circular‐stapled gastrojejunostomy and jejunojejunostomy of Roux‐en‐Y reconstruction during laparoscopic distal gastrectomy have been limited (no report of intracorporeal circular‐stapled jejunojejunostomy) because of the difficulties of intracorporeal purse‐string suture and anvil placement. To address these problems, a simple and safe intraluminal poke technique of universal surgical concept and procedure was introduced and evaluated.

Methods

Between March 2018 and August 2018, 24 consecutive patients with gastric cancer underwent totally laparoscopic distal gastrectomy in our hospital. Roux‐en‐Y reconstruction of intracorporeal circular‐stapled gastrojejunostomy and jejunojejunostomy with the intraluminal poke technique was performed in all patients. Demographic and clinicopathologic characteristics, perioperative details and postoperative outcomes were analyzed.

Results

The mean operative time was 203.6±26.2min, both proximal and distal tumor‐free margins were achieved in all patients. The time for anvil placement at stomach and intestine was 5.9±1.3min and 3.9±0.7min, respectively. Intracorporeal gastrojejunostomy and jejunojejunostomy were successively completed following anvil placement with no any anastomosis‐related sutures. There were 5 postoperative complications. Morbidities included pancreas fistula (n=1), stasis (n=2), atelectasis (n=1), pneumonia (n=1). These all patients recovered after conservative treatment. No postoperative anastomosis‐related complications, such as anastomotic bleeding and leakage, or stenosis occurred during the median follow‐up of 6.5 months.

Conclusion

The initial results suggest that the technique allowing easy and common anvil placement at stomach and intestine may be a simple, safe, preferable and time‐saving procedure to accomplish intracorporeal circular‐stapled gastrojejunostomy and jejunojejunostomy of Roux‐en‐Y reconstruction in totally laparoscopic distal gastrectomy as open surgery.
Simulation‐Guided Tracheotomy in a Patient With Fibrodysplasia Ossificans Progressiva
Authors: Padia Reema , Miller Craig , Patak Lance , Friedman Seth D. , Stone Kimberly , Otjen Jeffrey , Johnson Kaalan
Published: December 2018

Fibrodysplasia ossificans progressiva (FOP) is a rare disorder that causes heterotopic bone formation leading to chest wall and spinal deformities. This case describes an 11‐year‐old female with FOP who presented in respiratory failure necessitating two emergent fiberoptic nasotracheal intubations. The patient had severe trismus, rotary flexion of the neck, and distortion of the airway. A three‐dimensional printed model based off of a computed tomography reconstruction was created for an in situ simulation before the true procedure. The surgery and trach change were both uneventful. We propose that with careful preoperative planning, tracheotomy can be an appropriate option for FOP patients. Laryngoscope, 129:812–817, 2019
Patient‐reported versus physiologic swallowing outcomes in patients with head and neck cancer after chemoradiation
Authors: Kirsh Elliana , Naunheim Matthew , Holman Allison , Kammer Rachel , Varvares Mark , Goldsmith Tessa
Published: December 2018

Objective

The primary objective of this project was to retrospectively investigate the relationship between patient‐reported and physiologic swallowing measures after chemoradiation therapy for head neck cancer (HNC).

Methods

Adult patients who underwent chemoradiation therapy for HNC and presented for videofluoroscopic swallow study were reviewed retrospectively. Surgically treated patients were excluded. Patient perception of swallowing‐related outcomes was assessed via the MD Anderson Dysphagia Inventory (MDADI) on the same day that physiologic measures of swallow function were obtained. Using vidoefluoroscopic data, the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale yielded measures of safety (DIGEST‐S: penetration/aspiration) and efficiency (DIGEST‐E: residue). Statistical analysis for correlation coefficients was performed.

Results

Thirty patients met the inclusion criteria. The oropharynx was the most commonly affected site (70.0%), followed by the larynx (16.7%). The median radiation dose was 72 grays (Gy), and participants were assessed a mean of 4.6 (range 0–12) years following completion of treatment. There was no correlation between the MDADI and the DIGEST‐E score (Pearson rho = −0.045, P = 0.812), DIGEST‐S score (Pearson rho = 0.075, P = 0.695), or summary DIGEST grade (Pearson rho = 0.046, P = 0.810). MDADI scores did not change significantly with increasing time since radiation (P = 0.375), whereas the DIGEST‐E scores, DIGEST‐S score, and summary DIGEST grades worsened over time (P = 0.007, P = 0.002, and P = 0.0005, respectively).

Conclusion

Assessment of swallowing physiology showed that function worsened after chemoradiation therapy, but this did not correlate with patient‐reported quality‐of‐life measures. Reduced patient awareness of swallow dysfunction years after completion of chemoradiation has implications for management of dysphagia in the face of physiologic decline.

Level of Evidence

4

Laryngoscope, 129:2059–2064, 2019
Risk and outcomes for second primary human papillomavirus–related and –unrelated head and neck malignancy
Authors: Adjei Boakye Eric , Buchanan Paula , Hinyard Leslie , Stamatakis Katie , Osazuwa‐Peters Nosayaba , Simpson Matthew C. , Schootman Mario , Piccirillo Jay F.
Published: December 2018

Objectives/Hypothesis

To 1) examine the characteristics of patients who develop second primary malignancies (SPMs) from an index human papillomavirus (HPV)‐related head and neck squamous cell carcinoma (HNSCC) and HPV‐unrelated HNSCC and to 2) compare overall survival between those with HPV‐related and HPV‐unrelated index HNSCC among patients who develop SPM.

Study Design

Retrospective cohort analysis.

Methods

A retrospective study was conducted of 113,259 patients who were diagnosed with HNSCC from 2000 to 2014. SPM was defined as the first subsequent primary cancer occurring at least 2 months after index cancer diagnosis, and HPV‐relatedness was based on whether patients’ index HNSCC was potentially HPV‐related or HPV‐unrelated. Multivariable Fine and Gray (FG) competing‐risks regression models were used to estimate factors associated with risk of SPM by HPV‐relatedness. Among patients with SPM, an adjusted Cox proportional hazards (PH) regression model was used to assess the association between HPV‐relatedness and survival.

Results

Approximately 13,900 patients (12.3%) developed SPM. In the FG model, patients with HPV‐unrelated HNSCC had a 15% higher risk of developing SPM (adjusted hazard ratio: 1.15, 95% confidence interval: 1.10‐1.20) than those with potentially HPV‐related HNSCC, but the same characteristics were associated with SPM development. In the Cox PH model, patients with SPM whose index HNSCC was HPV‐unrelated had higher risk of death than those whose index HNSCC was potentially HPV‐related (adjusted hazard ratio: 1.06; 95% confidence interval: 1.02‐1.11).

Conclusions

Patients with HPV‐unrelated HNSCC have a higher risk of SPM development than do those with HPV‐related HNSCC. Effective secondary disease‐prevention strategies should be established to improve long‐term patient outcomes.

Level of Evidence

NA

Laryngoscope, 129:1828–1835, 2019
Morbidity after pediatric tonsillotomy versus tonsillectomy: A population‐based cohort study
Authors: Odhagen Erik , Stalfors Joacim , Sunnergren Ola
Published: December 2018

Objectives/Hypothesis

To compare and evaluate morbidity following pediatric tonsillectomy (TE) and tonsillotomy (TT) performed due to tonsil‐related upper airway obstruction.

Study Design

Retrospective population‐based cohort study based on data from the Swedish National Patient Register (NPR).

Methods

All patients aged 1 to 12 years who were registered in the NPR between January 1, 2007 and December 31, 2015, and who underwent an isolated tonsil surgery (± adenoidectomy) for the sole indication of upper airway obstruction were included. Postoperative morbidity within 30 days of surgery, including readmission due to hemorrhage and return to theater (RTT), was evaluated and compared between the two groups. A forward stepwise multivariable logistic regression analysis was used to identify independent predictors of postoperative morbidity.

Results

In total, 35,060 patients were included in the study, 23,447 of whom underwent TT and 11,613 of whom underwent TE. Readmission due to postoperative hemorrhage, RTT, readmission due to any reason, and contact with healthcare were all less common after TT than after TE. Readmission due to postoperative hemorrhage was significantly more common after TE (2.5%) than after TT (0.6%) (odds ratio: 3.91, 95% confidence interval: 3.20‐4.77).

Conclusions

This study showed that TT is associated with a statistically significantly lower risk of postoperative complications than TE when performed in children to correct tonsil‐related upper airway obstruction. Statistically significant differences were found for all outcome variables, namely, readmission to hospital due to bleeding, RTT, readmission due to any reason, and postoperative contact with healthcare for any reason.

Level of Evidence

2b Laryngoscope, 129:2619–2626, 2019
Disparities in adherence to head and neck cancer follow‐up guidelines
Authors: Perlow Haley K. , Ramey Stephen J. , Cassidy Vincent , Kwon Deukwoo , Farnia Benjamin , Nicolli Elizabeth , Samuels Michael A. , Freedman Laura , Elsayyad Nagy , Yechieli Raphael , Samuels Stuart E.
Published: December 2018

Objectives

In this study, we aim to determine the frequency of adherence to National Comprehensive Cancer Network follow‐up guidelines in a population of head and neck cancer patients who received curative treatment. We will also assess the impact of race, ethnicity, socioeconomic status, and treatment setting on utilization of follow‐up care.

Methods

This study included patients with biopsy‐proven, nonmetastatic oropharyngeal or laryngeal cancer treated with radiotherapy between January 1, 2014, and June 30, 2016, at a safety‐net hospital or adjacent private academic hospital. Components of follow‐up care analyzed included an appointment with a surgeon or radiation oncologist within 3 months and posttreatment imaging of the primary site within 6 months. Univariable and multivariable analyses were conducted using a logistic regression model to estimate odds ratios and corresponding 95% confidence intervals.

Results

Two hundred and thirty‐four patients were included in this study. Of those, 88.8% received posttreatment imaging of the primary site within 6 months; 88.5% attended a follow‐up appointment with a radiation oncologist within 3 months; and 71.1% of patients attended a follow‐up appointment with a surgeon within 3 months. On multivariable analysis, private academic hospital treatment versus safety‐net hospital treatment was associated with increased utilization of both surgical and radiation oncology follow‐up. Non‐Hispanic black (NHB) patients, Hispanic patients, and those with a low socioeconomic status were also less likely to receive follow‐up.

Conclusion

Safety‐net hospital treatment, socioeconomic status, Hispanic ethnicity, and NHB race were associated with decreased follow‐up service utilization. Quality improvement initiatives are needed to reduce these disparities.

Level of Evidence

2b

Laryngoscope, 129:2303–2308, 2019