bluuebunny/crossref_metadata_2025 huggingface dataset:
Scores in Space: Multidimensional Scaling of the WISC-V
Authors: Meyer Emily M. , Reynolds Matthew R.
Published: March 2017

The purpose of this study was to use multidimensional scaling (MDS) to investigate relations among scores from the standardization sample of the Wechsler Intelligence Scale for Children–Fifth edition (WISC-V; Wechsler, 2014). Nonmetric two-dimensional MDS maps were selected for interpretation. The most cognitively complex subtests and indexes were located near the center of the maps. Subtests were also grouped together in the way that they are organized in the primary and complementary indexes, and not necessarily on content surface features. Naming Speed and Symbol Translation scores may be better off kept as separate indexes, and Digit Span Sequencing appeared to add more complexity to the Digit Span subtest. One implication related to score interpretation is that General Ability Index (GAI) and Cognitive Proficiency Index (CPI) may be distinguished by the level of complexity of the subtests included in each index (i.e., more complex subtests included in GAI and less complex subtests included in the CPI).
Schooling, Learning Disposition, and Life Course Transitions: A Life History Study on Korean Elite Adult Learners
Authors: Choi Seonjoo
Published: March 2017

This article analyzes the crystallized learning disposition formed in secondary schools and its persistent influence on the transition between educational sectors and the workplace. Using interview data from eight adults who graduated from a prestigious university in Korea, this study reveals that exam-inclined self-direction, a manner of self-direction without self, is strongly associated with types of knowledge and the method of constructing the self under extreme ranking competition. Exam-inclined self-direction, firmly ingrained in the students, has momentum beyond secondary schools, in which it was cultivated, and has constrained some of their life choices. This article problematizes some ideas of self-direction and discusses exam-inclined self-direction as socially and institutionally conditioned, as well as the reason it has survived in the Korean social context. Finally, this article calls for the in-depth investigation of a new category of learner, exam-friendly adult learners.
Analysis of mechanical behaviors of internal helically wound strand wires of stranded wire helical spring
Authors: Li Xiaoyong , Liang Liang , Wu Shijing
Published: March 2017

A stranded wire helical spring is a cylindrical helical spring, which is usually composed of an optional core wire and several layers of twisted external wires. The mechanical behavior of the internal helically wound strand wire is critical to determining the spring performance. Based on the previous studies of the mechanical properties of wire rope, a mathematical model to calculate the curvature of the helically wound strand wires, twist, and contact force among the adjacent wires of strand wires spring is established when the spring is subjected to axial load. The proposed kinematics is based on the assumption that there is no friction among the adjacent wires. Furthermore, a parametric study of factors influencing the curvature, twist, and contact force, such as the helix angle of spring and strand and deformation types, is committed for understanding of the mechanical characteristics of the helically wound strand wires with different geometric parameters. It is found that the curvature and twist are strongly dependent upon the two angles. Moreover, this study can provide significant reference for the design and manufacturing of the spring to control the contact force among external wires.
Relative Physical Position as an Impression-Management Strategy: Sex Differences in Its Use and Implications
Authors: Makhanova Anastasia , McNulty James K. , Maner Jon K.
Published: March 2017

People’s physical position relative to others may shape how those others perceive them. The research described here suggests that people use relative physical position to manage impressions by strategically positioning themselves either higher or lower relative to ostensible observers. Five studies supported the prediction that women take and display photographs portraying themselves in a low relative physical position to highlight their youthful features and appear attractive, whereas men take and display photographs portraying themselves in a high relative physical position to highlight their size and appear dominant. The effectiveness of these strategies was confirmed in two studies that measured social perceptions of male and female targets who varied in their relative position. In sum, as do members of other social species, people use relative physical position to manage social impressions, and although these impression-management strategies may have deep ancestral roots, they appear to manifest themselves through a contemporary human modality—photographs.
Premature Mortality From Noncommunicable Diseases in the Federated States of Micronesia, 2003-2012
Authors: Gopalani Sameer Vali , Samo Marcus , Soaz Siocy , David Wincener J. , Mori Scott , Luther X-ner , Carter Karen L.
Published: March 2017

This study was conducted to assess status, and understand burden, of premature and leading causes of deaths from noncommunicable diseases (NCDs) in the Federated States of Micronesia (FSM). From 2003 to 2012, ICD-10 coded mortality data from the national Health Information System were analyzed. Proportional mortality was calculated and a ranking list of the leading causes of premature death was produced. Of the 2349 premature deaths reported, 1970 (83.9%) were due to NCDs, and 1680 (71.5%) were from 4 main NCD groups—cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. Diabetes (19.5%), ischemic heart diseases (13.2%), and cerebrovascular diseases (7.1%) were the leading causes of premature deaths. The findings indicate that the burden of premature NCD deaths in FSM is higher than global levels, and existing efforts need to be strengthened to alter their course.
Zedoary Guaiane-Type Sesquiterpenes-Eluting Stents Accelerate Endothelial Healing Without Neointimal Hyperplasia in a Porcine Coronary Artery Model
Authors: Cui Yuanyuan , Zhao Fuhai , Liu Jiangang , Wang Xin , Du Jianpeng , Shi Dazhuo , Chen Keji
Published: March 2017

Objective:

The effects of zedoary guaiane-type sesquiterpenes (ZGS)-based eluting stent (ZES) in accelerating reendothelialization and inhibiting neointimal hyperplasia were examined in a porcine coronary artery model.

Methods:

The ZES was prepared by polymer-free 316L stainless metal stents. Sirolimus-eluting stents (SES) and bare metal stents (BMS) with identical platforms were used as controls. Stents with 15 mm in length and 2.0 to 3.5 mm in diameter were implanted in porcine coronary arteries. Scanning electron microscopy (SEM) and histopathology were performed to assess the reendothelialization and neointimal hyperplasia. The 3-(4, 5-dimethylthiazol-2yl)-2, 5-diphenyl-2H-tetrazoliumbromide assay and flow cytometry were used to assess the influence of ZGS on human umbilical vascular endothelial cells (HUVECs).

Results:

At 7 days, SEM showed that percentage of endothelial coverage area was 94.04% ± 5.01% for ZES, 47.59% ± 19.91% for SES ( P < .01 for ZES vs SES), and 59.58% ± 19.61% for BMS ( P < .05 for ZES vs BMS). At 28 days, the percentage of coverage area was 98.51% ± 1.86% for ZES, 86.18% ± 8.16% for SES ( P < .05 for ZES vs SES), and 94.26% ± 5.58% for BMS. Neointimal area and stenosis were significantly lower in ZES (1.07 ± 0.48 mm2, 27.66% ± 12.20%) compared to BMS (1.73 ± 0.69 mm2, 44.08% ± 15.03%, both P < .01, respectively), with no difference in SES (0.94 ± 0.12 mm2, 28.87% ± 6.00%, both P > .05, respectively). The ZGS also promoted HUVECs viability and improved HUVECs proliferation compared to sirolimus.

Conclusion:

The ZES accelerated reendothelialization and suppressed neointimal hyperplasia in a porcine coronary artery model, with beneficial effects on HUVECs.
A GPU-accelerated continuous and discontinuous Galerkin non-hydrostatic atmospheric model
Authors: Abdi Daniel S , Wilcox Lucas C , Warburton Timothy C , Giraldo Francis X
Published: March 2017

We present a Graphics Processing Unit (GPU)-accelerated nodal discontinuous Galerkin method for the solution of the three-dimensional Euler equations that govern the motion and thermodynamic state of the atmosphere. Acceleration of the dynamical core of atmospheric models plays an important practical role in not only getting daily forecasts faster, but also in obtaining more accurate (high resolution) results within a given simulation time limit. We use algorithms suitable for the single instruction multiple thread architecture of GPUs to accelerate our model by two orders of magnitude relative to one core of a CPU. Tests on one node of the Titan supercomputer show a speedup of up to 15 times using the K20X GPU as compared to that on the 16-core AMD Opteron CPU. The scalability of the multi-GPU implementation is tested using 16,384 GPUs, which resulted in a weak scaling efficiency of about 90%. Finally, the accuracy and performance of our GPU implementation is verified using several benchmark problems representative of different scales of atmospheric dynamics.
A Novel Biomarker Panel to Identify Steroid Resistance in Childhood Idiopathic Nephrotic Syndrome
Authors: Bennett Michael R , Pleasant LaTawnya , Haffner Christopher , Ma Qing , Haffey Wendy D , Ying Jun , Wagner Michael , Greis Kenneth D , Devarajan Prasad
Published: March 2017

Idiopathic nephrotic syndrome (NS) is the most common glomerular disorder of childhood. Response to initial treatment with corticosteroids is an indicator of prognosis, as resistant patients often present more progressive disease. In this cross-sectional pilot study, we set out to discover a panel of noninvasive biomarkers that could distinguish steroid-resistant nephrotic syndrome (SRNS) from steroid-sensitive nephrotic syndrome (SSNS). Information gleaned from such a panel could yield more individualized treatment plans and prevent unnecessary steroid exposure in patients unlikely to respond. Urine was collected from 50 pediatric patients diagnosed with idiopathic NS at Cincinnati Children’s Hospital Medical Center. Isobaric tags for relative and absolute quantitation (iTRAQ) was used to discover 13 proteins that were differentially expressed in SSNS vs SRNS in a small 5 × 5 discovery cohort. Suitable assays were found for 9 of the 13 markers identified by iTRAQ and were used in a 25 SRNS × 25 SSNS validation cohort. Vitamin D–binding protein (VDBP), alpha-1 acid glycoprotein 1 (AGP1), alpha-1 acid glycoprotein 2 (AGP2), alpha-1-B glycoprotein (A1BG), fetuin-A, prealbumin, thyroxine-binding globulin and hemopexin, and alpha-2 macroglobulin were measured and combined with urine neutrophil gelatinase–associated lipocalin (NGAL), which had been previously shown to distinguish patients with SRNS. Urinary VDBP, prealbumin, NGAL, fetuin-A, and AGP2 were found to be significantly elevated in SRNS using univariate analysis, with area under the receiver operating characteristic curves (AUCs) ranging from 0.65 to 0.81. Multivariate analysis revealed a panel of all 10 markers that yielded an AUC of 0.92 for identification of SRNS. A subset of 5 markers (including VDBP, NGAL, fetuin-A, prealbumin, and AGP2) showed significant associations with SRNS and yielded an AUC of 0.85.
Magnetic Resonance Imaging Detection of Intraplaque Hemorrhage
Authors: McNally J Scott , Kim Seong-Eun , Mendes Jason , Hadley J Rock , Sakata Akihiko , De Havenon Adam H , Treiman Gerald S , Parker Dennis L
Published: March 2017

Carotid artery atherosclerosis is a major cause of ischemic stroke. For more than 30 years, future stroke risk and carotid stroke etiology have been determined using percent diameter stenosis based on clinical trials in the 1990s. In the past 10 years, magnetic resonance imaging (MRI) sequences have been developed to detect carotid intraplaque hemorrhage. By detecting carotid intraplaque hemorrhage, MRI identifies potential stroke sources that are often overlooked by lumen imaging. In addition, MRI can dramatically improve assessment of future stroke risk beyond lumen stenosis alone. In this review, we discuss the use of heavily T1-weighted MRI sequences used to detect carotid intraplaque hemorrhage. In addition, advances in ciné imaging, motion robust techniques, and specialized neck coils will be reviewed. Finally, the clinical use and future impact of MRI plaque hemorrhage imaging will be discussed.
Critical junctures: place-based storytelling in the Big Stories, Small Towns participatory documentary project
Authors: Potter Martin
Published: March 2017

Since 2008, the multi-year and multi-platform Big Stories, Small Towns documentary project (bigstories.com.au) has facilitated the telling, recording, archiving and dissemination of auto/biographical narratives in Australia, Cambodia, West Papua, Malaysia and Indonesia. Through this work, a critical juncture has been identified in the mediascape where reconstruction can materialise. While a level of interconnectivity has always underpinned storytelling within communities, shifting global dynamics and new mediums allow for an alternative examination of multi-layered communities and the complex relations between people, social backgrounds, technology/media and place. I argue that this represents a fundamental shift away from a centralised vision of storymaking (i.e. author/documenter-centric) to a collectivised storytelling practice. Thus, this article moves attention from the rhetoric of texts to practices of community organisation and the technological and embodied material relations, which aspire to produce a collectively enacted sense of place and identity.
Using tele-emergency to avoid patient transfers in rural emergency departments: An assessment of costs and benefits
Authors: Natafgi Nabil , Shane Dan M , Ullrich Fred , MacKinney A Clinton , Bell Amanda , Ward Marcia M
Published: March 2017

Introduction

Tele-emergency can address several challenges facing emergency departments in rural areas. The purpose of this paper is to (a) examine the rates of avoided transfers in rural emergency departments that adopted tele-emergency applications; and (b) estimate the costs and benefits of using tele-emergency to avoid transfers.

Methods

Analysis is based on 9048 tele-emergency encounters generated by the Avera eEmergency programme (Sioux Falls, South Dakota) in 85 rural hospitals across seven states between October 2009–February 2014. For each non-transfer patient, physicians indicated whether the transfer was avoided because of tele-emergency activation. The cost-benefit analysis is conducted from the hospital, patient and societal perspectives, and includes technology costs, local hospital revenues and patient-associated savings. All monetary values are expressed in US$. Sensitivity analysis is conducted by examining the worst and best case scenarios of costs, revenues and savings.

Results

In these analyses, 1175 avoided transfers were attributed to tele-emergency. From a rural hospital perspective, tele-emergency costs around US$1739 to avoid a single transfer. However, tele-emergency saves around US$5563 in avoided transportation and indirect patient costs. Combining these, from a societal perspective, tele-emergency has the potential to result in a net savings of US$3823 per avoided transfer while accounting for tele-emergency technology costs, hospital revenues, and patient-associated savings.

Conclusion

This study highlights various stakeholder perspectives on the financial impact of tele-emergency in avoiding patient transfers in rural emergency departments. Telemedicine has the potential to reduce the number of transfers of emergency department patients and generate some revenue for rural hospitals despite associated technology costs, while incurring substantial patient savings.
Objectively measured physical activity and 12-month trajectories of neck–shoulder pain in workers: A prospective study in DPHACTO
Authors: Hallman David M. , Birk Jørgensen Marie , Holtermann Andreas
Published: March 2017

Aims: This study aimed to investigate the association between objectively measured physical activity at work and leisure and the intensity (mean level and time course) of neck–shoulder pain (NSP) over 12 months among male and female blue collar workers. Methods: Data were obtained from 625 blue collar workers from the Danish cohort DPHACTO. Physical activity was measured objectively at baseline using accelerometers. The percentage of time spent in physical activity (walking, climbing stairs, running and cycling) was calculated for both work and leisure time. Longitudinal data on the intensity of NSP (numerical rating scale 0–10) were collected using text messages every fourth week over 12 months. Linear mixed models were used to investigate the associations between occupational physical activity (OPA) and leisure time physical activity (LTPA) and the trajectories of the intensity of NSP, adjusted for individual, biomechanical and psychosocial factors, and baseline pain. Results: OPA was not associated with the mean intensity of NSP over 12 months. LTPA was negatively associated with the mean intensity of NSP both among men ( B=−0.71, 95% CI −1.31 to −0.11) and women ( B=−0.85, 95% CI −1.57 to −0.13). Sex interactions on the 12-month trajectories of NSP showed that higher physical activity was associated with a slower reduction in NSP among men for OPA only ( B=0.03, 95% CI 0.01-0.05) and women for LTPA only ( B=0.05, 95% CI 0.00-0.09). Conclusions: We found that more time in LTPA was associated with a lower overall intensity of NSP over 12 months among blue collar workers. However, depending on sex and domain, high physical activity had an unfavourable effect on the course of NSP over 12 months.
Consumption of healthy foods and associated socio-demographic factors among Russian, Somali and Kurdish immigrants in Finland
Authors: Adebayo Folasade A. , Itkonen Suvi T. , Koponen Päivikki , Prättälä Ritva , Härkänen Tommi , Lamberg-Allardt Christel , Erkkola Maijaliisa
Published: March 2017

Aims: We evaluated the consumption of healthy foods among Russian, Somali and Kurdish immigrants in Finland, and examined the relationship between socio-demographic factors and food consumption. Methods: We used data from the Migrant Health and Wellbeing Study (Maamu), a population-based health interview and examination survey in six different municipalities in Finland between 2010 and 2012. Altogether, 635 men and 737 women, aged 18–64 years, of Russian ( n = 527), Somali ( n = 337) and Kurdish ( n = 508) origin were included. The important socio-demographic determinants of healthy food consumption – sex, age, education, place of residence and household size – were assessed by logistic regression. Results: Based on the consumption frequencies of recommended healthy foods – fruits, berries, vegetables, fish and rye bread – immigrants of Russian origin had higher consumption of healthy foods than their peers of Kurdish and Somali origin. Low consumption of fresh vegetables, fruits and berries was found among Somali immigrants. Sex and age were the most important determinants of healthy food consumption, as women and older age groups had diets closer to the national nutrition recommendations. High educational level was also positively associated with healthy food consumption. Conclusions: We found ethnic differences in the consumption of healthy foods among the immigrant groups of Russian, Somali and Kurdish origin in Finland. Socio-demographic factors, especially age, sex and education, seem to also play an important role in immigrants’ food consumption. Further studies examining the consumption of fruits, berries and fresh vegetables among Somali immigrants in Finland are needed.
Pre-pregnancy body mass index and inter-pregnancy weight change among women of Russian, Somali and Kurdish origin and the general Finnish population
Authors: Bastola Kalpana , Koponen Päivikki , Härkänen Tommi , Gissler Mika , Kinnunen Tarja I
Published: March 2017

Objectives: We studied the differences in the mean pre-pregnancy body mass index (BMI) and mean inter-pregnancy weight change in women of Russian, Somali and Kurdish origin and women in the general Finnish population. Methods: The population-based samples were from the Migrant Health and Wellbeing Study and the Health 2011 Survey conducted in six cities in Finland in 2010–2012. This study included women with at least one birth in Finland. Data on their previous pregnancies in Finland were obtained from the National Medical Birth Register for 318 Russian, 584 Somali and 373 Kurdish origin women and for 243 women in the general Finnish population (reference group). Data on pre-pregnancy weight and height were self-reported in early pregnancy. Linear logistic regression was the main method of analysis. Results: The unadjusted mean pre-pregnancy BMI was higher in Somali (27.0 kg/m2, p<0.001) and Kurdish (25.8 kg/m2, p<0.001) women, but lower in Russian (22.2 kg/m2, p<0.001) women than in the reference group (24.1 kg/m2). The adjusted coefficients for the difference in the mean pre-pregnancy BMI were −1.93 (95% CI −2.77 to −1.09) for Russian, 1.82 (95% CI 0.89–2.75) for Somali and 1.30 (95% CI 0.43–2.17) for Kurdish women compared with the reference group. Among women with at least two births, no statistically significant difference was observed in the mean inter-pregnancy weight change between the migrant groups and the reference group. Conclusions: Somali and Kurdish women had higher mean pre-pregnancy BMIs than women in the general Finnish population and may need special support and health promotion strategies for weight management.
Preventing Violence: A Public Health Participatory Approach to Homicide Reviews
Authors: O’Malley Teagen L. , Documét Patricia I. , Burke Jessica G. , Garland Richard , Terry Art , Slade Roland L. , Albert Steven M.
Published: March 2017

Death review teams are a common method for assessing preventable deaths, yet they rarely review adult homicides and do not typically include community members. Academic–community partnerships can enhance public health research by encouraging translation of research into practice and support a data-driven approach to improve community health and well-being. We describe the Pittsburgh Homicide Review Group, a community-partnered initiative to prevent future homicides through data review and community dialogue. Group members reviewed all 42 Pittsburgh 2012 homicides informed by three primary data sources: publicly available data, local service databases, and community outreach resources. Thirty-two individuals representing relevant county agencies and community groups participated in eight reviews. Data sharing among partners resulted in a comprehensive understanding of the context of homicides. Review meetings supported a collective discussion around potential contributing factors to homicides, intervention implications, and recommendations. Academic–community homicide review partnerships are a productive approach to inform homicide prevention and interventions that are relevant to communities and should be implemented widely.
Osteoclasis for the Treatment of Recalcitrant Diabetic Forefoot Ulceration
Authors: Graney Colin , Thorud Jakob C. , Murdoch Douglas
Published: March 2017

Recurrence after diabetic foot ulceration is a common occurrence after healing. Curative surgery has been suggested to reduce the incidence of recurrent ulcerations. Osteoclasis is a simple procedure used to fracture the metatarsal head in attempt to reduce pressure under the affected metatarsal without transferring excessive pressure to adjacent metatarsals. We present a case study of a 65-year-old diabetic male with multiple attempts to heal and maintain a healed ulceration who underwent an osteoclasis procedure. Following this patient for 3 years (until time of death), no recurrent or new ulcerations had occurred. Further studies should be conducted to identify if this result is reproducible prior to widespread use.
Comparison of the Neutrophil/Lymphocyte Ratio and C-Reactive Protein Levels in Patients With Amputation for Diabetic Foot Ulcers
Authors: Metineren Hasan , Dülgeroğlu Turan Cihan
Published: March 2017

This study compared the effectiveness of the neutrophil/lymphocyte ratio (NLR) versus C-reactive protein (CRP) for evaluating the prognosis and degree of inflammation in patients with amputation for a diabetic foot ulcer (DFU). This study enrolled 56 patients with amputations for DFU with gangrene and compared the CRP levels and NLR measured before and after surgery. Overall, 24 patients (42%) died within 2 weeks postoperatively. Mortality increased with a preoperative/postoperative CRP difference ≤1.5 ( P < .001) and age 73 years or older ( P < .001). The postoperative NLR was lower than the preoperative value but was not significant as a prognostic or inflammatory marker ( P = .945). An increasing serum CRP level is a significant predictor of mortality. CRP and old age are reliable prognostic factors in patients with DFU.
A Clinicoepidemiological Profile of Chronic Wounds in Wound Healing Department in Shanghai
Authors: Sun Xiaofang , Ni Pengwen , Wu Minjie , Huang Yao , Ye Junna , Xie Ting
Published: March 2017

The aim of the study was to update the clinical database of chronic wounds in order to derive an evidence based understanding of the condition and hence to guide future clinical management in China. A total of 241 patients from January 1, 2011 to April 30, 2016 with chronic wounds of more than 2 weeks’ duration were studied in wound healing department in Shanghai. Results revealed that among all the patients the mean age was 52.5 ± 20.2 years (range 2-92 years). The mean initial area of wounds was 30.3 ± 63.0 cm2 (range 0.25-468 cm2). The mean duration of wounds was 68.5 ± 175.2 months (range 0.5-840 months). The previously reported causes of chronic wounds were traumatic or surgical wounds (n = 82, 34.0%), followed by pressure ulcers (n = 59, 24.5%). To study the effects of age, patients were divided into 2 groups: less than 60 years (<60), and 60 years or older (≥60). The proportion of wounds etiology between the 2 age groups was analyzed, and there was significant statistical difference ( P < .05, 95% confidence interval [CI] = 0.076-0.987). To study the associations between outcome and clinical characteristics in chronic wounds, chi-square test was used. There were significant differences in the factor of wound infection. ( P = .035, 95% CI = 0.031-0.038) Regarding therapies, 72.6% (n = 175) of the patients were treated with negative pressure wound therapy. Among all the patients, 29.9% (n = 72) of them were completely healed when discharged while 62.7% (n = 150) of them improved. The mean treatment cost was 12055.4 ± 9206.3 Chinese Yuan (range 891-63626 Chinese Yuan). In conclusion, traumatic or surgical wounds have recently become the leading cause of chronic wounds in Shanghai, China. Etiology of the 2 age groups was different. Infection could significantly influence the wound outcome.
Childhood-Onset Epileptic Encephalopathy Associated With Isolated Focal Cortical Dysplasia and a Novel TSC1 Germline Mutation
Authors: Hoelz Hannes , Coppenrath Eva , Hoertnagel Konstanze , Roser Timo , Tacke Moritz , Gerstl Lucia , Borggraefe Ingo
Published: March 2017

Tuberous sclerosis complex (TSC) is an autosomal-dominant inheritable neurocutaneous disease due to mutations within the TSC1 and TSC2 genes. Many patients present with West syndrome, a severe epilepsy syndrome characterized by the triad of infantile spasms, an interictal electroencephalogram (EEG) pattern termed hypsarrhythmia (continuous slow activity with an amplitude higher than 300 µV and multiregional spikes/polyspikes/sharp waves) and developmental regression. In this study, we report on a previously healthy patient with positive family history of epilepsy with new-onset epileptic encephalopathy at the age of 9 years. Clinical signs alone were not sufficient to establish the diagnosis of TSC but epilepsy panel screening revealed a novel frameshift mutation (c.90delA; p.Glu31Argfs*12) within the TSC1 gene. Segregation gene analysis detected the same mutation in the mother. Cranial magnetic resonance imaging (MRI) studies from the index patient and his mother revealed a similar pattern of isolated subcortical white matter lesions resembling most likely focal cortical dysplasia (FCD) type IIb. In summary, in these 2 related patients, a novel TSC1 frameshift mutation was associated with an isolated FCD type IIb in the absence of further CNS abnormalities usually encountered in patients with TSC, fostering our understanding of the broad mutation spectra in the TSC1 gene and the close relationship between cortical tubers and FCD type IIb.
The Physiological Incubation Biosimulator (PIBS): An Improved Ex Vivo Experimental Setup for the Mechanical Stability of Biological Sealants in Surgical Procedures
Authors: Höhn Philipp , Buchholz Marie , Majchrzak Britta , Uhl Waldemar , Braumann Chris , Chromik Ansgar M.
Published: March 2017

Background. Tissue-bound fibrin sealants are used in a wide array of surgical procedures. The microenvironmental interaction between sealant and application site is often poorly evaluated due to a lack of suitable experimental models. Methods. A physiological incubation biosimulator (PIBS) was developed to test biological sealants in an ex vivo setup under physiological conditions comparable to the microenvironment at application site (temperature, humidity, pressure). PIBS was validated by a study on the effectiveness of TachoSil for leak closure at pancreatic resection sites. Defined defects in a thoracic membrane of porcine origin were sealed by TachoSil. Integrity of the sealing was tested in the presence of active pancreatic fluid over 60 minutes. Heat-inactivated pancreatic fluid and electrolyte solution served as controls. The time to leakage was recorded and experimental groups were analyzed by Kaplan-Meier analysis. Results. PIBS produced reliable results. TachoSil lead to a leakage rate of 96% after incubation with active pancreatic fluid (p = 34), which was significantly higher compared with heat-inactivated pancreatic fluid (p = 34, 52%) or electrolyte solution (p = 20, 19%). Conclusion. PIBS is an effective tool to evaluate microenvironmental effects on the adhesive strength of biomaterials. Tissue sealing effect of TachoSil is diminished in a “pancreatic” microenvironment rich with pancreatic enzymes. Our results might therefore explain the reason of the findings of randomized controlled trials recently published on this subject.
Comparison of Treatment Results for Mallet Finger Fractures in Children Between Low-Intensity Pulsed Ultrasound Stimulation and Ishiguro’s Method
Authors: Ota Tsuyoshi , Itoh Soichiro , Matsuyama Yoshihiko
Published: March 2017

Background: We compared the treatment results for displaced mallet finger fractures in children between low-intensity pulsed ultrasound (LIPUS) stimulation and Ishiguro’s method, which involves extension block and arthrodesis of the distal interphalangeal (DIP) joint with pinning. Methods: Eleven cases (5 females and 6 males; average age, 13.5 years) of mallet finger were operated with Ishiguro’s method, and 8 cases (3 females and 5 males; average age, 13.0 years) were treated with LIPUS stimulation. Lateral radiographs were used to determine the distance of fragment displacement and the percentage of the articular surface involved in the fragments. Functional outcomes in flexion and extension and those estimated using Crawford’s evaluation criteria at the final visits were assessed in each group. Results: The duration needed for fracture healing was longer, however, active extension and flexion of the DIP joint were significantly larger in the LIPUS group compared with those in the pinning group. Functional recovery was excellent in all cases in the LIPUS group; however, recovery was good in 3 cases and excellent in 8 cases in the pinning group. Extension of the DIP joint was significantly larger when pins were removed in 35 or lesser days postoperatively compared with cases in which pin fixation was continued for more than 35 days. Conclusions: LIPUS therapy may be recommended as an option to treat type I mallet finger in children for whom initiation of treatment was delayed up to 8 weeks. When Ishiguro’s method is applied to the displaced mallet fracture in children, arthrodesis of the DIP joint for more than 5 weeks should be avoided to prevent flexion contracture.
Retrograde semi-retrieval technique for combined stentriever plus aspiration thrombectomy in acute ischemic stroke
Authors: Wei Ming , Wei Zhiqiang , Li Xin , Li Hong
Published: March 2017

The endovascular treatment of acute ischemic stroke has become a standard procedure. The combination of multiple neuroendovascular devices provides more possibilities for the improvement of the thrombectomy technique. We describe a modified retrieval technique using a distal intracranial catheter (DIC) for the semi-retrieval of stentriever during the thrombectomy procedure. The retrograde semi-retrieval technique involves completely unfolding the stent retriever by pulling a Navien catheter and the partial re-sheath of a retrievable stent forming a tapered configuration by pushing the Navien catheter, which results in the thrombi being embedded into the strut, securing the clot within the stent and there being a shorter distance for the clot to travel. This technique may lessen the occurrence of thrombus fragmentation and injury to the vessel wall. The retrograde semi-retrieval technique is an optional thrombectomy technique that may improve the efficiency of this procedure in the treatment of acute ischemic stroke.
The dietary constituent resveratrol suppresses nociceptive neurotransmission via the NMDA receptor
Authors: Takehana Shiori , Kubota Yoshiko , Uotsu Nobuo , Yui Kei , Iwata Koichi , Shimazu Yoshihito , Takeda Mamoru
Published: March 2017

Background

Although we have previously reported that intravenous resveratrol administration inhibits the nociceptive neuronal activity of spinal trigeminal nucleus caudalis neurons, the site of the central effect remains unclear. The aim of the present study was to examine whether acute intravenous resveratrol administration in the rat attenuates central glutamatergic transmission of spinal trigeminal nucleus caudalis neurons responding to nociceptive mechanical stimulation in vivo, using extracellular single-unit recordings and microiontophoretic techniques.

Results

Extracellular single-unit recordings using multibarrel electrodes were made from the spinal trigeminal nucleus caudalis wide dynamic range neurons responding to orofacial mechanical stimulation in pentobarbital anesthetized rats. These neurons also responded to iontophoretic application of glutamate, and the evoked neuronal discharge frequency was significantly increased in a current-dependent and reversible manner. The mean firing frequency evoked by the iontophoretic application of glutamate (30, 50, and 70 nA) was mimicked by the application of 10 g, 60 g, and noxious pinch mechanical stimulation, respectively. The mean firing frequency of spinal trigeminal nucleus caudalis wide dynamic range neurons responding to iontophoretic application of glutamate and N-methyl-D-aspartate were also significantly inhibited by intravenous administration of resveratrol (2 mg/kg) and the maximal inhibition of discharge frequency was observed within 10 min. These inhibitory effects lasted approximately 20 min. The relative magnitude of inhibition by resveratrol of the glutamate-evoked spinal trigeminal nucleus caudalis wide dynamic range neuronal discharge frequency was similar to that for N-methyl-D-aspartate iontophoretic application.

Conclusion

These results suggest that resveratrol suppresses glutamatergic neurotransmission of the spinal trigeminal nucleus caudalis neurons responding to nociceptive mechanical stimulation via the N-methyl-D-aspartate receptor in vivo, and resveratrol may be useful as a complementary or alternative therapeutic agent for the treatment of trigeminal nociceptive pain.
Police officers, mental (ill-)health and spoiled identity
Authors: Bullock Karen , Garland Jon
Published: March 2017

This article considers the processes through which some police officers with mental ill-health experience stigmatization in police organizations. Situated in the sociological framework of Goffman and in modified labelling theory, it draws on the findings of a qualitative study and examines the sources of stigma embedded in police work, the consequences of stigma for the labelled officer, the nature of any resistance to the application of the label and approaches to challenging stigma within the policing context. It suggests that in order to tackle these negative attitudes constabularies must do more to address the processes of stigmatization associated with mental ill-health at the individual and institutional levels.
The way forward
Authors: Lowe Sandra A
Published: March 2017

Improving maternal health and reducing maternal morbidity and mortality into the future will require a range of health-related and non-health-related strategies. The latter include education for women, better communication, access to transport and technology and cultural change. The role of obstetric medicine practice, research and education in achieving these objectives is discussed in this article. We need to recognise that it will require improvements in health provision and access to achieve our goal of safer childbirth for women and babies throughout the world.
Cancer-induced muscle wasting: latest findings in prevention and treatment
Authors: Aversa Zaira , Costelli Paola , Muscaritoli Maurizio
Published: March 2017

Cancer cachexia is a severe and disabling clinical condition that frequently accompanies the development of many types of cancer. Muscle wasting is the hallmark of cancer cachexia and is associated with serious clinical consequences such as physical impairment, poor quality of life, reduced tolerance to treatments and shorter survival. Cancer cachexia may evolve through different stages of clinical relevance, namely pre-cachexia, cachexia and refractory cachexia. Given its detrimental clinical consequences, it appears mandatory to prevent and/or delay the progression of cancer cachexia to its refractory stage by implementing the early recognition and treatment of the nutritional and metabolic alterations occurring during cancer. Research on the molecular mechanisms underlying muscle wasting during cancer cachexia has expanded in the last few years, allowing the identification of several potential therapeutic targets and the development of many promising drugs. Several of these agents have already reached the clinical evaluation, but it is becoming increasingly evident that a single therapy may not be completely successful in the treatment of cancer-related muscle wasting, given its multifactorial and complex pathogenesis. This suggests that early and structured multimodal interventions (including targeted nutritional supplementation, physical exercise and pharmacological interventions) are necessary to prevent and/or treat the devastating consequences of this cancer comorbidity, and future research should focus on this approach.
Best practice in the management of clinical coding services: Insights from a project in the Republic of Ireland, Part 2
Authors: Reid Beth A , Ridoutt Lee , O’Connor Paul , Murphy Deirdre
Published: March 2017

Introduction:

This is the second of two articles about best practice in the management of coding services. The best practice project was part of a year-long project conducted in the Republic of Ireland to review the quality of the Hospital Inpatient Enquiry data for its use in activity-based funding.

Methods:

The four methods used to address the best practice aspect of the project were described in detail in Part 1.

Results:

The results included in this article are those relating to the coding manager’s background, preparation and style, clinical coder (CC) workforce adequacy, the CC workforce structure and career pathway, and the physical and psychological work environment for the clinical coding service.

Conclusion:

Examples of best practice were found in the study hospitals but there were also areas for improvement. Coding managers would benefit from greater support in the form of increased opportunities for management training and a better method for calculating CC workforce numbers. A career pathway is needed for CCs to progress from entry to expert CC, mentor, manager and quality controller. Most hospitals could benefit from investment in infrastructure that places CCs in a physical environment that tells them they are an important part of the hospital and their work is valued.
Telavancin: a novel semisynthetic lipoglycopeptide agent to counter the challenge of resistant Gram-positive pathogens
Authors: Das Biswadeep , Sarkar Chayna , Das Debasmita , Gupta Amit , Kalra Arnav , Sahni Shubham
Published: March 2017

Telavancin (TD-6424), a semisynthetic lipoglycopeptide vancomycin-derivative, is a novel antimicrobial agent developed by Theravance for overcoming resistant Gram-positive bacterial infections, specifically methicillin-resistant Staphylococcus aureus (MRSA). The US Food and Drug Administration (USFDA) had approved telavancin in 2009 for the treatment of complicated skin and skin structure infections (cSSSIs) caused by Gram-positive bacteria, including MRSA ( S. aureus, Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus anginosus group, or Enterococcus faecalis). Telavancin has two proposed mechanisms of action. In vitro, telavancin has a rapid, concentration-dependent bactericidal effect, due to disruption of cell membrane integrity. Telavancin has demonstrable in vitro activity against aerobic and anaerobic Gram-positive bacteria. Telavancin and vancomycin have similar spectra of activity. Gram-negative bacteria are usually non-susceptible to telavancin. Telavancin has been successfully tested in various animal models of bacteremia, endocarditis, meningitis, and pneumonia. Phase II Telavancin versus Standard Therapy for Treatment of Complicated Skin and Soft-Tissue Infections due to Gram-Positive Bacteria (FAST 1 and FAST 2) and phase III [Assessment of Telavancin in Complicated Skin and Skin Structure Infections 1 (ATLAS 1 and ATLAS 2)] clinical trials have been conducted for evaluating telavancin’s efficacy and safety in cSSSIs. Phase III clinical trials have been carried out for evaluating telavancin’s safety and efficacy in nosocomial pneumonia [Assessment of Telavancin for Treatment of Hospital acquired Pneumonia 1 and 2 (ATTAIN 1 and ATTAIN 2)]. A phase II randomized, double-blind, clinical trial has been carried out for evaluating telavancin’s safety and efficacy in uncomplicated S. aureus bacteremia [Telavancin for Treatment of Uncomplicated S. aureus Bacteremia (ASSURE)]. Pacemaker lead–related infective endocarditis due to a vancomycin intermediate S. aureus (VISA) strain (non-daptomycin susceptible) was successfully treated with parenteral telavancin for 8 weeks. Telavancin extensively binds to serum albumin (~93%) and has a relatively small volume of distribution. Telavancin is not biotransformed by any cytochrome P450 microsomal enzymes and excreted mainly in the urine. Though well-tolerated, worrisome adverse effects, including renal dysfunction and QTc prolongation are of potential concern. Given its extensive binding to plasma proteins, long half-life, and a long post-antibiotic effect, it represents a promising addition to the therapeutic armamentarium in combating infections caused by resistant Gram-positive pathogens, namely, MRSA.
Validation of single nucleotide polymorphisms in invasive aspergillosis following hematopoietic cell transplantation
Authors: Fisher Cynthia E. , Hohl Tobias M. , Fan Wenhong , Storer Barry E. , Levine David M. , Zhao Lu Ping , Martin Paul J. , Warren Edus H. , Boeckh Michael , Hansen John A.
Published: March 2017

Key Points

Two SNPs in PTX3 and CLEC7a previously associated with development of proven or probable invasive aspergillosis were validated. Thirteen SNPs in 9 genes were associated at P ≤ .05 with development of IA using a different genetic model than the original study.
Does personality play a role in continuous positive airway pressure compliance?
Authors: Maschauer Emily L. , Fairley Donna M. , Riha Renata L.
Published: March 2017

Key points

Continuous positive airway pressure (CPAP) adherence is low among individuals with obstructive sleep apnoea.

Type D personality and high scores on the depression and hypochondriasis scales on the Minnesota Multiphasic Personality Inventory (MMPI) have been identified as factors contributing to non-compliance with CPAP.

Further research into personality type may assist in understanding why some people adhere to CPAP, while others fail.

Obstructive sleep apnoea (OSA) is a condition characterised by repetitive, intermittent partial or complete collapse/obstruction of the upper airway during sleep. Continuous positive airway pressure (CPAP) is highly efficacious in treating OSA but its effectiveness is limited due to suboptimal acceptance and adherence rates, with as many as 50% of OSA patients discontinuing CPAP treatment within the first year. Until recently, research has focused on examining mechanistic and demographic factors that could explain nonadherence (e.g.age, sex, race and education level) with limited applicability in a prospective or clinical manner.

More recent research has focused on personality factors or types of patients with OSA who comply and do not comply with CPAP adherence in an attempt to enhance the accuracy of predicting treatment compliance. Type D personality has been found to be prevalent in one third of patients with OSA. The presence of Type D personality increases noncompliance and poor treatment outcomes due to negative affectivity, social inhibition, unhealthy lifestyle, and a reluctance to consult and/or follow medical advice. Conversely, individuals who are more likely to adhere to CPAP treatment tend to have a high internal locus of control and high self-efficacy, self-refer for treatment, and have active coping skills. By assessing personality and coping skills, the clinician may gain insight into the likelihood of a patient’s adherence to treatment. If the patient displays potential risk factors for CPAP noncompliance, the clinician can offer the patient education, refer them to a support group, engage in behavioural/motivational therapy and undertake regular follow-up visits or phone calls incorporating troubleshooting to increase CPAP adherence, especially in individuals with Type D personality.