bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective Cohort Study on the Employment Status of Working Age Patients After Recovery From Ankle Arthritis Surgery
Authors: Gagné Oliver J. , Veljkovic Andrea , Glazebrook Mark , Daniels Timothy R. , Penner Murray J. , Wing Kevin J. , Younger Alastair S. E.
Published: March 2018

Background:

People who are affected by end-stage ankle arthritis are as disabled as those suffering from arthritis in other main articulations of the lower extremity. Once these patients become unable to perform their job duties, they leave the workforce and require financial aid from government agencies, which represents a considerable economic burden. Regardless of whether arthrodesis or arthroplasty is performed, we hypothesized that patients younger than 55 years at the time of surgery should be able to return to work within 2 years and require less social assistance.

Methods:

Patients from 2002 to 2014 included in the nationwide prospective Ankle Reconstruction Database treated for end-stage ankle arthritis with a total ankle replacement or an ankle arthrodesis and younger than 55 years at the time of surgery were included. This study used a standard preoperative survey (AAOS, SF-36) along with the same survey filled by patients in intervals up to 2 years postoperatively. Their employment status was determined at each time point. Participation in third-party wage assistance programs was recorded. This cohort had 194 patients with an average age of 47.0 ± 7.2 years and was balanced in terms of sex (104 female) and side (94 left).

Results:

The employment rate prior to surgery was 56%, which increased to 62% at the 2-year postoperative mark. With regards to worker’s compensation, disability, and social security, 20% of patients left all subsidized programs whereas 4% entered at least 1 which is significant (P < .05).

Conclusion:

The 2-year follow-up after tibiotalar arthrodesis/arthroplasty in patients younger than 55 years showed that significantly more people were able to leave subsidized work assistance programs than enroll in them.

Level of Evidence:

Level II, prospective comparative study.
Does Socioeconomic Development Explain the Association Between Seafood Consumption and Cross-National Homicide?
Authors: Testa Alexander , Rennó Santos Mateus , Weiss Douglas B.
Published: March 2018

Biological theories of crime propose that neurological benefits from consuming omega-3 fatty acids can reduce aggressive behavior. At the macro level, prior work has found a negative bivariate association between seafood consumption and homicide rates. Using data from a sample of 82 countries, and applying both multivariate regression and structural equation modeling, we find that socioeconomic development simultaneously affects the consumption of seafood and homicide rates, generating a spurious relationship. These findings demonstrate that omitting theoretically relevant variables, as well as inferring macro-level associations from micro-level patterns, can lead to erroneous conclusions regarding support for criminological theories or criminal justice policies.
Building a Tribal–Academic Partnership to Address PTSD, Substance Misuse, and HIV Among American Indian Women
Authors: Pearson Cynthia R. , Smartlowit-Briggs Lucy , Belcourt Annie , Bedard-Gilligan Michele , Kaysen Debra
Published: March 2018

Objectives. To describe our partnership and research infrastructure development strategies and discuss steps in developing a culturally grounded framework to obtain data and identify a trauma-informed evidence-based intervention. Method. We present funding strategies that develop and maintain the partnership and tools that guided research development. We share how a community research committee was formed and the steps taken to clarify the health concern and develop a culturally tailored framework. We present results from our needs/assets assessment that led to the selection of a trauma-informed intervention. Finally, we describe the agreements and protocols developed. Results. We produced a strong sustainable research team that brought program and research funding to the community. We created a framework and matrix of program objectives grounded in community knowledge. We produced preliminary data and research and publication guidelines that have facilitated program and research funding to address community-driven concerns. Conclusions. This study highlights the importance of bidirectional collaboration with American Indian communities, as well as the time and funding needed to maintain these relationships. A long-term approach is necessary to build a sustainable research infrastructure. Developing effective and efficient ways to build culturally based community research portfolios provides a critical step toward improving individual and community health outcomes.
Risk analysis in low-voltage distribution systems
Authors: Aliyari Mostafa , Ayele Yonas Z , Barabadi Abbas , Droguett Enrique Lopez
Published: March 2018

Electric power distribution is a complex network involving technical challenges from a wide range of sources, a considerable degree of risk and substantial financial resources. Design and maintenance strategies must take account of the risk of failure of distribution components, that is, both the probability of failure and its consequences have to be considered. Historical failure and repair data are essential inputs for risk analysis, since they reflect the actual operational conditions that the system and its components have experienced. Failure and repair data analysis generally aims at decreasing the risk of failure, by providing essential information for maintenance and logistic planning to reduce the probability, as well as the consequence, of failure. Hence, when maintaining and designing distribution networks, it is imperative to identify and quantify all risks – direct financial, health, safety and environmental, and reputation – using the field failure and repair data. However, in the majority of the available literature regarding the failure and repair data analysis of distribution networks, especially the low-voltage distribution, the set of risk analysis principles is not integrated or in some cases is not detailed. The purpose of this article is to propose a methodology for identifying a suitable failure analysis tool for low-voltage distribution by integrating a set of risk analysis principles, as well as the reliability and maintainability estimation. The application of the proposed methodology is demonstrated by a real case study via an evaluation of the power outages data.
A method for evaluating the local failure of ultra-high-performance short polyvinyl alcohol fiber-reinforced concrete panels subjected to a projectile impact
Authors: Ueno Hironori , Beppu Masuhiro , Ichino Hiroyoshi , Musha Hiroyuki , Okamoto Shuichi
Published: March 2018

This study investigated local failure characteristics and failure limit thicknesses of an ultra-high-performance fiber-reinforced concrete panel reinforced with polyvinyl alcohol by conducting impact tests. In a series of tests, steel hemispherical projectiles with a mass of 46 g collided with ultra-high-performance fiber-reinforced concrete panels reinforced with polyvinyl alcohol. The ultra-high-performance fiber-reinforced concrete panels reinforced with polyvinyl alcohol with thicknesses in the range of 30–90 mm were tested at the impact velocities of 170–500 m/s. The experimental results revealed that the penetration depth or scabbing damage induced by the impact was significantly suppressed for the ultra-high-performance fiber-reinforced concrete panel reinforced with polyvinyl alcohol compared to that of a plain concrete panel. The experimental results demonstrated that local failure intensity for the panels was similar at equivalent impact energies, regardless of the combination of projectile mass and impact velocity. Based on the test results, we proposed a method for evaluating the penetration depth and scabbing limit thicknesses by the impact energy.
Psychometric testing of the caring assessment tool: Administration (CAT-Adm©)
Authors: Wolverton Cheryl Lynn , Lasiter Sue , Duffy Joanne R , Weaver Michael T , McDaniel Anna M
Published: March 2018

Objectives:

The overall purpose of this study was to evaluate the validity and reliability of the Caring Assessment Tool-Administration survey. Three specific aims were to (1) evaluate construct validity of the Caring Assessment Tool-Administration survey by testing the hypothesized eight-factor structure of staff nurses’ perceptions of nurse manager caring behaviors, (2) estimate the internal consistency, and (3) conduct item reduction analysis.

Methods:

A 94-item Caring Assessment Tool-Administration designed to assess nurse manager caring behaviors appeared in the literature but lacked robust psychometric testing. Using a foundational theory and a cross-sectional descriptive design, the Caring Assessment Tool-Administration was evaluated for reliability and construct validity. Using convenience sampling, 1143 registered nurses were recruited from acute care hospitals in three states located in the Midwestern, Mid-Atlantic, and Southern Regions of the United States.

Results:

Psychometric testing of the Caring Assessment Tool-Administration was conducted using confirmatory analysis to determine the dimensionality of the construct, nurse manager caring behavior. The null hypothesis was an eight-factor solution fitting the theoretical model being tested. The null hypothesis was rejected because none of the measures examined for goodness of fit indicated the model fit the data. Confirmatory factor analysis did not support the hypothesized structure; however, exploratory factor analysis supported a one-factor solution that was conceptually labeled caring behaviors. To decrease subject burden, the 94-item survey was reduced to 25 items using item reduction analysis including assessing minimum factor loadings of ≥0.60 and evaluating survey item-total correlation and alpha. The Cronbach’s alpha of the new 25-item survey was 0.98.

Conclusion:

The new 25-item Caring Assessment Tool-Administration survey provides hospital administrators, nurse managers, and researchers with a sound, less burdensome instrument to collect valuable information about nurse manager caring behaviors.
Problematic smartphone use: Digital approaches to an emerging public health problem
Authors: van Velthoven Michelle H , Powell John , Powell Georgina
Published: March 2018

Problematic smartphone use is an emerging public health problem since the launch of the first smartphone 10 years ago. In this article, pathways to problematic use of smartphones, approaches to deal with this issue and their limitations are discussed. This includes problematic use of smartphones by people who self-identify that they or their family members use mobile devices in a problematic way. Extreme problematic use (e.g. relating to online gambling or heavy gaming) that severely disrupts people’s lives is a form of digital addiction is excluded from this discussion. Smartphone use can be problematic for some people due to the availability of constant connection, the addictiveness of applications (apps) combined with personal psychological factors. This is facilitated by characteristics of the technology, including easy access, the possibility of escaping daily life, being able to remain anonymous online, and the frequency of alerts and messages. While various non-technical interventions, such as digital detoxes, and digital interventions, including apps to limit use, have been developed to help people control their smartphone use, none of these has proven to work yet. An overview of currently available apps for problematic smartphone use is provided. Further work is needed on various aspects of problematic smartphone use, including the understanding of how smartphone use impacts on people’s lives, strengthening the definition of problematic smartphone use, and validation of its measurement, and more rigorous development and assessment of tools. We hope that these efforts will help people to use their smartphones in a healthy and effective way.
Understanding and Recreating Historical Landscapes through Oral History, Architectural and Archival Research—A Methodology: The Case of the Royal Gardens of Rajnagar, Bundelkhand
Authors: Upadhyay Nishant , Sharma Anjaneya
Published: March 2018

Bundelkhand lies in the central part of India including 6 districts in northern Madhya Pradesh and 7 districts in southern Uttar Pradesh (13 districts in total). In Bundelkhand, a series of walled gardens of similar type (presumably of second half of the eighteenth/beginning of the nineteenth century) can be seen all across the region. These gardens are part of the social and cultural life of the Bundeli people, but still their historical and cultural values cannot be ascertained. Thus, in order to understand these gardens, a very detailed understanding of the regional landscape needs to be developed. This research article aims to understand and regenerate the cultural landscape of Rajnagar in Bundelkhand based on archival research, architectural documentation and oral history narratives.

The article elaborates upon the methodology followed to obtain sufficient information about the original planning, design and functions of the gardens, and the sociocultural spatial configuration of historical Rajnagar. Architectural and oral surveys were undertaken to generate data at settlement and garden level along with the archival research. Survey of the oral history regarding the settlement and general association with the gardens immensely facilitated to position the gardens in the historical context, given the lack of archival evidence. The interpolation of the three sources of data allowed to understand the pattern of evolution of the historical settlement of Rajnagar and the connections with the royal gardens within the settlement. Apart from furthering the understanding about these unique urban landscape phenomenon, the survey results contribute to the preparation of a sustainable tourism development plan for the royal Bundeli gardens of Rajnagar by Indian National Trust for Art and Cultural Heritage (INTACH) Belgium. The multiple oral and architectural surveys also raised awareness within the town about the historical Bundeli garden landscapes.
RETRACTED ARTICLE: MicroRNA-1468 promotes tumor progression by activating PPAR-γ-mediated AKT signaling in human hepatocellular carcinoma
Authors: Liu Zhikui , Wang Yufeng , Dou Changwei , Sun Liankang , Li Qing , Wang Liang , Xu Qiuran , Yang Wei , Liu Qingguang , Tu Kangsheng
Published: March 2018

Background

Accumulating evidence confirm that aberrant microRNAs (miRNAs) expression contributes to hepatocellular carcinoma (HCC) development and progression. Previous study reported that miR-1468 showed an up-regulated tendency and might be a potential prognostic biomarker in HCC samples derived from TCGA database. However, the role of miR-1468 and its underlying mechanisms involved in the growth and metastasis of HCC remain poorly investigated.

Methods

CCK-8, EdU, colony formation and flow cytometry were used to determine proliferation, cell cycle progression and apoptosis of HCC cells in vitro. The subcutaneous tumor model in nude mice was established to detect tumor growth of HCC in vivo. The direct binding of miR-1468 to 3’UTR of Cbp/p300 interacting transactivator with Glu/Asp rich carboxy-terminal domain 2 (CITED2) and Up-frameshift protein 1 (UPF1) was confirmed by luciferase reporter assay.

Results

Here, we demonstrated that miR-1468 expression was up-regulated in HCC tissues and cell lines. Clinical analysis revealed that increased miR-1468 level was significantly correlated with malignant prognostic features and shorter survival. Gain- and loss-of-function experiments indicated that miR-1468 promoted cell proliferation, colony formation, cell cycle progression and induced apoptosis of HCC cells in vitro and in vivo. Moreover, CITED2 and UPF1 were identified as direct downstream targets of miR-1468 in HCC cells, and mediated the functional effects of miR-1468 in HCC, resulting in peroxisome proliferator-activated receptor-γ (PPAR-γ)/AKT signaling activation. In clinical samples of HCC, miR-1468 inversely correlated with the levels of CITED2 and UPF1, which were confirmed to be down-regulated in HCC. Restoration of CITED2 or UPF1 expression at least partially abolished the biological effects of miR-1468 on HCC cells. Moreover, alteration of PPAR-γ or AKT phosphorylation could reverse the function of miR-1468 in HCC.

Conclusions

Taken together, this research supports the first evidence that miR-1468 plays an oncogenic role in HCC via activating PPAR-γ/AKT pathway by targeting CITED2 and UPF1, and represents a promising therapeutic strategy for HCC patients.
Control of Lyme borreliosis and other Ixodes ricinus-borne diseases
Authors: Sprong Hein , Azagi Tal , Hoornstra Dieuwertje , Nijhof Ard M. , Knorr Sarah , Baarsma M. Ewoud , Hovius Joppe W.
Published: March 2018

Lyme borreliosis (LB) and other Ixodes ricinus-borne diseases (TBDs) are diseases that emerge from interactions of humans and domestic animals with infected ticks in nature. Nature, environmental and health policies at (inter)national and local levels affect the risk, disease burden and costs of TBDs. Knowledge on ticks, their pathogens and the diseases they cause have been increasing, and resulted in the discovery of a diversity of control options, which often are not highly effective on their own. Control strategies involving concerted actions from human and animal health sectors as well as from nature managers have not been formulated, let alone implemented. Control of TBDs asks for a “health in all policies” approach, both at the (inter)national level, but also at local levels. For example, wildlife protection and creating urban green spaces are important for animal and human well-being, but may increase the risk of TBDs. In contrast, culling or fencing out deer decreases the risk for TBDs under specific conditions, but may have adverse effects on biodiversity or may be societally unacceptable. Therefore, in the end, nature and health workers together must carry out tailor-made control options for the control of TBDs for humans and animals, with minimal effects on the environment. In that regard, multidisciplinary approaches in environmental, but also medical settings are needed. To facilitate this, communication and collaboration between experts from different fields, which may include patient representatives, should be promoted.
Collaborative design of software applications: the role of users
Authors: Mirri Silvia , Roccetti Marco , Salomoni Paola
Published: March 2018

Drawing on a 1-year application design, implementation and evaluation experience, this paper examines how engaging users in the early design phases of a software application is tightly bound to the success of that application in use. Through the comparison between two different approaches to collaborative application design (namely, user-centered vs participatory), we reveal how sensitivity to the role that users may play during that collaborative practice rebounds to a good level of user satisfaction during the evaluation process. Our paper also contributes to conversations and reflections on the differences between those two design approaches, while providing evidences that the participatory approach may better sensitize designers to issues of users’ satisfaction. We finally offer our study as a resource and a methodology for recognizing and understanding the role of active users during a process of development of a software application.
Healthcare provision and the psychological, somatic and social impact on people involved in the terror attacks in January 2015 in Paris: cohort study
Authors: Vandentorren Stephanie , Pirard Philippe , Sanna Alice , Aubert Lyderic , Motreff Yvon , Dantchev Nicolas , Lesieur Sophie , Chauvin Pierre , Baubet Thierry
Published: March 2018

Background

Terrorist attacks occurred in Paris in January 2015.

Aims

To assess the mental health impact and the access to psychomedical care of people exposed to the attacks.

Method

We implemented an open-cohort design 6 and 18 months after the attacks. Exposed civilians and rescue workers were included according to the exposure criteria A for post-traumatic stress disorder (PTSD) in DSM-5. A face-to-face questionnaire conducted by trained psychologists was used to collect sociodemographic characteristics, exposure level, scores on psychometric scales, an international neuropsychiatric interview and access to care.

Results

Six months after the attacks, 18% of civilians reported symptoms of PTSD, 31% had anxiety disorders and 11% depression. Among rescue workers, 3% reported symptoms of PTSD and 14% anxiety disorders. During the 48 h following the attacks, 53.2% of civilian had access to psychomedical carev. 35% of rescue and police staff.

Conclusions

We found severe psychological consequences, even in people who were less exposed.

Declaration of interest

None.
Web-based intervention for depressive symptoms in adults with types 1 and 2 diabetes mellitus: a health economic evaluation
Authors: Nobis Stephanie , Ebert David Daniel , Lehr Dirk , Smit Filip , Buntrock Claudia , Berking Matthias , Baumeister Harald , Snoek Frank , Funk Burkhardt , Riper Heleen
Published: March 2018

Background

Web-based interventions are effective in reducing depression. However, the evidence for the cost-effectiveness of these interventions is scarce.

Aims

The aim is to assess the cost-effectiveness of a web-based intervention (GET.ON M.E.D.) for individuals with diabetes and comorbid depression compared with an active control group receiving web-based psychoeducation.

Method

We conducted a cost-effectiveness analysis with treatment response as the outcome and a cost-utility analysis with quality-adjusted life-years (QALYs) alongside a randomised controlled trial with 260 participants.

Results

At a willingness-to-pay ceiling of €5000 for a treatment response, the intervention has a 97% probability of being regarded as cost-effective compared with the active control group. If society is willing to pay €14 000 for an additional QALY, the intervention has a 51% probability of being cost-effective.

Conclusions

This web-based intervention for individuals with diabetes and comorbid depression demonstrated a high probability of being cost-effective compared with an active control group.

Declaration of interest

S.N., D.D.E., D.L., M.B. and B.F. are stakeholders of the Institute for Online Health Trainings, which aims to transfer scientific knowledge related to this research into routine healthcare.
Oncologists’ Views Regarding the Role of Electronic Health Records in Care Coordination
Authors: Asan Onur , Nattinger Ann B. , Gurses Ayse P. , Tyszka Jeanne T. , Yen Tina W.F.
Published: March 2018

Background

Electronic health records (EHRs) play a significant role in complex health care processes, especially in information transfer with patients and care coordination among providers. EHRs may also generate unintended consequences, introducing new patient safety risks. To date, little investigation has been performed in oncology settings, despite the need for quality provider-patient communication and information transfer during oncology visits. In this qualitative study, we focused on oncology providers’ perceptions of EHRs for supporting communication with patients and coordination of care with other providers.

Methods

We conducted semistructured interviews with oncologists from an urban academic medical center to learn their perceptions of the use of EHRs before, during, and after clinic visits with patients. Our interview guide was developed on the basis of the work system model. We coded transcripts using inductive content analysis.

Results

Data analysis yielded four main themes regarding oncologists’ practices in using the EHR and perceptions about EHRs: (1) EHR use for care coordination (eg, timeliness of receiving information, SmartSet documentation); (2) EHR use in the clinic visit (eg, educating patients, using as a reinforcement tool); (3) safety hazards in care coordination associated with EHRs (eg, incomplete documentation, error propagating, no filtering mechanism to capture errors); and (4) suggestions for improvements (eg, improved SmartSet functionalities, simplification of user interface).

Conclusion

Current EHRs do not adequately support teamwork of oncology providers, which could lead to potential hazards in the care of patients with cancer. Redesigning EHR features that are tailored to support oncology care and addressing the concerns regarding information overload, improved organization of flagging abnormal results, and documentation-related workload are needed to minimize potential safety hazards.
Welfare State Eras, Policy Narratives, and the Role of Expertise: The Case of the Affordable Care Act in Historical and Comparative Perspective
Authors: Tuohy Carolyn Hughes
Published: March 2018

This article presents a way of understanding the linkage of expert and public opinion through a focus on policy narratives, which serve as deliberately crafted rhetorical bridges between expert discourses and broader cultural experiences. Across advanced nations, the dynamics of this bridging function has differed in different phases of policy development (such as welfare-state establishment, retrenchment, and redesign), depending on the state of discourse in each realm. In the establishment phase in which most programs of universal health care coverage were adopted, expert discourses were relatively synchronized with but subservient to broader policy narratives about collective and individual rights and responsibilities. The United States, in contrast, pursued its final sprint toward universal coverage in a later phase, in which the policy analysis community had greatly expanded and expert discourses had evolved to focus on specialized issues of system redesign. The resulting highly complex technical design did not readily align with an epic narrative of public purpose. Advocates instead relied principally on two narrative lines: an aggregation of anecdotes that was vulnerable to the simpler opposition narrative of an overweening state, and a crusade narrative that met the opposing narrative of patriotic resistance on its own terms but could not allay partisan polarization.
Unsupervised classification of individual foodborne bacteria from a mixture of bacteria cultures within a hyperspectral
microscope image
Authors: Eady Matthew , Park Bosoon
Published: March 2018

Salmonella is a leading cause of foodborne illness. Traditional detection methods require lengthy incubation periods
or expensive reagent kits. Hyperspectral microscope images (HMIs) have been previously investigated as a method for
early and rapid detection of bacteria by using a spectral signature that is unique to the organism. Previous HMI use with
bacteria has consisted of supervised classification with hypercubes collected for single culture images isolated from
highly selective growth media. In order to move forward with HMI as a detection tool in the food industry, unsupervised
classification of bacteria cells in mixed culture HMIs was investigated. Four foodborne bacteria cultures, S. Typhimurium
(ST) E. coli (Ec), S. aureus (Sa) and L. innocua (Li) were combined in seven different culture combinations with HMIs
collected between 450 nm and 800 nm. A k-means divisive cluster analysis (CA) was implemented and mixed culture
image sets were found to contain between two and four clusters. CA cluster accuracy was obtained by assigning a
dummy variable of the proposed CA classification, then carrying out a discriminant analysis. From the mixed culture HMIs,
700 bacteria cells were classified and accuracies were between 91.92% and 100%, with six of the seven HMI sets
resulting in > 97% accuracies. A distance measure between clusters was applied to identify unknown clusters based
on single culture reference samples of the four bacteria used. Results showed that the CA has potential for unsupervised
classification of bacteria cells, but the distance metric was not an adequate method for identifying the unknown cluster
based on reference spectra, potentially due to the collinearity amongst bacteria spectra.
Correlations between intravoxel incoherent motion diffusion-weighted MR imaging parameters and 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases: initial experience
Authors: Park Sunghoon , Yoon Joon-Kee , Chung Nam-Su , Kim Sang Hyun , Hwang Jinwoo , Lee Hyun Young , Kwack Kyu-Sung
Published: March 2018

Objective:

To investigate the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted MRI (DW MRI) parameters and 18F-fluodeoxyglucose (FDG) (PET/CT) metabolic parameters in patients with vertebral bone metastases.

Methods:

19 patients with vertebral bone metastases were retrospectively included in this institutional review board-approved study. All patients underwent IVIM DW-MRI and 18F-FDG PET/CT before treatment. The IVIM parameters [molecular diffusion coefficient (D), perfusion fraction (f), and perfusion-related D (D*)] and apparent diffusion coefficient were acquired using 11 b-values (0, 10, 15, 20, 25, 50, 80, 120, 200, 300, and 800 s mm–  2). Maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis derived from 18F-FDG PET/CT were calculated using thresholds of 3.0 SUV. The associations among parameters were evaluated by Spearman’s correlation analysis.

Results:

A total of 19 patients and 41 regions of interest were included in this study. The IVIM parameter f was positively correlated with the metabolic parameters SUVmean and SUVmax [ρ = 0.499 (p < 0.01) and ρ = 0.413 (p < 0.01), respectively]. There was a weak positive correlation between D* and SUVmean (ρ﻿ = 0.321, p = 0.041).

Conclusion:

IVIM perfusion-related parameters, especially f, were correlated with 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases. IVIM DW-MRI, used to evaluate metabolic activity, appears to have diagnostic potential for bone metastasis and may also have utility in monitoring the post-treatment response.

Advances in knowledge:

The use of IVIM for vertebral bone metastasis is demonstrated. f may be more suitable to reflect the metabolic activity and may facilitate another diagnostic potential for monitoring the posttreatment response.
Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage
Authors: Bhatt Shuchi , Jain Bhupendra Kumar , Singh Vikas Kumar
Published: March 2018

Fistula-in-ano, or perianal fistula, is a challenging clinical condition for both diagnosis and treatment. Imaging modalities such as fistulography, anal endosonography, perineal sonography, magnetic resonance imaging (MRI), and computed tomography (CT) are available for its evaluation. MRI is considered as the modality of choice for an accurate delineation of the tract in relation to the sphincter complex and for the detection of associated complications. However, its availability and affordability is always an issue. Moreover, the requirement to obtain multiple sequences to depict the fistula in detail is cumbersome and confusing for the clinicians to interpret. The inability to show the fistula in relation to normal anatomical structures in a single image is also a limitation. Multi detector computed tomography fistulography (MDCTF) is an underutilized technique for defining perianal fistulas. Acquisition of iso-volumetric data sets with instillation of contrast into the fistula delineates the tract and its components. Post-processing with thin sections allows for a generation of good quality images for presentation in various planes (multi-planar reconstructions) and formats (volume rendered technique, maximum intensity projection). MDCTF demonstrates the type of fistula, its extent, whether it is simple or complex, and shows the site of internal opening and associated complications; all in easy to understand images that can be used by the surgeons. Its capability to represent the entire pathology in relation to normal anatomical structures in few images is a definite advantage. MDCTF can be utilized when MRI is contraindicated or not feasible. This pictorial review shares our initial experience with MDCT fistulography in evaluating fistula- in-ano, demonstrates various components of fistulas, and discusses the types of fistulas according to the standard Parks classification.
Clival Chordoma: Case Report and Review of Recent Developments in Surgical and Adjuvant Treatments
Authors: Khawaja Ayaz M. , Venkatraman Anand , Mirza Maira
Published: March 2018

Chordomas are rare tumors that can develop anywhere along the craniospinal axis. These tumors present challenges with respect to diagnosis and treatment due to a high rate of recurrence, even after multiple surgeries, and the propensity to involve any region within the craniospinal axis. New developments in radiation therapy have improved recurrence-free survival in patients with chordomas. Different regimens of chemotherapy and molecularly-targeted therapies, as adjuvants to surgery, have been described in individual case reports and case series. The purpose of this paper is to describe a case of clival chordoma and review recent developments in diagnostic and therapeutic options. A 77-year-old female was referred because of diplopia and progressively worsening headaches. Head imaging revealed a large expansile and erosive mass in the skull base. The patient underwent a successful endoscopic endonasal trans-sphenoidal resection of the mass, with biopsy confirming the diagnosis of chordoma. Postoperatively, the patient experienced an improvement in neurological symptoms. Chordomas can present a diagnostic challenge due to the rare occurrence and a tendency to involve any region within the craniospinal axis.
Extremely Rare Case of Bilateral Pure Primary Non-Gestational Ovarian Choriocarcinoma
Authors: Syed Moinullah , Meshram Shefali , Deshpande Pooja , Parida Bikash
Published: March 2018

Background: Germ cell tumors of the ovary constitute less than one percent of ovarian tumors worldwide. Choriocarcinoma arising de novo from the ovary is very rare and only occasionally reported in the literature. Herein, we report a case of bilateral non-gestational pure primary ovarian choriocarcinoma that was confirmed by beta human chorionic gonadotropin (b-HCG) levels and histopathology.

Case Report: Our case is of a middle-aged multiparous female who presented with amenorrhea for three months. She underwent an evaluation with ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), which revealed bilateral bulky solid adnexal masses. Based on an increased blood level of the beta human chorionic gonadotropin and a histopathological examination, the diagnosis of bilateral non-gestational pure primary ovarian choriocarcinoma was made.

Conclusions: The imaging findings were found to be specific for bilateral non-gestational pure primary ovarian choriocarcinoma.
Poland Syndrome with Ipsilateral Hypoplasia of Gluteal Muscles and Contralateral Hidradenitis Suppurativa
Authors: Goyal Pradeep , Motiwala Henal , Gupta Nishant , Gupta Sonali , Bansal Itisha , Hooda Kusum , Kumar Yogesh , Olsavsky Thomas D.
Published: March 2018

Background: Poland syndrome (PS) is a rare congenital anomaly associated with absent or hypoplastic pectoralis major muscle and a wide spectrum of ipsilateral thoracic and upper extremity deformities. Hidradenitis suppurativa (HS) is a recurrent inflammatory follicular disease that commonly affects the apocrine-bearing skin and involves follicular occlusion and hyperkeratosis.

Case Report: We report a case of a 46-year-old male with a history of chronic recurrent hidradenitis suppurativa who was incidentally found to have a simple type of Poland syndrome with incidental hypoplasia of ipsilateral gluteal muscles.

Conclusions: Not only can PS present with HS, which we describe for the first time, but it is also associated with a wide variability of symptoms such as previously unknown co-existence of gluteal muscles hypoplasia.
Diagnostic Imaging and Clinical Features of Intracranial Hypotension – Review of Literature
Authors: Michali-Stolarska Marta , Bladowska Joanna , Stolarski Mateusz , Sąsiadek Marek J.
Published: March 2018

Intracranial hypotension (IH) is an uncommon, benign, and usually self-limiting condition caused by low cerebrospinal fluid (CSF) pressure, usually due to CSF leakage. The dominant clinical finding is an orthostatic headache. Other common clinical features include fever, nausea, vomiting, and tinnitus. Magnetic resonance imaging (MRI) plays an important role in the diagnosis and follow-up of patients with IH. Specific MRI findings include intracranial pachymeningeal enhancement, sagging of the brain, pituitary enlargement, and subdural fluid collections. Intracranial hypotension can mimic other conditions such as aseptic meningitis or pituitary adenomas. Differential diagnosis is important, because misdiagnosis may lead to unnecessary procedures and prolonged morbidity.
Blood-derived extracellular vesicle proteins as potential biomarkers for the diagnosis of early ER+ breast cancer and detection of lymph node involvement
Authors: Tucker Rod , Pedro Ana
Published: March 2018

Extracellular vesicles (EV’s) are membrane surrounded structures released by different cell types and are emerging as potential therapeutic and diagnostic targets in cancer. In the present study, plasma samples derived from 7 patients with metastatic and non-metastatic ER+ (estrogen receptor positive) breast cancer (BC) were collected and their respective (EVs) isolated and the protein content analyzed by mass spectrometry and FunRich analysis. Here we report on the presence of  two putative plasma EV biomarkers (which were absent in healthy controls samples) that could be used to detect early ER+ breast cancer and for those with lymph node (LN) involvement However, given the preliminar nature of the work, further investigation in a larger patient cohort is warranted to corroborate these findings. If confirmed, these biomarkers could be incorporated into simple blood test kit for the early detection of those with ER+ breast cancer and lymph node involvement.
The convergent epidemiology of tuberculosis and human cytomegalovirus infection
Authors: Cobelens Frank , Nagelkerke Nico , Fletcher Helen
Published: March 2018

Although several factors are known to increase the risk of tuberculosis, the occurrence of tuberculosis disease in an infected individual is difficult to predict. We hypothesize that active human cytomegalovirus infection due to recent infection, reinfection or reactivation plays an epidemiologically relevant role in the aetiology of tuberculosis by precipitating the progression from latent tuberculosis infection to disease. The most compelling support for this hypothesis comes from the striking similarity in age-sex distribution between the two infections, important because the age-sex pattern of tuberculosis disease progression has not been convincingly explained. Cytomegalovirus infection and tuberculosis have other overlapping risk factors, including poor socio-economic status, sexual contact, whole blood transfusion and solid organ transplantation. Although each of these overlaps could be explained by shared underlying risk factors, none of the epidemiological observations refute the hypothesis. If this interaction would play an epidemiologically important role, important opportunities would arise for novel approaches to controlling tuberculosis.
Untangling phylogenetic patterns and taxonomic confusion in tribe Caryophylleae (Caryophyllaceae) with special focus on generic boundaries
Authors: Madhani Hossein , Rabeler Richard , Pirani Atefeh , Oxelman Bengt , Heubl Guenther , Zarre Shahin
Published: March 2018

Assigning correct names to taxa is a challenging goal in the taxonomy of many groups within the Caryophyllaceae. This challenge is most serious in tribe Caryophylleae since the supposed genera seem to be highly artificial, and the available morphological evidence cannot effectively be used for delimitation and exact determination of taxa. The main goal of the present study was to re–assess the monophyly of the genera currently recognized in this tribe using molecular phylogenetic data. We used the sequences of nuclear ribosomal internal transcribed spacer (ITS) and the chloroplast gene rps16 for 135 and 94 accessions, respectively, representing all 16 genera currently recognized in the tribe Caryophylleae, with a rich sampling of Gypsophila as one of the most heterogeneous groups in the tribe. Phylogenetic trees were reconstructed using maximum parsimony and Bayesian inference methods. The results show that most of the large genera of Caryophylleae are not monophyletic. As a result, we propose a new classification system matching both molecular phylogenetic and morphological evidence. The main taxonomic conclusions include: (1) the description of three new genera, (2) treating five small genera as synonyms, (3) resurrecting the genus Heterochroa with six species, and (4) proposing 23 new combinations plus 2 replacement names at the specific level. As a result, we recognize 14 genera in Caryophylleae. A diagnostic key to all genera of Caryophylleae is provided.
REMEMORANDO AS IMAGENS DE FORMAÇÃO DE PROFESSORES: EM BUSCA DAS EXPERIÊNCIAS VIVIDAS
Authors: França Cyntia Simioni , Prado Guilherme Do Val Toledo
Published: March 2018

O artigo faz parte de uma investigação que teve como mote fundamental a relação entre formação docente e experiências vividas, fomentada por uma pesquisa-ação. O referencial teórico e metodológico dialoga com Walter Benjamin, Edward Palmer Thompson e Maria Carolina Bovério Galzerani, tendo em vista que partilhamos da ideia da formação docente como indissociável de experiências culturais, individuais e coletivas, políticas, sociais e econômicas, constituídas em processos ampliados de educação que atravessam as dimensões racionais e sensíveis dos professores. Dialogamos ainda, com as práticas de memória, considerando-as fecundas no movimento de resignificação da docência, mobilizadas por professores que resistem ao apagamento de suas histórias e de suas experiências vividas, no bojo de uma educação cada vez mais dominada por formações instrumentais.
FORMANDO PROFESSORES PESQUISADORES: UMA EXPERIÊNCIA DE FORMAÇÃO DOCENTE INTEGRAL E INTEGRADA
Authors: Albuquerque Andrea Serpa
Published: March 2018

Este artigo apresenta as experiências desenvolvidas por um grupo de bolsistas do PIBID Pedagogia/UFF. A proposta desenvolvida em 2015 pelo subprojeto: "Alfabetização por projetos de trabalho: ler é conhecer o mundo.", se apresentou como uma rede formativa que extrapola o objetivo primeiro de ser uma iniciação à docência compreendo hoje o PIBID como um projeto de formação integrada e integral. Conceitos como professorapesquisadora, avaliação formativa, interdisciplinaridade, assim como discussões sobre a pedagogia de projetos, afetividade e disciplina, currículos e práticas pedagógicas, se materializam em situações complexas do cotidiano escolar, desafiando alunos, professoras e coordenadora a um movimento continuo de exame das teorias em diálogo com as práticas.PALAVRAS CHAVE: Formação docente, professora pesquisadora, formação integral.
A QUESTÃO DE GÊNERO NA ESCOLA FAMÍLIA AGRÍCOLA DE SANTA CRUZ DO SUL: um olhar sobre o estágio de vivência
Authors: Souza Mariana Barbosa de , Vergutz Cristina Luisa Bencke , Costa João Paulo Reis
Published: March 2018

O presente trabalho busca compreender o Estágio de Vivência desenvolvido na Escola Família Agrícola de Santa Cruz do Sul – EFASC tendo como enfoque a questão de gênero a partir das falas das estudantes. Busca entender a importância da proposta do Estágio de Vivência no processo de ensino e aprendizagem da Pedagogia da Alternância, além de tentar identificar posicionamentos, representações e percepções embasadas nas relações de gênero presentes no espaço social do cotidiano das relações familiares das agricultoras e agricultores da região do Vale do Rio Pardo. O trabalho é fruto de apontamentos da experiência empírica da atuação junto à Escola Família Agrícola de Santa Cruz do Sul-EFASC.
CONTRIBUIÇÕES DO PENSAMENTO FEMINISTA PARA UMA EXPLICAÇÃO LOCALIZADA DA EDUCAÇÃO E DA APRENDIZAGEM
Authors: Araldi Etiane
Published: March 2018

O artigo parte de algumas questões que emergiram na experiência recente das ocupações dos estudantes secundaristas no Brasil, conforme depoimentos de estudantes de São Paulo e do Rio de Janeiro. Reconhecendo o protagonismo das mulheres nesse movimento, são articuladas contribuições de autoras feministas para o desafio de pensar práticas educacionais e explicações da aprendizagem que estejam atentas ao problema da convivência, tão bem enunciado pelos estudantes. Aborda perspectivas críticas a teorias clássicas da psicologia do desenvolvimento e da aprendizagem, com o objetivo de produzir outras explicações para o processo educacional, que considerem seu caráter localizado, no sentido proposto para esse termo por Donna Haraway. Para isso, propõe o deslocamento de concepções de sujeito e política pautadas por uma racionalidade masculina, autônoma, abstrata e impessoal.
Surgical wound dehiscence: a conceptual framework for patient assessment
Authors: Sandy-Hodgetts Kylie , Carville Keryln , Leslie Gavin D.
Published: March 2018

This paper presents a conceptual framework which outlines the risk factors associated with surgical wound dehiscence (SWD) as identified in the literature. The purpose for the development of the conceptual framework was to derive an evidence-based, informed understanding of factors associated with SWD, in order to inform a programme of research on the aetiology and potential risk factors of SWD. Incorporated within the patient-centric conceptual framework are patient related comorbidities, intraoperative and postoperative risk factors related to SWD. These are categorised as either ‘mechanical’ or ‘physiological mechanisms’ posited to influence these relationships. The use of the conceptual model for assessment of patients has particular clinical relevance for identification of risk and the management of patients in the pre-, intra- and postoperative period.
Delayed referral of patients with diabetic foot ulcers across Europe: patterns between primary care and specialised units
Authors: Manu Chris , Lacopi Elisabetta , Bouillet Benjamin , Vouillarmet Julien , Ahluwalia Raju , Lüdemann Claas , Garcia-Klepzig José Luis , Meloni Marco , De Buruaga Víctor Rodriguez-Saenz , Sánchez-Ríos Juan Pedro , Edmonds Mike , Apelqvist Jan , Lázaro-Martínez José Luis , Van Acker Kristien
Published: March 2018

Objective:

Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units.

Method:

A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU. The second part of the questionnaire collected data on recently managed DFU cases.

Results:

There were 600 questionnaires collected in the first part of the study (150 per country), and 1188 patient cases of DFU management were included in the second part. Up to 95% of patients had type 2 diabetes. Patients' complaints led to diagnosis, on average, 60% of the time, and the diagnosis was an incidental finding during a consultation 13–28% of the time. On average, only 40% of GPs completely agreed that they have clearly identified DFU clinical practitioners working in a hospital facility. In 55–66% of cases, the duration of DFU was unknown or DFU diagnosis was delayed more than three weeks from the onset of the wound. On average, 48% of patients were referred after an unknown duration or more than one month from the onset of DFU.

Conclusion:

Despite differences in health-care structures across Europe, delays in referral to specialist foot care teams seems to be a common theme. There is an ongoing need to educate GPs, nurses and patients to be more aware of the risk of DFU, and the need for prompt referral to specialist diabetic foot teams.