bluuebunny/crossref_metadata_2025 huggingface dataset:
Activation of Wnt/β-Catenin in Ewing Sarcoma Cells Antagonizes EWS/ETS Function and Promotes Phenotypic Transition to More Metastatic Cell States
Authors: Pedersen Elisabeth A. , Menon Rajasree , Bailey Kelly M. , Thomas Dafydd G. , Van Noord Raelene A. , Tran Jenny , Wang Hongwei , Qu Ping Ping , Hoering Antje , Fearon Eric R. , Chugh Rashmi , Lawlor Elizabeth R.
Published: July 2016

Ewing sarcomas are characterized by the presence of EWS/ETS fusion genes in the absence of other recurrent genetic alterations and mechanisms of tumor heterogeneity that contribute to disease progression remain unclear. Mutations in the Wnt/β-catenin pathway are rare in Ewing sarcoma but the Wnt pathway modulator LGR5 is often highly expressed, suggesting a potential role for the axis in tumor pathogenesis. We evaluated β-catenin and LGR5 expression in Ewing sarcoma cell lines and tumors and noted marked intra- and inter-tumor heterogeneity. Tumors with evidence of active Wnt/β-catenin signaling were associated with increased incidence of tumor relapse and worse overall survival. Paradoxically, RNA sequencing revealed a marked antagonism of EWS/ETS transcriptional activity in Wnt/β-catenin–activated tumor cells. Consistent with this, Wnt/β-catenin–activated cells displayed a phenotype that was reminiscent of Ewing sarcoma cells with partial EWS/ETS loss of function. Specifically, activation of Wnt/β-catenin induced alterations to the actin cytoskeleton, acquisition of a migratory phenotype, and upregulation of EWS/ETS–repressed genes. Notably, activation of Wnt/β-catenin signaling led to marked induction of tenascin C (TNC), an established promoter of cancer metastasis, and an EWS/ETS–repressed target gene. Loss of TNC function in Ewing sarcoma cells profoundly inhibited their migratory and metastatic potential. Our studies reveal that heterogeneous activation of Wnt/β-catenin signaling in subpopulations of tumor cells contributes to phenotypic heterogeneity and disease progression in Ewing sarcoma. Significantly, this is mediated, at least in part, by inhibition of EWS/ETS fusion protein function that results in derepression of metastasis-associated gene programs. Cancer Res; 76(17); 5040–53. ©2016 AACR.
Rapid Reprogramming of Primary Human Astrocytes into Potent Tumor-Initiating Cells with Defined Genetic Factors
Authors: Li Fang , Liu Xinjian , Sampson John H. , Bigner Darell D. , Li Chuan-Yuan
Published: July 2016

Cancer stem-like cells (CSC) are thought to drive brain cancer, but their cellular and molecular origins remain uncertain. Here, we report the successful generation of induced CSC (iCSC) from primary human astrocytes through the expression of defined genetic factors. Combined transduction of four factors, Myc, Oct-4, p53DD, and Ras, induced efficient transformation of primary human astrocytes into malignant cells with powerful tumor-initiating capabilities. Notably, transplantation of 100 transduced cells into nude mice was sufficient for tumor formation. The cells showed unlimited self-renewal ability with robust telomerase activities. In addition, they expressed typical glioma stem-like cell markers, such as CD133, CD15, and CD90. Moreover, these cells could form spheres in culture and differentiate into neuron-like, astrocyte-like, and oligodendrocyte-like cells. Finally, they also displayed resistance to the widely used brain cancer drug temozolomide. These iCSCs could provide important tools for studies of glioma biology and therapeutics development. Cancer Res; 76(17); 5143–50. ©2016 AACR.
Syndecan-1 (CD138) Suppresses Apoptosis in Multiple Myeloma by Activating IGF1 Receptor: Prevention by SynstatinIGF1R Inhibits Tumor Growth
Authors: Beauvais DeannaLee M. , Jung Oisun , Yang Yang , Sanderson Ralph D. , Rapraeger Alan C.
Published: July 2016

Syndecan-1 (Sdc1/CD138) expression is linked to disease severity in multiple myeloma, although the causal basis for this link remains unclear. Here we report that capture of the IGF1 receptor (IGF1R) by Sdc1 suppresses ASK1-dependent apoptosis in multiple myeloma cells. Sdc1 binds two different fractions of IGF1R, one that is constitutively active and a second that is activated by IGF1 ligand. Notably, IGF1R kinase activity in both fractions is blocked by synstatinIGF1R (SSTNIGF1R), a peptide that inhibits IGF1R capture by Sdc1, as well as by a truncated peptide (SSTNIGF1R-T) that appears to be specific for multiple myeloma cells. Mechanistically, we show that ASK1 is bound to active IGF1R and inhibited by Tyr and Ser83/Ser966 phosphorylation. When IGF1R engagement with Sdc1 is blocked by SSTNIGF1R, ASK1 becomes activated, and initiates JNK- and caspase-3–mediated apoptosis. In pharmacologic tests, we find SSTNIGF1R is highly stable in human plasma and displays a half-life of 27 hours in mice, wherein it significantly reduces both the size and neovascularization of CAG myeloma tumor xenografts. Taken together, our results offer a preclinical proof of concept and mechanistic rationale for the exploration of SSTNIGF1R as an experimental therapeutic to dually attack multiple myeloma tumor cell survival and tumor angiogenesis. Cancer Res; 76(17); 4981–93. ©2016 AACR.
Association of Lactase Persistence Genotypes with High Intake of Dairy Saturated Fat and High Prevalence of Lactase Non-Persistence among the Mexican Population
Authors: Ojeda-Granados Claudia , Panduro Arturo , Rebello Pinho João Renato , Ramos-Lopez Omar , Gleyzer Ketti , Malta Fernanda de Mello , Gonzalez-Aldaco Karina , Roman Sonia
Published: July 2016

Background/Aim: Lactase (LCT) -13910 C>T and -22018 G>A polymorphisms associated with the lactase non-persistence (LNP)/persistence (LP) phenotypes vary globally. LP has been associated with obesity in Europeans. However, it has not been genetically evaluated in Mexico, a country with admixed population, recent introduction of dairy, and a high prevalence of obesity. Thus, we aimed to determine the distribution of the LCT polymorphisms and their association with the nutritional profile of West Mexico's populations. Methods: Genotyping of 1,196 individuals (natives and mestizos) was carried out by a Taqman allelic discrimination assay. Descriptive statistics and interpopulation analyzes were performed by SPSS, Arlequin, and Structure software. Demographic, anthropometric, biochemical and dietary data were analyzed in 212 mestizos. Results: LNP genotypes mainly prevailed (CC 68.7% and GG 68.2%); both predominated in native Huicholes and Nahuas (>97.7%). Among the mestizos, the LP genotypes were associated with a higher intake of saturated fat (9.9 ± 3.9% vs. 8.5 ± 4.0%, p = 0.018; OR = 2.55, 95% CI 1.29-5.03, p = 0.006) and a daily/more frequent consumption of dairy (88.8 vs. 78.0%; p = 0.049) than LNP genotypes. Conclusion: The LNP trait was predominant in Mexicans with a major Amerindian ancestry. A daily consumption of dairy was associated with a higher intake of saturated fat in LP individuals.
Enhanced Torque Control and Reduced Switching Frequency in Direct Torque Control Utilizing Optimal Switching Strategy for Dual-Inverter Supplied Drive
Authors: Rahim M. Khairi , Jidin Auzani , Sutikno Tole
Published: July 2016

Direct Torque Control (DTC) of induction machine has received wide acceptance in many adjustable speed drive applications due to its simplicity and high performance torque control. However, the DTC using a common two-level inverter poses two major problems such as higher switching frequency (or power loss) and larger torque ripple. These problems are due to inappropriate voltage vectors which are selected among a limited number of voltage vectors available in two-level inverter. The proposed research aims to formulate an optimal switching strategy using Dual-Inverter Supplied Drive for high performances of DTC. By using dual-inverter supplied, it provides greater number of voltage vectors which can offer more options to select the most appropriate voltage vectors. The most appropriate voltage vectors should able to produce minimum torque slope but sufficient to satisfy torque demands. The identification is accomplished by using an equation of rate of change of torque which is derived from the induction machine equations. The proposed strategy also introduces a block of modification of torque error status which is responsible to modify the status such that it can determine the most optimal voltage vectors from a look-up table, according to motor operating conditions. The improvements obtained are as follows; 1) minimization of switching frequency (reduce power loss), and 2) reduction of torque ripple. Some improvements obtained in the proposed strategy were verified via experimentations.
FPGA Based Design and Validation of Asymmetrical Reduced Switch Multilevel Inverter
Authors: Bharatiraja C , Reddy Harshavardhan , Sai Suma Sunkavalli Satya , SriRamsai N
Published: July 2016

This paper proposes a new Asymmetrical multilevel inverter topology with reduced number of switches. This topology is superior to the existing multilevel inverter (MLI) conﬁgurations in terms of lower total harmonic distortion (THD) value and lower cost. The idea incorporates a new module setup comprising of four different voltage sources having voltage output levels in a specific ratio. The proposed topology uses a novel pulse width modulation (PWM) technique (as presented) to control the gating pulses. The operation is simulated using MATLAB/SIMULINK and its results are validated through FPGA Spartan 3 based hardware prototype inverter (using three voltage sources to produce a 7 level output, which may be extended to 15 level). The circuit complexity is drastically reduced and it is suitable for medium and high power applications. THD for the output is quite low when compared with the conventional inverter.
Possíveis leituras do conto O visto, de Ondina Ferreira
Authors: Gomes Mariana Andrade
Published: July 2016

Este texto tem como objeto de análise a breve narrativa ficcional decorrida no século XXI sobre uma mulher da ilha do Fogo. A partir da tentativa de retirada do Visto para os Estados Unidos por Dona Victória, pretendo analisar aqui as formas com as quais a potência subversora do riso pode ser utilizada para operacionalizar discursos de resistências/persistências entre Cabo Verde e os novos (EUA) e velhos (Portugal) centros de Poder.
Luís Saia e a evolução arquitetônica regional: da morada paulista às práticas de proteção ao patrimônio cultural nacional
Authors: Lowande Walter Francisco Figueiredo
Published: July 2016

Neste artigo trato das ações federais de proteção ao patrimônio cultural em São Paulo, com destaque à figura de Luis Saia, tomando como eixo central da reflexão a produção historiográfica que forneceu sentido e efetividade a esse conjunto de práticas. Pretendo demonstrar como a produção de uma narrativa relacionada à noção de “evolução cultural paulista” permitiu orientar um conjunto de práticas preservacionistas, num longo período que se inicia com uma frustração inicial dos projetos intelectuais paulistas sob a liderança de Mário de Andrade e deságuam num momento em que a expansão urbana cobrava novos significados ao patrimônio cultural nacional.
Terapia ocupacional e consultoria colaborativa: uma revisão narrativa da literatura.
Authors: Rizzo dos Santos Andréa , De La Libra Sarah
Published: July 2016

O objetivo deste estudo foi realizar uma análise reflexiva da literatura científica nacional sobre a atuação da Terapia Ocupacional na educação inclusiva por meio da Consultoria Colaborativa, identificando as dificuldades encontradas na prática, bem como as estratégias utilizadas e os benefícios resultantes. Foi realizado um levantamento de artigos publicados em quatro periódicos online na área de Terapia Ocupacional e Educação Especial, com os seguintes descritores: “Terapia Ocupacional”, “Consultoria Colaborativa”, “Consultoria Escolar” e “Inclusão Escolar”; quatro artigos foram selecionados e analisados. Como resultado temos: a deficiência na capacitação de recursos humanos e na provisão de recursos materiais como a principal barreira da educação inclusiva; as estratégias utilizadas variam, mas encontros presenciais entre terapeuta ocupacional e equipe escolar são relatados em todos os artigos; a possibilidade de resolução de problemas e o oferecimento de suporte técnico estão entre os benefícios citados. Como conclusão, os estudos apresentam a consultoria colaborativa como um modelo de prestação de serviço promissor, entretanto há a necessidade de desenvolver mais pesquisas sobre o assunto.
Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics
Authors: Gruca Thomas S. , Pyo Tae‐Hyung , Nelson Gregory C.
Published: July 2016

Background

Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access.

Methods and Results

Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty‐five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office‐based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year.

Conclusions

Cardiologists in Iowa and adjoining states have expanded access to office‐based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full‐time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients’ home county.
Effect of Varying Hemodynamic and Vascular Conditions on Fractional Flow Reserve: An In Vitro Study
Authors: Kolli Kranthi K. , Min James K. , Ha Seongmin , Soohoo Hilary , Xiong Guanglei
Published: July 2016

Background

The aim of this study was to investigate the impact of varying hemodynamic conditions on fractional flow reserve (ratio of pressure distal [P
d
] and proximal [P
a
] to stenosis under hyperemia) in an in vitro setting. Failure to achieve maximal hyperemia and the choice of hyperemic agents may have differential effects on coronary hemodynamics and, consequently, on the determination of fractional flow reserve.

Methods and Results

An in vitro flow system was developed to experimentally model the physiological coronary circulation as flow‐dependent stenosis resistance in series with variable downstream resistance. Five idealized models with 30% to 70% diameter stenosis severity were fabricated using VeroClear rigid material in an Objet260 Connex printer. Mean aortic pressure was maintained at 7 levels (60–140 mm Hg) from hypotension to hypertension using a needle valve that mimicked adjustable microcirculatory resistance. A range of physiological flow rates was applied by a steady flow pump and titrated by a flow sensor. The pressure drop and the pressure ratio (P
d
/P
a
) were assessed for the 7 levels of aortic pressure and differing flow rates. The in vitro experimental data were coupled with pressure–flow relationships from clinical data for populations with and without myocardial infarction, respectively, to evaluate fractional flow reserve. The curve for pressure ratio and flow rate demonstrated a quadratic relationship with a decreasing slope. The absolute decrease in fractional flow reserve in the group without myocardial infarction (with myocardial infarction) was on the order of 0.03 (0.02), 0.05 (0.02), 0.07 (0.05), 0.17 (0.13) and 0.20 (0.24), respectively, for 30%, 40%, 50%, 60%, and 70% diameter stenosis, for an increase in aortic pressure from 60 to 140 mm Hg.

Conclusions

The fractional flow reserve value, an index of physiological stenosis significance, was observed to decrease with increasing aortic pressure for a given stenosis in this idealized in vitro experiment for vascular groups with and without myocardial infarction.
Repeated Intravenous Thrombolysis for Early Recurrent Stroke
Authors: Kahles Timo , Mono Marie-Luise , Heldner Mirjam Rachel , Baumgartner Ralf Werner , Sarikaya Hakan , Luft Andreas , Bohlhalter Stephan , Traenka Christopher , Engelter Stefan T. , Kurka Natalia , Köhrmann Martin , Curtze Sami , Michel Patrik , Tatlisumak Turgut , Nedeltchev Krassen
Published: July 2016

Background and Purpose—

Intravenous thrombolysis (IVT) within 4.5 hours from symptom onset improves functional outcome in patients with acute ischemic stroke. Its use in patients with previous stroke within the preceding 3 months is contraindicated because of the assumed higher risk of intracranial hemorrhage. In addition, tissue-type plasminogen activator may itself promote neurotoxicity and blood–brain barrier disruption. However, safety and effectiveness of repeated IVT is essentially unknown in patients with early (<3 months) recurrent stroke (ERS), because they were excluded from thrombolysis trials. This article reports the largest case series of repeated IVT in ERS.

Methods—

We reviewed databases of prospectively collected patient data of 8 European stroke centers for the presence of patients with ERS, who received IVT for both the index stroke and ERS. Demographics, clinical and radiological data, bleeding complications, and functional outcome were analyzed.

Results—

We identified 19 subjects with repeated IVT in ERS. Mean age was 68±12 years, and 37% of them were female. Median interthrombolysis interval was 30 days (interquartile range, 13–50). Functional independence (modified Rankin scale score ≤2) was achieved in 79% of patients after the first and in 47.4% after repeated IV tissue-type plasminogen activator, respectively. There was no symptomatic intracranial hemorrhage. Median final infarct volume after the first IVT was 1.5 cm
3
(interquartile range, 0.5–3.1).

Conclusions—

Patients with small infarct volumes and robust clinical improvement might be considered for repeated IVT within 3 months. Studies following strict protocols and larger registries incorporating these patients might serve to identify selection criteria for the safe use of repeated IVT in ERS.
Safety of Computed Tomographic Angiography in the Evaluation of Patients With Acute Stroke
Authors: Ehrlich Matthew E. , Turner Heather L. , Currie Lillian J. , Wintermark Max , Worrall Bradford B. , Southerland Andrew M.
Published: July 2016

Background and Purpose—

Noncontrasted head computed tomography (NCHCT) has long been the standard of care for acute stroke imaging. New guidelines recommending advanced vascular imaging to identify eligible patients for endovascular therapy have renewed safety concerns on the use of contrast in the emergent setting without laboratory confirmation of renal function.

Methods—

We compared computed tomographic angiography (CTA) versus NCHCT alone during acute stroke evaluation with focus on renal safety and timeliness of therapy delivery. We reviewed data on all emergency department patients for whom the Acute Stroke Intervention Team was activated between December 2013 and September 2014. Primary outcomes included acute kidney injury and change in serum creatinine from presentation to 24 to 48 hours (Δ serum creatinine [Cr]). We assessed therapy delay using door-to-CT and door-to-needle times.

Results—

Of 289 patients requiring Acute Stroke Intervention Team activation, 157 received CTA and 132 NCHCT only. There was no difference between groups in mean Cr at 24 to 48 hours (1.06 CTA; 1.40 NCHCT;
P
=0.059), ΔCr (−0.07 CTA, −0.11 NCHCT,
P
=0.489), or rates of acute kidney injury (5 CTA, 7 NCHCT,
P
=0.422). There was no significant difference in mean intravenous tissue plasminogen activator treatment times (68.11 minutes CTA, 81.36 minutes NCHCT;
P
=0.577). In the 157 patients who underwent CTA, 16 (10.2%) vascular anomalies and 55 (35.0%) high-grade stenoses or occlusions were identified.

Conclusions—

CTA acquisition during acute stroke evaluation was safe with regards to renal function and did not delay appropriate therapy delivery. Acute CTA acquisition offers additional clinical value in rapid identification of vascular abnormalities.
The Pioneer of Generative Art: Georg Nees
Authors: Nake Frieder
Published: July 2016

The pioneer of computer art Georg Nees passed away on 3 January 2016, at the age of 89. He was the first to exhibit computer-generated drawings, in Stuttgart in February 1965. Influenced by Max Bense’s information aesthetics (a rational aesthetics of the object based on Shannon’s information theory), Nees completed his PhD thesis in 1968 (in German). Its title, Generative Computergraphik, is an expression of the new movement of generative art and design. Trained as a mathematician, Nees participated in many early, but also recent, displays of computer art. After retiring from his research position at Siemens in Erlangen, he again concentrated on computer-generated art and researched issues of digital coloring but also wrote several novels expressing his philosophy of a nonreligious, human-made culture.
Doing relationships and sexuality education with young people in state care
Authors: Hyde Abbey , Fullerton Deirdre , McKeown Caroline , Lohan Maria , Dunne Laura , Macdonald Geraldine
Published: July 2016

Background:

Existing literature indicates that young people in state care have particular sexual health needs that include addressing their social and emotional well-being, yet little has been published as to how these components of sex education are actually delivered by service-providers.

Objective:

The aim of this study was to analyse the processes involved in delivering relationship and sexuality education to young people in state care from the perspectives of a sample of service-providers with a role in sexual health-care delivery.

Design:

Qualitative methodological strategy.

Setting:

Service-delivery sites at urban and rural locations in Ireland.

Method:

A total of 22 service-providers were interviewed in depth, and data were analysed using a qualitative analytical strategy resembling modified analytical induction.

Findings:

Participants proffered their perceptions and examples of their practices of sex education in relation to the following themes: (1) acknowledging the multi-dimensional nature of sexual health in the case of young people in care; (2) personal and emotional development education to address poor self-esteem, emotional disconnectedness and an inability to recognise and express emotions; (3) social skills’ education as part of a repertoire of competencies needed to negotiate relationships and safer sex; (4) the application of positive social skills embedded in everyday social situations; and (5) factual sexuality education.

Conclusion:

Insights into service-providers’ perceptions of the multi-dimensional nature of the sexual health needs of young people in state care, and the ways in which these service-providers justified their practice make visible the complex character of sex education and the degree of skill required to deliver it to those in state care.
Depressive symptoms of house-poor persons: Korean panel data evidence
Authors: Lee Tae-Hoon , Park Eun-Cheol , Kim Woorim , Kim Juyeong , Shin Jaeyong , Kim Tae Hyun
Published: July 2016

Background:

There are no studies researching the relationship between house-poor persons and mental health. Therefore, this study aimed to investigate the relationship between house-poor status and depressive symptoms.

Aim:

To examine the relationship between the house-poor and depressive symptoms according to household income.

Methods:

Data from the Korean Welfare Panel Study were used. House-poor were defined as people having possession with over 10% house-related interest in disposable income. About 7,565 participants over the age of 19 years were followed up from 2011 to 2013. The generalized estimating equations were used for analysis.

Results:

Individuals with more house-related debt showed increasingly higher depression scores (possession with under 5% related debt to disposable income β = 0.2024, p = .1544; under 10% β = 0.7030, p = .0008; over 10% β = 1.3207, p < .0001). Individuals possessing houses with over 10% ratio of house-related debts to disposable income had higher depression scores than individuals without house ownership (no possession β = 0.8927, p < .0001).

Conclusion:

Individuals without houses and individuals owning houses with higher percentages of house-related interests showed higher levels of depressive symptoms. Therefore, this study affirmed that the importance of considering the most vulnerable groups in addressing the mental health of individual.
To do more, better, faster and more cheaply: using big data in public administration
Authors: Maciejewski Mariusz
Published: July 2016

Big data have become a game-changer for modern public administration in those areas in which they are used. Although their application is still limited in the public sector, their use develops dynamically in areas where they bring tangible results in terms of efficiency and efficacy. This article presents the concept of big data, outlines the possibilities for using big data in the public sector and methods of their utilization, highlights cases where these have been implemented, along with the results. This article discusses applications of big data methods in public policy design and implementation and in public authority internal management. It includes a summary of the benefits, disadvantages and challenges related to utilization of big data. The article also briefly addresses historical, current and predictive approaches. Research was carried out using internet-based case analysis and is limited by the confidentiality of details relating to big data methods. Although the research has had to be limited to publicly available descriptions, the findings make it possible to understand the big data phenomenon in public administration and to draw general lessons from their use.

Points for practitioners

Big data is a contemporary phenomenon. Properly utilized it brings astonishingly positive outcomes for public administration in terms of its efficacy, efficiency, and overall client satisfaction. These benefits are a result of significant increase in the accuracy of decision-making, a significant acceleration of performance of internal the ‘information task’ and a significant reduction in operating costs related to the decision-making process. This is possible thanks to the digitization of human life and IT developments applied in a specific way for public administration – the way of big data methods where huge amounts of data are processed in a form of reasoning by powerful IT technology to present information that helps public administration to better perform its task.
Which Personality Traits Moderate the Relationship Between Religious Capital and Depressive Symptomology in a National Sample of African Americans?
Authors: Clark Eddie M. , Holt Cheryl L. , Wang Min Qi , Williams Beverly R. , Schulz Emily
Published: July 2016

The present study examined the relationship between religious capital and depressive symptoms and the moderating role of the Big Five personality constructs in a national sample of African American adults. Data were collected from a national probability sample of 803 African American men and women using a telephone survey including measures of the Big Five personality traits, religious capital, and depressive symptomology. Most interestingly, there was evidence for Personality × Religious Capital interactions on depressive symptomology. Higher religious capital was related to lower depressive symptomology among persons with low conscientiousness or low openness to experience. However, religious capital was less related to depressive symptoms among those with high conscientiousness or high openness. This study reinforces the importance of examining the moderating effects of personality and perceived religious capital in understanding mental health outcomes. This information can be of use to practitioners in designing culturally appropriate interventions, including the use of capital from faith-based organizations.
Biracial Group Membership Scale
Authors: Franco Marisa G. , Holmes Olivia L.
Published: July 2016

With individuals of mixed African heritage increasingly identifying as Biracial, it is important to determine whether Black people continue to perceive Biracial people as members of their community. The status of Biracial individuals within the Black community has implications for the political power of the Black community and also for Biracial individuals’ racial identity development and well-being. Thus, the purpose of this study was to create a psychometrically sound measure to assess the degree to which Black people accept Biracial people as members of the Black community: the Biracial Group Membership Scale. Factor analyses were conducted with 328 Black adults. Exploratory factor analysis revealed two factors: Rejection of Biracial People and Forced Black Identity. A confirmatory factor analysis provided support for the initial factor structure. The scale related to the Attitudes Toward Multiracial Children Scale, essentialism, and items assessing interactions with Biracial individuals. Limitations, suggestions for future research, and implications are discussed.
Multi‐institutional Study of Voice Disorders and Voice Therapy Referral
Authors: Misono Stephanie , Marmor Schelomo , Roy Nelson , Mau Ted , Cohen Seth M.
Published: July 2016

Objectives

To assess perspectives of patients with voice problems and identify factors associated with the likelihood of referral to voice therapy via the CHEER (Creating Healthcare Excellence through Education and Research) practice‐based research network infrastructure.

Study Design

Prospectively enrolled cross‐sectional study of CHEER patients seen for a voice problem (dysphonia).

Setting

The CHEER network of community and academic sites.

Methods

Patient‐reported demographic information, nature and severity of voice problems, clinical diagnoses, and proposed treatment plans were collected. The relationship between patient factors and voice therapy referral was investigated.

Results

Patients (N = 249) were identified over 12 months from 10 sites comprising 30 otolaryngology physicians. The majority were women (68%) and white (82%). Most patients reported a recurrent voice problem (72%) and symptom duration >4 weeks (89%). The most commonly reported voice‐related diagnoses were vocal strain, reflux, and benign vocal fold lesions. Sixty‐seven percent of enrolled patients reported receiving a recommendation for voice therapy. After adjusting for sociodemographic and other factors, diagnoses including vocal strain/excessive tension and vocal fold paralysis and academic practice type were associated with increased likelihood of reporting a referral for voice therapy.

Conclusions

The CHEER network successfully enrolled a representative sample of patients with dysphonia. Common diagnoses were vocal strain, reflux, and benign vocal fold lesions; commonly reported treatment recommendations included speech/voice therapy and antireflux medication. Recommendation for speech/voice therapy was associated with academic practice type.
Variation in the Use of Vestibular Diagnostic Testing for Patients Presenting to Otolaryngology Clinics with Dizziness
Authors: Piker Erin G. , Schulz Kris , Parham Kourosh , Vambutas Andrea , Witsell David , Tucci Debara , Shin Jennifer J. , Pynnonen Melissa A. , Nguyen‐Huynh Anh , Crowson Matthew , Ryan Sheila E. , Langman Alan , Roberts Rhonda , Wolfley Anne , Lee Walter T.
Published: July 2016

Objective

We used a national otolaryngology practice–based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder.

Study Design

Database review.

Setting

The Creating Healthcare Excellence through Education and Research (CHEER) practice‐based research network of academic and community providers

Subjects and Methods

Dizzy patients in the CHEER retrospective database were identified through ICD‐9 codes; vestibular testing procedures were identified with CPT codes. Demographics and procedures per patient were tabulated. Analysis included number and type of vestibular tests ordered, stratified by individual clinic and by practice type (community vs academic). Chi‐square tests were performed to assess if the percentage of patients receiving testing was statistically significant across clinics. A logistic regression model was used to examine the association between receipt of testing and being tested on initial visit.

Results

A total of 12,468 patients diagnosed with dizziness and/or a vestibular disorder were identified from 7 community and 5 academic CHEER network clinics across the country. One‐fifth of these patients had at least 1 vestibular function test. The percentage of patients tested varied widely by site, from 3% to 72%; academic clinics were twice as likely to test. Initial visit vestibular testing also varied, from 0% to 96% of dizzy patients, and was 15 times more likely in academic clinics.

Conclusion

There is significant variation in use and timing of vestibular diagnostic testing across otolaryngology clinics. The CHEER network research database does not contain outcome data. These results illustrate the critical need for research that examines outcomes as related to vestibular testing.
Evaluation of Compliance for Treatment of Sudden Hearing Loss
Authors: Witsell David L. , Khoury Tawfiq , Schulz Kristine A. , Stachler Robert , Tucci Debara L. , Wojdyla Daniel
Published: July 2016

Objective

The objective of this study is to describe the presentation and management of sudden sensorineural hearing loss for patients seen in academic and community‐based practices within the context of the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s “Clinical Practice Guideline: Sudden Hearing Loss.” The intention is to use these findings to guide implementation strategies and quality improvement initiatives and as pilot data for the development of clinical research initiatives.

Study Design

A cross‐sectional study of patients with sudden hearing loss.

Setting

Patients were recruited from practices within the Creating Healthcare Excellence through Education and Research (CHEER) network. The CHEER network is an National Institutes of Health–funded network of 30 otolaryngology sites across the country, half of which are community based and half of which are academic practices.

Subjects and Methods

A total of 173 patients were recruited. Data were gathered via custom questionnaires collected by study site coordinators and entered into a secure online platform. Descriptive analyses and correlation statistics were run with SAS 9.3.1.

Results

Of the 13 guideline statements in the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s clinical practice guideline on sudden hearing loss, 11 statements were evaluable through this study. Compliance for otolaryngologists was >95% for key action statements (KASs) 1, 3, and 6; 90% to 95% for KASs 5 and 10; and <90% for KASs 7 and 13. Compliance was <45% for nonotolaryngologists for KASs 3 and 5‐7.

Conclusions

There is opportunity for nonotolaryngologists to improve for statements 3 and 5‐7. Otolaryngologists are compliant with many of the KASs overall, but there is significant room for improvement.
Smoking status and 30-day mortality in patients undergoing pulmonary resections
Authors: Mediratta Neeraj , Poullis Michael
Published: July 2016

Background

Smoking status has not been shown to have a significant effect on 30-day mortality after potentially curative resectional surgery for non-small-cell lung cancer, and this is reflected in the guidelines of the National Institute for Health and Care Excellence in the United Kingdom.

Methods

A validated prospective thoracic surgery database of consecutive patients undergoing potentially curative resection at a single institution was analyzed. Univariate and propensity analyses of 30-day mortality were performed.

Results

Univariate analysis identified 30-day mortality as significantly lower in current smokers ( n = 852, 2.6%) than ex-smokers ( n = 1587, 4.9%; p < 0.001). Propensity 1:1 matching of male patients resulted in 727 current smokers being matched to 727 ex-smokers. The overall balance test (χ2 = 6.1, degrees of freedom = 8, p = 0.6), indicated a good match. After propensity matching, the mortality rate was significantly higher in current smokers ( p = 0.01).

Conclusions

Current smokers and ex-smokers are statistically different with regard to risk factors for death. This results in a skewed population of current and ex-smokers undergoing resection for non-small-cell lung cancer. Development of a risk model for 30-day mortality revealed that current smokers have a lower predicted 30-day mortality than ex-smokers, a finding that is counterintuitive. Propensity matching balanced the current and ex-smoker groups to correct for group differences. Analysis after propensity matching identified current smoking as a significant factor determining 30-day mortality.
Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction
Authors: Lee Joon Kyu , Lee Sahnghoon , Lee Myung Chul
Published: July 2016

Background:

The choice of graft type is an important factor to the outcome of anterior cruciate ligament (ACL) reconstruction.

Purpose:

To compare knee joint stability and functional outcomes of anatomic ACL reconstruction with double-bundle hamstring tendon (DBHT) and bone–quadriceps tendon (BQT) autografts.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Ninety-six patients underwent ACL reconstruction with either DBHT (hamstring group) or BQT autograft (quadriceps group). Each group included 48 patients who were retrospectively matched on the basis of age, sex, and body mass index; there were no statistically significant differences between the 2 groups (all P > .05). All patients had a minimum follow-up of 2 years. Outcome evaluations included the manual laxity test, International Knee Documentation Committee subjective evaluation, Tegner activity score, modified Lysholm score, anterior knee pain questionnaire, KT-2000 arthrometer side-to-side difference, Cybex II isokinetic testing, and tunnel position evaluation by quadrant method.

Results:

Manual laxity test results were significantly improved in both groups after surgery (all P < .05). The maximum KT-2000 arthrometer side-to-side difference improved from 4.0 to 1.9 mm in the hamstring group and 3.9 to 2.1 mm in the quadriceps group ( P = .65). Modified Lysholm scores in the hamstring and quadriceps groups improved from 69.4 and 70.2 to 88.4 and 92.1 ( P = .30), and International Knee Documentation Committee subjective evaluation scores improved from 56.0 and 60.3 to 77.9 and 80.2 ( P = .37), respectively. Tegner activity scores for the hamstring and quadriceps groups were 4.7 and 4.6 preoperatively and 4.6 and 4.7 ( P = .80) at final follow-up, respectively. There were no between-group differences on postoperative anterior knee pain ( P > .05 for all questionnaire categories), nor were there differences in recovered extensor muscle strength during isokinetic testing (82.9% vs 81.0% at 60 deg/s, P = .71; 85.1% vs 83.8% at 180 deg/s, P = .81). However, flexor muscle strength recovery was better in the quadriceps group (86.6% vs 92.2% at 60 deg/s, P = .22; 87.1% vs 99.6% at 180 deg/s, P = .01). There were no significant differences in tunnel positioning between the 2 groups (all P > .05).

Conclusion:

Anatomic ACL reconstruction with the BQT autograft showed similar knee stability and functional outcome scores when compared with the DBHT autograft. Additionally, better flexor muscle strength recovery was found in the quadriceps group, indicating a potential advantage of the BQT autograft in ACL reconstruction.
Treatment pathways in an inception lupus cohort over the first three years
Authors: Hanly J G , Sayani A , Doucette S , Iczkovitz S , Terres J A Ross
Published: July 2016

Objective

The treatment algorithm for new onset systemic lupus erythematosus (SLE) is less well defined than for other rheumatic diseases. We examined the treatment patterns in an inception cohort of SLE patients over the first three years of disease between 2000 and 2010.

Methods

Patients fulfilled the American College of Rheumatology classification criteria for SLE within 12 months of enrollment and completed three subsequent annual visits. Data collection included patient demographics, SLE manifestations, medications, SLE disease activity index-2K (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index. Analysis included descriptive statistics and repeated measures mixed models.

Results

Seventy-nine patients, 83.5% female and 91.1% Caucasian were studied. At baseline the mean (SD) age was 40.6 (16.4) years, disease duration was 0.36 (0.28) years and SLEDAI-2K was 5.7 (4.6). Over three years, cumulative use of corticosteroids, antimalarials and immunosuppressants was 53.2%, 77.2% and 40.5% respectively. Corticosteroids were usually used in combination with antimalarials and/or immunosuppressants. Between baseline and final assessments the use of corticosteroids fell (44.3% vs 15.2%) in contrast to antimalarials (55.7% vs 70.9%) and immunosuppressants (26.6% vs 34.2%). Of 44/79 (55.7%) patients not receiving corticosteroids at baseline 84.1% remained off corticosteroids for the study duration. Thirty-seven of 79 (46.8%) patients never received corticosteroids and only 5/79 (6.3%) at all four assessments. Patients taking corticosteroids at baseline had higher mean (SD) daily dose and cumulative dose over three years compared with patients not on corticosteroids at baseline (9.0 (0.8) vs 0.3 (1.3) mg; 10.8 (8.5) vs 0.3 (1.2) g). As a group, SLE patients who used corticosteroids either at baseline, at any time in the three year study or in high cumulative doses had the highest average disease activity scores over the same time frame and had a significant fall in SLEDAI-2K scores ( p < 0.05) compared with patients not exposed to corticosteroids.

Conclusion

Use of corticosteroids occurred in approximately half of new onset SLE, usually in combination with antimalarials and/or immunosuppressants. It was associated with both higher disease activity at baseline and improvement over time. Patients who did not receive corticosteroids at presentation were unlikely to do so over the next three years.
Public engagement in Malawi through a health-talk radio programme ‘Umoyo nkukambirana’: A mixed-methods evaluation
Authors: Nyirenda Deborah , Makawa Tamara Chipasula , Chapita Greyson , Mdalla Chisomo , Nkolokosa Mzati , O’byrne Thomasena , Heyderman Robert , Desmond Nicola
Published: July 2016

Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ‘ Umoyo nkukambirana’ was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings.
Threats to nurses’ dignity and intent to leave the profession
Authors: Valizadeh Leila , Zamanzadeh Vahid , Habibzadeh Hosein , Alilu Leyla , Gillespie Mark , Shakibi Ali
Published: July 2016

Background:

It is essential to pay attention to and respect the dignity of nurses to maintain them in their profession while they deliver skilled nursing care. Little is known, however, about how a sense of dignity influences the practitioner.

Objectives:

The purpose of this study is to describe nurses’ experiences of threats to their dignity occurring within clinical settings, which generates an intention to leave clinical practice.

Research design and method:

The study was performed using qualitative content analysis. The participants were 21 clinical nurses with work experience who were employed across a range of clinical posts. Data obtained from the semi-structured interviews were analyzed and interpreted using a content analysis approach.

Ethical considerations:

The study was approved by the Ethics Committee of Tabriz University of Medical Sciences and was guided by the ethical principles of voluntary enrolment, anonymity, privacy, and confidentiality.

Findings:

Within data analysis, three main themes and nine categories were extracted as follows: (1) lack of professional pride (physician’s dominance, intangible nature of nursing, and negative attitude toward clinical nurses); (2) oppressive work environment (high workload, disrespect, discrimination, and lack of support); and (3) suppression of progressivism (lack of appreciation and attention to meritocracy).

Discussion:

Almost all of the participants have experienced some degree of disrespect and violation of dignity. In general, attempts made by the participants to show their objection to the threats and to support and protect their dignity have not been effective and in fact made them more inclined to leave the clinical work.

Conclusion:

According to the views of nurses themselves, identification of the factors threatening nurses’ dignity can be one of the appropriate solutions for the broader and deeper investigation of this phenomenon and can help promote and support nurses’ dignity and their retention within the profession.
Women’s Labour Force Participation and Domestic Violence
Authors: Paul Sohini
Published: July 2016

Domestic violence is recognized as a serious violation of women’s basic rights. Conventional economic models of domestic violence suggest that higher labour force participation by women leads to a decrease in domestic violence. In this article, we study the relationship between women’s employment and domestic violence using the ecological framework of violence developed by Heise (1998). We use a sample of 69,704 married women aged 15–49 years from Round III of the National Family Health Survey (NFHS) data (2005–2006) for our analysis. We report a positive association between women’s labour force participation and physical as well as emotional abuse by husbands: employed women are thus more exposed to intimate partner violence. However, we did not find much evidence that domestic violence resulted from a larger control of household resources by working women. We argue that the emotional cost may become high for men when household decision-making power diverges from the traditional gender norm, and men may turn to violence to restore their domestic dominance.