bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescent Behavioral Cancer Prevention in the United States: Creating a Composite Variable and Ranking States’ Performance
Authors: Moss Jennifer L. , Liu Benmei , Zhu Li
Published: April 2019

Preventive behaviors established during adolescence can reduce cancer throughout the life span. Understanding the combinations of multiple behaviors, and how these behaviors vary across states, is important for identifying where additional interventions are needed. Using data on 2011-2015 vaccination, energy balance, and substance use from national surveys, we created state-level composite scores for adolescent cancer prevention. Hierarchical Bayesian linear mixed models were used to predict estimates for states with no data on select behaviors. We used a Monte Carlo procedure with 100,000 simulations to generate states’ ranks and 95% confidence intervals. Across states, hepatitis B vaccination was 84.3% to 97.1%, and human papillomavirus vaccination was 41.8% to 78.0% for girls and 19.0% to 59.3% for boys. For energy balance, 20.2% to 34.6% of adolescents met guidelines for physical activity, 4.1% to 15.8% for fruit and vegetable consumption, and 66.4% to 82.0% for healthy weight. For substance use, 82.5% to 93.5% reported abstaining from binge alcohol use, 84.3% to 95.4% from cigarette smoking, and 62.9% to 92.8% from marijuana use. (1) Rhode Island, (2) Colorado, (4) Hawaii and New Hampshire (tied), and (5) Vermont performed the best for adolescent cancer prevention, and (47) Missouri, (48) Arkansas, Mississippi, and South Carolina (tied), and (51) Kentucky performed the worst. However, 95% CIs around ranks often overlapped, indicating lack of statistical differences. Adolescent cancer prevention behaviors clustered into a composite index. States varied on their performance on this index, especially for states at the high and low extremes, but most states did not differ statistically. These findings can inform decision makers about where and how to intervene to improve cancer prevention among adolescents.
Traction force for peroperative hip dislocation in hip arthroscopy
Authors: Röling Maarten A , Mathijssen Nina MC , Blom Ian , Lagrand Tirza , Minderman Donny , Bloem Rolf M
Published: April 2019

Objectives:

Traction force widens the joint space during hip arthroscopy. It is unclear how much the traction force varies and if it is related to the joint space widening. Main goal of our study was to measure the amount of force needed to widen the hip joint. Second goal was to study the relation between this force and the amount of joint space widening.

Methods:

Traction force was measured in 27 patients (of whom 24 female, mean age 41) during arthroscopy. Measurements were performed before the procedure, after vacuum seal release and after capsulotomy. Joint space widening was measured with fluoroscopy and was calibrated. Friedman and Wilcoxon tests were used to measure differences in traction. The Spearman’s rho correlation coefficient was used to identify a correlation in traction force and joint space widening. Regression analyses were used to identify relations between age, body mass index (BMI), hip degeneration and traction force.

Results:

The median traction force before arthroscopy was 714 N, lowered to 520 N after vacuum seal release and to 473 N after capsulotomy ( p < 0.001). Median joint space widening was 8.8 mm. Spearmans’ rho correlation between traction force and joint space widening was ‒0.13.

Discussion:

Median traction force of 714 N resulted in 8.8 mm of joint space widening. This traction force was significantly lowered by 200 N after release of the vacuum seal of the hip and 250 N after additional capsulotomy without loss of joint space narrowing. No significant relation was identified for age, BMI or progression of the Kellgren-Lawrence classification for hip degeneration and traction force. Netherlands Trial Registry number 8610
Genome-Wide Search for Tyrosine Phosphatases in the Human Genome Through Computational Approaches Leads to the Discovery of Few New Domain Architectures
Authors: Bhattacharyya Teerna , Sowdhamini Ramanathan
Published: April 2019

Reversible phosphorylation maintained by protein kinases and phosphatases is an integral part of intracellular signalling, and phosphorylation on tyrosine is extensively utilised in higher eukaryotes. Tyrosine phosphatases are enzymes that not only scavenge phosphotyrosine but are also involved in wide range of signalling pathways. As a result, mutations in these enzymes have been implicated in the pathogenesis of several diseases like cancer, autoimmune disorders, and muscle-related diseases. The genes that harbour phosphatase domain also display diversity in co-existing domains suggesting the recruitment of the catalytic machinery in diverse pathways. We have examined the current draft of the human genome, using a combination of 3 sequence search methods and validations, and identified 101 genes encoding tyrosine phosphatase-containing gene products, agreeing with previous reports. Such gene products adopt 37 unique domain architectures (DAs), including few new ones and harbouring few co-existing domains that have not been reported before. This semi-automated computational approach for detection of gene products belonging to a particular superfamily can now be easily applied at whole genome level on other mammalian genomes and for other protein domains as well.
Altered Tryptophan Catabolism in Placentas From Women With Pre-eclampsia
Authors: Keaton Sarah A , Heilman Patrick , Bryleva Elena Y , Madaj Zachary , Krzyzanowski Stanislaw , Grit Jamie , Miller Emily S , Jälmby Maya , Kalapotharakos Grigoros , Racicot Karen , Fazleabas Asgerally , Hansson Stefan R , Brundin Lena
Published: April 2019

Background:

The kynurenine pathway enzymes, breaking down tryptophan, are abundant in placental tissue. These metabolites are involved in immunoregulatory mechanisms, although the role of this pathway in pre-eclampsia (PE) has only begun to be characterized. Here, we determined tryptophan and metabolite levels together with the expression of kynurenine pathway enzymes and inflammatory factors in placental tissue from women with and without PE.

Methods:

Thirty-six placentas (18 PE and 18 controls) were analyzed for expression of kynurenine pathway enzymes indoleamine-2,3-dioxygenase (IDO1 and 2), tryptophan-2,3-dioxygenase (TDO), kynurenine-3-mono-oxygenase (KMO) and quinolinate phosphoribosyltransferase (QPRT) as well as interleukin (IL)-1β, IL-6, and serum amyloid A (SAA). Tryptophan and kynurenine content were measured using high-pressure liquid chromatography and quinolinic acid was measured using gas chromatography-mass spectrometry.

Conclusions:

Tryptophan content was reduced in placentas from women with PE. There was an increased kynurenine/tryptophan ratio in placentas from women with PE but no significant change in downstream metabolites. We confirmed a reduction in IDO1 expression and found a compensatory increase in TDO expression in placentas from women with PE. SAA was reduced in PE placentas compared with controls. Our data show that tryptophan content and the inflammatory mediator SAA are both compromised in placentas from women with PE. Further studies on the role of tryptophan catabolism and mediators of inflammation in sustaining healthy immunobiological pathways in the placenta are warranted.
Immune profiling of a patient with alemtuzumab-associated progressive multifocal leukoencephalopathy
Authors: Gerevini Simonetta , Capra Ruggero , Bertoli Diego , Sottini Alessandra , Imberti Luisa
Published: April 2019

A 31-year-old woman affected by multiple sclerosis (MS) experienced generalized tonic–clonic seizures 2 months after the second alemtuzumab cycle. Positive JC virus (JCV)-DNA in cerebrospinal fluid (CSF) and lesion iconography at magnetic resonance imaging (MRI) were suggestive of progressive multifocal leukoencephalopathy (PML). After 1 month, during full-blown immune reconstitution inflammatory syndrome, JCV-DNA became negative and symptoms gradually improved. New T- and B-cell output and T- and B-cell diversity were low and lymphocytes poorly responded to stimulation. This is the first case of an alemtuzumab-treated patient with clinical symptoms and radiological features compatible with PML. The lack of large T- and B-cell diversity, necessary for JCV recognition, is likely to have concurred to PML insurgence.
The material culture of burial and its microgeography: A Luxembourg cemetery as a methodological example of an object-centred approach to quantitative material culture studies
Authors: Streb Christoph K. , Kolnberger Thomas , Kmec Sonja
Published: April 2019

This article uses a novel quantitative methodology to examine sepulchral material culture. Drawing on the theoretical frameworks of social spatialization and art as agency, the authors contend that variations in grave designs and materiality cannot simply be explained in terms of changes in fashion and mentality. Other factors also need to be taken into account. Using a digital data collection tool, the Cemetery Surveyor Application (CSA) developed at the University of Luxembourg, they compile a set of data encompassing all the material aspects of each grave in a cemetery in Luxembourg (Western Europe), the setting of their case study. The graves are dated from the 1850s to 2015. |The authors compare the chronological evolution of the most recurrent material features with a GIS-based spatial analysis of the same features. The results of the spatial analysis not only largely confirm the chronological study, but also allow them to be more precise (dating is often problematic) and include undated graves (a third of the sample). The digital data collection tool also allows them to compare cemeteries and to highlight variations in these that cannot merely be imputed to chronology, but also to spatial proximity and material agency.
Is there a need for personal gambling licences?
Authors: Nikkinen Janne
Published: April 2019

Licensing is currently the most popular option among regulators for controlling gambling operations. However, approximately 20% of operators are still public monopolies. Many forms of gambling (especially lotteries) are government operated even in countries with a licensing system. This creates an inherent conflict of interest, given that government is supposed to protect the well-being of its citizenry and to reap the benefits of gambling at the same time. At least in the gambling monopoly, however, addressing the unavoidable harm that results from gambling should be a priority. Industry self-regulation and reliance on “responsible gambling” rely too much on individuals to control their own gambling. It is suggested in this contribution that it is possible to provide more comprehensive consumer protection, recognising both the duty of governments to take care of their own citizens and the fact that industry self-regulation is not enough. Pre-commitment cards have been tested in various contexts, and have shown promise in terms of providing tools for individuals to restrict their own gambling. However, given the known shortcomings such as allowing the use of other cards that are not one’s own, and other venues, it is clear that in themselves they do not guarantee effective prevention. Personal licensing is therefore explored as a move forward in this literature-based discussion. Although the system may be applicable to other contexts, the focus is on the Nordic countries. Given that the underlying justification for gambling monopolies is to control gambling-related harm, in the cases of Finland and Norway licensing could be combined with loyalty cards introduced by monopoly operators. This would provide a feasible alternative to current practices of responsible gambling.
Gamblers’ (mis-)interpretations of Problem Gambling Severity Index items: Ambiguities in qualitative accounts from the Swedish Longitudinal Gambling Study
Authors: Samuelsson Eva , Wennberg Peter , Sundqvist Kristina
Published: April 2019

The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify risk and problem gambling. Even though the PGSI has good psychometric properties, it still produces a large proportion of misclassifications.

Aims:

To explore possible reasons for misclassifications in problem gambling level by analysing previously classified moderate-risk gamblers’ answers to the PGSI items, in relation to their own current and past gambling behaviours.

Methods:

Semi-structured telephone interviews were conducted with 19 participants reporting no negative consequences from gambling. They were asked the PGSI questions within an eight-year time frame (2008 to 2016). Ambiguous answers to PGSI items were subject to content analysis.

Results:

Several answers to the PGSI items contained ambiguities and misinterpretations, making it difficult to assess to what extent their answers actually indicated any problematic gambling over time. The item about feelings of guilt generated accounts rather reflecting self-recrimination over wasting money or regretting gambling as a meaningless or immoral activity. The item concerning critique involved mild interpretations such as being ridiculed for buying lottery tickets or getting comments for being boring. Similar accounts were given by the participants irrespective of initial endorsement of the items. Other possible reasons for misclassifications were related to recall bias, language difficulties, selective memory, and a tendency to answer one part of the question without taking the whole question into account.

Conclusions:

Answers to the PGSI can contain a variety of meanings based on the respondents’ subjective interpretations. Reports of lower levels of harm in the population should thus be interpreted with caution. In clinical settings it is important to combine use of screening instruments with interviews, to be able to better understand gamblers’ perceptions of the gambling behaviour and its negative consequences.
FNGOs and financial inclusion: Investigating the impact of microcredit on employment growth in Ghana
Authors: Atiase Victor Yawo , Wang Yong , Mahmood Samia
Published: April 2019

Financial non-governmental organizations (FNGOs) are regulated microfinance institutions that operate with a social welfare logic in the delivery of microcredit to the financially excluded in Ghana. The microcredit is aimed at supporting the financially excluded individuals to create sustainable micro and small enterprises (MSEs) for the generation of both skilled and unskilled employment. From the institutional theory perspective, this study aims at investigating the impact of microcredit provided by FNGOs on employment growth among MSEs in Ghana. The major contribution of this study is the fact that, there is a little study on FNGOs and their impact on employment growth in the Ghanaian context. Therefore, this is one of the few studies that highlights the role of FNGOs in promoting financial inclusion through the provision of microcredit for employment generation purposes. Through a multiple regression analysis, the study uses primary data collected from 506 MSEs in Ghana. The results show that microcredit which is flexible in repayment mode, accessible and adequate has a positive impact on employment generation among MSEs in Ghana. However, the current cost of microcredit in Ghana has a negative impact on employment growth among MSEs.
Prediction of Early Response to Chemotherapy in Breast Cancer Liver Metastases by Diffusion-Weighted MR Imaging
Authors: Bai Genji , Wang Yating , Zhu Yan , Guo Lili
Published: April 2019

Objective:

To determine whether change in apparent diffusion coefficient value could predict early response to chemotherapy in breast cancer liver metastases.

Materials and Methods:

We retrospectively studied 42 patients (86 lesions) with breast cancer liver metastases who had undergone conventional magnetic resonance imaging and diffusion-weighted imaging (b = 0.700 s/mm2) before and after chemotherapy. Maximum diameter and mean apparent diffusion coefficient value (×10−3 mm2/s) of liver metastases from breast cancer were evaluated. The grouping reference was based on magnetic resonance imaging according to Response Evaluation Criteria in Solid Tumors (RECIST). Analysis of variance and receiver–operating characteristic analyses were performed.

Results:

Eighty-six metastases were classified as 40 responders and 46 nonresponders. A statistically significant correlation was found between prechemotherapy and postchemotherapy apparent diffusion coefficient values in responders, which were 0.9 ± 0.16 × 10−3 mm2/s, 1.05 ± 0.12 × 10−3 mm2/s, 1.26 ± 0.12 × 10−3 mm2/s, and 1.33 ± 0.87 × 10−3 mm2/s, respectively. No statistically significant difference was found between prechemotherapy and postchemotherapy apparent diffusion coefficient values in nonresponders. Differences were statistically significant between responders and nonresponders at prechemotherapy, 2 weeks after chemotherapy, and 4 weeks after chemotherapy ( P = 0.014, P = .001, and P = .000, respectively). Receiver operating characteristic curves showed that apparent diffusion coefficient values could predict treatment response early at 2 weeks after chemotherapy with 64.5% sensitivity and 91.8% specificity.

Conclusion:

The change in apparent diffusion coefficient value may be a sensitive indicator to predict early response to chemotherapy in breast cancer liver metastases.
Serum Level of Total Lipids and Telomere Length in the Male Population: A Cross-Sectional Study
Authors: Karimi Behrooz , Yunesian Masud , Nabizadeh Ramin , Mehdipour Parvin
Published: April 2019

Telomeres contain TTAGGG (T; Thymine, A; Adenine and G; Guanine) repetitive sequences and are placed at the end of human chromosomes. Telomere dysfunction is implicated in some age-related and chronic diseases, but its association with total serum lipids and obesity is unknown. Our objective was to determine influenced of total serum lipids on leukocyte telomere lengths (TLs). Participants were selected by cluster sampling from 22 districts of Tehran. The questionnaires were completed by 500 subjects and after the initial assessment in terms of lifestyle, nutrition, home, and job, 300 healthy people, aged 25–40 years were finally selected. TLs and serum level of total lipids were measured by quantitative real-time PCR and the Phillips method, respectively. The average telomere length (T/S) and total lipids were 1.05 ± 0.3 mg/dl and 643.3 ± 70.8 mg/dl, respectively. We found that a one unit difference in the following parameters were associated with kilo base pair differences in TL: Age −0.0002 (95% CI [−0.0022, −0.0018]), BMI −0.0019 (95% CI [−0.0003, −0.0034]), TC 0.0001 (95% CI [−0.0006, −0.0007]), TG −0.0010 (95% CI [−0.0015, −0.0004]), PL 0.0001 (95% CI [−0.0005, −0.0007]), and TSL −0.0003 (95% CI [−0.0008, 0.0001]). Spearman correlation analysis revealed an inverse relationship between TC (R = −0.53; 95% CI [−0.61, −0.44]), TG (R = −0.50; 95% CI [−0.58, −0.41]), PL (R = −0.46; 95% CI [−0.54−0.36]), and TSL (R = −0.63; 95% CI [−0.69, −0.56]) with T/S. Our research suggests that the inverse relationship was found between TL and weight, BMI, age, and TSL which were associated with obesity. High serum lipids concentration may be associated with systemic inflammation and atherosclerosis and may lead to oxidative stress, resulting in telomere shortening.
Damage detection of carbon fiber reinforced plastic π adhesive-bonded joints based on the peeling stress reconstruction with hybrid artificial fish swarm and frog leaping algorithm
Authors: Huang Xiangyang , Liu Xingyu , Song Chunsheng , Jiang Feng , Jiang Youliang , Zhou Zude
Published: April 2019

In this article, we first research on the relationship between joint damage evolution and peeling stress distribution of carbon fiber reinforced plastic π adhesive-bonded joints by finite element method. According to the damage form of carbon fiber reinforced plastic π adhesive-bonded joints, we established its progressive damage finite element model based on the two-dimensional Hashin failure criterion and cohesive zone model. Then, based on the fiber Bragg grating reflectance spectra at the debonding part during the damage evolution process obtained by simulation analysis, the distribution of peeling stress at the debonding area is reconstructed using the hybrid artificial fish swarm and frog leaping algorithm. The results show that the convergence of the artificial fish swarm and frog leaping algorithm is improved significantly in the early stage, the time consumed in getting out of the local convergence and finding optimal solutions is obviously shortened, and the reconstructed stress distribution is in high agreement with the ideal stress distribution corresponding to numerical simulation, which verifies the feasibility of this method in the damage detection of carbon fiber reinforced plastic π adhesive-bonded joints.
Adherence to recommended imaging surveillance of acutely presenting Stanford type-B aortic dissections
Authors: Doshi Sachin , Eisenberg Naomi , Bailey Shawn , Annamalai Ganesan , Roche-Nagle Graham
Published: April 2019

Objective

Acutely presenting Stanford type B aortic dissections (type-B AD) primarily receive medical or endovascular management and require lifelong imaging surveillance. CT and MR imaging are the best modalities to assess early indications of potentially fatal developments. Published guidelines recommend that imaging occur at 1, 3, 6, and 12 months following acute presentation, and annually thereafter. This study evaluates adherence to recommended imaging surveillance for newly presenting type-B AD patients at a tertiary hospital.

Methods

A retrospective review of patients presenting with a new, acute type-B AD between January 2010 and March 2017 was performed. Patient demographics, type-B AD admission details, and medical histories were obtained from electronic and paper chart reviews. CT and MR images were reviewed, and aortic sizes were measured by two independent radiologists. Patients without a clinical visit or type-B AD surveillance imaging for greater than 15 months were considered lost to follow-up after their last appointment. Overall clinical follow-up and adherence to recommended were analyzed using Kaplan–Meier graphs. Log-rank analysis assessed factors increasing risk of poor clinical follow-up and adherence to surveillance guidelines.

Results

Sixty-two patients (38 male, 24 female) were included. At the time of index admission, median age was 62 (SD 14), and median aortic diameter was 45 mm (SD 11.2). Median duration of overall follow-up was 24 months. Kaplan–Meier analysis of overall follow-up, censoring death, and external follow-up, indicated clinical follow-up rates of 87.1% (SE = 4.3%) at 3 months, 85.2% (SE = 4.6%) at 6 months, 77.5% (SE = 5.6%) at 12 months, and 63.8% (SE = 8.1%) at 60 months. Similar analysis of adherence to recommended imaging surveillance revealed rates of 56.5% (SE 6.3%) at 3 months, 36.9% (6.7%) at 6 months, 21.5% (6.5%) at 12 months, and 12.9% (6.1%) at 24 months. Log-rank analysis indicated that specialty arranging follow-up – medical ( n = 24) versus surgical ( n = 38) – did not impact overall follow-up or adherence to recommended guidelines. Similarly, none of patient distance to hospital, medical versus endovascular intervention, initial dissection size, smoking history, or additional medical/demographic impacted these outcomes.

Conclusions

At our institution, we identified a gap between imaging surveillance following type-B AD and adherence to recommended, published guidelines. This was consistent across all type-B AD patients with no subset in isolation. Multiple opportunities for quality improvement exist to facilitate improved compliance with published guidelines.
The patient experience in a community pharmacy mental illness and addictions program
Authors: Murphy Andrea L. , Gardner David M. , Jacobs Lisa M.
Published: April 2019

Background:

The Bloom Program was designed to enhance pharmacists’ care of people with lived experience of mental illness and addictions in Nova Scotia. The Program’s demonstration period was from September 2014 to December 2016 and included a qualitative evaluation of the patient experience.

Methods:

Patients were recruited for individual interviews through Bloom Program pharmacies. Interviews were transcribed verbatim and analyzed following Braun and Clarke’s 6-step approach for thematic analysis.

Results:

Ten patients were interviewed between May and June 2016. Ten themes were determined through data analysis and included medication management, accessing pharmacists in a new way, providing social support, bridging service gaps, providing interim care, reducing financial barriers, navigation and advocacy, holistic approaches, empowerment through knowledge and awareness and collaboration.

Discussion:

Pharmacists expectedly provided medication management activities to patients for both physical and mental health concerns in the Bloom Program. Many activities conducted with Bloom Program patients fell outside of dispensing roles and medication management. These activities, such as social support, triage, navigation and increasing access, which were highly valued by patients, are poorly measured and assessed in pharmacy practice research.

Conclusion:

Participants in the Bloom Program reported the significant contributions of pharmacists and pharmacy teams in their overall health and wellness. Future evaluations of interventions like the Bloom Program should include measurement of constructs valued by patients and also consider impacts on inequalities and inequities. Pharmacy practice researchers can benefit from other research and evaluation being conducted for primary care interventions.
Judicial independence: The master narrative in sentencing practice
Authors: Jamieson Fiona
Published: April 2019

This article draws on biographical narrative accounts of retired Scottish judges to provide insight about the operation of judicial independence in the routine practice of criminal justice. This oblique and often reified legal concept is given new meanings and understandings through the lived experiences of retired judicial actors, demonstrating its role as the ‘master narrative’ of the judiciary in their routine sentencing work. This research points to some of the adaptive judicial strategies necessary for the maintenance and reinforcement of the concept in the context of the everyday challenges of sentencing practice. It is argued that although judicial independence represents an aspirational conception of judicial work, this symbolic value also carries important meanings and has material effects in sentencing practice. Moreover, the boundaries of the judicial role in daily criminal practice may be less sharply defined than strong ‘Olympian’ interpretations of judicial independence would otherwise suggest.
Noho Taiao: reclaiming Māori science with young people
Authors: Moewaka Barnes Helen , Henwood Wendy , Murray Joanne , Waiti Pauline , Pomare-Peita Mina , Bercic Selena , Chee Rebecca , Mitchell Mishayla , McCreanor Tim
Published: April 2019

Connections and belonging to ancestral lands are strongly and consistently argued as fundamental to Māori education, health and wellbeing. When our connections with and access to health-promoting places of belonging are damaged, we lose more than component parts of wellbeing. An entire cultural infrastructure integral to identity, community, spirituality, sustainability and even material sustenance is eroded, compromising health, wellbeing and vitality. Young people in rural areas are often seen as missing out on the amenities and attractions available in cities, but are assumed to have compensatory access to and positive relationships with ‘nature’. For multiple reasons, many arising from colonial legacies, this is often not so for young Māori and there are initiatives underway that seek to reconnect them with customary environments. Place-based learning approaches that use local environments and ecosystems as living laboratories, reimagining the way students engage with knowledge, science and understandings of the natural world can be valuable in this respect.

Te Rārawa Noho Taiao projects in the Far North of Aotearoa have been operating for nearly a decade, using indigenous pedagogy that promotes Māori science, science leadership, and learning, applying them in ways that produce a range of health and wellbeing benefits. These include enhanced educational engagement, strengthened capabilities, increased participation/belonging, stronger connections, constructive peer processes and positive intergenerational interactions, all based in Māori values and praxis. Such elements are widely recognised in health-promoting frameworks as highly implicated in the creation and maintenance of health and wellbeing for individuals, communities and populations. In this paper, we use interviews with organisers and teachers of these Noho Taiao and a survey of student participants, to explore the educational and health promotion effects.
Neuroimaging Findings on Amodal Completion: A Review
Authors: Thielen Jordy , Bosch Sander E. , van Leeuwen Tessa M. , van Gerven Marcel A. J. , van Lier Rob
Published: April 2019

Amodal completion is the phenomenon of perceiving completed objects even though physically they are partially occluded. In this review, we provide an extensive overview of the results obtained from a variety of neuroimaging studies on the neural correlates of amodal completion. We discuss whether low-level and high-level cortical areas are implicated in amodal completion; provide an overview of how amodal completion unfolds over time while dissociating feedforward, recurrent, and feedback processes; and discuss how amodal completion is represented at the neuronal level. The involvement of low-level visual areas such as V1 and V2 is not yet clear, while several high-level structures such as the lateral occipital complex and fusiform face area seem invariant to occlusion of objects and faces, respectively, and several motor areas seem to code for object permanence. The variety of results on the timing of amodal completion hints to a mixture of feedforward, recurrent, and feedback processes. We discuss whether the invisible parts of the occluded object are represented as if they were visible, contrary to a high-level representation. While plenty of questions on amodal completion remain, this review presents an overview of the neuroimaging findings reported to date, summarizes several insights from computational models, and connects research of other perceptual completion processes such as modal completion. In all, it is suggested that amodal completion is the solution to deal with various types of incomplete retinal information, and highly depends on stimulus complexity and saliency, and therefore also give rise to a variety of observed neural patterns.
False activation of the cardiac catheterization laboratory: The price to pay for shorter treatment delay
Authors: Degheim George , Berry Abeer , Zughaib Marcel
Published: April 2019

Introduction

In patients with acute ST elevation myocardial ischemia (STEMI), national efforts have focused on reducing door-to-balloon (D2B) times for primary percutaneous coronary intervention (PCI). This emphasis on time-to-treatment may increase the rate of inappropriate cardiac catheterization laboratory (CCL) activations and unnecessary healthcare utilization. To achieve lower D2B times, community hospitals and EMS systems have enabled emergency medical technicians (EMTs) and emergency department (ED) physicians to activate the CCLs without immediately consulting a cardiologist.

Objective

The purpose of this study is to determine the rate and main causes of inappropriate activation of the CCL which will aid in finding solutions to reduce this occurrence.

Method

This is a retrospective study, based on an electronic medical system review of all inappropriate CCL activation who presented to Providence Hospital and Medical Centers (PHMC) in Michigan, from January 2015 to July 2016.

Results

The CCL was activated 375 times for suspected STEMI. The false STEMI activation was identified in 47 patients which represents 12.5% of total CCL activation. The vast majority of this false activation was due to non-diagnostic electrocardiogram (ECG) that did not meet the STEMI criteria.

Conclusion

The subjective interpretation of the ECG by EMTs and ED physicians tend to show a wide variability, which may lead to higher-than-anticipated false activation rates of up to 36% in one study. Some studies had reported that up to 72% of inappropriate activations were caused by ECG misinterpretations. These false activations have ramifications that lead to both clinical and financial costs.
A 7-year follow-up of antenatal depression treatment with cognitive behavioral therapy: A case report of maternal and child outcomes
Authors: Bleker Laura S , Milgrom Jeannette , Gemmill Alan W , Roseboom Tessa J , de Rooij Susanne R
Published: April 2019

There are few studies of cognitive behavioral therapy for women with antenatal depression including qualitative and quantitative data, and yet, individual cases can provide valuable information on personal experiences of treatment effectiveness and acceptability. The purpose of this case report is to explore the long-term qualitative outcomes following cognitive behavioral therapy for antenatal depression. A pregnant woman with a Diagnostic and Statistical Manual of Mental Disorders diagnosis of depression was allocated to receive seven sessions of cognitive behavioral therapy in a randomized controlled trial. We describe her experiences and mood during treatment, at 12 weeks, 9 months, 2 years, and 7 years postpartum, as well as markers of her child’s development. The woman’s mood symptoms were dramatically improved after treatment and remained in the mild to moderate range until 7 years postpartum. Her child showed overall age-appropriate development, with strengths highlighted in his nonverbal and problem-solving ability. Relative weaknesses were in the communication domain and his processing speed. This case report suggests that psychological treatment for depression during pregnancy can be both acceptable to women and potentially protective in the long term.
Osteomyelitis due to methicillin-resistant Staphylococcus aureus successfully treated by an oral combination of minocycline and trimethoprim–sulfamethoxazole
Authors: Sato Kojiro , Yazawa Hiroaki , Ikuma Daisuke , Maruyama Takashi , Kajiyama Hiroshi , Mimura Toshihide
Published: April 2019

Most of the anti-methicillin-resistant Staphylococcus aureus drugs available in Japan are administered intravenously, except for linezolid, which can also be administered orally. Here, we report a lupus patient with methicillin-resistant S. aureus–induced osteomyelitis. Linezolid had to be stopped due to severe anemia. In an effort to treat her on an outpatient basis, we planned to use a combination of minocycline and trimethoprim–sulfamethoxazole that exhibited in vitro sensitivity against the methicillin-resistant S. aureus detected, and rifampicin is used against methicillin-resistant S. aureus in certain cases. The use of rifampicin increased the level of C-reactive protein even though the prednisolone dose used was doubled, so we gave up using it. The combined application of oral minocycline and trimethoprim–sulfamethoxazole, however, controlled the inflammation, and the patient was able to be discharged. Fourteen months later, we discontinued the administration of both drugs and there has been no relapse more than a year. This combination of antibiotics may be useful, especially when patients want to be treated on an outpatient basis.
Late-onset osteosarcoma after onychectomy in a cat
Authors: Breitreiter Katrina
Published: April 2019

Case summary

A 12-year-old neutered male onychectomized Ragdoll cat presented for a 3 day history of swelling and hemorrhagic purulent discharge on the first digit of the left manus. Radiographs revealed fragments of the third phalangeal bone (P3) present in the partially amputated digits with swelling adjacent to the P3 fragment on the first digit of the left manus. Thoracic radiographs revealed no evidence of primary or metastatic neoplasia. Surgery was performed to remove all P3 fragments and the associated swelling on the diseased digit. On gross examination of the excised swelling, a mass was present at the cut edge of P3. The bone fragment and associated mass were submitted for histopathological evaluation. Osteosarcoma was diagnosed. Because neoplastic cells extended to the surgical margins, amputation of the left thoracic limb was performed. The cat recovered from surgery, and survival time at the time of writing was 8 months.

Relevance and novel information

To our knowledge, this is the first reported case of onychectomy-associated osteosarcoma. Trauma from partial P3 amputation during onychectomy is suspected to have played a role in osteosarcoma development in this case. Malignant transformation may be considered a potential complication of onychectomy achieved by partial P3 amputation.
Intramural duodenal hematoma: clinical course and imaging findings
Authors: Niehues Stefan M , Denecke Timm , Bassir Christian , Hamm Bernd , Haas Matthias
Published: April 2019

Background

Intramural duodenal hematoma is a rare condition. Different imaging modalities are at hand for diagnosis.

Purpose

To identify patients with intramural duodenal hematoma and report imaging findings and clinical courses.

Material and Methods

Typical imaging patterns using ultrasound, computed tomography, and magnetic resonance imaging were carried out on 10 patients.

Results

The mean patient age was 7.5 years. The average disease duration was 13 months. Clinical signs of improvement were observed within 16 days. Residues were still detectable at long-term follow-up.

Conclusion

For patients with intramural duodenal wall hematoma, diagnosis should be considered early. Typical imaging findings should be known to ensure optimal treatment.
The Ball Game Is for the Boys: The Visual Framing of Female Athletes on National Sports Networks’ Instagram Accounts
Authors: Romney Miles , Johnson Rich G.
Published: April 2019

Despite the growth of female participation in sports, media coverage of female athletics remains stagnant. Scholarship regarding the treatment of female athletes in magazines, newspapers, and news and highlight programming has shown that sports journalism organizations demonstrate ambivalence with minimal coverage that reinforces gender stereotypes. This study examined 1,587 Instagram images from the primary accounts of the four major American sports networks. The resulting data indicate that women’s athletic coverage lags significantly behind men’s athletics. Females are more likely to appear alongside a male and are more likely be shown in culturally “appropriate” sports and in nonathletic roles.
Gender Equality and Labour Force Participation: Mind the Gap
Authors: Banerjee Madhusree
Published: April 2019

Despite increase in education, female labour force participation in India is abysmally low and has fallen over the years. The reasons for this are complex and involve a whole range of social and cultural dimensions apart from objective conditions. The article attempts to analyze how social mindset of women being homemakers is one of the reasons that affect this. In addition, lack of education and job-oriented courses, lack of mobility and discrimination at workplace have acted as deterrents for women to come out to the public space for work. Thus, policy which tries to address this gap must be holistic. Legislations alone are not enough, and all stakeholders should join hands to close this gap.
Promoting Women’s Participation in Cross-border Trade in South Asia
Authors: Livani Talajeh , Solotaroff Jennifer
Published: April 2019

Historically, practitioners and policymakers have overlooked gender issues in the trade space; however, research in recent decades strongly suggests that trade is not gender neutral. Cross-border trade produces changes in employment and prices, and these changes have different effects on women and men. Moreover, because women and men do not have equal access to education, networks, transportation and productive resources, their ability to seize trade-related opportunities differs. General trade barriers, such as deficient infrastructure and cumbersome regulatory and documentary requirements, also have gender-differentiated impacts. Drawing from the global literature, this article proposes policy recommendations to expand the benefits of trade to women in South Asia. The recommendations range from strengthening female-dominated export sectors and implementing trade facilitation measures to increasing women’s access to training, productive resources, information, transportation and trade networks.
Second victims and mindfulness: A systematic review
Authors: S Miller Courtney , Scott Susan D , Beck Mary
Published: April 2019

Second victims are healthcare professionals who have been involved in an unanticipated clinical event or medical error and are negatively impacted on professional and/or personal levels. One of the most prevalent symptoms second victims endure is stress, which correlates with burnout and powerlessness. These symptoms may deeply impact second victims on professional and personal levels, but can also influence healthcare organizations. Distracted and stressed clinicians can possibly create a medical error and are at an increased risk to leave their chosen profession or institution. The purpose of this systematic review is to evaluate the literature pertaining to the second victim phenomenon and the effect of mindfulness-based interventions on perceived symptoms. PubMed, CINAHL, Scopus, and Google Scholar were used to conduct this literature search. There were 23,294 articles for consideration, after the original search. The review identified n = 15 publications as meeting inclusion requirements. These studies indicated that mindfulness-based interventions positively impact stress, burnout, and self-compassion. Future research is needed to establish mindfulness-based interventions effectiveness on second victims.
Discrepancies Between Patient Self-Reported and Electronic Health Record Documentation of Medication Allergies and Adverse Reactions in the Acute Care Setting: Room for Improvement
Authors: Kabakov Anna , Rhodes Nathaniel J. , Wenzel Richard
Published: April 2019

Background: Allergy information is commonly transcribed into an electronic health record (EHR) for all patients admitted to acute care hospital units by a licensed health care professional. The allergy history is utilized each time a new inpatient medication is prescribed to identify the patient’s risk of having an allergic reaction and/or anaphylaxis. There is potential for negative consequences in cases where the allergy history is incorrectly documented. Objective: The objective of this study was to assess the discordance between documented allergy information in the EHR and verbally reported allergy information from a patient interview. Methods: Prospective, observational, nonrandomized study performed within a 2-month period during the Spring of 2016. The study was performed at a teaching community hospital in Chicago, Illinois. A total of 270 patients were interviewed on the general medicine (n = 216) and headache (n = 54) units regarding their medication allergies and reactions. The outcomes were discordance among EHR-documented and verbally stated medication allergies and reactions. Results: The agreement across all medications and reactions between the EHR and patient self-reported interview was 80.9%. There were 31 reactions (6.7%) that were verbally reported by patients but were not documented in the EHR (omissions) and 57 reactions (12.4%) that were verbally reported but were incorrectly documented in the EHR (incorrect documentations). Only 20 out of the 264 verbally reported reactions (7.5%) met the study definition of anaphylaxis. The highest rate of incorrect documentations occurred with opiate agonists, and the highest rate of omissions occurred with anticonvulsants. EHR documentation was more likely to be incorrect among patients who reported gastrointestinal reactions and was more likely to be correct among patients who reported cutaneous reactions. Conclusion: There was a high rate of discordance amid EHR-documented and verbally stated medication allergies and reactions. Errors among opiate agonists, anticonvulsants, and sulfa drugs were most prevalent.
Evaluation of the geriatric curriculum implemented at Shiraz University of Medical Sciences, Iran, since 2017: A qualitative study
Authors: Jaafari Faezeh , Delavari Somayeh , Bazrafkan Leila
Published: April 2019

Background:Recently, there has been an increase in life expectancy due to improvements in nutrition, health, and sanitation. The aim of this study was to evaluate the geriatric curriculum in the field of general medicine at Shiraz University of Medical Sciences (SUMS), Iran to improve the quality of services provided to this population in the community.

Methods:This was a qualitative study­­. Six educational hospitals and ambulatory centers of Shiraz University of Medical Sciences participated in this study. Within these centers, 15 medical education faculty members and educational experts, 6 medical students, 6 elderly patients and 6 nurses working in the university related to the geriatric field were selected using purposive sampling. Data were gathered through semi-structured interviews, focus group discussion and field observations in the teaching hospital and ambulatory setting of SUMS from June 2017 to May 2018.  Based on the qualitative research, the data underwent conventional content analysis and the main themes were developed from this.

Results:Three main themes were extracted from the data: effective clinical education, geriatrics curriculum challenges and promotion strategies for geriatric medicine. Subcategories that emerged were a competent curriculum teacher, a challenging program, management of resources, promotion of the program, and the revision required in the curriculum, which were related to other concepts and described in the real-world situation of the geriatric curriculum in the university, as observed in field observations.

Conclusions:This study identified three concepts as main themes that can be used to explain how to implement a geriatric curriculum in a medical university. The main contributing factor to different views of the participants was identified as the revision required to the curriculum for integrative care in a geriatric patient. This should be taken into consideration while planning any programs and decisions aimed at education of medical students on this topic.
Presence and diversity of Salmonella isolated from layer farms in central Ecuador
Authors: Salazar Gabriela A. , Guerrero-López Ricardo , Lalaleo Liliana , Avilés-Esquivel Diana , Vinueza-Burgos Christian , Calero-Cáceres William
Published: April 2019

Background: Given the considerable role played by Salmonella in the incidence of food contamination, around the world, surveillance of this infection is prioritized by both food producers and health care authorities. Data remains insufficient concerning the prevalence of Salmonella in poultry systems in Ecuador and in Latin America in general.

Methods: In this study, we evaluated the presence and diversity of Salmonella serovars in samples taken from 21 layer farms and backyard layers in central Ecuador during August-November 2017.   Salmonella was isolated following standardized methods (ISO 6579) and the serovar determination was carried out by PCR.

Results: A significant presence of Salmonella was detected in the 21 farms evaluated, with a frequency of 76% (95% confidence interval (CI): 53-92) in environmental surfaces, 33% (95%CI: 15-57) in pooled cloacal swabs from layer hens, 33% (95% CI: 13–59) on feed samples, and 10% (95%CI: 1-30) in backyard layer feces from traditional local markets. The dominant serovars detected were S. Infantis and S. Typhimurium.

Conclusions: This study forms a basis for further surveillance of Salmonella serovars in layer farms in central Ecuador.