bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood Glucose Disorders and Access to Health Care Services Among Adults Aged 30 to 69 Years in Chi Linh, Hai Duong, Vietnam
Authors: Lan Vu Thi Hoang , Hoang Le Tu , Linh Nguyen Thuy , Quyen Bui Thi Tu
Published: July 2017

Planning for control of diabetes in Vietnam needs valid information about the burden of diseases in general population. This study employed a cross-sectional design among population aged 30 to 69 years to measure the burden of type 2 diabetes and gaps in access to health care to explore the negative effects of rapid economic growth and urbanization in Chi Linh in recent years. A total of 594 adults were interviewed and had their fasting blood glucose tested. Results indicated that the prevalence of impaired fasting glycaemia was 11.8% and of diabetes was 12.1%. Only 16.8% diabetes cases detected in this study were diagnosed before, indicating a high level of unmet needs for detecting/managing diabetes in Chi Linh population. Significant associated factors with abnormal blood glucose included age and body mass index level. Without effective intervention programs for diabetes control and management, its burden will continue raising in the coming years. Chi Linh need to strengthen the diagnostic/treatment services at primary health care levels to ensure that people at early stage of raised blood pressure, raised blood glucose can be detected and provided with proper management to avoid serious complications, and to reduce hospital overload at central level.
Household Exposure to Livestock and Health in the CHILILAB HDSS Cohort, Vietnam
Authors: Dang-Xuan Sinh , MacDonald Lauren E. , Schurer Janna M. , Nguyen-Viet Hung , Pham-Duc Phuc
Published: July 2017

In Vietnam, pigs and poultry are predominantly produced by small-scale farmers, creating challenges for zoonotic disease management. The objective of this study was to characterize practices related to livestock and manure management and to measure association with 3 self-reported health symptoms (coughing, fever, and diarrhea/nausea/vomiting) in a region currently undergoing health transitions. We analyzed cross-sectional survey data collected from a subset (N = 5520) of the Chi Linh Health and Demographic Surveillance System cohort in Chi Linh district, Vietnam. Bivariate analyses indicated that female gender was a significant risk factor for all 3 health symptoms, whereas age (≥60 years), suburban living, low education level, and household wealth were risk factors for 2 symptoms. Overall, we found no indication that biogas production or exposure to livestock and manure adversely affected human health. Efforts to control zoonotic disease transmission should prioritize utilization of veterinarians, enhanced farm biosecurity, and improvements to commune drinking water/wastewater infrastructure.
Inequalities in Household Catastrophic Health Expenditure and Impoverishment Associated With Noncommunicable Diseases in Chi Linh, Hai Duong, Vietnam
Authors: Kien Vu Duy , Minh Hoang Van , Ngoc Nguyen Bao , Phuong Tran Bich , Ngan Tran Thu , Quam Mikkel B.
Published: July 2017

A costly modern-day double burden, the expenses of noncommunicable diseases (NCDs) are becoming a devastating epidemic. The World Health Organization estimates $7 trillion in economic losses from NCDs in 2011-2025. Although regarded as affluent diseases, the burden of NCDs is shifting into poorer groups. In this study, we assessed the socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with NCDs in Northern Vietnam. We also identified associated factors for catastrophic health expenditure and impoverishment. Households self-reporting NCD diagnoses had the highest association with both catastrophic health expenditure and impoverishment, followed by those in urban areas. Such households were likely poorer according to our calculations estimating socioeconomic inequalities. Households with at least 1 member older than 60 years were also more likely to suffer catastrophic health expenditures. These findings suggest that targeted policy to prevent or subsidize care for NCDs could prevent catastrophic health expenditure and impoverishment among those already most disadvantaged.
A Secular Trend in Birth Weight and Delivery Practices in Periurban Vietnam During 2005-2012
Authors: Duong Duc Minh , Nguyen Anh Duy , Nguyen Chuong Canh , Le Vui Thi , Hoang Son Ngoc , Bui Ha Thi Thu
Published: July 2017

The remarkable increase in Vietnamese economic conditions can increase the birth weight in neonates and better delivery practices among women. The Chi Linh Health and Demographic Surveillance System started in 2004. An open cohort of data consisting of about 57 561 people from 17 993 households has been followed primarily with respect to demography, economy, and education. The aim of this research is to study secular trends in delivery practice and birth weight in the past decade (2005-2012) in Chi Linh. We found a significant change in delivery rates at hospitals and cesarean section rates, but the birth weights over a decade of drastic economic development were stable. Furthermore, the findings show significant associations of birth weight and delivery practices with the child’s sex, mother’s age, and household income. Our results might be considered as representative for other similar periurban settings in Vietnam. We suggest that appropriate policies should be developed given the reduction in the use of delivery services in commune health centers in urban areas.
The Teaching Excellence Framework in the United Kingdom: An Opportunity to Include International Students as “Equals”?
Authors: Hayes Aneta
Published: July 2017

Research on international students in British higher education points to marginalization of their unique perspectives in university classrooms. The aim of the article is to consider how the most recent policy changes, particularly the teaching excellence framework (TEF), continue to do so. The article also argues that the TEF, being a major higher education reform, can lead to change in attitudes toward international students and contribute to their more equal status. The article discusses how this could be done and proposes changes to the TEF that would distance universities from policy moves that have contributed to the “peripheral” status of international students for many years. Despite being British-based, the analysis has international implications as it points to a series of ways in which the scope and nature of metrics used in national evaluations of teaching quality can affect the status of international students in higher education.
Analysis of Reflected Appraisal Using SYMLOG Rating Data
Authors: Ichiyama Michael A.
Published: July 2017

The causal relationship between self (SE) and perceived (PE) appraisals was examined in a small group field setting. SYMLOG rating data were obtained at two time periods to enable analysis of reciprocal causal paths in a lagged panel design. Extending a similar investigation by Nowack, cross-lagged regressions were employed to decompose direct and indirect effects in model estimation. The results suggested the selective operation of reflected appraisal (PE–>SE) versus projection (SE–>PE) effects as a function of which SYMLOG dimension was being assessed. The use of multiple regression techniques on longitudinal data, versus reliance on cross-lagged panel correlation, for analyzing reciprocal causation was recommended for future research in this area.
The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse-Midwives and Obstetricians
Authors: Mselle Lilian Teddy , Aston Megan , Kohi Thecla W. , Mbekenga Columba , Macdonald Danielle , White Maureen , Price Sheri , Tomblin Murphy Gail , O’Hearn Shawna , Jefferies Keisha
Published: July 2017

Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted. Feminist poststructuralism guided the research process. Postpartum education was seen to be an urgent matter; there was a lack of supportive resources and infrastructure in the hospital clinics, and nurse-midwives and obstetricians had to negotiate conflicting health and traditional discourses using various strategies. Nurse-midwives and obstetricians are well positioned to deliver life-saving postpartum education; however, improvements are required including increased number of nurse-midwives and obstetricians.
Success Stories: Overcoming Barriers to Research in Southern and Eastern African Countries
Authors: Sun Carolyn , Dlamini Priscilla S. , Maimbolwa Margaret C. , Changala Lukwesa Mukonka Cynthia , Nyamakura Rudo , Omoni Grace , Seboni Naomi , Larson Elaine
Published: July 2017

There is an ever-growing need for clinically focused, culturally relevant research on which nurses can base their practice. However, there may not be a concurrent rise in efforts to strengthen infrastructure needed to promote research in developing and low-income countries. In such cases, nurse researchers must find innovative ways to address and overcome barriers to research. This article presents five exemplars of nurses conducting high-quality nursing research in resource-poor settings in southern and eastern Africa. Furthermore, it suggests strategies to address these barriers, such as piggybacking on larger studies, interdisciplinary collaboration, and partnership with influential stakeholders. These tactics may be used to increase research productivity elsewhere.
Sports Participation, Functional Outcome, and Complications After Ankle Arthrodesis: Midterm Follow-up
Authors: Kerkhoff Yvonne R. A. , Keijsers Noël L. W. , Louwerens Jan Willem K.
Published: July 2017

Background:

Ankle arthrodesis provides satisfactory functional outcome based on basic daily activities, but information regarding more demanding tasks is limited. Also, studies reporting longer term survival and complication rates are sparse and concern small study populations. This study reports functional outcome with more focus on demanding tasks and sports and reports the mid- to long-term union and complication rates in a large study population.

Methods:

Between 2005 and 2010, an ankle arthrodesis was performed on 185 ankles. Clinical results were retrospectively assessed with the Foot Function Index (FFI), visual analog scale (VAS) for pain, and the Foot and Ankle Ability Measure (FAAM). Information regarding sports pre- and postoperatively was obtained through a questionnaire. In addition, postoperative complications, reoperations, and failures (defined as nonunion of the ankle arthrodesis) were determined. Mean follow-up time was 8 years.

Results:

FFI scores significantly improved, the FAAM ADL score was 70%, and the mean VAS for pain at the ankle/hindfoot at follow-up was 20. Sports participation slightly diminished from 79.5% prior to the onset of disabling complaints to 68.9% postoperatively. Of the patients, 73.1% were able to hike with a median hiking time of 40 minutes (range, 2-600 minutes). Kneeling could be performed on average 10 minutes (range, 2-60 minutes) in 39.8% and jumping down from steps by 23.5% of the patients. A small selection of patients was able to sprint (14%), and 16.8% of the patients were able to run a median distance of 60 meters (range, 3-1000 meters). Failure occurred in 9.2% and other postoperative complications were present in 21.6%, requiring reoperation in 8.6% of the cases.

Conclusion:

Ankle arthrodesis led to satisfactory functional outcome and pain reduction. Most patients remained active in sports, but a transition to less demanding sporting activities was seen. The complication and failure rates were similar with previous literature, and the incidence of nonrevision secondary surgery was relatively low.

Level of Evidence:

Level III, retrospective comparative study
Informed Consent as Societal Stewardship
Authors: Sawicki Nadia N.
Published: July 2017

When individual patients' medical decisions contribute to population-level trends, physicians may struggle with how to promote justice while maintaining respect for patient autonomy. This article argues that this tension might be resolved by using the informed consent conversation as an opportunity to position patients as societal stewards.
Living Organ Donation and Informed Consent in the United States: Strategies to Improve the Process
Authors: Henderson Macey L. , Gross Jed Adam
Published: July 2017

About 6,000 individuals participate in the U.S. transplant system as a living organ donor each year. Organ donation (most commonly a kidney or part of liver) by living individuals is a unique procedure, where healthy patients undergo a major surgical operation without any direct functional benefit to themselves. In this article, the authors explore how the ideal of informed consent guides education and evaluation for living organ donation. The authors posit that informed consent for living organ donation is a process. Though the steps in this process are partially standardized through national health policy, they can be improved through institutional structures at the local, transplant center-level. Effective structures and practices aimed at supporting and promoting comprehensive informed consent provide more opportunities for candidates to ask questions about the risks and benefits of living donation and to opt out voluntarily Additionally, these practices could enable new ways of measuring knowledge and improving the consent process.
Is There a ParticularEthical Practice and Policy Spacein North America for Uncontrolled Kidney Donation after Circulatory Death?
Authors: Kirby Jeffrey
Published: July 2017

Despite successful transplantation outcomes in Europe, uncontrolled organ donation after circulatory determination of death (uDCDD) has essentially been a non-starter in North America. In this paper, I identify and explore a set of interesting, ethics-related considerations that are of relevance to this organ donation-transplantation practice. The analysis provides a theoretical platform for my development of a proposal for the creation of a particular ethical practice and policy space for kidney uDCDD in the U.S. and Canada that recognizes and aims to effectively address the various, identified challenges and constraints.
The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws
Authors: Barraza Leila , Schmit Cason , Hoss Aila
Published: July 2017

This paper discusses recent changes to state legal frameworks for mandatory vaccination in the context of school and healthcare worker vaccination. It then discusses state laws that allow pharmacists the authority to vaccinate.
Climate Change and Public Health Policy
Authors: Smith Jason A. , Vargo Jason , Hoverter Sara Pollock
Published: July 2017

Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.
Traditional Artistic Expressions in Science Communication in a Globalized World: Contributions From an Exploratory Project Developed in Northeast Brazil
Authors: Campos Rita , Araújo Magnólia
Published: July 2017

Science communication projects share one main goal: to bring together academia and society. However, despite the several formats used to make this bridge, traditional artistic expressions—those that are part of the cultural identity of a group—are seldom used. These formats can be particularly relevant in a globalized world where people from different social and cultural backgrounds meet. We present a project developed in Brazil that used a traditional type of theatre and literature to engage the public in a health control program, and reflect on the potentialities of these formats to communicate science in our multicultural societies.
Clinical Aspects of Heparin-Induced Thrombocytopenia and Thrombosis and other Side Effects of Heparin Therapy
Authors: Bick Rodger L. , Frenkel Eugene P.
Published: July 2017

Heparin, first used to prevent the clotting of blood in vitro, has been clinically used to treat thrombosis for more than 50 years. Although several new anticoagulant drugs are in development, heparin remains the anticoagulant of choice to treat acute thrombotic episodes. The clinical effects of heparin are meritorious, but side effects do exist. Bleeding is the primary untoward effect of heparin. Major bleeding is of primary concern in patients receiving heparin therapy. However, additional important untoward effects of heparin therapy include heparin-induced thrombocytopenia, heparin-associated osteoporosis, eosinophilia, skin reactions, allergic reactions other than thrombocytopenia, alopecia, transaminasemia, hyperkalemia, hypoaldosteronism, and priapism. These side effects are relatively rare in a given individual, but given the extremely widespread use of heparin, some are quite common, particularly HITT and osteoporosis. Although reasonable incidences of many of these side effects can be “softly” deduced from current reports dealing with unfractionated heparin, at present the incidences of these side effects with newer low molecular weight heparins appear to be much less common. However, only longer experience will more clearly define the incidence of each side effect with low molecular weight preparations.
Antithrombin Agents: The New Class of Anticoagulant and Antithrombotic Drugs
Authors: Fareed Jawed , Lewis Bruce E. , Callas Demetra D. , Hoppensteadt Debra A. , Walenga Jeanine M. , Bick Rodger L.
Published: July 2017

Antithrombin drugs represent a wide group of natural agents, recombinant agents equivalent to some of the naturally occurring proteins, and synthetic agents. This group of drugs is characterized by marked structural and functional heterogeneity. Several of these drugs are currently in various phases of development. Argatroban represents the first clinically approved antithrombin agent, which was made available in Japan several years ago. Two recombinant hirudin preparations, Revasc (Novartis) and Refludan (Aventis), are available for postsurgical DVT prophylaxis and alternate anticoagulant use in patients with heparin-induced thrombocytopenia. A synthetic antithrombin agent based on the combined structures of hirudin and antithrombin peptides, hirulog (Bivalirudin), is undergoing clinical trials in cardiovascular indications. Additional studies on the hirudins are being carried out to test their efficacy as surgical and interventional anticoagulants as replacements for heparin. However, the need for a proper antagonist is one of the limiting factors for the optimal development of hirudin in this indication. Several of the synthetic thrombin inhibitors are also being developed for oral use for the prophylaxis of DVT in surgical patients. Since the therapeutic index of thrombin inhibitors is narrower than that of heparin, this route may not be an optimal approach for the development of these agents. Despite several unresolved developmental issues, the thrombin inhibitors provide a useful alternative to heparin anticoagulation and may prove to be useful in validated clinical use.
Low Molecular Weight Heparins and Heparin-Induced Thrombocytopenia
Authors: Mammen Eberhard F.
Published: July 2017

Heparin-induced thrombocytopenia (HIT) and HIT thrombosis syndrome (HITTS) are immune-mediated complications of clinical use of unfractionated heparin (UFH). The antibody/antigen complex is composed of heparin and platelet factor 4. This complex not only activates platelets but also the clotting system leading to thrombin generation. This explains the thrombosing tendency of these patients, and venous and arterial thromboembolisms are encountered with a morbidity and mortality of about 25–37%. The incidence of HIT is about 3% when UFH is administered therapeutically. The diagnosis is at this time based on clinical observations, especially a sudden, unexplained drop in platelet counts without other reasons. Laboratory tests can be used to confirm the clinical diagnosis, but none of the available tests is 100% reliable. There is no test that will predict HIT and no test that will signal the development of HITTS. Treatment consists of discontinuation of UFH in any form and anticoagulation with danaparoid or r-hirudin, if needed. The use of low molecular weight heparins instead of UFH could largely (not totally) alleviate the problem.
Discrete optimization for actuator and sensor positioning for vibration control using genetic algorithms
Authors: Soubhia Ana Luisa , Serpa Alberto Luiz
Published: July 2017

Research about actuator and sensor positioning is important to obtain smart structures that can achieve better performance, and studies concerning controller design techniques are also important. In some studies on smart structures, the positioning of sensors and actuators are defined by some physical criteria and, thereafter, the controller is designed to satisfy some requirements of the controlled system. However, the optimal number and placement of sensors and actuators can also be obtained through the solution of an optimization problem, taking into account, for example, the possible positions to allocate the active elements and the available number of these. This paper presents a discrete heuristic optimization technique in order to determine the discrete positions of the active elements in active control systems. Furthermore, a technique that involves the determination of the number of active elements and the positioning is shown. These techniques have been implemented based on the genetic algorithms. Depending on the desired number of the sensors and actuators, and the number of candidate positions, it is impractical to use a combinatorial algorithm, as this is very expensive in terms of computational time due to the number of possible combinations. Thus, the techniques developed here have the aim to obtain good solutions analyzing fewer combinations than the combinatorial method and in reduced computational time. In this paper, the controllers are designed based on the [Formula: see text] control theory. The objective function used to solve the positioning problem of active elements is the [Formula: see text] norm of the closed-loop system.
Exit Outcomes for Probation-Supervised Youth in Foster Care: An Examination of Past Child Protection Involvement
Authors: Eastman Andrea Lane , Putnam-Hornstein Emily
Published: July 2017

Research on youth in foster care has focused on those placed for reasons of maltreatment rather than delinquency, yet most states provide foster care services to youth under probation supervision. This analysis generated knowledge about youth in probation-supervised foster care (PSFC) in California by examining the relationship between past child protective services (CPS) involvement and exit type. CPS records were extracted to identify 17-year-old youths in PSFC between 2008 and 2012 ( N = 11,188). The relationship between allegations of maltreatment and exit type was assessed using regression models. Of the PSFC youth, 64.6% had previous allegations of maltreatment and a quarter had been reported at least 6 times. Youth with a history of placement in CPS foster care were more likely to age out relative to achieving permanency in comparison to PSFC youth with no maltreatment history (relative risk ratio = 2.20; 95% confidence interval [1.90, 2.55]). As the number of reports increased, the likelihood of exiting care by aging out increased relative to achieving permanency ( p < .001). The findings suggest a majority of PSFC youth had maltreatment histories, the overlap between CPS and probation was constant, and maltreatment records may characterize youth in PSFC at risk of negative exits from care.
Gemcitabine associated pseudocellulitis: A missed diagnosis
Authors: Gill Dalvir , Schrader Josh , Kelly Matthew , Martinez Fidel , Syed Wajihuddin , Wright Jonathan
Published: July 2017

We report a case of a 51-year-old male with past medical history significant for cholangiocarcinoma presented with two weeks of worsening bilateral lower extremity swelling and erythema. Patient has been on active chemotherapy for his cholangiocarcinoma with Gemcitabine weekly infusions. Physical exam was significant for bilaterally petechial rash coalescing into ecchymoses over the dorsum of the feet, sparing soles and toes, which dissipated into thinning petechiae more proximally. On labs he did not have any leukocytosis, his platelet count was 50 × 103/µL and basic metabolic panel was benign. Patient was started on Vancomycin for presumed cellulitis. Lower extremity ultrasound Doppler ruled out deep venous thrombosis. Patient did have biopsies bilaterally on his legs, which showed hypersensitivity reaction consistent with the diagnosis of pseudocellulitis. His Vancomycin was discontinued and his symptoms improved. Our case further supports that pseudocellulitis is underrecognized and underreported, potentially leading to unnecessary antibiotic exposure and unnecessary diagnostic work-up as seen unfortunately in our patient. Unnecessary antibiotic exposure is increasing the risk for clostridium difficile and or antibiotic resistance, therefore awareness of this reaction is critical, as to avoid unnecessary antibiotics, and costly diagnostic workups.
The Motivation-Facilitation Model of Sexual Offending
Authors: Seto Michael C.
Published: July 2017

In this article, I describe the motivation-facilitation model of sexual offending, which identifies the traits of paraphilia, high sex drive, and intense mating effort as primary motivations for sexual offenses, as well as trait (e.g., antisocial personality) and state (e.g., intoxication) factors that can facilitate acting on these motivations when opportunities exist. Originally developed to explain contact sexual offending against children, the motivation-facilitation model was subsequently extended as an explanation for child pornography offending and for online solicitations of young adolescents. Here, I argue it has the potential to be expanded to explain other forms of sexual offending, including sexual assaults of adults and noncontact offenses involving exhibitionism or voyeurism. In this review, I critically examine the evidence for and against the model, discuss its limitations, and identify critical gaps for future research.
Offense Processes of Online Sexual Grooming and Abuse of Children Via Internet Communication Platforms
Authors: Kloess Juliane A. , Hamilton-Giachritsis Catherine E. , Beech Anthony R.
Published: July 2017

The aim of the present study was to provide an inclusive and realistic account of the offense processes of naturally occurring, sexually exploitative interactions between offenders and victims that took place via Internet communication platforms, and develop an offense process diagram of online sexual grooming and abuse. Five case series, comprising 29 transcripts of 22 interactions, were analyzed using the qualitative approach of thematic analysis. Police reports were reviewed for descriptive and case-specific information. The five offenders were men aged between 27 and 52 years ( M = 33.6, SD = 5.6), and the number of children they communicated with ranged from one to 12 ( M = 4.6, SD = 4.5). Victims were aged between 11 and 15 ( M = 13.0, SD = 1.2), and were both female ( n = 17) and male ( n = 6). Findings revealed that offenders employed either an indirect or a direct approach to conversations with victims and initiating contact with them. The approach offenders employed was also reflected in the types of strategies they used. Only two offenders were found to engage in aspects of sexual grooming as part of an indirect approach; the majority of the interactions by the other three offenders, that lacked features of sexual grooming altogether, were found to be of a direct approach. These findings are discussed in relation to current issues surrounding terminology and definition of sexual grooming, as well as theoretical and practical implications, concluding with suggestions for future research.
Familial Support as Perceived by Adult Victims of Childhood Sexual Abuse
Authors: Stroud Delores D.
Published: July 2017

With the increasing popularity of family therapies in cases of childhood sexual abuse (CSA), many studies have discussed the importance of familial support in the successful recovery of victims. Therefore, a systematic study exploring family support of victims was undertaken to shed light on the level of family support perceived by adult victims of CSA. It was anticipated that victims of intrafamilial CSA would report more family dissatisfaction and perceive less family support than extrafamilial victims. As hypothesized, intrafamilial victims reported significantly more general family dissatisfaction and specifically, perceived significantly less father, parent, and brother support. Additionally, the gender of the victim played a significant role: Male victims reported less father, parent and sister support and less family protectiveness after disclosure when compared to female victims. Based on the results, clinicians should be aware that issues of gender and relatedness may play a significant part in the effectiveness of their CSA clients' family support systems.
Pediatric Intraocular Immature Teratoma Associated With Sacrococcygeal Teratoma
Authors: Zhelnin Kristen E , Gebhard Grant M , Mirsky David M , Oliver Scott CN , Lovell Mark A , Galambos Csaba , Crombleholme Timothy M , McCourt Emily A
Published: July 2017

Intraocular teratomas are rare neoplasms with only three previously reported cases. We present the fourth case of intraocular teratoma and the second associated with sacrococcygeal teratoma. While the nature of the association between intraocular teratomas and sacrococcygeal teratomas is unclear, it suggests a need for careful ophthalmologic follow-up of infants with congenital sacrococcygeal teratomas.
CD30 Expression in Pediatric Neoplasms, Study of 585 Cases
Authors: Cheng Jinjun , Zhu Haiqing , Choi John Kim
Published: July 2017

CD30 is a member of the tumor necrosis factor receptor superfamily, member 8 (TNFRSF8), and its normal expression is restricted to activated T and B cells. In tumor cells, CD30 expression is most commonly associated with lymphoid malignancies (Hodgkin and non-Hodgkin lymphomas) and is a therapeutic target using anti-CD30 antibody. CD30 expression has been reported also in mostly adult non-lymphoid malignancies, raising the possibility of CD30-targeted therapy for additional tumors. In this study, we examined the incidence of CD30 expression in 251 hematopoietic and 334 non-hematopoietic cases of pediatric tumors. As expected, strong and membranous CD30 staining was seen in anaplastic large cell lymphoma, classical Hodgkin lymphoma, and embryonal carcinoma while variable staining was seen in diffuse large B cell lymphoma. In addition, positive CD30 staining was also seen in cases of neuroblastoma (33 of 56), neoplasm with chondroid differentiation (8 of 25), myeloid neoplasms (11 of 120), hemangioma (2 of 12), and mature teratoma (1 of 11). In neuroblastoma, the CD30 expression was generally restricted to cells with ganglion differentiation; staining of ganglion cells was also seen in the one positive case of mature teratoma. In neoplasm with chondroid differentiation, the positive cases were chondrosarcoma (3 of 5), chondroblastic osteosarcoma (2 of 10), and chondroblastoma (3 of 7). In acute myeloid leukemia, the CD30 positive cases were more common in AML with monocytic differentiation but did not correlate with any specific molecular change. We conclude that CD30 expression in pediatric tumors is more general than anticipated and future studies are warranted to understand the biologic and therapeutic significances.
Fetal Dysmorphology—Still an Essential Art. Analysis of the Limitations of Microarray in a Fetal Population and a Look Toward the Genome Sequencing Era
Authors: Fletcher E , Porteous M , McKenzie KJ , Maher EJ , Evans MJ
Published: July 2017

Cytogenomic microarray allows assessment of the genome at higher resolutions than traditional karyotyping. The objective of this study is to evaluate the utility of microarray in a routine fetal autopsy setting before the advent of routine fetal exome/genome sequencing and the issues these technologies may generate. A systematic review of fetal postmortems at 12–24 weeks gestation between January 2011 and December 2014 was undertaken. Cases where there was no consent for audit, research, or genetic testing were excluded as were cases referred to the Procurator Fiscal, stillbirths, and neonatal deaths. Copy number variations were detected in 16 cases. In addition, there was 1 case of uniparental disomy; not all of these were related to the phenotype. There were a number of cases with phenotypic abnormalities and normal array results. Five of these underwent directed mutation analysis—3 were positive. Genetic laboratory investigations such as microarray and Quantitative Fluorescent-Polymerase Chain Reaction may increase the diagnostic yield in the assessment of fetal dysmorphology. However, this study shows that genetic results not only require careful review given the potential uncertain significance but also require phenotypic assessment of the fetus by a competent fetal dysmorphologist to determine the likely causative effect of any detected anomaly. This best practice will also extend to next generation sequencing and interpretation of variants of unknown significance. Fetal medicine teams should ideally include specialists well versed in assessment of fetal anomaly to provide families with the best possible information about the cause of their pregnancy loss and their options for future pregnancies.
Pediatric Non-vestibular Schwannoma
Authors: Broehm Cory , Al-Ibraheemi Alyaa , Fritchie Karen J
Published: July 2017

While the clinicopathologic features of pediatric vestibular schwannomas, often in the context of neurofibromatosis type 2 (NF2), have been well studied, there is less data regarding the characteristics of pediatric non-vestibular schwannomas (NVS). Additionally, the rate of loss of SMARCB1/INI1 expression in this population has not been systematically evaluated. Our institutional archives were searched for cases of NVS arising in patients 18 years or younger. Clinicopathologic features including SMARCB1/INI1 status were assessed for each case. Twenty-three NVS from 9 males and 13 females (age range, 2 months to 18 years) were identified, and sites included paraspinal (n = 10), head and neck (n = 6), extremities (n = 4), trunk (n = 1), mediastinum (n = 1), and retroperitoneum (n = 1); 22 cases were Antoni A predominant with 6 cases comprising solely Antoni A tissue. The mitotic rate of the tumors ranged from 0 to 10/10 high-power fields (HPFs), and 3 tumors had mitotic rates of ≥4 mitoses/10 HPFs. Two tumors showed plexiform architecture. No NVS showed diffuse atypia, calcifications, microcystic/reticular architecture, epithelioid morphology, pseudoglandular change, neuroblastoma-like features, or necrosis. All tumors tested (23/23) showed retained nuclear expression of SMARCB1/INI1. Follow-up was available in 21 patients (range 1 week to 194 months), and 5 tumors recurred. Pediatric NVS have a relatively homogeneous appearance with a predominance of Antoni A areas. Pathologists should be aware that schwannomas in this age group may be cellular with mitotic rates of ≥4/10 HPFs to avoid misclassification as a spindle cell sarcoma.
Malignant Rhabdoid Tumor of Soft Tissue
Authors: Guilmette Julie , Laverdière Caroline , Soulières Denis , Patey Natasha , Soucy Geneviève , Trudel Dominique , Bouron-Dal Soglio Dorothée
Published: July 2017

Introduction

Malignant rhabdoid tumor (MRT) is defined as a high-grade sarcoma derived from an uncertain cell of origin. Its diagnosis is associated with poor prognosis and patient’s life expectancy is greatly reduced.

Material and method

Here, we describe a unique case of 9-month-old boy who presented with a large MRT arising from the soft tissue of the neck. Following intensive multimodal treatment, the patient benefited from a 25 years’ remission until the discovery of multiple liver metastases.

Conclusion

MRT of soft tissue needs to be distinguished from other soft tissue neoplasms, as MRT is highly aggressive and is usually associated with a poor outcome. In addition, this is the longest remission time reported in a patient with soft tissue MRT and this might be related to the use of early intensive multimodal treatments.
Use of single-dose oral gabapentin to attenuate fear responses in cage-trap confined community cats: a double-blind, placebo-controlled field trial
Authors: Pankratz Katherine E , Ferris Kelli K , Griffith Emily H , Sherman Barbara L
Published: July 2017

Objectives

This double-blind, placebo-controlled study evaluated the safety and efficacy of single-dose oral gabapentin administered for the attenuation of fear responses in cage-trap confined community cats.

Methods

Community cats presented in cage traps for trap–neuter–return (TNR) were recruited and screened for inclusion. Each enrolled cat was randomly assigned and administered one of three equal-volume, single-dose treatments: placebo, low-dose gabapentin (50 mg) or high-dose gabapentin (100 mg). At baseline, 1, 2, 3 and 12 h post-administration, a single, blinded observer scored each cat for signs of fear and sedation using published paradigms, calculated the respiratory rate and documented any observable facial injuries.

Results

Fifty-three cats met the inclusion criteria and completed the study. Cat stress score (a measure of fear) was lower in cats that received gabapentin (50 or 100 mg) than in cats that received placebo (50 mg: P = 0.027; 100 mg: P = 0.029), with the greatest reduction at 2 h post-treatment ( P = 0.0007). Respiratory rates did not differ between treatment groups. There was no difference in sedation scores between the groups ( P = 0.86) at any time point ( P = 0.09). Cat facial injuries did not vary by treatment group or over time. No adverse effects were detected specific to gabapentin administration. At 1 h, hypersalivation was observed in four cats across all treatment groups. All cats recovered from surgery and anesthesia uneventfully.

Conclusions and relevance

This study supports the hypothesis that 50 mg or 100 mg gabapentin (9.2–47.6 mg/kg per cat) reduces fear responses in confined community cats without measurable sedation over 3 h post-administration vs placebo. Gabapentin treatment was well tolerated in this population of cats. Further studies are recommended to investigate the use of oral gabapentin earlier in the TNR process, such as immediately after trapping or prior to transport for the prevention of confinement-related injuries.
Association of Isotretinoin With Depression and Suicide: A Review of Current Literature
Authors: Oliveira João Miguel , Sobreira Gonçalo , Velosa Jorge , Telles Correia Diogo , Filipe Paulo
Published: July 2017

Acne vulgaris, a condition that can affect people at any age, is the most common cause of referral to a dermatologist. Isotretinoin (ITT) is the most effective treatment available, but serious adverse effects, including a possible association with depression and suicide, limit its use. We review the current literature regarding the association of ITT with depression and suicide. Case reports and database studies show a clear association, and this association is biologically plausible. Although prospective studies have opposite results, limitations make them unsuitable to identify a subgroup of patients who may be at risk of developing depression or suicidal ideation with ITT. Overall, it seems some people might be at risk, particularly those with a personal or family history of mental disorder, but further studies are needed to identify those patients who would benefit from an early referral to a mental health professional when ITT is initiated. Currently, no conclusions can be drawn, and it seems appropriate to regularly screen all patients on ITT for depressive symptoms and suicidal ideation and promptly refer them to a mental health professional if any are found.
Island Encounters: Experiential Modes of Insideness and Outsideness on Pitcairn Island
Authors: Amoamo Maria
Published: July 2017

In a case study of Pitcairn Island, this article uses Relph’s experiential notion insideness/outsideness to deliver perspectives on islands as places of local and multiple meanings that are constructed spatially and experienced diversely. Results reveal how place, for different individuals and groups, induces a spectrum of situations, meanings, and identities, and whereby extremes of insideness (existential) and outsideness (alienation) become critical points of juncture that can work to maintain, restore, or threaten permanence of place. More specifically, as a subnational island jurisdiction, Pitcairn reveals the complex and often contested nature of place reflected in relationships of center/periphery (geographical) and island/metropole (sociopolitical). In isolation, specific subnational island jurisdictions like Pitcairn Island offer particular rather than general assumptions on the nature of place experience. Nonetheless, they better equip us to maintain perspectives on islands as currently ongoing and commonly contested processes of creation and becoming, with largely indeterminate futures.
Numerical analysis of a rigid rotor mounted on four-pad hydrostatic squeeze film damper lubricated with micropolar lubricant
Authors: Benariba Aboubakeur , Bouzidane Ahmed , Thomas Marc , Guilbault Raynald
Published: July 2017

The present work deals with a numerical resolution of the modified Reynolds equation using micropolar lubrication theory to study the effects of coupling number and the characteristic length of the micropolar lubricant on the performance characteristics of hydrostatic squeeze film damper, which consists of four hydrostatic pads fed through four capillary restrictors. According to the results, the bearing operating with micropolar lubricant shows an increase in the value of pressure inside the recess. These results suggest that the influence of micropolar effect on the bearing performance is predominantly affected by the pressure ratio. Therefore, the bearing operator must judiciously choose an appropriate value of the pressure ratio in order to get an overall enhanced bearing performance.
Justice and the faithless: The demand for disobedience in international criminal law
Authors: Leebaw Bronwyn
Published: July 2017

How is disobedience required under international criminal law? How do war crimes trials demand and seek to cultivate disobedience as a response to atrocity? It is widely recognized that international law may require disobedience as a response to domestic authorities that order or legalize war crimes, yet this obligation to disobey is commonly conceptualized as a kind of byproduct of efforts to establish compliance with international norms. Drawing on empirical and theoretical scholarship analyzing “crimes of obedience,” this article investigates the demand for disobedience as articulated in international legal conventions and in war crimes trials dealing with lower-level soldiers and civilian authorities. It argues that disobedience is an important response to war crimes and that the capacity to disobey abusive authorities does not follow logically or inevitably from a commitment to obey laws that criminalize their abuses. In international criminal law, the obligation to disobey abusive authorities has been articulated in ways that require the exercise of critical judgment, as well as moral and political agency, in order to overcome various pressures to obey domestic authority. Prominent theoretical explanations of compliance with international law not only neglect the importance of such skills, but call for strategies that are in tension with their development. Closer attention to the role of exemplary disobedience in the legal reasoning animating war crimes prosecutions, I suggest, could strengthen the pedagogical role of legal institutions as a response to criminal obedience and as interventions in the politics of memory.
Playing at apocalypse: Reading Plague Inc. in pandemic culture
Authors: Mitchell Scott , Hamilton Sheryl N
Published: July 2017

Plague Inc. is an enduringly popular mobile video game in which players create diseases and attempt to eradicate humanity; it has been downloaded more than 60 million times and been met with largely positive critical reception, with many reviews praising the game as a ‘realistic outbreak simulator’. This article explores Plague Inc. as both an artifact, and productive, of ‘pandemic culture’, a social imaginary that describes how the threat of pandemic increasingly shapes our day-to-day life. Ludic and narrative elements of the game were identified and selected for analysis, along with paratexts surrounding the game. Three aspects of Plague Inc. were used to structure the analysis: its politics of global scale, its viral realism, and its visual culture of contagion. The article examines how the ways in which Plague Inc. articulates ideas about pandemic may not only explain the game’s immense success but also provide insights into public perceptions and popular discourses about disease threats. The article argues that the game is an incomplete text that depends on preexisting familiarity with other disease media. It concludes that the popularity and longevity of Plague Inc., as well as its broader social relevance, can be explained by placing it within the context of public anxieties about vulnerability to infectious diseases.
Speaking of the weather
Authors: Jensen Klaus Bruhn
Published: July 2017

Climate change raises the stakes of human communication to the existential level of the species and the planet. This article presents an empirical study of how users make sense of climate change as they traverse the contemporary digital media environment. Departing from a baseline survey and drawing on the tradition of reception analysis, focus groups of different ages and with various political and religious affiliations identified distinctive themes, narratives, and arguments regarding the natural environment as represented and received across different media. Climate change appears out of scale – incommensurable not only with established media formats and genres but also with common frames of human cognition and communication. In conclusion, the article addresses climate change from the perspective of human rights and social justice, under the recent heading of climate justice.