bluuebunny/crossref_metadata_2025 huggingface dataset:
New Doppler imaging technique for assessing angiogenesis in breast tumors: correlation with immunohistochemically analyzed microvessels density
Authors: Kim Sewha , Lee Hye Jin , Ko Kyung Hee , Park Ah Young , Koh Jieun , Jung Hae Kyoung
Published: April 2018

Background

Microvessel density (MVD) is associated with grade and prognosis in breast tumors. However, conventional color Doppler flow (CDF) imaging has been limited to represent MVD of breast tumors.

Purpose

To evaluate whether a new Doppler imaging technique (AngioPLUS) can represent MVD of breast tumors.

Material and Methods

The institutional review board approved this retrospective study, and patients’ informed consent was waived. CDF and AngioPLUS were available in pathologically confirmed 55 breast tumors of 53 women. For each lesion, vascular flow patterns (distribution and amount) of both Doppler images were retrospectively reviewed, and MVD was measured using immunohistochemical analysis of the biopsied tissue sections. MVD was subcategorized as low or high group with reference to the median. The associations between the Doppler features and MVD were evaluated using Fisher’s exact test and Student’s t test.

Results

Of the 55 masses, 28 (50.9%) were benign and 27 (49.1%) were malignant. Vascular flow distribution and amount of both Doppler imaging were different between the benign and malignant lesions (CDF, P = 0.020 and P = 0.010; AngioPLUS, P = 0.002 and P = 0.005). MVD had no significant relationships with CDF features, but vascular flow distribution on AngioPLUS showed significant differences between the lesions with low and high MVD ( P = 0.020); Combined distribution was more frequent in the high MVD lesions than in the low MVD lesions (17/28, 60.7% vs. 6/27, 22.2%).

Conclusion

Our data confirmed the correlation between a new Doppler imaging technique, AngioPLUS, and MVD. We suggest that AngioPLUS can be used for assessing MVD in breast tumors.
Relationship between kurtosis and bi-exponential characterization of high b-value diffusion-weighted imaging: application to prostate cancer
Authors: Karunamuni Roshan A , Kuperman Joshua , Seibert Tyler M , Schenker Natalie , Rakow-Penner Rebecca , Sundar VS , Teruel Jose R , Goa Pal E , Karow David S , Dale Anders M , White Nathan S
Published: April 2018

Background

High b-value diffusion-weighted imaging has application in the detection of cancerous tissue across multiple body sites. Diffusional kurtosis and bi-exponential modeling are two popular model-based techniques, whose performance in relation to each other has yet to be fully explored.

Purpose

To determine the relationship between excess kurtosis and signal fractions derived from bi-exponential modeling in the detection of suspicious prostate lesions.

Material and Methods

This retrospective study analyzed patients with normal prostate tissue (n = 12) or suspicious lesions (n = 13, one lesion per patient), as determined by a radiologist whose clinical care included a high b-value diffusion series. The observed signal intensity was modeled using a bi-exponential decay, from which the signal fraction of the slow-moving component was derived ( SFs). In addition, the excess kurtosis was calculated using the signal fractions and ADCs of the two exponentials ( KCOMP). As a comparison, the kurtosis was also calculated using the cumulant expansion for the diffusion signal ( KCE).

Results

Both K and KCE were found to increase with SFs within the range of SFs commonly found within the prostate. Voxel-wise receiver operating characteristic performance of SFs, KCE, and KCOMP in discriminating between suspicious lesions and normal prostate tissue was 0.86 (95% confidence interval [CI] = 0.85 – 0.87), 0.69 (95% CI = 0.68–0.70), and 0.86 (95% CI = 0.86–0.87), respectively.

Conclusion

In a two-component diffusion environment, KCOMP is a scaled value of SFs and is thus able to discriminate suspicious lesions with equal precision . KCE provides a computationally inexpensive approximation of kurtosis but does not provide the same discriminatory abilities as SFs and KCOMP.
Cho/Cr ratio at MR spectroscopy as a biomarker for cellular proliferation activity and prognosis in glioma: correlation with the expression of minichromosome maintenance protein 2
Authors: Gao Wenjing , Wang Xiao , Li Fuyan , Shi Wenqi , Li Hongxia , Zeng Qingshi
Published: April 2018

Background

Magnetic resonance (MR) spectroscopy (1H-MRS) has been demonstrated to be useful in grading glioma, but the utility in assessing cellular proliferation activity and prognosis correlated with the expression of minichromosome maintenance protein 2 (MCM2) has not been reported.

Purpose

To explore the correlation between proton MR spectroscopy parameters (including choline [Cho]/creatine [Cr], N-acetyl aspartate [NAA]/Cr, and Cho/NAA ratios) and the expression of MCM2 and to further evaluate whether 1H-MRS can predict cell proliferative activity and provide prognostic information in high-grade gliomas (HGGs).

Material and Methods

Forty-three patients with histopathologically confirmed gliomas were involved in this study. All patients underwent 1H-MRS examination before surgery. Proliferative activity of gliomas was evaluated by MCM2 labeling index (LI). Pearson correlation analysis and empiric receiver operating characteristic (ROC) curves were performed. The Kaplan–Meier method and Cox regression were used for survival analysis.

Results

Significant correlation was observed between the Cho/Cr ratio and MCM2 LI ( r = 0.522, P < 0.01); however, there was no correlation between MCM2 LI and the Cho/NAA or NAA/Cr ratios ( r = 0.295, P = 0.55 and r = −0.042, P = 0.788, respectively). According to ROC analysis, MCM2 LI of 50% and Cho/Cr ratio of 2.68 represented the optimized cut-off values, respectively, to distinguish longer or shorter survival than 15 months in HGGs patients. Multivariate analysis revealed that both the Cho/Cr ratio and MCM2 expression were independent prognostic markers.

Conclusion

Cho/Cr ratio has a potential in predicting the expression of MCM2 and can evaluate cell proliferative activity noninvasively. Both the Cho/Cr ratio and MCM2 expression are independent prognostic markers in patients with HGGs.
Significance of incidental intra-articular and peri-articular FDG avid foci on PET/CT
Authors: Cohen-Levy Wayne B , Pretell-Mazzini Juan , Singer Adam D , Subhawong Ty , Greif Dylan N , Jose Jean
Published: April 2018

Background

Positron emission tomography/computed tomography (PET/CT) is a useful imaging adjunct in patients with sarcoma. Intra-articular and peri-articular 18F-fluoro-2-deoxy-D-glucose (FDG) avid lesions are often discovered incidentally.

Purpose

To describe the etiology, appearance, and standardized uptake values (SUV) of incidentally detected FDG avid intra-articular and peri-articular foci in patients with sarcoma.

Material and Methods

The institutional sarcoma database between November 2011 and November 2016 was retrospectively reviewed. Patients were included if a PET/CT scan was performed and an FDG avid intra-articular or peri-articular focus was found that was distinct from the primary sarcoma.

Results

The majority of FDG avid foci represented benign, non-physiologic conditions such as osteoarthritis, enthesopathy, bursitis, and post-surgical changes. Six patients each had radiographic features consistent with tenosynovial giant cell tumor (TSGCT) and metastatic disease, respectively. Lower SUV, bilateral findings, and the absence of metastatic disease elsewhere were associated with benign etiologies. There was a statistically significant difference between the mean SUV measured in patients with TSGCT and those with benign, non-physiologic conditions ( P < 0.001). The difference between the benign, non-physiologic cohort and the cohort with widespread metastatic disease did not reach statistical significance ( P = 0.07).

Conclusions

In patients with soft-tissue or osseous sarcomas, isolated FDG avid intra-articular or peri-articular foci without additional metastatic lesions likely represent benign processes. Isolated intra-articular or peri-articular foci with significantly elevated SUV measurements were favored to represent TSGCT in this series.
Low-dose CT of postoperative pelvic fractures: a comparison with radiography
Authors: Eriksson Thomas , Berg Per , Olerud Claes , Shalabi Adel , Hänni Mari
Published: April 2018

Background

Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose.

Purpose

To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture.

Material and Methods

Twenty-one patients were examined with LDCT and CR 0–9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated.

Results

LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001).

Conclusion

LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.
Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty
Authors: Zhong Guangjun , Liang Zhu , Kan Jiang , Muheremu Aikeremujiang
Published: April 2018

Objective

This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA).

Methods

Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively.

Results

The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group.

Conclusions

Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.
Histopathologic Findings in Canine Pituitary Glands
Authors: Miller Margaret A. , Bruyette David S. , Scott-Moncrieff J. Catharine , Owen Tina Jo , Ramos-Vara José A. , Weng Hsin-Yi , Vanderpool Andrea L. , Chen Annie V. , Martin Linda G. , DuSold Deidre M. , Jahan Sina
Published: April 2018

To optimize the histologic evaluation of hypophysectomy specimens, sections of 207 canine pituitary glands (196 postmortem, 11 hypophysectomy specimens) were reviewed. Adenohypophyseal proliferation was the most common (n = 79) lesion. Proliferative lesions were sparsely to densely granulated; the granules were usually basophilic to chromophobic and periodic acid-Schiff-positive. Adenohypophyseal proliferation was classified as hyperplasia (n = 40) if ≤2 mm diameter with intact reticulin network, as microadenoma (n = 22) for 1–5 mm homogeneous nodules with lost reticulin network, or as macroadenoma (n = 17) for larger tumors. Craniopharyngeal duct cysts were common incidental lesions and the only lesion in 15 dogs. Uncommon diagnoses included lymphoma (n = 4), hemorrhagic necrosis (n = 4), metastatic carcinoma (n = 3), hypophysitis (n = 3), ependymoma (n = 2), craniopharyngioma (n = 2), and 1 case each of metastatic melanoma, pituicytoma, gliomatosis, germ cell tumor, meningioma, and atrophy. The pituitary histologic diagnosis was associated with hyperadrenocorticism (HAC; P < .001) and adrenocortical histologic diagnosis ( P = .025). Both HAC and adrenocortical hyperplasia showed a positive trend with the degree of adenohypophyseal proliferation. The association of adrenocortical hyperplasia with HAC was not significant ( P = .077). Dogs with adenohypophyseal proliferations were older than dogs with normal pituitary glands ( P < .05). Brachycephalic breeds were overrepresented among dogs with pituitary macroadenoma or craniopharyngeal duct cysts, but the association was not statistically significant ( P = .076). Adenohypophyseal hyperplasia was more common than adenoma among postmortem specimens, but was unexpected in >80% of cases. Pituitary macroadenoma was the most common diagnosis in hypophysectomy specimens.
Content and acceptability of an Occupational Therapy intervention in HomEcare Re-ablement Services (OTHERS)
Authors: Whitehead Phillip J , Drummond Avril ER , Parry Ruth H , Walker Marion F
Published: April 2018

Introduction

Despite clear compatibilities between the tenets of occupational therapy and re-ablement, there is limited research on occupational therapy in homecare reablement services. This article describes an occupational therapy intervention that was delivered as part of a feasibility randomised controlled trial (Occupational Therapy intervention in HomEcare Re-ablement Services), and evaluates whether the intervention was acceptable to participants.

Method

There were three phases: (1) a bespoke pro forma was completed, recording the activities undertaken after each therapy visit; (2) an acceptability questionnaire was sent to every intervention participant and (3) semi-structured interviews were completed with key informants who received the intervention.

Results

The principal activities undertaken were assessment, case management, goal-setting, advice and support, and practising activities in relation to bathing/showering or kitchen activities. Participants particularly valued the advice and support provided. However, there were difficulties due to fluctuations in circumstances and with activities of daily living outside the home within the 6 week timescale.

Conclusion

An intervention focusing on activities of daily living within the home was acceptable for participants and consistent with their goals; however, they also had goals beyond personal activities of daily living and the timescale of the re-ablement episode. Further research should focus on extended activities of daily living, beyond this time-limited period.
Posthuman policies for creative, smart, eco-cities? Case studies from China
Authors: Visser Robin
Published: April 2018

Policies promoting creative, smart, sustainable cities continue to dominate global urban policy scripts. This article explores how posthuman assumptions embedded in such scripts render the socially embodied human invisible and analyzes cases of their rationalization and enactment within China. The article concludes that understandings of creativity in Chinese urban aesthetics expose premises of globally promoted urban policy scripts more transparently than those informed by European aesthetic traditions. The Chinese city is understood to manifest the creative obsessions of humans rather than to actualize a transcendent, idealized vision separate from that of its human creators. This resembles Guy Debord’s idea that what we see in the world—how the world is architected—is a materialization of triumphant ideologies. The contemporary Chinese city, incentivized by the entrepreneurial state, makes visible Debord’s globally dominant “integrated spectacular.” Once creativity and intelligence are rationalized, the autonomous “creative,” “smart,” “eco” city is branded in a global supply chain of city production. Consequently, the posthuman city need not account for the conditions under which embodied humans are actually inspired to create and adequately compensated for their creations. Rather than attributing the failure of posthuman policies in Chinese cities to Chinese exceptionalism, these cases expose universal fault lines in the policies themselves.
Miles O. Hayes, Hurricanes as Geological Agents: Case studies of Hurricanes Carla, 1961, and Cindy, 1963, 1967
Authors: Hodge Joshua Brian , Anzah Faisal , Dixon Richard W
Published: April 2018

Hurricanes affect coastal regions with high winds, storm surges, and flooding rains. However, hurricanes can also alter the geomorphology of coastal regions. Miles O. Hayes’ 1967 report was the seminal work in documenting how hurricanes play an important role in nearshore sedimentation processes and how they leave recognizable storm deposits in the rock record. This paper briefly describes Hayes’ background, the writing of the text, and its impact and legacy.
Hydrological modelling as a tool for interdisciplinary workshops on future drought
Authors: Rangecroft S , Birkinshaw S , Rohse M , Day R , McEwen L , Makaya E , Van Loon AF
Published: April 2018

Transformative interdisciplinary methods and tools are required to address crucial water-related challenges facing societies in the current era of the Anthropocene. In a community-based study in the Limpopo basin of South Africa, physical and social science methods were brought together to run interdisciplinary workshops aimed at enhancing preparedness for possible future drought. To generate storylines for the workshops, relevant scenarios were modelled using a catchment-scale hydrological model, SHETRAN. Set up using freely available data, local knowledge, and narrative-based group interviews on past experiences of drought, the model acted as a locally-relevant tool for prompting discussions about potential future drought impacts, responses and preparedness, and to stimulate the production of community future narratives. In this paper, we discuss the elements involved in the modelling process: the building of the model through an interdisciplinary approach; setting up the model with limited data; and the translation of the model results into storylines for the workshops. We found that by using this methodology scientific grounding was given to the workshop storylines, and that the local context of the model and the engaging approach of creating narratives encouraged participant involvement in discussions about the future. The method of generating these future stories was an important process for the participants in developing their thinking about possible futures, preparedness and adaptation. In this paper we show how this alternative approach of using a hydrological model has benefits and we discuss the limitations and lessons of the approach for future interdisciplinary research.
Nano-CuO impairs spatial cognition associated with inhibiting hippocampal long-term potentiation via affecting glutamatergic neurotransmission in rats
Authors: Li Xiaoliang , Sun Wei , An Lei
Published: April 2018

Manufactured metal nanoparticles and their applications are continuously expanding because of their unique characteristics while their increasing use may predispose to potential health problems. Several studies have reported the adverse effects of copper oxide nanoparticles (nano-CuO) relative to ecotoxicity and cell toxicity, whereas little is known about the neurotoxicity of nano-CuO. The present study aimed to examine its effects on spatial cognition, hippocampal function, and the possible mechanisms. Male Wistar rats were used to establish an animal model, and nano-CuO was administered at a dose of 0.5 mg/kg/day for 2 weeks. The Morris water maze (MWM) test was employed to evaluate learning and memory. The long-term potentiation (LTP) from Schaffer collaterals to the hippocampal CA1 region, and the effects of nano-CuO on synases were recorded in the hippocampal CA1 neurons of rats. MWM test showed that learning and memory abilities were impaired significantly by nano-CuO ( p < 0.05). The LTP test demonstrated that the field excitatory postsynaptic potential (fEPSP) slopes were significantly lower in nano-CuO-treated groups compared with the control group ( p < 0.01). Furthermore, the data of whole-cell patch-clamp experiments showed that nano-CuO markedly depressed the frequencies of both spontaneous excitatory postsynaptic currents (sEPSCs) and miniature EPSCs (mEPSCs), indicating an effect of nano-CuO on inhibiting the release frequency of glutamate presynapticly ( p < 0.01). Meanwhile, the amplitudes of both sEPSC and mEPSC were significantly reduced in nano-CuO-treated animals, which suggested that the effect of nano-CuO modulates postsynaptic receptor kinetics ( p < 0.01). Paired pulse facilitation (PPF) ( p < 0.05) and the expression of NR2A, but not NR2B, of N-methyl-d-aspartate (NMDA) subunits ( p < 0.05), were decreased significantly. In conclusion, nano-CuO impaired glutamate transmission presynapticly and postsynapticly, which may contribute importantly to diminished LTP and other induced cognitive deficits.
Breaking the Silence and Other Prevention Lessons From the Opioid Epidemic
Authors: Terry Paul E.
Published: April 2018

The goal of this editorial is to equip readers with opioid education resources that enable you to role model what it looks like to speak out about addiction. How are we doing as a profession speaking up about addiction? Stigma is commanded by a deep irony: where peer pressure is what likely keeps us quiet, peer support is what enables us to speak up. The “#MeToo” movement is an extraordinary example of the inertia needed to break open a taboo topic. From Hollywood celebrities to US women’s gymnastics stars, it was clear that as more women spoke up about sexual harassment, well, the more women spoke out. As unnatural as it felt to talk about being harassed or abused, many simply acknowledged that it was the courage of their peers that helped them find their courage. Workplace supervisors have a front row seat for watching the epidemic and our role relates to what I consider the most straightforward definition of addiction: It is when “it” (i.e., alcohol, opioids, gambling) begins to cause problems.
Prevalence of Physical Inactivity and Associated Factors Among Older Caregivers of Older Adults
Authors: Gomes Grace Angélica de Oliveira , Luchesi Bruna Moretti , Gratão Aline Cristina Martins , Orlandi Fabiana de Souza , Say Karina Gramani , Inouye Keika , Alexandre Tiago da Silva , Brigola Allan Gustavo , Pavarini Sofia Cristina Iost
Published: April 2018

Objective: The aim of this study is to analyze the prevalence of physical inactivity (PI) and associated factors in older caregivers of older adults. Method: A cross-sectional study was conducted including 312 older caregivers. Sociodemographic, clinical, and care-related characteristics were considered the independent variables for the determination of associated factors with PI in the logistic regression model. Results: The prevalence of PI was 75.3% (95% confidence interval [CI] = [70.1%, 80.0%]). The following factors were associated with PI: being female (odds ratio [OR] = 2.8, 95% CI = [1.3, 5.9]), being older than 75 years of age (OR = 7.1, 95% CI = [2.2, 22.9]), not having a marital life (OR = 4.2, 95% CI = [1.1, 15.8]), being prefrail (OR = 6.2, 95% CI = [1.7, 21.9]), and being frail (OR = 14.8, 95% CI = [3.8, 57.7]). Discussion: The prevalence of PI was high and associated with the female sex, an advanced age, and not being married. Specific public policies considering these results should be created for older caregivers.
Strain modal-based damage identification method and its application to crane girder without original model
Authors: Yang Huichao , Xu Feiyun , Ma Jiaxin , Huang Kai
Published: April 2018

Although there are many methods to identify structural damage of the crane girder, almost all of them are used by means of comparing specific parameters of original and existing structures. And it leads to difficulties in practice. So, a method to identify damage of the crane girder is proposed based on strain modal without original model. First, the strain modal difference curve was obtained by using difference algorithm to deal with strain modal and cubic spline interpolation algorithm to fit the curve, and the damage location was realized by constructing and comparing damage sensitive index (IDSI). Then, the data of undamaged checkpoints adjacent to damaged checkpoints are stationary and modeled by Auto-Regressive Moving-Average Model, with this modeling the original data of the damaged checkpoints was predicted, and variation of the got strain modal difference curve was used to determine damage degree. Finally, the application of this method was implemented by some experiments and numerical calculations, and the results demonstrated that this method can effectively identify the damage of the crane girder.
Numerical simulation of drive axles considering the nonlinear couplings between gears and bearings
Authors: Zhou Chi , Wang Qi , Ding Weiqi , Gui Liangjin , Fan Zijie
Published: April 2018

The drive axle is the core of the powertrain in automotive vehicles, and numerical simulation is a common and effective approach for designing and analysing drive axles. This article develops a new numerical simulation method for drive axles considering the nonlinear couplings between gears and bearings. Two types of models are proposed and integrated: a reduced model with nonlinear bearing elements and equivalent gear elements, which is efficient for nonlinear bearing simulation, and a gear contact analysis model with equivalent bearing stiffnesses, which can accurately reflect the gear mesh conditions and system deflection. The equivalent gear mesh parameters used in the reduced model are derived from the contact analysis model, and the linear equivalent bearing stiffness matrices used in the contact analysis model are derived from the reduced model. Therefore, the static equilibrium condition of the entire drive axle system is obtained through an iterative calculation process involving the two models under the same load condition. The good correlation between the numerical and experimental results of the gear-loaded contact pattern indicates that the proposed method is reliable.
The efficacy of adjunct tacrolimus treatment in pregnancy outcomes in patients with systemic lupus erythematosus
Authors: Ichinose K , Sato S , Kitajima Y , Horai Y , Fujikawa K , Umeda M , Fukui S , Nishino A , Koga T , Kawashiri S Y , Iwamoto N , Tamai M , Nakamura H , Origuchi T , Yasuhi I , Masuzaki H , Kawakami A
Published: April 2018

Systemic lupus erythematosus (SLE) involves multiple organ systems and primarily affects women during their reproductive years. Pregnancy in a woman with SLE may lead to higher rates of disease flares. Little is known regarding which medications are safe to maintain remission and/or treat flares throughout such pregnancies. Here we retrospectively analyzed the efficacy of tacrolimus (TAC) in the pregnancy outcomes of SLE patients. We studied the 54 deliveries of 40 SLE patients over an eight-year period from 2008 to 2016. We used analyses of covariance with adjustments for the propensity score and inverse probability of treatment weights to compare the patient backgrounds between the TAC users and non-TAC users. TAC was administered to the patient in 15 of the 54 (27.8%) pregnancies, and these patients had a significantly higher dose of prednisolone, hypocomplementemia, lower estimated glomerular filtration rate, past history of lupus nephritis, and complication with antiphospholipid syndrome. In the adjusted background of the TAC deliveries, the risks of decreased fetal body weight, low birth weight infant, non-reassuring fetal status (NRFS), and preterm birth were not increased compared to the non-TAC deliveries. Thrombocytopenia and hypertension during the pregnancy were extracted as independent predictive risk factors for decreased fetal body weight and NRFS, respectively. We had anticipated that the maternal and fetal outcomes in the TAC-use deliveries would be poor before the analysis; however, the TAC-use group showed no significant difference in risks contributing to outcomes compared to the non-TAC group, suggesting that adjunct TAC treatment corrected various risk factors during the lupus pregnancies.
Fiscal Impact of Smoking Cessation in Thailand: A Government Perspective Cost-Benefit Analysis
Authors: Connolly Mark P. , Kotsopoulos Nikolaos , Suthipinijtham Pichaya , Rungruanghiranya Suthat
Published: April 2018

We evaluate the broader public economic consequences of investments in smoking cessation that change lifetime productivity, which can influence future government tax revenue and social transfer costs and health care spending. The analysis applies a government perspective framework for assessing the intergenerational relationships between morbidity and mortality and lifetime tax revenue and social transfers received. Applying smoking prevalence in Thailand, a cohort model was developed for smoker and former smokers to estimate impact on lifetime direct taxes and tobacco taxes paid. Age-specific earnings for males and wage appropriate tax rates were applied to estimate net taxes for smokers and former smokers. Introducing smoking cessation leads to lifetime public economic benefits of THB13 998 to THB43 356 per person depending on the age of introducing smoking cessation. Factoring in the costs of smoking cessation therapy, an average return on investment of 1.35 was obtained indicating fiscal surplus generated for government from the combined effect of increased tax revenues and of averting smoking-attributable health care costs.
Radiological features of body packers: An experience from a regional accident and emergency department in close proximity to the Hong Kong International Airport
Authors: Tsang Ho Kai Patrick , Wong Cheuk Kei Kathy , Wong Oi Fung , Chan Wing Lun William , Ma Hing Man , Lit Chau Hung Albert
Published: April 2018

Background:

Body packing is a frequently used method for drug trafficking. Local information about the clinical and radiological features of body packing is lacking.

Objectives:

To evaluate the radiological features of body packers presenting to a hospital near to the Hong Kong International Airport and to compare the radiological features of solid form versus liquid cocaine.

Methods:

This was a retrospective cohort study. Medical notes of 269 suspected body packers, presenting to the Accident and Emergency Department of North Lantau Hospital under the detention by the law enforcement personnel from 1st January 2015 to 28th February 2017, were reviewed. The radiological features of body packing were retrospectively evaluated.

Results:

Sixty-nine cases were confirmed body packers radiographically. Majority of them (81%, 56/69) were cocaine packers. Powder form cocaine (67%, 49/69) was the most popular drug packed, followed by liquid cocaine (15%, 10/69). There was a trend of increasing incidence of liquid cocaine packers. The classical ‘double condom’, ‘tic tac’ and ‘halo’ signs were present in 94%, 72.5% and 42% of cases with radiologically confirmed body packing respectively. The ‘rosette’ sign was only identified in 1 case. Three new radiological signs, the ‘bag of eggs’, ‘lucent triangle’ and ‘black crescent’ sign, were suggested to aid identification of drug packets. The classical ‘tic tac’ sign was absent in all liquid cocaine packing cases (p<0.05). The liquid cocaine packets appeared irregular with indistinct border in majority of cases (p<0.05). The solid form packets were mostly opaque to faeces while liquid cocaine had variable density (p<0.05). Most solid form packets had homogeneous content which was in contrast to the heterogeneous content in liquid cocaine (p<0.05).

Conclusion:

Failure in detecting drug body packing may result in medicolegal consequences. Emergency physicians need to be aware of subtle radiological signs of liquid cocaine packets in the plain abdominal radiography.
Revisiting a Criminological Classic: The Cycle of Violence
Authors: Myers Wesley , Lloyd Kristin , Turanovic Jillian J. , Pratt Travis C.
Published: April 2018

There is a growing “replication crisis” in the social and behavioral sciences, where original research across a wide array of substantive areas has failed to replicate when conducted by others. This problem highlights the importance of carefully revisiting original research—particularly studies that have exerted a significant influence over the field. Accordingly, in the present study, we subject Widom’s classic work, “The Cycle of Violence,” to a rigorous empirical reproduction and extension. We subjected her original data to alternative analytic techniques and to different measurement strategies and model specifications. Our results indicated that although we were able to replicate her original results, the link between childhood physical abuse and violence in adulthood failed to survive the robustness checks we conducted. Instead, childhood neglect emerged as the most robust predictor of adult violence.
Decreasing Inappropriate Mobile Device Use in Middle and High School Classrooms
Authors: Hernan Colleen J. , Morrison Julie Q. , Collins Tai A. , Kroeger Stephen D.
Published: April 2018

Although mobile phones and tablets can be effective tools for searching and retrieving information efficiently, accessing interactive learning platforms, and capturing audio/video, the inappropriate use of mobile devices can create distractions in the classroom that are detrimental to learning. This column presents a classroom management strategy for reducing the inappropriate use of mobile devices and increasing academic engagement in middle and high school classrooms, including students with emotional and behavioral disorders.
Thyroid-Like Intrahepatic Cholangiocarcinoma: Report of a Case and Review of the Literature
Authors: Chen Shao-hua , Zheng Zhi-yong , Wang Hanlin L. , Yu Ying-hao , Zeng De-hua , Qu Li-juan , Ye Xian-zong
Published: April 2018

Intrahepatic cholangiocarcinoma is a relatively uncommon malignant neoplasm. We recently encountered an unusual case of intrahepatic cholangiocarcinoma that histologically resembled a thyroid carcinoma. A thorough review of the English literature revealed only 2 similar cases that have been previously reported. Immunohistochemical studies are imperative to confirm the diagnosis of cholangiocarcinoma and to exclude the possibility of metastatic thyroid carcinoma and other malignancies with thyroid-like features.
Recognizing and leveraging the bilingual meaning-making potential of young people aged six to eight years old in one Australian classroom
Authors: D'warte Jacqueline
Published: April 2018

Although unevenly distributed, many Australian classrooms are increasingly diverse and include young people from a wide variety of cultural and linguistic backgrounds, young people who speak many different languages and dialects of English. These diverse classrooms offer rich and exciting teaching and learning opportunities and require innovative pedagogies that bolster the abilities of educators to draw upon young peoples' transcultural and translingual competencies. This paper details curricula and pedagogies employed in a classroom with six- to eight-year old children newly arrived in Australia. In this classroom, children were positioned as ethnographers of their own language practices; language repertoires were recognized, validated and treated as resources for learning. Analysis centres on the relevant connections made between academic content, children's experiences and the promotion of children's identities as bilingual meaning-makers.
Expression and Functions of Formyl Peptide Receptor 1 in Drug-Resistant Bladder Cancer
Authors: Jiang Xue , Lei Ting , Zhang Man
Published: April 2018

Objective:

To explore the correlation of formyl peptide receptor 1 expression with drug resistance and the functions of formyl peptide receptor 1 in drug-resistant bladder cancer.

Methods:

Expression of formyl peptide receptor 1 in T24 and T24/DDP cisplatin-resistant bladder cancer cell lines was tested by quantitative real-time Polymerase Chain Reaction and Western blotting. After incubation of T24/DDP with N-formyl-Met-Leu-Phe, the phosphor proteins were tested by Western blot analysis. We characterized the functions of formyl peptide receptor 1 in T24/DDP cells by assessing proliferation, migration, and changes of cell cycles.

Results:

Formyl peptide receptor 1 was expressed in both T24 and T24/DDP, and it was overexpressed in T24/DDP compared with T24. Formyl peptide receptor 1 activation promoted the expression of the messenger RNA of resistance-related proteins, such as multidrug resistance-associated protein 1 (MRP1) and lung resistance-related protein (LRP). The expression of 4 signal pathway proteins were upregulated: signal transducer and activator of transcription 3, Janus kinase 2, extracellular regulated protein kinases, and protein kinase B, while the expression of phosphatidylinositol 3-kinase was observed to be downregulated in drug-resistant bladder cancer cells. Formyl peptide receptor 1 activation also improved the expression of phospho-signal transducer and activator of transcription 3 and phospho-extracellular regulated protein kinases 1/2 and promoted the proliferation and migration of T24/DDP cells. In addition, formyl peptide receptor 1 inhibition led to the change in the cell cycle in T24/DDP.

Conclusions:

The overexpression of formyl peptide receptor 1 may be related to drug-resistant bladder cancer and promotes the deterioration of drug-resistant bladder cancer.
In Vivo Antitumor Effects of MK615 Led by PD-L1 Downregulation
Authors: Yanaki Masashi , Kobayashi Masayuki , Aruga Atsushi , Nomura Minoru , Ozaki Makoto
Published: April 2018

Background/Aim: MK615 extracted from Prunus mume was reported to have anti-inflammatory effects. In this article, we examined the in vivo antitumor effect of MK615 (an extract from Japanese apricot) using mouse tumor xenografts and focusing on the downregulation of PD-L1 (programmed death-ligand 1), a ligand of programmed cell death-1, a surface protein of activated T cells. Materials and Methods: B16/BL6 melanoma cells were injected into C57BL/6 or BALB/c-nu/nu mice to establish lung metastasis. BALB/c-nu/nu mice (nude mice) were used as a T cell–deficient model. The mice were given MK615 or saline orally every other day for approximately 8 weeks, and their survival was observed. NF-κB (nuclear factor-κB) and PD-L1 expressions of metastatic lung tissues were also examined. Results: The survival rate was improved only in the MK615-treated C57BL/6 mice ( P < .05), not in the saline-given control mice or BALB/c-nu/nu mice. The downregulations of NF-κB and PD-L1 were observed in both MK615-treated C57BL/6 and BALB/c-nu/nu mice. These results suggest that the antitumor effects of MK615 are associated with T cell–mediated immunity activated by MK-615-induced PD-L1 downregulation in tumor cells. Conclusion: MK615 is beneficial for a prolonged host survival time in the B16/BL6 melanoma xenograft model associated with T cell–mediated antitumor immunity.
Physical Activity and Heart Failure: Taking Steps to Control a Major Public Health Burden
Authors: LaMonte Michael J.
Published: April 2018

Heart failure (HF) is a complex clinical syndrome that is increasingly prevalent among US adults and accounts for substantial burden of healthcare costs and morbidity. HF is commonly associated with prior myocardial infarction as well as prolonged exposure to hypertension, diabetes, and coronary atherosclerosis. Exercise training is becoming established in the management of HF because of its beneficial effect on both central (cardiac) and peripheral (skeletal muscle) HF mechanisms. The role of habitual physical activity in the primary prevention of HF is less clear. Recent prospective observational studies suggest there is lower risk of developing HF in adults who are more physically activity and have higher cardiorespiratory fitness compared with their less active and fit peers. This article reviews the published evidence on physical activity and HF prevention, discusses potential mechanisms for this benefit, and suggests areas where further research is needed to establish recommendations on the type, amount, and intensity of physical activity required to prevent occurrence of HF.
The Lie group Euler methods of multibody system dynamics with holonomic constraints
Authors: Ding Jieyu , Pan Zhenkuan
Published: April 2018

The Euler methods on Lie group are developed for the differential–algebraic equations of multibody system dynamics with holonomic constraints. The implicit Euler method is used to solve the differential–algebraic equations as Euler–Lagrange equations on Lie group with indices 1, 2, and 3 and the case of overdetermined differential–algebraic equations mixing with configuration space. The symplectic Euler method is used to solve the differential–algebraic equations as constrained Hamilton equations on Lie group. For the discrete mapping between Lie group and Lie algebra, the canonical coordinates of the second kind for implicit first-order Crouch–Grossman Euler methods of differential–algebraic equations are used. A single pendulum and a double pendulum in the space are used to verify the accuracy of the Lie group Euler methods.
Dynamic magnification response of a vertical plate exposed to breaking wave impact
Authors: Tanrikulu Ali Hamza
Published: April 2018

The dynamic behavior of coastal structures under wave impact closely depends on the temporal and spatial variations of the impact load. The dynamic analyses and design of a coastal structure succeeds if the design load history for the wave impact is available. Since these types of data are very difficult to find, it is more proper to use a method based on static analysis. For this purpose, the ratio of the maximum value of the dynamic response to that found by static analysis is presented as a factor of multiplication and is called “dynamic magnification factor.” The dynamic magnification factors from waves breaking directly on vertical coastal plates with built-in edges are calculated for different thicknesses and aspect ratios. The governing equation of the problem is solved by finite element method in which a mesh dependency study is carried out for each plate to find the most appropriate mesh density. From the present computational results, it is suggested that the bending moments from the static analysis of plates can be modified by a factor of 1.15 to obtain the equivalent dynamic bending moments for the plate dimensions in the range of 0.8 ≤  a/ b ≤ 3 and the wave condition considered in the study.
Incidence and mitigation of gastrointestinal events in patients with relapsing–remitting multiple sclerosis receiving delayed-release dimethyl fumarate: a German phase IV study (TOLERATE)
Authors: Gold Ralf , Schlegel Eugen , Elias-Hamp Birte , Albert Christian , Schmidt Stephan , Tackenberg Björn , Xiao James , Schaak Tom , Salmen Hans Christian
Published: April 2018

Background:

Gastrointestinal (GI) events are common adverse events (AEs) associated with delayed-release dimethyl fumarate (DMF), an approved treatment for relapsing–remitting multiple sclerosis (RRMS). The objective of the TOLERATE study was to evaluate GI tolerability and GI mitigation via symptomatic therapies in patients initiating DMF in a real-world clinical setting in Germany.

Methods:

TOLERATE was a multicentre, open-label, single-arm study performed at 25 German sites. Endpoints were frequency, severity, duration (all primary) and mitigation of GI-related events (secondary). Patients were instructed to take DMF according to the prescribing information for up to 12 weeks and to document GI events and intake of GI-symptomatic therapy on numerical rating scales, using eDiaries.

Results:

A total of 211 patients were included in the safety population (71% female; mean age 40 ± 11 years). Of these, 185 patients (87.7%) reported GI-related events, out of which nearly half received GI-symptomatic therapy (84/185; 45.4%). The most frequently reported GI events were upper abdominal pain, flatulence and nausea. GI-related events peaked during the first 3 weeks of therapy and rapidly decreased thereafter. The severity of GI events over 12 weeks according to the Modified Overall Gastrointestinal Symptom Scale were mild to moderate in the majority of patients reporting GI-related events and taking symptomatic GI medication (53.6%). Only 10% of all patients discontinued study treatment due to AEs in general, while 6.6% discontinued due to GI-related events. The severity of GI-related events decreased over time in patients who received symptomatic treatment with one or more medications (e.g. acid secretion blockers, antidiarrhoeals or antiemetics).

Conclusion:

Gastrointestinal events associated with delayed-release DMF were mainly mild to moderate in severity. Prevalence of GI events peaked during the first 3 weeks of therapy and rapidly faded thereafter. Although 44.9% of patients experiencing GI events used common GI symptomatic therapies, only 6.6% of patients discontinued DMF because of GI events, suggesting that GI events could be managed well with common symptomatic therapy.
Crowdsourcing sugammadex adverse event rates using an in-app survey: feasibility assessment from an observational study
Authors: Jabaley Craig S. , Wolf Francis A. , Lynde Grant C. , O’Reilly-Shah Vikas N.
Published: April 2018

Background:

Mobile applications (apps) have become a ubiquitous source of clinical decision support. We sought to ascertain the feasibility of using an app platform to obtain a crowdsourced measure of adverse drug reaction reporting rates associated with sugammadex administration and compare it with traditionally-derived estimates.

Methods:

Using the widely-distributed anesthesia calculator app, ‘Anesthesiologist’, we surveyed anesthesia providers regarding their experience with adverse drug reactions associated with sugammadex administration.

Results:

Data were analyzed from 2770 participants in 119 countries responding between March 2016 and May 2017, who were estimated to have administered between 1.6–2.9 million doses (588–1040 administrations per participant). A low and high-end reporting rate of adverse events was estimated based on respondents’ reported frequency and duration of sugammadex use. The estimated reporting rate of anaphylaxis due to sugammadex was 0.0055–0.098%, similar in range to previously published estimates.

Conclusions:

Use of an in-app survey facilitated a global assessment of anesthesia providers and could have useful applications in monitoring adverse events and estimating their rates. Further work is needed to validate this approach for other medications and clinical domains.