bluuebunny/crossref_metadata_2025 huggingface dataset:
Representations and symbols of Kuafu’s myth in Analytical Psychology and Chinese culture: History vs. contemporary, consciousness vs. unconscious, collective vs. individual
Authors: Guo Ruitong , Shen Heyong , Zhang Yancui , Wu Bo
Published: October 2018

The paper collaboratively probes the diachronic, cultural and psychological resources inherited from the classical heroic myth of China, Kuafu Chases after the Sun. With the conceptual system of Analytical Psychology and Chinese culture, starting with ancient mythological texts, the authors carry out studies on three dimensions of the historical and contemporary images of Kuafu, the conscious and unconscious contents, and the collective and the individual psyche. First, the paper explores the collective representations of consciousness based on ancient and modern works of art, reviews and cultural phenomena. Second, on collective and cultural unconscious symbols, Kuafu is a heroic archetypal image, and there are four dynamic images from change to transformation. Third, the exploratory study of a case with Sandplay Therapy finds the projection and emergence of the Kuafu myth for individual consciousness is of great clinical value for helping the client experience and transform their psychological conflicts.
Factors affecting the use of home-based services and out-of-home respite care services: A survey of family caregivers for older persons with dementia in Northern Norway
Authors: Moholt Jill-Marit , Friborg Oddgeir , Blix Bodil H , Henriksen Nils
Published: October 2018

Background

Family caregivers contribute substantially to the care for older home-dwelling people with dementia, although community healthcare services tend to be underutilized. In this study, we aimed to explore the use and predictors of use of home-based and out-of-home respite care services available to older home-dwelling persons with dementia, as reported by the family caregivers.

Method

A cross-sectional survey was administered to family caregivers ( n = 430) in Northern Norway during April to November 2016. The use of healthcare services was categorized into two types according to principal component analysis: home-based services and out-of-home respite care services ( R2 = 44.1%). Predictors of service use were examined with bivariate correlation, multiple linear regression, and Poisson regression analyses.

Results

The use of home-based services among persons with dementia was significantly higher for persons with advanced age, persons living in urban areas, persons living in an assisted living facility, persons living alone, and persons able to manage being alone for a short period of time. Among the family caregiver variables, higher age, status as a daughter, son, or other family member, higher educational level, and full-time employment also predicted greater use of home-based services. Same ethnicity was associated with use of fewer home-based services. The use of out-of-home respite care services was significantly higher among male persons with dementia and among those living in urban areas. In addition, fewer out-of-home respite care services were used by male caregivers or daughters of the care recipient, while the use was higher when the caregivers experienced more caregiving demands or had provided care for longer periods of time.

Conclusions

These results indicate areas that policymakers and healthcare providers should consider to identify families who underutilize healthcare services and to achieve a more equal and efficient allocation of services in accordance with families' needs.
Mitigating the effects of boom occlusion on automated aerial refueling through shadow volumes
Authors: Paulson Zachary , Nykl Scott , Pecarina John , Woolley Brian
Published: October 2018

In-flight refueling of unmanned aerial vehicles (UAVs) is critical to the United States Air Force (USAF). However, the large communication latency between a ground-based operator and his/her remote UAV makes docking with a refueling tanker unsafe. This latency may be mitigated by leveraging a tanker-centric stereo vision system. The vision system observes and computes an approaching receiver’s relative position and orientation offering a low-latency, high frequency docking solution. Unfortunately, the boom – an articulated refueling arm responsible for physically pumping fuel into the receiver – occludes large portions of the receiver especially as the receiver approaches and docks with the tanker. The vision system must be able to compensate for the boom’s occlusion of the receiver aircraft. We present a novel algorithm for mitigating the negative effects of boom occlusion in stereo-based aerial environments. Our algorithm dynamically compensates for occluded receiver geometry by transforming the occluded areas into shadow volumes. These shadow volumes are then used to cull hidden geometry that is traditionally consumed, in error, by the vision processing and point registration pipeline. Our algorithm improves computer-vision pose estimates by 44% over a naïve approach without shadow volume culling.
Effect of radial homogeneity on low-strain integrity detection of a pipe pile in a viscoelastic soil layer
Authors: Cui Chunyi , Meng Kun , Liang Zhimeng , Xu Chengshun , Yang Gang , Zhang Shiping
Published: October 2018

This article proposes a new analytical model for the low-strain integrity detection of a pipe pile embedded in a viscoelastic soil layer with radial inhomogeneity by extending Novak’s plane-strain model and transfer method of complex stiffness to consider viscous-type damping. The analytical solutions for the complex impedance, the velocity admittance and the reflected wave signal of velocity at the pile head are also derived. Extensive parametric analyses are further conducted to investigate the effects of the disturbance degree and the disturbance range of surrounding soil due to construction operation on the velocity admittance and the reflected wave signal of velocity at the pile head. It is demonstrated that the proposed model and the obtained solutions can provide extensive scope of application, compared with the relevant existing solutions.
Pulmonary Toxicity Induced by N-Hexane in Wistar Male Rats After Oral Subchronic Exposure
Authors: Bouakkaz Imane , Khelili Kamel , Rebai Tarek , Lock Andreas
Published: October 2018

Studies of pulmonary toxicity induced by oral exposure to n-hexane are very few, in contrast to those studying the exposure by inhalation. This research tackles the oral toxic effect of n-hexane solvent on the lungs after subchronic exposure of Wistar male rats at 300, 600, and 1200 mg/kg, respectively, each day for 8 weeks. The pneumotoxicity observed in this study was marked by an immune toxicity in the form of a significant increase in the levels of white blood cells, lymphocytes, granulocytes, and eosinophils, as well as a significant increase in relative and absolute lung weight in both groups treated at the doses of 600 and 1200 mg/kg. n-Hexane also resulted in a significant increase in serum total proteins and acid phosphatase in the 3 doses tested daily for 8 weeks. In addition, we found a significant increase in total protein and a decrease in glutathione at 600 and 1200 mg/kg, in the pulmonary homogenate. Furthermore, the rate of lipid peroxidation increased in the 3 doses tested. Histological findings revealed a pneumonia characterized by bronchopneumonia, fibronecrotic lesions, congestion, hemorrhage, type II pneumocyte hyperplasia, alveolar lesions, bronchial epithelium degradation, and inflammation.
Theoretical and experimental investigation on maximum pressure loads of labyrinth seal’s teeth
Authors: Jiang Jie , Yang Yiyong , Li Yongjian , Huang Weifeng
Published: October 2018

The pressure loads acting on the teeth of a labyrinth seal are usually not uniform. Sometimes, one tooth would take almost half of the total pressure difference, which is detrimental to the teeth’s working life and sealing effect. Therefore, the estimation of maximum pressure load on the teeth is helpful to design a sound structure of labyrinth seal. This article analyzes the influence of teeth number, boundary condition, clearances, and structure parameters on maximum pressure loads of labyrinth seal teeth in low pressure ratio conditions ( PR≤ 0.5, PR = Pout/ Pin). Both the computational fluid dynamics model and test results show that teeth number and pressure load are main factors influencing the maximum pressure load on teeth. Finally, a fitting equation is given to estimate the maximum pressure load on labyrinth seal teeth and its results are in good agreement with the computational fluid dynamics model.
Plasma Fibronectin in Hemoblastosis
Authors: Curci Giuseppe , Frassoldati Antonio , Zioni Franco , Zaniol Paolo , Piccinini Lino
Published: October 2018

Fibronection (FN) is a glycoprotein whose plasma concentrations are reduced in many pathological conditions. In patients with hemoblastosis plasma FN was correlated with some clinical and biological parameters (stage of the disease, hepatosplenomegaly, infections and DIC), in order to assess its value as a tumor marker. The results suggest a poor relationship between FN levels and the course of the disease. However, the behaviour of the protein in relation with treatment was dynamic.
Enzyme and Immunohistochemistry of Follicular Hyperplasia in AIDS-related Lymphadenopathy
Authors: Carbone Antonino , Poletti Alessandro , Manconi Riccardo , Cozzi Marzia , Sulfaro Sandro , Volpe Rachele
Published: October 2018

We used a panel of monoclonal and polyclonal antibodies to analyze frozen and paraffin-embedded lymph node biopsy specimens from 25 intravenous drug abusers (IVDA) with acquired immunodeficiency syndrome (AIDS)-related lymphadenopathy histologically characterized by follicular hyperplasia. Our aim was to obtain diagnostic clues to this commonly occurring pattern. Double-labelling immunohistological studies were also performed on selected frozen sections and 13 plastic-embedded specimens were tested by a number of enzyme reactions. Consistent features in IVDA included abnormally high numbers of intrafollicular T-cells, positive for acid phosphatase and beta-glucuronidase, most of which had Leu-2a-positive phenotype; a marked reduction or loss of mantle zone B-cells (positive for surface IgD-IgM and alkaline phosphatase); and disarray of the network of follicular dendritic reticulum cells (DRCs), as revealed with DRC-1 and anti-S-100 protein antibodies or with reaction for 5'-nucleotidase. When present, distinctive intrafollicular clusters of Leu-2a-positive T-cells and mantle zone B-cells were nearly always associated with areas lacking DRCs in some patients. The intrafollicular hypervascularity invariably found in IVDA proved to be of a true capillary nature, as demonstrated by alkaline phosphatase, 5'-nucleotidase, and ATPase reactions. In control tissues, all showing absence of Leu-2a-positive intrafollicular T-cells, most of the above individual changes could be detected, although they were occasional, mild, and never associated within the same follicle. By contrast, combined immunohistological and enzyme histochemical findings in IVDA indicated that in most follicles such changes were marked and very often associated within the same follicle in each case. It can be concluded that on the basis of a combined analysis of lymphoid and non-lymphoid follicular constituents, the histological changes of AIDS-related lymphadenopathy with follicular hyperplastic pattern are further defined and corroborated.
Creatine Kinase Isoenzyme BB: A Lung Cancer Associated Marker
Authors: Neri B. , Bartalucci S. , Gemelli M.T. , Tommasi M. , Bacalli S.
Published: October 2018

We investigated the diagnostic role of creatine kinase isoenzyme BB (CK-BB) in lung cancer. CK-BB was assayed using a radioimmunological system by saturation with Mallinchrodt double antibody 125I labelled (RIA Quant-CPK-BB).

Sensitivity was 97% and specificity 90% in 44 cancers (T2-T3), in 36 non-cancers (chronic bronchitis) and in 48 healthy controls.

Mean serum CK-BB values for patients with chronic bronchitis (2.64 ± 1.1 ng/ml) were virtually the same as in normal subjects. Patients with lung cancer had markedly higher serum CK-BB values (9.17 ± 2.6 ng/ml) than either the control group (healthy subjects) or the chronic bronchitis patients (p < 0.01). These results lead us to suggest that CK-BB serum determination might prove useful in screening pulmonary disorders. However, further studies are essential to establish: 1) the relationship between serum levels of the isoenzyme and the histology and stage of the neoplastic disease; 2) the relation between CK-BB and the aggressive potential of the neoplastic clone.
The Monoclonal Antibody-defined CAR-3 Antigen is a Serological Marker Associated with Pancreatic Carcinoma
Authors: Prat M. , Medico E. , Piantino P. , Bretti S. , Rossini F.P. , Comoglio P.M.
Published: October 2018

The monoclonal antibody-defined CARS antigen is a new carcinoma associated marker which is expressed on a mucin-like molecule. Serum concentrations of CARS were assayed in 181 patients with carcinomas of different organs, 20 patients with non-carcinomatous malignancies, 123 patients with inflammatory diseases and 150 healthy controls. Serum levels of CARS were significantly increased in 51% of the patients with pancreatic carcinomas, in 60% of patients with biliary tract carcinomas and in about 15% of the patients with carcinomas of the digestive apparatus. Sera from patients with breast carcinomas were negative, as well as sera from patients with melanomas or sarcomas. CAR-3 values in samples from patients with chronic pancreatitis were constantly negative, as were samples from healthy donors. Significant concentrations of CAR-3 were detected in 20% of the sera from patients with acute pancreatitis and in 15% of the sera from patients with cirrhosis. Because of its high specificity for pancreatic carcinomas compared to chronic pancreatitis, CARS seems a promising marker for distinguishing between neoplastic and chronic inflammatory diseases of the pancreas, whose differential diagnosis is difficult.
S-100 Protein Detection in “Follicular Macrophages” of Mouse Lymphoid Organs by ABC Immunoperoxidase Method
Authors: Carbone A. , Poletti A. , Volpe R. , Manconi R.
Published: October 2018

The distribution of S-100 protein was investigated in normal or reactive lymphoid organs from adult mice, rats and humans by the avidin-biotin complex ABC) immunoperoxidase method. In mouse lymph nodes and spleen the protein appeared to be confined to the “tingible-body macrophages” and occasionally in sinus histiocytes in the lymph nodes. No immunoreaction product was detected in the other cell types present inside or outside the follicles. In the thymus the immunostained cells were located in the medullary area and corresponded morphologically to mononuclear PAS-positive cells with histiocytic appearance. By contrast, in rat and human organs S-100 protein was detected in interdigitating reticulum cells and dendritic reticulum cells. The present findings indicate that S-100 protein is located differently in mouse lymphoid organs and in other mammalian dspecies.
Preoperative and Longitudinal Serum Levels of CA 125 and CA 15.3 in Patients with Breast Cancer
Authors: Omar Y.T. , Behbehani A.E. , Al-Naqeeb N. , Motawy MM. , Foudeh M.O. , Awwad A.H. , Nasralla M. Y. , Szymendera J.J.
Published: October 2018

Serum levels of ovarian carcinoma antigen (CA 125) and breast carcinoma antigen (CA 15.3) were determined in 237 patients with breast carcinoma, 121 before any therapy and 116 after initial treatment, during uneventful follow-up or at the time of relapse. The aim was to assess how often the CA 125 test failed, i.e., was false-negative inpatients in whom the CA 15.3 test was true-positive and, more important, whether it gave diagnostic information in patients in whom the CA 15.3 test failed. Before surgery or other initial therapy, serum CA 125 and CA 15.3 gave similar information in 85.1 percent of the patients: true-positive in 4.1 percent and false negative in 81.0 percent; CA 125 gave less information in 13.2 percent; and more information in only 1.7 percent. During follow-up, serum CA 125 and CA 15.3 gave similar information in 73.3 percent of the patients: true-positive (i.e., rising persistently from a nadir or elevated above 65 U/ml) in 23.3 percent, true-negative in 36.2 percent, and false-negative in 13.8 percent; CA 125 gave less information in 25.0 percent: false negative in 22.4 percent and false-positive in 2.6 percent; and more information in only 1.7 percent. Therefore, the CA 125 test appears useless for staging and is redundant when the CA 15.3 test is employed, for management of patients with breast cancer.
Correlation of an Estrogen Receptor-related Phosphoprotein with Histopathological Features in Breast Cancer
Authors: Tomasino R.M. , Daniele E. , Nuara R. , Morello V. , Salvato M. , Florena A.M.
Published: October 2018

A series of 65 cases of different histological types of breast carcinoma was investigated for the immunohistochemical location of the estrogen receptor-related, 29 kD phosphoprotein using the ER-D5 monoclonal antibody.

The ER-D5 response is heterogeneous in relation to some therapeutic limitations and is correlated with histopathological features of the tumors and survival. The main parameters for evaluation of breast cancers are reviewed, both those that are statistically correlated and those that are not apparently always correlated but are known to have considerable biological meaning, such as the ER-status of tumors.
Diamine oxidase (DAO) activity increase in sera of tumor patients: An unreliable marker
Authors: Romano M. , Pasquinelli R.
Published: October 2018

Circulating diamine oxidase (DAO) (EC 1.4.3.6) activity was determined in the sera of patients with different malignant tumors. The increase in this activity only partially reflected tumor activity so it is presumably unreliable as a diagnostic marker. The increase in activity may be linked to the tumor location: the lung and intestine are rich in DAO so the rise cannot be considered a characteristic consequence of the tumor's activity. Besides, increases in DAO activity have also been observed in non-neoplastic diseases.
Serum levels of interleukin-2 in cancer patients: Preliminary considerations
Authors: Lissoni P. , Viviani S. , Santoro A. , Barni S. , Tancini G.
Published: October 2018

In order to investigate the production of interleukin-2 (IL-2) in human neoplasms, we determined IL-2 and soluble IL-2 receptors (sIL-2R) in serum from 18 patients with lymphoma and 28 patients with solid tumors, with (15 cases) or without (13 cases) metastases. As controls, 58 healthy subjects were evaluated. Low levels of IL-2 were not observed in patients with lymphoma or limited solid tumor but abnormally low concentrations of IL-2 were seen in 4/15 metastatic solid tumors, associated with abnormally high values of sIL-2R. This preliminary study confirms in vivo the reduced IL-2 production in metastatic solid neoplasms, previously documented in vitro
Relationship of CA 125 and CA 19.9 with lung carcinoma histological subtype: Preliminary study
Authors: Molina R. , Santabarbara P. , Filella X. , Mengual P. , Ballesta A.M. , Balague A.
Published: October 2018

The aim of this work was to study the possible utility of simultaneous determination of CA 125 and CA 19.9 in patients with lung cancer. Serum levels of both markers were studied in 87 patients without metastases (Mo), 72 patients with distant metastases (MT) and 15 cases without clinical evidence of disease after primary treatment (NED). Sitxty-five tumors were epidermoid, 34 were adenocarcinomas, 24 were cell undifferentiated carcinomas and 51 were small-cell carcinomas. Sera from 75 healthy subjects and 20 patients with benign lung disease were used as controls. The cutoff values used were 35 and 37 U/ml for CA 125 and CA 19.9, respectively. CA 125 and CA 19.9 serum levels were within normal limits in all control patients. In NED patients these markers were not elevated, except in one with chronic liver disease who showed elevated CA 19.9 (76 U/ml). Twenty-five percent of Mo lung cancer patients and 40.3% of MT cases had CA 19.9 over 37 U/ml. Abnormally high levels of CA 125 were found in 18.7% and 22.9% of Mo and MT patients, respectively. Sixty percent of patients with large cell undifferentiated carcinoma had elevated CA 125 (mean 176 U/ml) compared to 15.4% of patients with all other histological types of tumors combined (54.3 U/ml, p< 0.01). CA 19.9 serum levels were also more often elevated in patients with large cell undifferentiated carcinomas (50%, 7/14 cases) than in other histological types (30%, 36/120 patients), but the difference was not statistically significant. There were no differences in CA 125 and CA 19.9 serum levels in relation to location of metastatic disease including liver. Although the sensitivity of CA 125 and CA 19.9 in lung cancer is low, they may be useful as serum markers of recurrent disease in the follow-up of patients with large cell carcinoma.
Different mechanisms regulate the IFN-inducible expression of 40 kDa human 2'-5' oligo (A) synthetase in HeLa and Molt 4 cells
Authors: Gribaudo G. , Fizzotti M. , Cocciolo M.G. , Vallo G. Ca , Landolfo S.
Published: October 2018

Expression of 40 kDa 2'-5' oligo (A) synthetase can serve as a marker of interferon (IFN) activity on the biological target. The mechanisms of induction of human 40 kDa 2'-5' oligo (A) synthetase by IFNs were investigated in HeLa and Molt 4 cells. Using a combined treatment with cycloheximide and actinomycin D we observed that in HeLa cells IFN-α did not need ongoing protein synthesis to induce the enzyme, whereas the addition of cycloheximide prevented the induction by IFN-γ. IFN-α induced the 40 kD enzyme in the T-cell line Molt 4 to a level comparable to that in HeLa cells, but only in the presence of active protein synthesis. These results suggest that an early response gene coding for a positive IFN-inducible protein may be needed in T cells, but not in HeLa cells to regulate the transcription of this 2'-5' oligo (A) synthetase gene.
Pain-related white matter tract abnormalities in mild traumatic brain injury patients with persistent headache
Authors: Leung Albert , Yang Eric , Lim Michael , Metzger-Smith Valerie , Theilmann Rebecca , Song David , Lin Lisa , Tsai Alice , Lee Roland
Published: October 2018

Background

The occurrence of debilitating chronic persistent (24/7) headache after mild traumatic brain injury represents a central neuropathic pain state. Previous studies suggest that this chronic headache state can be attributed to altered supraspinal modulatory functional connectivity in both resting and evoked pain states. Abnormalities in the myelin sheaths along the supraspinal superior longitudinal fasciculus and anterior thalamic radiation are frequently associated with alteration in pain modulation related to functional connectivity deficit with the prefrontal cortex. This study assessed the correlated axonal injury-related white matter tract abnormality underlying these previously observed prefrontal functional connectivity deficits by comparing the fractional anisotropy, axial diffusivity, and radial diffusivity of brain white matter in patients with mild traumatic brain injury-related headache to healthy controls.

Result

Diffusion tensor imaging data from patients ( N = 12, average age ±  SD = 35.0 ± 8.0 years old, 10 male) with mild traumatic brain injury-headache were compared with images acquired from healthy controls. The mild traumatic brain injury cohort demonstrated two areas of significant ( P < 0.01, F value >16, cluster size >50 voxels) white matter tract abnormalities closely related to pain affective and modulatory functions in (1) the left superior longitudinal fasciculus which connects the prefrontal cortices with the parietal cortices and (2) the right anterior thalamic radiation connecting the prefrontal cortices with the anterior cingulate cortex. In addition, a significant ( P < 0.01) decrease in axial diffusivity and increase in radial diffusivity at the superior longitudinal fasciculus cluster were noted in the mild traumatic brain injury cohort.

Conclusion

The identified white matter tract abnormalities may represent a state of Wallerian degeneration which correlates with the functional connectivity deficit in pain modulation and can contribute to the development of the chronic persistent headache in the patients with mild traumatic brain injury.
Is Hate Worst When It Is Fresh? The Development of Hate Over Time
Authors: Ben-Ze’ev Aaron
Published: October 2018

When it comes to eggs, two aspects are central—taste and nutritional value. And it is when eggs are fresh that these are at their peak. Hate “tastes” worst, that is, its negative intensity is highest, when it is fresh. Yet, when hate is not merely a temporary eruption but a constant feature, it distorts the agent’s behavior and attitudes. As such, its moral value worsens with maturity.
Jealousy as a Specific Emotion: The Dynamic Functional Model
Authors: Chung Mingi , Harris Christine R.
Published: October 2018

We review the jealousy literature and present our Dynamic Functional Model of Jealousy (DFMJ), which argues that jealousy evolved and has its own unique motivational state aimed at preventing others from usurping important relationships. It has a core form that exists in infants and nonhuman animals and an elaborated form in humans that emerges as cognitive sophistication develops. The DFMJ proposes that jealousy is an unfolding process with early and late phases that can be differentially impacted by relationship and personality factors. It also notes the importance of looking at multiple concomitants of jealousy, including action tendencies. We discuss how jealousy fits with current emotion theories and suggest that theories of specific emotions need to be broadened.
Author Reply: Why Hate Is Unique and Requires Others for Its Maintenance
Authors: Fischer Agneta H.
Published: October 2018

In this reply, I discuss some important issues raised in two commentaries. One relates to the distinction between hate and revenge, which also touches upon the more general problem of the usefulness of distinguishing between various related emotions. I argue that emotion researchers need to define specific emotions carefully in order to be able to examine such emotions without necessarily using emotion words. A second comment focusses on the factors influencing the development of hate over time. The question is whether there is an intrapersonal mechanism leading to an increase or decrease of hate over time. I think it is the social environment that is essential in the maintenance of hate.
Author Reply: What Jealousy Can Tell Us About Theories of Emotion
Authors: Harris Christine R. , Chung Mingi
Published: October 2018

We clarify aspects of our Dynamic Functional Model of Jealousy in response to D’Arms (2018) and Stets (2018). Our model proposes that jealousy is an evolved motivational state that arises over threat by a rival to one’s relationship or some aspect of one’s relationship (such as attention, affection, or love). The formation or loss of relationships rarely occurs instantaneously. Therefore, we argue that jealousy, whose goal is to remove or reduce the rival threat, can occur over a longer time course than is often assumed in theories of specific emotions. We further suggest that other emotions such as grief and fear also can occur over extended periods. This raises challenges for emotion theories that assume that emotions must be short-lived.
Health needs of Gypsy Travellers
Authors: Van Cleemput Patrice
Published: October 2018

Gypsy Travellers have the poorest health of any ethnic group in the population; they also have an inverse relationship between their health needs and access to healthcare services. This article aims to explain the reasons for such stark health inequality, to identify the specific health needs of Gypsy Travellers, and to describe the role of the GP in meeting those needs.
Migrant access to NHS healthcare
Authors: Fox Hannah , Hiam Lu
Published: October 2018

The three core principles of the NHS: that it meets the needs of everyone, that it be free at the point of delivery, that it be based on clinical need not ability to pay, are under threat. Recent policy changes compromise these principles by denying treatment to those in need who cannot pay. This article will give an overview of the policy changes and the impact these have on individuals in vulnerable situations trying to access care, on healthcare staff and our society. Case studies from the Doctors of the World clinic are used to illustrate the effect these changes are having. All names have been changed to protect anonymity.
Principles of palliative care
Authors: Getty Joshua
Published: October 2018

Palliative care traditionally focused on symptom-control in dying patients, but has recently evolved to include care of life-threatening or limiting conditions by optimising the benefits of treatment and considering other ways to improve the quality of life for patients. This is achieved through holistic consideration of physical, psychosocial and spiritual factors affecting the individual patient. The aim of this article is to explore these factors and initial management options.
Breaking bad news
Authors: Liddicoat Patrick
Published: October 2018

Bad news constitutes any piece of information with the potential to have a negative impact on a person’s life. During their career, all doctors will break bad news on a regular basis, and the manner in which this news is broken can deeply influence how much patients understand and then react. This article will explore the importance of breaking bad news, and outline a selection of techniques to help achieve more effective and empathetic communication.
Infections in pregnancy
Authors: O’Neill Danielle , Thirumalaikumar Lakshmi
Published: October 2018

Infections can impact the outcome of pregnancy, causing pre-term labour, growth restriction and congenital malformations. Vertical transmission can cause significant morbidity and mortality to fetus and new born infant. Pregnant women with any infection are often seen first in primary care, and it is vital to recognise the implications of infections in pregnancy, as timely referral and treatment can have a positive influence on outcomes. This review focuses on some of the major infections affecting pregnancy, outlining the feto-maternal complications and management plans with key points relevant to primary care. The infections covered are cytomegalovirus, hepatitis B and C, herpes, parvovirus, rubella, syphilis, varicella, and zika virus. Human immunodeficiency virus, malaria and toxoplasmosis are not covered in this review. This article, consistent with the position of the Health Protection Agency, considers a clinically significant contact as being in the same room with an affected person for more than 15 minutes or face-to-face contact.
The future of the Economic and Monetary Union to 2025 and beyond: the need for convergence
Authors: Simeonov Kaloyan Dimitrov
Published: October 2018

As set forth in the Maastricht Treaty, the objective of establishing the Economic and Monetary Union (EMU) was based mainly on the need to achieve nominal convergence. However, the global economic and financial crisis has since proved that the EMU architecture is not solid enough. Therefore, EU institutions and member states have developed and started to implement plans for the completion of the EMU. The main focus of these plans up to 2025 is on institutional and regulatory reform. However, more attention should be paid to other types of convergence: real convergence, social convergence, financial convergence, cyclical convergence and structural convergence. This would lead to sustainable and strong all-round convergence in the EMU. This article outlines recommendations for the completion and sustainable maintenance of the EMU, concentrating on social, financial and cyclical convergence.
Corporate Investment and Hotel Firm Value: Does Corporate Governance Matter in Financially Constrained Firms?
Authors: Dogru Tarik
Published: October 2018

Corporate investments are expected to create value for firms. Although some studies report evidence supporting such expectations, many studies document contradictory findings. However, it is not clear why corporate investments create value in some firms but reduce value in others. The purpose of this study is to examine the extent to which the quality of corporate governance and the degrees of financial constraints affect the relationship between corporate investments and hotel firm value in a unified model where both weak corporate governance and financial constraint problems are concurrently observed. Shareholders of poorly governed firms place a lower value on corporate investments compared with those of well-governed firms, whereas shareholders of financially constrained firms perceive corporate investments to be of greater value compared with those of unconstrained firms. The results further showed that CEOs of financially constrained firms make value-increasing investments despite poor corporate governance mechanisms. Theoretical and practical implications are discussed within the realm of corporate finance theories.
Licorice Root Associated With Intracranial Hemorrhagic Stroke and Cerebral Microbleeds
Authors: Shin Hannah , Chung Matthew , Rose David Z.
Published: October 2018

Chinese Licorice root “gan zao” ( Glycyrrhiza uralensis) is an ancient, medicinal herb utilized in Traditional Chinese Medicine for its presumably antiulcer, anti-inflammatory, antiviral, antibacterial, and expectorant properties. One of the major biologically active components is glycyrrhizin, which when hydrolyzed to glycyrrhetinic acid in the human body, possesses significant hypertensive effects due to interaction with the enzyme 11-β-hydroxysteroid dehydrogenase-2. 1 Glycyrrhizin and glycyrrhetinic acid also show antithrombotic properties, as orally active, direct inhibitors of blood coagulation factor Xa as well as of thrombin. 2 To our knowledge, this is the first reported case of intracranial hemorrhagic stroke associated with Chinese Licorice Root, and first reported case of cerebral microbleeds (CMB) associated with it as well.
Distinctive FDG-PET/CT Findings in Acute Neurological Hospital Care
Authors: Heckmann Josef G. , Niedermeier Wolfgang , Büchner Markus , Scher Bernhard
Published: October 2018

A compilation of 6 distinctive 18F-fluorodeoxyglucose positron emission tomography (PET) combined with computed tomography (CT) findings in the acute setting of neurohospital care is presented. In case 1, PET/CT allowed the final diagnosis of circumscribed ischemic infarction by demonstrating a clear pattern of luxury perfusion. In case 2, diagnosis of thalamic abscess was made, whereby PET/CT demonstrated an empty zone. Hypermetabolic enlarged hilar lymph nodes and hypermetabolic spinal lumbar roots in PET/CT led to the diagnosis of neurosarcoidosis in case 3. In case 4, a hypermetabolic brain focus in PET/CT identified the seizure focus in epilepsia partialis continua. A cerebral hemispheric hypometabolism in PET/CT in case 5 supported the diagnosis of Creutzfeldt-Jakob disease, which initially mimicked acute stroke. In case 6, PET/CT detected infective endocarditis as a source of multiple cerebral ischemic lesions. In conclusion, PET/CT can contribute importantly to find the correct diagnosis in acute neurohospital patients.
Beliefs About Religious and Scientific Entities Among Parents and Children in Iran
Authors: Davoodi Telli , Jamshidi-Sianaki Maryam , Abedi Faezeh , Payir Ayse , Cui Yixin Kelly , Harris Paul L. , Corriveau Kathleen H.
Published: October 2018

Previous research has shown that children and adults express more confidence in the existence of unobservable scientific (e.g., germs), as compared to religious, phenomena (e.g., the soul). We asked if the same pattern would emerge among parents ( N = 77) and children ( N = 85) in Iran, a country with widespread commitment to religious values and beliefs. Parents expressed confidence in the existence of various scientific and religious phenomena but were more confident that scientific phenomena exist. Moreover, even though Iranian parents expressed a high valuation of both science and religion, their valuation of science was higher than that of religion. Like their parents, older children also expressed greater confidence in the existence of scientific, as compared to religious, phenomena. We conclude that with age, the kind of discourse children are exposed to elicits more confidence in the existence of scientific phenomena even in a religious society.
Inflammatory Comments Elicit Less Outrage When Made in Anonymous Online Contexts
Authors: Puryear Curtis , Vandello Joseph A.
Published: October 2018

Digital communities often face difficulties in limiting inflammatory social exchanges. The present studies test one potential obstacle to combating malicious comments online: that characteristics of specific online environments dull emotional reactions to inflammatory speech. Across four studies, results suggest that online contexts, particularly those lacking social information such as names and profile pictures, attenuate negative reactions to malicious behavior relative to face-to-face contexts. Shifting expectations and perceptions of harm may partly account for varying outrage across face-to-face and digital environments.
Wide Dissection and Intercostal Vessel Division Allows for Repair of Hypoplastic Aortic Arch Through Thoracotomy
Authors: Sandoval Néstor F. , Acevedo Catalina Vargas , Umaña Juan Bernardo , Pineda Ivonne , Guerrero Albert , Obando Carlos , Umaña Juan P. , Camacho Jaime
Published: October 2018

Background:

The approach to coarctation of the aorta with hypoplastic aortic arch is controversial. We evaluated the outcomes in patients with coarctation of the aorta with or without hypoplastic aortic arch operated through a posterior left lateral thoracotomy.

Methods:

A retrospective cohort of patients with aortic coarctation, who underwent repair between January 2009 and October 2017, was analyzed. Preoperative, postoperative, and echocardiographic characteristics were reviewed. Statistical analysis examined survival, freedom from reintervention, and freedom from recoarctation.

Results:

In nine years, 389 patients who underwent surgical treatment for coarctation of the aorta were identified; after exclusion criteria and complete echocardiographic reports, 143 patients were analyzed, of which 29 patients had hypoplastic aortic arch. The modification in the extended end-to-end anastomosis technique was a wide dissection and mobilization of the descending aorta that was achieved due to the ligation and division of 3 to 5 intercostal vessels. In both groups, patients were close to one month of age and had a median weight of 3.6 and 3.4 kg for hypoplastic and nonhypoplastic arch, respectively. In postoperative events, there was no statistically significant difference between the groups ( P = .57 for renal failure, P = .057 for transient, nonpermanent neurologic events, P = .496 for sepsis), as for intensive care unit ( P = .502) and total in-hospital stay ( P = .929). There was one case of postoperative mortality in each group and both were associated with noncardiac comorbidities. Regarding survival (log-rank = 0.060), freedom from reintervention (log-rank = 0.073), and freedom from recoarctation (log-rank = 0.568), there was no statistically significant difference between the groups.

Conclusion:

We believe that it is the modified technique that allowed greater mobilization of the aorta and successful repair of hypoplastic arch through thoracotomy, without an increase in paraplegia or other adverse outcomes.
Incremental History of the Congenital Heart Surgeons’ Society (2014-2018)
Authors: Mavroudis Constantine , Kirklin James K. , DeCampli William M.
Published: October 2018

The history of the first 41 years of the Congenital Heart Surgeons Society (CHSS) was recorded in 2015 which chronicled the metamorphosis of a small informal meeting into a mature organization with bylaws, officers, committees, funded research, the Kirklin-Ashburn Fellowship, and a vision to become the premier organization of congenital heart surgery in North America. Chief among these transformations was the implementation and development of the CHSS Data Center. Member participation, fellowship education, and significant outcomes research have been the hallmark of the CHSS. This incremental historical review highlights continued CHSS sentinel advances. Fifty-three CHSS Data Center manuscripts have been published. Citation scores (number of literature citations that each manuscript has accrued) have been collated and analyzed by cohort study. The average citation score for all manuscripts was 75.4 ± 76.3 (range: 1-333). The Kirklin/Ashburn Fellowship continues to thrive with academic achievements and generous contributions to the endowment. The World Journal of Pediatric and Congenital Heart Surgery has been adopted as the official organ of the CHSS. A Past President’s Dinner has been inaugurated serving as a senior advisory committee to the Executive Council. Toronto Work Weekends continue. Congenital Heart Surgeons Society growth has accrued to 159 active members and 82 institutional members. Future considerations include the size, content, and duration of the annual meeting; the potential for increased membership; and political penetrance into national cardiothoracic governing organizations regarding committee appointments, executive council representation, and education initiatives. Congenital Heart Surgeons Society has achieved numerous advances during this incremental period.
Lay People Representations on the Common Good and Its Financial Provision
Authors: Castiglioni Cinzia , Lozza Edoardo , Bosio Albino Claudio
Published: October 2018

The financial contribution to the common good is a relevant issue to contemporary societies, especially in the wake of the Global Financial Crisis. In the economic literature, taxes and monetary donations have been regarded as two complementary ways of financially providing for the common good. In the psychological literature, instead, they have not been studied in conjunction. In-depth interviews have been conducted using interpretative phenomenological analysis (IPA) approach and a photo-elicitation technique to investigate the representations people share on the financial provision for the common good. Results suggest that both taxes and donations are seen as indirect, rather than direct, ways of providing for the common good. From a formal and cognitive level, paying taxes and making donations can be seen as two sides of the same coin, but they present differences at the affective level. When paying taxes, people are concerned mostly about the effects and expect a material exchange in return; when making a monetary donation, people are concerned mostly about the motivations and expect an emotional exchange in return.
Non–Muscle Invasive Papillary Urothelial Carcinoma Metastatic to the Mandible
Authors: Frydenlund Noah , Zakharia Yousef , Garje Rohan , Dahmoush Laila , O’Donnell Michael A.
Published: October 2018

Urothelial carcinoma, the most common histologic subtype of bladder cancer in the United States, most frequently presents as non–muscle invasive disease. Initially, therapy involves transurethral endoscopic resection and subsequent intravesical therapies with extended surveillance for high-risk disease. Even with the best treatments, recurrence and progression can occur. However, metastasis of non–muscle invasive bladder cancer to distant sites without evidence of progression or regional metastasis is rare. In this article, we present the case of a patient with high-grade papillary urothelial carcinoma who developed an unusual metastasis to the mandible, confirmed by GATA-3 immunostaining, over 4 years after initial transurethral resection. Prior to the development of metastatic disease, this patient had no evidence of local recurrence during maintenance Bacillus Calmette-Guerin intravesical therapy and concurrent surveillance. Positron emission tomography-computed tomography taken after presentation with mandibular metastasis did not show any evidence of regional metastasis. This case highlights an unusual location for distant metastasis of urothelial carcinoma occurring in a patient without evidence of muscle invasive disease or regional metastasis. We additionally highlight the utility of GATA-3 immunostaining in identifying urothelial carcinoma histologically.
Malignant Peritoneal Mesothelioma: A Rare Cause of Ascites
Authors: Ibrahim Abdisamad M. , Al-Akchar Mohammad , Obaidi Zainab , Al-Johany Hamid
Published: October 2018

Malignant peritoneal mesothelioma (MPM) is a rare diagnosis that presents with difficulties in diagnosis and management. This article reports a case of an 88-year-old male who presented with a 2-week history of abdominal distention and bloating. He worked at an insulation production factory between the ages of 23 and 25 years with presumed asbestos exposure. On the computed tomography scan of the abdomen/pelvis, the patient was found to have diffuse omental, peritoneal, and mesenteric nodularity with moderate to large ascites. Omental biopsy revealed MPM. The overall prognosis of MPM remains poor, with a median survival time of 12 months at the time of diagnosis. Treatment modalities offered in the United States include chemotherapy alone, cytoreductive surgery alone, or cytoreductive surgery/chemotherapy combination.
An Extended Binaural Real-Time Auralization System With an Interface to Research Hearing Aids for Experiments on Subjects With Hearing Loss
Authors: Pausch Florian , Aspöck Lukas , Vorländer Michael , Fels Janina
Published: October 2018

Theory and implementation of acoustic virtual reality have matured and become a powerful tool for the simulation of entirely controllable virtual acoustic environments. Such virtual acoustic environments are relevant for various types of auditory experiments on subjects with normal hearing, facilitating flexible virtual scene generation and manipulation. When it comes to expanding the investigation group to subjects with hearing loss, choosing a reproduction system which offers a proper integration of hearing aids into the virtual acoustic scene is crucial. Current loudspeaker-based spatial audio reproduction systems rely on different techniques to synthesize a surrounding sound field, providing various possibilities for adaptation and extension to allow applications in the field of hearing aid-related research. Representing one option, the concept and implementation of an extended binaural real-time auralization system is presented here. This system is capable of generating complex virtual acoustic environments, including room acoustic simulations, which are reproduced as combined via loudspeakers and research hearing aids. An objective evaluation covers the investigation of different system components, a simulation benchmark analysis for assessing the processing performance, and end-to-end latency measurements.