bluuebunny/crossref_metadata_2025 huggingface dataset:
Birth Prevalence of Orofacial Clefts in Kuwait From Hospital-Based Registration
Authors: Alhayyan Wasmiya A. , Pan Sharat C. , AlQatami Fawzi M.
Published: April 2018

Introduction:

Cleft lip and palate (CLAP) are the most common craniofacial anomalies and birth defects globally. Despite the fact that a tertiary care registry of clefts has existed in Kuwait since 2008, to date there is no published data regarding the prevalence of orofacial clefts in this population.

Objective:

To tabulate the pattern of orofacial clefts from tertiary care center registration during 2009 through 2014 and to estimate the prevalence and trend using population-based records.

Methodology:

Data from all CLAP cases (born in Kuwait) registered in the central cleft center registry of the Al-Amiri hospital, Kuwait City, Kuwait, from January 2009 to December 2014 were obtained. Data regarding the type, severity, gender as well as nationality, parental consanguinity, and associated syndrome were obtained from medical records. Birth prevalence was tabulated against the population statistics for the period obtained from the central department of statistics.

Result:

A total of 202 CLAP patients were recorded in the study period with a mean birth prevalence of 0.57 per 1000 live births (95% confidence interval [CI] .57 ± .23). The registry recorded 108 (53.2%) males and 94 (47.8%) females. Children born to Kuwaitis represented 53.7% of cases while those born to non-Kuwaitis represented 45.3%. The most common oral cleft was CLAP (47.3%), followed by cleft palate (30.5%), cleft lip (20.2%), and other facial clefts (2%). Other congenital anomalies were recognized in 33% of all cases. There were no statistically significant differences in oral cleft prevalence across gender or nationality.

Conclusion:

The prevalence of oral cleft in Kuwait appears to be similar to those of other Middle Eastern populations.
Quality of Life Among Children and Adolescents With Tourette Disorder and Comorbid ADHD: A Clinical Controlled Study
Authors: Erbilgin Gün Seda , Kilincaslan Ayse
Published: April 2018

Objective: To examine (a) the quality of life (QOL) in children with Tourette’s disorder (TD) and ADHD (TD + ADHD) compared with ADHD without tics (ADHD alone) and (b) the effects of the severity of tics, ADHD symptoms, comorbid diagnoses, and family functioning on QOL. Method: The assessments included the Kiddie-Schedule for Affective Disorders and Schizophrenia, Yale Global Tic Severity Scale, ADHD Rating Scale, Pediatric Quality of Life Inventory, and Family Assessment Device. Results: The TD + ADHD group had poorer psychosocial QOL. Agreement between child and parent ratings was higher in the TD + ADHD group, and children reported higher scores than their parents in both groups. Severity of tics and ADHD symptoms had stronger negative associations with parent-reported than child-reported QOL. Significant positive correlations were detected between QOL and family functioning in both groups. Conclusion: Children with TD + ADHD have lower QOL than their peers with ADHD alone. Family functioning seems to affect QOL in both groups.
Using the Contribution Analysis Approach to Evaluate Science Impact: A Case Study of the National Institute for Occupational Safety and Health
Authors: Downes Amia , Novicki Emily , Howard John
Published: April 2018

Interest from Congress, executive branch leadership, and various other stakeholders for greater accountability in government continues to gain momentum today with government-wide efforts. However, measuring the impact of research programs has proven particularly difficult. Cause and effect linkages between research findings and changes to morbidity and mortality are difficult to prove. To address this challenge, the National Institute for Occupational Safety and Health program evaluators used a modified version of contribution analysis (CA) to evaluate two research programs. CA proved to be a useful framework for assessing research impact, and both programs received valuable, actionable feedback. Although there is room to further refine our approach, this was a promising step toward moving beyond bibiliometrics to more robust assessment of research impact.
Internal Procedural Justice, Moral Alignment, and External Procedural Justice in Democratic Policing
Authors: Sun Ivan Y. , Wu Yuning , Van Craen Maarten , Hsu Kevin Kuen-lung
Published: April 2018

Notwithstanding the popularity of the process-based model of policing among social scientists, research on factors that encourage police officers to engage in procedurally fair behavior is relatively scarce. Based on the fair policing from the inside out framework and survey data collected from Taiwan police officers, this study explored the connection between internal procedural justice and external procedural justice through the mechanisms of moral alignment with both supervisors and citizens and perceived citizen trustworthiness. Fair supervision was found to build up moral alignment between officers and supervisors and between officers and citizens, which in turn led to stronger commitment to responsiveness and fair treatment of the public. Internal procedural justice and moral alignment also cultivated officers’ perceptions of public trustworthiness, which similarly strengthened officers’ response and fair treatment toward the public.
Normal feline behaviour: … and why problem behaviours develop
Authors: Bradshaw John
Published: April 2018

Practical relevance:

Cats are descended from a solitary, territorial ancestor, and while domestication has reduced their inherited tendency to be antagonistic towards all animals larger than their typical prey, they still place more reliance on the security of their territory than on psychological attachments to people or other cats, the exact opposite to dogs. Many feline problem behaviours stem from perceived threats to this security, often due to conflicts with other cats. Others are more developmental in origin, often caused by inadequate exposure to crucial stimuli, especially people, during the socialisation period. Strongly aversive events experienced at any age can also contribute. A third category comprises normal behaviour that owners deem unacceptable, such as scratching of furniture.

Evidence base:

This review identifies three areas in which basic research is inadequate to support widely employed concepts and practices in feline behavioural medicine. First, classification of cats’ problem behaviours relies heavily on approaches derived from studies of their behavioural ecology and, to some extent, extrapolation from canine studies. Few studies have focused on cats in the home, the environment in which most behavioural disorders are expressed. Secondly, cats’ chemical senses (olfactory and vomeronasal) are far more sensitive than our own, making it difficult for owners or clinicians to fully comprehend the sensory information upon which they base their behaviour. Thirdly, although the concept of psychological distress is widely invoked as an intervening variable in behavioural disorders, there are still no reliable measures of distress for pet cats in the home.

Global importance:

Psychological distress of some kind is the primary cause of many of the behavioural problems presented to clinicians, but surveys indicate that many more cats display the same clinical signs without their owners ever seeking help. The welfare of this ‘invisible’ group could be improved by veterinarians taking a more proactive approach to educating their clients about the behavioural needs of pet cats.
Behavioral awareness in the feline consultation: Understanding physical and emotional health
Authors: Horwitz Debra F , Rodan Ilona
Published: April 2018

Practical relevance:

Awareness of the strong connection between observed behavior and physical and emotional health is essential for patient welfare. It is often a change in the individual’s normal behavior that informs owners and veterinarians of the possibility of illness, pain and stress/distress. There is ample evidence in the feline literature that medical and behavioral health go hand in hand. In most feline cases, medical and behavioral conditions contribute concurrently to clinical signs.

Clinical challenges:

Our domestic cats do not express change in physiological and emotional states in a way that is easily recognized. Therefore, it can be difficult to diagnose medical and behavioral illnesses and ascertain contributions from each one to the final diagnosis. When various levels of stress are present, especially distress, this compromises behavioral and physical health, and influences treatment outcomes.

Aims:

This review is intended to help veterinarians recognize physical and behavioral changes associated with acute stress through to chronic distress, including stress-associated diseases. An emphasis on thorough history-taking will allow the clinician to ascertain which signs are behavioral and which are medical, with the understanding that they are not mutually exclusive. Equally important is the contribution of pain, chronic disease and poor environmental situations to behavioral changes and the expression of medical disorders.

Evidence base:

There is an increasing amount of evidence that stress and distress have profound effects on feline health, behavior and welfare. The authors have drawn on a substantial body of published veterinary research in producing this review.
Mortality in Advanced Chronic Obstructive Pulmonary Disease and Heart Failure Following Cardiopulmonary Rehabilitation
Authors: Kang Youjeong , Steele Bonnie G. , Burr Robert L. , Dougherty Cynthia M.
Published: April 2018

Cardiopulmonary rehabilitation (CR) improves physical function and quality of life (QoL) in chronic obstructive pulmonary disease (COPD) and heart failure (HF), but it is unknown if CR improves outcomes in very severe disease. This study’s purpose was to describe functional capacity (6-min walk distance [6MWD], steps/day), symptoms (dyspnea, depression), QoL (Short-Form Health Survey–Veterans [SF-36 V]) and cardiopulmonary function ( N-terminal pro-brain natriuretic peptide [NT-proBNP], forced expiratory volume in 1 s [FEV1]), and derive predictors of mortality among patients with severe COPD and HF who participated in CR.

Methods and Results:

In this secondary analysis of a randomized controlled trial comparing two CR methods in severe COPD and HF, 90 (COPD = 63, HF = 27) male veterans, mean age 66 ± 9.24 years, 79% Caucasian, and body mass index 31 kg/m2, were followed for 12 months after CR. The COPD group had greater functional decline than the HF group (6MWD, p = .006). Dyspnea was lower ( p = .001) and QoL higher ( p = .006) in the HF group. Mean NT-proBNP was higher in the HF group at all time points. FEV1 improved over 12 months in both groups ( p = .01). Mortality was 8.9%, 16.7%, and 37.8% at 12, 24, and 60 months, respectively. One-year predictors of mortality were baseline total steps (<3,000/day), 6MWD (<229 meters), and NT-proBNP level (>2,000 mg/pg).

Conclusions:

In very severe COPD and HF, risks of mortality over 12 months can predict patients unlikely to benefit from CR and should be considered at initial referral.
The influence of early radiolucent lines appearing on femoral head penetration into HXLPE cemented sockets
Authors: Morita Daigo , Seki Taisuke , Higuchi Yoshitoshi , Takegami Yasuhiko , Amano Takafumi , Ishiguro Naoki
Published: April 2018

Introduction:

This study investigates differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets both with and without radiolucent lines (RLLs) in the early postoperative phase and at 5 years follow-up.

Methods:

There were 35 patients (37 hips), mean age of 66.8 years, who underwent total hip arthroplasty (THA) using highly HXLPE cemented sockets. They were divided into 2 groups based on postoperative the early appearance of RLLs. Femoral head penetrations on both anteroposterior- and Lauenstein-view radiographs were evaluated, and the mean polyethylene (PE) wear rate was calculated based on femoral head penetrations between 2 and 5 years.

Results:

Femoral head penetrations in the proximal direction were 0.075 mm and 0.150 mm in the RLL and non-RLL groups at 1 year postoperatively ( p = 0.019). At 5 years measured penetration was 0.107 mm and 0.125 mm in the RLL and non-RLL groups, respectively ( p = 0.320). The mean PE wear rates in anteroposterior-view were 0.008 mm/year and 0.003 mm/year in the RLL and non-RLL groups ( p = 0.390) and those in Lauenstein-view were 0.010 mm/year and 0.005 mm/year, respectively ( p = 0.239).

Conclusions:

In the RLL group, the PE bedding-in was less compared with those in the non-RLL group. Additionally, the mean PE wear rate in the RLL group tended to be higher than that in the non-RLL group. The distribution of stress loading through the cement may differ according to whether early RLLs appear.
Fulminant rebound of relapsing–remitting multiple sclerosis after discontinuation of dimethyl fumarate: A case report
Authors: Harmel Peter , Schlunk Frieder , Harms Lutz
Published: April 2018

Background:

Rebound phenomena after discontinuation of different treatments for relapsing–remitting multiple sclerosis (RRMS) have previously been described. Systematic database research in PubMed did not show any report with relapse directly associated with dimethyl fumarate (DMF) cessation.

Case presentation:

Here, we report on a 38-year-old Caucasian male patient suffering from a relatively mild course of RRMS who developed a fulminant clinical rebound 2 months after discontinuation of DMF therapy. Radiological alterations presented impressively with primarily spinal involvement. The patient received intensive care and multiple immunomodulating therapies.

Conclusion:

We report on this case to raise neurologist’s awareness of complications of basic therapy discontinuation in RRMS.
The impact of ethnic diversity on tourism revenue and tourist arrivals
Authors: Awaworyi Churchill Sefa , Nuhu Ahmed Salim
Published: April 2018

We address the question “can cross-country differences in ethnic diversity explain cross-country differences in tourism revenues and tourist arrivals?” Thus, using data from 141 countries, we examine the effects of ethnic diversity on tourism revenues and tourist arrivals. We measure ethnic diversity using indices of ethnic fractionalization and measure tourism revenue using total, direct and indirect tourism contributions to gross domestic product. We find detrimental effects of ethnic diversity. Our results are robust to alternative estimation approaches as well as alternative ways to measure ethnic diversity.
Flânerie in the dark woods: Shattering innocence and queering time in The Path
Authors: Pelurson Gaspard
Published: April 2018

Focusing on The Path, this article aims at moving beyond the duality between the concepts of productivity and idleness in order to explore how the practice of gaming can escape heteronormative time. Positioning the gamer as a flâneur, I argue that The Path locates the player in a queer time through the fragmentation of its narrative, but also the shattering of heteronormative imagery – such as the figure of the child as pure and innocent – and its reappropriation in a queer text. Ultimately, this article argues that gaming has the potential to be considered a site of queer practice. In order to perform this reading, I first introduce my critical framework comprised from exploring how queer lifestyles detach themselves from normative time and focusing on the practice of flânerie as queer performance.
The Amazing Bounce-Backable Woman: Resilience and the Psychological Turn in Neoliberalism
Authors: Gill Rosalind , Orgad Shani
Published: April 2018

This article examines the growing prominence accorded to the idea of ‘resilience’ as a regulatory ideal, locating it in the context of a ‘turn to character’ in contemporary culture which we see as part of a wider psychological turn within neoliberalism. Building from discussions of ‘resilience’ as a quality demanded and promoted by public policy in the context of austerity and worsening inequality, we argue that resilience has also emerged as a central term in popular culture in genres such as self-help literature, lifestyle magazines, and reality television, as well as in a burgeoning social media culture focussed on positive thinking, affirmations, and gratitude. It calls on people to be adaptable and positive, bouncing back from adversity and embracing a mind-set in which negative experiences can–and must–be reframed in upbeat terms. The article examines three case studies–women’s magazines, self-help books, and smartphone apps–to explore how resilience is constituted, how it operates, and how it materialises across different sites. We extend existing work by highlighting the classed and gendered dimensions of injunctions to resilience, pointing to the ways that middle-class women are hailed as emblematic ‘bounce-backable’ subjects. We explore how notions of elasticity, inspiration, and affirmation are deployed in ways that systematically outlaw critique or any need for social transformation while inciting a vast range of physical, social and, above all, psychological labours on the part of ‘resilient’ subjects.
It takes time: Building relationships and understanding through an intergenerational ballet programme
Authors: Canning Shelley E , Gaetz Michael , Blakeborough Darren
Published: April 2018

Individuals living in long-term residential care homes are often viewed through a negative lens. These residents have increasingly complex care needs, and their functional, communication and cognitive challenges can support conceptualizations of difference and disability perpetuating negative stereotypes of age and dementia. However, engaging in meaningful activities and relationships with older adults, including those with dementia, has been shown to promote positive attitudes. Specifically, intergenerational programming that provides opportunities for meaningful engagement between children and older adults has been shown to support positive emotional experiences through socializing and building relationships. This qualitative study explored the development of relationships between school-aged children and older adults with dementia living in a long-term residential care home. Residents in long-term care homes and children typically have limited opportunities to interact with each other; in this study, participating in an intergenerational dance programme provided an opportunity for meaningful relationships to develop. This paper focuses on the development of the children’s attitudes and understandings of their much older dance partners. Seven girls between the ages of seven and nine participated in ballet classes with residents in a long-term care home for one hour each week over a six-month period. All of the residents had a diagnosis of moderate to advanced dementia. Further, all of the residents also had other chronic health issues such as cardiac, respiratory and/or neurological diseases. The children were interviewed at the baseline, three- and six-month intervals. Prior to beginning the dance programme, the children anticipated their dance partners to be unwell and unable. However, by the end of six months, the children described the residents much more positively highlighting their abilities and strengths. Over time, through participating in a structured intergenerational programme, the children’s views of disability and difference disappeared as they formed dance partnerships and developed meaningful relationships.
A Qualitative Analysis of South African Health Professionals’ Discussion on Distrust and Unwillingness to Refer Organ Donors
Authors: Etheredge Harriet Rosanne , Penn Claire , Watermeyer Jennifer
Published: April 2018

Introduction:

South Africa is faced with very low deceased organ donor numbers. Often, sociocultural practices, which are thought to be fundamentally opposed to deceased organ donation, are hailed as the cause. However, other factors such as context, social perceptions, and clinical environment may play a role.

Aim:

The aim of this article is to present research that explored communication in organ transplant and identified barriers to organ donation decisions in a province of South Africa.

Methods:

Qualitative methods were used. Thirty semistructured interviews with transplant professionals and 2 focus groups with transplant coordinators took place across 6 health institutions in Gauteng Province.

Results:

Barriers that may prevent transplant professionals from referring potential donors were identified: The wider public and transplant professionals may be suspicious of biomedicine and have a perception that people could be killed for their organs. Organ donation was sometimes framed as “murder,” “killing,” or a “bunch of vultures.” Doctors may be unwilling to refer brain-dead patients, as this was seen as failing in one’s professional duty to cure the patient. The role of sociocultural practices was inconclusive, with the sample divided based on the extent of their influence.

Conclusion:

Low donor numbers may be a manifestation of barriers to referral in the clinical setting. These barriers interplay in a context of suspicion and are framed by a clinical transplant discourse that is sometimes loaded with negative connotation. Sociocultural practices are influential, but they may not be the overriding cause of low donor numbers.
The Napa County Agricultural Preserve: Fifty Years as a Foundation of America’s Premier Wine Region
Authors: Daniels Tom
Published: April 2018

In 1968, Napa County, California, created an agricultural preserve of 23,000 acres zoned for agriculture, wineries, and houses with a large minimum lot size of twenty acres. Over time, the agricultural preserve was expanded to 32,000 acres and the zoning tightened to a forty-acre minimum lot size. Concerns about nonfarm development and marketing activities at wineries compelled county voters to pass three referenda that limited population growth in the countryside and required a countywide vote for any zoning changes in the agricultural preserve. Thanks in part to the agricultural preserve, Napa County became America’s most famous wine-producing region.
Variable size sampling to support high uniformity confidence in sensor data streams
Authors: Kim Hajin , Gil Myeong-Seon , Moon Yang-Sae , Choi Mi-Jung
Published: April 2018

In order to rapidly process large amounts of sensor stream data, it is effective to extract and use samples that reflect the characteristics and patterns of the data stream well. In this article, we focus on improving the uniformity confidence of KSample, which has the characteristics of random sampling in the stream environment. For this, we first analyze the uniformity confidence of KSample and then derive two uniformity confidence degradation problems: (1) initial degradation, which rapidly decreases the uniformity confidence in the initial stage, and (2) continuous degradation, which gradually decreases the uniformity confidence in the later stages. We note that the initial degradation is caused by the sample range limitation and the past sample invariance, and the continuous degradation by the sampling range increase. For each problem, we present a corresponding solution, that is, we provide the sample range extension for sample range limitation, the past sample change for past sample invariance, and the use of UC-window for sampling range increase. By reflecting these solutions, we then propose a novel sampling method, named UC-KSample, which largely improves the uniformity confidence. Experimental results show that UC-KSample improves the uniformity confidence over KSample by 2.2 times on average, and it always keeps the uniformity confidence higher than the user-specified threshold. We also note that the sampling accuracy of UC-KSample is higher than that of KSample in both numeric sensor data and text data. The uniformity confidence is an important sampling metric in sensor data streams, and this is the first attempt to apply uniformity confidence to KSample. We believe that the proposed UC-KSample is an excellent approach that adopts an advantage of KSample, dynamic sampling over a fixed sampling ratio, while improving the uniformity confidence.
The Need for Innovative Methods to Increase Adherence in Individuals Experiencing Cognitive Decline
Authors: Gorniak Stacey L. , Johnson Craig A.
Published: April 2018

Cognitive impairment, particularly coupled with advanced age, is becoming an increasing concern for both clinicians and caregivers. Nonadherence is a common problem in individuals with cognitive impairment, leading to concerns regarding patient autonomy. The development and use of innovative strategies to overcome nonadherence is important to increase the likelihood of engagement in healthy lifestyle behaviors.
Is jellyfish more of a fish in English than in Dutch? The effect of informative labels
Authors: Djalal Farah M , Voorspoels Wouter , Storms Gert , Heyman Tom
Published: April 2018

Some words are lexically suggestive about the taxonomic position of their referent (e.g., jellyfish in English), and this information can vary across languages (e.g., in Dutch the equivalent of jellyfish holds no taxonomic information: kwal). To evaluate the role of such lexical suggestions, we conducted a cross-linguistic study in which similarity judgements from two language groups (Dutch and English speakers) were compared. We paired asymmetrically informative items with items that are considered to be typical members of the referenced category (e.g., jellyfish–salmon). Our analyses revealed that items were deemed more similar by speakers of a language in which the lexical information was present (e.g., English speakers tended to give relatively higher ratings for jellyfish–salmon than Dutch participants did for the non-informative equivalent kwal–zalm). Results are discussed in light of theories of concept representation and compound processing.
Becoming an International Baccalaureate Middle Years Program: Perspectives of Teachers, Students, and Administrators
Authors: Storz Mark , Hoffman Amy
Published: April 2018

As an urban middle school begins to implement the International Baccalaureate Middle Years Program, this study explores the process of experiencing a curricular change from the perspective of the teachers and students themselves. Through the use of a mixed methods approach, key administrators, teachers, and students were interviewed in the first year of implementation. During the second year, teachers were surveyed as a means of tracking the change over time that teachers may have been experiencing. Themes emerged in the areas of instructional practice, professional experiences, and student experiences. Most interestingly and not expected was a theme related to whether IB was a “good fit” for the students in this particular school. Participants’ ability to highlight the successes and challenges inherent in a change process is discussed in light of future planning.
Studies on sporadic non-syndromic thoracic aortic aneurysms: II. Alterations of extra-cellular matrix components and focal adhesion proteins
Authors: Chiarini Anna , Onorati Francesco , Marconi Maddalena , Pasquali Alessandra , Patuzzo Cristina , Malashicheva Anna , Irtyega Olga , Faggian Giuseppe , Pignatti Pier F , Trabetti Elisabetta , Armato Ubaldo , Dal Pra Ilaria
Published: April 2018

Background

Sporadic non-syndromic thoracic aortic aneurysms (SNSTAAs) are less well understood than familial non-syndromic or syndromic ones. Here, we focused on morphologic and molecular changes of the extracellular matrix of the tunica media of SNSTAAs.

Design

Single centre design.

Methods

Surgical media samples from seven SNSTAAs and seven controls underwent quantitative polymerase chain reaction, proteomics-bioinformatics, immunoblotting, histology and immunohistochemistry analysis.

Results

A down-regulation of Decorin mRNA with unchanged protein levels associated with a remarkable increase of collagen fibres. A reduced and distorted network of elastic fibres partnered with an attenuated expression of microfibril-associated glycoprotein1 despite the rise of MFAP2 gene-encoded mRNA levels. An increasingly proteolysed paxillin (55 kDa PXN), a focal adhesion protein, combined with an upregulated 62 kDa PXN holoprotein, without changes in amount and phosphorylation of focal adhesion kinase (pp125FAK). The upregulation of SPOCK2-encoded Testican2 proteoglycan and of ectodysplasin (EDA) protein was coupled with a down-regulation of EDA2 receptor (EDA2R).

Conclusions

Several tunica media extracellular matrix-related changes favour SNSTAA development. A steady level of decorin and a microfibril-associated glycoprotein1 protein shortage cause the assembly of structurally defective collagen and elastic fibres. Up-regulation of PXN holoproteins perturbs PXN/pp125FAKinteraction and focal adhesion functioning. Testican2 up-regulation suppresses the membrane-type matrix metalloproteinase inhibiting activities of other SPOCK family members thus enhancing extracellular matrix proteolysis. Finally, the altered EDA•EDA2R signalling would impact on the remodelling of SNSTAA tunica media. Altogether, our results pave the way to a deeper molecular understanding of SNSTAAs necessary to identify their early diagnostic biochemical markers.
Aortic centres should represent the standard of care for acute aortic syndrome
Authors: Mariscalco Giovanni , Maselli Daniele , Zanobini Marco , Ahmed Aamer , Bruno Vito D , Benedetto Umberto , Gherli Riccardo , Gherli Tiziano , Nicolini Francesco
Published: April 2018

Background

Existing evidence suggests that patients affected by acute aortic syndromes (AAS) may benefit from treatment at dedicated specialized aortic centres. The purpose of the present study was to perform a meta-analysis to evaluate the impact aortic service configuration has in clinical outcomes in AAS patients.

Methods

The design was a quantitative and qualitative review of observational studies. We searched PubMed/ MEDLINE, EMBASE, and Cochrane Library from inception to the end of December 2017 to identify eligible articles. Areas of interest included hospital and surgeon volume activity, presence of a multidisciplinary thoracic aortic surgery program, and a dedicated on-call aortic team. Participants were patients undergoing repair for AAS, and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were adopted for synthesizing hospital/30-day mortality.

Results

A total of 79,131 adult patients from a total of 30 studies were obtained. No randomized studies were identified. Pooled unadjusted ORs showed that patients treated in high-volume centres or by high-volume surgeons were associated with lower mortality rates (OR 0.51; 95% CI 0.46–0.56, and OR 0.41, 95% CI 0.25–0.66, respectively). Pooled adjusted estimates for both high-volume centres and surgeons confirmed these survival benefits (adjusted OR, 0.56; 95% CI 0.45–0.70, respectively). Patients treated in centres that introduced a specific multidisciplinary aortic program and a dedicated on-call aortic team also showed a significant reduction in mortality (OR 0.31; 95% CI 0.19–0.5, and OR 0.37; 95% CI 0.15–0.87, respectively).

Conclusions

We found that specialist aortic care improves outcomes and decreases mortality in patients affected by AAS.
Use of checkpoint inhibitors in liver transplant recipients
Authors: Munker Stefan , De Toni Enrico N
Published: April 2018

In spite of their major impact in cancer therapy, immune checkpoint inhibitors are considered to be contraindicated in liver transplant recipients due to fear of rejection and fatal liver failure. Nevertheless, an increasing number of instances of liver transplant recipients treated with checkpoint inhibitors is being published. We reviewed the reports on 14 known cases of liver transplant recipients who underwent treatment with checkpoint inhibitors and discuss factors likely to determine susceptibility to organ rejection including the choice of the agent and the immunosuppression employed, the assessment of Programmed cell death 1 ligand 1 (PD‐L1) status in liver graft biopsies, and the time of treatment initiation.
Employing participatory methods to engage an under-researched group: Opportunities and challenges
Authors: Pettinger Clare , Letherby Gayle , Parsons Julie M , Withers Lyndsey , Cunningham Miranda , Whiteford Andrew , D’Aprano Gia , Ayres Richard , Sutton Carole
Published: April 2018

In this article, we report on our experience of working on an exploratory project where the primary objective was to involve homeless service users with food-based participatory qualitative approaches. The project FLM aimed to explore food experiences and behaviours in a sample of users of homelessness services in a south west UK coastal city, in order to create solutions to improve their wellbeing. A mixture of qualitative methods was used, including observations, photo-elicitation and focus group discussions. We aimed to be participatory and ‘creative’ in our approach and in our analysis. Here, we focus on detailing and critiquing our approach to the collection and analysis of data.
Use of a Deep Recurrent Neural Network to Reduce Wind Noise: Effects on Judged Speech Intelligibility and Sound Quality
Authors: Keshavarzi Mahmoud , Goehring Tobias , Zakis Justin , Turner Richard E. , Moore Brian C. J.
Published: April 2018

Despite great advances in hearing-aid technology, users still experience problems with noise in windy environments. The potential benefits of using a deep recurrent neural network (RNN) for reducing wind noise were assessed. The RNN was trained using recordings of the output of the two microphones of a behind-the-ear hearing aid in response to male and female speech at various azimuths in the presence of noise produced by wind from various azimuths with a velocity of 3 m/s, using the “clean” speech as a reference. A paired-comparison procedure was used to compare all possible combinations of three conditions for subjective intelligibility and for sound quality or comfort. The conditions were unprocessed noisy speech, noisy speech processed using the RNN, and noisy speech that was high-pass filtered (which also reduced wind noise). Eighteen native English-speaking participants were tested, nine with normal hearing and nine with mild-to-moderate hearing impairment. Frequency-dependent linear amplification was provided for the latter. Processing using the RNN was significantly preferred over no processing by both subject groups for both subjective intelligibility and sound quality, although the magnitude of the preferences was small. High-pass filtering (HPF) was not significantly preferred over no processing. Although RNN was significantly preferred over HPF only for sound quality for the hearing-impaired participants, for the results as a whole, there was a preference for RNN over HPF. Overall, the results suggest that reduction of wind noise using an RNN is possible and might have beneficial effects when used in hearing aids.
Why Is the Time Always Right for White and Wrong For Us? How Racialized Youth Make Sense of Whiteness and Temporal Inequality
Authors: Mahadeo Rahsaan
Published: April 2018

Independently, the study of whiteness and the study of time are important interventions in sociology. A solid foundation for any empirical investigation of the relationship between whiteness and the racialized temporalities of racialized youth, however, has yet to be set. Drawing on data from 30 in-person interviews and ethnographic methods, the author explores how racialized youth interpret time in relation to whiteness and the experiences of white youth. The data for this research are based on more than one year of fieldwork at Run-a-Way, a multiservice center for youth. Results show that racialized youth view white youth as having more time to take advantage of educational and employment opportunities. As a result of the perceived temporal advantage held by their white counterparts, racialized youth expressed feelings of temporal inequality and disparate life chances. Forced to work twice as hard to be half as good, youth saw their time horizons as compressed. The author shows how racialized youth lose time through physical, psychic, and emotional labor required to process racialization and racism and illustrates the various structural mechanisms that steal their time. Despite the temporal inequalities between them and their white counterparts, youth at Run-a-Way discovered ways to invert the terms of temporality to ensure that their culture was always most relevant and “up to date.” Although whiteness is linked to modernity and that which is future oriented, racialized youth viewed their white counterparts as behind time, lame, or just plain “wack” (uncool).
Yield of Echocardiogram and Predictors of Positive Yield in Pediatric Patients: A Study in an Urban, Community-Based Outpatient Pediatric Cardiology Clinic
Authors: Billa Ramya Deepthi , Szpunar Susan , Zeinali Lida , Anne Premchand
Published: April 2018

The yield of outpatient echocardiograms varies based on the indication for the echocardiogram and the age of the patient. The purpose of this study was to determine the cumulative yield of outpatient echocardiograms by age group and reason for the test. A secondary aim was to determine the predictors of a positive echocardiogram in an outpatient cardiology clinic at a large community teaching hospital. We retrospectively reviewed the charts of 891 patients who had a first-time echocardiogram between 2011 and 2015. Positive yield was defined as echocardiographic findings that explained the reason for the echocardiogram. The overall positive yield was 8.2%. Children between birth and 3 months of age had the highest yield (34.2%), and children between 12 and 18 years of age had the lowest yield (1%). Patients with murmurs (18.1%) had the highest yield compared with patients with other signs or symptoms. By age group and reason, the highest yields were as follows: 0 to 3 months of age, murmur (39.2%); 4 to 11 months of age, >1 symptom (50%); and 1 to 5 years of age, shortness of breath (66.7%). Based on our study, the overall yield of echocardiograms in the outpatient pediatric setting is low. Age and symptoms should be considered before ordering an echocardiogram.
PRECIOUS: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke. Rationale and design of a randomised, open, phase III, clinical trial with blinded outcome assessment
Authors: Reinink Hendrik , de Jonge Jeroen C , Bath Philip M , van de Beek Diederik , Berge Eivind , Borregaard Saskia , Ciccone Alfonso , Csiba Laszlo , Demotes Jacques , Dippel Diederik W , Kõrv Janika , Kurkowska-Jastrzebska Iwona , Lees Kennedy R , Macleod Malcolm R , Ntaios George , Randall Gary , Thomalla Götz , van der Worp H Bart
Published: April 2018

Background

Elderly patients are at high risk of complications after stroke, such as infections and fever. The occurrence of these complications has been associated with an increased risk of death or dependency. Hypothesis: Prevention of aspiration, infections, or fever with metoclopramide, ceftriaxone, paracetamol, or any combination of these in the first four days after stroke onset will improve functional outcome at 90 days in elderly patients with acute stroke.

Design

International, 3 × 2-factorial, randomised-controlled, open-label clinical trial with blinded outcome assessment (PROBE) in 3800 patients aged 66 years or older with acute ischaemic stroke or intracerebral haemorrhage and an NIHSS score ≥ 6. Patients will be randomly allocated to any combination of oral, rectal, or intravenous metoclopramide (10 mg thrice daily); intravenous ceftriaxone (2000 mg once daily); oral, rectal, or intravenous paracetamol (1000 mg four times daily); or usual care, started within 24 h after symptom onset and continued for four days or until complete recovery or discharge from hospital, if earlier. Outcome: The primary outcome measure is the score on the modified Rankin Scale at 90 days (± 14 days), as analysed with multiple regression. Summary: This trial will provide evidence for a simple, safe and generally available treatment strategy that may reduce the burden of death or disability in patients with stroke at very low costs. Planning: First patient included in May 2016; final follow-up of the last patient by April 2020. Registration: ISRCTN, ISRCTN82217627, https://doi.org/10.1186/ISRCTN82217627
Mechanism of Action of the Biologics for Treatment of Psoriasis
Authors: Behnam Shahrad M. , Behnam Shahdad E. , Koo John
Published: April 2018

In the past, the treatment for psoriasis included steroid and non-steroid topicals, systemic agents and phototherapy. The bio-logics are a new class of drugs that attack the immune cells and cytokines to inhibit the pathogenesis of psoriasis. Alefacept (Amevive) inhibits the interaction between CD45 RO+ T cells and Antigen Presenting Cells (APCs) and also induces apoptosis of the CD45 RO+ T cells. Efalizumab (Raptiva) inhibits the interaction between CD45 RO+ T cells and APC and it prevents CD45 RO+ T cells from migrating across the blood vessel wall. Etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira) inhibit TNF-α and prevent the inflammatory cascade that is responsible for the pathogenesis of psoriasis. These new medications will offer new hope for the treatment of psoriasis.
Bathing Practices and Emollient Use among Psoriasis Patients
Authors: Kazanis Maryanne , Horn Liz , Boer Kimball Alexa
Published: April 2018

The following submission is a brief report of a recently conducted survey on the bathing practices of people with psoriasis. The scope of the survey was to discover what practices psoriasis patients have adopted in caring for their skin as compared to controls. An Institutional Review Board (IRB)-approved survey was conducted in conjunction with the National Psoriasis Foundation National Conference, which took place Aug. 5–7, 2005, in Boston, Mass. Subjects reported their frequency of bathing, the amount of pain they experienced when bathing and showering, and whether or not they applied moisturizer on a daily basis. Psoriasis subjects were also asked to rate the severity of their psoriasis. Significant differences were found in people reporting pain with showering in the psoriasis group as compared with controls, and psoriasis respondents preferred cooler water temperatures when bathing. Both of these findings correlated with disease severity. Further, psoriasis subjects were found to use moisturizers more frequently and avoid the use of harsher products such as exfoliators when compared to controls. The findings of this survey suggest that the bathing practices of psoriasis patients are affected by their skin condition. In addition, daily pain associated with showering may negatively impact a patient's quality of life. The results of this research suggest that increased efforts should be made to evaluate pain severity and other affected aspects of caring for skin in this patient population.
Relapse Rate and Duration of Therapeutic Effect of Oral Psoralen plus Ultraviolet a (PUVA) in the Treatment of Plaque-type Psoriasis: Original Data Utilizing Standardized Measures of Effect Duration
Authors: Hong Judith , Priya Sivanesan S. , Chavez-Frazier Arianne , Bandow Grace D. , Malick Farah , Kricorian Greg , Letsinger Julie
Published: April 2018

Background

Treatments with long duration of therapeutic effects are ideal for the long-term treatment of psoriasis. This study evaluates psoralen plus ultraviolet light A (PUVA) therapy using standardized definitions of relapse and durability of therapeutic effect.

Objectives

The purpose of this study was to evaluate the relapse rate and duration of therapeutic effect for PUVA patients who achieved at least 75% reduction in the Psoriasis Area and Severity Index (PASI 75) score after 12 weeks of treatment.

Methods

This study involved 40 patients with psoriasis; 30 received PUVA and 10 received UVA with placebo for 12 weeks during the double-blind treatment phase. During the post-treatment follow-up, patients who achieved PASI 75 after 12 weeks of PUVA were followed for 48 weeks without treatment to evaluate for relapse (time when subjects return to ≤50% reduction in baseline PASI) and durability of therapeutic effect (time from stopping treatment until 50% of improvement in PASI from the treatment is lost).

Results

Using per-protocol analysis, 18 out of the 21 patients (86%) who completed the double-blind treatment phase achieved PASI 75 after 12 weeks of PUVA. None of the placebo-treated patients achieved PASI 75. Of the patients who reached PASI 75 after 12 weeks, 89% (16/18) did not relapse after 12 weeks, 69% (11/16) did not relapse after 24 weeks, and 36% (5/14) did not relapse after 48 weeks follow-up. Of the patients who relapsed during the 48-week follow-up, the median time to relapse was 32 weeks. The durability of therapeutic effect was at least 12 weeks, 24 weeks, and 48 weeks respectively in 100% (18/18), 75% (12/16) and 42% (6/14) of the patients.

Limitations

The study was relatively small with only 14 patients completing the total follow-up period and per-protocol analysis was used. In addition, the patients were generally younger and less severe than those evaluated in biologic studies. There was no direct head-to-head comparison with other treatment modalities to evaluate relative relapse rates.

Conclusions

The study results support previous reports in the literature and the general clinical impression that PUVA provides prolonged duration of response in patients with plaque-type psoriasis.
Poor Patient Satisfaction and Medication Adherence among Patients with Psoriasis: Results from a Large National Survey
Authors: Wu Ying , Mills Douglas , Barrett James , Bala Mohan
Published: April 2018

Psoriasis is a chronic immune-mediated disease that is difficult to treat. Psoriasis treatment adherence and patients' satisfaction with their psoriasis treatment are important components to positive clinical outcomes.

Data collected during the July 2005 U.S. National Health and Wellness Survey were analyzed. As part of this survey, patients with psoriasis self-assessed their adherence to and satisfaction with their psoriasis therapy. The Morisky-Green Test (MGT) was used to assess medication adherence, and a 5-point scale ranging from 1(not at all satisfied) to 5 (extremely satisfied), was used to assess psoriasis therapy satisfaction.

Of 41,184 respondents included in the survey, 1,240 reported a diagnosis of psoriasis. Overall, patients were not satisfied with their treatment and their adherence was less than optimal. In this study, patients receiving biologics appeared to be the most satisfied and adherent. More than half of the patients were satisfied with biologics (72.1%), phototherapy (60.7%) and corticosteroid topical agents (50.4%), but levels of satisfaction were lower with noncorticosteroid topical therapies (42.6), oral immunosuppressants (41.2), vitamin-derived topical agents (37.2), other prescription treatments (37.0) and tars (32.6).

Further research should focus more on patient education and improving physician-patient interactions to improve patient adherence to achieve optimal therapy outcome.
Hydrogel Patch: A New Occlusive Device for the Treatment of Psoriasis—Patient Feedback from a Bilaterally Controlled Study
Authors: Koo Bonnie , Hong Judith , Colaco Shanthi , Cheung Lawrence C.C.
Published: April 2018

Occlusion is an effective therapeutic modality for treating psoriasis either by itself or by enhancing the efficacy of topical agents. However, the affordable material available, namely Saran wrap and other similar plastic sheets, make it unfeasible for widespread use. The hydrogel patch is a new medical device that is not only efficacious, but also improves upon the shortcomings of previous occlusive dressing materials. It is not yet available in the market but is expected to become available soon. This article introduces the use of the hydrogel patch and presents patient input regarding its feasibility and acceptability from a bilaterally controlled study for the treatment of psoriasis.