bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of a Heterotopic Cardiac Isotransplant for Pharmacological and Toxicological Studies*
Authors: Korecky Borivoj , Masika Mary
Published: February 2020

The heterotopically transplanted rat heart provides a unique model for examination of the direct humoral effects on the myocardium since the transplanted heart is exposed to the same hormonal milieu as the in situ heart but does not support the hemodynamic load. In this model, the heart of an inbred rat is transplanted into the abdomen of a recipient of the same inbred strain by attaching the stumps of aorta and pulmonary artery end to side to the abdominal aorta and inferior vena cava of the recipient. The transplanted heart is perfused by the recipients’ blood through the coronary vessels. Its left ventricle beats mostly isovolumically and at a slower rate than the heart in situ. The transplant functions as a denervated “non working” Langendorf heart and does not appreciably contribute to the haemodynamics, while the recipient in situ heart supports the haemodynamics and serves as a control heart. The above model has been used to study the direct and indirect effects of thyroxine, catecholamines and of physical exercise on the cardiac mass and on its structure, function and chemical composition. It can also be used to study the acute and chronic effects of unloading and subsequent reloading. It can also shed some light upon the effect of denervation and potential reinnervation of the myocardium.
Factors Controlling Growth of Arterial Cells following Injury*
Authors: Reidy Michael A. , Jackson Christopher L.
Published: February 2020

The proliferation of vascular smooth muscle cells is a key event in the development of arterial lesions. In experimental models, loss of arterial endothelium followed by platelet adherence does not necessarily stimulate smooth muscle cell proliferation. Furthermore, using animals deficient in platelets, smooth muscle cell proliferation was induced to an equal extent as in control animals following injury with a balloon catheter. Modulation of the smooth muscle response, however, was achieved by totally denuding arteries with a technique which did not traumatize medial cells. These data suggested that injury and cell death might induce proliferation of cells by release of endogenous mitogen. Basic FGF is present in the arterial wall and addition of this mitogen to denuded arteries was found to cause a highly significant increase in smooth muscle cell proliferation. These studies suggest that smooth muscle cell proliferation could be induced by factors present in the arterial wall and does not require exogenous factors. Smooth muscle cell proliferation following balloon catheter injury is significantly reduced by administration of calcium antagonists. Repeated administration of nifedipine caused a significant reduction in intimal lesion size induced by injury. The anti-proliferative. effect was not observed in other tissues. Influx of Ca++ ions into medial smooth muscle cells may therefore be an obligatory step for replication.
The reliability of the graded Wolf Motor Function Test for stroke
Authors: Turtle Beverley , Porter-Armstrong Alison , Stinson May
Published: February 2020

Introduction

The graded Wolf Motor Function Test assesses upper limb function following stroke. Clinical utility is limited by the requirement to video record for scoring purposes. This study aimed to (a) assess whether video recording is required through examination of inter-rater reliability and agreement; and (b) assess intra-rater reliability and agreement.

Method

A convenience sample of 30 individuals were recruited following stroke. The graded Wolf Motor Function Test was administered within 2 weeks of rehabilitation commencement and at 3 months. Two occupational therapists scored participants through either direct observation or video. Inter- and intra-rater reliability and agreement were examined for item-level and summary scores.

Results

Excellent inter-rater reliability ( n = 28) was found between scoring through direct observation and by video (intraclass correlation coefficients >0.9), and excellent intra-rater reliability ( n = 21) was found (intraclass correlation coefficients >0.9) for item-level and summary scores. Low agreement was found between raters at the item level. Adequate agreement was found for total functional ability, with increased measurement error found for total performance time.

Conclusion

The graded Wolf Motor Function Test is a reliable measure of upper limb function. Video recording may not be required by therapists. In view of low agreement, future studies should assess the impact of standardised training.
Mortality and Revascularization among Myocardial Infarction Patients with Schizophrenia: A Population-Based Cohort Study
Authors: Hauck Tanya S. , Liu Ning , Wijeysundera Harindra C. , Kurdyak Paul
Published: February 2020

Background:

Cardiovascular disease is a major source of mortality in schizophrenia, and access to care after acute myocardial infarction (AMI) is poor for these patients.

Aims:

To understand the relationship between schizophrenia and access to coronary revascularization and the impact of revascularization on mortality among individuals with schizophrenia and AMI.

Method:

This study used a retrospective cohort of AMI in Ontario between 2008 and 2015. The exposure was a diagnosis of schizophrenia, and patients were followed 1 year after AMI discharge. The primary outcome was all-cause mortality within 1 year. Secondary outcomes were cardiac catheterization and revascularization (percutaneous coronary intervention or coronary artery bypass graft). Cox proportional hazard regression models were used to study the relationship between schizophrenia and mortality, and the time-varying effect of revascularization.

Results:

A total of 108,610 cases of incident AMI were identified, among whom 1,145 (1.1%) had schizophrenia. Schizophrenia patients had increased mortality, with a hazard ratio (HR) of 1.55 (95% CI, 1.37 to 1.77) when adjusted for age, sex, income, rurality, geographic region, and comorbidity. After adjusting for time-varying revascularization, the HR reduced to 1.38 (95% CI, 1.20 to 1.58). The impact of revascularization on mortality was similar among those with and without schizophrenia (HR: 0.42; 95% CI, 0.41 to 0.44 vs. HR: 0.40; 95% CI, 0.26 to 0.61).

Conclusions:

In this sample of AMI, mortality in schizophrenia is increased, and treatment with revascularization reduces the HR of schizophrenia. The higher mortality rate yet similar survival benefit of revascularization among individuals with schizophrenia relative to those without suggests that increasing access to revascularization may reduce the elevated mortality observed in individuals with schizophrenia.
Quantitative Study of Dual Circadian Oscillator Models under Different Skeleton Photoperiods
Authors: Flôres Danilo E. F. L. , Oda Gisele A.
Published: February 2020

The daily proportion of light and dark hours (photoperiod) changes annually and plays an important role in the synchronization of seasonal biological phenomena, such as reproduction, hibernation, and migration. In mammals, the first step of photoperiod transduction occurs in the suprachiasmatic nuclei (SCN), the circadian pacemaker that also coordinates 24-h activity rhythms. Thus, in parallel with its role in annual synchronization, photoperiod variation acutely shapes day/night activity patterns, which vary throughout the year. Systematic studies of this behavioral modulation help understand the mechanisms behind its transduction at the SCN level. To explain how entrainment mechanisms could account for daily activity patterns under different photoperiods, Colin Pittendrigh and Serge Daan proposed a conceptual model in which the pacemaker would be composed of 2 coupled, evening (E) and morning (M), oscillators. Although the E-M model has existed for more than 40 years now, its physiological bases are still not fully resolved, and it has not been tested quantitatively under different photoperiods. To better explore the implications of the E-M model, we performed computer simulations of 2 coupled limit-cycle oscillators. Four model configurations were exposed to systematic variation of skeleton photoperiods, and the resulting daily activity patterns were assessed. The criterion for evaluating different model configurations was the successful reproduction of 2 key behavioral phenomena observed experimentally: activity psi-jumps and photoperiod-induced changes in activity phase duration. We compared configurations with either separate light inputs to E and M or the same light inputs to both oscillators. The former replicated experimental results closely, indicating that the configuration with separate E and M light inputs is the mechanism that best reproduces the effects of different skeleton photoperiods on day/night activity patterns. We hope this model can contribute to the search for E and M and their light input organization in the SCN.
Breakfast Positively Impacts Cognitive Function in College Students With and Without ADHD
Authors: Brandley Elizabeth T. , Holton Kathleen F.
Published: February 2020

Purpose:

To compare the effects of a nutritionally balanced breakfast on cognitive function in college students with and without attention-deficit/hyperactivity disorder (ADHD).

Design:

Pre–post dietary intervention.

Setting:

University.

Sample:

College students aged 18 to 25 years with (n = 19) and without (n = 27) ADHD.

Intervention:

Participants completed computerized cognitive assessment after an overnight fast and again 1 hour after consuming a nutritionally balanced breakfast shake.

Measure:

CNS Vital Signs computerized cognitive testing.

Analysis:

Chi-square tests were used to compare categorical variables, and nonparametric Wilcoxon rank sum and signed rank tests were used to compare continuous data between and within groups (respectively). Multivariable logistic regression was used to estimate the likelihood of ADHD based on cognitive improvement from breakfast consumption, after adjusting for age, sex, GPA, and year in school.

Results:

A significant proportion of those with and without ADHD (47% and 33%, respectively) reported not typically eating breakfast at baseline. One hour after consuming a balanced breakfast shake, both groups demonstrated improvements in 4 cognitive function domains. Those with ADHD were more likely to improve in reaction time than those without ADHD (odds ratio [95% confidence interval] = 1.07 [1.00-1.15], P = .04).

Conclusions:

The results of this pilot study suggest that college students with and without ADHD may benefit cognitively from a balanced breakfast. More research is needed to confirm these findings.
Neuropsychiatric Effects on Decision-Making in Early Alzheimer Disease
Authors: Yerstein Oleg , Carr Andrew R. , Jimenez Elvira , Mendez Mario F.
Published: February 2020

Background:

Neuropsychiatric symptoms can impact decision-making in patients with Alzheimer disease (AD).

Methods:

Using a simple decision-making task, a variant of the ultimatum game (UG) modified to control feelings of unfairness, this study investigated rejection responses among responders to unfair offers. The UG was administered to 11 patients with AD, 10 comparably demented patients with behavioral variant frontotemporal dementia (bvFTD), and 9 healthy controls (HC). The results were further compared with differences on the caregiver Neuropsychiatric Inventory (NPI).

Results:

Overall, patients with AD significantly rejected more total offers than did the patients with bvFTD and the HC ( P < .01). On the NPI, the only domain that was significantly worse among the patients with AD compared to the other groups was dysphoria/depression.

Conclusions:

These results suggest that early AD can be distinguished based on increased rejections of offers in decision-making, possibly consequent to a heightened sense of unfairness from dysphoria/depression.
Praxivist imaginaries of decolonization: Can the psy be decolonized in the world as we know it?
Authors: Miller Lindsay Lee , Miller Michael J
Published: February 2020

Guided by Denise Ferreira da Silva’s contributions to decolonization through a black feminist poethical mode of intervention, this article overall offers the provocation: Is decolonization possible in this world as we know it? Having been provoked by this question and its implications ourselves, we deem this provocation both necessary and an important contribution to the topic of this special issue. Within this provocation we briefly consider decolonization of the psy-disciplines, decolonization of the psy-curriculum, and decolonization as the end of the world as we know it, particularly through a praxivist imaginary. With this, we furthermore consider the radical potentials of abolition pedagogies that guide us to state that mental health, or the psyche, or the professions that take the psyche as their object of study, cannot be decolonized in the context of the world as we know it.
Enshrined Fortification: A Trialogue on the Rise and Fall of Safed
Authors: Shachar Uri Zvi
Published: February 2020

The study of castles has formed a major part of crusade historiography since its inception in the early nineteenth century. Fortification has been taken to represent the magnificence of the efforts to rule the Holy Land and the battle between Christianity and Islam. Recently, however, scholars have recognised that, inasmuch as castles were celebrated as the epitomes of resilience and hostility, military architecture was far more dialogical than previously noticed. The design of castles involved a highly nuanced familiarity with the culture from which they were intended to defend. This article seeks to show that not only the physical characteristics of castles but also ideas about what made them religiously successful, in their capacity to enact and protect ritual spaces, were shaped through a dynamic inter-religious dialogue. Taking Safed as a case study, this article brings together three narratives—in Latin, Arabic and Hebrew—that share the attempt to laud the castle by drawing a dialectic between its strategic might and the sanctity of the soil upon which it is built. While the three accounts differ radically in their political stakes, the rhetorical strategies they employ in order to contemplate the spiritual efficacy of the castle is profoundly entangled.
Antiproliferative and proapoptotic effects of Inula viscosa extract on Burkitt lymphoma cell line
Authors: Virdis Patrizia , Migheli Rossana , Galleri Grazia , Fancello Silvia , Cadoni Maria Piera L , Pintore Giorgio , Petretto Giacomo Luigi , Marchesi Irene , Fiorentino Francesco Paolo , di Francesco Alessandra , Sanges Francesca , Bagella Luigi , Muroni Maria Rosaria , Fozza Claudio , De Miglio Maria Rosaria , Podda Luigi
Published: February 2020

Burkitt lymphoma is a very aggressive B-cell non-Hodgkin lymphoma. Although remarkable progress has been made in the therapeutic scenario for patients with Burkitt lymphoma, search and development of new effective anticancer agents to improve patient outcome and minimize toxicity has become an urgent issue. In this study, the antitumoral activity of Inula viscosa, a traditional herb obtained from plants collected on the Asinara Island, Italy, was evaluated in order to explore potential antineoplastic effects of its metabolites on Burkitt lymphoma. Raji human cell line was treated with increasing Inula viscosa extract concentration for cytotoxicity screening and subsequent establishment of cell cycle arrest and apoptosis. Moreover, gene expression profiles were performed to identify molecular mechanisms involved in the anticancer activities of this medical plant. The Inula viscosa extract exhibited powerful antiproliferative and cytotoxic activities on Raji cell line, showing a dose- and time-dependent decrease in cell viability, obtained by cell cycle arrest in the G2/M phase and an increase in cell apoptosis. The treatment with Inula viscosa caused downregulation of genes involved in cell cycle and proliferation (c-MYC, CCND1) and inhibition of cell apoptosis (BCL2, BCL2L1, BCL11A). The Inula viscosa extract causes strong anticancer effects on Burkitt lymphoma cell line. The molecular mechanisms underlying such antineoplastic activity are based on targeting and downregulation of genes involved in cell cycle and apoptosis. Our data suggest that Inula viscosa natural metabolites should be further exploited as potential antineoplastic agents against Burkitt lymphoma.
Boundaries, Bridges and Brands: A Comment on Alvesson, Hallett, and Spicer’s “Uninhibited Institutionalisms”
Authors: Kraatz Matthew S.
Published: February 2020

This essay responds to Alvesson, Hallett, and Spicer’s recent critique of the instiutional literature. While it affirms and extends some of their particular criticisms, I reject their bleak assessment of the larger field and find value in some of the very features that they find to be most objectionable. I also offer some alternative suggestions for reform and future development. These include an explicit embrace of theoretical pluralism, a renewed focus on values, and a return to institutionalism’s pragmatist roots.
Dislocation damage and adiabatic shear mechanisms of 7055 aluminum alloy during cutting process
Authors: Ping Zhang , Youqiang Wang , Qing Wang , Xiao Yu
Published: February 2020

This paper is intended to examine the dislocation and adiabatic shear mechanisms of 7055 aluminum alloy during cutting process with different cutting speeds. The result indicates that, at low cutting speeds, isometric dislocation cells appear, the dislocation cells are interconnected into dislocation cell blocks, and the dislocation movement is controlled by thermal activation; at high cutting speeds, dislocations mostly come in the form of elongated or not fully closed dislocation cells, and the dislocation movement is controlled by phonon drag; the width of an adiabatic shear band increases with the cutting speed, and low cutting speeds are more likely to result in microcracks. The precipitation-free zones on the grain boundary display a discontinuity under all cutting speeds; distribution and grain size of the precipitates also vary significantly.
Investigation of the unbiased probabilistic behavior of the fiber-reinforced concrete's elastic moduli using stochastic micromechanical approach
Authors: Liu XZ , Zhu HH , Ju JW , Chen Q , Jiang ZW , Yan ZG
Published: February 2020

The probabilistic behavior of the fiber-reinforced concrete is usually represented by the common probability density functions, which will lead to the biased results. This study aims to develop a stochastic multiphase micromechanical framework with Legendre orthogonal polynomial to investigate the unbiased probabilistic behavior of the fiber-reinforced concrete's moduli. The different phase volume fractions are analytically calculated based on the aggregate grading and the material's effective properties are quantitatively reached by employing the multilevel micromechanical homogenization schemes. The Monte Carlo simulations are adopted to attain the different order moments of fiber-reinforced concrete's effective properties, with which the unbiased probability density functions are reached by using the Legendre orthogonal polynomial approximations and the linear transformations. Numerical examples indicate that the proposed framework is accurate and computationally efficient to characterize the fiber-reinforced concrete's probabilistic behavior.
Prenatal Plasma Fibrinogen Level Predicts Postpartum Hemorrhage of Patients With HELLP Syndrome
Authors: Cui Chanjuan , Ma Sisi , Qiao Rui
Published: February 2020

Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a serious complication of pregnancy. Postpartum hemorrhage indicates poor prognosis of pregnant women with HELLP syndrome. The aim of our study is to investigate the predictive value of coagulation markers for postpartum hemorrhage of pregnant women with HELLP syndrome. In a retrospective cohort study, 106 patients who were diagnosed as pregnant women with HELLP syndrome in Peking University Third Hospital from August 2010 to January 2017 were analyzed. The demographic characters of maternal and fetus, days of hospital stay, postpartum complications, and the laboratory tests of coagulation markers within 3 days before delivery were collected. In addition, 100 healthy pregnant women were collected as a control group. The result showed that the incidence of preeclampsia in pregnant women with postpartum hemorrhage was higher than that in pregnant women without hemorrhage ( P = .011). The level of fibrinogen (FIB) in postpartum hemorrhage pregnant women with HELLP syndrome was lower than that in nonpostpartum hemorrhage pregnant women with HELLP syndrome and healthy pregnant women (2.3 [1.68-2.81] vs 3.64 ± 0.95, P = .000; 2.3 [1.68-2.81] vs 4.48 ± 0.62, P = .000). Multivariate analysis showed that decreased FIB levels independently predicted the postpartum hemorrhage of pregnant women with HELLP syndrome (odds ratio = 7.374, 95% confidence interval [CI], 1.551-35.05, P = .012). The receiver operating characteristic curve showed that the area under the curve of FIB level when predicting postpartum hemorrhage is 0.841 (95% CI, 0.708-0.976). When the cutoff value of FIB was 3.04 g/L, the sensitivity was 90.90% and the specificity was75.80%. Therefore, the low level of prenatal FIB is a reliable biomarker to predict postpartum hemorrhage of pregnant women with HELLP syndrome, which make it useful for pregnant women with HELLP syndrome in guiding surveillance therapy and prognosis assessment.
Narratives of power: Bringing ideology to the fore of planning analysis
Authors: Shepherd Edward , Inch Andy , Marshall Tim
Published: February 2020

This Special Issue starts from the premise that the concept of ideology holds significant analytical potential for planning but that this potential can only be realised if ideology is brought to the fore of analysis. By naming ideology and rendering it visible, we hope to bring it out from the shadows and into the open to examine its value and what it can tell us about the politics of contemporary planning. The articles in this Special Issue therefore seek to contribute to established academic debates by exploring some of the ways ideology can be deployed as a tool in the analysis of planning problems. This article introduces the Special Issue by exploring the various accounts in the articles of (1) what ideology is; (2) what its effects are; (3) where ideology may be identified and (4) what different theories of ideology can tell us about planning. There inevitably remain many un-answered questions, paths not taken and debates left unaddressed. We hope other scholars will be inspired (or provoked) to address these omissions in the future.
Principios Directrices y Desarrollo del Modelo Islandés para la Prevención del Uso de Sustancias en Adolescentes
Authors: Kristjansson Alfgeir L. , Mann Michael J. , Sigfusson Jon , Thorisdottir Ingibjorg E. , Allegrante John P. , Sigfusdottir Inga Dora
Published: February 2020

Resumen

El uso de sustancias por los adolescentes (i.e. el consumo de alcohol, tabaco, y otras drogas), persiste como un problema global, y se mantiene como un desafío para nuestras sociedades y autoridades de salud pública. Como respuesta a las altas tasas de uso de sustancias en adolescentes en los años ‘90, en Islandia han sido pioneros en el desarrollo del Modelo Islandés Para la Prevención Primaria del Uso de Substancias – un método basado en la teoría y evidencia científica que ha demostrado su efectividad en bajar los niveles de consumo en Islandia en los últimos 20 años. Para documentar este método e informar sobre los procesos basados-en-la-práctica que puedan ayudar en establecer este modelo en otros países, describimos esquemáticamente en esta serie de dos partes la teoría, antecedentes, principios directrices del método, y los pasos centrales en la implementación exitosa del modelo. En este artículo describimos los antecedentes y contexto necesarios, la orientación teórica, el desarrollo del método, y brevemente revisamos los hallazgos y datos publicados. Adicionalmente, presentamos los cinco principios guía en los que se basa el método del Modelo de Prevención Islandés para la prevención del uso de sustancias en adolescentes, y discutimos la evidencia acumulada que apoya la efectividad del modelo. En el siguiente artículo, parte 2, identificamos y describimos procesos clave en el modelo y los diez pasos centrales de la implementación efectiva y basada en la práctica de este modelo.
Innominate to contralateral brachial artery bypass via ministernotomy with anatomic tunneling for critical ischemia of the left upper extremity
Authors: Sharp Alexandra J , Sharafuddin Mel J
Published: February 2020

Objectives

Scarring from prior bypass surgery and irradiation may compromise revascularization options in critical ischemia due to underlying occlusive disease. Occlusive disease of the axillo-brachial artery is particularly difficult to revascularize under such hostile conditions.

Method

We present a case of a 58-year-old woman presenting with a painful, pulseless, and cool left upper extremity. The patient had a known history of left upper extremity occlusive disease which was managed by subclavian–axillary artery stenting with re-occlusion and subsequent extra-anatomic left carotid-to-proximal brachial artery prosthetic bypass, which was complicated by stroke. The patient had a history of left mastectomy, axillary node dissection, and external beam radiation therapy. When considering revascularization options, the combination of post-radiation changes and scarring of the conventional operative zones for revascularization posed a high risk for complications. We describe a novel approach for such revascularization, where the inflow source was the terminal brachiocephalic artery, outflow to the upper left brachial artery, with anatomic intrathoracic-to-axillary tunneling through the thoracic outlet after verifying the lack of dynamic extrinsic compression at that level.

Result

The procedure resulted in resolution of the symptoms and the patient continued to do well 2 years later.

Conclusion

This case shows that anatomic tunneling through the thoracic outlet can be a viable option for upper extremity revascularization when hostile conditions preclude other anatomic tunneling routes or extra-anatomic options.
A realistic flow phantom model of the carotid artery in preterm infants for training and research
Authors: Pereira Sujith , Reeves Jonathan , Birch Malcolm , Finton-James Sakthi , Verma Komal , Krug Robert , Sinha Ajay , Kempley Stephen
Published: February 2020

Introduction

Cerebral blood flow is increasingly monitored in preterm infants. Doppler ultrasound of the carotid artery is a widely available method but is operator dependent. Our aim was to design and produce a realistic flow phantom model of the carotid artery of preterm infants.

Methods

Data from cerebral blood flow measurements using Doppler ultrasound of the right common carotid artery from 21 premature newborn infants were used to produce a Doppler flow phantom model with three different vessel diameters. Vessel diameter, continuous and pulsatile flow volume measurements were performed by two blinded observers (with more than eight and 20 years of experience).

Results

Vessel diameter measurements using the phantom were underestimated by 7%. Continuous flow volume measurements were overestimated by 7% by both observers (observer 1 mean difference 1.5 ± 1.96 SD −3.3 to 6.3 ml/min versus observer 2, 1.9 ± 1.96 SD −3.6 to 7.4 ml/min). Pulsatile flow measurements were overestimated by 12.6% by observer 1 (2.7 ± 1.96 SD −0.6 to 5.9 ml/min) and by 7.8% by observer 2 (1.7 ± 1.96 SD −1.6 to 4.9 ml/min). There was good interobserver and intraobserver reliability for the majority of measurements using continuous and pulsatile flow.

Conclusion

It is feasible to produce a realistic flow phantom model of the neonatal carotid artery of preterm infants. Diameter measurements were underestimated and flow measurements were overestimated. These errors fell within acceptable limits for in vivo measurements. If these limitations were related to materials, this could be explored using a wall-less model. The flow phantom could be utilised for research and training clinicians in measuring cerebral blood flow using the carotid artery in this vulnerable group of infants.
Searching for the Big Pictures
Authors: Reed Stephen K.
Published: February 2020

My goal in searching for the big pictures is to discover novel ways of organizing information in psychology that will have both theoretical and practical significance. The first section lists my reasons for writing each of five articles. The second section discusses an additional five articles that integrate advancements in artificial intelligence and cognitive psychology. The following two sections elaborate on my collaboration with ontologists to use formal ontologies to organize psychological knowledge, including the National Institute of Mental Health Research Domain Criteria, for formulating a biological basis for mental illness. I next discuss strategies for writing integrative articles. The following section describes the helpfulness of the integrations for making psychology relevant to a general audience. I conclude with recommendations for creating breadth in doctoral training.
Jane Austen Goes to Drury Lane: Identifying Individuals in a Late Georgian Audience
Authors: Worrall David
Published: February 2020

This essay identifies the theatre box where the novelist, Jane Austen (1775–1817), sat in 1814 to watch Edmund Kean in Shakespeare’s The Merchant of Venice. The Folger Shakespeare Library’s Drury Lane Box Book enables calendar analysis of box occupancy with names, titles and, occasionally, addresses. Critical practice has tended to treat audiences as undifferentiated groups. Assemblage theory makes it possible to conceptualise individuals in audiences as equivalent to audiences in their entirety. Sitting in the same box as Austen was Lady Cecil Copley (1770–1819), the divorced 1st Marchioness of Abercorn. Amongst the other boxes were parties formed by wives of army and naval personnel and a British consul to Brazil. A few boxes away sat Jane Akers, née Ramsay (1772–1842), the wife of a St Kitts slave owner. Akers later claimed compensation under the 1833 Slavery Abolition Act. That weekend Austen had with her the manuscript of Mansfield Park (1814), a novel recognised as a critique of a fictional parkland estate sustained by slavery. Given the steep cultural differentials evident in this single box tier, it is argued theatrical performance, even in Kean’s re-evaluation of Shylock, may have been only tangential in altering the behaviour of that night’s audience.
Sexual assault
Authors: Kumar Monica
Published: February 2020

As GPs we provide life-long care for patients. This provides an opportunity to sensitively and meaningfully help victims of sexual assault and can have a profound impact on patients, their families, and society. Many patients present late, due to fears of sharing their story and a lack of faith in organisations. This article aims to discuss the impact of sexual assault, and provide a practical approach to identifying and managing sexual assault in primary care. We will discuss the role of the sexual assault referral centres and additional resources available to support patients and doctors.
Supporting carers
Authors: Spencer Sarah , Swinglehurst Deborah
Published: February 2020

The number of individuals who provide unpaid care across the UK is rising: it currently stands at approximately 8 800 000 people. Some carers can experience a cycle of financial difficulty, isolation, physical and mental ill health. Recommendations for support of this marginalised group have become enshrined in national health policy and GPs have a pivotal role in delivering this help. Involving carers in management plans and providing appropriate support can improve a carer’s wellbeing, and reduce avoidable hospital admissions and residential placements, thus, enabling people to live independent lives for longer. Every caring circumstance is different. In order to provide appropriate, tailored, timely support there needs to be individual identification, assessment and support of carers.
Changing Patterns of Factionalism in Indonesia: From Principle to Patronage
Authors: Fionna Ulla , Tomsa Dirk
Published: February 2020

Party politics in Indonesia’s current democratic regime takes place within the parameters of a heavily fragmented multi-party system. Factionalism exists in most parties, but the influence of factions on internal party dynamics is only weak to moderate. Where factions exist, they are usually driven by clientelism and patronage rather than the representation of social cleavages, ideological differences, or regional affiliations, although traces of programmatically infused factionalism do persist in some parties. The intensity of factional conflicts in Indonesia’s young democracy has varied significantly over time and across different parties. While temporal variations are mostly related to changing institutional incentive structures, disparities between individual parties can be attributed to different organisational histories and structures as well as divergent levels of rootedness in social cleavage structures. It is noteworthy that several Indonesian parties have relatively deep roots in society and, in some cases, close links to long-established civil society organisations that preceded party formation. Given these constraints on more severe factionalism, damaging effects on governance have been fairly limited. The most debilitating effects of factionalism have been felt within the parties themselves, whereas government effectiveness and coalition formation has, ironically, sometimes benefitted from factional disputes.
Pre-screening the intrinsic angiogenic capacity of biomaterials in an optimised ex ovo chorioallantoic membrane model
Authors: Kohli Nupur , Sawadkar Prasad , Ho Sonia , Sharma Vaibhav , Snow Martyn , Powell Sean , Woodruff Maria A , Hook Lilian , García-Gareta Elena
Published: February 2020

Biomaterial development for clinical applications is currently on the rise. This necessitates adequate in vitro testing, where the structure and composition of biomaterials must be specifically tailored to withstand in situ repair and regeneration responses for a successful clinical outcome. The chorioallantoic membrane of chicken embryos has been previously used to study angiogenesis, a prerequisite for most tissue repair and regeneration. In this study, we report an optimised ex ovo method using a glass-cling film set-up that yields increased embryo survival rates and has an improved protocol for harvesting biomaterials. Furthermore, we used this method to examine the intrinsic angiogenic capacity of a variety of biomaterials categorised as natural, synthetic, natural/synthetic and natural/natural composites with varying porosities. We detected significant differences in biomaterials’ angiogenesis with natural polymers and polymers with a high overall porosity showing a greater vascularisation compared to synthetic polymers. Therefore, our proposed ex ovo chorioallantoic membrane method can be effectively used to pre-screen biomaterials intended for clinical application.
Sternoclavicular joint septic arthritis presenting as cervical abscess and subcutaneous emphysema: A case report
Authors: Fornwalt Brandon E , Goosmann Madeline , Reynolds Stephen , Bunevich Jared D
Published: February 2020

Sternoclavicular joint septic arthritis results from hematogenous spread of a bacterial infection, usually in the immunocompromised. It commonly presents as a chest wall abscess. Cervical abscess resulting from sternoclavicular joint septic arthritis is a rare complication with only one reported case in the English literature. We describe a case of sternoclavicular joint septic arthritis in an elderly diabetic adult with cervical abscess as initial presentation.
Sterile osteomyelitis in the ulnar diaphysis of a young indoor cat
Authors: Sainato Domenico , Cinti Filippo , Renfrew Helen
Published: February 2020

Case summary

A 3-year-old neutered male indoor British Shorthair cat was referred for a 2-week history of intermittent right forelimb lameness. Radiographic examination showed a diaphyseal monostotic, expansile, fusiform, lytic lesion in the right ulna. CT further defined the lesion and also demonstrated ipsilateral pulmonary consolidation. Histology was conclusive of osteomyelitis, and microbiology and fluorescence in situ hybridisation analysis (FISH) were negative on aerobic and anaerobic bacterial culture, as well as fungal culture. Clinical and radiographic improvement was seen after anti-inflammatory treatment and a short initial period of antibiosis.

Relevance and novel information

This is an unusual monostotic diaphyseal cortical location for osteomyelitis in cats and, moreover, may represent a rare case of sterile osteomyelitis. To our knowledge, non-traumatic osteomyelitis in this location in cats has not been reported in the veterinary literature.
Excess abdominal fat is associated with cutaneous allodynia in individuals with migraine: a prospective cohort study
Authors: Mínguez-Olaondo Ane , Martínez-Valbuena Iván , Romero Sonia , Frühbeck Gema , Luquin María Rosario , Martínez-Vila Eduardo , Irimia Pablo
Published: February 2020

Objective

To investigate the specific relationship between cutaneous allodynia (CA) and the percentages of body fat (BF) and abdominal fat in migraineurs. Additionally, we compared serum levels of inflammatory biomarkers in patients with and without CA.

Background

Excess abdominal fat might facilitate progressive changes in nociceptive thresholds causing central sensitization, clinically reflected as CA, which could drive migraine progression.

Methods

This prospective cohort study included 80 patients with migraine (mean age 39 years, 81.2% female) and 39 non-migraine controls. We analysed each participant’s height, body weight, and body mass index (BMI). The amount and distribution of BF was also assessed by air displacement plethysmography (ADP) and ViScan, respectively. We analysed serum levels of markers of inflammation, during interictal periods.

Results

We studied 52 patients with episodic migraine (EM) and 28 with chronic migraine (CM). Of the 80 patients, 53 (53.8%) had CA. Migraineurs with CA had a higher proportion of abdominal fat values than patients without CA (p = 0.04). The independent risk factors for CA were the use of migraine prophylaxis (OR 3.26, 95% CI [1.14 to 9.32]; p = 0.03), proportion of abdominal fat (OR 1.13, 95% CI [1.01 to 1.27]; p = 0.04), and presence of sleep disorders (OR 1.13, 95% CI [00.01 to 1.27]; p = 0.04). The concordance correlation coefficient between the ADP and BMI measurements was 0.51 (0.3681 to 0.6247). CA was not correlated with the mean plasma levels of inflammatory biomarkers.

Conclusions

There is a relation between excess abdominal fat and CA. Abdominal obesity might contribute to the development of central sensitization in migraineurs, leading to migraine chronification.
Home-based telemonitoring versus hospital admission in high risk pregnancies: a qualitative study on women’s experiences
Authors: van den Heuvel J. F. M. , Teunis C. J. , Franx A. , Crombag N. M. T. H. , Bekker M. N.
Published: February 2020

Background

Hospital admission during pregnancy complications is considered to be an event of significant impact. Besides conventional in-clinic maternal and fetal monitoring, recent technologies enable home-based telemonitoring with self-measurements in high risk pregnancy. This study is part of a feasibility pilot to explore the usability and acceptability of telemonitoring and aims to gain insight in the experiences and preferences of high risk pregnant women concerning the novel strategy of telemonitoring, opposed to women who were hospitalized in pregnancy.

Methods

Using secured Facebook Groups, we conducted four online focus groups: two focus groups with women who were admitted during pregnancy (n = 11) and two with women who received home telemonitoring in the pilot phase (n = 11). The qualitative data were analyzed thematically.

Results

Four major themes emerged from both participant groups: [1] care experience, [2] emotions regarding pregnancy, [3] privacy and [4] impact on daily life. Different views were reported on all four themes, resulting in a direct comparison of experiences during hospitalization and telemonitoring. Most admitted patients reported a growing sense of boredom and anxiety during their clinical admission. Lack of privacy on ward was a great concern, as it affected their contact with hospital staff and family. This issue was not reported amongst telemonitored women. These participants still felt like a patient at times but responded that the comfort of their own home and bed was pleasant. Only a minority of telemonitored participants reported being anxious at times at home, while not having a physician or nurse nearby. Being at home resulted in less travel time for partners or family for hospital visits, which had its positive effects on family life.

Conclusions

Telemonitoring of a high-risk pregnancy provides an innovative manner to monitor fetal and maternal condition from home. Compared to the experiences of hospital admission in high risk pregnancy, it allows women to be in a comforting and private environment during an anxious time in their lives. As future studies should further investigate the safety and cost effectiveness of this novel strategy, women’s views on the preference of telemonitoring need to be taken into consideration.
AMLVaran: a software approach to implement variant analysis of targeted NGS sequencing data in an oncological care setting
Authors: Wünsch Christian , Banck Henrik , Müller-Tidow Carsten , Dugas Martin
Published: February 2020

Background

Next-Generation Sequencing (NGS) enables large-scale and cost-effective sequencing of genetic samples in order to detect genetic variants. After successful use in research-oriented projects, NGS is now entering clinical practice. Consequently, variant analysis is increasingly important to facilitate a better understanding of disease entities and prognoses. Furthermore, variant calling allows to adapt and optimize specific treatments of individual patients, and thus is an integral part of personalized medicine.However, the analysis of NGS data typically requires a number of complex bioinformatics processing steps. A flexible and reliable software that combines the variant analysis process with a simple, user-friendly interface is therefore highly desirable, but still lacking.

Results

With AMLVaran (AML Variant Analyzer), we present a web-based software, that covers the complete variant analysis workflow of targeted NGS samples. The software provides a generic pipeline that allows free choice of variant calling tools and a flexible language (SSDL) for filtering variant lists. AMLVaran’s interactive website presents comprehensive annotation data and includes curated information on relevant hotspot regions and driver mutations. A concise clinical report with rule-based diagnostic recommendations is generated.An AMLVaran configuration with eight variant calling tools and a complex scoring scheme, based on the somatic variant calling pipeline appreci8, was used to analyze three datasets from AML and MDS studies with 402 samples in total. Maximum sensitivity and positive predictive values were 1.0 and 0.96, respectively. The tool’s usability was found to be satisfactory by medical professionals.

Conclusion

Coverage analysis, reproducible variant filtering and software usability are important for clinical assessment of variants. AMLVaran performs reliable NGS variant analyses and generates reports fulfilling the requirements of a clinical setting. Due to its generic design, the software can easily be adapted for use with different targeted panels for other tumor entities, or even for whole-exome data. AMLVaran has been deployed to a public web server and is distributed with Docker scripts for local use.
Correction to: Screening for posttraumatic stress disorder in ARDS survivors: validation of the impact of event Scale-6 (IES-6)
Authors: Hosey Megan M. , Leoutsakos Jeannie-Marie S. , Li Ximin , Dinglas Victor D. , Bienvenu O. Joseph , Parker Ann M. , Hopkins Ramona O. , Needham Dale M. , Neufeld Karin J.
Published: February 2020

In the publication of this article [1], there is an error in the Abstract. This has now been included in this correction article.
R-spondin 2 mediates neutrophil egress into the alveolar space through increased lung permeability
Authors: Jackson S. R. , Costa M. F. D. M. , Pastore C. F. , Zhao G. , Weiner A. I. , Adams S. , Palashikar G. , Quansah K. , Hankenson K. , Herbert D. R. , Vaughan A. E.
Published: February 2020

Objective

R-spondin 2 (RSPO2) is required for lung morphogenesis, activates Wnt signaling, and is upregulated in idiopathic lung fibrosis. Our objective was to investigate whether RSPO2 is similarly important in homeostasis of the adult lung. While investigating the characteristics of bronchoalveolar lavage in RSPO2-deficient (RSPO2−/−) mice, we observed unexpected changes in neutrophil homeostasis and vascular permeability when compared to control (RSPO2+/+) mice at baseline. Here we quantify these observations to explore how tonic RSPO2 expression impacts lung homeostasis.

Results

Quantitative PCR (qPCR) analysis demonstrated significantly elevated myeloperoxidase (MPO) expression in bronchoalveolar lavage fluid (BALF) cells from RSPO2−/− mice. Likewise, immunocytochemical (ICC) analysis demonstrated significantly more MPO+ cells in BALF from RSPO2−/− mice compared to controls, confirming the increase of infiltrated neutrophils. We then assessed lung permeability/barrier disruption via Fluorescein Isothiocyanate (FITC)-dextran instillation and found a significantly higher dextran concentration in the plasma of RSPO2−/− mice compared to identically treated RSPO2+/+ mice. These data demonstrate that RSPO2 may be crucial for blood-gas barrier integrity and can limit neutrophil migration from circulation into alveolar spaces associated with increased lung permeability and/or barrier disruption. This study indicates that additional research is needed to evaluate RSPO2 in scenarios characterized by pulmonary edema or neutrophilia.