bluuebunny/crossref_metadata_2025 huggingface dataset:
Physiognomy
Authors: Leunissen Mariska
Published: July 2018

The chapters delineates the content of the ancient science of determining someone’s innate character on the basis of their outward, and hence observable, bodily features. Greek culture tended to assume that correspondence between body and character was no accident. Likewise, the practice of attributing character traits associated with a particular animal species to a person based on similarities in their physique was first formalized in physiognomy, but was already widely used in a nontechnical way in ancient literature. The chapter focuses on physiognomy as a formalized and technical discipline.
The Greek Neoplatonist Commentators on Aristotle
Authors: Griffin Michael
Published: July 2018

Greek Neoplatonist commentators on Aristotle practiced philosophy and science in the third through seventh centuries ce by performing innovative exegesis of Aristotle’s works. To investigate nature is, for the commentators, to read with understanding Aristotle’s treatises in a set curriculum, with a commentary and teacher. Therefore, a mature philosopher would often prove to be a capable commentator, or interpreter, who could foster the reading of the primary texts with charity and objectivity, eliciting the author’s meaning through paraphrase, lemmatized discussion, and a critically evaluated doxography of the puzzles presented by the text. On the Neoplatonist account, the system expounded in Aristotle’s treatises is uniform and consistent, and is harmonious with the philosophy expounded in Plato’s dialogues. This chapter surveys concepts in the commentators including nature (phusis), biological reproduction, the five or four elements, dynamics and Philoponus’ impetus, natural place and three-dimensional space, modes of causation, teleology, time, cosmogony, and cosmology.
Roman Medical Sects
Authors: Caldwell Lauren
Published: July 2018

The chapter treats the three chief medical sects that began in the first through third centuries ce of the Roman period, the Asclepiadeans, the Methodists, and the Pneumatists, based primarily on the hostile witness of Galen (we have few or no other sources). Physicians’ participation in debates suggests how sectarian membership may have advanced the careers of the physicians who offered their services in an unregulated and rather chaotic market and hoped to attract the patronage of aristocrats. Individual teachers, not formal institutions, served as guardians of the doctrines of the sects. The rise and spread of intellectual ideas and debate in the Roman Empire depended on teacher-student relationships and personal connections. Although social bonds did not necessarily stand in the way of debate and study, Galen suggested that the system’s reliance on individuals could impede the advancement of ideas by prioritizing personal loyalties over intellectual rigor.
Medical Sects
Authors: Stok Fabio
Published: July 2018

The chapter treats the three chief medical sects, or schools, of the Hellenistic period, the schools founded by Herophilus, and by Erasistratus, and the Empiricists. The anatomical research of Herophilus and Erasistratus remained an exceptional case throughout antiquity because of the use they made of dissection. The Library fostered the growing production and circulation of books and conferred importance to written communication. That, plus the debates and controversies aroused by the many scientists and practitioners in the same city, promoted the formation of groups of physicians and students, united by a doctrine and by confidence in a teacher. Herophilus and Erasistratus opened schools in their homes, and Philinus, a defector from the Herophilus’ school, founded the Empiricist sect.
Music and Harmonic Theory
Authors: Hagel Stefan
Published: July 2018

The chapter studies ancient Greek music theory, primarily of the 5th and 4th centuries bce and throughout the Hellenistic and Greco-Roman eras. Instruments that must be tuned, either during manufacturing or right before performance, prompt reflection on pitch relations. Stringed instruments, which require repeated tuning, form the background of the earliest testimonies of “western” musical terminology, preserved in cuneiform texts from the second millennium bce. In the Greek world, an outburst of music-theoretical activity began around 500 bce, crystalizing, after about two centuries of lively discussion, in theoretical edifices whose principles remained largely unchallenged until late antiquity. Musical scales were the concern of the science named harmoniké, whereas other aspects of music-making are harder to analyze. Two harmonic traditions existed, one called “Pythagorean” emphasizing numerical ratios, and the other associated with Aristoxenus, focusing on musical perception. Both were explored and amplified in the Hellenistic and Greco-Roman eras, especially by Ptolemy.
Polycystic Ovary Syndrome
Authors: Azziz Ricardo
Published: July 2018

Polycystic ovary syndrome (PCOS) is a highly prevalent disorder, representing the single most common endocrine–metabolic disorder in reproductive-aged women. Currently there are four recognized phenotypes of PCOS: 1) hyperandrogenism+oligo-anovulation+polycystic ovarian morphology; 2) hyperandrogenism+oligo-anovulation; 3) hyperandrogenism+polycystic ovarian morphology; and 4) oligo-anovulation+polycystic ovarian morphology, each with different long-term health and metabolic implications. Clinicians should clearly denote a patient's phenotype when making the diagnosis of PCOS. Polycystic ovary syndrome is a highly inherited complex polygenic, multifactorial disorder. Pathophysiologically abnormalities in gonadotropin secretion or action, ovarian folliculogenesis, steroidogenesis, insulin secretion or action, and adipose tissue function, among others, have been described in PCOS. Women with PCOS are at increased risk for glucose intolerance and type 2 diabetes mellitus; hepatic steatosis and metabolic syndrome; hypertension, dyslipidemia, vascular thrombosis, cerebrovascular accidents, and possibly cardiovascular events; subfertility and obstetric complications; endometrial atypia or carcinoma, and possibly ovarian malignancy; and mood and psychosexual disorders. The evaluation of patients suspected of having PCOS includes a thorough history and physical examination, assessment for the presence of hirsutism, ovarian ultrasonography, and hormonal testing to confirm hyperandrogenism and oligo-anovulation as needed and to exclude similar or mimicking disorders. Therapeutic decisions in PCOS depend on the patients' phenotype, concerns, and goals, and should focus on 1) suppressing and counteracting androgen secretion and action, 2) improving metabolic status, and 3) improving fertility. However, despite significant progress in understanding the pathophysiology and diagnosis of the disorder over the past 20 years, the disorder remains underdiagnosed and misunderstood by many practitioners.
Temporal Differences in Utilization of Intracytoplasmic Sperm Injection Among U.S. Regions
Authors: Zagadailov Pavel , Hsu Albert , Stern Judy E. , Seifer David B.
Published: July 2018

OBJECTIVE:

To analyze changes in intracytoplasmic sperm injection (ICSI) utilization, indications, and outcomes across U.S. regions.

METHODS:

We conducted a retrospective cohort study. Data sets for 2000–2014 were obtained from the Centers for Disease Control and Prevention. Clinics with 100 or greater fresh, nondonor cycles were grouped by 10 nationally recognized Department of Health and Human Services (DHHS) regions and were compared for use of ICSI, frequency of male factor infertility, preimplantation genetic therapies, pregnancy, and live birth rates per cycle among fresh in vitro fertilization cycles in women younger than 35 years of age.

RESULTS:

Nationwide ICSI utilization increased 52% (46.3±6.1% to 70.0±7.1%) from 2000 to 2014, whereas pregnancy and live birth rates per cycle modestly increased by 8.5% (39.2±3.8% to 42.5±2.5%) and 7.6% (34.4±3.6% to 37±2.6%), respectively, showing a positive correlation (r=0.78, P<.001; r=0.76, P=.001) with ICSI rates per clinic. All DHHS Services regions demonstrated increases in ICSI utilization over time, although the magnitude of increase varied in different regions. Regions also had similarities in trends for pregnancy and live birth rates per cycle in women younger than 35 years. There was no correlation between male factor and ICSI rates per clinic from 2000 to 2010 (r=0.32, P=.33) or 2011 to 2014 (r=0.85, P=.068). From 2007 to 2014, ICSI and preimplantation genetic testing did not demonstrate a strong correlation (r=0.68, P=.062).

CONCLUSION:

From 2000 to 2014, ICSI rates per clinic significantly varied among geographic regions. Increased use of ICSI did not correlate with an increase in male factor diagnoses. These findings suggest that ICSI may be overused, because its use is not accompanied by proportionate increases in medical indications or effectiveness.
Hodgkin lymphoma in elderly patients
Authors: Borchmann Sven , Engert Andreas , Böll Boris
Published: July 2018

Purpose of review

We aim to summarize the current knowledge on the treatment of elderly Hodgkin lymphoma patients with a focus on evidence from clinical trials and novel drugs.

Recent findings

For elderly Hodgkin lymphoma patients above 60 years without precluding comorbidities a curative treatment approach is warranted. Early favorable stage patients should receive two cycles of multiagent chemotherapy followed by 20 Gy localized radiotherapy. Early unfavorable stage patients should receive four cycles of multiagent chemotherapy followed by 30 Gy localized radiotherapy. For advanced stage patients six cycles of multiagent chemotherapy can be recommended and should be followed by localized radiotherapy on residual disease manifestations. Relapsed or refractory patients should be treated in an individually tailored approach that considers both the patient's objectives and comorbidities. The antibody–drug conjugate brentuximab vedotin is a very effective option for elderly patients with a high response rate albeit limited durability. Anti-programed cell death protein 1 antibodies might also be effective in elderly Hodgkin lymphoma patients with a mechanism of action distinct from chemotherapy.

In conclusion, the goal of treatment in newly diagnosed elderly Hodgkin lymphoma patients is curative whenever possible and prospective and retrospective evidence has shown that this is feasible for all disease stages with a variety of multiagent chemotherapy regimen. Relapsed and refractory elderly Hodgkin lymphoma patients can mostly only be treated with the goal of palliation. However, it remains to be seen if novel substances and new combination regimen are able to change that.
Targeting CD47 as a cancer therapeutic strategy: the cutaneous T-cell lymphoma experience
Authors: Folkes Alecia S. , Feng Mingye , Zain Jasmine M. , Abdulla Farah , Rosen Steven T. , Querfeld Christiane
Published: July 2018

Purpose of review

To describe the relevance of CD47 in the tumor microenvironment and summarize data on anti-CD47 therapies, including its role in cutaneous T-cell lymphoma (CTCL).

Recent findings

CD47 is expressed on all normal cells and targets SIRPα on the surface of myeloid cells. However, CD47 is found to be overexpressed on cancer cells. CD47–SIRPα interaction inhibits macrophage phagocytosis, allowing cancer cells to escape immune surveillance. Current focus in immunotherapy has been targeted toward inhibiting CD47–SIRPα interaction via anti-CD47 antibodies. This activates innate immunity, promoting cancer cell destruction by macrophages. It also activates adaptive immunity resulting in antigen-presentation, mostly by dendritic cells, leading to antitumor cytotoxic reactions. Current CD47 antagonists undergoing clinical trials include Hu5F9 (an anti-CD47 antibody that directly inhibits the CD47–SIRPα interaction) and TTI-621, (a fusion protein composed of CD47 binding domain of human SIRPα and linked to the Fc region of IgG1). These agents have continued to show strong efficacy against solid and hematological tumors.

In the CTCL tumor microenvironment, increased immune checkpoint inhibition expression via CD47 bound to SIRPα correlates with a more advanced disease state. Continued success in treating these patients requires further studies on CD47 antagonists, specifically when combined with other antibodies.
Serum androgen profiles in women with premature ovarian insufficiency: a systematic review and meta-analysis
Authors: Soman Midhun , Huang Li-Cong , Cai Wen-Hui , Xu Jun-Bi , Chen Jun-Yao , He Ren-Ke , Ruan Heng-Chao , Xu Xiang-Rong , Qian Zhi-Da , Zhu Xiao-Ming
Published: July 2018

Objective:

This meta-analysis aims to investigate serum androgen profiles (testosterone, dehydroepiandrosterone sulfate, androstenedione, and sex hormone-binding globulin) in women with premature ovarian failure and to establish if there is evidence of diminished androgen levels in these women.

Methods:

Various Internet sources of PubMed, Cochrane library, and Medline were searched systematically until February, 2018. Out of a pool of 2,461 studies, after applying the inclusion/exclusion criterion, 14, 8, 10, and 9 studies were chosen for testosterone, dehydroepiandrosterone sulfate, androstenedione, and sex hormone-binding globulin, respectively, for this meta-analysis. The effect measure was the standardized mean difference with 95% confidence interval (95% CI) in a random-effects model.

Results:

The testosterone concentrations in premature ovarian insufficiency were compared with fertile controls: stamdard mean difference (IV, random, 95% CI) −0.73 [−0.99, −0.46], P value < 0.05. The dehydroepiandrosterone sulfate concentrations in premature ovarian insufficiency compared to fertile controls: standard mean difference (IV, random, 95% CI) −0.65 [−0.92, −0.37], P value < 0.05. Androstenedione in premature ovarian insufficiency were compared with fertile controls: standard mean difference (IV, random, 95% CI) −1.09 [−1.71, −0.48], P value < 0.05. Sex hormone-binding globulin levels did not show statistical significance. The dehydroepiandrosterone sulfate levels were reduced in premature ovarian insufficiency cases, but still showed a higher level than in postmenopausal women.

Conclusions:

Women with premature ovarian insufficiency are at risk for decreased concentrations of testosterone, dehydroepiandrosterone sulfate, and androstenedione. Dehydroepiandrosterone sulfate levels were more reduced in postmenopausal controls when compared with premature ovarian insufficiency cases.
The many menopauses: searching the cognitive research literature for menopause types
Authors: Edwards Hannaford , Duchesne Annie , Au April S. , Einstein Gillian
Published: July 2018

Objective:

Recent evidence suggests that early or induced menopause increases the risk for cognitive impairment and dementia. Given the potential for different cognitive outcomes due to menopause types, it is important that present research on menopause and cognition distinguishes between types. The aim of this project was to determine to what extent research looking at cognition in postmenopausal women published in one year, 2016, accounted for menopausal type.

Methods:

We searched MEDLINE, EMBASE, and PsychINFO using keywords and MeSH terms for menopause and cognition. We included any research paper reporting a cognitive outcome measure in a menopausal human population. Differentiation between the types of menopause was defined by four categories: undifferentiated, demographic differentiation (menopause type reported but not analyzed), partial differentiation (some but not all types analyzed), and full differentiation (menopause types factored into analysis, or recruitment of only one type).

Results:

Fifty research articles were found and analyzed. Differentiation was distributed as follows: undifferentiated, 38% (19 articles); demographic differentiation, 16% (8); partial differentiation, 28% (14); and full differentiation, 18% (9).

Conclusions:

This review revealed that although some clinical studies differentiated between the many menopauses, most did not. This may limit their relevance to clinical practice. We found that when menopause types are distinguished, the differing cognitive outcomes of each type are clarified, yielding the strongest evidence, which in turn will be able to inform best clinical practice for treating all women.
Functional Improvement with Free Vascularized Toe-to-hand Proximal Interphalangeal (PIP) Joint Transfer
Authors: Kuzu İsmail Melih , Kayan Reşit Burak , Öztürk Kahraman , Güneren Ethem
Published: July 2018

Background:

Reconstruction of small joints of fingers is still challenging in hand surgery. Implant arthroplasty and arthrodesis have some limitations in the reconstruction of small finger joints. Free vascularized PIP joint transfer from second toe to finger is a promising autogenous reconstructive alternative.

Methods:

In this prospective study, 7 cases of free vascularized PIP joint transfer were analyzed. The measurements for active and passive range of motion (ROM), grip, and pinch strength has been done preoperatively and 1-year postoperatively. The functional change in daily life quality and work-related activities was evaluated with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

Results:

Mean follow-up period was 20.3 months (12–25). Preoperative mean active and passive ROM values were 3.6° (0–14°) and 11.9° (0–29°), respectively. Postoperative 1-year measurements revealed a mean active ROM of 24.1° and a mean passive ROM of 31.6°. Mean grip and pinch strength increased from 52.1 to 58.6 lbs and from 5.1 to 5.9 lbs, respectively. Mean preoperative and postoperative DASH-scores were 41.3 and 30.3.

Conclusion:

The improvement in ROM, increasing grip strength, and declining DASH scores in our study support that free vascularized joint transfer improves patients’ daily life quality and work-related activities via providing a functional joint if performed with appropriate indications, careful planning, and meticulous surgical execution. Free vascularized joint transfer provides an autogenous, painless, mobile, and stable joint. It also has the advantages of composite tissue reconstruction and lacks the disadvantages of arthrodesis and synthetic joint implants.
Electrophysiological characterisation of central sensitisation in canine spontaneous osteoarthritis
Authors: Hunt James R. , Goff Megan , Jenkins Helen , Harris John , Knowles Toby G. , Lascelles B. Duncan X. , Enomoto Masataka , Mendl Michael , Whay Helen R. , Murrell Joanna C.
Published: July 2018

In man, central sensitisation (CS) contributes to the pain of osteoarthritis (OA). Dogs with spontaneous OA may also exhibit CS. Electrophysiological reflex measurements are more objective than behavioural assessments and can be used to evaluate CS in preclinical and clinical studies. It was hypothesised that dogs suffering from OA would exhibit electrophysiological characteristics indicative of CS, associated with reduced diffuse noxious inhibitory controls (DNICs). One hundred and seventeen client-owned dogs were recruited to the study. Hind limb nociceptive withdrawal reflex thresholds, stimulus response, and temporal summation characteristics were recorded, during alfaxalone anaesthesia, from 46 OA dogs, 29 OA dogs receiving nonsteroidal anti-inflammatory drugs (OANSAIDs), and 27 breed- and weight-matched control dogs. Efficacy of DNIC was evaluated in 12 control and 11 of the OA dogs, by application of a mechanical conditioning stimulus to the contralateral forelimb. Nociceptive withdrawal reflex thresholds were higher in OA compared with control dogs (P = 0.02). Stimulus response characteristics demonstrated an augmented response in OANSAID dogs compared with OA (P < 0.001) and control (P < 0.001) dogs. Temporal summation demonstrated exaggerated C-fibre-mediated responses in both OA (P < 0.001) and OANSAID (P = 0.005) groups, compared with control animals. Conditioning stimulus application resulted in inhibition of test reflex responses in both OA and control animals (P < 0.001); control animals demonstrated greater inhibition compared with OA (P = 0.0499). These data provide evidence of neurophysiological changes consistent with CS in dogs with spontaneous OA and demonstrate that canine OA is associated with reduced DNIC.
Preventing Exercise-Associated Collapse Using Online Runner Education: A Randomized, Controlled Trial
Authors: Worley David M. , Renier Colleen M. , Woehrle Theo A. , Stovitz Steven D. , Nelson Benjamin D.
Published: July 2018

Objective:

To determine whether online exercise-associated collapse (EAC) prevention education decreases medical tent EAC visits among first-time marathoners.

Design:

A prospective controlled study, with age- and sex-stratified randomization, evaluated rates of medical tent diagnosed EAC among runners randomized to the intervention group and intervention participants, compared with a control group.

Setting:

Grandma's Marathon Medical Tent in Duluth, MN, June 2016.

Participants:

Runners in the 2016 Grandma's Marathon who never previously ran a marathon (n = 2943), randomized into control (n = 1482) and intervention (n = 1461) groups. Intervention participants opened the EAC prevention video (n = 590).

Interventions:

Online EAC education included an introductory webpage and 5-minute professional video describing EAC and prevention.

Main Outcome Measures:

Medical tent visit with EAC diagnosis.

Results:

Intervention participants had no decreased likelihood of EAC, compared with controls [odds ratio (OR), 0.88, 95% confidence interval (CI), 0.46-1.69]. Exercise-associated collapse occurred less frequently in those with longer race times (OR, 0.58, 95% CI, 0.43-0.79). Intervention participation was associated with longer race times (OR, 1.12, 95% CI, 1.10-1.23).

Conclusions:

Those opening the EAC prevention video and controls had similar EAC rates. Slower running speed was associated with lower EAC rates. Video viewing was a predictor of slower running pace.
Preliminary Results With Image-guided Cochlear Implant Insertion Techniques
Authors: Labadie Robert F. , Noble Jack H.
Published: July 2018

Hypothesis:

Using patient-customized cochlear measurements obtained from preoperative computed tomography (CT) scans to guide insertion of cochlear implant (CI) electrode arrays will lead to more optimal intracochlear positioning.

Background:

Cochlear duct length is highly variable ranging from 25.26 to 35.46 mm, yet CI electrode arrays are treated as one size fits most. We sought to investigate the impact of patient-customized insertion plans on final location of electrode arrays.

Methods:

Twenty cadaveric temporal bone specimens were CT scanned and randomly divided into groups A and B. Group A specimens had an optimal customized insertion plan generated including entry site (e.g., round window versus extended round window), entry vector based on anatomical landmarks (e.g., hug posterior aspect of facial recess and angle 1 mm inferior to stapes), depth to begin advancing off stylet, and final insertion depth. Suboptimal plans were chosen for group B by selecting an approach that was normal yet predicted to result in poor final electrode location. One surgeon, blinded as to group, carried out the CI insertions following which the electrode array was fixed using superglue and the specimen CT scanned to allow assessment of final electrode location.

Results:

Average perimodiolar distances for groups A and B were 0.51 and 0.60 mm, respectively. For group A, full scala tympani insertion was achieved in all specimens while in group B, 4 of 10 specimens had scalar translocation.

Conclusion:

Patient customized cochlear implant insertion techniques achieved better positioning of electrode arrays in this study and have potential for improving electrode positioning in patients.
Low Concentration Intra-Tympanic Gentamicin Treatment for Menière's Disease: A Long-Term Follow Up
Authors: Nathan Shlamkovitch , Lasry Reut , Ephraim Eviatar , Marom Tal , Gavriel Haim
Published: July 2018

Background:

Intra-tympanic injections of gentamicin (ITG), a known ototoxic agent, have been proven to be effective in controlling Menière's disease (MD) symptoms, in patients who did not respond to conservative therapy, although its safety was questionable.

Objectives:

To study whether low-concentration ITG, in refractory MD, had an effect on the ipsilateral hearing, in comparison to the contralateral ear, and to study the effectiveness of such treatment.

Methods:

A comparative, retrospective cohort study was conducted between 2003 and 2015, and compared the change in the hearing level between the injected ear and the contralateral, untreated ear.

Outcomes:

In 20 of 27 patients (74.1%), one course of ITG treatment was considered as successful. In the short-term, there was improvement of hearing level at 1000 Hz (p = 0.014), and deterioration of hearing level at 8000 Hz (p = 0.039), both in comparison to the control ear. In the long-term and after confounders adjustment, we found there were no differences in the hearing levels between the treated ear and the untreated contralateral ear.

Conclusions:

A high success rates of treating vertigo attacks with low concentration ITG in refractory unilateral MD patients is herein reported, while a significant difference was not observed in the hearing threshold compared with the healthy contralateral ear.
Epitope-based human leukocyte antigen matching for transplantation: a personal perspective of its future
Authors: Duquesnoy René J.
Published: July 2018

Purpose of review

This study reflects my personal experience with the characterization of human leukocyte antigen (HLA) epitopes and their significance in HLA matching for transplantation. It offers a subjective assessment what further studies are needed to have this concept be applied in the clinical setting.

Recent findings

This study addresses the structural characteristics of antibody-reactive HLA epitopes determined by different methods, eplet-associated antibody analysis and acceptable mismatching for sensitized patients and eplet immunogenicity and determination of mismatch permissibility.

Basic implications

for clinical practice and research consider the need for further studies of the structural basis of antibody-verified HLA epitopes determined in different techniques and their clinical relevance, the biological basis of epitope immunogenicity and determinations of permissible mismatches and a computerized clinical transplant database with an Artificial Intelligence component that can generate evidence-based information for the practical application of epitope-based HLA matching.
Beyond Early Infant Diagnosis: Changing the Approach to HIV-Exposed Infants
Authors: Modi Surbhi , Broyles Laura N. , Montandon Michele , Itoh Megumi , Ochanda Boniface , Langat Agnes , Sullivan David , Dale Helen
Published: July 2018

Despite dramatic global progress with implementing prevention of mother-to-child HIV transmission (PMTCT) programs, there were 160,000 new pediatric HIV infections in 2016. More than 50% of infant HIV infections now occur in the postpartum period, reflecting the relatively high coverage of interventions in the antenatal period and the need for greater attention to the breastfeeding mother and her HIV-exposed infant (HEI). Early diagnosis and treatment are critical to prevent morbidity and mortality in HIV-infected children; however, early infant HIV testing rates remain low in most high HIV-burden countries. Furthermore, systematic retention and follow-up of HEI in the postpartum period and ascertainment of final HIV status remain major program gaps. Despite multiple calls to action to improve infant HIV testing rates, progress has been marginal due to a lack of focus on the critical health care needs of HEI coupled with health system barriers that result in fragmented services for HIV-infected mothers and their families. In this paper, we describe the available evidence on the health outcomes of HEI, define a comprehensive care package for HEI that extends beyond early HIV testing, and describe successful examples of integrated services for HEI.
Zvandiri—Bringing a Differentiated Service Delivery Program to Scale for Children, Adolescents, and Young People in Zimbabwe
Authors: Willis Nicola , Napei Tanyaradzwa , Armstrong Alice , Jackson Helen , Apollo Tsitsi , Mushavi Angela , Ncube Getrude , Cowan Frances M.
Published: July 2018

Since 2004, there has been a dramatic shift in the HIV response for children, adolescents, and young people in low resource settings. Previous programs and services were largely orientated to adults. This is now changing, but there is limited evidence on how to take services for children, adolescents, and young people living with HIV (CAYPLHIV) to scale. Zvandiri is a theoretically grounded, multicomponent-differentiated service delivery model for children, adolescents, and young people in Zimbabwe that integrates peer-led, community interventions within government health services. Africaid analyzed routine program and other data from November 2004 to October 2017 to document Zvandiri scale-up, framed by the World Health Organization framework for scaling up interventions. Since 2004, Zvandiri has evolved from one support group in Harare into a comprehensive model, combining community- and clinic-based health services and psychosocial support for CAYPLHIV. Zvandiri was scaled up across Zimbabwe through phased expansion into 51 of 63 districts, reaching 40,213 CAYPLHIV. Evidence indicates that this approach improved uptake of HIV testing services, adherence, and retention in care. The environment and strategic choices were critical when taking the model to scale, particularly nesting the program within existing services, and capacity strengthening of service providers working jointly with trained, mentored CAYPLHIV. The results provide a firm foundation for programming and from which to build evidence of sustainable impact. Formal impact evaluation is needed and underway. These program data contribute to the essential evidence base on strategic approaches to assist in planning services for this relatively neglected group.
Getting Treatment and Care Services Right for Children and Adolescents to Reach High Viral Suppression
Authors: Penazzato Martina , Sugandhi Nandita , Essajee Shaffiq , Doherty Meg , Ficht Allison , Phelps Benjamin Ryan
Published: July 2018

In August 2014, PEPFAR and the Children's Investment Fund Foundation launched the Accelerating Children's HIV/AIDS Treatment (ACT) initiative with the aim of doubling the number of children on antiretroviral treatment in 9 African countries. Increasing rates of pretreatment drug resistance and use of suboptimal treatment regimens and formulations result in poor adherence and high rates of viral failure. Supporting adherence and ensuring appropriate treatment monitoring are needed to maximize duration of first-line treatment and enable timely sequencing to subsequent lines of antiretroviral treatment. Although timely antiretroviral treatment is the core of clinical care for infants, children and adolescents living with HIV, ensuring a broader package of biomedical and non-biomedical interventions is also required to address highly prevalent comorbidities among children living with HIV. Providing such a comprehensive package has been challenging for health care workers who lack the necessary skills and confidence to care for pediatric populations. Efforts to simplify clinical management and specific training and mentorship are needed to address these challenges. In this article, we review the progress made during the ACT initiative and the persistent challenges in achieving and maintaining virological suppression across the age spectrum. We identify innovations needed to build on the success of the ACT initiative. Despite the challenges, achieving high levels of virological suppression in children and adolescents is possible. The complexity of pediatric HIV treatment can be offset as antiretroviral regimens become more effective, tolerable, and easier to prescribe and administer. Meanwhile, basic programmatic elements to address comorbidities as well as support health care workers remain critical. In this article we review the progress made through the ACT initiative, as well as identify innovations needed to address persistent challenges to viral suppression across the age spectrum.
Effect of Hospital Volume With Respect to Performing Gastric Cancer Resection on Recurrence and Survival
Authors: Claassen Yvette H. M. , van Amelsfoort Romy M. , Hartgrink Henk H. , Dikken Johan L. , de Steur Wobbe O. , van Sandick Johanna W. , van Grieken Nicole C. T. , Cats Annemieke , Boot Henk , Trip Anouk K. , Jansen Edwin P. M. , Kranenbarg Elma Meershoek-Klein , Braak Jeffrey P. B. M. , Putter Hein , van Berge Henegouwen Mark I. , Verheij Marcel , van de Velde Cornelis J. H.
Published: July 2018

Objective:

We examined the association between surgical hospital volume and both overall survival (OS) and disease-free survival (DFS) using data obtained from the international CRITICS (ChemoRadiotherapy after Induction chemotherapy In Cancer of the Stomach) trial.

Summary Background Data:

In the CRITICS trial, patients with resectable gastric cancer were randomized to receive preoperative chemotherapy followed by adequate gastrectomy and either chemotherapy or chemoradiotherapy.

Methods:

Patients in the CRITICS trial who underwent a gastrectomy with curative intent in a Dutch hospital were included in the analysis. The annual number of gastric cancer surgeries performed at the participating hospitals was obtained from the Netherlands Cancer Registry; the hospitals were then classified as low-volume (1–20 surgeries/year) or high-volume (≥21 surgeries/year) and matched with the CRITICS trial data. Univariate and multivariate analyses were then performed to evaluate the hazard ratio (HR) between hospital volume and both OS and DFS.

Results:

From 2007 through 2015, 788 patients were included in the CRITICS trial. Among these 788 patients, 494 were eligible for our study; the median follow-up was 5.0 years. Five-year OS was 59.2% and 46.1% in the high-volume and low-volume hospitals, respectively. Multivariate analysis revealed that undergoing surgery in a high-volume hospital was associated with higher OS [HR = 0.69, 95% confidence interval (CI) = 0.50–0.94,P= 0.020] and DFS (HR = 0.73, 95% CI: 0.54–0.99,P= 0.040).

Conclusions:

In the CRITICS trial, hospitals with a high annual volume of gastric cancer surgery were associated with higher overall and DFS. These findings emphasize the value of centralizing gastric cancer surgeries in the Western world.
The pitch of babies’ cries predicts their voice pitch at age 5
Authors: Levrero Florence , Mathevon Nicolas , Pisanski Katarzyna , Gustafsson Erik , Reby David
Published: July 2018

Voice pitch (fundamental frequency,
F
0
) is a key dimension of our voice that varies between sexes after puberty, and also among individuals of the same sex both before and after puberty. While a recent longitudinal study indicates that inter-individual differences in voice pitch remain stable in men during adulthood and may even be determined before puberty (Fouquet
et al.
2016
R. Soc. open sci.
3
, 160395. (
doi:10.1098/rsos.160395
)), whether these differences emerge in infancy remains unknown. Here, using a longitudinal study design, we investigate the hypothesis that inter-individual differences in
F
0
are already present in the cries of pre-verbal babies. While based on a small sample (
n
= 15), our results indicate that the
F
0
of babies' cries at 4 months of age may predict the
F
0
of their speech utterances at 5 years of age, explaining 41% of the inter-individual variance in voice pitch at that age in our sample. We also found that the right-hand ratio of the length of their index to ring finger (2D : 4D digit ratio), which has been proposed to constitute an index of prenatal testosterone exposure, was positively correlated with
F
0
at both 4 months and 5 years of age. These findings suggest that a substantial proportion of between-individual differences in voice pitch, which convey important biosocial information about speakers, may partly originate
in utero
and thus already be present soon after birth.
Bistable fully developed mixed convection flow with viscous dissipation in a vertical channel
Authors: Miklavčič M.
Published: July 2018

It is shown that unstable dual solutions in fully developed mixed convection flow in a vertical channel disappear in the presence of relatively strong thermal radiation. In this case, we have a unique stable flow at each pressure gradient. When the effect of thermal radiation is weak another branch of stable solutions is created, resulting in bistable flows. In this case, the flow exhibits hysteresis with variation of the pressure gradient. Optically, a thin radiation model is used.
Intra-individual variation in performance on novel variants of similar tasks influences single factor explanations of general cognitive processes
Authors: van Horik Jayden O. , Langley Ellis J. G. , Whiteside Mark A. , Laker Philippa R. , Madden Joah R.
Published: July 2018

Intra-individual variation in performance within and across cognitive domains may confound interpretations of both domain-general and domain-specific abilities. Such variation is rarely considered in animal test batteries. We investigate individual consistency in performance by presenting pheasant chicks (n = 31), raised under standardized conditions, with nine different cognitive tasks. Among these tasks were two replicated novel variants of colour learning and colour reversal problems, tests of positional learning and memory, as well as two different tasks that captured multiple putative measures of inhibitory control and motor-related performance. These task variants were also used to compare subjects' performance on alternative test batteries comprised of different task combinations. Subjects’ performance improved with experience, yet we found relatively little consistency in their performance, both within similar tasks using different paradigms and across different tasks. Parallel analysis revealed non-significant factors when all nine tasks were included in a principal axis factor analysis. However, when different combinations of six of the nine tasks were included in principal axis factoring, 14 of 84 combinations revealed significant main factors, explaining between 28 and 35% of the variance in task performance. While comparable findings have been suggested to reflect domain-general intelligence in other species, we found no evidence to suggest that a single factor encompassed a diverse range of cognitive abilities in pheasants. Instead, we reveal how single factor explanations of cognitive processes can be influenced by test battery composition and intra-individual variation in performance across tasks. Our findings highlight the importance of conducting multiple tests within specific domains to ensure robust cognitive measures are obtained.
Synergistic effect of eicosapentaenoic acid-enriched phospholipids and sea cucumber saponin on orotic acid-induced non-alcoholic fatty liver disease in rats
Authors: Guo Ying , Han Xiuqing , Che Hongxia , Li Zhaojie , Dong Ping , Xue Changhu , Zhang Tiantian , Wang Yuming
Published: July 2018

Non-alcoholic fatty liver disease (NAFLD) is becoming an increasingly prevalent chronic liver disease all over the world. The present study was undertaken to explore the synergistic effects of sea cucumber saponins (SCS) and eicosapentaenoic acid-enriched phospholipids (EPA-PL) at ratios of 0.5 : 0.5 and 1 : 1 on NAFLD and demonstrate possible protective mechanisms. It was found that the combination of EPA-PL and SCS at half dose exhibited better effects than EPA-PL or SCS alone and the combination of EPA-PL and SCS at full dose in alleviating orotic acid (OA)-induced symptoms including growth parameters, serum parameters and liver function. Further evaluation of the mechanism illustrated that EPA-PL and SCS combination at the ratio of 0.5 : 0.5 could markedly reduce the mRNA expressions of fatty acid synthase, acetyl-CoA carboxylase, glucose-6-phosphate dehydrogenase and malic enzyme genes and significantly increase expression of genes relevant to fatty acid β-oxidation including peroxisome proliferator-activated receptor and its target genes (CPT1, CPT2 and ACOX1), suggesting that the protection of the EPA-PL and SCS combination at the ratio of 0.5 : 0.5 against OA-induced NAFLD might be mainly via lipogenesis inhibition and β-oxidation enhancement in the liver. The synergistic effects of EPA-PL and SCS make it possible to reduce the doses of EPA-PL or SCS to avoid side effects, which is of value for the development of dietary supplements or functional foods for preventing or treating NAFLD.
Effect of high-frequency electric field on the tissue sticking of minimally invasive electrosurgical devices
Authors: Zheng Liang , Wan Jianfei , Long Yunjiang , Fu Helin , Zheng Jing , Zhou Zhongrong
Published: July 2018

Generally minimally invasive surgery is performed using an endoscope and other instruments including electrosurgical units (ESUs), and the adhesion of tissue to electrodes is a major concern. The mechanism governing this tissue sticking, especially the influence of high-frequency electric field, is still unclear. In this study, the effect of high-frequency electric field on the tissue sticking upon electrodes was investigated. The electrosurgical cutting test was performed onex vivofresh porcine liver under blend mode using a monopolar ESU. A heat-adherence test without electric field was used as a control. For the control group, the electrode was heated and maintained at a certain temperature and directly in contact with porcine liver. Both sticking tissues obtained from these two tests are partially carbonized porcine liver tissue, but their microstructure and bonding with electrode are obviously different. The sticking tissue formed just under heat is composed of biggish nanoparticles of different sizes which are loosely aggregated and has a weak bonding with the electrode, while the sticking tissue from the electrosurgical cutting test consists of tightly packed fine nanoparticles of equable size as a result of thermo-electric coupling and has a strong bonding with the electrode. Obviously, high-frequency electric field plays an extremely important role in the formation of the sticking tissue. It is the thermo-electric coupling that underlies the function of minimally invasive electrosurgical devices, and the effect of high-frequency electric field cannot be ignored in the tissue sticking study and anti-sticking strategies.
Impact of soil contamination on the growth and shape of ant nests
Authors: Leclerc Jean-Baptiste , Pinto Silva Jennifer , Detrain Claire
Published: July 2018

As entomopathogens are detrimental to the development or even survival of insect societies, ant colonies should avoid digging into a substrate that is contaminated by fungal spores. Here, we test the hypotheses that
Myrmica rubra
ant workers (i) detect and avoid fungus-infected substrates and (ii) excavate nest patterns that minimize their exposure to entomopathogenic spores. Small groups of
M. rubra
workers were allowed to dig their nest in a two-dimensional sand plate of which one half of the substrate contained fungal spores of
Metarhizium brunneum
, while the other half was spore-free. We found that the overall digging dynamics of
M. rubra
nests was not altered by the presence of fungus spores. By contrast, the shape of the excavated areas markedly differed: control nests showed rather isotropic patterns, whereas nests that were partially dug into a fungus-contaminated substrate markedly deviated from a circular shape. This demonstrates that the sanitary risks associated with a digging substrate are key factors in nest morphogenesis. We also found that
M. rubra
colonies were able to discriminate between the two substrates (fungus-infected or not). Furthermore, some colonies unexpectedly showed a high consistency in excavating mainly the infected substrate. This seemingly suboptimal preference for a contaminated soil suggests that non-lethal doses of fungal spores could help ant colonies to trigger ‘immune priming’. The presence of fungi may also indicate favourable ecological conditions, such as humid and humus-rich soil, that ants use as a cue for selecting suitable nesting sites.
Design and implementation of levee project information management system based on WebGIS
Authors: Zhang Bin , Ye Yi-wei , Shen Xi-zhong , Mei Gang , Wang Han-xun
Published: July 2018

The China Levee Project Information Management System (CLPIMS) is an information management platform that was established for levee project management within the seven major river basins in China. The system was developed on the basis of the VS.NET and ArcGIS Server and was combined with the database theory and key techniques of WebGIS, which has the features of real-time display, enquiry, statistics and management of spatial data under browser/server mode. Moreover, additional applications, such as real-time monitoring, safety assessment, early warning and danger forecasting and online analysis, can be further explored through reserved modules. The CLPIMS can serve not only as a scientific, systematic, visual tool for analysis and decision management in levee projects in China but also as a technical platform for flood control practice. Furthermore, the system is capable of unified management and sharing of the levee project information for the seven major river basins in China, and it is important for the improvement of office automation, E-government applications and the level of flood control operations.
Penetration Assessment of Dietary Supplements and Drugs through the Blood-Brain Barrier for Potential Treatment of Parkinson ‘s Disease
Authors: Chevalier Roger
Published: July 2018

Parkinson’s disease (PD) is a progressive neurodegenerative disorder, affecting 2% of the population over the age of 60. To date, there is no disease modifying drugs to prevent dopaminergic neuron loss and abnormal protein deposition in the brains. There is a strong demand for neuroprotective therapies to prevent or slow down dopaminergic neuron degeneration. An essential prerequisite for a compound designed to affect the central nervous system (CNS) is a satisfactory transport through the blood brain barrier (BBB). Numerous posts on the net suggest that both repositioned drugs molecules and active molecules present in dietary supplements may slow down PD’s progression. The logBB is an index of BBB permeability. Starting from quantitative and qualitative permeability data, this study tries to predict logBB values from various physicochemical properties of molecules, including, among others, molecular size, polar surface area (PSA) and logP values. Quantitative logBB models were implemented using MLP (multiple linear regression), PLS (Partial Least Square), AAKR (Auto Associative Kernel Regression) and ECM (Evolving Cluster Method). Qualitative models were carried out with SVM (Support Vector Method).

The paper estimates the BBB permeability of 39 molecules potentially able to slow down PD’s progression and compares the performances of qualitative and quantitative machine learning method used. For information, the current study also gives a short overview of the state of the art on the potential impact of dietary supplements on PD.