bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring service users’, carers’ and professionals’ perspectives and experiences of current antipsychotic prescribing: A qualitative study
Authors: Harris Kamelia , Brooks Helen , Lythgoe Garry , Bee Penny , Lovell Karina , Drake Richard J
Published: February 2017

Objectives

Shared decision-making is the pinnacle of patient-centred care; mental health stakeholders value shared decision-making but find it difficult to enact. The objective was to compare and synthesise mental health stakeholder views on antipsychotic prescribing in one NHS Trust, to understand potential reasons for the difficult enactment of shared decision-making in practice.

Methods

We conducted 12 interviews and 5 focus groups with 33 mental health stakeholders, after obtaining their informed consent. They shared their experiences in and perceptions of antipsychotic prescribing and were recruited from Manchester Mental Health and Social Care Trust.

Results

Stakeholders agreed that successful shared decision-making demands a collaborative approach. We elucidated a striking divergence in views of the decision-making process and understanding of collaboration. Nurses, consultants and the pharmacist seemed most satisfied with the amount of collaboration but most pessimistic about the scope for it. Carers and most service users did not feel that there was any collaboration.

Discussion

Comparison of perspectives demonstrated the complexity of shared decision-making which is not addressed in current operational definitions or policy or nursing practice initiatives. The findings have the potential to progress initiatives in the mental health field from those that emphasise the need for shared decision-making to those that develop tools to promote shared decision-making.
Parental happiness and strain among young adult parents diagnosed with Attention Deficit Hyperactivity Disorder
Authors: Kroeger Rhiannon A
Published: February 2017

This study used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine whether young adult parents diagnosed with Attention Deficit Hyperactivity Disorder experience less parental happiness and/or more parental strain than their counterparts not diagnosed with Attention Deficit Hyperactivity Disorder. Results from logistic regression models indicated that young adult parents ever diagnosed with Attention Deficit Hyperactivity Disorder have significantly greater odds of feeling overwhelmed as parents and significantly lower odds of feeling close to their children or happy in their role as parents compared to those never diagnosed with Attention Deficit Hyperactivity Disorder. Potential implications of these results for scholars as well as health professionals treating adult Attention Deficit Hyperactivity Disorder patients with children are discussed.
Too many pills to swallow: A case of a mixed overdose
Authors: Hopkins Louise Emily , Sunkersing Jonathan , Jacques Andrew
Published: February 2017

Propranolol is a highly lipid-soluble beta-receptor antagonist. We describe a case of mixed overdose, including propranolol, amlodipine and olanzapine, resulting in severe resistant hypotension which was successfully treated. A 21-year-old student ingested 6.4 g of propranolol, 280 mg of amlodipine and 560 mg of olanzapine. The patient was brought to the emergency department and exhibited signs of severe systemic toxicity – profound hypotension and circulatory collapse, respiratory depression and coma. The patient had conventional therapy but failed to respond to this and was therefore commenced on IntraLipid infusion, high-dose insulin infusion and inotrope infusion. An endoscopy was performed in intensive care which revealed a large drug beozar – this was removed. We believe that this combination of infusions with early endoscopy could be beneficial in treating similar patients in the future and present the first case of a propranolol drug bezoar.
Simple elbow dislocation
Authors: Robinson Paul M. , Griffiths Emmet , Watts Adam C
Published: February 2017

The elbow is the second most commonly dislocated major joint in adults. Good long-term outcomes have been reported after non-operative management; however, a small proportion (<10%) of patients have a poor outcome and some do require surgical intervention. A review of the anatomy, pathoanatomy, management and outcomes of simple elbow dislocations is presented. Emphasis is placed on emerging concepts regarding the soft tissue injury, the stabilising structures that are injured, the sequence and mechanism of injury and the relationship to elbow stability. The benefits of nonsurgical and surgical management are discussed and a treatment algorithm based on the pathoanatomy is proposed.
Analysis of “Accuracy and User Performance Evaluation of a New, Wireless-Enabled Blood Glucose Monitoring System That Links to a Smart Mobile Device”
Authors: Rutschmann Malte
Published: February 2017

In the study published in Journal of Diabetes, Science and Technology, Timothy S. Bailey and coauthors evaluated system accuracy and user performance of a new, wireless-enabled blood glucose monitoring system, the Contour Plus ONE blood glucose monitoring system. The authors declare that the study protocol was performed according to ISO 15197:2013 guidelines, in particular to clauses 6.3 and 8. Results show a high level of accuracy of the product in a laboratory setting as well as in the hands of lay users. However, differences between both study parts emerge that stimulate discussion about the used comparison method.
Computerised tomography and magnetic resonance imaging of laryngeal squamous cell carcinoma: A practical approach
Authors: Agnello Francesco , Cupido Francesco , Sparacia Gianvincenzo , Midiri Federico , Miroddi Martina , Grassedonio Emanuele , Galia Massimo
Published: February 2017

Squamous cell carcinoma is the most common head and neck cancer. This review describes the state-of-the-art computerised tomography and magnetic resonance imaging protocols of the neck and the normal larynx anatomy, and provides a practical approach for the diagnosis and staging of laryngeal squamous cell carcinoma.
Diagnostic performance of reformatted isotropic thin-section helical CT images in the detection of superior semicircular canal dehiscence
Authors: Sparacia Gianvincenzo , Iaia Alberto
Published: February 2017

Purpose

The purpose of this article is to assess the diagnostic performance of computed tomography (CT) reformatted images for detection of superior semicircular canal (SSC) dehiscence.

Material and methods

Forty-two patients, with sound- and/or pressure-induced vestibular symptoms, and 42 control participants underwent helical CT examination with a highly collimated beam (0.5 mm). Reformatted images of the vestibular labyrinth were obtained in the standard axial and coronal planes (group A images), and in a plane parallel and perpendicular to the SSC (group B images). Diagnostic performance obtained by evaluating the group A images alone and the group B images alone was analyzed by using the area under the receiver operating characteristic curve (AUC).

Results

The diagnostic performance of group A images was AUC = 0.929 with an overall accuracy of 92.9%. The diagnostic performance of group B images was AUC = 0.988 with an overall accuracy of 98.8%. The evaluation of group B images alone showed an improved diagnostic performance over the group A images alone.

Conclusion

Thin-section 0.5-mm collimation CT with reformatted images oriented in the plane parallel and perpendicular to the SSC improves diagnostic accuracy in assessing for SSC dehiscence in comparison to CT images with reconstructions limited to traditional axial and coronal planes.
Susceptibility weighted imaging in acute cerebral ischemia: review of emerging technical concepts and clinical applications
Authors: Hsu Charlie Chia-Tsong , Kwan Gigi Nga Chi , Hapugoda Sachintha , Craigie Michelle , Watkins Trevor William , Haacke E Mark
Published: February 2017

Susceptibility weighted imaging (SWI) is an essential magnetic resonance imaging sequence in the assessment of acute ischemic stroke. In this article, we discuss the physics principals and clinical application of conventional SWI and multi-echo SWI sequences. We review the research evidence and practical approach of SWI in acute ischemic stroke by focusing on the detection and characterization of thromboembolism in the cerebral circulation. In addition, we discuss the role of SWI in the assessment of neuroparenchyma by depiction of asymmetric hypointense cortical veins in the ischemic territory (surrogate tissue perfusion), detection of existing microbleeds before stroke treatment and monitoring for hemorrhagic transformation post-treatment. In conclusion, the SWI sequence complements other parameters in the stroke magnetic resonance imaging protocol and understanding of the research evidence is vital for practising stroke neurologists and neuroradiologists.
Classifying Twitter Topic-Networks Using Social Network Analysis
Authors: Himelboim Itai , Smith Marc A. , Rainie Lee , Shneiderman Ben , Espina Camila
Published: February 2017

As users interact via social media spaces, like Twitter, they form connections that emerge into complex social network structures. These connections are indicators of content sharing, and network structures reflect patterns of information flow. This article proposes a conceptual and practical model for the classification of topical Twitter networks, based on their network-level structures. As current literature focuses on the classification of users to key positions, this study utilizes the overall network structures in order to classify Twitter conversation based on their patterns of information flow. Four network-level metrics, which have established as indicators of information flow characteristics—density, modularity, centralization, and the fraction of isolated users—are utilized in a three-step classification model. This process led us to suggest six structures of information flow: divided, unified, fragmented, clustered, in and out hub-and-spoke networks. We demonstrate the value of these network structures by segmenting 60 Twitter topical social media network datasets into these six distinct patterns of collective connections, illustrating how different topics of conversations exhibit different patterns of information flow. We discuss conceptual and practical implications for each structure.
Platform (Non-)Intervention and the “Marketplace” Paradigm for Speech Regulation
Authors: Medeiros Ben
Published: February 2017

This article analyzes grassroots opposition to the website Ripoff Report (RoR). RoR is a user-generated content (UGC) platform for “consumer reviews” about both business entities and, often, individuals. In America, Section 230 of the CDA (1996) empowers RoR to refuse removing even postings that have been judged defamatory. Instead, the site counsels rebuttal (“counterspeech”) or paying for its self-administered arbitration service—audaciously casting itself as a more efficient (for-profit) substitute for the court system. RoR therefore represents the liberal “marketplace” orientation of Section 230 taken to its logical extreme. Grassroots opponents claim that official legal deference to the content policies of sites like RoR creates a unique kind of symbolic and normative harm. Building on the existing practical critiques of Section 230, I argue that they implicitly invoke Donald Downs’ “community security” paradigm in a digital context. They call on both websites and government to increasingly prioritize protecting citizens from the indignity of confronting (what they see as) personally humiliating speech rather than simply counseling “more speech” as the solution. The RoR controversy thus gives us additional insight into the popular objections provoked by Section 230. Overall, studying them helps further our nascent understanding of the consequences and reactions when “platforms intervene” as regulatory forces.
Biomechanical comparison between cortical screw–rod construct versus pedicle screw–rod construct in transforaminal lumbar interbody fusion
Authors: Yin Wei Chris Chan , Haw Sem Sei , Bashir Elrofai Suliman , Beng Saw Lim , Shanmugam Rukmanikanthan , Keong Kwan Mun
Published: February 2017

Objective:

To compare construct stiffness of cortical screw (CS)-rod transforaminal lumbar interbody fusion (TLIF) construct (G2) versus pedicle screw (PS)-rod TLIF construct (G1) in the standardized porcine lumbar spine.

Methods:

Six porcine lumbar spines (L2–L5) were separated into 12 functional spine units. Bilateral total facetectomies and interlaminar decompression were performed for all specimens. Non-destructive loading to assess stiffness in lateral bending, flexion and extension as well as axial rotation was performed using a universal material testing machine.

Results:

PS and CS constructs were significantly stiffer than the intact spine except in axial rotation. Using the normalized ratio to the intact spine, there is no significant difference between the stiffness of PS and CS: flexion (1.41 ± 0.27, 1.55 ± 0.32), extension (1.98 ± 0.49, 2.25 ± 0.44), right lateral flexion (1.93 ± 0.57, 1.55 ± 0.30), left lateral flexion (2.00 ± 0.73, 2.16 ± 0.20), right axial rotation (0.99 ± 0.21, 0.83 ± 0.26) and left axial rotation (0.96 ± 0.22, 0.92 ± 0.25).

Conclusion:

The CS-rod TLIF construct provided comparable construct stiffness to a traditional PS-rod TLIF construct in a ‘standardized’ porcine lumbar spine model.
Solitary thoracic intramedullary spinal neurofibroma microsurgically extirpated via recapping T-saw laminoplasty
Authors: Rosario Mamer Soriano , Murakami Hideki , Kato Satoshi , Fujii Moriyuki , Yonezawa Noritaka , Tsuchiya Hiroyuki
Published: February 2017

We report the case of a 40-year-old female presenting with back pain that was complicated by a solitary intramedullary spinal cord mass at the T10–11 levels, confirmed by magnetic resonance imaging and computed tomography myelography. Microsurgical en bloc extirpation of the tumor approached through a recapping T-saw laminoplasty of T10 was done, and histopathology findings revealed a diagnosis of neurofibroma. Solitary spinal neurofibroma is one of the rarest tumors involving the spinal cord and is very adherent for the lack of a well-defined capsule, requiring careful dissection under microscope magnification for successful en bloc resection. Recapping T-saw laminoplasty affords both maximal exposure and anatomic reconstruction postextirpation, avoiding most postoperative spinal complications.
Perceived risk factors for nonunion following foot and ankle arthrodesis
Authors: Thevendran Gowreeson , Shah Kalpesh , Pinney Stephen J , Younger Alastair SE
Published: February 2017

Background:

A major complication of foot and ankle arthrodesis is nonunion, which occurs in approximately 12% of cases. Various factors influence a patient’s risk for nonunion following foot and ankle arthrodesis. We surveyed international foot and ankle surgeons to determine (1) risk factors perceived most important for nonunion, (2) factors considered absolute contraindications for arthrodesis, and (3) differences among expert groups regarding perceived risk factors and their stratification.

Methods:

A questionnaire was e-mailed to members of a major foot and ankle journal editorial board and four foot and ankle society executive committees. The relative risk of 18 potential nonunion risk factors was rated from 1 to 10, using smoking 1 pack/day as a benchmark score of 5.00.

Results:

The response rate was 72% (100/139); 81% declared foot and ankle surgery encompasses >90% of their practice. The highest perceived risk factors ( p < 0.001) were smoking 2 packs/day (mean score 8.69), lack of fusion site stability (8.66), and poor local vascularity (7.66). The least important risk factors ( p < 0.001) were perceived to be age >60 years (mean score 2.54), rheumatoid arthritis (3.05), and osteoporosis (3.56). The most frequently cited absolute contraindications to arthrodesis surgery were local infection (46%), poor local vascularity (41%), and smoking (32%).

Conclusion:

To improve arthrodesis outcomes, resource allocation and patient and surgeon education should focus on smoking, construct stability, and local vascularity. Development of an objective nonunion risk assessment tool to identify patients at risk for nonunion using these results could help maximize the efficiency of available resources.
Measurement of Personality through Modified Instrument: A Study of Young Consumers of India
Authors: Sofi Shakeel Ahmad , Nika Fayaz Ahmad
Published: February 2017

Purpose

The present work on personality of a consumer focuses on revising and building a comprehensive framework that would help ascertain personality of an individual from consumer behaviour perspective. It proposes a relook at the validation and reconsideration of earlier developed scales in the subject of personality with special reference to Big Five Personality Framework. A sample of 624 was chosen for this study and multi-stage sampling was adopted in view of layer wise spread of population. Based on the results of exploratory factor analysis (EFA), some of the dimensions of Big Five Personality Framework have been retained whereas few emerging constructs were adopted for their relevance to consumer behaviour. Emotional stability and conscientiousness were left unchanged, whereas extraversion, agreeableness and openness were transformed to new constructs for their foundation in organisational behaviour and having relevance of newly adopted constructs in consumer behaviour. One more construct ‘conserving propensity’ was appended to Big Five Model of personality to make it Big Six from Consumer Behaviour Perspective.

Background

The number of questionnaires either developed or simply used for exploring the personality of an individual has increased in manifolds in recent years. While the rigour applied to the questionnaire development process may be improving, but there still emerges need to make the use of sophisticated procedures to determine the realistic reliability and validity of the instrument, particularly in the field of consumer behaviour and consumer personality.

Design/Methodology/Approach

The research design was exploratory in nature that helped the researcher in identifying the items falling in the particular construct. EFA was applied for identifying items and constructs. Furthermore, CFA was employed to determine the reliability and validity of the proposed instrument. The quantitative data was collected through structured questionnaire from young consumers being part of higher educational institutes vis-a-vis colleges and universities of J&K state. A collection of prominent tools like Cronbach’s alpha, principal component analysis and structural equation modelling was applied for validation and development of the modified scale.

Results

Overall results have shown that scale is highly reliable and possesses both discriminant and convergent validity. Furthermore, other reliability forms are on higher side which supports the consistency of the scale. The present scale would have greater credence for researcher in the field of organisational behaviour, consumer behaviour and interdisciplinary areas of both the subjects.
Autologous Tenocyte Injection for the Treatment of Chronic Recalcitrant Gluteal Tendinopathy
Authors: Bucher Thomas A. , Ebert Jay R. , Smith Anne , Breidahl William , Fallon Michael , Wang Tao , Zheng Ming-Hao , Janes Gregory C.
Published: February 2017

Background:

Gluteal tendinopathy is a common cause of lateral hip pain, and existing conservative treatment modalities demonstrate high symptom recurrence rates. Autologous tenocyte injection (ATI) is a promising cell therapy that may be useful for the treatment of gluteal tendinopathy.

Purpose:

To investigate the safety and effectiveness of ATI, specifically in patients with chronic recalcitrant gluteal tendinopathy.

Study Design:

Case series; Level of evidence, 4.

Methods:

Twelve female patients with a clinical and radiological diagnosis of gluteal tendinopathy were recruited. Patients demonstrated a mean duration of symptoms of 33 months (range, 6-144 months), had undergone a mean 3.2 prior corticosteroid injections (range, 2-5), and had failed to respond to existing conservative treatments including physiotherapy and injections. In an initial procedure, tendon cells were harvested from a needle biopsy of the patella tendon and propagated in a certified Good Manufacturing Practice (GMP) laboratory. In a secondary procedure, a single injection of 2 mL autologous tenocytes (2-5 × 106 cells/mL) suspended in patient serum was injected into the site of the pathological gluteal tendons under ultrasound guidance. Patients were assessed pre- and postinjection (3, 6, 12, and 24 months) using the Oxford Hip Score (OHS), a visual analog pain scale (VAS), the Short Form–36 (SF-36), and a satisfaction scale. Magnetic resonance imaging (MRI) was undertaken at 8.7 months (range, 6-12 months) postinjection.

Results:

Molecular characterization of autologous tendon cells showed a profile of growth factor production in all cases, including platelet-derived growth factor α, fibroblast growth factor β, and transforming growth factor β. The OHS (mean, 24.0 preinjection to 38.9 at 12 months [14.9-point improvement]; 95% CI, 10.6-19.2; P < .001), VAS (mean, 7.2 preinjection to 3.1 at 12 months [4.1-point improvement]; 95% CI, 2.6-5.6; P < .001), and SF-36 (mean, 28.1 preinjection to 43.3 at 12 months [15.2-point improvement]; 95% CI, 9.8-20.5; P < .001) significantly improved to 12 months postinjection, sustained to 24 months. Eight patients were satisfied with their outcomes. Significant MRI-based improvement could not be demonstrated in the majority of cases.

Conclusion:

ATI for gluteal tendinopathy is safe, with improved and sustained clinical outcomes to 24 months.
The Effect of the Number of Carries on Injury Risk and Subsequent Season’s Performance Among Running Backs in the National Football League
Authors: Kraeutler Matthew J. , Belk John W. , McCarty Eric C.
Published: February 2017

Background:

In recent years, several studies have correlated pitch count with an increased risk for injury among baseball pitchers. However, no studies have attempted to draw a similar conclusion based on number of carries by running backs (RBs) in football.

Purpose:

To determine whether there is a correlation between number of carries by RBs in the National Football League (NFL) and risk of injury or worsened performance in the subsequent season.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The ESPN NFL statistics archives were searched from the 2004 through 2014 regular seasons. During each season, data were collected on RBs with 150 to 250 carries (group A) and 300+ carries (group B). The following data were collected for each player and compared between groups: number of carries and mean yards per carry during the regular season of interest and the subsequent season, number of games missed due to injury during the season of interest and the subsequent season, and the specific injuries resulting in missed playing time during the subsequent season. Matched-pair t tests were used to compare changes within each group from one season to the next in terms of number of carries, mean yards per carry, and games missed due to injury.

Results:

During the seasons studied, a total of 275 RBs were included (group A, 212; group B, 63). In group A, 140 RBs (66%) missed at least 1 game the subsequent season due to injury, compared with 31 RBs (49%) in group B ( P = .016). In fact, players in group B missed significantly fewer games due to injury during the season of interest ( P < .0001) as well as the subsequent season ( P < .01). Mean yards per carry was not significantly different between groups in the preceding season ( P = .073) or the subsequent season ( P = .24).

Conclusion:

NFL RBs with a high number of carries are not placed at greater risk of injury or worsened performance during the subsequent season. These RBs may be generally less injury prone compared with other NFL RBs.
Predicting the Perceptual Consequences of Hidden Hearing Loss
Authors: Oxenham Andrew J.
Published: February 2017

Recent physiological studies in several rodent species have revealed that permanent damage can occur to the auditory system after exposure to a noise that produces only a temporary shift in absolute thresholds. The damage has been found to occur in the synapses between the cochlea’s inner hair cells and the auditory nerve, effectively severing part of the connection between the ear and the brain. This synaptopathy has been termed hidden hearing loss because its effects are not thought to be revealed in standard clinical, behavioral, or physiological measures of absolute threshold. It is currently unknown whether humans suffer from similar deficits after noise exposure. Even if synaptopathy occurs in humans, it remains unclear what the perceptual consequences might be or how they should best be measured. Here, we apply a simple theoretical model, taken from signal detection theory, to provide some predictions for what perceptual effects could be expected for a given loss of synapses. Predictions are made for a number of basic perceptual tasks, including tone detection in quiet and in noise, frequency discrimination, level discrimination, and binaural lateralization. The model’s predictions are in line with the empirical observations that a 50% loss of synapses leads to changes in threshold that are too small to be reliably measured. Overall, the model provides a simple initial quantitative framework for understanding and predicting the perceptual effects of synaptopathy in humans.
Botulinum Toxin a for the Management of Hidradenitis Suppurativa
Authors: Reilly Daniel J , Munasinghe Charlene P , Nizzero Danielle E , Morsi Adel W
Published: February 2017

Hidradenitis suppurativa is a chronic, debilitating condition of apocrinebearing skin. It is frequently difficult to manage, with multiple modalities often required. The authors present a case of hidradenitis suppurativa managed successfully with botulinum toxin A, and review the existing literature on the topic.
Iatrogenic Median Nerve Compression with a Silicone Rod: A Case Report and Review of the Literature
Authors: Curran Terry-Ann , Yap Lee , Kneafsey Brian
Published: February 2017

The use of silicone rods for two-stage tendon reconstruction was described in the 1970s. Since that time, it has become the procedure of choice for delayed tendon reconstruction. Migration of the rod from its distal attachment can occur at any time; however, the risk is increased when there is a delay in progressing to the second stage. The author presents a case in which a silicone rod migrated to the carpal tunnel five years after a first-stage tendon reconstruction. An acute onset of median nerve neuropathy was the presenting symptom of rod migration. A thorough history, examination and recognition of the relationship between the background history and symptoms led to a prompt progression to surgery and a good overall outcome.
The Temporalis Muscle Flap: A Useful Adjunct in Reconstruction of Combined Defects of the Upper and Lower Eyelids
Authors: Haykal Siba , Antonyshyn Oleh M , Gill Harmeet S
Published: February 2017

BACKGROUND:

Eyelid reconstruction following oncological resection remains a challenge. Multiple techniques have been described for isolated upper or lower eyelid defects.

OBJECTIVE:

To describe the use of the temporalis flap for reconstruction of an eyelid defect involving both the upper and lower eyelids.

METHODS:

Excision of a basal cell carcinoma was performed. This resulted in full-thickness defects of the upper and lower eyelids, the lateral canthus including upper and lower canthal tendons, the upper right mid-face, temple, lateral two-thirds of the eyebrow and forehead. The tumour was found to be adherent to bone and dissecting deeply into the lateral orbital cavity as well as along the orbital roof.

RESULTS:

The lateral orbital rim was reconstructed using the prebent titanium mesh implant. A temporalis muscle flap allowed for draping over the reconstructed orbital rim and to provide reconstruction of the tarsal plates of the upper and lower eyelids. The remaining large cutaneous defect, which involved more than half of the lower eyelid, was reconstructed using a large Mustarde cervical facial rotation flap.

CONCLUSIONS:

The temporalis muscle flap provides abundant well vascularized tissue and has been described for head and neck reconstruction. A novel technique allows reconstruction of both the upper and lower eyelids using the temporalis muscle in combination with local flaps.
Surgical Treatment of Chronic Perilunate Dislocation for Prevention of Attritional Flexor Tendon Rupture
Authors: Haykal Siba , Pennings Amanda L , Chung Karen Y , Elmaraghy Amr W
Published: February 2017

A 25-year-old man presented with a chronic perilunate dislocation. While awaiting surgery, he developed flexor tendon rupture. The authors present an indication to proceed to emergently prioritize surgical treatment of even chronic perilunate dislocation. A delay in treatment may lead to attritional flexor tendon rupture.
Ulnar Nerve Compression in the Proximal Forearm By An Intraneural Arteriovenous Malformation
Authors: Saquib Mohd , Khan Nida , Mir Altaf
Published: February 2017

Compression of the ulnar nerve is most commonly caused by ganglions, lipomas, anomalous tendon and muscles, trauma related to an occupation and arthritis in the upper limb; however, nerve compression in the upper limb and, more importantly, in the proximal forearm by a vascular lesion is rare. A rare case of ulnar nerve compression in the proximal forearm by an arteriovenous malformation in a 45-year-old man who presented with six-year history of gradually increasing swelling in medial aspect of proximal forearm is reported. After excision of the tumour, it was found to be an arteriovenous malformation.
Supernumerary Nostril: Report of a Rare Case and a Review of the Literature
Authors: Mishra Laxmi Kanta , Pradhan Surya Kanta , Gupta Sanjeev , Sahoo Satyajit
Published: February 2017

Supernumerary nostril is an extremely rare congenital entity that results from aberrant embryological development. A review of the literature reveals that only 33 cases of supernumerary nostril have been reported. They can be associated with other congenital anomalies. The accessory nostril may or may not communicate with the ipsilateral nasal cavity, probably depending on the degree of embryological progression of the anomaly. A case of supernumerary left nostril with no nasal cavity communication is presented. The surgical treatment is described and different speculative theories related to the embryogenesis of supernumerary nostrils are also reviewed.
Bilateral Lower-Lip Foreign Body Granuloma Secondary to Hyaluronic Acid Injection
Authors: Alghonaim Yazeed A , Solomon Philip D
Published: February 2017

Hyaluronic acid injection has become one of the most common dermal filler procedures performed by clinicians worldwide. Although it is considered to be a very safe and successful treatment option, several complications have been reported from this type of filler injection. A case of bilateral lower-lip foreign body granuloma secondary to hyaluronic acid injection is presented. The granulomas were successfully resected and histopathology confirmed the diagnosis.
Cutaneous Leishmaniasis of the Fingers: A Case Series Including a Case Involving a Pregnant Woman
Authors: Al-Qattan Mohammad M , Sayed Amel Af El
Published: February 2017

The authors report a case series involving leishmaniasis of the fingers. The presentation was variable. The clinical diagnosis was suspected on obtaining travel history. The response to sodium stibogluconate was excellent. Hot compresses may be used in pregnant women because the teratogenicity of sodium stibogluconate is unknown.
Complications of Polyacrylamide Hydrogel Augmentation Mammoplasty: A Case Report and Review of the Literature
Authors: Winter J , Shiga S , Islur A
Published: February 2017

The use of Polyacrylamide hydrogel (PAAG) as an injectable filler for breast augmentation has fallen out of popularity since its first use in the 1980s, but has produced an increasing patient population presenting with complications related to PAAG injections. PAAG use was popularized most notably in China, Russia and Iran. However, given immigration trends and medical tourism, PAAG-related complications have become increasingly more common in North America. These complications can be difficult to treat, often necessitating complex surgery that includes gel removal, debridement procedures and, often, breast reconstruction. Approaches to surgical treatment and subsequent breast reconstruction are not universally defined primarily because of the limited knowledge about this group of patients. The present article presents the option of autologous free flap reconstruction for a patient with extensive muscular involvement, and aims to summarize complications and risks associated with PAAG through a case presentation and literature review.
High-quality-draft genome sequence of the fermenting bacterium Anaerobium acetethylicum type strain GluBS11T (DSM 29698)
Authors: Patil Yogita , Müller Nicolai , Schink Bernhard , Whitman William B. , Huntemann Marcel , Clum Alicia , Pillay Manoj , Palaniappan Krishnaveni , Varghese Neha , Mikhailova Natalia , Stamatis Dimitrios , Reddy T. B. K. , Daum Chris , Shapiro Nicole , Ivanova Natalia , Kyrpides Nikos , Woyke Tanja , Junghare Madan
Published: February 2017

Anaerobium acetethylicum strain GluBS11T belongs to the family Lachnospiraceae within the order Clostridiales. It is a Gram-positive, non-motile and strictly anaerobic bacterium isolated from biogas slurry that was originally enriched with gluconate as carbon source (Patil, et al., Int J Syst Evol Microbiol 65:3289-3296, 2015). Here we describe the draft genome sequence of strain GluBS11T and provide a detailed insight into its physiological and metabolic features. The draft genome sequence generated 4,609,043 bp, distributed among 105 scaffolds assembled using the SPAdes genome assembler method. It comprises in total 4,132 genes, of which 4,008 were predicted to be protein coding genes, 124 RNA genes and 867 pseudogenes. The G + C content was 43.51 mol %. The annotated genome of strain GluBS11T contains putative genes coding for the pentose phosphate pathway, the Embden-Meyerhoff-Parnas pathway, the Entner-Doudoroff pathway and the tricarboxylic acid cycle. The genome revealed the presence of most of the necessary genes required for the fermentation of glucose and gluconate to acetate, ethanol, and hydrogen gas. However, a candidate gene for production of formate was not identified.
Randomized Phase II Study of Clofarabine-Based Consolidation for Younger Adults With Acute Myeloid Leukemia in First Remission
Authors: Thomas Xavier , de Botton Stéphane , Chevret Sylvie , Caillot Denis , Raffoux Emmanuel , Lemasle Emilie , Marolleau Jean-Pierre , Berthon Céline , Pigneux Arnaud , Vey Norbert , Reman Oumedaly , Simon Marc , Recher Christian , Cahn Jean-Yves , Hermine Olivier , Castaigne Sylvie , Celli-Lebras Karine , Ifrah Norbert , Preudhomme Claude , Terré Christine , Dombret Hervé
Published: February 2017

Purpose

To evaluate the efficacy and safety of a clofarabine-based combination (CLARA) versus conventional high-dose cytarabine (HDAC) as postremission chemotherapy in younger patients with acute myeloid leukemia (AML).

Patients and Methods

Patients age 18 to 59 years old with intermediate- or unfavorable-risk AML in first remission and no identified donor for allogeneic stem-cell transplantation (SCT) were eligible. Two hundred twenty-one patients were randomly assigned to receive three CLARA or three HDAC consolidation cycles. The primary end point was relapse-free survival (RFS). To handle the confounding effect of SCT that could occur in patients with late donor identification, hazard ratios (HRs) of events were adjusted on the time-dependent treatment × SCT interaction term.

Results

At 2 years, RFS was 58.5% (95% CI, 49% to 67%) in the CLARA arm and 46.5% (95% CI, 37% to 55%) in the HDAC arm. Overall, 110 patients (55 in each arm) received SCT in first remission. On the basis of a multivariable Cox-adjusted treatment × SCT interaction, the HR of CLARA over HDAC before or in absence of SCT was 0.65 (95% CI, 0.43 to 0.98; P = .041). In a sensitivity analysis, when patients who received SCT in first remission were censored at SCT time, 2-year RFS was 53.3% (95% CI, 39% to 66%) in the CLARA arm and 31.0% (95% CI, 19% to 43%) in the HDAC arm (HR, 0.63; 95% CI, 0.41 to 0.98; P = .043). Gain in RFS could be related to the lower cumulative incidence of relapse observed in the CLARA arm versus the HDAC arm (33.9% v 46.4% at 2 years, respectively; cause-specific HR, 0.61; 95% CI, 0.40 to 0.94; P = .025). CLARA cycles were associated with higher hematologic and nonhematologic toxicity than HDAC cycles.

Conclusion

These results suggest that CLARA might be considered as a new chemotherapy option in younger patients with AML in first remission.
Inhibiting Histone Deacetylase as a Means to Reverse Resistance to Angiogenesis Inhibitors: Phase I Study of Abexinostat Plus Pazopanib in Advanced Solid Tumor Malignancies
Authors: Aggarwal Rahul , Thomas Scott , Pawlowska Nela , Bartelink Imke , Grabowsky Jennifer , Jahan Thierry , Cripps Amy , Harb Armand , Leng Jim , Reinert Anne , Mastroserio Ilaria , Truong Thach-Giao , Ryan Charles J. , Munster Pamela N.
Published: February 2017

Purpose

This phase I trial evaluated epigenetic modulation of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor by using a histone deacetylase abexinostat in combination with pazopanib to enhance response and reverse resistance.

Patients and Methods

Pazopanib was administered once a day on days 1 to 28 and abexinostat was administered orally twice a day on days 1 to 5, 8 to 12, and 15 to 19 (schedule A) or on days 1 to 4, 8 to 11, and 15 to 18 (schedule B). Dose escalation (3 + 3 design) in all solid tumors was followed by dose expansion in renal cell carcinoma (RCC).

Results

Fifty-one patients with RCC (N = 22) were enrolled, including 30 (59%) with one or more lines of prior VEGF-targeting therapy. Five dose-limiting toxicities, including fatigue (n = 2), thrombocytopenia (n = 2), and elevated AST/ALT (n = 1), were observed with schedule A; one dose-limiting toxicity was observed (elevated AST/ALT) was observed with schedule B. Grade ≥ 3 related adverse events included fatigue (16%), thrombocytopenia (16%), and neutropenia (10%). The recommended phase II dose was established as abexinostat 45 mg/m2 twice a day administered per schedule B plus pazopanib 800 mg/d. Objective response rate was 21% overall and 27% in the RCC subset. Median duration of response was 9.1 months (1.2 to > 49 months). Eight patients (16%) had durable control of disease for > 12 months. Durable tumor regressions were observed in seven (70%) of 10 patients with pazopanib-refractory disease, including one patients with RCC with ongoing response > 3.5 years. Peripheral blood histone acetylation and HDAC2 gene expression were associated with durable response to treatment.

Conclusion

Abexinostat is well tolerated in combination with pazopanib, allowing prolonged exposure and promising durable responses in pazopanib- and other VEGF inhibitor-refractory tumors, which supports epigenetically mediated reversal of treatment resistance.
Somatic BRCA1/2 Recovery as a Resistance Mechanism After Exceptional Response to Poly (ADP-ribose) Polymerase Inhibition
Authors: Lheureux Stephanie , Bruce Jeff P. , Burnier Julia V. , Karakasis Katherine , Shaw Patricia A. , Clarke Blaise A. , Yang S.Y. Cindy , Quevedo Rene , Li Tiantian , Dowar Mark , Bowering Valerie , Pugh Trevor J. , Oza Amit M.
Published: February 2017

Purpose

Durable and long-term responses to the poly (ADP-ribose) polymerase inhibitor olaparib are observed in patients without BRCA1/2 mutations. However, beyond BRCA1/2 mutations, there are no approved biomarkers for olaparib in high-grade serous ovarian cancer (HGSOC). To determine mechanisms of durable response and resistance to olaparib therapy, we performed an analysis of HGSOC tumors from three patients without germline BRCA1/2 mutations who experienced exceptional responses to olaparib.

Patients and Methods

We performed integrated exome, low-pass genome, and RNA sequence analysis of tumors at diagnosis and upon relapse from patients with platinum-sensitive HGSOC recurrence who were treated > 5 years with olaparib therapy as a single agent.

Results

We observed somatic disruption of BRCA1/2 in all three patients at diagnosis, followed by subsequent BRCA recovery upon progression by copy number gain and/or upregulation of the remaining functional allele in two patients. The third patient with ongoing response (> 7 years) had a tumor at diagnosis with biallelic somatic deletion and loss-of-function mutation, thereby lacking a functional allele for recovery of BRCA1 activity and indicating a potential cure.

Conclusion

Olaparib has durable benefit for patients with ovarian cancer beyond germline BRCA1/2 carriers. These data suggest that biallelic loss of BRCA1/2 in cancer cells may be a potential marker of long-term response to poly (ADP-ribose) polymerase inhibition and that restoration of homologous repair function may be a mechanism of disease resistance.
Accuracy and Thoroughness of Treatment Summaries Provided as Part of Survivorship Care Plans Prepared by Two Cancer Centers
Authors: Tevaarwerk Amye J. , Hocking William G. , Zeal Jamie L. , Gribble Mindy , Seaborne Lori , Buhr Kevin A. , Wisinski Kari B. , Burkard Mark E. , Wiegmann Douglas A. , Sesto Mary E.
Published: February 2017

Purpose:

Treatment summaries prepared as part of survivorship care planning should correctly and thoroughly report diagnosis and treatment information.

Methods:

As part of a clinical trial, summaries were prepared for patients with stage 0 to III breast cancer at two cancer centers. Summaries were prepared per the standard of care at each center via two methods: using the electronic health record (EHR) to create and facilitate autopopulation of content or using manual data entry into an external software program to create the summary. Each participant's clinical data were abstracted and cross-checked against each summary. Errors were defined as inaccurate information, and omissions were defined as missing information on the basis of the Institute of Medicine recommended elements.

Results:

One hundred twenty-one summaries were reviewed: 80 EHR based versus 41 software based. Twenty-four EHR-based summaries (30%) versus six software-based summaries (15%) contained one or more omissions. Omissions included failure to provide dates and specify all axillary surgeries for EHR-based summaries and failure to specify receptors for software-based summaries. Eight EHR-based summaries (10%) versus 19 software-based summaries (46%) contained one or more errors. Errors in EHR-based summaries were mostly discrepancies in dates, and errors in software-based summaries included incorrect stage, surgeries, chemotherapy, and receptors.

Conclusion:

A significant proportion of summaries contained at least one error or omission; some were potentially clinically significant. Mismatches between the clinical scenario and templates contributed to many of the errors and omissions. In an era of required care plan provision, quality measures should be considered and tracked to reduce rates, decrease inadvertent contributions from templates, and support audited data use.
Are They Married?
Authors: Ahmad Attiya
Published: February 2017

In recent years marriages among Muslims of different ethnonational backgrounds have developed in the Gulf region. While proponents of these “Muslim marriages” depict them as transnational alternatives to ethnonational forms of affinity and belonging, as I discuss in this article these marriages are shaped and constrained by the very ethnonational processes they are often juxtaposed against. Based on over eighteen months of ethnographic fieldwork conducted on foreign resident women’s Islamic halaqa in Kuwait, sites where “Muslim marriages” are deliberated and discussed, I argue that “Muslim marriages” constitute transnational forms that are not simply marked by the extension or diffusion of kinship networks, ethnonational forms, and religious piety movements across borders. They reveal how transnationalism constitutes a dynamic field in which kinship, ethnonationalism, and religious movements are invoked and reworked, configured and reconfigured together in often complex and contradictory ways.
Ethnographic and Literary Reflections on Miral Al-Tahawy’s The Tent
Authors: Seymour-Jorn Caroline
Published: February 2017

This article focuses on the Egyptian writer Miral al-Tahawy’s 1996 novel The Tent (al-Khibāʾ). This ethnographically informed novel sheds light on liminal, emotional, and imaginative aspects of social and personal life—those aspects that tend to be particularly challenging for the ethnographer to transmit in his or her writing about culture. I argue that we can read The Tent as ethnographically informed primarily because of the complex way in which al-Tahawy incorporates authentic poetry into the text and that this usage allows her to represent poetry as a culturally significant element of Bedouin women’s lives. I approach the novelist’s manner of writing about emotion and imaginativeness by attending to aesthetic processes themselves, which are often ignored by anthropologists looking at fiction.
Distinct intracellular Ca2+ dynamics regulate apical constriction and differentially contribute to neural tube closure
Authors: Suzuki Makoto , Sato Masanao , Koyama Hiroshi , Hara Yusuke , Hayashi Kentaro , Yasue Naoko , Imamura Hiromi , Fujimori Toshihiko , Nagai Takeharu , Campbell Robert E. , Ueno Naoto
Published: February 2017

Early in the development of the central nervous system, progenitor cells undergo a shape change, called apical constriction, that triggers the neural plate to form a tubular structure. How apical constriction in the neural plate is controlled and how it contributes to tissue morphogenesis are not fully understood. In this study, we show that intracellular calcium ions (Ca2+) are required for Xenopus neural tube formation and that there are two types of Ca2+-concentration changes, a single-cell and a multicellular wave-like fluctuation, in the developing neural plate. Quantitative imaging analyses revealed that transient increases in Ca2+ concentration induced cortical F-actin remodeling, apical constriction and accelerations of the closing movement of the neural plate. We also show that extracellular ATP and N-cadherin (cdh2) participate in the Ca2+-induced apical constriction. Furthermore, our mathematical model suggests that the effect of Ca2+ fluctuations on tissue morphogenesis is independent of fluctuation frequency and that fluctuations affecting individual cells are more efficient than those at the multicellular level. We propose that distinct Ca2+ signaling patterns differentially modulate apical constriction for efficient epithelial folding and that this mechanism has a broad range of physiological outcomes.