bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding changes in dyspnoea perception in obstructive lung disease after mindfulness training
Authors: Malpass Alice , Feder Gene , Dodd James W
Published: June 2018

Introduction

Dyspnoea has been defined as a ‘subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’. However, the majority of available dyspnoea measures treat it as a single entity and rely on quantitative methodology. We propose that qualitative research can enhance our understanding of dyspnoea, in particular, how perception varies so much among patients with similar disease states. In this paper, we focus on how a specific type of inner attention—mindfulness—may alter perceptions of dyspnoea. The aim is to characterise mindfulness attention, which impacts on perceptions of dyspnoea and relate these to the multidimensional model of dyspnoea. We explore how an individual can change their perception and therefore relationship to similar disease states.

Method

22 patients with asthma or chronic obstructive pulmonary disease were recruited from primary and secondary care to an 8-week course in mindfulness-based cognitive therapy (MBCT). 12 patients took part in an in-depth qualitative interview 2 months after completing the MBCT course. Data were recorded, transcribed and then analysed using a framework approach, drawing on components of the multidimensional model of dyspnoea (multidimensional dyspnoea profile, MDP).

Results

We found that MBCT training involves developing three types of mindful attention (broad attention, informative attention and re-directive attention), which impact on perceptions of the sensory dimension of dyspnoea. MBCT appears to target affective and sensory perceptions articulated in the MDP model.

Conclusion

More research is needed into how mindfulness-based interventions may mediate the relationship between affective experience and the sensory perception of dyspnoea symptoms.
Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the English Longitudinal Study of Ageing (ELSA)
Authors: Fleischmann Maria , Carr Ewan , Xue Baowen , Zaninotto Paola , Stansfeld Stephen A , Stafford Mai , Head Jenny
Published: June 2018

Background

Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons.

Methods

We used waves 2–7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50–60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease.

Results

For employees, on diagnosis of chronic disease autonomy marginally decreased (−0.10, 95% CI −0.20 to 0.00) and physical job demands significantly increased (0.13, 95% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (−0.36, 95% CI −0.64 to –0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (−2.78, 95% CI −6.03 to 0.48).

Conclusion

Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work.
Cause-specific mortality by partnership status: simultaneous analysis using longitudinal data from England and Wales
Authors: Franke Sebastian , Kulu Hill
Published: June 2018

Background

This paper examines cause-specific mortality by partnership status. Although non-marital cohabitation has spread rapidly in industrialised countries, only a few studies have investigated mortality by partnership status and no recent study has investigated cause-specific mortality by partnership status.

Methods

We use data from the Office for National Statistics Longitudinal Study and apply competing risks survival models.

Results

The simultaneous analysis shows that married individuals have lower mortality than non-married from circulatory, respiratory, digestive, alcohol and accident related causes of deaths, but not from cancer. The analysis by partnership status reveals that once we distinguish premarital and postmarital cohabitants from other non-married groups, the differences between partnered and non-partnered individuals become even more pronounced for all causes of death; this is largely due to similar cause-specific mortality levels between married and cohabiting individuals.

Conclusions

With declining marriage rates and the spread of cohabitation and separation, a distinction between partnered and non-partnered individuals is critical to understanding whether and how having a partner shapes the individuals’ health behaviour and mortality. The cause-specific analysis supports both the importance of selection into partnership and the protective effect of living with someone together.
Placebo effects and racial and ethnic health disparities: an unjust and underexplored connection
Authors: Friesen Phoebe , Blease Charlotte
Published: June 2018

While a significant body of bioethical literature considers how the placebo effect might introduce a conflict between autonomy and beneficence, the link between justice and the placebo effect has been neglected. Here, we bring together disparate evidence from the field of placebo studies and research on health inequalities related to race and ethnicity, and argue that, collectively, this evidence may provide the basis for an unacknowledged route by which health disparities are exacerbated. This route is constituted by an uneven distribution of placebo effects, resulting from differences in expressions of physician warmth and empathy, as well as support and patient engagement, across racial and ethnic lines. In a discussion of the ethical implications of this connection, we argue that this contribution to health disparities is a source of injustice, consider ways in which these disparities might be ameliorated and suggest that this conclusion is likely to extend to other realms of inequality as well.
Use of HINTS in the acute vestibular syndrome. An Overview
Authors: Kattah Jorge C
Published: June 2018

Following the initial description of HINTS to diagnose acute vestibular syndrome (AVS) in 2009, there has been significant interest in the systematic evaluation of HINTs to diagnose stroke and other less common central causes of AVS. This trend increased with availability of the video head impulse test (video-HIT). This article reviews the original papers and discusses the main publications from 2009 to 2017. Many authors use video-HIT in the diagnosis of patients with AVS; this paper focuses on the major publications on the topic featuring nystagmus, manual and video-HIT, and skew deviation. Twenty-five papers provide a summary of the last 8 years’ application of HINTS, the video-HIT added quantitative information to the early clinical observations. Further research will undoubtedly provide specific combination of abnormalities with high degree of lesion localisation and aetiology. In a short time following the original description, neurotologist and neurologists in the evaluation of AVS use the HINTS triad. The introduction of the video-HIT added greater understanding of the complex interaction between the primary vestibular afferents, brainstem and cerebellum. In addition, it permits evaluation of the angular vestibulo-ocular reflex in the plane of all six semicircular canals, with accurate peripheral versus central lesion localisation often corroborated by brain imaging.
Efficient Design of Quantum Circuits Using Nearest Neighbor Constraint in 3D Architecture
Authors: Marbaniang Leniency , Datta Kamalika
Published: June 2018

Synthesis and optimization of quantum circuits have received significant attention from researchers in recent years. Developments in the physical realization of qubits in quantum computing have led to new physical constraints to be addressed. One of the most important constraints that is considered by many researchers is the nearest neighbor constraint which limits the interaction distance between qubits for quantum gate operations. Various works have been reported in the literature that deal with nearest neighbor compliance in multi-dimensional (mostly 1D and 2D) qubit arrangements. This is normally achieved by inserting SWAP gates in the gate netlist to bring the interacting qubits closer together. The main objective function to minimize here is the number of SWAP gates. The present paper proposes an efficient qubit placement strategy in a three-dimensional (3D) grid that considers not only qubit interactions but also the relative positions of the gates in the circuit. Experimental evaluation on a number of benchmark circuits show that the proposed method reduces the number of SWAP gates by 16.2% to 47.0% on the average as compared to recently published works.
Age Replacement Models with Constant and Random Replacement Times
Authors: Zhao Xufeng , Qian Cunhua , Nakagawa Toshio
Published: June 2018

Preventive replacement policy conducted at a routine time [Formula: see text] has been surveyed extensively in literatures. Another two random replacement times [Formula: see text] and [Formula: see text] for time [Formula: see text] are jointly considered in this paper. We formulate the models of replacement first, replacement last and replacement middle, which are based on the respective assumptions of whichever occurs first, whichever occurs last and whichever occurs middle. Next, we modify replacement first and replacement last by using whichever occurs first and last jointly. Furthermore, we give the model of replacement overtime when the assumptions of whichever occurs first, whichever occurs last and replacing the unit over time [Formula: see text] are simultaneously considered. Comparisons among these replacement models are made to find which policy is more economical than the other.
Cyclooxygenase-2 Expression Is a Predictive Marker for Late Recurrence in Colorectal Cancer
Authors: Kim Sung Hoo , Ahn Byung Kyu , Paik Seung Sam , Lee Kang Hong
Published: June 2018

Introduction. Cyclooxygenase-2 (COX-2) expression is elevated in colorectal cancer (CRC). However, data about the relation between COX-2 expression and the impact on the biologic behavior of recurrent disease are inconclusive as yet. The aim of this study is to investigate the relationship between the status of COX-2 expression in the primary CRC and the characteristics of recurrence after curative resection of stage I to III CRC. Materials and Methods. Ninety-eight patients with recurrence in 376 CRC patients, who underwent curative surgery between January 1991 and August 2001, were retrospectively assessed. Immunohistochemical staining, performed for the presence of COX-2 on tissue microarrays, was analyzed. Results. Forty-six patients showed elevated COX-2 expression, and 52 patients did not. The mean time to recurrence was significantly longer in the positive group than in the negative group (34.1 months ± 30.0 versus 21.9 months ± 17.4; P=0.019). Positive COX-2 expression was correlated with late recurrence (>3 years after surgery) [43.5% versus 13.5%; P=0.001]. In multivariate analysis, COX-2 expression was an independent factor associated with late recurrence (OR 4.656; 95% CI, 1.696 to 12.779; P=0.003). Recurrence pattern and postrecurrence survival were not different between the two groups. Conclusions. Elevated COX-2 expression in itself is not a prognostic factor, but COX-2 expression in tumor tissue may be an independent predictive marker of late recurrence for patients with stage I to III CRC.
Anti‐TIM‐1 Monoclonal Antibody (RMT1‐10) Attenuates Atherosclerosis By Expanding IgM‐producing B1a Cells
Authors: Hosseini Hamid , Yi Li , Kanellakis Peter , Cao Anh , Tay Christopher , Peter Karlheinz , Bobik Alex , Toh Ban‐Hock , Kyaw Tin
Published: June 2018

Background

Peritoneal B1a cells attenuate atherosclerosis by secreting natural polyclonal immunoglobulin M (IgM). Regulatory B cells expressing T‐cell immunoglobulin mucin domain‐1 (
TIM
‐1) expanded through
TIM
‐1 ligation by anti‐
TIM
‐1 monoclonal antibody (
RMT
1‐10) induces immune tolerance.

Methods and Results

We examined the capacity of
RMT
1‐10 to expand peritoneal B1a cells to prevent atherosclerosis development and retard progression of established atherosclerosis.
RMT
1‐10 treatment selectively doubled peritoneal B1a cells, tripled
TIM
‐1
+
B1a cells and increased
TIM
‐1
+
IgM
+
interleukin (IL)‐10
+
by 3‐fold and
TIM
‐1
+
IgM
+
IL‐10
−
B1a cells by 2.5‐fold. Similar expansion of B1a B cells was observed in spleens. These effects reduced atherosclerotic lesion size, increased plasma IgM and lesion IgM deposits, and decreased oxidatively modified low‐density lipoproteins in lesions. Lesion
CD
4
+
and
CD
8
+
T cells, macrophages and monocyte chemoattractant protein‐1, vascular cell adhesion molecule‐1, expression of proinflammatory cytokines monocyte chemoattractant protein‐1, vascular cell adhesion molecule‐1,
IL
1β, apoptotic cell numbers and necrotic cores were also reduced.
RMT
1‐10 treatment failed to expand peritoneal B1a cells and reduce atherosclerosis after splenectomy that reduces B1a cells, indicating that these effects are B1a cell‐dependent. Apolipoprotein E‐
KO
mice fed a high‐fat diet for 6 weeks before treatment with
RMT
1‐10 also increased
TIM
‐1
+
IgM
+
IL
‐10
+
and
TIM
‐1
+
IgM
+
IL
‐10
−
B1a cells and IgM levels and attenuated progression of established atherosclerosis.

Conclusions

RMT
1‐10 treatment attenuates atherosclerosis development and progression by selectively expanding IgM producing atheroprotective B1a cells. Antibody‐based in vivo expansion of B1a cells could be an attractive approach for treating atherosclerosis.
Method and Theory in the U.K.
Authors: Owen Suzanne
Published: June 2018

In this review, I will bring in my own experiences and observations of teaching method and theory in the United Kingdom before responding to some of the papers in Theory in a Time of Excess.
Arsacid Cities in the Hanshu and Houhanshu
Authors: Zanous Hamidreza Pasha , Yang Juping
Published: June 2018

In the reports of Chinese travellers submitted to the Emperors, they mentioned the places they had visited or heard of. Although some scholars have tried to identify these Chinese names as specific places in the Iranian Plateau and its bordering plains, their locations are still somewhat vague and debatable. This article discusses the place-names mentioned in Chinese sources and attempts to verify that they could have denoted the localities along the ancient Great Khorasan Road and other routes, which were once the main sections of the Silk Road. Among them, the route that Chinese traveller Gan Ying might have passed before he reached the western frontier of the Arsacid Empire will also be discussed in this study.
From Zanzibar to Zaytun: Iranian Merchants across the Indian Ocean Basin
Authors: Foltz Richard
Published: June 2018

The role of Iranian merchants in the maritime trade of the Indian Ocean basin from antiquity up to the 16th century is often underestimated. From scholarly histories to popular culture the “Muslim sailor” is typically portrayed as being an Arab. In fact, from pre-Islamic times the principal actors in Indian Ocean trade were predominantly Persian, as attested by the archaeological data, local written records, and the names of places and individuals.
On Some Pre-Islamic Beliefs among the Gidatli-Avars
Authors: Osmanov Akhmed , Seferbekov Magomedkhabib , Seferbekov Ruslan
Published: June 2018

The paper describes several interesting details from the rich repository of folk beliefs, cults, rites and ceremonies of obviously pre-Islamic nature, recorded among the Gidatlis. The latter are a sub-ethnic group of the Avars living in the Shamil region of Dagestan.
A Note on the Ancient World-Systems
Authors: Margaryan Ervand
Published: June 2018

The article deals with the relationship of such concepts as the world-system and civilisation, both living independently and co-existing in time and space. World-systems and civilisations may be forced to unite into hyper-systems, or world-empires of different kind—self-sufficient, militarist-parasitic, and mixed type. Militarist empires-parasites can be settled and nomadic. Nomadic or bivouac empires are empires-armies, which exist only in movement. Stopping leads either to the death of the empire-army, or to the transformation into one but usually several stationary empires, mostly also militarist-parasitic.
An Overview of the Missions Activities of the Southern Baptist Convention’s Foreign Mission Board in Iran
Authors: Hopkins Philip O.
Published: June 2018

This paper overviews the American missionary activity in Iran from the Southern Baptist Convention’s Foreign Mission Board. Much of the research is based on the Board of Trustee minutes of the Foreign Mission Board, as well as archival material from the International Mission Board, the new name for the Foreign Mission Board that includes personal correspondences, letters, communications, statistics of churches in Iran, strategies for missions, and other documents. Academic papers, diaries, composed and written oral histories, and other information from Foreign Mission Board missionaries of this period also are used. Therefore, the significance of this paper lies, I hope, at least in presenting documents previously unknown and inaccessible.
Aryan Traces in the Onomastics of Hayasa
Authors: Petrosyan Armen
Published: June 2018

Among the attested personal names in the Hayasa onomastics, there are some of the probable Aryan origin. Three of them are associated with the religion (Akni, Š(a)ummatar, takšanna) and one, with the ruling elite of the kingdom (Mariya). If this is correct, it can be assumed that the Aryans could constitute a considerable part of the population of Hayasa.
De Facto State Foreign Policy “Social Moves” in Abkhazia and South Ossetia
Authors: Smith Mary Elizabeth
Published: June 2018

This paper presents “social moves” as a new strategy de facto states can use in their interactions with the international community, with or without the possibility of a formal recognition of sovereignty. Special attention is paid to Abkhazia’s continuing desire for an independent state compared to South Ossetia’s desire for Russian absorption in light of both regions’ ethnic histories and turbulent relationships with Georgia. Key analysis includes discussion of the diplomatic soft power “social moves” the Abkhazian Foreign Ministry has begun in the last two years and the absence of similar “social moves” within the South Ossetian Foreign Ministry.
The Image of the Babel Tower in Contemporary Art and a Parallel Disruption of the Statue of Liberty
Authors: Karabıyık Ayfer
Published: June 2018

The ‘Legend of the Babel Tower’ is mentioned in local narratives in many regions of the world and in mainstream religions, and is a subject much worked on in the field of art. This study will focus on the theme of the Babel Tower myth as discussed in contemporary art. The intention here is to discuss the reasons for the different assessments of the Babel myth in each period.
The walking stick in the nineteenth-century city: Conflicting ideals of urban walking
Authors: Andersson Peter K
Published: June 2018

This article reflects on the role of the walking stick in the nineteenth-century city and explores the nature of the criticisms directed at it. The criticism and mocking of certain ways of holding the cane display the deep conflicts within the culture of urban strolling concerning how to take part in it, and who were allowed to do so. By identifying an irritation with canes, we see that there was a conflict between the purposeful culture of walking and the superficial culture of performativity and display, which forced Victorian men to be extremely careful of how their behaviour was perceived. By bringing the walking stick to the fore, the paper illustrates its role in a struggle between ostentation and sobriety and how its importance in cultures of both self-possession and flamboyance is indicative of aspects of the history of urban walking.
Postoperative catecholamine resistance following fetal methamphetamine exposure
Authors: Perumal Gopinath , Marathe Supreet P , Schlapbach Luregn J , Morwood Jim , Venugopal Prem , Alphonso Nelson
Published: June 2018

Methamphetamine and its related compounds are among the most widely abused recreational drugs worldwide. While a myriad of clinical complications of methamphetamine use have been described, there is a paucity of literature regarding the effects of maternal abuse during pregnancy on neonatal hearts. In this report, we describe a neonate who underwent Norwood-type palliation and subsequently developed catecholamine-resistant cardiogenic shock, likely related to methamphetamine exposure, which recovered after a period of venoarterial extracorporeal membrane oxygenation support.
Robotic assistance in the coordination of patient care
Authors: Gombolay Matthew , Yang Xi Jessie , Hayes Bradley , Seo Nicole , Liu Zixi , Wadhwania Samir , Yu Tania , Shah Neel , Golen Toni , Shah Julie
Published: June 2018

We conducted a study to investigate trust in and dependence upon robotic decision support among nurses and doctors on a labor and delivery floor. There is evidence that suggestions provided by embodied agents engender inappropriate degrees of trust and reliance among humans. This concern represents a critical barrier that must be addressed before fielding intelligent hospital service robots that take initiative to coordinate patient care. We conducted our experiment with nurses and physicians, and evaluated the subjects’ levels of trust in and dependence upon high- and low-quality recommendations issued by robotic versus computer-based decision support. The decision support, generated through action-driven learning from expert demonstration, produced high-quality recommendations that were accepted by nurses and physicians at a compliance rate of 90%. Rates of Type I and Type II errors were comparable between robotic and computer-based decision support. Furthermore, embodiment appeared to benefit performance, as indicated by a higher degree of appropriate dependence after the quality of recommendations changed over the course of the experiment. These results support the notion that a robotic assistant may be able to safely and effectively assist with patient care. Finally, we conducted a pilot demonstration in which a robot-assisted resource nurses on a labor and delivery floor at a tertiary care center.
Dual source abdominal computed tomography: the effect of reduced X-ray tube voltage and intravenous contrast media dosage in patients with reduced renal function
Authors: Svensson Anders , Thor Daniel , Fischer Michael A , Brismar Torkel
Published: June 2018

Background

X-ray tube voltage (kVp) reduction increases intravenous contrast medium (CM) attenuation at computed tomography (CT), but tube output limits its use in large patients.

Purpose

To evaluate the feasibility and image quality of reducing CM dose by low kVp and using dual X-ray source at liver CT.

Material and Methods

Patients with estimated glomerular filtration rate (eGFR) < 45 mL/min (n = 43) aged 60–91 years (75 ± 7.7), weighing 42–114 kg (75 ± 15) were prospectively scanned using a reduced CM dose of 0.25 or 0.3 g iodine (I)/kg with 70 or 80 kVp respectively, using either single-source or dual-source CT depending on patient size. Liver contrast-to-noise ratio (CNR), liver noise, and muscle noise were quantitatively compared with those of 43 consecutive patients aged > 65 years with eGFR > 45 mL/min scanned using a standard abdominal protocol at 120 kVp after receiving 0.5 gI/kg.

Results

There was no statistically significant difference in CNR, liver noise, or muscle noise at reduced CM protocols compared to the standard protocol: CNR was 4.6 (95% CI = 4.2–5.0) vs. 5.0 (95% CI = 4.5–5.5), liver noise was 11.1 (95% CI = 10.7–11.6) vs. 11.0 (95% CI = 10.5–11.6), muscle noise was 11.7 (95% CI = 11.2–12.1) vs. 10.8 (95% CI = 10.1–11.4). The mean SSDE was 70% higher with the reduced CM protocol.

Conclusion

CM dosage can be reduced by 40–50% with maintained measured noise and CNR in patients with BMIs of 15–36 kg/m2 by lowering the tube voltage and dual-source CT scanning of the liver.
Myocardial volume change during cardiac cycle derived from three orthogonal systolic strains: towards a quality assessment of strains
Authors: Bonnemains Laurent , Guerard Anne Sophie , Soulié Paul , Odille Freddy , Felblinger Jacques
Published: June 2018

Background

The relative modification of the myocardial volume between end-systole and end-diastole ([Formula: see text]) has already been assessed with different methods and falls in a range of 0.9–0.97 (mean value = 0.93).

Purpose

To estimate [Formula: see text] from the three longitudinal ([Formula: see text], circumferential ([Formula: see text]), and radial ([Formula: see text]) strains of the left ventricle using the formula: [Formula: see text] and to test whether this estimate of [Formula: see text] can be used as a marker of the echocardiography quality.

Material and Methods

Two hundred manuscripts, including a total of 34,690 patients or healthy volunteers, were identified in the Medline database containing values of [Formula: see text], [Formula: see text], and [Formula: see text] measured from echocardiography.

Results

The median value of was 0.93, in accordance with the literature, with no significant difference between patients or healthy volunteers ( P = 0.38). The proportion of studies with [Formula: see text] was 79%. When only considering groups of healthy volunteers, the studies failing this test had higher standard deviations for the three individual strains: 0.038 vs. 0.029 ( P = 0.02) for [Formula: see text]; 0.060 vs. 0.034 ( P < 10–6) for [Formula: see text], and 0.243 vs. 0.101 ( P < 10–14) for [Formula: see text].

Conclusion

The median ratio of the left ventricular myocardial volumes between end-systole and end-diastole in the investigated studies was [Formula: see text]. The formula [Formula: see text] could be used to detect studies with inaccurate strain measurements.
CT pulmonary angiography: dose reduction via a next generation iterative reconstruction algorithm
Authors: Sauter Andreas , Koehler Thomas , Brendel Bernhard , Aichele Juliane , Neumann Jan , Noël Peter B , Rummeny Ernst J , Muenzel Daniela
Published: June 2018

Background

Computed tomography pulmonary angiography (CTPA) is the standard imaging modality for detection or rule out of pulmonary embolism (PE); however, radiation exposure is a serious concern. With iterative reconstruction algorithms a distinct dose reduction could be achievable.

Purpose

To evaluate a next generation iterative reconstruction algorithm for detection or rule-out of PE in simulated low-dose CTPA.

Material and Methods

Low-dose CT datasets with 50%, 25%, and 12.5% of the original tube current were simulated based on CTPA examinations of 92 patients with suspected PE. All datasets were reconstructed with two reconstruction algorithms: standard filtered back-projection (FBP) and iterative model reconstruction (IMR). In total, 736 CTPA datasets were evaluated by three blinded radiologists regarding image quality, diagnostic confidence, and detectability of PE. Furthermore, contrast-to-noise ratio (CNR) was calculated.

Results

Images reconstructed with IMR showed better detectability of PE than images reconstructed with FBP, especially at lower dose levels. With IMR, sensitivity was over 95% for central and segmental PE down to a dose level of 25%. Significantly higher subjective image quality was shown at lower dose levels (25% and 12.5%) for IMR images whereas it was higher for FBP images at higher dose levels. FBP was rated as showing less artificial image appearance. CNR was significantly higher with IMR at all dose levels.

Conclusion

By using IMR, a dose reduction of up to 50% while maintaining satisfactory image quality seems feasible in standard clinical situations, resulting in a mean effective dose of 1.38 mSv for CTPA.
Beyond academic outcomes: Occupational profile and quality of life among college students with and without attention deficit hyperactivity disorder
Authors: Goffer Ayelet , Cohen Maayan , Berger Itai , Maeir Adina
Published: June 2018

Introduction

The purpose of this cross-sectional study was to describe the occupational profile and quality of life among college students with and without attention deficit hyperactivity disorder.

Method

Forty college students with attention deficit hyperactivity disorder and 40 controls (mean age 25.81 years, SD = 3.02) were evaluated with the Occupational Questionnaire and the Adult ADHD Quality-of-Life scale.

Results

The two groups demonstrated similar amounts of time spent in occupational domains, as well as similar ratings of ‘perceived importance’. However, the ‘perceived competence’ and ‘perceived enjoyment’ were significantly lower in the attention deficit hyperactivity disorder group than in the control group in most occupational domains and in the total score. Significant differences, with very large effect sizes, were found between the groups on all measures of the Adult ADHD Quality-of-Life scale. A moderate significant correlation was found between the mean perceived competence score and Adult ADHD Quality-of-Life scale total score within the attention deficit hyperactivity disorder group.

Conclusion

The results highlight the negative effect of attention deficit hyperactivity disorder on quality of life among college students. The perception of competence and enjoyment in occupations may be optimal targets for therapeutic intervention.
Cluster headache is associated with unhealthy lifestyle and lifestyle-related comorbid diseases: Results from the Danish Cluster Headache Survey
Authors: Lund Nunu , Petersen Anja , Snoer Agneta , Jensen Rigmor H , Barloese Mads
Published: June 2018

Aim

To compare the prevalence of unhealthy lifestyle factors and comorbid disorders in cluster headache patients with headache-free controls, in order to discuss pathophysiology and possible consequences.

Methods

Cluster headache patients from the Danish cluster headache survey aged 18–65 years, diagnosed according to ICHD-II, were compared to sex- and age-matched headache-free controls. Participants completed questionnaires and structured interviews.

Results

A total of 400 cluster headache patients and 200 controls participated. Patients had a more unhealthy lifestyle compared with controls in the form of current and current/former smoking (48.3% vs. 9.0%, p < 0.001 and 74.5% vs. 30.0%, p < 0.001, respectively), higher average alcohol intake per week (98.2 grams vs. 77.9 grams, p = 0.033) and BMI (26.1 vs. 24.2 kg/m2, p < 0.001), whereas coffee and energy drink consumption was equally distributed. Further, lifestyle-related, psychiatric and pain-related diseases were much more prevalent in patients compared with controls, except for diabetes. Sub-group analyses revealed that current/former smokers had a worse clinical presentation than never smokers.

Conclusion

Unhealthy lifestyle factors and lifestyle-related diseases were more prevalent in cluster headache patients compared to controls. As lifestyle-related diseases might have serious consequences in the management of cluster headache, it is key to inform patients at an early time point about the possible risks of their lifestyle choices.
Alginate hydrogel co-loaded with cisplatin and gold nanoparticles for computed tomography image-guided chemotherapy
Authors: Keshavarz Marzieh , Moloudi Kave , Paydar Reza , Abed Ziaeddin , Beik Jaber , Ghaznavi Habib , Shakeri-Zadeh Ali
Published: June 2018

The biomedical applications of gold nanoparticles (AuNPs) have experienced rapid growth in recent years, due to their expected benefits in medical imaging and therapy. In this work, we report the development of a theranostic nanocomplex constructed from alginate hydrogel co-loaded with cisplatin and AuNPs (abbreviated as ACA) for simultaneous drug delivery and computed tomography imaging. CT26 cells derived from mouse colon adenocarcinoma were exposed to various concentrations of ACA nanocomplex (for 24 h) and the cytotoxicity was measured using MTT assay. Moreover, the cells treated with ACA nanocomplex were imaged in a computed tomography scanner and the contrast enhancement due to the presence of nanocomplex was assessed. The cytotoxicity results showed that ACA nanocomplex had a more potent chemotherapy efficacy than free cisplatin, so that ACA nanocomplex at the concentration of 5 µg/ml (per cisplatin) and 20 µg/ml of free cisplatin resulted in the same cytotoxicity (survival rate: 66%). The computed tomography imaging study revealed that ACA nanocomplex increased the brightness of computed tomography images, the computed tomography number value, and contrast-to-noise ratio (CNR). ACA nanocomplex can be presented as a computed tomography-traceable nanocarrier that allows to monitor the delivery of therapeutics by assessing their localized accumulation and in vivo biodistribution.
Dynamic crashing behavior of thin-walled conical tubular structures with nonlinearly-graded diameters
Authors: Xu Fengxiang , Zhang Suo , Wu Kunying
Published: June 2018

Thin-walled structures with graded property have been paid more attention in recent years due to their significant balance between lightweight and crashworthiness. However, few studies have been focused on energy absorption capacity of thin-walled conical tubes with graded diameters. In this paper, the thin-walled conical aluminum tubes with nonlinearly-graded diameters are introduced and their corresponding crashing characteristics are performed. The diameters are assumed to nonlinearly vary according to a power-law distribution function primarily determined by a graded exponent n. It is found that the total weight of thin-walled conical tubes decreases with the increasing of the gradient exponent. The energy-absorbed performances such as specific energy absorption, initial peak crashing force, and mean crashing force of those graded tubular structures are numerically analyzed. And then the effects of various geometric parameters such as the gradient exponent, deformation distance, and diameter range on crashing behaviors are further evaluated. It is observed that those parameters especially the gradient exponent has significantly obvious effects on crashworthiness of the proposed nonlinearly graded tubes. It is also noted that the straight conical structure with gradient n = 1.0 may not show the best energy absorption characteristics compared with other gradients. The work could provide valuable information for effective design of thin-walled energy-absorbing structures with variable geometrical parameters.
Treading water: Street sex workers negotiating frantic presents and speculative futures in the Mekong Delta, Vietnam
Authors: Lainez Nicolas
Published: June 2018

Structural conditions shape the temporalities that govern the lives of street sex workers operating in Châu Đốc, a small town in Southern Vietnam. These women live each day as they come and make decisions based on quick returns and the management of daily needs, prioritizing short-term solutions over planning for the future. The ethnographic study of the multiple temporalities that govern street sex work, family care, gambling and debt-juggling practices shows that these women live in a frantic present-oriented temporality that is filled with pressing tasks and routines. This leads to an uncertain future that engenders various forms of hopeful and speculative behaviour, but precludes systematic planning. As a result, these women are treading water: putting effort into keep themselves afloat but never furthering their status and lives or catching up with the currents of development and progress. Overall, this article argues that this day-to-day lifestyle goes hand in hand with the linear and future-oriented time of capitalism and wage-labour that has infiltrated everyday life in post-reform Vietnam.
Azacitidine-associated pleuropericardial effusion in myelodysplastic syndrome: A case report
Authors: Goo Kelli , Uy Rosalynda , Roswarski Joseph
Published: June 2018

Azacitidine, a deoxyribonucleic acid hypomethylating agent, is used in the treatment of myelodysplastic syndrome. Common adverse effects of azacitidine include bone marrow suppression, injection site reactions, nausea, vomiting, diarrhea, and fatigue. This report focuses on pleuropericardial effusions, an infrequently reported and potentially reversible adverse effect of azacitidine. In this case report, pleuropericardial effusion manifested as the sole radiographic finding in the evaluation of cough occurring during the eighth cycle of treatment with azacitidine. Symptoms and radiographic abnormalities resolved with corticosteroids and diuretics, and the patient could continue with therapy.
Inferior outcomes in immunocompromised Merkel cell carcinoma patients: Can they be overcome by the use of PD1/PDL1 inhibitors?
Authors: Dasanu Constantin A , Del Rosario Michael , Codreanu Ion , Hyams David M , Plaxe Steven C
Published: June 2018

Cases of Merkel cell carcinoma have become increasingly more common in the last two decades, and its incidence has been predicted to climb further. Immunosenescence might explain in part the higher Merkel cell carcinoma prevalence in seniors aged 70 and older. This cancer might also be more aggressive in immunocompromised patients. In a subset of immunocompromised Merkel cell carcinoma patients, we identified significant lymphopenia and a more advanced disease stage compared with their immunocompetent counterparts. Time to death in this cohort was much shorter than in immunocompetent subjects, and their likelihood of death from Merkel cell carcinoma was five times higher. Avelumab approval in 2017 represents an important step forward in the therapy of Merkel cell carcinoma. Hopefully, PD1/PDL1 inhibitors will improve survival in immunocompromised Merkel cell carcinoma hosts, traditionally linked with inferior clinical outcomes.
Preliminary hazard analysis applied to outsourcing sterile chemotherapy preparations
Authors: Geraudie Bastien , Kabiche Sofiane , Rigal Marthe , Malki Myriam , Fontan Jean-Eudes , Jacolot Anne , Schlatter Joël
Published: June 2018

Background

Our hospital organization raised the possibilities of outsourcing their sterile pediatric chemotherapy preparations to another hospital conditional on analyzing the potential hazardous events that need to be anticipated.

Methods

The study was conducted by a multidisciplinary working group from September 2015 to January 2016 with the support of a risk manager. A list of hazardous situations that could occur during outsourcing process was assessed. First, a map of hazardous situations was developed by crossing outsourcing processes divided into phases classified as critical or not. Second, a map of risk was established by crossing potential consequences of these hazardous situations and elaborating corrective actions to reduce the initial risks.

Results

The map of hazardous situations identified 183 relevant hazardous situations, 78 of which were considered high priority and 154 scenarios were developed. Slightly more than half of these hazardous situations concerned information system (30%), human resources (14%), and management (11%). The generic hazards of information system and human generated 37 (24%) and 41 (27%) scenarios, respectively. To reduce critical risks, 33 corrective actions were proposed. Working time required was estimated at 35 days. The subcontractor personnel for this new organization included an estimated extra time of 0.7-pharmacist working day and 1.4-pharmacy dispenser working day.

Conclusions

The preliminary hazard analysis method appeared to apply to our system of outsourcing sterile cytotoxic preparations in another hospital. Regardless, this analysis is complex and requires time and expertise.
Predicting the wear coefficient and friction coefficient in dry point contact using continuum damage mechanics
Authors: Ghatrehsamani Sahar , Akbarzadeh Saleh
Published: June 2018

Wear coefficient and friction coefficient are two of the key parameters in the performance of any tribo-system. The main purpose of the present research is to use continuum damage mechanics to predict wear coefficient. Thus, a contact model is utilized that can be used to obtain the friction coefficient between the contacting surfaces. By applying this model to the continuum damage mechanics model, the wear coefficient between dry surfaces is predicted. One of the advantages of using this model is that the wear coefficient can be numerically predicted unlike other methods which highly rely on experimental data. In order to verify the results predicted by this model, tests were performed using pin-on-disk test rig for several ST37 samples. The results indicated that the wear coefficient increases with increasing the friction coefficient.
What do Australian dermatologists expect to be paid for store-and-forward teledermoscopy? A preliminary investigation
Authors: Snoswell Centaine L , Whitty Jennifer A , Caffery Liam J , Finnane Anna , Soyer H Peter
Published: June 2018

Introduction

Determining appropriate remuneration for teledermoscopy service is important because inadequate remuneration can be a barrier to practitioner uptake and participation. This study explores dermatologist remuneration expectations for a single lesion store-and-forward teledermoscopy consultation.

Methods

Fourteen dermatologists participated in telephone interviews during May–June 2017. Questions regarding remuneration focused on a clinical scenario involving teledermoscopy of a single lesion suspected to be skin cancer. The initial scenario was an existing patient, with a provisional diagnosis of benign neoplasm from the images, to be followed-up with routine skin checks, taking three minutes to review. Participants indicated their remuneration expectation by selecting from an ascending array of pre-determined remuneration ranges. The question was repeated a further four times with one aspect of the scenario changed each time; consultation length, source (patient or general practitioner), required follow-up, and a new rather than existing patient. Participants were also asked how appropriate they thought teledermoscopy was for the scenario, and whether they would choose to undertake the consultation presented.

Results

Nine dermatologists selected the AU$61–90 or AU$91–120 remuneration ranges for the initial scenario. When given the opportunity to comment on teledermoscopy service provision in Australia, respondents reflected that it was a valuable, advanced dermatology service, but they would prefer face-to-face consultation with patients where possible to allow for a full body examination.

Discussion

Dermatologists expect to be remunerated in the range of AU$61–120 for a single lesion store-and-forward teledermoscopy consultation when face-to-face examination is not possible.
Dermatology ECHO: A case presentation demonstrating benefits of specialty telementoring in primary care
Authors: Ladd Ryan , Becevic Mirna , Misterovich Hope , Edison Karen
Published: June 2018

Allergic contact dermatitis (ACD) is a common dermatologic disorder that is estimated to affect 15–20% of the general population. Because of its prevalence, it may be expected that ACD should be easily recognized. However, it can present with many clinical variations that may complicate diagnosis. Although ACD is a treatable condition, patients from rural and underserved areas suffer if timely access to specialty care is limited. Dermatology Extension for Community Healthcare Outcomes (Dermatology ECHO) telemedicine sessions were created to mentor rural primary care providers (PCPs). To illustrate their benefit, we present the case of a 19-year-old female patient who suffered from worsening undiagnosed ACD for over nine months following a laparoscopic appendectomy. During that time, the surgeon and multiple PCPs treated her with antibiotics, antivirals, and Scabicide without improvement in her condition. The de-identified patient case was presented by her PCP during the Dermatology ECHO session. The Dermatology ECHO specialty team mentored and educated the PCP in the diagnosis and treatment of ACD. After making the diagnosis, the patient received new treatment and her condition improved significantly. Dermatology ECHO provides a knowledge-sharing network for participating PCPs that may improve patient outcomes and reduce patient suffering.
The development of agency in professional youth work with girls and young women in the Netherlands
Authors: Boomkens Cynthia , Metz Judith W , Van Regenmortel Tine MRF , Schalk René MJD
Published: June 2018

Young people living in north-west European welfare states are challenged to develop their individual strength. This is especially difficult for girls living in vulnerable circumstances, because they face a form of marginalization. Girls work is a method of professional youth work that supports girls in their identity development, making them more capable of shaping their own lives now and as adults. This is conceptualized as agency, which consist of the properties: intentionality, forethought, self-reactiveness, self-reflection. This paper examines the extent to which girls work helps girls living in vulnerable circumstances to develop their individual strength.

Findings

The article is based on a questionnaire filled out by 393 girls who participate in 59 girls work activities in the Netherlands. This study shows that participation in girls work contributes to the development of intentionality of these girls (F(3,387) = 4.60, p = .004). Furthermore, girls who received an individual approach are better capable of reflecting on their actions than girls who only participated in group activities (F(2,388) = 3.10, p = .046).

Applications

The findings suggest that participation in girls work contributes to the intentionality of girls in vulnerable circumstances, which is an important step in the development of agency. But to accomplish this, girls need to learn how to act upon their personal intentions. However, the findings do not show that girls work contributes to the other properties of agency, suggesting that to support girls in shaping their own lives, youth workers need to contribute more to the other levels of agency.
Research roundup: June 2018
Authors: Som Rita
Published: June 2018

In brief

Surveillance study of Yellow Card reports finds no significant safety concerns over the introduction of Bexsero Inappropriate medicines and prescription omissions compromise quality and longevity of life Community nurses' prescribing needs: expert consensus reached
Cost-effective inhaler device prescribing for COPD
Authors: Gundry Stephen
Published: June 2018

Pharmacological treatment for chronic obstructive pulmonary disease (COPD) is typically focused on the use of inhaled medication. Treatment is expensive and there is an imperative to provide medication that yields maximum therapeutic benefit with the least cost. With an increasing number of inhaler devices available, selecting suitable inhalers for individual patients involves ever more complex decision-making.

The challenge for prescribers is to ensure that patients have the right medication delivered with a competent inhaler technique. This requires a detailed understanding of the mechanics of inhaler devices as well as an understanding of an individual patients capacity to use an inhaler effectively.