bluuebunny/crossref_metadata_2025 huggingface dataset:
Corneoscleral xanthogranuloma treated with chemotherapy: The room for nonsurgical management
Authors: Mustafa Osama M , Daoud Yassine J
Published: February 2019

Purpose:

To describe a clinical case of corneoscleral xanthogranuloma, a rare manifestation of juvenile xanthogranuloma, and xanthoma disseminatum, which responded well to chemotherapy.

Methods:

Interventional case report and literature search.

Results:

A 9-year-old female patient with a disseminated disease showed complete regression of her corneoscleral xanthogranuloma with methotrexate and azathioprine therapy.

Conclusion:

Since they are potentially blinding, corneoscleral xanthogranulomas are commonly surgically excised. While surgical resection has been widely advocated in the literature, immunosuppressive therapy alone may be a pertinent management line of corneoscleral xanthogranuloma, especially with systemic involvement.
Bio-Field Array: The Influence of Junction Mediating and Regulatory Protein Expression on Cytoskeletal Filament Behavior During Apoptosis in Triple-Negative Breast Cancer
Authors: Purnell Marcy C
Published: February 2019

Introduction:

The Bio-Field Array (BFA) is a device that generates a dielectrophoretic electromagnetic field (DEP-EMF) when placed in a hypotonic saline solution and a direct current (dc) of ~3 amperes is applied. Human triple-negative breast cancer (MDA-MB-231 cells) is known to have a high percentage of apoptotic ( P53) deficient cells and some patients can have poor outcomes with current treatments.

Objectives:

Previously, we reported a strong upregulation of the apoptotic arm of the unfolded protein response, via reverse transcription–quantitative polymerase chain reaction (RT-qPCR), as well as positive annexin staining in this human breast carcinoma, when grown in media prepared with BFA’s dc DEP-EMF treated saline. Here we will examine and discuss cytoskeletal microtubule changes that were noted in the treated breast carcinoma that are strongly suggestive of apoptosis and the possible correlation of these microtubule changes to the upregulation of Junction Mediating and Regulatory Protein ( JMY, a P53/TP53 cofactor) that is known to drive cytoskeleton microfilaments (actin) function.

Methods:

In addition to microarray and RT-qPCR analyses, we conducted 7 days of fluorescent microscopic analyses of tubulin assays in these treated versus control MDA-MB-231 cells.

Results:

These data suggest 2 possible forms of apoptosis, rounded and irregular, may be occurring and possibly facilitated by the significant upregulation (via microarray and RT-qPCR) of an important but poorly understood Nucleation-Promoting Factor (NPF), JMY.

Conclusions:

The ability of the BFA dc DEP-EMF to significantly upregulate JMY and possibly influence the regulation of unbranched (nucleation-microtubule spikes) and branched forms (autophagy) of actin in the cytoplasmic domains may facilitate a “two coffins” or round and irregular necrosis-like apoptosis for this highly aggressive and often apoptotic-deficient breast cancer cell line.
‘Take it down!’: Estonian parents’ and pre-teens’ opinions and experiences with sharenting
Authors: Lipu Merike , Siibak Andra
Published: February 2019

Semi-structured individual interviews with 14 Estonian mothers and their children (aged 9–13 years) pairs who had ‘friended’ each other on Facebook were carried out to study pre-teens’ and parents’ reflections and experiences regarding information disclosures and sharenting on Facebook. We wanted to know what kind of information mothers shared about their children on Facebook and how the children perceived and reacted to such posts. Our findings indicated that there was a major discrepancy in the parents’ and children’s views about whether a parent should ask for permission to upload child-related content on social media. Pre-teens were often frustrated by their mothers’ sharenting practices, which led to privacy boundary turbulence between parents and the children. Raising the awareness of parents is crucial as children not only feel a need to negotiate the terms of acceptable information sharing with their parents but also expect their parents to respect their views on the topic.
The effect of feedback timing on L2 Spanish vocabulary acquisition in synchronous computer-mediated communication
Authors: Henderson Carly
Published: February 2019

The benefits of corrective feedback (CF) for second language (L2) learning are empirically attested, and multiple factors mediating CF effectiveness have been investigated. However, the timing of oral CF has received less attention given most research examines corrections provided immediately after an error. Delayed CF also warrants investigation; it occurs naturally in L2 classrooms and may be an appealing alternative in online learning contexts. Existing CF timing research shows either no significant differences between immediate and delayed CF, or advantages for immediate CF. To elucidate mixed findings, more CF timing studies are needed, especially those considering the effects of factors such as CF type, linguistic target and communication mode. Regarding communication mode, the effect of CF timing on errors made during text-based synchronous computer-mediated communication (SCMC), for instance, has received less attention. Examining text-based SCMC is important given its empirically attested benefits for L2 learning, and in some cases its advantage over face-to-face interaction for fostering CF effectiveness. Investigating the role of CF timing on errors made in text-based SCMC will contribute to efforts to maximize CF effectiveness in online learning environments, which are becoming increasingly common. In this study, 30 third-year learners of Spanish as a foreign language completed a one-way information-gap task with an interlocutor using Skype text-chat. On vocabulary errors, learners received either immediate or delayed error repetition plus recast, or no CF. Results revealed both CF groups significantly outperformed the comparison group on an oral picture description task, with no significant differences between immediate and delayed CF. Results may be due to the salience of the CF modality, type, and target.
Closed due to ‘flooding’? UK media representations of refugees and migrants in 2015–2016 – creating a crisis of borders
Authors: Pruitt Lesley J
Published: February 2019

This article reports on a discourse analysis of high circulation news media sources in the United Kingdom, around six key events relating to migration in 2015–2016. This article argues that the dominant discourse in UK media constructed the increase in movements of people and applications for asylum as a ‘crisis of borders’. In this context, Europe’s borders were deemed problematically porous in enabling large numbers of people to enter. This porosity was painted as leading to an ongoing crisis for people in Europe, with the assumption being that allowing more people to enter would threaten European borders, security forces, people, and identity. These discursive constructions serve to marginalise considerations of insecurity and dangers that asylum seekers and refugees face in conflicts, and instead paint them not as experiencing violence, but rather as perpetrators of crisis themselves.
Influence of physical and psychosocial working conditions for the risk of disability pension among healthy female eldercare workers: Prospective cohort
Authors: Andersen LL , Villadsen E , Clausen T
Published: February 2019

Aim: To investigate the influence of physical and psychosocial working conditions on the risk of disability pension among eldercare workers. Methods: After responding to a questionnaire in 2005, 4699 healthy female eldercare workers – free from chronic musculoskeletal pain, depressive symptoms and long-term sickness absence – were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated the hazard ratio (HR) for disability pension from physical exertion during work, emotional demands, influence at work, role conflicts, and quality of leadership. Analyses were mutually adjusted for these work environmental factors as well as for age, education, smoking, leisure physical activity and body mass index. Results: During follow-up, 7.6% received disability pension. Physical exertion and emotional demands were associated with risk of disability pension, and both interacted with age. In age-stratified analyses, older eldercare workers (mean age 53 years at baseline) with moderate and high physical exertion (reference: low) were at increased risk with HRs of 1.51, 95% CI [1.06–2.15] and 2.54, 95% CI [1.34–4.83], respectively. Younger eldercare workers (mean age 36 years at baseline) with moderate emotional demands (reference: low) were at decreased risk with an HR of 0.57, 95% CI [0.37–0.85]. Conclusions: While a higher level of physical exertion is a risk factor for disability pension among older female eldercare workers, a moderate level of emotional demands is associated with lower risk among the younger workers. The age of the worker may be an important factor when providing recommendations for promoting a long and healthy working life.
Neighborhood Socioeconomic Status and Feeding Practices in Finnish preschools
Authors: Lehto Reetta , Lehto Elviira , Konttinen Hanna , Vepsäläinen Henna , Nislin Mari , Nissinen Kaija , Vepsäläinen Ciara , Koivusilta Leena , Erkkola Maijaliisa , Roos Eva , Ray Carola
Published: February 2019

Aims: Certain feeding practices, such as role modeling healthy eating and encouragement are recommended to be used in preschools. Little is known about whether preschool characteristics are associated with the use of these feeding practices. Our aim was to examine whether the socioeconomic status (SES) of the preschool neighborhood is associated with the feeding practices in preschools. Methods: This study was part of the cross-sectional DAGIS study. We studied 66 municipal preschools and 378 early childhood educators (ECEs). Preschool neighborhood SES was assessed with map grid data. Feeding practices were assessed by questionnaires and lunchtime observation. Associations between preschool neighborhood SES and feeding practices were tested with logistic regression analyses adjusted for ECEs’ educational level and municipal policies on ECEs’ lunch prices, and on birthday foods. Results: The crude model showed that in high-SES neighborhood preschools ECEs were more likely to eat the same lunch as the children (OR 2.46, 95% CI 1.42–4.24) and to reward children with other food for eating vegetables (OR 2.48, 95% CI 1.40–4.41). Furthermore, in high-SES preschools it was less likely that birthday foods outside of the normal menu were available on birthdays (OR 0.29, 95% CI 0.12–0.71). In the adjusted model, rewarding with other food remained associated with preschool neighborhood SES (OR 2.13, 95% CI 1.12–4.07). Conclusions: After adjustments, preschool neighborhood SES was mostly unassociated with the feeding practices in preschools. Municipal policies may have a significant impact on feeding practices and ultimately on young children’s food intake in Finland where most children attend municipal preschools.
Vibration-based damage localization and quantification in a pretensioned concrete girder using stochastic subspace identification and particle swarm model updating
Authors: Cancelli Alessandro , Laflamme Simon , Alipour Alice , Sritharan Sri , Ubertini Filippo
Published: February 2019

A popular method to conduct structural health monitoring is the spatio-temporal study of vibration signatures, where vibration properties are extracted from collected vibration responses. In this article, a novel methodology for extracting and analyzing distributed acceleration data for condition assessment of bridge girders is proposed. Three different techniques are fused, enabling robust damage detection, localization, and quantification. First, stochastic subspace identification is used as an output-only method to extract modal properties of the monitored structure. Second, a reduced-order stiffness matrix is reconstructed from the stochastic subspace identification data using the system equivalent reduction expansion process. Third, a particle swarm optimization algorithm is used to update a finite element model of the bridge girder to match the extracted reduced-order stiffness matrix and modal properties. The proposed approach is first verified through numerically simulated data of the girder and then validated using experimental data obtained from a full-scale pretensioned concrete beam that experienced two distinct states of damage. Results show that the method is capable of localizing and quantifying damages along the girder with good accuracy, and that results can be used to create a high-fidelity finite element model of the girder that could be leveraged for condition prognosis and forecasting.
Large-Group Application of Communication Partner Instruction With Stakeholders of Adults With Severe Intellectual Disabilities
Authors: Ogletree Billy T. , Bartholomew Patrick , Price Johanna R.
Published: February 2019

This brief report describes a large-group application of the Communication Partner Instruction (CPI) training model as a means of improving the interactive skills of stakeholders who communicate with individuals with severe intellectual disabilities presenting complex communication and physical profiles. Findings support CPI for large stakeholder groups as study participants reported general satisfaction with both the training sequence and their use of skills learned 1 year post training.
Investigation on thermo-mechanical characteristics of treated/untreated Portunus sanguinolentus shell powder-based jute fabrics reinforced epoxy composites
Authors: Kumaran P , Mohanamurugan S , Madhu S , Vijay R , Lenin Singaravelu D , Vinod A , Sanjay MR , Siengchin Suchart
Published: February 2019

The current study deals with the effective usage of Portunus sanguinolentus shell, which is a solid waste in the seafood industry. This Portunus sanguinolentus shell waste was powdered and used as untreated fillers in jute fabrics reinforced epoxy composites. Then Portunus sanguinolentus shell waste powder was treated with chemicals to perform fat removal, deproteination, decarbonization and deacetylation to obtain treated Portunus sanguinolentus shell filler. Three different composites were developed with traditional hand layup process consisting of four layers jute fabrics that were filled with 10 wt% untreated Portunus sanguinolentus shell filler, chemical treated 10 wt% Portunus sanguinolentus shell filler and unfilled one. The thermo-mechanical and fracture morphologies were assessed by tensile, flexural, compression, shear, impact, hardness thermogravimetric analysis, Fourier-transform infrared spectroscopy and scanning electron microscopy analysis. The results showed an increase in the thermo-mechanical property of chemical-treated Portunus sanguinolentus shell powder-filled jute fabrics-based epoxy composite. This phenomenon is due to the increase in the chitosan, mineral contents and decrease in the organic content in the Portunus sanguinolentus shell powder due to chemical treatment, thus enhancing the bonding between the filler and fiber matrix with reduction of the void. A showcase stand was developed with the best performer, as an attempt in the perfection of application. The application is then analyzed using ANSYS to predict the deformation behavior when subjected to 0.25 kg, 0.5 kg and 1 kg loads.
An Ecosystems Perspective on International Human Resource Development: A Meta-Synthesis of the Literature
Authors: Garavan Thomas N. , McCarthy Alma , Carbery Ronan
Published: February 2019

There has been significant growth of interest in both international human resource development (IHRD) and ecosystems research. Both literatures highlight important characteristics of each concept; however, to date, they have not yet been linked. We propose an ecosystem perspective as an important framework to understand IHRD. Ecosystems emphasize interdependencies, actor centrality, bargaining power, and relationships between actors as important in shaping IHRD. We utilize a meta-synthesis of the IHRD literature to identify content and process dimensions of an IHRD ecosystem. We conclude with a discussion of implications for IHRD research.
Numerical study of effects of geometric parameters on the flow and cavitation characteristics inside conical nozzle of autonomous underwater vehicles
Authors: Wang Chunyan , Liang Jian , Huo Hua
Published: February 2019

The geometric parameters (ratio of orifice’s length to diameter, conical angle, and inner-wall roughness) of conical nozzle are investigated via computational fluid dynamic method to reveal the effect on the flow and cavitation characteristics. The variation of geometric parameters affects the distribution of the static pressure and the drag force, which in turn affects the mass flow rate at the outlet. The results indicate that the conical angle plays a dominant role in effecting the flow and cavitation characteristics. The higher the intensity of cavitation, the more notable the effect of geometric parameters on cavitation characteristics.
Carrier-borne aircrafts aviation operation automated scheduling using multiplicative weights apprenticeship learning
Authors: Zheng Mao , Yang Fangqing , Dong Zaopeng , Xie Shuo , Chu Xiumin
Published: February 2019

Efficiency and safety are vital for aviation operations in order to improve the combat capacity of aircraft carrier. In this article, the theory of apprenticeship learning, as a kind of artificial intelligence technology, is applied to constructing the method of automated scheduling. First, with the use of Markov decision process frame, the simulative model of aircrafts launching and recovery was established. Second, the multiplicative weights apprenticeship learning algorithm was applied to creating the optimized scheduling policy. In the situation with an expert to learn from, the learned policy matches quite well with the expert’s demonstration and the total deviations can be limited within 3%. Finally, in the situation without expert’s demonstration, the policy generated by multiplicative weights apprenticeship learning algorithm shows an obvious superiority compared to the three human experts. The results of different operation situations show that the method is highly robust and well functional.
Analysis of ball carrier head motion during a rugby union tackle without direct head contact: A case study
Authors: Tierney Gregory J , Gildea Kevin , Krosshaug Tron , Simms Ciaran K
Published: February 2019

Rugby union players can be involved in many tackles per game. However, little is known of the regular head loading environment associated with tackling in rugby union. In particular, the magnitude and influencing factors for head kinematics during the tackle are poorly understood. Accordingly, the goal of this study was to measure head motion of a visually unaware ball carrier during a real game tackle to the upper trunk with no direct head contact, and compare the kinematics with previously reported concussive events. Model-Based Image-Matching was utilised to measure ball carrier head linear and angular velocities. Ball carrier componential maximum change in head angular velocities of 38.1, 20.6 and 13.5 rad/s were measured for the head local X (coronal plane), Y (sagittal plane) and Z (transverse plane) axes respectively. The combination of a high legal tackle height configuration and visually unaware ball carrier can lead to kinematics similar to average values previously reported for concussive direct head impacts.
A four-dimensional-CT study of in vivo scapholunate rotation axes: possible implications for scapholunate ligament reconstruction
Authors: de Roo Marieke G. A. , Muurling Marijn , Dobbe Johannes G. G. , Brinkhorst Michelle E. , Streekstra Geert J. , Strackee Simon D.
Published: February 2019

Additional fixation of the palmar scapholunate interosseous ligament has been advocated to improve the long-term results of dorsal scapholunate interosseous ligament reconstruction. To investigate the validity of this approach, we determined normal scapholunate motion patterns and calculated the location of the scapholunate rotation axis. We hypothesized that the optimal location of the scapholunate interosseous ligament insertion could be determined from the scapholunate rotation axis. Four-dimensional computerized tomography was used to study the wrist motion in 21 healthy participants. During flexion–extension motions, the scaphoid rotates 38° (SD 0.6°) relative to the lunate; the rotation axis intersects the dorsal ridge of the proximal pole of the scaphoid and the dorsal ridge of the lunate. Minimal scapholunate motion is present during radioulnar deviation. Since the scapholunate rotation axis runs through the dorsal proximal pole of the scaphoid, this is probably the optimal location for attaching the scapholunate ligament during reconstructive surgery.
Madelung’s deformity: capitate-related versus ulna-related measurement methods
Authors: Hegazy Galal , Mansour Tarek , Alshal Ehab , Abdelaziz Mohammed , Alnahas Mohammed , El-Sebaey Ibrahem
Published: February 2019

Several investigators have defined measurements for Madelung’s deformity based on the distal radius or on the longitudinal ulnar axis to avoid the distorted distal radius and its lunate fossa. However, errors may occur in severe cases because of ulnar deformity and displacement. We quantified seven established measurements for Madelung’s deformity relying on the central axis of the capitate. The inter- and intrarater reliability of the capitate-related and the ulna-related techniques were compared. We observed a higher inter- and intrarater reliability for the capitate-related method than for the ulna-related method. Better agreement was also observed for measurements of distance than for measurements of angles. However, the palmar tilt angle measurement method was neither reliable nor reproducible. The capitate-related technique can help to accurately determine the severity of Madelung’s deformity, assist in surgical planning and identify the prognosis.

Level of evidence: III
Accuracy of the new rapid test for monitoring adalimumab levels
Authors: Rocha Cátia , Afonso Joana , Lago Paula , Arroja Bruno , Vieira Ana I. , Dias Claudia C. , Magro Fernando
Published: February 2019

Background:

The loss of response to adalimumab (ADL) has been related to low serum concentrations at trough. Currently, most methods commercially available for the quantification of ADL are enzyme-linked immunosorbent assay (ELISA) based, with a turnaround time of approximately 8 h, delaying the target dosage adjustment to the subsequent infusion. In this study, we aimed to evaluate the performance of the newly available rapid-test ADL quantification assay by comparing it with three established ELISA methods, using spiked samples and a set of clinical samples.

Methods:

Spiked samples from control donors and 120 serum samples from inflammatory bowel disease (IBD) patients undergoing ADL therapy were quantified using lateral flow Quantum Blue® Adalimumab and, the ELISA formats from Immundiagnostik, R-Biopharm and an in-house assay.

Results:

The rapid-test assay had intraclass correlation coefficients of 0.590, 0.864 and 0.761 when comparing with the Immundiagnostik, R-Biopharm and in-house assays, respectively. For the five therapeutic windows, the accuracy was high: ADL rapid test compared with the Immundiagnostik (58–88%); R-Biopharm, 68–89%; and in house, 60–88%; and kappa statistics revealed 0.492–0.602, 0.531–0.659 and 0.545–0.682, respectively.

Conclusions:

The Quantum Blue® Adalimumab assay can replace the commonly used ELISA-based ADL quantification kits and it is a reliable alternative to these methods. This rapid-test assay enables the quantitative determination of ADL serum trough level in only 15 min. The developed assay allows measurement of ADL over a wide range. Hence, it represents a valuable tool for the clinician to assess the ADL trough level.
Fear and behavior of young pheasants reared with or without parent figure
Authors: Santilli Francesco , Bagliacca Marco
Published: February 2019

Modern game birds rearing methods use mechanical incubators to hatch eggs and artificial brooders to intensively rear birds. However, the lack of parental care can have consequences on behavior and welfare of these birds affecting also survival after their release in the wild. In this study, we compared the response of 4-week-old young pheasants (brooded by a foster mother hen and artificially brooded) to two behavioral tests (duration of tonic immobility and response to aerial predator). Tonic immobility was significantly different between the two groups of birds indicating a higher level of fear in artificially brooded pheasants compared to brooded pheasants. Pheasants brooded by a foster hen showed a stronger response to aerial predator compared to artificially brooded pheasants. The foster hen seems to have a positive effect on pheasant chicks’ behavior reducing the fear and improving the ability to perceive threats.
Mathematical modeling of bone in-growth into undegradable porous periodic scaffolds under mechanical stimulus
Authors: Liu Lingze , Shi Quan , Chen Qiang , Li Zhiyong
Published: February 2019

Undegradable scaffolds, as a key element in bone tissue engineering, prevail in the present clinical applications, and the bone in-growth into such scaffolds under mechanical stimulus is an important issue to evaluate the bone-repair effect. This work aims to develop a mathematical framework to investigate the effect of mechanical stimulus on the bone in-growth into undegradable scaffolds. First, the osteoclast and osteoblast activities were coupled by their autocrine and paracrine effects. Second, the mechanical stimulus was empirically incorporated into the coupling cell activities on the basis of experimental observations. Third, the effect of mechanical stimulus including intensity and duration on the bone in-growth process was numerically studied; moreover, the homeostasis of scaffold–bone system under the mechanical stimulus was also treated. The results showed that the numbers of osteoblasts and osteoclasts in the scaffold–bone system tended to constants representing the system homeostasis. Both the mechanical intensity and duration optimized the final bone formation. The numerical results of the bone formation were comparable to the experimental results in rats. The findings from this modeling study could be used to explain many physiological phenomena and clinical observations. The developed model integrates both cell and tissue scales, which can be used as a platform to investigate bone remodeling under mechanical stimulus.
The revised Atlanta criteria more accurately reflect severity of post‐ERCP pancreatitis compared to the consensus criteria
Authors: Smeets XJNM , Bouhouch N , Buxbaum J , Zhang H , Cho J , Verdonk RC , Römkens TEH , Venneman NG , Kats I , Vrolijk JM , Hemmink GJM , Otten A , Tan ACITL , Elmunzer BJ , Cotton PB , Drenth JPH , van Geenen EJM
Published: February 2019

Background and objective

Post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most prevalent complication after ERCP with an incidence of 3.5%. PEP severity is classified according to either the consensus criteria or the revised Atlanta criteria. In this international cohort study we investigated which classification is the strongest predictor of PEP‐related mortality.

Methods

We reviewed 13,384 consecutive ERCPs performed between 2012 and 2017 in eight hospitals. We gathered data on all pancreatitis‐related adverse events and compared the predictive capabilities of both classifications. Furthermore, we investigated the correlation between the two classifications and identified reasons underlying length of stay.

Results

The total sample consisted of 387 patients. The revised Atlanta criteria have a higher sensitivity (100 vs. 55%), specificity (98 vs. 72%) and positive predictive value (58 vs. 5%). There is a significant difference (p < 0.001) between the two classifications. In 124 patients (32%), the length of stay was influenced by concomitant diseases.

Conclusion

The revised Atlanta classification is superior in predicting mortality and better reflects PEP severity. This has important implications for researchers, clinicians and patients. For the diagnosis of PEP pancreatitis, the consensus criteria remain the golden standard. However, the revised Atlanta criteria are preferable for defining PEP severity.
The importance of leadership in innovation processes in nursing homes: An integrative review
Authors: Brodtkorb Kari , Skaar Ragnhild , Slettebø Åshild
Published: February 2019

The rapidly growing number of older people with increasingly complex needs places pressure on quality of care and thereby presents a need for innovation in nursing homes. The aim of this review was to provide a comprehensive overview of the current state of evidence for the importance of leadership in innovation processes in nursing homes. A systematic search was conducted. Titles and abstracts were screened for relevance, data from full texts were extracted and reduced and quality appraisal was performed. Content analysis resulted in two categories: organizational factors associated with innovation and leadership characteristics in innovation, constructing the overall theme, ‘leadership: a key to successful innovations’. The innovations described in the included studies transform the underlying values of organizational culture. The review shows that participative, involving and innovative leadership is the key to success in innovation processes.
Method Bias in Cloze Tests as Reading Comprehension Measures
Authors: Baghaei Purya , Ravand Hamdollah
Published: February 2019

In many reading comprehension tests, different test formats are employed. Two commonly used test formats to measure reading comprehension are sustained passages followed by some questions and cloze items. Individual differences in handling test format peculiarities could constitute a source of score variance. In this study, a bifactor Rasch model is applied to separate the cloze-specific variance in a reading comprehension test composed of sustained passages (plus questions) and a cloze passage. The results are compared with a unidimensional Rasch model where all items load on a single dimension. The inclusion of the cloze-specific dimension, that is, the method factor, improved the fit and resulted in substantially lower item difficulty estimates for the cloze items. Findings indicate that reading comprehension tests comprising sustained passages and cloze items are not unidimensional and contain a cloze-specific nuisance dimension that contaminates the latent construct variance.
Extra-articular, Intraepiphyseal Drilling for Osteochondritis Dissecans of the Knee: Characterization of a Safe and Reproducible Surgical Approach
Authors: Lee Cody S. , Larsen Christopher G. , Marchwiany Daniel A. , Chudik Steven C.
Published: February 2019

Background:

Osteochondritis dissecans (OCD) is an idiopathic focal condition affecting the subchondral bone of joints, and it is increasingly prevalent among the active young adult population. For lesions that have failed nonoperative management, transarticular drilling and extra-articular drilling are surgical options. Although the extra-articular approach preserves the articular cartilage, it is technically challenging and could benefit from a study of surgical approach.

Purpose:

To use 3-dimensional modeling of magnetic resonance imaging (MRI) scans from skeletally immature individuals to characterize safe tunnel entry points, trajectories, and distances from the physeal and articular cartilage along the course of the distal femoral epiphysis to the OCD target in their most common location of the medial femoral condyle (MFC).

Study Design:

Descriptive laboratory study.

Methods:

A total of 17 MRI scans from skeletally immature patients were used to create 3-dimensional models of the knee joint. Virtual representations of an OCD lesion were placed in the lateral aspect of the MFC; cylinders simulating tunnel length, diameter, and trajectory were superimposed onto the models; and measurements were taken.

Results:

Two safe tunnels were identified, 1 anterior and 1 posterior to the medial collateral ligament (MCL). The anterior tunnel had a diameter of 10.3 ± 1.4 mm, skin entry point of 16.9 ± 12.1 mm anterior and 7.1 ± 5.9 mm superior to the medial epicondyle, bony entry point of 12.1 ± 3.5 mm anterior and 2.4 ± 3.5 mm inferior to the medial epicondyle, and tunnel length of 31.8 ± 3.7 mm. The posterior tunnel had a diameter of 7.8 ± 1.8 mm, skin entry point of 9.4 ± 5.1 mm posterior and 26.0 ± 14.0 mm superior to the medial epicondyle, bony entry point of 8.6 ± 2.6 mm posterior and 5.1 ± 4.2 mm superior to the medial epicondyle, and tunnel length of 33.5 ± 4.5 mm.

Conclusion:

This anatomic characterization study identifies and defines 2 safe and reproducible tunnel approaches, 1 anterior and 1 posterior to the MCL, for drilling or creating tunnels to OCD lesions of the MFC in an extra-articular fashion.

Clinical Relevance:

The study findings provide valuable anatomic references for surgeons performing extra-articular drilling or tunneling of OCD lesions.
Carfilzomib or bortezomib with melphalan-prednisone for transplant-ineligible patients with newly diagnosed multiple myeloma
Authors: Facon Thierry , Lee Jae Hoon , Moreau Philippe , Niesvizky Ruben , Dimopoulos Meletios , Hajek Roman , Pour Ludek , Jurczyszyn Artur , Qiu Lugui , Klippel Zandra , Zahlten-Kumeli Anita , Osman Muhtarjan , Paiva Bruno , San-Miguel Jesus
Published: February 2019

The phase 3 CLARION study compared carfilzomib-melphalan-prednisone (KMP) with bortezomib-melphalan-prednisone (VMP) in transplant-ineligible newly diagnosed multiple myeloma (NDMM) patients. Patients were randomized 1:1 to KMP or VMP for nine 42-day cycles (C). Patients received carfilzomib on days (D) 1, 2, 8, 9, 22, 23, 29, 30 (20 mg/m2: C1D1, C1D2; 36 mg/m2 thereafter) or bortezomib on D1, 4, 8, 11, 22, 25, 29, 32 (1.3 mg/m2; D4, 11, 25, 32 omitted for C5-9). Melphalan (9 mg/m2) and prednisone (60 mg/m2) were administered on D1-4. The primary endpoint was progression-free survival (PFS). Nine hundred fifty-five patients were randomized (intention-to-treat population: KMP, n = 478; VMP, n = 477). Median PFS was 22.3 months with KMP vs 22.1 months with VMP (hazard ratio [HR], 0.906; 95% confidence interval [CI], 0.746-1.101; P = .159). Median overall survival was similar and not reached in either group (HR, 1.08; 95% CI, 0.82-1.43). Overall response rate was 84.3% for KMP and 78.8% for VMP. Complete response rate was 25.9% for KMP and 23.1% for VMP. Minimal residual disease–negative rates were 15.7% (KMP) and 15.5% (VMP). Adverse events (AEs) of interest (any grade) occurring with a ≥5% higher patient incidence in the KMP arm were acute renal failure (13.9% [KMP] vs 6.2% [VMP]) and cardiac failure (10.8% vs 4.3%). Grade ≥3 AE rates were 74.7% (KMP) and 76.2% (VMP). Grade ≥2 peripheral neuropathy was lower for KMP vs VMP (2.5% vs 35.1%). Treatment with KMP in CLARION did not yield a statistically significant difference in PFS vs VMP. This trial was registered at www.clinicaltrials.gov as #NCT01818752.
Centrally located lung cancer and risk of occult nodal disease: an objective evaluation of multiple definitions of tumour centrality with dedicated imaging software
Authors: Casal Roberto F. , Sepesi Boris , Sagar Ala-Eddin S. , Tschirren Juerg , Chen Minxing , Li Liang , Sunny Jennifer , Williams Joyce , Grosu Horiana B. , Eapen George A. , Jimenez Carlos A. , Ost David E.
Published: February 2019

Introduction

Current guidelines recommend invasive mediastinal staging in patients with centrally located radiographic stage T1N0M0 nonsmall cell lung cancer (NSCLC). The lack of a specific definition of a central tumour has resulted in discrepancies among guidelines and heterogeneity in practice patterns.

Methods

Our objective was to study specific definitions of tumour centrality and their association with occult nodal disease. Pre-operative chest computed tomography scans from patients with clinical (c) T1N0M0 NSCLC were processed with a dedicated software system that divides the lungs in thirds following vertical and concentric lines. This software accurately assigns tumours to a specific third based both on the location of the centre of the tumour and its most medial aspect, creating eight possible definitions of central tumours.

Results

607 patients were included in our study. Surgery was performed for 596 tumours (98%). The overall pathological (p) N disease was: 504 (83%) N0, 56 (9%) N1, 47 (8%) N2 and no N3. The prevalence of N2 disease remained relatively low regardless of tumour location. Central tumours were associated with upstaging from cN0 to any N (pN1/pN2). Two definitions were associated with upstaging to any N: concentric lines, inner one-third, centre of the tumour (OR 3.91, 95% CI 1.85–8.26; p<0.001) and concentric lines, inner two-thirds, most medial aspect of the tumour (OR 1.91, 95% CI 1.23–2.97; p=0.004).

Conclusions

We objectively identified two specific definitions of central tumours. While the rate of occult mediastinal disease was relatively low regardless of tumour location, central tumours were associated with upstaging from cN0 to any N.
High content screening for drug discovery from traditional Chinese medicine
Authors: Wang Jing , Wu Ming-Yue , Tan Jie-Qiong , Li Min , Lu Jia-Hong
Published: February 2019

Traditional Chinese medicine (TCM) represents the crystallization of Chinese wisdom and civilization. It has been valued as the renewable source for the discovery of novel drugs, owing to its long-term proved efficacy in human diseases and abundant biologically active components pools. To dissect the mystery of TCM, modern technologies such as omics approaches (proteomics, genomics, metabolomics) and drug screening technologies (high through-put screening, high content screening and virtual screening) have been widely applied to either identify the drug target of TCM or identify the active component with certain bio-activity. The advent of high content screening technology has absolutely contributed to a breakthrough in compounds discovery and influenced the evolution of technology in screening field. The review introduces the concept and principle of high content screening, lists and compares the currently used HCS instruments, and summarizes the examples from ours and others research work which applied HCS in TCM-derived compounds screening. Meanwhile, this article also discusses the advantages and limitations of HSC technology in drug discovery from TCM libraries.
TRPM7 promotes the epithelial–mesenchymal transition in ovarian cancer through the calcium-related PI3K / AKT oncogenic signaling
Authors: Liu Lu , Wu Nayiyuan , Wang Ying , Zhang Xiaoyun , Xia Bing , Tang Jie , Cai Jingting , Zhao Zitong , Liao Qianjin , Wang Jing
Published: February 2019

Background

The epithelial-mesenchymal transition (EMT) is crucial for metastasis and positively regulated by calcium-related signaling. The melastatin-related transient receptor potential 7 (TRPM7) regulates a non-selective cation channel and promotes cancer metastasis. However, the mechanisms underlying the action of TRPM7 in ovarian cancer are unclear.

Methods

The expression of TRPM7 and EMT markers (Vimentin, N-cadherin, Twist and E-cadherin) in ovarian cancer samples was detected. TRPM7was knockdown by shRNA in Ovarian cancer cell lines to examine calcium [Ca2+]i, EMT markers and PI3K/AKT markers. Various cellular assays, such as invasion and migration, were performed in vitro, and further confirmed in vivo.

Results

TRPM7 expression is negatively correlated with E-cadherin, but positively with N-cadherin, Vimentin and Twist expression in ovarian cancer samples. TRPM7 depletion inhibited the migration and invasion in SKOV3 and OVCAR3 cells. In addition, TRPM7 silencing decreased the lung metastasis of SKOV3 tumors and prolonged the survival of tumor-bearing mice. Similar to that of TRPM7 silencing, treatment with MK886, a potent 5-lipoxygenase inhibitor to reduce TRPM7 expression, and/or BAPTA-AM, an intracellular calcium chelator, significantly mitigated the Epidermal growth factor (EGF) or Insulin-like growth factors (IGF)-stimulated migration, invasion, and the EMT in ovarian cancer cells by decreasing the levels of intracellular calcium [Ca2+]i. Furthermore, treatment with LY2904002, a PI3K inhibitor, also inhibited the migration, invasion, and treatment with both LY2904002 and BAPTA-AM further enhanced their inhibition in ovarian cancer cells. Moreover, treatment with BAPTA-AM mitigated the IGF-stimulated migration, invasion, particularly in TRPM7-silenced ovarian cancer cells. Finally, TRPM7 silencing attenuated the PI3K/AKT activation, which was enhanced by BAPTA-AM, MK886 or LY2904002 treatment in ovarian cancer cells.

Conclusions

TRPM7 silencing inhibited the EMT and metastasis of ovarian cancer by attenuating the calcium-related PI3k/AKT activation. Our findings suggest that TRPM7 may be a therapeutic target for intervention of ovarian cancer.
MIGHT PLIGHT: THE SOCIAL ANXIETY FELT BY MEN IN THE WEIGHTLIFTING ENVIRONMENT
Authors: Cyr Alex , Munroe-Chandler Krista , Gammage Kimberley
Published: February 2019

Apply It!

Be aware of the specific elements and scenarios in your fitness facility that may elicit anxiety in men and work to improve the environment to eliminate or alleviate those feelings of anxiety. Be especially aware of these scenarios in gyms where there might be a number of clients who are bodybuilders.

Consider the development of all-male fitness classes to alleviate perceived anxiety and encourage physical activity in men.

Consider the physical space and the addition of equipment in your fitness facility to eliminate conflicts over resources.
O conselheiro do mercado
Authors: Wilner Adriana , Dos Santos Aline Lilian
Published: February 2019

Desde os anos 1980, Guilherme Affonso Ferreira é um importante investidor de longo prazo no mercado de ações no Brasil. Compra participações relevantes o suficiente para ter direito a uma cadeira no conselho de administração de grandes empresas. Foi assim em dezenas de casos, como Pão de Açúcar, Metal Leve, Eternit, Manah, Gafisa e Unibanco.Nesta entrevista exclusiva à GV-executivo, Guilherme compartilha sua trajetória, experiência, desafios e aprendizados nomercado de ações brasileiro. Ele também fala sobre seus melhores investimentos e quais setores considera promissores para se apostar nos próximos anos.
Valor em saúde
Authors: Silva Guilherme do Espirito Santo , Malik Ana Maria
Published: February 2019

Uma nova perspectiva estratégica deve provocar mudanças nos serviços e sistemas de saúde ao otimizar os resultados que são importantes para os pacientes ao longo de todo o ciclo de atendimento.
Comparison of Weight-for-Height Z-score and mid-upper arm circumference to diagnose moderate and severe acute malnutrition in children aged 6-59 months
Authors: Bari Attia , Nazar Mubeen , Iftikhar Aisha , Mehreen Sana
Published: February 2019

Objective: To compare weight for height (WHZ) and mid upper arm circumference (MUAC) to diagnose malnutrition in children aged 6–59 months and to determine the association of various risk factors with the nutritional status of the children.

Methods: Descriptive study conducted at the Department of Paediatric Medicine of The Children’s Hospital Lahore from May 2017 to April 2018. A total of 257 children 6 to 59 months of age having MUAC of <125mm were included. WHZ scoring was done and compared with MUAC.

Results: There was slight male predominance 135 (52.5%). Mean age of children was 13.43 + 8.81 months (95% CI: 12.34-14.51). Mean MUAC was 103±13.5 mm (95%CI: 101-105mm). Exclusive breast feeding was present in 82 (32%). Maternal illiteracy was common in SAM (p = was 0.001). More children (73.2%) were identified as SAM by MUAC of <115 mm as compared to WHZ of <-3SD (70%). The ROC curve analysis for MUAC (cut-off value:103, 95%CI; AUC: 101-107 mm) showed it as an excellent predictor (p=<0.001) for children having SAM and WHZ <-3SD, with (AUC= 0.786 [95%CI; 0.725-0.848]).

Conclusion: Both MUAC and WHZ showed fair degree of agreement to diagnose moderate and severe acute malnutrition among children aged 6–59 months. At the community level of resource limited countries, MUAC can be used as an appropriate rapid diagnostic method to identify malnourished children to be managed in nutritional rehabilitation programs.

How to cite this:Bari A, Nazar M, Iftikhar A, Mehreen S. Comparison of Weight-for-Height Z-score and mid-upper arm circumference to diagnose moderate and severe acute malnutrition in children aged 6-59 months. Pak J Med Sci. 2019;35(2):337-341.  doi: https://doi.org/10.12669/pjms.35.2.45

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Recent advances in understanding immune phenotypes of thyroid carcinomas: prognostication and emerging therapies
Authors: Liotti Federica , Prevete Nella , Vecchio Giancarlo , Melillo Rosa Marina
Published: February 2019

Tumors modulate the host immune cells within their microenvironment to avoid recognition and elimination by our immune system, a phenotype called cancer immune escape. Different mechanisms responsible for cancer immune escape that result either in decreased tumor immunogenicity or in increased tumor immunosuppressive activity have been identified. Recently, various immunotherapeutic approaches have been developed with the aim to revert tumor immune escape. The aims of this review are to explore the immunological aspects of thyroid cancer and to assess whether these features can be exploited in the prognosis and treatment of advanced forms of this disease. Therefore, we will describe the immune landscape and phenotypes of thyroid cancer, summarize studies investigating the expression of immunomodulatory molecules, and finally describe the preclinical and clinical trials investigating the utility of immunotherapies in the management of thyroid cancer.

The aim of this review is to explore the immunological aspects of thyroid cancer and to assess whether these features can be exploited in the prognosis and treatment of advanced forms of this disease. Therefore, we will describe the immune-landscape and phenotypes of thyroid cancer, we will summarize studies investigating the expression of immunomodulatory molecules, and we will finally describe the preclinical and clinical trials investigating the utility of immunotherapies in the management of thyroid cancer.
Recent advances in the understanding of Dupuytren’s disease
Authors: Layton Thomas , Nanchahal Jagdeep
Published: February 2019

Dupuytren’s disease (DD) is a common fibrotic disorder of the hand and can significantly impair hand function. Although the exact pathogenesis of this disorder remains to be elucidated, immunological, genetic and cellular factors likely interact. In this review, we summarise recent advances in the understanding of DD pathogenesis and look to the future for potential novel therapeutic targets. In addition, we discuss the therapeutic options in DD with a focus on the need for more rigorous evidence to allow a meaningful comparison of different treatment modalities.