bluuebunny/crossref_metadata_2025 huggingface dataset:
Tobacco Use Behaviors and Perceptions of Parental Smokers in the Emergency Department Setting
Authors: Mahabee-Gittens E Melinda , Merianos Ashley L , Stone Lara , Tabangin Meredith E , Khoury Jane C , Gordon Judith S
Published: June 2019

Background:

More information is needed about modifiable child tobacco smoke exposure (TSE) patterns in racially diverse parental smokers to tailor interventions designed to help parents quit smoking and reduce their child’s TSE. Our objectives were to determine whether there were differences in smoking and TSE patterns based on parental race and child age and whether these patterns differed based on child age within black and white parental smokers. Secondary objectives were to assess the relationship between parental perceptions about the effects of smoking and the benefits of quitting on their child based on child age, race, and reported TSE patterns and to examine biochemically verified TSE levels by child age, race, and parent-reported TSE patterns.

Methods:

Participants (N = 415) were non-Hispanic black and non-Hispanic white parental smokers, mean age (standard deviation [SD]) = 31.2 (7.2) years, who visited the Pediatric Emergency Department (PED) or Urgent Care (UC) with their child, mean age (SD) = 4.7 (4.6) years. Parents reported sociodemographics, smoking, and child TSE patterns. We conducted chi-square tests, independent t-tests, and general linear regression models to answer our primary objectives and linear regression models to answer our secondary objectives.

Results:

Parents were 56.1% non-Hispanic black; 87.5% women; mean (SD) number of cigarettes smoked/day was 10.5(6.8). A higher proportion of parents with younger children <3 years old reported smoking bans compared with parents with older children ⩾3 to <18 years old (41.3% vs 19.7%, P < .0001). Subsequent analyses revealed this pattern for both black and white parents. A total of 212 (51%) of children had biochemical assessment of TSE; 89.6% had detectable TSE. Younger children had significantly higher cotinine levels than older children independent of their race ( P < .001).

Conclusions:

Children of parental smokers who visit the PED/UC were highly tobacco smoke exposed. Both black and white parental smokers with younger children were more likely to enforce smoking bans, but younger children had higher TSE levels than older children. Interventions that target this group of parental smokers with younger children may be more effective than interventions geared to all parental smokers.
The Impact of a Newly Established Multidisciplinary Team on the Interventional Treatment of Patients With Emphysema
Authors: Kouritas Vasileios , Milton Richard , Kefaloyannis Emmanouel , Papagiannopoulos Kostas , Brunelli Allesandro , Dimov Doytchin , Karthik Sishik , Hardy Andrew , Tcherveniakov Peter , Chaudhuri Nilanjan
Published: June 2019

Background:

The emphysema interventional treatment involves mainly lung volume reduction surgery (LVRS) and endobronchial valve (EBV) implantation. Few institutes discuss these cases at a dedicated emphysema multidisciplinary team (MDT) meeting.

Objectives:

To investigate the impact of a newly established dedicated emphysema MDT meeting on the interventional treatment of such patients.

Methods:

During a study period of 4 years, the outcome of 44 patients who underwent intervention according to the proposal of the emphysema MDT (group A) was compared with the outcome of 44 propensity score matched patients (group B) treated without the emphysema MDT proposal.

Results:

More LVRS and less EBV insertions were performed in group A ( P =  .009). In group B, the interventions were performed sooner than in group A ( P =  .003). Postoperative overall morbidity and length of in-hospital stay were similar in the 2 groups ( P =  .918 and .758, respectively). Improvement of breathing ability was reported in more patients from group A ( P =  .012). In group B, the total number of re-interventions was higher ( P =  .001) and the time to re-intervention had the tendency to be less ( P =  .069). Survival was similar between the 2 groups ( P =  .884). Intervention without discussion at the MDT and EBV as initial intervention was an independent predictor of re-intervention.

Conclusions:

Interventional treatment for patients with chronic obstructive pulmonary disease (COPD) after discussion at a dedicated MDT involved more LVRS performed, required fewer interventions for their disease, and had longer re-intervention-free intervals and better breathing improvement.
When the political becomes (painfully) personal: Org-studying the consequences of Brexit
Authors: Kerr Ron , Śliwa Martyna
Published: June 2019

This ‘Speaking Out’ essay contributes to debates over Brexit and populism by suggesting how we, as management and organisation studies scholars, might approach ‘org-studying’ Brexit. First, as UK-based European Union citizens working in UK business schools, we clarify our own position(s) in relation to Brexit. Second, we position ourselves more specifically as management and organisation studies academics by considering how we might begin to analyse the organisational consequences of Brexit through seeing it as part of a continuing global crisis – or series of crises – including and going beyond those affecting American and European societies and economies, as well as their political and other social fields and organisations. We highlight the salience of emotions with regard to Brexit, and in particular ressentiment in relation to populism as a political methodology. We also note the importance of identity and how political and personal identities are being reconstituted in the United Kingdom in light of the Brexit vote. We put forward suggestions for how management and organisation studies scholars might integrate these insights into an overarching approach to researching the organisational consequences of Brexit based on the works of Pierre Bourdieu and Gisèle Sapiro on the transposition of crisis. Our final remarks address the way that Brexit crisis continues to challenge our own established identities.
Power through empowerment? The managerial discourse on employee empowerment
Authors: Ivanova Mirela , von Scheve Christian
Published: June 2019

Informed by the sociology of knowledge approach to discourse, the current study explores how employee empowerment is discursively constructed as a management technique. Combing insights from labour process theory, Foucauldian approaches to governmentality and neo-Weberian interpretations of the ideological basis of capitalism, we develop an empirically informed theoretical framework that accounts for the multifaceted character of employee empowerment. Results show, first, that discourse justifies the necessity of this technique by presenting it as an efficient answer to perceived increases in competitive pressures and an ever-changing economic environment since the beginning of the 1990s. The discourse promotes advanced liberal modes of (self-)governance, which are created and maintained through a complex set of means for the control of labour. Second, although the ideological structure of the empowerment discourse is in accordance with the third spirit of capitalism, as identified by Boltanski and Chiapello, it also introduces changes by removing the neo-manager and granting the empowered employee a central role. Furthermore, our analysis suggests that empowerment is associated with strategies for reducing labour costs, such as de-layering and work intensification.
A study on the stack effect of a super high-rise residential building in a severe cold region in China
Authors: Man Xiaoxin , Lu Yanyu , Li Guolei , Wang Yanling , Liu Jing
Published: June 2019

A recent trend in China has seen super high-rise residential buildings spreading to severe cold regions. These buildings face tough challenges concerning building energy consumption and the thermal environment due to their stack effect. The stack effect is greatly influenced by air infiltration, but current guidance on component airtightness is often neither specific nor consistent for different buildings. This paper presents field measurements and numerical simulations of airtightness performance and stack pressure distribution for a a 106.7-m high-rise residential building in Harbin, Northeast China. An airtightness field test was performed using the fan pressurisation method, and measured values were utilised as the input data for predictions. The numerical analysis was implemented by applying CONTAMW, and the simulation results were compared to measurement data. The results demonstrated that the measured components were all leakier than the current standards allow. The greatest stack pressure difference on the ground floor reached 51.5 Pa, considered a severe stack effect. Furthermore, the influences of the location and airtightness of different staircase doorways on the stack effect were studied and analysed. This research assists in clarifying the significance of building airtightness in cold climates and in reducing the stack effect of high-rise buildings.
Digital brief interventions for risky drinkers are not the panacea: A pilot study exploring barriers for its implementation according to professionals’ perceptions
Authors: López-Pelayo Hugo , Caballeria Elsa , Díaz Estela , Sánchez Ariadna , Segura Lidia , Colom Joan , Wallace Paul , Gual Antoni
Published: June 2019

Digital brief interventions have emerged as an instrument to improve the implementation of Screening, Brief Intervention and Referral to Treatment programs for risky drinkers. However, trials in Catalonia have been unsuccessful. This study was aimed at researching professionals’ perceptions regarding the usefulness of digital brief interventions in overcoming traditional barriers of face-to-face Screening, Brief Intervention and Referral to Treatment and new barriers posed by the use of digital brief interventions. Professionals who participated in the Effectiveness of primary care based Facilitated Access to alcohol Reduction website (EFAR)digital brief intervention clinical trial were surveyed on April 2017 on the following areas: (1) satisfaction, (2) usefulness, (3) perceived ability of digital interventions on overcoming traditional barriers and (4) perceived new barriers of digital interventions. Sixty-eight professionals completed the survey. Univariate and multivariate analyses were performed using the level of professional engagement with the project as the dependent variable, barriers as independent variables and socio-demographic characteristics as covariables. Of all professionals, 79.4 percent were satisfied with their participation in the project, but only 26.5 percent perceived the website as useful. Low engagement was associated with the perceived lack of feedback (0.22; 95% confidence interval: 0.05 -0.88), perception that it was difficult to use among the elderly(0.22; 95 confidence interval: 0.05 -0.091) and among low socioeconomic population (0.14; 95% confidence interval: 0.03 -0.64). The majority of the participants indicated that digital brief intervention for risky drinkers succeeded in overcoming most of the traditional barriers. However, new barriers emerged as difficulties for implementing digital brief interventions in the Catalan Primary Health Care System. Usefulness perception is a key factor, which must be addressed in any proposed intervention in primary care.
Coalitions and counter-coalitions in online contestation: An analysis of the German and British climate change debate
Authors: Adam Silke , Häussler Thomas , Schmid-Petri Hannah , Reber Ueli
Published: June 2019

We seek to understand the role of the Internet in policy monopolies characterized by a dominant coalition in traditional political venues. In these settings, we identify coalitions and counter-coalitions on the Web and ask how these coalitions differ resource-wise and where these differences come from. To do so, we combine link tracing and quantitative content analysis in the field of climate change in Germany and the United Kingdom. Our results show that online contestation is indeed structured by competing coalitions of climate advocates and skeptics. Moreover, the counter-coalitions of climate skeptics turn out to be the true winners of online communication: they have not only incorporated conservative media as their allies, but also managed to make themselves more visible than climate advocates. This visibility stems from their own link setting activity, which makes climate advocates’ passive online strategy of just ignoring the skeptical camp ineffective.
Reading Clausewitz, reimagining the practice of strategy
Authors: Kornberger Martin , Engberg-Pedersen Anders
Published: June 2019

Strategy and organization theory enjoy a reawakening interest in historical analysis. In this essay, we suggest that this engagement should include strategy’s linkage to the history of military strategy. We develop our argument through an exegesis of Carl von Clausewitz’ treatise On War. We claim that Clausewitz’ theorization of strategy advances the ongoing scholarly conversation on the practice of strategy in three specific ways. First, he defines a distinctive locus for the notion of strategy as the bridge between policy and tactics; in so doing, he addresses what has been criticized as strategy’s conceptual drift. Second, with Clausewitz, we can pose the question of strategy’s effectiveness in a critical, reflexive way. This opens up a way to answer the “so-what” question that has hampered strategy as practice research. Third, as an educator in military affairs of the Crown Prince, Clausewitz invites reflection on strategy’s pedagogy. Following Clausewitz, strategy may not want to concern itself with distilling the next practice from past history but immerse strategy students in great detail in history in order to develop their critical faculties.
EEG Findings in Posterior Reversible Encephalopathy Syndrome
Authors: Murray Kathleen , Amin Ushtar , Maciver Stephanie , Benbadis Selim R
Published: June 2019

Introduction. Posterior reversible encephalopathy syndrome (PRES) is a relatively common cause of encephalopathy in the hospital setting, and the EEG findings have not been well described. The purpose of this study was to review the EEG findings in a series of patients with PRES. Methods. We retrospectively reviewed our electronic medical record database to identify patients who received a diagnosis of PRES at Tampa General Hospital from January 2016 to October 2017. The diagnosis of PRES was suspected on clinical presentation and confirmed by magnetic resonance imaging. We selected patients with PRES who had received at least 1 EEG. EEGs were interpreted by 2 board-certified electroencephalographers. Results. From January 2016 to October 2017, 19 patients were diagnosed with PRES at Tampa General Hospital. Of those, 10 received at least 1 EEG. Four patients were male, 6 were female. The ages ranged from 21 to 87 (mean was 47). The patients had the following clinical presentations: 5 with encephalopathy, 8 with seizures, 2 with vision changes, and 3 with headache (some patients had more than 1 symptom). EEGs findings were as follows: 3 were normal; 3 showed intermittent generalized slowing; 2 showed continuous generalized slowing; 3 showed background slowing; 1 showed background suppression; 1 showed generalized rhythmic delta activity (GRDA); 1 showed GRDA, plus spike/sharp-wave discharges; 1 showed generalized periodic discharges. The etiologies were as follows: 9 from hypertension, 1 secondary to eclampsia, 3 due to posttransplant immunosuppression, and 1 patient was undergoing chemotherapy (some were multifactorial). Conclusion. EEG findings in PRES are diverse, with no specific or even predominant pattern, based on this small sample size.
Leadership in a Fiscally Distressed School District: The Case of Daly City Schools
Authors: Zender Joshua R. , Lochmiller Chad R.
Published: June 2019

This case positions the reader as the superintendent of Daly City Community Schools (DCCS), a mid-sized public school district located in the Midwestern United States facing a fiscal crisis. The case requires the reader to propose fiscal alternatives to a school board. For example, the case might invite the reader to consider the appointment of an emergency financial manager, implement a “reduction in force” strategy, or declare Chapter 9 bankruptcy as part of an overarching plan to achieve fiscal stability. Through the case experience, students will become familiar with the actions available to educational leaders working within a fiscally distressed school district, as well as the political consequences that these actions have for a variety of stakeholders.
A New Amide From Piper maingayi Hk.F. (Piperaceae)
Authors: Hashim Nur Athirah , Ahmad Farediah , Salleh Wan Mohd Nuzul Hakimi Wan , Khamis Shamsul
Published: June 2019

Phytochemical investigation from the leaves and stem extracts of Piper maingayi Hk.F. resulted in the isolation of a new amide, N-isobutyl-15-(3″,4″-methylenedioxyphenyl)-2 E,4 E,12 Z-pentadecatrienamide (1), together with sesamin (2), piperumbellactam A (3), cepharadione A (4), cepharadione B (5), piperolactam A (6), oleic acid (7), methyl linolenate (8), β-sitosterol (9), butyl dodecanoate (10), and isovanillic acid (11). Their structures were established by the analysis of their spectroscopic (1D and 2D NMR) and spectrometric (MS) data, as well as by comparison with those reported in the literature. Compound (1) exhibited strong inhibition against lipoxygenase (15-LOX) at IC50 42.5 μM and antibacterial activity toward Bacillus subtillis and Pseudomas aeruginosa with minimum inhibitory concentration (MIC) value of 250 μg/mL each.
Inter-organisational collaboration in palliative care trajectories for nursing home residents: A nation-wide mixed methods study among key persons
Authors: Hermans Sofie , Sevenants Aline , Declercq Anja , Broeck Nady V , Deliens Luc , Cohen Joachim , Audenhove Chantal V
Published: June 2019

Introduction

Multiple care organisations, such as home care services, nursing homes and hospitals, are responsible for providing an appropriate response to the palliative care needs of older people admitted into long-term care facilities. Integrated palliative care aims to provide seamless and continuous care. A possible organisational strategy to help realise integrated palliative care for this population is to create a network in which these organisations collaborate. The aim is to analyse the collaboration processes of the various organisations involved in providing palliative care to nursing home residents.

Method

A sequential mixed-methods study, including a survey sent to 502 participants to evaluate the collaboration between home and residential care, and between hospital and residential care, and additionally three focus group interviews involving a purposive selection among the survey participants. Participants are key persons from the nursing homes, hospitals and home care organisations that are part of the 15 Flemish palliative care networks dispersed throughout the region of Flanders, Belgium.

Results

Survey data were gathered from 308 key persons (response rate: 61%), and 16 people participated in three focus group interviews. Interpersonal dimensions of collaboration are rated higher than structural dimensions. This effect is statistically significant. Qualitative analyses identified guidelines, education, and information-transfer as structural challenges. Additionally, for further development, members should become acquainted and the network should prioritise the establishment of a communication infrastructure, shared leadership support and formalisation.

Discussion

The insights of key persons suggest the need for further structuration and can serve as a guideline for interventions directed at improving inter-organisational collaboration in palliative care trajectories for nursing home residents.
Differences in primary care providers’ and oncologists’ views on communication and coordination of care during active treatment of patients with cancer and comorbidities
Authors: P Brockway Julia , Murari Keerti , Rosenberg Alexandra , Saigh Orit , Press Matthew J , Lin Jenny J
Published: June 2019

Introduction

Management of comorbid diseases in patients with cancer is often unclear. The purpose of our study was to identify differences and similarities between primary care providers and oncologists’ knowledge, attitudes, and beliefs regarding coordination of care and comorbid disease management for patients undergoing active cancer treatment.

Methods

We conducted a cross-sectional study using an anonymous self-administered survey which was available to approximately 600 providers in primary care and medical oncology practicing in both outpatient and inpatient settings from March to December 2014 at three academic hospitals in New York City (Mount Sinai Hospital, Mount Sinai Beth Israel, and Weill Cornell). Our survey instrument assessed physician knowledge, attitudes, and beliefs using a clinical vignette of a cancer patient undergoing active treatment. Descriptive statistics were used to summarize the demographic and practice details of survey responses, and univariate analyses were used to assess differences in responses between primary care providers and oncologists.

Results

The survey was completed by 203 providers, including 127 primary care providers (62.5%), 32 medical oncologists (15.8%), 11 palliative care physicians (5.4%), and 33 nurse practitioners or physician assistants (16.3%). Medical oncologists admitted more uncertainty regarding who should manage preventive care as compared to primary care providers (34.4% vs. 16.5%, p = 0.02), whereas primary care providers were more concerned about duplicated care (22.8% vs. 6.3%, p = 0.03). Both primary care providers and medical oncologists agreed that diabetes should be actively managed during cancer treatment. More primary care providers felt less strict glycemic control was allowable (56.8% vs. 37.5%, p = 0.05) and that it is allowable for patients to miss some diabetes-related visits (80.6% vs. 56.3%, p = 0.01).

Discussion

Primary care providers and medical oncologists differ in their knowledge, attitudes, and beliefs regarding coordination of care and management of comorbid conditions in patients undergoing cancer treatment. These differences reflect systemic challenges to provision of care to cancer patients and the need for a model of care coordination.
Collaborative capacity and patient-centered care in the Veterans’ Health Administration Community Living Centers
Authors: Sullivan Jennifer L , Weinburg Dana Beth , Gidmark Stefanie , Engle Ryann L , Parker Victoria A , Tyler Denise A
Published: June 2019

Introduction

Previous research in acute care settings has shown that collaborative capacity, defined as the way providers collaborate as equal team members, can be improved by the ways in which an organization supports its staff and teams. This observational cross-sectional study examines the association between collaborative capacity and supportive organizational context, supervisory support, and person-centered care in nursing homes to determine if similar relationships exist.

Methods

We adapted the Care Coordination Survey for nursing homes and administered it to clinical staff in 20 VA Community Living Centers. We used random effects models to examine the associations between supportive organizational context, supervisory support, and person-centered care with collaborative capacity outcomes including quality of staff interactions, task independence, and collaborative influence.

Results

A total of 723 Community Living Center clinical staff participated in the Care Coordination Survey resulting in a response rate of 29%. We found that teamwork and collaboration—measured as task interdependence, quality of interactions and collaborative influence—did not differ significantly between Community Living Centers but did differ significantly across occupational groups. Moreover, staff members’ experiences of teamwork and collaboration were positively associated with supportive organizational context and person-centered care.

Discussion

Our findings suggest that elements of organizational context are important to facilitating collaborative capacity. Additionally, investing in staffing, rewards, and person-centered care may improve teamwork.
Battlefield of global ranking: How do power rivalries shape soft power index building?
Authors: Zhang Chang , Wu Ruiqin
Published: June 2019

International competition over soft power has largely transformed from image promotion and cultural diplomacy to benchmark setting. Benchmarks breed discourses and discourses embody power. The article argues that the soft power index building has turned into a battlefield where different values, norms and development models struggle for legitimacy through quasi-scientific validations. By critically examining the methods employed by two soft power indexes, Portland Soft Power 30 Index and China National Image Global Survey, this article unpacks the mechanisms by which institutions from western and emerging (Brazil, Russia, India, China and South Africa (BRICS)) states embed political values, interests and agendas in the selection of data, indicators and treatments of data. The article finds that while the soft power indexes originating from Western organizations largely normalized liberal values and the current international hierarchy, the Chinese national image survey provides a more self-reflective approach to soft power measurement.
Lightweight metallic matrix composites: Development of new composites material reinforced with carbon structures
Authors: Valente Marco , Marini Danilo , Genova Virgilio , Quitadamo Alessia , Marra Francesco , Pulci Giovanni
Published: June 2019

Carbon nano/micro-structures used as fillers in metallic lightweight alloy matrix composites are receiving considerable attention in scientific research and industrial applications. Aluminum and magnesium are the most studied light metals used as matrices in metal composites materials, principally for their low density (respectively 2.7 g/cm3 and 1.7 g/cm3) and low melting temperature (around 660 °C for both metals). A good interaction between matrix and fillers is the first step to obtain an increase in bulk properties; furthermore, the manufacturing procedure of the composite is fundamental in terms of quality of fillers dispersion. In this work the influence of surface modifications for three classes of carbon fillers for aluminum and magnesium alloy (AZ63) as matrices is studied. In particular, the selected fillers are short carbon micro fibers (SCMFs), carbon woven fabrics (CWF), and unidirectional yarn carbon fibers (UYFs). The surface modification was carried out by a direct coating of pure nickel on fibers. The electroless pure nickel plating was chosen as the coating technique and the use of hydrazine as reducing agent has prevented the co-deposition of other elements (such as P or B). Scanning electron microscope (SEM) and energy-dispersive X-ray spectroscopy (EDS) analyses were performed to study the effect of surface modifications. The mechanical properties of manufactured composites were evaluated by 4-point flexural tests according to ASTM C1161 (room temperature). Results confirm improved interactions between matrix and fillers, and the specific interaction was studied for any chosen reinforcement.
Think Pink! Dialectical Tensions in Survivor Discourse About Corporate Support of Breast Cancer Awareness
Authors: Mize Smith Jennifer
Published: June 2019

This study adopted a dialectical approach to explore the discourse of breast cancer survivors as they talked about and made sense of corporate involvement in promoting and sustaining breast cancer as a social cause. During semistructured interviews, participants reflected on the commercialization of breast cancer and seemed to grapple with corporate motives, corporate constructions of the disease, and corporate influence on their identity; thus, creating three dialectical tensions: (a) corporate altruism versus self-interest, (b) corporate romanticism versus reality, and (c) survivor identification versus disidentification. Corporations are encouraged to consider ways in which they might collaborate with survivors to BOTH maximize corporate profits AND propel the cause in positive and important ways.
Age-Related Hearing Loss Associations With Changes in Brain Morphology
Authors: Eckert Mark A. , Vaden Kenneth I. , Dubno Judy R.
Published: June 2019

Age-related hearing loss has been associated with varied auditory cortex morphology in human neuroimaging studies. These findings have suggested that peripheral auditory system declines cause changes in brain morphology but could also be due to latent variables that affect the auditory periphery and brain. The current longitudinal study was designed to evaluate these explanations for pure-tone threshold and brain morphology associations. Thirty adults (mean age at Time 1 = 64.12 ± 10.32 years) were studied at two time points (average duration between visits = 2.62 ± 0.81 years). Small- to medium-effect size associations were observed between high-frequency pure-tone thresholds and auditory cortex gray matter volume at each time point. Although there were significant longitudinal changes in low- and high-frequency hearing measures and brain morphology, those longitudinal changes were not significantly correlated across participants. High-frequency hearing measures at Time 1 were significantly related to more lateral ventricle expansion, such that participants with higher measures exhibited larger increases in ventricle size. This ventricle effect was statistically independent of high-frequency hearing associations with auditory cortex morphology. Together, these results indicate that there are at least two mechanisms for associations between age-related hearing loss and brain morphology. Potential explanations for a direct hearing loss effect on brain morphology, as well as latent variables that likely affect both the inner ear and brain, are discussed.
Initial Symptoms of Langerhans Cell Histiocytosis: A Case Series
Authors: Atsumi Yukari , Saito Yuya , Hataya Hiroshi , Yuza Yuki
Published: June 2019

Langerhans cell histiocytosis (LCH) is a rare childhood hematopoietic disease, and hence, there are few reports summarizing the course leading to the diagnosis. We described the initial symptoms and the clinical course of LCH. We carried out a retrospective review of charts from a single medical center, and 21 patients with the diagnosis of LCH were enrolled. The initial symptoms of 16 cases were caused by bone lesions; of these cases, there were 8 instances of soft tissue swelling as the initial symptom (38%) and 8 instances of bone pain without swelling (38%). Among the cases of bone lesion, 4 of 6 cases of skull lesion were painless while all vertebral body lesions and long bone lesions were accompanied by pain. LCH bone lesions caused various symptoms depending on the site of the lesion and this makes the diagnosis difficult. A detailed physical examination and imaging studies are recommended for early diagnosis.
Biopsychosocial Factors in Children Referred With Failure to Thrive: Modern Characterization for Multidisciplinary Care
Authors: Mazze Nina , Cory Emma , Gardner Julie , Alexanian-Farr Mara , Mutch Carly , Marcus Sherna , Johnstone Julie , van den Heuvel Meta
Published: June 2019

The objective of this study was to characterize biopsychosocial characteristics in children with failure to thrive with a focus on 4 domains: medical, nutrition, feeding skills, and psychosocial characteristics. A retrospective cross-sectional chart review was conducted of children assessed at the Infant and Toddler Growth and Feeding Clinic from 2015 to 2016. Descriptive statistics were used to analyze the data. One hundred thirty-eight children, 53.6% male, mean age 16.9 months (SD = 10.8), were included. Approximately one quarter of the children had complex medical conditions, medical comorbidities, and developmental delays. The mean weight-for-age percentile was 15.5 (SD = 23.9), and mean weight-for-length z score was −1.51 (SD = 1.4). A total of 22.5% of children had delayed oral-motor skills and 28.3% had oral aversion symptoms. Caregiver feeding strategies included force feeding (14.5%) and the use of distractions (47.1%). The multifactorial assessment of failure to thrive according to the 4 domains allowed for a better understanding of contributing factors and could facilitate multidisciplinary collaboration.
Motor speech impairment predicts expressive language in minimally verbal, but not low verbal, individuals with autism spectrum disorder
Authors: Chenausky Karen , Brignell Amanda , Morgan Angela , Tager-Flusberg Helen
Published: June 2019

Background and aims

Developmental motor speech impairment has been suspected, but rarely systematically examined, in low- and minimally verbal individuals with autism spectrum disorder. We aimed to investigate the extent of motor speech impairment in this population and its relation to number of different words produced during a semi-structured language sample.

Methods

Videos of 54 low-verbal and minimally verbal individuals (ages 4;4–18;10) performing portions of a speech praxis test were coded for signs of motor speech impairment (e.g., childhood apraxia of speech). Age, autism spectrum disorder severity, nonspeech oral-motor ability, speech production ability, nonverbal IQ, and receptive vocabulary were compared between groups.

Results

Four groups emerged: (1) speech within normal limits ( n = 12), (2) non-childhood apraxia of speech impairment ( n = 16), (3) suspected childhood apraxia of speech ( n = 13), and (4) insufficient speech to rate ( n = 13). Groups differed significantly in nonspeech oral-motor ability, speech production ability, nonverbal IQ, and receptive vocabulary. Overall, only speech production ability and receptive vocabulary accounted for significant variance in number of different words. Receptive vocabulary significantly predicted number of different words only in Groups 1 and 2, while speech production ability significantly predicted number of different words only in Groups 3 and 4.

Conclusions and implications

If replicated, our findings have important implications for developing much-needed spoken language interventions in minimally verbal individuals with autism spectrum disorder.
Germline mutations in the transcription factor IKZF5 cause thrombocytopenia
Authors: Lentaigne Claire , Greene Daniel , Sivapalaratnam Suthesh , Favier Remi , Seyres Denis , Thys Chantal , Grassi Luigi , Mangles Sarah , Sibson Keith , Stubbs Matthew , Burden Frances , Bordet Jean-Claude , Armari-Alla Corinne , Erber Wendy , Farrow Samantha , Gleadall Nicholas , Gomez Keith , Megy Karyn , Papadia Sofia , Penkett Christopher J. , Sims Matthew C. , Stefanucci Luca , Stephens Jonathan C. , Read Randy J. , Stirrups Kathleen E. , Ouwehand Willem H. , Laffan Michael A. ,   NIHR BioResource, Frontini Mattia , Freson Kathleen , Turro Ernest
Published: June 2019

The authors provide evidence of a novel association between transcription factor IKZF5, one of the IKAROS family proteins, and thrombocytopenia with decreased alpha granules, thus significantly extending our understanding of the gene defects leading to inherited thrombocytopenia.
PRMT1-mediated FLT3 arginine methylation promotes maintenance of FLT3-ITD+ acute myeloid leukemia
Authors: He Xin , Zhu Yinghui , Lin Yi-Chun , Li Min , Du Juan , Dong Haojie , Sun Jie , Zhu Lei , Wang Hanying , Ding Zonghui , Zhang Lei , Zhang Lianjun , Zhao Dandan , Wang Zhihao , Wu Herman , Zhang Han , Jiang Wenjuan , Xu Yang , Jin Jian , Shen Yudao , Perry Jeff , Zhao Xinyang , Zhang Bin , Liu Songbai , Xue Sheng-Li , Shen Binghui , Chen Chun-Wei , Chen Jianjun , Khaled Samer , Kuo Ya-Huei , Marcucci Guido , Luo Yun , Li Ling
Published: June 2019

The presence of FMS-like receptor tyrosine kinase-3 internal tandem duplication (FLT3-ITD) mutations in patients with acute myeloid leukemia (AML) is associated with poor clinical outcome. FLT3 tyrosine kinase inhibitors (TKIs), although effective in kinase ablation, do not eliminate primitive FLT3-ITD+ leukemia cells, which are potential sources of relapse. Thus, understanding the mechanisms underlying FLT3-ITD+ AML cell persistence is essential to devise future AML therapies. Here, we show that expression of protein arginine methyltransferase 1 (PRMT1), the primary type I arginine methyltransferase, is increased significantly in AML cells relative to normal hematopoietic cells. Genome-wide analysis, coimmunoprecipitation assay, and PRMT1-knockout mouse studies indicate that PRMT1 preferentially cooperates with FLT3-ITD, contributing to AML maintenance. Genetic or pharmacological inhibition of PRMT1 markedly blocked FLT3-ITD+ AML cell maintenance. Mechanistically, PRMT1 catalyzed FLT3-ITD protein methylation at arginine 972/973, and PRMT1 promoted leukemia cell growth in an FLT3 methylation–dependent manner. Moreover, the effects of FLT3-ITD methylation in AML cells were partially due to cross talk with FLT3-ITD phosphorylation at tyrosine 969. Importantly, FLT3 methylation persisted in FLT3-ITD+ AML cells following kinase inhibition, indicating that methylation occurs independently of kinase activity. Finally, in patient-derived xenograft and murine AML models, combined administration of AC220 with a type I PRMT inhibitor (MS023) enhanced elimination of FLT3-ITD+ AML cells relative to AC220 treatment alone. Our study demonstrates that PRMT1-mediated FLT3 methylation promotes AML maintenance and suggests that combining PRMT1 inhibition with FLT3 TKI treatment could be a promising approach to eliminate FLT3-ITD+ AML cells.
Unilateral L4-dorsal root ganglion stimulation evokes pain relief in chronic neuropathic postsurgical knee pain and changes of inflammatory markers: part II whole transcriptome profiling
Authors: Kinfe Thomas M. , Asif Maria , Chakravarthy Krishnan V. , Deer Timothy R. , Kramer Jeffery M. , Yearwood Thomas L. , Hurlemann Rene , Hussain Muhammad Sajid , Motameny Susanne , Wagle Prerana , Nürnberg Peter , Gravius Sascha , Randau Thomas , Gravius Nadine , Chaudhry Shafqat R. , Muhammad Sajjad
Published: June 2019

Background

In our recent clinical trial, increased peripheral concentrations of pro-inflammatory molecular mediators were determined in complex regional pain syndrome (CRPS) patients. After 3 months adjunctive unilateral, selective L4 dorsal root ganglion stimulation (L4-DRGSTIM), significantly decreased serum IL-10 and increased saliva oxytocin levels were assessed along with an improved pain and functional state. The current study extended molecular profiling towards gene expression analysis of genes known to be involved in the gonadotropin releasing hormone receptor and neuroinflammatory (cytokines/chemokines) signaling pathways.

Methods

Blood samples were collected from 12 CRPS patients for whole-transcriptome profiling in order to assay 18,845 inflammation-associated genes from frozen blood at baseline and after 3 months L4-DRGSTIM using PANTHER™ pathway enrichment analysis tool.

Results

Pathway enrichment analyses tools (GOrilla™ and PANTHER™) showed predominant involvement of inflammation mediated by chemokines/cytokines and gonadotropin releasing hormone receptor pathways. Further, screening of differentially regulated genes showed changes in innate immune response related genes. Transcriptomic analysis showed that 21 genes (predominantly immunoinflammatory) were significantly changed after L4-DRGSTIM. Seven genes including TLR1, FFAR2, IL1RAP, ILRN, C5, PKB and IL18 were down regulated and fourteen genes including CXCL2, CCL11, IL36G, CRP, SCGB1A1, IL-17F, TNFRSF4, PLA2G2A, CREB3L3, ADAMTS12, IL1F10, NOX1, CHIA and BDKRB1 were upregulated.

Conclusions

In our sub-group analysis of L4-DRGSTIM treated CRPS patients, we found either upregulated or downregulated genes involved in immunoinflammatory circuits relevant for the pathophysiology of CRPS indicating a possible relation. However, large biobank-based approaches are recommended to establish genetic phenotyping as a quantitative outcome measure in CRPS patients.

Trial registration The study protocol was registered at the 15.11.2016 on German Register for Clinical Trials (DRKS ID 00011267). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011267
On the physical principles underlying electromagnetic induction
Authors: Everett Mark E. , Chave Alan D.
Published: June 2019

This paper provides a theoretical overview of some of the fundamental concepts underlying electromagnetic (EM) induction exploration methods using marine controlled-source EMs as an exemplar. In particular, it will be shown, from different vantage points, that EM induction operates in the magnetoquasistatic regime in which inductive effects dominate, capacitive effects are ignored, and the displacement current is negligible; hence, charge polarization and dielectric phenomena play no role. We determine some of the major physical consequences of this approximation, and we make a distinction between wave physics and diffusive behavior, which is of particular interest in the special case of time-periodic excitation. We distinguish the fundamentally different roles of mobile charge carriers and bound charges in EM induction. It is emphasized that EM induction cannot be fully understood by comparing and contrasting Maxwell’s equations with governing equations from other disciplines that possess a similar mathematical structure. It is suggested that visualizations of energy flow using the Poynting vector and the Joule heating parameters provide a powerful tool to understand how the geologic medium shapes EM induction responses.
Predicting Renal Cancer Recurrence: Defining Limitations of Existing Prognostic Models With Prospective Trial-Based Validation
Authors: Correa Andres F. , Jegede Opeyemi , Haas Naomi B. , Flaherty Keith T. , Pins Michael R. , Messing Edward M. , Manola Judith , Wood Christopher G. , Kane Christopher J. , Jewett Michael A.S. , Dutcher Janice P. , DiPaola Robert S. , Carducci Michael A. , Uzzo Robert G.
Published: June 2019

PURPOSE

To validate currently used recurrence prediction models for renal cell carcinoma (RCC) by using prospective data from the ASSURE (ECOG-ACRIN E2805; Adjuvant Sorafenib or Sunitinib for Unfavorable Renal Carcinoma) adjuvant trial.

PATIENTS AND METHODS

Eight RCC recurrence models (University of California at Los Angeles Integrated Staging System [UISS]; Stage, Size, Grade, and Necrosis [SSIGN]; Leibovich; Kattan; Memorial Sloan Kettering Cancer Center [MSKCC]; Yaycioglu; Karakiewicz; and Cindolo) were selected on the basis of their use in clinical practice and clinical trial designs. These models along with the TNM staging system were validated using 1,647 patients with resected localized high-grade or locally advanced disease (≥ pT1b grade 3 and 4/pTanyN1Mo) from the ASSURE cohort. The predictive performance of the model was quantified by assessing its discriminatory and calibration abilities.

RESULTS

Prospective validation of predictive and prognostic models for localized RCC showed a substantial decrease in each of the predictive abilities of the model compared with their original and externally validated discriminatory estimates. Among the models, the SSIGN score performed best (0.688; 95% CI, 0.686 to 0.689), and the UISS model performed worst (0.556; 95% CI, 0.555 to 0.557). Compared with the 2002 TNM staging system (C-index, 0.60), most models only marginally outperformed standard staging. Importantly, all models, including TNM, demonstrated statistically significant variability in their predictive ability over time and were most useful within the first 2 years after diagnosis.

CONCLUSION

In RCC, as in many other solid malignancies, clinicians rely on retrospective prediction tools to guide patient care and clinical trial selection and largely overestimate their predictive abilities. We used prospective collected adjuvant trial data to validate existing RCC prediction models and demonstrate a sharp decrease in the predictive ability of all models compared with their previous retrospective validations. Accordingly, we recommend prospective validation of any predictive model before implementing it into clinical practice and clinical trial design.
Increasing ergosterol levels delays formin-dependent assembly of F-actin cables and disrupts division plane positioning in fission yeast
Authors: Arbizzani Federica , Rincon Sergio A. , Paoletti Anne
Published: June 2019

In most eukaryotes, cytokinesis is mediated by the constriction of a contractile acto-myosin ring (CR), which promotes the ingression of the cleavage furrow. Many components of the CR interact with plasma membrane lipids suggesting that lipids may regulate CR assembly and function. Although there is clear evidence that phosphoinositides play an important role in cytokinesis, much less is known about the role of sterols in this process. Here, we studied how sterols influence division plane positioning and CR assembly in fission yeast. We show that increasing ergosterol levels in the plasma membrane blocks the assembly of F-actin cables from cytokinetic precursor nodes, preventing their compaction into a ring. Abnormal F-actin cables form after a delay, leading to randomly placed septa. Since the formin Cdc12 was detected on cytokinetic precursors and the phenotype can be partially rescued by inhibiting the Arp2/3 complex, which competes with formins for F-actin nucleation, we propose that ergosterol may inhibit formin dependent assembly of F-actin cables from cytokinetic precursors.
Processo e estratégia como prática na tomada de decisão: um estudo de caso
Authors: Werlang Nathalia Berger , Lavarda Rosália Aldraci Barbosa , Lorenzatto Liara Letícia
Published: June 2019

Este estudo teve como objetivo compreender como ocorre o processo de tomada de decisão, a partir da análise das práticas estratégicas e da ação dos praticantes, em uma indústria de confecção. Para isso, foi realizada uma pesquisa qualitativa, por meio de um estudo de caso. Os dados coletados nas entrevistas semiestruturadas, observação direta e análise documental foram tratados com a técnica de análise da narrativa e pela triangulação de dados. Os resultados apontam que diferentes formas de análise do contexto organizacional têm gerado práticas importantes, como a adoção de ferramentas estratégicas, a exemplo da análise SWOT, planejamento estratégico e pesquisas de mercado. Essas práticas articuladas pelos praticantes da estratégia têm proporcionado à organização maior acertividade no processo de tomada de decisão.
FDTool: a Python application to mine for functional dependencies and candidate keys in tabular data
Authors: Buranosky Matt , Stellnberger Elmar , Pfaff Emily , Diaz-Sanchez David , Ward-Caviness Cavin
Published: June 2019

Functional dependencies (FDs) and candidate keys are essential for table decomposition, database normalization, and data cleansing. In this paper, we present FDTool, a command line Python application to discover minimal FDs in tabular datasets and infer equivalent attribute sets and candidate keys from them. The runtime and memory costs associated with seven published FD discovery algorithms are given with an overview of their theoretical foundations. Previous research establishes that FD_Mine is the most efficient FD discovery algorithm when applied to datasets with many rows (> 100,000 rows) and few columns (< 14 columns). This puts it in a special position to rule mine clinical and demographic datasets, which often consist of long and narrow sets of participant records. The structure of FD_Mine is described and supplemented with a formal proof of the equivalence pruning method used. FDTool is a re-implementation of FD_Mine with additional features added to improve performance and automate typical processes in database architecture. The experimental results of applying FDTool to 13 datasets of different dimensions are summarized in terms of the number of FDs checked, the number of FDs found, and the time it takes for the code to terminate. We find that the number of attributes in a dataset has a much greater effect on the runtime and memory costs of FDTool than does row count. The last section explains in detail how the FDTool application can be accessed, executed, and further developed.