bluuebunny/crossref_metadata_2025 huggingface dataset:
PictureSensation – a mobile application to help the blind explore the visual world through touch and sound
Authors: Banf Michael , Mikalay Ruben , Watzke Baris , Blanz Volker
Published: October 2016

We present PictureSensation, a mobile application for the hapto-acoustic exploration of images. It is designed to allow for the visually impaired to gain direct perceptual access to images via an acoustic signal. PictureSensation introduces a swipe-gesture based, speech-guided, barrier free user interface to guarantee autonomous usage by a blind user. It implements a recently proposed exploration and audification principle, which harnesses exploration methods that the visually impaired are used to from everyday life. In brief, a user explores an image actively on a touch screen and receives auditory feedback about its content at his current finger position. PictureSensation provides an extensive tutorial and training mode, to allow for a blind user to become familiar with the use of the application itself as well as the principles of image content to sound transformations, without any assistance from a normal-sighted person. We show our application’s potential to help visually impaired individuals explore, interpret and understand entire scenes, even on small smartphone screens. Providing more than just verbal scene descriptions, PictureSensation presents a valuable mobile tool to grant the blind access to the visual world through exploration, anywhere.
Life-threatening MRSA sepsis with bilateral pneumonia, osteomyelitis, and septic arthritis of the knee in a previously healthy 13-year-old boy: a case report
Authors: Hardgrib Nina , Wang Michala , Jurik Anne Grethe , Petersen Klaus K
Published: October 2016

The incidence and severity of methicillin resistant Staphylococcus aureus (MRSA) infections are increasing and cause high mortality and morbidity. We describe the first pediatric case in Scandinavia with Panton-Valentine leucocidin (PVL) positive MRSA septicemia who developed bilateral pneumonia, arthritis of the knee, and osteomyelitis of the tibia. Radiological investigation and interpretation directed the treatment, especially the surgical debridement, and combined with clinical and biochemical findings lead to close interdisciplinary treatment with frequent surgical interventions and antimicrobial combination therapy. The outcome was a healthy patient without sequelae, a favorable course unlike those previously described in the literature. This case underlines the necessity of a close interdisciplinary cooperation in children with severe MRSA infection encompassing pneumonia, septic arthritis, and osteomyelitis, using different imaging modalities to guide the surgical and antibiotic treatment.
Effects of Success for All on Reading Achievement
Authors: Cheung Alan C. K. , Slavin Robert E.
Published: October 2016

This study examined the effects of the Success for All (SFA) whole-school reform approach on student reading achievement. The data were collected for the Study of Instructional Improvement by the University of Michigan, which did not previously report the achievement outcomes in detail but did make the data available online. Using propensity matching, we matched 27 SFA with 27 comparable schools based on several key demographic variables. The evaluation used hierarchical linear modeling with students nested within schools. Results showed that SFA students significantly outperformed their counterparts in the matched schools on reading achievement, with an effect size of +0.26 for students in a 3-year longitudinal comparison. Effect sizes were similar for 2-year cohorts (mean effect size = +0.31). Policy implications are discussed.
Design and characterization of an APC-specific serpin for the treatment of hemophilia
Authors: Polderdijk Stéphanie G. I. , Adams Ty E. , Ivanciu Lacramioara , Camire Rodney M. , Baglin Trevor P. , Huntington James A.
Published: October 2016

Key Points

The endogenous inhibitors of APC also inhibit other coagulation proteases rendering them unacceptable for treatment of hemophilia. Rationally designed APC-specific serpins rescue thrombin generation in vitro and restore hemostasis in hemophilia mouse models.
Left-right axis asymmetry determining human Cryptic gene is transcriptionally repressed by Snail
Authors: Gupta Kartik , Pilli Vijaya Satish Sekhar , Aradhyam Gopala Krishna
Published: October 2016

Background

Establishment of the left-right axis is important for positioning organs asymmetrically in the developing vertebrate-embryo. A number of factors like maternally deposited molecules have emerged essential in initiating the specification of the axis; the downstream events, however, are regulated by signal-transduction and gene-expression changes identifying which remains a crucial challenge. The EGF-CFC family member Cryptic, that functions as a co-receptor for some TGF-beta ligands, is developmentally expressed in higher mammals and mutations in the gene cause loss or change in left-right axis asymmetry. Despite the strong phenotype, no transcriptional-regulator of this gene is known till date.

Results

Using promoter-analyses tools, we found strong evidence that the developmentally essential transcription factor Snail binds to the human Cryptic-promoter. We cloned the promoter-region of human Cryptic in a reporter gene and observed decreased Cryptic-promoter activation upon increasing Snail expression. Further, the expression of Cryptic is down-regulated upon exogenous Snail expression, validating the reporter assays and the previously identified role of Snail as a transcriptional repressor. Finally, we demonstrate using gel-shift assay that Snail in nuclear extract of PANC1 cells interacts with the promoter-construct bearing putative Snail binding sites and confirm this finding using chromatin immunoprecipitation assay.

Conclusions

Snail represses the expression of human Cryptic and therefore, might affect the signaling via Nodal that has previously been demonstrated to specify the left-right axis using the EGF-CFC co-receptors.
Mesenchymal stromal cell treatment prevents H9N2 avian influenza virus-induced acute lung injury in mice
Authors: Li Yan , Xu Jun , Shi Weiqing , Chen Cheng , Shao Yan , Zhu Limei , Lu Wei , Han XiaoDong
Published: October 2016

Background

The avian influenza virus (AIV) can cross species barriers and expand its host range from birds to mammals, even humans. Avian influenza is characterized by pronounced activation of the proinflammatory cytokine cascade, which perpetuates the inflammatory response, leading to persistent systemic inflammatory response syndrome and pulmonary infection in animals and humans. There are currently no specific treatment strategies for avian influenza.

Methods

We hypothesized that mesenchymal stromal cells (MSCs) would have beneficial effects in the treatment of H9N2 AIV-induced acute lung injury in mice. Six- to 8-week-old C57BL/6 mice were infected intranasally with 1 × 104 MID50 of A/HONG KONG/2108/2003 [H9N2 (HK)] H9N2 virus to induce acute lung injury. After 30 min, syngeneic MSCs were delivered through the caudal vein. Three days after infection, we measured the survival rate, lung weight, arterial blood gas, and cytokines in both bronchoalveolar lavage fluid (BALF) and serum, and assessed pathological changes to the lungs.

Results

MSC administration significantly palliated H9N2 AIV-induced pulmonary inflammation by reducing chemokines and proinflammatory cytokines levels, as well as reducing inflammatory cell recruit into the lungs. Thus, H9N2 AIV-induced lung injury was markedly alleviated in mice treated with MSCs. Lung histopathology and arterial blood gas analysis were improved in mice with H9N2 AIV-induced lung injury following MSC treatment.

Conclusions

MSC treatment significantly reduces H9N2 AIV-induced acute lung injury in mice and is associated with reduced pulmonary inflammation. These results indicate a potential role for MSC therapy in the treatment of clinical avian influenza.
Investigation of EZH2 pathways for novel epigenetic treatment strategies in oropharyngeal cancer
Authors: Idris Sherif , Lindsay Cameron , Kostiuk Morris , Andrews Colin , Côté David W. J. , O'Connell Daniel A. , Harris Jeffrey , Seikaly Hadi , Biron Vincent L.
Published: October 2016

Background

In recent decades, the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been rising worldwide as a result of increasing oncogenic human papillomavirus (HPV) infections in the oropharynx. EZH2 is an epigenetic regulatory protein associated with tumor aggressiveness and negative survival outcomes in several human cancers. We aimed to determine the role of EZH2 as a potential therapeutic epigenetic target in HPV-positive and negative OPSCC.

Methods

The expression of EZH2 was measured by immunohistochemistry (IHC) and droplet digital PCR (ddPCR) in 2 HPV-positive and 2 HPV-negative cell lines. The cell lines were then cultured and treated with one of 3 EZH2 epigenetic inhibitors (3-deazaneplanocin A, GSK-343 and EPZ005687) or DMSO (control). Following 2, 4 and 7 days of treatment, cells were analyzed and compared by gene expression, cell survival and proliferation assays.

Results

EZH2 targeting resulted in greater inhibition of growth and survival in HPV-positive compared to HPV-negative cells lines. The expression profile of genes important in OPSCC also differed according to HPV-positivity for Ki67, CCND1, MET and PTEN/PIK3CA, but remained unchanged for EGFR, CDKN2A and p53.

Conclusion

Inhibition of EZH2 has anti-tumorigenic effects on OPSCC cells in culture that is more pronounced in HPV-positive cell lines. EZH2 is a promising epigenetic target for the treatment of OPSCC.
Practice patterns among thyroid cancer surgeons: Implications of performing a prophylactic central neck dissection
Authors: Deutschmann Michael W. , Chin-Lenn Laura , Nakoneshny Steven C. , Dort Joseph C. , Pasieka Janice L. , Chandarana Shamir P.
Published: October 2016

Background

Indications for performing a prophylactic central neck dissection (pCND) in papillary thyroid cancer (PTC) remain controversial. It is unclear how identification of lymph node (LN) metastases should impact the decision to treat with radioactive iodine (RAI). The goals of this study were to identify indications for performing pCND and identify factors that predict the use of adjuvant RAI.

Methods

This was a population based cross-sectional analysis. A prospectively collected database identified 594 patients who underwent total thyroidectomy +/− CND. A multivariate model was constructed to identify indications for pCND and predictors of the use of RAI.

Results

425 CNDs were performed of which 224 were prophylactic. Conventional risk factors (age, tumor size, extra-thyroidal extension) were not associated with performing a pCND. The presence of clinically suspicious lymphadenopathy was the only factor associated with performing CND, thus rendering the CND therapeutic. Positive LNs were retrieved in 39 % of pCND's, upstaging 87 patients. Among all peri-operative predictors of receiving RAI, presence of LN metastases was the strongest predictor [OR = 5.9 (3.7–9.5)], while tumor size was a modest predictor [OR = 1.8 (1.5–2.1)]. Other conventional risk factors did not predict use of adjuvant RAI.

Conclusions

Conventional risk factors were not indications for performing a pCND, implying that the decision was based on individual surgeon preference. Performing pCND upstaged 39 % of patients from cN0 to pN1a, increasing the likelihood of receiving RAI 6-fold. Conventional risk factors were not predictors of receiving adjuvant RAI. This highlights the need for a unified approach to performing a pCND and administering RAI.
Filamin A- and formin 2-dependent endocytosis regulates proliferation via the canonical Wnt pathway
Authors: Lian Gewei , Dettenhofer Markus , Lu Jie , Downing Michael , Chenn Anjen , Wong Timothy , Sheen Volney
Published: October 2016

Actin-associated proteins regulate multiple cellular processes, including proliferation and differentiation, but the molecular mechanisms underlying these processes are unclear. Here, we report that the actin-binding protein filamin A (FlnA) physically interacts with the actin-nucleating protein formin 2 (Fmn2). Loss of FlnA and Fmn2 impairs proliferation, thereby generating multiple embryonic phenotypes, including microcephaly. FlnA interacts with the Wnt co-receptor Lrp6. Loss of FlnA and Fmn2 impairs Lrp6 endocytosis, downstream Gsk3β activity, and β-catenin accumulation in the nucleus. The proliferative defect in Flna and Fmn2 null neural progenitors is rescued by inhibiting Gsk3β activity. Our findings thus reveal a novel mechanism whereby actin-associated proteins regulate proliferation by mediating the endocytosis and transportation of components in the canonical Wnt pathway. Moreover, the Fmn2-dependent signaling in this pathway parallels that seen in the non-canonical Wnt-dependent regulation of planar cell polarity through the Formin homology protein Daam. These studies provide evidence for integration of actin-associated processes in directing neuroepithelial proliferation.
Syndecan 4 controls lymphatic vasculature remodeling during mouse embryonic development
Authors: Wang Yingdi , Baeyens Nicolas , Corti Federico , Tanaka Keiichiro , Fang Jennifer S. , Zhang Jiasheng , Jin Yu , Coon Brian , Hirschi Karen K. , Schwartz Martin A. , Simons Michael
Published: October 2016

The role of fluid shear stress in vasculature development and remodeling is well appreciated. However, the mechanisms regulating these effects remain elusive. We show that abnormal flow sensing in lymphatic endothelial cells (LECs) caused by Sdc4 or Pecam1 deletion in mice results in impaired lymphatic vessel remodeling, including abnormal valve morphogenesis. Ablation of either gene leads to the formation of irregular, enlarged and excessively branched lymphatic vessels. In both cases, lymphatic valve-forming endothelial cells are randomly oriented, resulting in the formation of abnormal valves. These abnormalities are much more pronounced in Sdc4−/−; Pecam1−/− double-knockout mice, which develop severe edema. In vitro, SDC4 knockdown human LECs fail to align under flow and exhibit high expression of the planar cell polarity protein VANGL2. Reducing VANGL2 levels in SDC4 knockdown LECs restores their alignment under flow, while VANGL2 overexpression in wild-type LECs mimics the flow alignment abnormalities seen in SDC4 knockdown LECs. SDC4 thus controls flow-induced LEC polarization via regulation of VANGL2 expression.
Ligament versus bone cell identity in the zebrafish hyoid skeleton is regulated by mef2ca
Authors: Nichols James T. , Blanco-Sánchez Bernardo , Brooks Elliott P. , Parthasarathy Raghuveer , Dowd John , Subramanian Arul , Nachtrab Gregory , Poss Kenneth D. , Schilling Thomas F. , Kimmel Charles B.
Published: October 2016

Heightened phenotypic variation among mutant animals is a well-known, but poorly understood phenomenon. One hypothetical mechanism accounting for mutant phenotypic variation is progenitor cells variably choosing between two alternative fates during development. Zebrafish mef2cab1086 mutants develop tremendously variable ectopic bone in their hyoid craniofacial skeleton. Here, we report evidence that a key component of this phenotype is variable fate switching from ligament to bone. We discover that a ‘track’ of tissue prone to become bone cells is a previously undescribed ligament. Fate-switch variability is heritable, and comparing mutant strains selectively bred to high and low penetrance revealed differential mef2ca mutant transcript expression between high and low penetrance strains. Consistent with this, experimental manipulation of mef2ca mutant transcripts modifies the penetrance of the fate switch. Furthermore, we discovered a transposable element that resides immediately upstream of the mef2ca locus and is differentially DNA methylated in the two strains, correlating with differential mef2ca expression. We propose that variable transposon epigenetic silencing underlies the variable mef2ca mutant bone phenotype, and could be a widespread mechanism of phenotypic variability in animals.
Exploring Process Dynamics by near Infrared Spectroscopy in Lactic Fermentations
Authors: Svendsen Carina , Cieplak Tomasz , van den Berg Frans W.J.
Published: October 2016

In the industrial production of yoghurt, measurement of pH is normally the only in-line technique applied as a real-time monitoring signal for following the dynamics during the fermentation process. However, every dairy company would benefit from an in-line technique giving information about the chemical composition, physical/textural properties and/or microbial contamination. In this study lactic fermentation batches with the starter bacteria Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus are explored by in-line near infrared (NIR) spectroscopy. The dynamics obtained from NIR spectroscopy is elucidated in order to explain what causes the variation of the indirect measurements. The results show that viscosity change has a large impact on the scatter, which affects the NIR data. It seems that the variation found by NIR spectroscopy is caused by both scatter and absorption, where the scatter gives us information about the textural change happening, and the absorption gives us information about the biomass formation plus the conversion of sugar into lactic acid.
Evaluation of the Effect of near Infrared Spectrometer Wavelength Range and Calibration Algorithms on Prediction of Crushing Strength of Pharmaceutical Tablets
Authors: Talwar Sameer , Igne Benoît , Anderson Carl A. , Drennen James K.
Published: October 2016

This study was aimed at understanding the effect of near infrared (NIR) spectrometer wavelength range and calibration approaches on the performance of pharmaceutical tablet crushing strength prediction methods. The study utilised a six-component tablet formulation, created with variability in excipient ratio and compression force. Method development was tested with two NIR spectrometers and three calibration approaches: spectral slope, partial least squares (PLS) and multiple linear regression (MLR). The sensors used in the study were based on diffuse reflectance sensing geometry with wavelength ranges of 1100–2498 nm and 1350–1800 nm. The three calibration approaches demonstrated an improved prediction of crushing strength with the longer wavelength range, indicative of its significant impact on method performance. It was established that the PLS approach reduced the impact of wavelength range on performance by maximising the covariance between crushing strength and the spectral features associated with baseline shift/slope change and excipient ratio. The MLR approach incorporated variables of physical/chemical nature to mitigate risks to method performance.
New Directions for Modelling Strategic Behavior: Game-Theoretic Models of Communication, Coordination, and Cooperation in Economic Relationships
Authors: Crawford Vincent P.
Published: October 2016

In this paper, I discuss the state of progress in applications of game theory in economics and try to identify possible future developments that are likely to yield further progress. To keep the topic manageable, I focus on a canonical economic problem that is inherently game-theoretic, that of fostering efficient coordination and cooperation in relationships, with particular attention to the role of communication. I begin with an overview of noncooperative game theory's principal model of behavior, Nash equilibrium. I next discuss the alternative “thinking” and “learning” rationales for how real-world actors might reach equilibrium decisions. I then review how Nash equilibrium has been used to model coordination, communication, and cooperation in relationships, and discuss possible developments
Diversity in the Economics Profession: A New Attack on an Old Problem
Authors: Bayer Amanda , Rouse Cecilia Elena
Published: October 2016

The economics profession includes disproportionately few women and members of historically underrepresented racial and ethnic minority groups, relative both to the overall population and to other academic disciplines. This underrepresentation within the field of economics is present at the undergraduate level, continues into the ranks of the academy, and is barely improving over time. It likely hampers the discipline, constraining the range of issues addressed and limiting our collective ability to understand familiar issues from new and innovative perspectives. In this paper, we first present data on the numbers of women and underrepresented minority groups in the profession. We then offer an overview of current research on the reasons for the underrepresentation, highlighting evidence that may be less familiar to economists. We argue that implicit attitudes and institutional practices may be contributing to the underrepresentation of women and minorities at all stages of the pipeline, calling for new types of research and initiatives to attack the problem. We then review evidence on how diversity affects productivity and propose remedial interventions as well as findings on effectiveness. We identify several promising practices, programs, and areas for future research.
Kc167, a widely used Drosophila cell line, contains an active primary piRNA pathway
Authors: Vrettos Nicholas , Maragkakis Manolis , Alexiou Panagiotis , Mourelatos Zissimos
Published: October 2016

PIWI family proteins bind to small RNAs known as PIWI-interacting RNAs (piRNAs) and play essential roles in the germline by silencing transposons and by promoting germ cell specification and function. Here we report that the widely used Kc167 cell line, derived from Drosophila melanogaster embryos, expresses piRNAs that are loaded to Aub and Piwi. Kc167 piRNAs are produced by a canonical, primary piRNA biogenesis pathway, from phased processing of precursor transcripts by the Zuc endonuclease, Armi helicase, and dGasz mitochondrial scaffold protein. Kc167 piRNAs derive from cytoplasmic transcripts, notably tRNAs and mRNAs, and their abundance correlates with that of parent transcripts. The expression of Aub is robust in Kc167, that of Piwi is modest, while Ago3 is undetectable, explaining the lack of transposon-related piRNA amplification by the Aub-Ago3, ping-pong mechanism. We propose that the default state of the primary piRNA biogenesis machinery is random transcript sampling to allow generation of piRNAs from any transcript, including newly acquired retrotransposons. This state is unmasked in Kc167, likely because they do not express piRNA cluster transcripts in sufficient amounts and do not amplify transposon piRNAs. We use Kc167 to characterize an inactive isoform of Aub protein. Since most Kc167 piRNAs are genic, they can be mapped uniquely to the genome, facilitating computational analyses. Furthermore, because Kc167 is a widely used and well-characterized cell line that is easily amenable to experimental manipulations, we expect that it will serve as an excellent system to study piRNA biogenesis and piRNA-related factors.
Modification of the solar activity indices in the International Reference Ionosphere IRI and IRI-Plas models due to recent revision of sunspot number time series
Authors: Гуляева Тамара , Gulyaeva Tamara
Published: October 2016

The International Reference Ionosphere (IRI) imports global effective ionospheric IG12 index based on ionosonde measurements of the critical frequency foF2 as a proxy of solar activity. Similarly, the global electron content (GEC), smoothed by the sliding 12-months window (GEC12), is used as a solar proxy in the ionospheric and plasmaspheric model IRI-Plas. GEC has been calculated from global ionospheric maps of total electron content (TEC) since 1998 whereas its productions for the preceding years and predictions for the future are made with the empirical model of the linear dependence of GEC on solar activity. At present there is a need to re-evaluate solar and ionospheric indices in the ionospheric models due to the recent revision of sunspot number (SSN2) time series, which has been conducted since July 1, 2015 [Clette et al., 2014]. Implementation of SSN2 instead of the former SSN1 series with the ionospheric model could increase model prediction errors. A formula is proposed to transform the smoothed SSN212 series to the proxy of the former basic SSN112=R12 index, which is used by the IRI and IRI-Plas models for long-term ionospheric predictions. Regression relationships are established between GEC12, the sunspot number R12, and the proxy solar index of 10.7 cm microwave radio flux, F10.712. Comparison of calculations by the IRI-Plas and IRI models with observations and predictions for Moscow during solar cycles 23 and 24 has shown the advantage of implementation of GEC12 index with the IRI-Plas model.
Modeling of the effect of internal gravity waves on upper atmospheric conditions during sudden stratospheric warming
Authors: Васильев Павел , Vasilyev Pavel , Карпов Иван , Karpov Ivan , Кшевецкий Сергей , Kshevetskii Sergey
Published: October 2016

We present results of modeling of the effect of internal gravity waves (IGW), excited in the region of development of a sudden stratospheric warming (SSW), on upper atmospheric conditions. In the numerical experiment, we use a two-dimensional model of propagation of atmospheric waves, taking into account dissipative and nonlinear processes accompanying wave propagation. As a source of disturbances we consider temperature and density disturbances in the stratosphere during SSWs. Amplitude and frequency characteristics of the source of disturbances are estimated from observations and IGW theory. Numerical calculations showed that waves generated at stratospheric heights during SSW can cause temperature changes in the upper atmosphere. Maximum relative disturbances, caused by such waves, with respect to quiet conditions are observed at 100–200 km. Disturbances of the upper atmosphere in turn have an effect on the dynamics of charged component in the ionosphere and can contribute to observable ionospheric effects of SSW.
Smart Data Pricing: The Value of Shared Data Plans
Authors: Jin Yue , Pang Zhan
Published: October 2016

This paper studies a monopoly telecom operator’s decision on the adoption of shared data plans. A shared data plan allows sharing data quota among multiple devices or users, while conventional single device data plans only allow the use of a single device. We develop analytical models and compare a simple shared data plan (i.e., bundling pricing) to single device data plans (i.e., partitioned pricing). We aim to identify key factors that drive the optimal pricing policies under the two pricing plans and the value of data shared plans. We first consider a base model with independent consumer valuations (usages) of different devices. We find a threshold on the unit usage cost below which the shared data plan yields more profits than single device data plans. The optimal price for the shared data plan is less than the sum of the single device data plans. The disparity of the devices’ mean usages reduces the relative value of the shared data plan against the single device data plans. We also show that shared data plans increases the social welfare and consumer surplus when it yields a higher profit. We then examine the effects of complementarity and substitution between consumer valuations of the devices on the value of data shared plans. Two commonly used approaches to modeling the complementarity and substitution in the literature are considered: utility scaling and correlation. We examine how the utility scaling factor and correlation affect the value of shared data plans, respectively. We find that a higher degree of complementarity (or a lower degree of substitution) may not necessarily increase the value of shared data plan, which is counter to our common intuition that shared data plans are more attractive for complementary products. We provide the rationale and managerial insights. We also examine the value of bundling under a quadratic usage cost function.
Men's health: an overlooked inequality
Authors: Baker Peter
Published: October 2016

Men's health outcomes are problematic globally, regionally and nationally. Male life expectancy was 3.6 years shorter than female life expectancy in the UK in 2015. Men take more risks with their health and are less likely than women to be aware of disease symptoms. They use primary care services less frequently than women, with likely impacts on health outcomes, especially for mental health, although there is evidence that for some conditions men may seek help just as quickly as women. Men's health initiatives have increased and there is growing evidence that ‘gender-sensitive’ interventions aimed at men can be effective. However, a strategic response, locally or nationally, to men's health problems in the UK has been absent. A number of actions, including by nurses, could make a difference. A national men's health policy, extended open hours in primary care, more outreach work and professional training, are among the measures suggested.
Tension pneumothorax recurrence in COPD: a care study
Authors: Loftus Nicholas Woolfe , Bowden Tracey
Published: October 2016

This care study concerns a patient with chronic obstructive pulmonary disease, who endures the recurrence of a tension pneumothorax. A holistic and evidence-based approach is employed to critically discuss his assessment, pathophysiology, and nursing care. These discussions facilitate extrapolation of implications pertinent to nursing practice.
The impact of sharps injuries on student nurses: a systematic review
Authors: Hambridge Kevin , Nichols Andrew , Endacott Ruth
Published: October 2016

Aims and objectives:

The purpose of this review was to discover the impact of sharps injuries in the student nurse population.

Background:

Much is known and reported about sharps injuries in registered nurses, but there has been a lack of published evidence regarding sharps injuries within the student nurse population.

Method:

A systematic review of nursing, health and psychology databases was conducted. The limits set were publications between 1980 and 2014 in the English language. Studies were identified then, following a rigorous critical and quality appraisal with validated tools, were selected for the systematic review.

Results:

A total of 40 articles met the inclusion criteria, reporting studies conducted in 18 countries. Psychological and physical impacts of sharps injuries in student nurses were reported, such as fear, anxiety and depression, although these impacts were not quantified using a validated instrument.

Conclusion:

The impact of sharps injuries can be severe, both psychological and physical. This systematic review shows that further research is needed into this, especially in under-researched areas such as the UK, to establish the impact of sharps injuries within this population. Further research would also aid the education and prevention of this harmful problem. The review also emphasises the psychological issues relating to sharps injuries, the impact these can have on individuals and the support and counselling that student nurses require after injury.

Relevance to practice:

These findings highlight the potential psychological issues that can result from sharps injuries in this population
Work-based learning using action learning sets
Authors: Rosser Elizabeth
Published: October 2016

Elizabeth Rosser, Deputy Dean (Education and Professional Practice) and Professor of Nursing at Bournemouth University reflects on the concept of action learning, and the benefits of being part of an action learning set
Can the courts order that a child be immunised?
Authors: Griffith Richard
Published: October 2016

In this article Richard Griffith, Senior Lecturer in Health Law at Swansea University, reviews the involvement and approach of the Courts in cases of hotly disputed immunisation.
We must let nurses keep developing
Authors: Foster Sam
Published: October 2016

Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, discusses the importance of professional development and career progression for nurses and other health workers, particularly in light of apprenticeships
Optimising patient safety when using elastomeric pumps to administer outpatient parenteral antibiotic therapy
Authors: Oliver Gemma
Published: October 2016

Outpatient parenteral antibiotic therapy (OPAT) is a growing area of practice that has numerous benefits for both patients and the healthcare system. In order for OPAT services to be successful, strategies need to be in place to maximise efficiency while providing safe, high-quality care. The use of elastomeric pumps to deliver intravenous (IV) antibiotics can have many benefits for OPAT services; they are cost-effective, easy to use and allow the patient to be fully ambulant. However, plans need to be put in place to make sure their use is safe and effective. This article discusses the use of elastomeric pumps by a UK-based OPAT team and the governance processes the team put in place to optimise patient safety when using elastomeric pumps to deliver IV antibiotics. Furthermore, with experience of using elastomeric pumps for more than 4 years the OPAT team was asked to evaluate an elastomeric pump new to the UK market: the Accufuser pump (Vygon (UK) Limited). By collecting data on its use it was found to be safe and easy to use. The team felt that the Accufuser pump ran to time in 96% of completed evaluations and considered it to be clinically acceptable in all responses.
Epidemiology and predictors of recurrence of Marjolin’s ulcer: experience from Mansoura Universityxs
Authors: Metwally IH , Roshdy A , Saleh SS , Ezzat M
Published: October 2016

INTRODUCTION

Marjolin’s ulcer (MU) is an uncommon malignancy occurring on top of old scars. Once thought to be more common in Caucasians, is now detected increasingly in Africa.

METHODS

This was a retrospective study of patients with MU attending a tertiary centre within Mansoura University (Egypt) from 2004 to 2015. An institutional-based registry of skin and soft-tissue malignancies in this period revealed 560 cases, from which there were 26 cases of MU.

RESULTS

The most common underlying cause of MU was burns (92% of patients), followed by trauma. A predilection towards males was detected. The latent period was 4–70 (median, 25) years. Recurrence occurred in 12 cases, with multiple recurrences occurring in 5 cases. MU recurrence was noted as early as 3 months and as late as 25 years after surgery.

CONCLUSIONS

Young patients with MU are at higher risk of recurrence and should be followed up closely. A thorough search for nodal metastasis (especially in those with high-grade tumours) should be done. Wide local excision and leaving wounds to heal by secondary intention seems to be a viable treatment option.
Performance and learning curve of a surgical care practitioner in completing hip aspirations
Authors: Tingle SJ , Marriott A , Partington PF , Carluke I , Reed MR
Published: October 2016

INTRODUCTION

The roles of non-medically trained practitioners within the NHS are expanding; they are now being employed by many specialties, including surgery, to relieve pressures on healthcare teams.

AIMS

To investigate the learning curve and competence of an orthopaedic surgical care practitioner (SCP) in performing hip aspirations.

METHODS

Data were retrospectively collected on 510 orthopaedic hip aspirations, of which 360 were completed by a single SCP and 150 were completed by surgeons before the SCP took over routine aspiration. The 360 aspirations completed by an SCP were separated into groups of 30 by date, so any trend in failure rate could be analysed. Ordinal χ2 analysis was used to analyse this trend and Pearson χ2 analysis was used to analyse differences in failure rates between professionals.

RESULTS

The hip aspiration failure rate for the SCP was significantly lower than for the surgeons; 8.6% vs 20.7% (P<0.001). With the experience gained in completing the first 210 procedures, the failure rate of the SCP dropped to 3.3% for the remaining 150 procedures. This downward trend in hip aspiration failure rate, with advancing experience of the SCP, was shown to be statistically significant (P=0.006).

DISCUSSION

SCPs who complete hip aspirations on a regular basis have significantly lower failure rates than surgeons, probably as a result of the learning curve, which this study demonstrated. Other trusts should consider delegating routine hip aspiration work to a designated SCP to lower failure rates.
Nine-year results of whole femoral head allograft with articular cartilage for acetabular impaction grafting in revision hip replacement
Authors: Drampalos E , Fadulelmola A , Mohammed R , Shaw D , Subramanian S , Jain KD , Hodgkinson J
Published: October 2016

INTRODUCTION

Acetabular impaction bone grafting with a cemented polyethylene socket aims to reconstitute the bone stock in hip revision. This is an effective but resource intensive and time consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. Our objective was to assess the late results of using the whole femoral head, retaining the cartilage.

METHODS

Forty-two acetabular revisions using impacted morselised bone graft (retaining the articular cartilage) and a cemented socket were studied retrospectively. The mean follow-up duration was 9.3 years (range: 6–13 years). Clinical and radiological assessment was made using the Oxford hip score, the classification of Hodgkinson et al (1988) for socket loosening and the classification of Gie et al (1993) for evaluation of allograft incorporation.

RESULTS

Twenty-seven sockets (75.0%) were radiologically stable, six (16.7%) were radiologically loose and three (8.3%) had migrated. Thirty cases (83.3%) showed good trabecular remodelling and six (16.74%) showed trabecular incorporation without remodelling. Six patients were lost to follow-up. Kaplan–Meier analysis calculated a survival rate of 94.5% at a mean of 9.3 years (95% confidence interval: 8.1–10.4 years) for all reasons of failure, with two re-revisions.

CONCLUSIONS

The nine-year results of the aforementioned technique are comparable with other major studies. Particularly when the supply of allograft and operative time are limited, retaining the articular cartilage of the femoral head is a safe and successful alternative.
Second isolated anastomotic recurrence after curative surgery for colorectal cancer
Authors: Bailon-Cuadrado M , Blanco-Alvarez JI , Velasco-Lopez R , Rodriguez-Lopez M
Published: October 2016

Introduction

The two mechanisms postulated for cancer recurrence at the anastomosis site (‘anastomotic recurrence’ (AR)) after curative surgery for colorectal cancer are: (i) intraluminal dissemination of viable cancer cells; (ii) metachronous carcinogenesis related with changes in the local milieu provoked by the materials employed to carry out the anastomosis.

Case History

We describe a 79-year-old female who underwent a left hemicolectomy due to a stenotic lesion shown on colonoscopy: an adenocarcinoma (pT3NO, G2). One year after surgery, control colonoscopy revealed an AR, so a new resection was carried out. Pathology showed it to be a recurrent adenocarcinoma over the staple line (pT3N0, G2). One year after the second surgical procedure, control colonoscopy evinced a new AR, resulting in a new resection. Pathology revealed a new AR.

Conclusions

This is only the second time that a second isolated AR after curative resection for colorectal cancer has been reported.
A review of the management of blunt splenic trauma in England and Wales: have regional trauma networks influenced management strategies and outcomes?
Authors: Yiannoullou P , Hall C , Newton K , Pearce L , Bouamra O , Jenks T , Scrimshire AB , Hughes J , Lecky F , Macdonald ADH
Published: October 2016

INTRODUCTION

The spleen remains one of the most frequently injured organs following blunt abdominal trauma. In 2012, regional trauma networks were launched across England and Wales with the aim of improving outcomes following trauma. This retrospective cohort study investigated the management and outcomes of blunt splenic injuries before and after the establishment of regional trauma networks.

METHODS

A dataset was drawn from the Trauma Audit Research Network database of all splenic injuries admitted to English and Welsh hospitals from 1 April 2010 to 31 March 2014. Demographic data, injury severity, treatment modalities and outcomes were collected. Management and outcomes were compared before and after the launch of regional trauma networks.

RESULTS

There were 1457 blunt splenic injuries: 575 between 2010 and 2012 and 882 in 2012–14. Following the introduction of the regional trauma networks, use of splenic artery embolotherapy increased from 3.5% to 7.6% (P = 0.001) and splenectomy rates decreased from 20% to 14.85% (P = 0.012). Significantly more patients with polytrauma and blunt splenic injury were treated with splenic embolotherapy following 2012 (61.2% vs. 30%, P < 0.0001). Increasing age, injury severity score, polytrauma and Charlson Comorbidity Index above 10 were predictors of increased mortality (P < 0.001). Increasing systolic blood pressure (odds ratio, OR, 0.757, 95% confidence interval, CI, 0.716–0.8) and Glasgow Coma Scale (OR 0.988, 95% CI 0.982–0.995) were protective.

CONCLUSIONS

This study demonstrates a reduction in splenectomy rate and an increased use of splenic artery embolotherapy since the introduction of the regional trauma networks. This may have resulted from improved access to specialist services and reduced practice variation since the establishment of these networks.
Giant maxillary gingival fibromatosis
Authors: Stephenson KA , Klopper GJ , Opperman J , Favara C
Published: October 2016

We present a case of both unusual pathology and severity – giant maxillary gingival fibromatosis – and discuss the disease and its management, accompanied by clinical imaging. This represents an overlap between maxillofacial and oral surgery, and may present as demonstrated in this case.
Evaluation of Akt and RICTOR Expression Levels in Astrocytomas of All Grades
Authors: Alvarenga Arthur William , Machado Luis Eduardo , Rodrigues Bruna Roz , Lupinacci Fernanda Cristina Sulla , Sanemastu Paulo , Matta Eduardo , Roffé Martín , Torres Luís Fernando Bleggi , da Cunha Isabela Werneck , Martins Vilma Regina , Hajj Glaucia Noeli Maroso
Published: October 2016

The mammalian target of rapamycin (mTOR) binds to several protein partners and forms two complexes, termed mTOR complexes 1 and 2 (mTORC1/2), that differ in components, substrates, and regulation. mTORC2 contains the protein Rapamycin-insensitive companion of mTOR (RICTOR); phosphorylates kinases of the AGC family, such as Akt; and controls the cytoskeleton. Even though the regulation of mTORC2 activity remains poorly understood, the hyperactivation of this signaling pathway has been shown to contribute to the oncogenic properties of gliomas in experimental models. In this work, we evaluated expression and phosphorylation of Akt, and expression of RICTOR and Ki-67 in 195 human astrocytomas of different grades (38 cases of grade I, 49 grade II, 15 grade III, and 93 grade IV) and 30 normal brains. Expression and phosphorylation of Akt increased with histological grade and correlated with a worse overall survival in glioblastomas (GBMs). RICTOR was overexpressed in grade I and II astrocytomas and demonstrated a shift to nuclear localization in GBMs. Nuclear RICTOR was associated to increased proliferation in GBMs. Our results point to an increase in total and phosphorylated Akt in high-grade gliomas and to a possible role of RICTOR in proliferations of high-grade GBM cells.
Effects of an educational program in increasing knowledge and reducing premenstrual syndrome signs, symptoms and severity among nursing college students
Authors: Abdalla Nafisa , Gibreel Mohammed
Published: October 2016

Objective: The objective of the following study is to determine the effects of an Educational Program in increasing knowledge and reducing premenstrual syndrome symptoms and severity among nursing college students.Material and Methods: A total of 60 students with Premenstrual Syndrome (PMS) symptoms were included in the study group (n=60), the age of the majority of them (75.8%) was between 20-24 years, pre and post education program questionnaire was developed as a tool of data collection before and after the educational program. Also premenstrual symptoms and severity follow-up sheet was designed and conducted three month after the post education program to follow the effectiveness of the educational program in reducing the severity of the symptoms.Results: The study results indicate that there was significant difference between students’ knowledge before and after the program, the total score mean rank before program was (34.72), while after program was (86.28) p < 0.01 with significant difference between score before and after the program at 1% level of significant. It also shows a significant difference between PMS signs, symptoms and severity before and after program at 1% level of significant (total score mean and SD before program were (132.42, 13.72) respectively, and after program are (107.52, 14.47) respectively p < 0.01 with larger effect size of 0.613. The follow-up result shows a reduction in PMS symptom’s severity, the total severity averages of PMS sign and symptoms were 3.4 first month, 2.6 the second month and 2.2 for the third month out of 4 respectively.Conclusion: The educational program had a positive effect on increasing knowledge and decreasing PMS signs and symptoms severity. Also the program has decrease the effect of PMS signs and symptoms on study group life.
The Return of Baal to the Holy Land
Authors: Feraro Shai
Published: October 2016

This article focuses on the recent emergence of Canaanite Reconstructionism in Israel—a miniature movement within the country’s small, but growing, Pagan community. The discourse of Israeli adherents of Canaanite Reconstructionism regarding its links to ancient Canaanite culture and the land—indeed the very soil—of modern-day Israel is highlighted. The development of Israeli Canaanite Reconstructionism is examined in relation to the unique nature of Israeli society and identity politics, as well as to Canaanism, a cultural and ideological movement that climaxed during the 1940s in British Mandate Palestine but declined after the founding of the State of Israel in 1948.
Coining a Name, Casting the Self
Authors: van Gulik Léon A.
Published: October 2016

In this article, I explore how a contemporary religion affects the self-understanding of its adherents and may contribute to the construction of their personal identity, by examining the Wiccan practice of adopting a “Craft name.” All people tell stories to maintain a coherent personal history, and stories about their names help create a sense of identity. I offer psychological interpretations of such narratives within the context of Flemish and Dutch Wicca, illustrated with quotes from lightly structured in-depth interviews. I found that names and their referents may be either passively accepted or intuitively recognized as one’s own, and that such impressions contrast with expressive and active understandings in which a name implies one’s potency and helps to frame one’s aspirations.