bluuebunny/crossref_metadata_2025 huggingface dataset:
Complete Tissue Submission to Increase Lymph Node Detection in Pelvic Lymph Node Packets Submitted for Patients Undergoing Radical Prostatectomy and Radical Cystectomy
Authors: Rais-Bahrami Soroush , Tracht Jessica P. , McIntosh Eleanor R. , Lai Win Shun , Gordetsky Jennifer B.
Published: July 2016

Background. Pelvic lymphadenectomy has prognostic and therapeutic implications in both bladder and prostate cancer. Pelvic lymphadenectomy specimens are fatty and identification of lymph nodes (LNs) can be difficult during the grossing process. We investigated the benefit of a new grossing method requiring entire LN packet submission. Materials/Methods. We introduced a new grossing protocol requiring total submission of LN packets for patients undergoing radical prostatectomy (RP) or radical cystectomy (RC). A retrospective review was performed to evaluate clinical and pathologic data for RP (n = 59) and RC (n = 56) cases performed 18 months prior to and 18 months following implementation of the new lymphadenectomy grossing protocol. Results. For RP and RC cases, significantly more LNs were found when total LN packets were submitted with the new technique: mean 14.1 versus 8.7, and mean 25.2 versus 15.9, respectively ( P = .007, P = .011). For RP cases, there was no significant change in the number of LN packets submitted for evaluation from the operating room ( P = .76). For RC cases, more LNs were found with the new technique despite a significantly fewer number of LN packets sent from the operating room in the cohort that were processed with the new technique: mean 2.2 versus 4.0 LN packets ( P < .001). Significantly more paraffin blocks were required using the new grossing method for both RP and RC: mean 13.53 versus 6.9 and mean 19.0 versus 12.4, respectively ( P < .001, P = .018). Conclusions. Submitting all additional fatty tissue after palpable identification of LNs can significantly increase the detection of LNs in RP and RC cases.
Insulin Postconditioning Reduces Infarct Size in the Porcine Heart in a Dose-Dependent Manner
Authors: Slettom Grete , Jonassen Anne K. , Dahle Geir O. , Seifert Reinhard , Larsen Terje H. , Berge Rolf K. , Nordrehaug Jan E.
Published: July 2016

Aim:

Insulin and glucose may have opposite effects when used to reduce ischemia–reperfusion injury. When insulin is administered alone, feeding state determines tolerance and further induces metabolic and hormonal changes. Higher insulin doses are needed for similar activation of cardioprotective Akt signaling in the fed compared to the fasted pig heart. Thus, the aim of the study was to investigate the effects of 2 prespecified insulin doses on infarct size, apoptosis, metabolism, and cardiac function in a clinically relevant, randomized large animal model using conventional percutaneous catheter intervention techniques and including different fasting states.

Methods and Results:

Twenty-seven female pigs were subjected to 40-minute ischemia and 120-minute reperfusion. Pharmacological postconditioning with intracoronary infusions administered over 3 × 30 seconds was performed at immediate reperfusion. Animals were randomly assigned to 3 groups—preexperimental fasting and intracoronary saline ( controls), preexperimental fasting and 0.1U of insulin ( fasted Ins0.1U), and preexperimental feeding and 1.0U of insulin ( fed Ins1.0U). A significant reduction in infarct size was demonstrated in the fed Ins1.0U group ( P = .047) but not in the fasted Ins0.1U group ( P = .531) compared to controls (infarct size normalized to area at risk ± standard deviation: controls 70.2% ± 12.9%, fasted Ins0.1U 65.0% ± 9.4%, and fed Ins1.0U 54.4% ± 7.3%). Infarct limitation was associated with more uncleaved caspase-3 in the area of risk and the infarcted area, lower circulating free fatty acids, and less increase in heart rate during reperfusion. Fed animals had higher levels of glucose, carnitine, potassium, and normetanephrine and higher heart rate at baseline compared to controls.

Conclusion:

Insulin postconditioning reduced infarct size in the in vivo pig heart, but the beneficial effects were restricted to the highest dose, which is limited by side effects and can only be given to nonfasted animals. The finding challenges successful general use of insulin in the treatment of reperfusion injury in clinical acute myocardial infarction.
A numerical and experimental implementation and integration of Steiglitz–McBride algorithm with the frequency domain IIR filtering technique for active vibration control
Authors: Boz Utku , Basdogan Ipek
Published: July 2016

In adaptive control applications for noise and vibration, finite ımpulse response (FIR) or ınfinite ımpulse response (IIR) filter structures are used for online adaptation of the controller parameters. IIR filters offer the advantage of representing dynamics of the controller with smaller number of filter parameters than with FIR filters. However, the possibility of instability and convergence to suboptimal solutions are the main drawbacks of such controllers. An IIR filtering-based Steiglitz–McBride (SM) algorithm offers nearly-optimal solutions. However, real-time implementation of the SM algorithm has never been explored and application of the algorithm is limited to numerical studies for active vibration control. Furthermore, the prefiltering procedure of the SM increases the computational complexity of the algorithm in comparison to other IIR filtering-based algorithms. Based on the lack of studies about the SM in the literature, an SM time-domain algorithm for AVC was implemented both numerically and experimentally in this study. A methodology that integrates frequency domain IIR filtering techniques with the classic SM time-domain algorithm is proposed to decrease the computational complexity. Results of the proposed approach are compared with the classical SM algorithm. Both SM and the proposed approach offer multimodal vibration suppression and it is possible to predict the performance of the controller via simulations. The proposed hybrid approach ensures similar vibration suppression performance compared to the classical SM and offers computational advantage as the number of control filter parameters increases.
Sexist Humor and Rape Proclivity: The Moderating Role of Joke Teller Gender and Severity of Sexual Assault
Authors: Romero-Sánchez Mónica , Carretero-Dios Hugo , Megías Jesús L. , Moya Miguel , Ford Thomas E.
Published: July 2016

Three experiments examined the effect of sexist humor on men’s self-reported rape proclivity (RP). Pilot study demonstrated that people differentiate the five rape scenarios of Bohner et al.’s. RP Scale based on the degree of physical violence perpetrated against the victim. Experiment 1 demonstrated that men higher in hostile sexism report greater RP upon exposure to sexist jokes when a woman (vs. a man) delivers them, and that this effect is limited to rape scenarios depicting a moderate versus a high level of physical violence. Experiment 2 further demonstrated that the relationship between hostile sexism and rape proclivity in response to a moderately violent rape scenario after exposure to sexist humor generalizes beyond women in the immediate humor context to women as a whole.
Effect of process technology on the nutritional, functional, and physical quality of grapefruit powder
Authors: Agudelo C , Igual M , Camacho MM , Martínez-Navarrete N
Published: July 2016

The health properties of fruit are widely known. Powdered fruit may be a practical format to be offered to the consumer. Nevertheless, the process used to obtain the powder must ensure the maximum retention of the bioactive compounds and the functional value of the fruit while retaining adequate physical properties. The aim of this study was to compare freeze-drying and spray drying as the drying technologies to obtain grapefruit powder. The obtained results allow freeze-drying to be proposed as a better technology than spray drying in order to obtain a product with a higher content of vitamin C and total carotenoids. Moreover, all of the edible part of the fruit is used in this case, so a greater quantity of healthy compounds is preserved and by-product generation is avoided. Adding about 6 g water, 4 g Arabic gum and 0.6 g bamboo fibre/100 g grapefruit pulp is recommended before freeze-drying.
A Meta-Analytic Review of Social Identification and Health in Organizational Contexts
Authors: Steffens Niklas K. , Haslam S. Alexander , Schuh Sebastian C. , Jetten Jolanda , van Dick Rolf
Published: July 2016

We provide a meta-analytical review examining two decades of work on the relationship between individuals’ social identifications and health in organizations (102 effect sizes, k = 58, N = 19,799). Results reveal a mean-weighted positive association between organizational identification and health ( r = .21, T = .14). Analysis identified a positive relationship for both workgroup ( r = .21) and organizational identification ( r = .21), and in studies using longitudinal/experimental ( r = .13) and cross-sectional designs ( r = .22). The relationship is stronger (a) for indicators of the presence of well-being ( r = .27) than absence of stress ( r = .18), (b) for psychological ( r = .23) than physical health ( r = .16), (c) to the extent that identification is shared among group members, and (d) as the proportion of female participants in a sample decreases. Overall, results indicate that social identifications in organizations are positively associated with health but that there is also substantial variation in effect size strength. We discuss implications for theory and practice and outline a roadmap for future research.
Renal pelvic and ureteral ultrasonographic characteristics of cats with chronic kidney disease in comparison with normal cats, and cats with pyelonephritis or ureteral obstruction
Authors: Quimby Jessica M , Dowers Kristy , Herndon Andrea K , Randall Elissa K
Published: July 2016

Objectives

The objective was to describe ultrasonographic characteristics of cats with stable chronic kidney disease (CKD) and determine if these were significantly different from cats with pyelonephritis (Pyelo) and ureteral obstruction (UO), to aid in clinical assessment during uremic crisis.

Methods

Sixty-six cats with stable CKD were prospectively enrolled, as well as normal control cats (n = 10), cats with a clinical diagnosis of Pyelo (n = 13) and cats with UO confirmed by surgical resolution (n = 11). Renal ultrasound was performed and routine still images and cine loops were obtained. Analysis included degree of pelvic dilation, and presence and degree of ureteral dilation. Measurements were compared between groups using non-parametric one-way ANOVA with Dunn’s post-hoc analysis.

Results

In total, 66.6% of CKD cats had measurable renal pelvic dilation compared with 30.0% of normal cats, 84.6% of Pyelo cats and 100% of UO cats. There was no statistically significant difference in renal pelvic widths between CKD cats and normal cats, or CKD cats and Pyelo cats. On almost all measurement categories, UO cats had significantly greater renal pelvic widths compared with CKD cats and normal cats ( P <0.05) but not Pyelo cats. Six percent of stable CKD cats had measurable proximal ureteral dilation on one or both sides vs 46.2% of Pyelo cats and 81.8% of UO cats. There was no statistically significant difference in proximal ureteral width between normal and CKD cats, or between Pyelo and UO cats. There was a statistically significant difference in proximal ureteral width between CKD and Pyelo cats, CKD and UO cats, normal and UO cats, and normal and Pyelo cats.

Conclusions and relevance

No significant difference in renal pelvic widths between CKD cats and Pyelo cats was seen. These data suggest CKD cats should have a baseline ultrasonography performed so that abnormalities documented during a uremic crisis can be better interpreted.
Challenges and opportunities for the regeneration of multinational worker cooperatives: Lessons from the Mondragon Corporation—a case study of the Fagor Ederlan Group
Authors: Bretos Ignacio , Errasti Anjel
Published: July 2016

Organisations with alternative structures have been forced to grow internationally in order to remain competitive in the current global context. Some of the industrial cooperatives that belong to the Mondragon Corporation have since the 1990s followed internationalisation strategies that have increased their competitiveness, the number of their employees and their ability to create wealth. However, these moves have also called into question the founding nature of these enterprises. Recently, the Corporation itself has adopted a discourse based on strengthening workers’ participation in capitalist subsidiaries, but to date, the initiatives taken by its multinational cooperatives have been few and the results not particularly impressive. This article investigates this disconnect, delving into the problems of replicating the cooperative model in these subsidiaries and seeking solutions. It focuses on the case of Fagor Ederlan (Mondragon Corporation), examining the efforts to transform capitalist subsidiaries, especially the ‘cooperativisation’ of the Fagor subsidiary in Tafalla (Spain), which is the biggest regeneration project in Mondragon’s Industrial Division. This work also contributes to the broader field of organisational theory by analysing the tensions and opportunities for regeneration in worker-owned organisations under the current globalised context.
Are we ethical? Approaches to ethics in management and organisation research
Authors: Jeanes Emma
Published: July 2016

We are currently witnessing two concurrent trajectories in the field of research ethics, namely the increasingly explicit and formalised requirements of research governance and the ongoing debate around the implicit nature of ethics, which cannot be assured by these methods, and related—for some—the role that reflexivity can play in research ethics. This article seeks to address two questions. First, given the focus of these discussions is often theoretical rather than on practice, how do our colleagues engage with research ethics and what is their ethical position? Second, given reflexivity is typically focused on knowledge construction, to what extent does it influence (if at all) their ethics throughout the research process? Interviews were undertaken with senior colleagues who have established modes of research practice and ethical approaches. Drawing on understandings of reflexivity and ethics, this article explores an ethical subjectivity that was typically reflective and sometimes reflexive and was usually related to personal rather than procedural ethics. It demonstrates contrasting ethical concerns of society, participant and researcher community, and how some researchers saw their ethical obligation as focused on producing meaningful research at the expense of more traditional concerns for the research participant.
Influence of couple stress lubricant on the performance of textured two-lobe slot-entry hybrid journal bearing system
Authors: Khatri Chandra B , Sharma Satish C
Published: July 2016

This paper concerns with theoretical investigation to predict the combined influence of textured surface and couple stress lubricant behavior on the performance of circular/two-lobe slot-entry hybrid journal bearing. The flow of incompressible couple stress lubricant through the clearance of a textured journal bearing system is governed by the modified Reynolds equation. The modified Reynolds equation has been derived on the basis of Stokes micro-continuum theory and is solved using a finite element method technique for computing the bearing performance characteristics parameters. The static and dynamic characteristics of circular/two-lobe slot-entry hybrid journal bearing have been computed for textured and non-textured bearings with influence of couple stress lubricant. The present study indicates that the influence of couple stress lubricant behavior is significantly more on the values of fluid film stiffness coefficients [Formula: see text], critical mass of journal [Formula: see text], and stability threshold speed margin [Formula: see text] for textured surface than that of non-textured surface in case of a slot-entry hybrid journal bearing system.
A new asperity interaction model considering transient flash temperature and inhomogeneous distribution of oil viscosity
Authors: Liu Jun , Zhang Zhinan , Zhao Bo , Xie Youbai
Published: July 2016

A momentary contact of asperities will generate transient flash temperature phenomena in boundary lubrication. According to the viscosity–temperature characteristics of lubricant, the inhomogeneous distribution of temperature during the process of asperity contact would cause the inhomogeneous distribution of oil viscosity. This paper proposes a coupled Eulerian–Lagrangian based approach to analyze the influence of inhomogeneous distribution of viscosity on the friction coefficient of an asperity junction. The asperity interaction in boundary lubrication with different sliding velocities and different degrees of overlap of the undeformed surfaces were taken into account. Simulation results showed that the friction coefficient is proportional to the overlap and inversely proportional to sliding velocity. The results also showed that the influence of inhomogeneous distribution of oil viscosity on friction coefficient in boundary lubrication is limited.
Representing women voters
Authors: Campbell Rosie
Published: July 2016

While analysis of the relationship between the descriptive and substantive representation of women has mainly focused on women politicians as critical actors in many contexts political parties provide the linkage between voters’ preferences and policy programmes. The manner in which political parties respond to women voters is shaped by both the information they receive about women voters’ preferences, from the news media, pollsters and other sources, and by gendered party type. Analysis of parties’ attempts to target women voters can help us understand whether parties perceive women as typical or average voters. I conduct two case studies on the influence of gendered newsframes on party policy and inter-party competition in the United States and Great Britain to formulate a preliminary analytic framework designed to facilitate research to assess how parties’ responses to portrayals of women voters vary according to institutional and contextual factors across time and space.
Gaining qualitative insight into the subjective experiences of adherers to an exercise referral scheme: A thematic analysis
Authors: Eynon Michael John , O’Donnell Christopher , Williams Lynn
Published: July 2016

Nine adults who had completed an exercise referral scheme participated in a semi-structured interview to uncover the key psychological factors associated with adherence to the scheme. Through thematic analysis, an exercise identity emerged to be a major factor associated with adherence to the scheme, which was formed of a number of underpinning constructs including changes in self-esteem, changes in self-efficacy and changes in self-regulatory strategies. Also, an additional theme of transitions in motivation to exercise was identified, showing participants’ motivation to alter from extrinsic to intrinsic reasons to exercise during the scheme.
Using a theoretical approach to identify factors influencing adherence to an exercise programme for adults with venous leg ulcers
Authors: O’Brien Jane , Finlayson Kathleen , Kerr Graham , Shortridge-Baggett Lillie , Edwards Helen
Published: July 2016

This study assessed the relationships between self-efficacy, outcome expectations, fear-avoidance beliefs and adherence to an exercise for a home-based exercise programme for adults with venous leg ulcers. Patients ( n=63) were randomised to receive either an intervention or usual care group. Of those in the exercise intervention group, 59per cent adhered to the exercise protocol more than 75per cent of the time. There was a significant relationship between self-efficacy and outcome expectations, and both of these constructs were significantly related to adherence to the leg exercise programme. Adherence significantly correlated with wound healing indicating a possible pathway to healing.
Intolerance to environmental chemicals and sounds in irritable bowel syndrome: Explained by central sensitization?
Authors: Ståhlberg Linnea , Palmquist Eva , Nordin Steven
Published: July 2016

This study tested the hypotheses of irritable bowel syndrome showing (1) comorbidity with chemical and sound intolerance, other types of functionally somatic syndromes, and psychiatric disorders and (2) stronger than normal affective reactions to and behavioral disruptions from odorous/pungent chemicals and sounds in daily life. These hypotheses were tested by means of data from a large-scale population-based questionnaire study. The results showed comorbidity in irritable bowel syndrome with chemical and sound intolerance, fibromyalgia, migraine, post-traumatic stress disorder, generalized anxiety disorder, panic syndrome, and depression as well as strong reactions/disruptions from odorous/pungent chemicals and sounds in irritable bowel syndrome.
Qualitative inquiry into reasons why vaccination messages fail
Authors: Masaryk Radomír , Hatoková Mária
Published: July 2016

A growing tendency to refuse child vaccination is commonly regarded as a reason for concern. Attempts to promote vaccination by authorities often prove to be unsuccessful or even counter-productive. The aim of this study was to explore how parents perceived four messages used to promote vaccination. In eight focus groups ( N = 73), we presented participants with messages and asked them to assess them. Using thematic analysis, we identified themes that our participants considered the most important. Messages that promote vaccination should be unambiguous, more balanced, not focus on repeating the negative effects of vaccine-preventable diseases and provide links to the evidence.
Reducing Turkish Cypriot children’s prejudice toward Greek Cypriots: Vicarious and extended intergroup contact through storytelling
Authors: Husnu Shenel , Mertan Biran , Cicek Onay
Published: July 2016

Two studies investigated the effectiveness of intergroup contact in Turkish Cypriot children with the aim of improving attitudes, intentions, and trust toward Greek Cypriots. In the first study, we found that positive contact and positive family storytelling were associated with more positive outgroup attitudes and intended outgroup behavior in a group of 6- to 12-year-old Turkish Cypriots. We followed this up in Study 2 by using a vicarious intergroup contact intervention technique. Turkish Cypriot children aged 6–11 years took part in a 3-week intervention involving reading stories of solidarity between Turkish and Greek Cypriot children. Results showed that the intervention worked to improve outgroup attitudes, intended behavior, and outgroup trust. These findings suggest that indirect contact techniques such as extended contact and vicarious intergroup contact can be used as prejudice-reduction tools in intractable conflict zones, most in need of such interventions.
Educational attainment, labour market position and mental ill health as pathways from adversities in adolescence to disability pension in early adulthood: A Finnish cohort study using register data
Authors: Harkko Jaakko , Kouvonen Anne , Virtanen Marianna
Published: July 2016

Background: We investigated whether social adversities (parents’ receipt of income support and care placement) in adolescence were associated with the receipt of work disability pension (DP) in early adulthood. A further aim was to examine whether and to what extent individual educational attainment, labour market position and mental disorders during the period of transition to adulthood operate as underlying mechanisms in this relationship. Methods: This was a nationwide cohort study of a 60% representative sample of Finnish young adults born between 1983 and 1985 with no prior DP at entry to the study ( N=116,788). Data from several nationwide registers were used with a follow-up time from 2004 to 2010. The age range of the cohort was 19–21 years at the beginning of the follow-up period. Hazards ratios (HRs) with 95% confidence intervals (CIs) were calculated using a Cox regression. Mediation analyses for educational attainment, labour market position and purchases of psychotropic drugs were performed. Results: A total of 1597 (1.37%) people were granted a DP during the follow-up period of 687,429 years at risk. After adjustment for mediators, the HR (95% CI) of DP for those whose parents had received income support was 1.36 (1.21–1.53) for men and 1.21 (1.07–1.36) for women. The corresponding figures for those with a history of care placement were 1.23 (1.00–1.51) and 1.58 (1.29–1.92), respectively. Conclusions: Social adversities in adolescence increase the risk of DP in early adulthood. The intergenerational social determination of disability could be addressed through interventions promoting mental health and improving educational and employment opportunities for young people.
High-risk mechanism of injury: A new indication for screening for blunt cerebrovascular injury?
Authors: Mendoza AE , Wybourn CA , Knudson MM
Published: July 2016

Blunt cerebrovascular injury is a rare but catastrophic injury. Screening for blunt cerebrovascular injury after high-impact mechanism remains ill-defined but several associated lesions have been identified as high risk for concomitant blunt cerebrovascular injury and are used to prompt further investigation for early identification and intervention. We describe a case of a large cerebral infarction caused by a high cervical internal carotid dissection after a motorcycle collision. Upon presentation, the patient had a Glasgow coma scale of 14 and an open pelvic fracture, which was immediately addressed in the operating room. His subsequent imaging revealed a nasal fracture, bilateral rib fractures, bilateral pubic rami fractures and left acetabular fracture without evidence of traumatic brain injury, cervical spine injury or extensive facial fractures. After 48 h, he displayed a depressed sensorium and an abnormal pupillary exam. He was diagnosed by computed tomography angiogram with a carotid dissection resulting in a large infarct of the right hemisphere with herniation requiring emergent craniectomy. This case suggests screening for blunt cerebrovascular injury beyond the current recommendations especially in patients with high-impact mechanism.
Comparison of Trauma and Injury Severity Score model with alternative approach in outcome prediction in trauma using National Trauma Database in Malaysia
Authors: Chen Won-Sun , Lee Shaun-Wen Huey , Jamaluddin Sabariah , Wong Chee-Piau
Published: July 2016

Objective

The coefficients for the Trauma and Injury Severity Score are derived from the Major Trauma Outcome Study (MTOS) in North America, so the applicability of the MTOS-Trauma and Injury Severity Score (TRISS) in different populations remains challenging. This study proposed an alternate TRISS model called National Trauma Database-TRISS, where the coefficients were derived from the National Trauma Database (NTrD) in Malaysia.

Methods

This study utilised data derived from the National Trauma Database in Malaysia with 70% of the cases being used to develop the NTrD-TRISS model, while model validation was conducted based on the remaining 30% of cases. Fractional polynomial method was applied to correct the non-linearity in the logit of Injury Severity Score (ISS) and New Injury Severity Score (NISS). The predictive validity of the NTrD-TRISS model was compared with the MTOS-TRISS model. The predictive validity of these models was further examined with ISS and NISS.

Results

A total of 5857 major trauma cases reported to 13 trauma centres located throughout Malaysia for patients aged 16 and above were included in the study. The outcome prediction in trauma from NTrD-TRISS model was found to be more accurate compared to the MTOS-TRISS model.

Conclusions

This study has ascertained the applicability of the MTOS-TRISS model in Malaysia. The outcome prediction in trauma from the NTrD-TRISS was found to outperform the MTOS-TRISS model. Given the complex computational nature of ISS, the MTOS-TRISS and NTrD-TRISS models with NISS were recommended for future practical usage.
News media repertoires and strategic narrative reception: A paradox of dis/belief in authoritarian Russia
Authors: Szostek Joanna
Published: July 2016

With Internet access, citizens in non-democracies are often able to diversify their news media repertoires despite government-imposed restrictions on media freedom. The extent to which they do so depends on motivations and habits of news consumption. This article presents a qualitative study of the motivations and habits underlying news media repertoires among a group of digitally connected university students in authoritarian Russia. Interviews reveal awareness and dissatisfaction vis-a-vis the ‘propagandistic’ nature of state-controlled news content, resulting in a preference for using multiple different sources – including foreign websites and ‘non-official’ citizen accounts – to build a personal understanding of what is ‘really’ going on. The article then examines how the students make sense of conflicting narratives about international affairs which they encounter in state and non-state sources. Paradoxically, low reported consumption of distrusted, ‘propagandistic’ state television is often accompanied by reproduction of the overarching strategic narrative which state television conveys.
A class of mixture models for multidimensional ordinal data
Authors: Colombi Roberto , Giordano Sabrina
Published: July 2016

In rating surveys, people are requested to express preferences on several aspects related to a topic by selecting a category in an ordered scale. For such data, we propose a model defined by a mixture of a uniform distribution and a Sarmanov distribution with CUB (combination of uniform and shifted binomial) marginal distributions ( D'Elia and Piccolo, 2005 ). This mixture generalizes the CUB model to the multivariate case by taking into account the association among answers of the same individual to the items of a questionnaire. It also allows us to distinguish two kinds of uncertainty: specific uncertainty, related to the indecision for single items, and global uncertainty referred to the respondent's hesitancy in completing the whole questionnaire. A simulation and a real case study highlight the usefulness of the new methodology.
The family accompaniment of persons with dementia seen through the lens of the capability approach
Authors: Le Galès Catherine , Bungener Martine
Published: July 2016

Using the capability approach initially developed by A Sen as a theoretical framework, this paper analyses both what people with dementia and their families do in response to difficulties in their daily life brought about by the disease, and the reasons they give for acting as they do. Individual and collective interviews and ethnographic observations with 15 persons with dementia and one or more of their family members were conducted. Follow-up interviews were possible for nine families. Results highlight a great diversity in ways of doing things and in accompaniment by family members. Daily adjustments are often hidden or minimized, at least at the onset of the dementia. Later, they become more frequent, repetitive and indispensable but remain influenced by the social and gender roles that existed prior to the illness. The inventiveness of families, in a context marked by various kinds of constraints, is primarily motivated by their desire to maintain the apparently intact abilities of the person with dementia but especially to preserve forms of liberty and what counted for the person, what that person valued before the disease. There are some ways of living with dementia, even when accompanied, which may long remain preferable to others, which better answer to the past and present aspirations of persons with dementia and the purposes of the accompanying persons. It is thus essential that health professionals, as well as society in general, recognize and address this issue.
Adhesive bond-line degradation detection via a cross-correlation electromechanical impedance–based approach
Authors: Dugnani Roberto , Zhuang Yitao , Kopsaftopoulos Fotis , Chang Fu-Kuo
Published: July 2016

This article describes how piezoelectric transducers embedded in the adhesive bond-line of lap-joints can be used to effectively monitor structural integrity. Various lap-joint coupons with embedded piezoelectric transducers were manufactured with and without artificial contamination at the bond-line and tested statically and cyclically. A novel scheme based on the electromechanical impedance response of the transducer was implemented to predict the failure of the tested lap-joint samples. The results from the mechanical testing indicated that monitoring the transducer’s electromechanical impedance is an effective way of predicting the failure of the bond-line. Specifically for static tests, local damage to the bond-line was consistently detected at approximately 84% of the failure load for transducers located at the center of the bond-line, whereas for transducers embedded near the edge of the bond-line, the failure of the adhesive was detected at 60% of the failure load. Moreover, preliminary fatigue tests showed that significant changes in the electromechanical impedance signals were apparent starting at 60% of the life of the bond-line. In addition to the mechanical testing, the effectiveness of the proposed electromechanical impedance–based scheme was investigated by means of a three-dimensional finite element model corresponding to the specific coupon geometry tested and through a two-dimensional analytical solution.
Pre-mortem interventions for donation after circulatory death and overall benefit: A qualitative study
Authors: Gathani Aisha , Moorlock Greg , Draper Heather
Published: July 2016

This article explores how the type of consent given for organ donation should affect the judgement of a patient's overall benefit with regards to donation of their organs and the pre-mortem interventions required to facilitate this. The findings of a qualitative study of the views of 10 healthcare professionals, combined with a philosophical analysis inform the conclusion that how consent to organ donation is given is a reliable indicator only of the strength of evidence about views on donation and subsequent willingness to undergo pre-mortem interventions. It is not an indicator of the strength of actual desire to donate. Clinical management of living patients prior to donation after circulatory death must therefore respect the values, wishes and beliefs of the potential donation after circulatory death donor. Our participants, however, suggested that the information currently provided is sufficient to authorise donation and that this consent, however provided, was sufficient to proceed with pre-mortem interventions. Respect for autonomy underpinned this ‘all or nothing’ approach. Although the legal requirements for donation authorisation and the protection of patients without capacity are clear, practice and policy regarding consent in donation after circulatory death may be based on donation following brainstem death where the patient is already dead when the family is approached. Custom and practice in donation after circulatory death may need to be revised to protect the interests of the dying potential donor.
Fever Therapy With Intravenously Applied Mistletoe Extracts for Cancer Patients: A Retrospective Study
Authors: Schläppi Marc , Ewald Christoph , Kuehn Jürgen Johannes , Weinert Tomas , Huber Roman
Published: July 2016

Purpose. So-called spontaneous remissions in cancer often seem to occur after febrile events. Mistletoe preparations (MPs) are used off-label intravenously to induce fever within concepts of integrative oncology. We wanted to investigate the frequency of febrile reactions and safety related to intravenously applied MPs (IAMPs). Methods. This was a retrospective analysis of data from consecutive cancer patients who were treated in 2 anthroposophic hospitals with IAMPs. The main outcome parameter was the rate of core temperature increase to ≥38.5°C within 24 hours after IAMPs. Secondary outcome parameters were Common Toxicity Criteria for Adverse Events (CTCAE; version 4.0). Results. 59 patients, with in total 567 IAMPs, were analyzed; 45 patients (76%, 95% CI = 65%-87%) had an increase of core temperature to ≥38.5°C after at least 1 treatment. Mean increase in temperature was 1.5°C ± 0.8°C. Adverse events were mostly fever-related symptoms (headache, joint pain, shivering). Grade 1 allergic reactions were documented in 0.6% of treatments. CTCAEs grade 3 to 5 did not occur; 38/59 patients had advanced and/or metastatic disease. Conclusion. IAMPs resulted in febrile reactions to >38.5°C in the majority of patients and can be considered as safe. Adverse events were mostly related to fever and were not severe.
Molecular aspects of β, β-carotene-9′, 10′-oxygenase 2 in carotenoid metabolism and diseases
Authors: Wu Lei , Guo Xin , Wang Weiqun , Medeiros Denis M , Clarke Stephen L , Lucas Edralin A , Smith Brenda J , Lin Dingbo
Published: July 2016

Carotenoids, the carotenes and xanthophylls, are essential components in human nutrition. β, β-carotene-9′, 10′-oxygenase 2 (BCO2), also named as β, β-carotene-9′, 10'-dioxygenase 2 (BCDO2) catalyzes the asymmetrical cleavage of carotenoids, whereas β, β-carotene-15, 15′-monooxygenase (BCMO1) conducts the symmetrical cleavage of pro-vitamin A carotenoids into retinoid. Unlike BCMO1, BCO2 has a broader substrate specificity and has been considered an alternative way to produce vitamin A. In contrast to BCMO1, a cytoplasmic protein, BCO2 is located in the inner mitochondrial membrane. The difference in cellular compartmentalization may reflect the different substrate specificity and physiological functions with respect to BCMO1 and BCO2. The BCO2 gene mutations are proven to be associated with yellow color of skin and fat tissue and milk in livestock. Mutation in intron 2 of BCO2 gene is also supposed to be related to the expression of IL-18, a pro-inflammatory cytokine associated with obesity, cardiovascular diseases, and type 2 diabetes. Further, BCO2 is associated with the development of mitochondrial oxidative stress, macular degeneration, anemia, and hepatic steatosis. This review of the literature will mostly address recent updates regarding the role of BCO2 in carotenoid metabolism, and discuss the potential impacts of BCO2 protein and the mutations in mammalian diseases.
Expression kinetics of hepatic progenitor markers in cellular models of human liver development recapitulating hepatocyte and biliary cell fate commitment
Authors: Chaudhari Pooja , Tian Lipeng , Deshmukh Abhijeet , Jang Yoon-Young
Published: July 2016

Due to the limitations of research using human embryos and the lack of a biological model of human liver development, the roles of the various markers associated with liver stem or progenitor cell potential in humans are largely speculative, and based on studies utilizing animal models and certain patient tissues. Human pluripotent stem cell-based in vitro multistage hepatic differentiation systems may serve as good surrogate models for mimicking normal human liver development, pathogenesis and injury/regeneration studies. Here, we describe the implications of various liver stem or progenitor cell markers and their bipotency (i.e. hepatocytic- and biliary-epithelial cell differentiation), based on the pluripotent stem cell-derived model of human liver development. Future studies using the human cellular model(s) of liver and biliary development will provide more human relevant biological and/or pathological roles of distinct markers expressed in heterogeneous liver stem/progenitor cell populations.
Liver metastases: Microenvironments andex-vivomodels
Authors: Clark Amanda M , Ma Bo , Taylor D Lansing , Griffith Linda , Wells Alan
Published: July 2016

The liver is a highly metastasis-permissive organ, tumor seeding of which usually portends mortality. Its unique and diverse architectural and cellular composition enable the liver to undertake numerous specialized functions, however, this distinctive biology, notably its hemodynamic features and unique microenvironment, renders the liver intrinsically hospitable to disseminated tumor cells. The particular focus for this perspective is the bidirectional interactions between the disseminated tumor cells and the unique resident cell populations of the liver; notably, parenchymal hepatocytes and non-parenchymal liver sinusoidal endothelial, Kupffer, and hepatic stellate cells. Understanding the early steps in the metastatic seeding, including the decision to undergo dormancy versus outgrowth, has been difficult to study in 2D culture systems and animals due to numerous limitations. In response, tissue-engineered biomimetic systems have emerged. At the cutting-edge of these developments are ex vivo ‘microphysiological systems’ (MPS) which are cellular constructs designed to faithfully recapitulate the structure and function of a human organ or organ regions on a milli- to micro-scale level and can be made all human to maintain species-specific interactions. Hepatic MPSs are particularly attractive for studying metastases as in addition to the liver being a main site of metastatic seeding, it is also the principal site of drug metabolism and therapy-limiting toxicities. Thus, using these hepatic MPSs will enable not only an enhanced understanding of the fundamental aspects of metastasis but also allow for therapeutic agents to be fully studied for efficacy while also monitoring pharmacologic aspects and predicting toxicities. The review discusses some of the hepatic MPS models currently available and although only one MPS has been validated to relevantly modeling metastasis, it is anticipated that the adaptation of the other hepatic models to include tumors will not be long in coming.
Preexposure Prophylaxis and Patient Centeredness
Authors: Snowden Jonathan M. , Rodriguez Maria I. , Jackson Skyler D. , Marcus Julia L.
Published: July 2016

Preexposure prophylaxis has transformed HIV prevention, becoming widespread in communities of gay and bisexual men in the developed world in a short time. There is a broad concern that preexposure prophylaxis will discourage condom use among gay men (i.e., “risk compensation”). This commentary argues for broadening the focus on gay men’s health beyond sexual health to address the holistic health and well-being of gay men. Gay men may benefit from being offered candid, nonjudgmental health promotion/HIV prevention messages not requiring condom use for anal sex. Lessons can be drawn from the family planning movement, which has undergone a similar shift in focus. The principle of patient centeredness supports such a shift in gay men’s health toward the goal of providing men with the knowledge to evaluate various prevention approaches according to the specifics of their life circumstances and health needs. Bringing more nuance to discussions of sexual risk and sexual pleasure could facilitate more universally healthy attitudes regarding sex among gay men, in turn enabling healthier decisions more compatible with men’s own values and preferences.
Chronic Obstructive Pulmonary Disease
Authors: O’Reilly Sean
Published: July 2016

COPD is a common, preventable, and treatable disease characterized by persistent airflow obstruction associated with enhanced inflammation in the airways and the lung in response to noxious particles or gases. Clinical history and pulmonary function testing are necessary for accurate diagnosis. While exposure to tobacco smoke remains a common cause, other etiologies and underlying genetic predisposition play significant roles. Treatment options are numerous and should be individualized based on symptoms and exacerbation frequency.
Intracranial non-galenic pial arteriovenous fistula: A review of the literature
Authors: Yu Jinlu , Shi Lei , Lv Xianli , Wu Zhongxue , Yang Hongfa
Published: July 2016

An intracranial non-galenic pial arteriovenous fistula (NGPAVF) is a direct connection between the intracranial artery and vein without a nidus. NGPAVFs are clinically rare, and the current understanding of NGPAVFs is limited. This study searched PubMed for the currently available literature, and a review of the relevant publications revealed that NGPAVFs require aggressive treatment, spontaneous occlusion is uncommon, and the prognosis following conservative treatment is poor. NGPAVFs can be divided into congenital and traumatic (including iatrogenic) types. Clinically, NGPAVFs are characterized by congestive heart failure, epilepsy, hemorrhage, mass effects, and nerve function deficits. For the imaging examination of NGPAVFs, digital subtraction angiography (DSA) is still the gold standard for diagnosis, although magnetic resonance DSA (MRDSA) and 4D computed tomography angiography (CTA) can also provide hemodynamic data in a non-invasive manner. Current treatments for NGPAVFs include surgical resection and endovascular embolization, both of which can yield clinical improvements. However, potential postoperative complications should be addressed, such as fatal bleeding due to rupture and deep vein thrombosis. Some studies recommend postoperative anticoagulation to reduce postoperative thrombotic complications.
Women’s experiences of perpetrating family violence: a qualitative study
Authors: Keiski Pia , Flinck Aune , Kaunonen Marja , Paavilainen Eija
Published: July 2016

Female-perpetrated family violence is a difficult phenomenon to understand, as it does not easily conform to normative, gendered expectations of women. However, women can sometimes perpetrate family violence against their children and spouses. The aim of this study is to describe and make visible women’s experiences of perpetrating family violence. Nineteen women were interviewed about their experiences of perpetrating family violence. The data were analysed with an inductive content analysis and three categories emerged: the threat of losing the sense of self, acknowledging harming behaviour and challenges in obtaining help. These categories describe women’s conception of self, of their feminine identity and of gender role expectations in a family violence perpetrator context. If female-perpetrated family violence were acknowledged as a part of women’s behaviour this would reflect a shift in society’s notions of gender roles. Results of the study may be used by nurses when encountering women who have perpetrated family violence or in the development of nursing policies aimed at enhancing the wellbeing of the family.
Ethical challenges in online research: Public/private perceptions
Authors: Sugiura Lisa , Wiles Rosemary , Pope Catherine
Published: July 2016

With its wealth of readily and often publicly available information about Web users’ lives, the Web has created new opportunities for conducting online research. Although digital data are easily accessible, ethical guidelines are inconsistent about how researchers should use them. Some academics claim that traditional ethical principles are sufficient and applicable to online research. However, the Web poses new challenges that compel researchers to reconsider concerns of consent, privacy and anonymity. Based on doctoral research into the investigation of online medicine purchasing, this article presents a case study involving online forums, and reviews the existing ethical guidance surrounding the Web. The suggestion is that new ethical guidelines, particularly in relation to informed consent and participants’ own perceptions of what is public or private, are needed owing to the unique challenges of online research.