bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleep disturbances among pregnant women with history of migraines: A cross-sectional study
Authors: Qiu Chunfang , Frederick Ihunnaya O , Sorensen Tanya , Aurora Sheena K , Gelaye Bizu , Enquobahrie Daniel A , Williams Michelle A
Published: January 2015

Background

Migraine is associated with sleep disturbances in men and non-pregnant women. However, relatively little is known about sleep disturbances among pregnant migraineurs. We investigated sleep disturbances among pregnant women with and without history of migraine.

Methods

This cross-sectional study was conducted among 1324 women who were recruited during early pregnancy. Migraine diagnoses were based on the International Classification of Headache Disorders-II criteria. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to evaluate sleep-related characteristics including sleep duration, sleep quality, excessive daytime sleepiness, and other sleep traits. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs).

Results

Migraineurs were more likely than non-migraineurs to report short sleep duration (<6.5 hours) (AOR = 1.47, 95% CI 1.07–2.02), poor sleep quality (PSQI>5) (AOR = 1.73, 95% CI 1.35–2.23), and daytime dysfunction due to sleepiness (AOR = 1.51, 95% CI 1.12–2.02). Migraineurs were also more likely than non-migraineurs to report taking sleep medication during pregnancy (AOR = 1.71, 95% CI 1.20–2.42). Associations were generally similar for migraine with or without aura. The odds of sleep disturbances were particularly elevated among pre-pregnancy overweight migraineurs.

Conclusion

Migraine headache and sleep disturbances are common comorbid conditions among pregnant women.
Influence of chronic cadmium exposure on the tissue distribution of copper and zinc and oxidative stress parameters in rats
Authors: Erdem Onur , Yazihan Nuray , Kocak Mehtap Kacar , Sayal Ahmet , Akcil Ethem
Published: January 2015

The aim of this study was to investigate the effect of oral cadmium (Cd) intoxication on the antioxidant response and its relationship with essential bioelements like copper (Cu) and zinc (Zn). The experimental group was chronically exposed to Cd daily for 8 weeks via consumption of water containing 15 ppm cadmium chloride. Cu, Zn, and Cd concentrations and oxidative stress parameters were analyzed in liver, kidney, and heart tissues. Exposure to Cd led to a significant decrease in the activities of superoxide dismutase in all considered samples while a significant increase in the activity of glutathione peroxidase except for the kidney. We found a significant increase in malondialdehyde concentration in the tissues except for heart. Also oral administration of Cd caused a significant reduction of Zn and Cu in the tissues. Our results allow us to hypothesize that higher Cd concentration in the tissues causes oxidative stress by increasing malondialdehyde as a means of altering antioxidant defense system and deterioration of bioelements in rat liver, kidney, and heart. In addition, further studies are needed to explain the effect of long-term, low-dose exposure to Cd on distribution of bioelements and its relationship with oxidative stress.
Comment la marque donne du sens au collaborateur : vers une vision élargie du capital-marque
Authors: Berger-Remy Fabienne , Michel Géraldine
Published: January 2015

La marque est un capital de l’entreprise évalué principalement aujourd’hui sous un angle marketing et financier. Cette recherche montre que la valeur de la marque peut également s’apprécier selon le supplément de sens qu’elle engendre auprès des collaborateurs. Sur la base d’une étude de cas dans quatre organisations, nous montrons que la marque crée du sens de manière spécifique pour les collaborateurs à travers des significations, une direction et des sensations distinctes de ce que ressent et comprend le consommateur. Le concept de capital-marque est ainsi revisité au regard de cette nouvelle dimension, le capital-marque du point de vue des collaborateurs ou employee-based brand equity (EBBE).
A new method for meniscus repair using type I collagen scaffold and infrapatellar fat pad
Authors: Oda Shuhei , Otsuki Shuhei , Kurokawa Yoshitaka , Hoshiyama Yoshiaki , Nakajima Mikio , Neo Masashi
Published: January 2015

Aim

The aim of this study was to investigate a new method for meniscal repair by combinative transplantation with type I collagen scaffold and infrapatellar fat pad.

Methods

Two-mm cylindrical defects at the anterior part of bilateral medial menisci were prepared in nine Japanese white rabbits. The 18 knees were equally divided into three groups: I, no treatment; II, collagen scaffold transplantation; and III, collagen scaffold and infrapatellar fat pad transplantation. Another three rabbits (six knees) underwent sham surgery and served as controls. Rabbits were sacrificed at eight weeks after transplantation. Surface area of the medial meniscus was evaluated using macrophotographs. Ishida score for meniscal regeneration was used for assessment. To evaluate the composition of regenerated tissue, immunohistochemistry was analyzed with anti-type I and anti-type II collagen antibodies, and anti-Ki67 antibody. To investigate the effects of collagen scaffold on human meniscus, cells were isolated from human meniscus and infrapatellar fat pad, and cultured with collagen scaffold for three weeks. After that, gene expression was evaluated by using quantitative real-time polymerase chain reaction.

Results

In group I, the meniscus shrank anterior to posterior, and the surface area was significantly less than that of normal meniscus. However, the surface area was maintained in group III. Ishida score and Ki67-positive cell ratio in group III were significantly higher than that in any other group, and staining with type I and type II collagen was similar to that of the control. Expression of matrix metalloproteinase was significantly lower in cocultures of collagen scaffold, meniscus cell, and infrapatellar fat pad cell than in monocultured meniscus cell, and expression of interleukin-1β was not increased. Conclusion: This new method for meniscal repair by combinative transplantation with type I collagen scaffold and infrapatellar fat pad showed meniscal regeneration and potential for suppressing inflammation.
Enhanced osteogenesis on titanium implants by UVB photofunctionalization of hydrothermally grown TiO2 coatings
Authors: Lorenzetti Martina , Dakischew Olga , Trinkaus Katja , Susanne Lips Katrin , Schnettler Reinhard , Kobe Spomenka , Novak Saša
Published: January 2015

Even though Ti-based implants are the most used materials for hard tissue replacement, they may present lack of osseointegration on the long term, due to their inertness. Hydrothermal treatment (HT) is a useful technique for the synthesis of firmly attached, highly crystalline coatings made of anatase titanium dioxide (TiO2), providing favorable nanoroughness and higher exposed surface area, as well as greater hydrophilicity, compared to the native amorphous oxide on pristine titanium. The hydrophilicity drops even more by photofunctionalization of the nanostructured TiO2-anatase coatings under UV light. Human mesenchymal stem cells exhibited a good response to the combination of the positive surface characteristics, especially in respect to the UVB pre-irradiation. The results showed that the cells were not harmed in terms of viability; even more, they were encouraged to differentiate in osteoblasts and to become osteogenically active, as confirmed by the calcium ion uptake and the formation of well-mineralized, bone-like nodule structures. In addition, the enrichment of hydroxyl groups on the HT-surfaces by UVB photofunctionalization accelerated the cell differentiation process and greatly improved the osteogenesis in comparison with the nonirradiated samples. The optimal surface characteristics of the HT-anatase coatings as well as the high potentiality of the photo-induced hydrophilicity, which was reached during a relatively short pre-irradiation time (5 h) with UVB light, can be correlated with better osseointegration ability in vivo; among the samples, the superior biological behavior of the roughest and most hydrophilic HT coating makes it a good candidate for further studies and applications.
A Pharmacist’s Impact on 30-Day Readmission Rates When Compared to the Current Standard of Care Within a Patient-Centered Medical Home
Authors: Tedesco Gary W. , McConaha Jamie L. , Skomo Monica L. , Higginbotham Suzanne K.
Published: January 2015

Objective:

To evaluate the effect transition of care follow-up and counseling performed by a pharmacist, within a physician’s practice, can have on 30-day hospital readmissions among Medicare patients when compared to the current standard of care

Methods:

A pharmacist telephonically contacted patients ≥65 years with Medicare insurance following hospital discharge to perform medication reconciliation, review discharge instructions, and schedule a follow-up appointment (n = 34). At this follow-up appointment, the pharmacist reviewed the patient’s electronic medical record (EMR) and communicated recommendations to the physician. The current standard of care, which does not involve a pharmacist, at a similar local physician practice was used as a comparative group (n = 45)

Results:

The difference in 30-day readmission rates did not reach statistical significance ( P = .27); however, there was a trending decrease in the percentage of patients readmitted between the control and the intervention groups (26.7% vs 14.7%). Additionally, there was nearly a statistically significant decrease in readmission rates for those patients who interacted with the pharmacist face to face versus only telephonically ( P = .05)

Conclusions:

These results impact the decision to continue and expand the pilot program and demonstrate that pharmacists in the ambulatory setting based within a patient-centered medical home have a potential role in decreasing 30-day hospital readmissions.
A novel self-alignment method for SINS based on parameter recognition and dual-velocity vectors
Authors: Liu Xixiang , Zhao Yu , Liu Zhipeng , Wang Lihui
Published: January 2015

In this paper, self-alignment problem for strapdown inertial navigation system based on tracing gravity drift in inertial frame and dual-vector attitude determination is studied. Aiming to further ease, the interference from sensor random errors, especially accelerometer random noise, without adding alignment time, a novel alignment method based on integrating gravitational apparent motion to form apparent velocity is designed, using recursive least squares algorithm to recognize the parameters describing the theoretical apparent velocity from the calculated velocity containing random noise. Analysis and simulation indicate that with this method, random noise can be effectively removed compared with the only operation of integration. Meanwhile, a reconstruction algorithm with current recognized parameters for dual-velocity vectors is devised which can fully utilize all measurement information and completely avoid collinear problem. Simulation and turntable results show that compared with the existing integrating methods, the proposed method can acquire sound alignment results with lower standard variances and can improve alignment accuracy with the same alignment time or shorten alignment time with the same accuracy.
Optimal autotuning of nonminimum phase processes under relay control
Authors: Mehta Utkal , Ananthanarayanan Rajeshkannan
Published: January 2015

Nonminimum phase processes with poles and/or zeros in the right half plane are always difficult to estimate and design a regulator assuring the better performance. In this article, exact analytical expressions of the time-domain output for a class of nonminimum phase processes are derived under a relay control system. Process parameters are assumed to be unknown before the test. A single symmetrical relay test is performed to estimate up to five unknown parameters of process model effectively. Based on the estimated process model, new optimum proportional–integral–derivative gains are obtained from a novel technique of evolutionary algorithm. A new control performance index has been defined to achieve a balanced tradeoff between transient performance and actuator preservation. Simulation result has proven the feasibility of the technique by showing the robustness in the presence of static load disturbances and measurement noise.
Curcumin and resveratrol in combination modulate drug-metabolizing enzymes as well as antioxidant indices during lung carcinogenesis in mice
Authors: Liu Y , Wu Y-M , Yu Y , Cao C-S , Zhang J-H , Li K , Zhang P-Y
Published: January 2015

This study investigated combined chemopreventive potential of curcumin and resveratrol during benzo(a)pyrene (BP)-induced lung carcinogenesis in mice. The mice were segregated into five groups that included normal control, BP-treated, BP + curcumin-treated, BP + resveratrol-treated, and BP + curcumin + resveratrol-treated groups. A statistically significant increase in the levels of lipid peroxidation (LPO) was observed in the lungs of mice after 22 weeks of single dose of benzo(a)pyrene. Further, BP treatment also resulted in a significant increase in the enzyme activities of aryl hydrocarbon hydroxylase as well as drug-metabolizing enzymes, namely cytocrome P450 and cytochrome b5. On the other hand, reduced glutathione (GSH) levels, the activities of superoxide dismutase (SOD), glutathione reductase (GR), and glutathione- S-transferase (GST) were found to be significantly decreased following BP treatment. Supplementation with curcumin and resveratrol to BP-treated mice significantly decreased the LPO levels, GSH levels, and enzyme activities of drug-metabolizing enzymes. Further, treatment of curcumin and resveratrol to BP-treated mice significantly elevated the activities of SOD, GR, and GST. Histoarchitectural studies showed well-differentiated signs of lung carcinogenesis following BP administration to mice. However, combined treatment with curcumin and resveratrol resulted in a noticeable improvement in the lung histoarchitecture. This study, therefore, concludes that curcumin and resveratrol when supplemented in combination regulate drug-metabolizing enzymes as well as antioxidant enzymes during lung carcinogenesis in mice.
Increased corticotropin-releasing hormone (CRH) expression in cutaneous lupus lesions
Authors: Schmitz M K , Botte D A , Sotto M N , Borba E F , Bonfa E , de Mello S B V
Published: January 2015

Objective

Corticotropin-releasing hormone (CRH) and pro-opiomelanocortin (POMC) axis activation leads to the production of hormones, such as adrenocorticotrophic hormone (ACTH) and the α-melanocyte stimulating hormone (α-MSH). Data regarding the role of these hormones in systemic lupus erythematosus (SLE) are scarce. In the present study we aim to evaluate the participation of this axis in the cutaneous involvement of SLE.

Methods

Seventeen SLE patients were clinically evaluated, and biopsies from affected and unaffected skin of these patients were compared with 17 healthy control individuals. Immunohistochemical analyses for CRH, ACTH, α-MSH, and MC-1R were performed, and the serum levels of α-MSH, IL-1, IL-1ra, IL-6, IL-10, IL-12p70, IL-17, TNF-α, and IFN-γ were measured.

Results

The affected skin of the SLE patients exhibited higher CRH expression in the deep dermis compared to the skin of the controls ( p = 0.024), whereas the tissue expression of ACTH, cortisol, α-MSH and its receptor MC-1R were comparable in SLE patients and controls. Higher serum levels of IFN-γ ( p = 0.041), TNF-α ( p = 0.001) and IL-6 ( p = 0.049) were observed in SLE patients compared with controls, while α-MSH levels were similar in both groups.

Conclusion

The novel finding of elevated CRH expression solely in the affected skin deep dermis supports the notion of a cutaneous local dysfunction of the CRH-POMC axis in the pathogenesis of cutaneous SLE lesions.
The impact of an “equal opportunities” ideological framework on coaches’ knowledge and practice
Authors: Norman Leanne
Published: January 2015

This study focuses upon UK professional coaches’ experiences of equity training and the impact of the conceptualisation of equity as a matter of equal opportunities on this education and subsequent coaching practice. The research employs a critical feminist approach to connect the ideological framing of gender equity by sporting organisations to coaches’ ability to understand, identify and manage issues of gender equity, equality and diversity. The discussions are based on interviews with four coaches, Jack, Peter, Charlotte and Tony, who had all recently undertaken equity training, and all of whom represented sports and different stages of the coaching pathway. The data highlights that seeing gender equity through an “equal opportunities” lens results in a narrow conceptualisation of such issues by coaches, fails to challenge dominant and discriminative ideologies, and does not enable coaches to address equity within their practices. Consequently, coaches struggle to understand the importance of and manage such issues. The participants’ experiences reveal that gender relations, intersected principally with religion and ethnicity, underpinned their everyday coaching practices. The findings illustrate the need for sporting organisations to redefine how they approach equality and equity and for a more sophisticated sociocultural educational programme for coaches.
Factors Affecting Health-Promoting Behaviors in Nursing Students at a University in Turkey
Authors: Polat Ülkü , Özen Şükrü , Kahraman Burcu Bayrak , Bostanoğlu Hatice
Published: January 2015

This descriptive study was carried out to determine factors affecting health-promoting behaviors in nursing students. The sample consisted of 245 students. A questionnaire about factors affecting lifestyle behavior and the Health Promotion Lifestyle Profile Scale-II were used to collect data from 245 nursing students during the spring semester of the 2012-2013 academic year. A significant difference was found between students with and without diagnosed health problems in terms of their mean scores on the Health Promotion Lifestyle Profile Scale-II subscales of health responsibility, spiritual growth, and interpersonal relations, as well as their total mean scores ( p < .05). The exercise, nutrition, spiritual growth, and stress management subscale scores of those students regularly going for health checks were determined to be significantly higher than those of the students who did not obtain regular health checks. Students’ healthy lifestyle behaviors were generally found to be at the medium level. This study provides evidence of the need for interventions to help nurses in Turkey.
Robust control in rotating machinery using linear matrix inequalities
Authors: Koroishi EH , Lara-Molina FA , Borges AS , Steffen V
Published: January 2015

Some active vibration control methods are based on mathematical models. In these cases, parameter variations play an important role in the system performance. As it is not possible to know in advance the precise values for all parameters of the mechanical system, a possible alternative is to design robust controllers that take into account the uncertainties. In this context, this work presents a vibration active control technique devoted to rotating machinery by incorporating electromagnetic actuators, which considers uncertainties in the parameters of the system. the gains of the electromagnetic actuator are determined by using linear matrix inequalities, which consist in a powerful tool for the cases in which parameter uncertainties are taken into account. In addition, Kalman estimators are employed to deduce the modal states of the system. The model of the rotating system is obtained by using the finite element method and the potentiality of the methodology for applications in engineering was investigated through experimental tests.
A numerical solution for fractional optimal control problems via Bernoulli polynomials
Authors: Keshavarz E , Ordokhani Y , Razzaghi M
Published: January 2015

This paper presents a new numerical method for solving fractional optimal control problems (FOCPs). The fractional derivative in the dynamic system is described in the Caputo sense. The method is based upon Bernoulli polynomials. The operational matrices of fractional Riemann–Liouville integration and multiplication for Bernoulli polynomials are derived. The error upper bound for the operational matrix of the fractional integration is also given. The properties of Bernoulli polynomials are utilized to reduce the given optimization problems to the system of algebraic equations. By using Newton’s iterative method, this system is solved and the solution of FOCPs are achieved. Illustrative examples are included to demonstrate the validity and applicability of the technique.
Improved feedforward inverse control with adaptive refinement for acceleration tracking of electro-hydraulic shake table
Authors: Tang Yu , Zhu Zhen-Cai , Shen Gang , Li Xiang
Published: January 2015

Shake tables are essential facilities in the laboratory for evaluating structural performance subject to vibration excitation. In this paper, to improve the time waveform replication accuracy of electro-hydraulic shake tables (EHSTs), an improved feedforward inverse control algorithm with adaptive refinement is proposed. The EHST system transfer function and stable inverse model is firstly estimated and designed by multi-step recursive extended least squares algorithm and zero magnitude error tracking controller technology, respectively. To reduce the side effect of model identification errors between the estimated and actual system, a system model corrector is further identified based on the previous estimated EHST model and an inverse corrector is obtained so as to constitute the improved feedforward inverse controller (iFIC) by cascading the inverse corrector to the previous designed inverse model. Then, an adaptive refinement controller using a least mean square algorithm is applied to the iFIC controlled system to cope with system uncertainties and nonlinear effects. Therefore, the proposed algorithm combines the merits of feedforward inverse control and adaptive control. Finally, with the help of xPC rapid prototyping technology, experiments are conducted on a real uniaxial EHST system and the experimental results demonstrate that the proposed algorithm exhibits a better tracking accuracy than the conventional controllers for shake tables.
Citizens’ attitudes towards descriptive representation: The case of women in Portugal
Authors: Espírito-Santo Ana
Published: January 2015

Although the gender composition of assemblies is slowly changing in order to include more women, very little is known about citizens’ attitudes towards women’s descriptive representation. Using data from a representative sample of the Portuguese population, this article aims to offer an explanation of citizens’ attitudes towards women in parliament. It demonstrates that the Portuguese population is willing to see the presence of women in political power increase, but only up to a certain point: although most people support an increase in the number of female MPs, only a minority wish a substantial increase. This article makes a valuable contribution to the literature by demonstrating that, more than party identification or gender stereotypes, issues surrounding concerns with women’s interests and with the quality of democracy are strongly related to a desire for a gender equilibrated political environment.
Is organizational innovation always a good thing?
Authors: Mariano Stefania , Casey Andrea
Published: January 2015

Is organizational innovation always a good thing? When is innovation negative? What are the damaging effects of innovation? In this article, it is argued that innovation has negative impacts on organizational performance when the newly introduced knowledge is not compatible with an organization’s prior knowledge. In this instance, an organization may experience knowledge loss or organizational dysfunctions, such as avoidance, resistance, struggle, alteration, and conversion processes. To avoid the negative impacts of innovation, we suggest that organizations should first recognize the incompatibility between the new knowledge and prior knowledge and then reformulate the newly introduced knowledge. Implications for theory and research are offered as well as suggestions for practice.
Brief measures of anxiety in non-treatment-seeking youth with autism spectrum disorder
Authors: Kerns Connor Morrow , Maddox Brenna B , Kendall Philip C , Rump Keiran , Berry Leandra , Schultz Robert T , Souders Margaret C , Bennett Amanda , Herrington John , Miller Judith
Published: January 2015

This study investigated the accuracy of brief anxiety scales for non-treatment-seeking youth with autism spectrum disorder. In all, 54 youth (7–17 years; IQ: 67–158) with autism spectrum disorder and their parents completed (a) an expanded version of the Anxiety Disorders Interview Schedule—Child/Parent designed to capture typical and atypical fears and (b) brief scales of anxiety symptoms (Behavior Assessment Schedule for Children, Second Edition; Screen for Child Anxiety and Related Emotional Disorders; Negative Affective Self-Statement Questionnaire; Pediatric Anxiety Rating Scale). The results indicate that measures lacked adequate sensitivity and specificity, and the detection of atypical fears was particularly poor. Revised cut scores are offered, but refined and/or revised instruments are likely needed for research on youth with autism spectrum disorder.
Evidentiality and lexicalisation in the Spanish phraseological system: A study of the idiom a fe mía (and its variants)
Authors: Torrent Aina
Published: January 2015

This work addresses the relation among the semantic-pragmatic categories of evidentiality, epistemicity and intensification based on a study of the discursive use of certain Spanish idiomatic phraseological units. The first part offers an introduction to some theoretical aspects, while the second part analyses the usage of the idiom a fe que. Two important theses that are defended in this article are as follows: (a) evidentiality has played an important role in the process of lexicalisation and grammaticalisation of a number of idiomatic phraseological units and (b) some evidential expressions display the existence of close relationships among evidentiality, epistemicity and intensification.
The effects of die geometry in tube channel pressing: Severe plastic deformation
Authors: Farshidi MH , Kazeminezhad M
Published: January 2015

The effects of die geometry on the deformation behavior of aluminum 6061 alloy tube in a novel severe plastic deformation (SPD) process called tube channel pressing (TCP) were studied using the Abaqus 6.10 software. Using the optimized die geometry, 1 to 3 passes of TCP is imposed not only to validate the simulation results, but also to investigate the performance of TCP as a SPD process. The finite element method (FEM) simulation results show that the moderated plastic strain, the lower inhomogeneity in distribution of plastic strain, and the lower risk of fracture during process can be obtained using the proper die geometry. In addition, the imposed strain is a mixture of shear strain and hoop strain accompanying with little bending strain which makes it relatively different from conventional SPD processes. Experiments shows that the experimentally obtained load–displacement curve of TCP is very close to its FEM predicted counterpart which validates the FEM simulation results. Additionally, after imposing of 3 passes of TCP to 6061 alloy, the grain size of the tube is decreased from a few tens of microns to less than 1 µm while the yield strength is increased from 110 MPa to 325 MPa which show the capability of TCP as a SPD process for tubes.
Working together for a meaningful daily life for older persons: A participatory and appreciative action and reflection project—The lessons we learned
Authors: James Inger , Blomberg Karin , Liljekvist Elisabeth , Kihlgren Annica
Published: January 2015

This interdisciplinary action research project has its background in the Swedish government’s introduction of national guidelines to address deficiencies in elderly care, wherein it gave each municipality the responsibility to formulate its own guidelines. The main purpose is how we successfully involved stakeholders to create and agree on core values and local guarantees of dignity with regard to elderly care. This paper focuses on the choices we made that led to the politicians adopting the guidelines, and we discuss the lessons learned. This project is based on a participatory and appreciative action and reflection approach. We worked with stakeholders, including managers, politicians, older persons, relatives, nurse assistants, nurses, occupational therapists, and organizations for retired persons (n ∼ 386) in elderly care in three phases from 2010 to 2013. Firstly, we cocreated practical knowledge via interviews, focus group discussions, and participated in nurse assistants’ work. Secondly, we trained managers who formulated preliminary core values and guarantees of dignity. Thirdly, we returned to the stakeholders for a critical review. We learned it is possible to manage a project and involve stakeholders in an action research project by having access to scheduled meetings, providing training to managers, and using appreciative intelligence and technical aids.
Cancer patients’ acceptability of incorporating an epidemiology questionnaire within a clinical trial
Authors: Cuffe Sinead , Hon Henrique , Tobros Kimberly , Espin-Garcia Osvaldo , Brhane Yonathan , Harland Luke , Fadhel Ehab , Eng Lawson , LaDelfa Anthony , Waldron John , Siu Lillian L , Chen Bingshu E , Xu Wei , Simmons Christine , Kassam Zahra , Montenegro Alexander , Parulekar Wendy R , Liu Geoffrey
Published: January 2015

Background/aims

Understanding the influence or impact of epidemiological factors on cancer outcomes in clinical trials can broaden our knowledge of disease, trial populations and therapeutic effects thus leading to improved patient care. However, there is a lack of data on cancer patients’ compliance with an epidemiology questionnaire in the context of a clinical trial.

Patients and methods

Cancer patients were provided with a hypothetical scenario and surveyed regarding their willingness and preferences to complete an epidemiology questionnaire if incorporated into a cancer therapy trial. Patient compliance with completing a voluntary epidemiology questionnaire and trial coordinators perceptions therein were separately determined in the NCIC Clinical Trials Group HN.6 clinical trial, an ongoing randomized phase III trial comparing two first-line treatment regimens in patients with locoregionally advanced head and neck cancer.

Results

Of 617 cancer patients from community, academic and tertiary cancer centres, the majority were willing to complete an epidemiology questionnaire either unconditionally (45%), or provided it did not inconvenience them (31%); 4% would refuse. Patients preferred shorter questionnaires of 30–50 questions requiring 10–20 min to complete, administered over 1–3 sessions. Patients were less willing, but still compliant, to answer questions relating to sexual history (71%) and annual household income (66%) relative to other questions (>90%). Eighteen percent thought that the questionnaire should be mandatory, with 31% believing that they may benefit personally from such research. In the HN.6 trial, compliance averaged 94.8% per question.

Conclusions

Cancer patients are very willing to complete epidemiology questions in clinical trials.
A snapshot summary of consultant cover and current working practices in Intensive Care Medicine across the United Kingdom
Authors: Evans Lynn , Boyd Owen
Published: January 2015

A challenge lies ahead in ensuring that consultant workforce planning within Intensive Care Medicine meets changing and expanding health care needs at a time of financial constraint. During the development of an enlarging consultant intensivist workforce, it is important to explore existing practices to ensure subsequent contracts provide optimal work intensity and on-call frequency as well as appropriate SPA time for clinical governance and professional development. We conducted a survey across 14 deaneries, 43 ICUs and 398 consultant job plans to compare current working practices and set these against new guidelines and standards. It demonstrated that 93% of consultants work 10 PAs or more, with an average of 5.14 Direct Clinical Care PAs in Intensive Care and an average of 2.14 SPAs. Seven of 43 ICUs had consultant-to-patient ratios greater than 1:8 and 33 ICUs had insufficient resident cover overnight, highlighting challenges with trainee staffing and anticipated service reconfiguration.
Critical care admissions in a cardiothoracic hospital: Mortality in patients aged over 80 years
Authors: Quarterman Clare , Kirmani Bilal H , Al-Rawi Omar
Published: January 2015

Background

Cardiac surgery is increasingly performed on patients aged 80 years and over. Previous studies have shown an associated longer length of hospital stay and higher morbidity and mortality. Our aim was to establish whether an increased mortality was demonstrated in patients aged over 80 undergoing surgery in our centre, and the impact of age upon critical care and hospital stay, and 30-day and 6-month survival.

Methods

Over a 12-month period, 2042 critical care episodes were examined collectively and divided into those undergoing thoracic and cardiac surgery. Propensity matching of 216 patients who underwent cardiac surgery was performed for parameters including Acute Physiology And Chronic Health Evaluation (APACHE) II and Intensive Care National Audit and Research Centre score.

Results

Of the admissions studied, 1784 were of patients under 80 years of age, and 258 over 80. Thirty-day mortality of those aged over 80 was significantly higher (8.9% vs. 3.8%, p < 0.0001), although the number of days of each level of organ support and total duration of critical care stay was not significantly different. Propensity matching of cardiac surgery patients indicated a longer length of hospital stay in those aged over 80, but no significant difference in length of critical care stay or mortality at six months.

Conclusions

As previously demonstrated, we found an increased mortality in the older patient group. Following propensity matching, there was no significant difference in 30-day or 6-month mortality. Older patients must be fitter than their younger peers to compensate for the effects of age on APACHE II score. Even when this is taken into consideration, cardiothoracic operations appear to be safe in patients aged over 80.
Rehabilitation following rotator cuff repair: a systematic review
Authors: Littlewood Chris , Bateman Marcus , Clark David , Selfe James , Watkinson Duncan , Walton Mike , Funk Lennard
Published: January 2015

Background

The aim of this systematic review was to evaluate the effectiveness of rehabilitation programmes following surgical repair of the rotator cuff with emphasis upon length of immobilisation and timing of introduction of load.

Methods

An electronic search of CENTRAL, MEDLINE and PEDro was undertaken to August 2014 and supplemented by hand searching. Randomised controlled trials were included, quality appraised using the PEDro scale and synthesised via meta-analysis or narrative synthesis, based upon levels of evidence, where appropriate.

Results

Twelve studies were included. There is strong evidence that early initiation of rehabilitation does not adversely affect clinical outcome but there is a marginally higher, statistically non-significant, incidence of tendon re-tear (OR 1.3; 95% CI 0.72 to 2.2). There is strong evidence that initiation of functional loading early in the rehabilitation programme does not adversely affect clinical outcome.

Discussion

Concern about early initiation of rehabilitation and introduction of gradual functional load does not appear warranted but this should be considered in a context of potential for Type II error. There is further need to evaluate approaches that foster early initiation of rehabilitation and gradual introduction of functional load as well as considering key outcomes such as return to work.
The Transmission of Historical Racial Violence
Authors: Petersen Nick , Ward Geoff
Published: January 2015

Research finds that historic racial violence helps predict spatial distributions of contemporary outcomes, including homicide. These findings underscore the continued need to historicize modern race relations, yet intervening processes linking past violence with present events remain unclear. This study examines these intermediary mechanisms by reducing the century-long time-lapse common to legacy of racial violence research. We use mid-century measures of violent opposition to the Civil Rights Movement to bridge the historical gap between lynchings and later homicide, thus clarifying the dynamic and contingent nature of the legacy of racial violence. Structural equation models indicate that incidents of anti-civil rights enforcement and contemporary homicides are more likely to occur in areas with pronounced histories of lynching. Civil rights era assaults mediate the relationship between lynchings and contemporary homicide generally, but not White-on-Black homicide, signaling a need for further research documenting events of mid-century racial violence and clarifying these and other sources of historical transmission. Implications for future research and public policy are considered.
A Review on Promising Natural Agents Effective on Hyperlipidemia
Authors: Bahmani Mahmoud , Mirhoseini Mahmoud , Shirzad Hedayatollah , Sedighi Mehrnoosh , Shahinfard Nejmeh , Rafieian-Kopaei Mahmoud
Published: January 2015

Hyperlipidemia is a prevalent disease and a major component of the metabolic syndrome resulting from various factors. This disease increases morbidity and mortality when combined with other prevalent diseases such as diabetes mellitus, hypertension, and cardiovascular diseases. The side effects of the current lipid-lowering drugs have increased the tendency to move toward traditional and alternative treatments. Epidemiological observations indicate that using alternative treatments, consumption of medicinal plants, diet, and consumption of fruits have had satisfactory results on the effects of hyperlipidemia in many societies. It should be noted that in majority of societies, even developed countries, the tendency toward eating lipid-lowering medicinal plants has increased extensively. Using these plants especially when common remedies cannot control the disease is significant. Although consumption of medicinal plants by hyperlipidemic patients may show improvement in disease state, drug interaction and side effects may cause complications in disease control. Therefore, in this review, apart from introducing some of the reliable plants effective in inhibition and decrease of hyperlipidemia, the possibility of their intoxication and drug interaction is also presented.
miR-29a maintains mouse hematopoietic stem cell self-renewal by regulating Dnmt3a
Authors: Hu Wenhuo , Dooley James , Chung Stephen S. , Chandramohan Dhruva , Cimmino Luisa , Mukherjee Siddhartha , Mason Christopher E. , de Strooper Bart , Liston Adrian , Park Christopher Y.
Published: January 2015

Key Points

miR-29a maintains HSC function by targeting Dnmt3a.
Successful treatment of severe sepsis and diarrhea after vagotomy utilizing fecal microbiota transplantation: a case report
Authors: Li Qiurong , Wang Chenyang , Tang Chun , He Qin , Zhao Xiaofan , Li Ning , Li Jieshou
Published: January 2015

Introduction

Dysbiosis of intestinal microbiota likely plays an important role in the development of gut-derived infections, making it a potential therapeutic target against sepsis. However, experience with fecal microbiota transplantation (FMT) in the treatment of sepsis and knowledge of the underlying mechanisms are extremely lacking. In this article, we describe a case of a patient who developed sepsis after a vagotomy and later received an infusion of donor feces microbiota, and we report our findings.

Methods

A 44-year-old woman developed septic shock and severe watery diarrhea 4 days after undergoing a vagotomy. Antibiotics, probiotics and supportive treatment strategies were used for about 30 day after surgery, but the patient’s fever, bacteremia and watery diarrhea persisted. Considering the possibility of intestinal dysbiosis, we evaluated the structure and composition of the patient’s fecal microbiota using 16S rDNA-based molecular techniques. As expected, the gut microbiota was extensively disrupted; therefore, a donor fecal suspension was delivered into the patient by nasoduodenal tube. The patient’s clinical outcomes and shifts of the gut microbiota following the treatment were also determined.

Results

Dramatically, the patient’s septic symptoms and severe diarrhea were successfully controlled following FMT. Her stool output markedly declined after 7 days and normalized 16 days after FMT. A significant modification in her microbiota composition was consistently seen, characterized by a profound enrichment of the commensals in Firmicutes and depletion of opportunistic organisms in Proteobacteria. Furthermore, we identified a reconstituted bacterial community enriched in Firmicutes and depleted of Proteobacteria members that was associated with fecal output, plasma markers of inflammation and T helper cells.

Conclusions

In this report, we describe our initial experience with FMT, in which we successfully used it in the treatment of a patient with sepsis and severe diarrhea after a vagotomy. Our data indicate an association between repaired intestinal microbiota barrier and improvement of clinical outcomes. Our patient’s surprising clinical benefits from FMT demonstrate the role of intestinal microbiota in modulating immune equilibrium. It represents a breakthrough in the clinical management of sepsis and suggests new therapeutic avenues to pursue for microbiota-related indications.
Targeted screening for third-generation cephalosporin-resistant Enterobacteriaceae carriage among patients admitted to intensive care units: a quasi-experimental study
Authors: Dananché Cédric , Bénet Thomas , Allaouchiche Bernard , Hernu Romain , Argaud Laurent , Dauwalder Olivier , Vandenesch François , Vanhems Philippe
Published: January 2015

Introduction

Identification of third-generation, cephalosporin-resistant Enterobacteriaceae (3GC-RE) carriers by rectal screening at admission seems to be an important step in the prevention of transmission and outbreaks; however, little is known about its effectiveness. The aim of this study was to evaluate the impact of ‘targeted screening’ at patient admission to intensive care units (ICUs) on the incidence of 3GC-RE hospital-acquired infections (HAIs) and compare it to ‘universal screening’.

Methods

We undertook a quasi-experimental study of two ICUs (unit A: intervention group; unit B: control group) at a university-affiliated hospital between 1 January 2008 and 31 December 2011. In unit A, patients were screened universally for 3GC-RE at admission during period 1 (1 January 2008 through 30 September 2010). During period 2 (2011 calendar year), the intervention was implemented in unit A; patients transferred from another unit or hospital were screened selectively. In unit B, all patients were screened throughout periods 1 and 2. 3GC-RE-related HAI incidence rates were expressed per 1,000 patient-days. Incidence rate ratios (IRRs) were examined by multivariate Poisson regression modelling.

Results

In unit A, 3GC-RE-related HAI incidence rates decreased from 5.4 (95% confidence interval (CI), 4.1 to 7.0) during period 1 to 1.3 (95% CI, 0.5 to 2.9) during period 2 (P < 0.001). No changes were observed in unit B between periods 1 and 2 (P = 0.5). In unit A, the adjusted incidence of 3GC-RE-related HAIs decreased in period 2 compared with period 1 (adjusted IRR, 0.3; 95% CI, 0.1 to 0.9; P = 0.03) independently of temporal trend, trauma and age. No changes were seen in unit B (P = 0.4). The total number of rectal swabs taken showed an 85% decrease in unit A between period 1 and 2 (P < 0.001).

Conclusions

Targeted screening of 3GC-RE carriers at ICU admission was not associated with an increase in 3GC-RE-related HAI incidence compared with universal screening. Total number of rectal swabs decreased significantly. These findings suggest that targeted screening may be worth assessing as an alternative to universal screening.
A whole-genome shotgun approach for assembling and anchoring the hexaploid bread wheat genome
Authors: Chapman Jarrod A , Mascher Martin , Buluç Aydın , Barry Kerrie , Georganas Evangelos , Session Adam , Strnadova Veronika , Jenkins Jerry , Sehgal Sunish , Oliker Leonid , Schmutz Jeremy , Yelick Katherine A , Scholz Uwe , Waugh Robbie , Poland Jesse A , Muehlbauer Gary J , Stein Nils , Rokhsar Daniel S
Published: January 2015

Polyploid species have long been thought to be recalcitrant to whole-genome assembly. By combining high-throughput sequencing, recent developments in parallel computing, and genetic mapping, we derive, de novo, a sequence assembly representing 9.1 Gbp of the highly repetitive 16 Gbp genome of hexaploid wheat, Triticum aestivum, and assign 7.1 Gb of this assembly to chromosomal locations. The genome representation and accuracy of our assembly is comparable or even exceeds that of a chromosome-by-chromosome shotgun assembly. Our assembly and mapping strategy uses only short read sequencing technology and is applicable to any species where it is possible to construct a mapping population.
Assembling allopolyploid genomes: no longer formidable
Authors: Ming Ray , Man Wai Ching
Published: January 2015

A combined approach of whole genome shotgun sequencing and ultra-high density linkage mapping using skim sequencing of a segregating population is effective for assembling allopolyploid genomes.
Probabilistic constrained multicast beamforming in cognitive relay systems
Authors: Li Shengyu , Xu Wenjun , Lu Xiaomei , Lin Jiaru
Published: January 2015

In this paper, multicast beamforming in cognitive relay systems is investigated with the consideration of imperfect channel state information at the transmitter (CSIT). We focus at the design of the optimal signal forwarding matrix at the cognitive relay in both centralized relay mode (CRM) and distributed relay mode (DRM). The problem is formulated aiming at minimizing the total consumed power at the relay node with suitable QoS guarantee for secondary users and strict interference control for primary users. Due to the uncertainty of transmission channel gains, constraints for QoS guarantee and interference control cannot be expressed in closed forms, making it extremely difficult to solve the problem directly. To circumvent this, we first employ the Bernstein-type inequality to convert the probabilistic constraints into closed-form expressions and then present both the semi-definite relaxation (SDR) algorithm and the penalty function (PenFun) algorithm to accomplish the non-convex problem optimization. Simulation results show that CRM is more resource efficient than DRM, and the PenFun algorithm can achieve a much better solution than the SDR algorithm at the cost of complexity. Meanwhile, compared with existing schemes which do not consider the CSIT error, the proposed schemes can support a much lower outage probability and enjoy perfect interference control for primary users.