bluuebunny/crossref_metadata_2025 huggingface dataset:
Fiber-reinforced hydrogel scaffolds for heart valve tissue engineering
Authors: Eslami Maryam , Vrana Nihal Engin , Zorlutuna Pinar , Sant Shilpa , Jung Sungmi , Masoumi Nafiseh , Khavari-Nejad Ramazan Ali , Javadi Gholamreza , Khademhosseini Ali
Published: April 2014

Heart valve-related disorders are among the major causes of death worldwide. Although prosthetic valves are widely used to treat this pathology, current prosthetic grafts cannot grow with the patient while maintaining normal valve mechanical and hemodynamic properties. Tissue engineering may provide a possible solution to this issue through using biodegradable scaffolds and patients’ own cells. Despite their similarity to heart valve tissue, most hydrogel scaffolds are not mechanically suitable for the dynamic stresses of the heart valve microenvironment. In this study, we integrated electrospun poly(glycerol sebacate) (PGS)–poly(ɛ-caprolactone) (PCL) microfiber scaffolds, which possess enhanced mechanical properties for heart valve engineering, within a hybrid hydrogel made from methacrylated hyaluronic acid and methacrylated gelatin. Sheep mitral valvular interstitial cells were encapsulated in the hydrogel and evaluated in hydrogel-only, PGS–PCL scaffold-only, and composite scaffold conditions. Although the cellular viability and metabolic activity were similar among all scaffold types, the presence of the hydrogel improved the three-dimensional distribution of mitral valvular interstitial cells. As seen by similar values in both the Young’s modulus and the ultimate tensile strength between the PGS–PCL scaffolds and the composites, microfibrous scaffolds preserved their mechanical properties in the presence of the hydrogels. Compared to electrospun or hydrogel scaffolds alone, this combined system may provide a more suitable three-dimensional structure for generating scaffolds for heart valve tissue engineering.
What Type of Social Support Influences Self-Reported Physical and Mental Health Among Older Women?
Authors: Wong Sabrina T. , Wu Amery , Gregorich Steven , Pérez-Stable Eliseo J.
Published: April 2014

Objective: We examined which types of social support were associated with older women’s self-report of physical and mental health and whether the effects of social support were moderated by race/ethnicity. Method: Women completed a health behavior survey that included the Medical Outcomes Study–Short Form–12 (MOS SF-12). Single race/ethnic group regressions examined whether different types of social support were related to health. We also examined Pratt’s relative importance measures. Results: Emotional support had the strongest effect on both physical and mental health, explaining the highest amount of variation, except among African Americans. Race/ethnicity moderated the association of informational support for Asian women’s reports of their mental health. Discussion: For clinicians, assessing individuals’ emotional support is important for maintaining or increasing physical and mental health. Clinicians can also assess Asian women’s stress, providing informational support accordingly as too much information could be detrimental to their health. For researchers, the inclusion of emotional support items is the most important.
Religious Attendance and Biological Functioning
Authors: Hill Terrence D. , Rote Sunshine M. , Ellison Christopher G. , Burdette Amy M.
Published: April 2014

Objective: This study explores the role of religious attendance across a wide range of biological markers. Method: The data are drawn from the National Social Life, Health, and Aging Project to assess continuous and categorical biomarker specifications. Results: Across specifications, higher levels of attendance are associated with lower levels of pulse rate and overall allostatic load. Depending on the specification, higher levels of attendance are also associated with lower levels of body mass, diastolic blood pressure, C-reactive protein, and Epstein–Barr virus. Attendance is unrelated to dehydroepiandrosterone, systolic blood pressure, and glycosylated hemoglobin across specifications. Discussion: The study confirms that religious attendance is associated with healthier biological functioning in later life. Additional research is needed to verify these patterns with other data sources and to test viable mediators of the association between religious attendance and biological risk.
Single-point incremental forming of 6061-T6 using electrically assisted forming methods
Authors: Adams David , Jeswiet Jack
Published: April 2014

In this article, large direct current is applied through the tool to improve formability while forming 6061-T6 Al using single-point incremental forming. Special attention is paid to the direct effect of current density, as opposed to bulk resistive heating, to determine whether the electroplastic effect is significant in raising the formability without requiring temperature rise. Tests are performed to determine the maximum wall angle that can be formed for a variety of current and tool settings. The area of contact between the tool and sheet is modeled, and a control system is proposed and tested to vary the current to maintain a constant current density during tests. The phenomenon of current threshold density is observed at a current density range agreeing with previous studies forming the same material in different loading cases. A significant formability increase is observed at a range of current density values that agree with previously published work with this material in different loading cases. Surface roughness and spalling are also shown to be directly affected by current.
PolyJet technology for product prototyping: Tensile strength and surface roughness properties
Authors: Cazón Aitor , Morer Paz , Matey Luis
Published: April 2014

Design and manufacturing engineers are not fully aware of the different possibilities that PolyJet™ technology offers. The goal of this article is to provide the design and manufacturing engineers with greater knowledge about the final properties of parts printed with PolyJet rapid prototyping technology. This knowledge includes the effect of printing orientation and post-processing on the mechanical and surface properties of printed parts. Eighteen different samples considered all the possible printing orientations and the surface finishing treatments recommended by the manufacturer. These finishing properties include part printing using the matte/glossy option and removal of the support material using water pressure and/or a caustic soda bath. Tensile tests and surface roughness measurements were analysed for the printed samples using the statistical design of experiments in order to determinate the influence of the printing orientation and finishing properties on the results. These tests showed that the part orientation has a significant effect on elastic modulus and fracture stress while there is no statistical significance on ultimate tensile strength. With regard to the finish, none of the tensile test outputs showed significant differences. In terms of roughness, the analysis of variance indicated that position and finish presented statistically significant differences between the means of the three roughness directions. From all these experiences, it is possible to conclude that the glossy finish and the xy printing direction worked very well regarding roughness, whereas the critical load direction of the part should be placed along the x-axis when printing.
A simulation-based approach to the determination of forming limit diagrams
Authors: Hashemi Ramin , Mamusi Hossein , Masoumi Abolfazl
Published: April 2014

This article presents the results of simulated hemispherical die stretching of low-carbon steel (ST12 and ST14) blanks of various thicknesses. The simulations were designed to obtain forming limit diagrams. Multiple criteria, including the second time derivatives of major strain, thickness strain and equivalent plastic strain extracted from the strain history of simulations, were used to accurately detect the start of necking in forming limit diagrams. This is to say that necking starts when the second derivative of the thickness strain, major strain or plastic strain reaches its maximum value. Knowing the onset of necking, one can measure the major and minor strains at the critical area and produce the corresponding forming limit diagram. Moreover, a modified Marciniak and Kuczynski method was used to predict the forming limit diagrams. The results from the proposed methods and those from experimental tests are compared to demonstrate the efficiency of the proposed methods.
Multi-disciplinary design optimisation of mechanical parts with freeform surfaces: Case study encompassing manufacturing criteria
Authors: Vosniakos George-Christopher , Benardos Panorios , Lipari Virginia
Published: April 2014

Designing parts with freeform surfaces, as typically applied in dies and moulds, is currently dealt with through designer experience, if design intent is to be maintained and if, at the same time, the manufacturing process is to be facilitated. This work puts forward a solution to these issues which is based on computational intelligence. A library of freeform surface morphological features is defined using parametric wireframe models that include constraints. The part is constructed using wireframe features from this library and these are subsequently converted to solid models. The effect of changes of feature parameter values is linked to part functional characteristics in standard design environment. Regarding the effect on manufacturing process characteristics, various models may be employed. As an example, a fuzzy system that decides tool diameter and the necessity of a semi-finishing operation is employed in this work. Artificial neural networks are trained with a number of workpiece variations corresponding to different feature parameter values and the pertinent outputs from functional and manufacturing assessment. Next, a standard genetic algorithm is set up to find the best values of the feature parameters based on both functionality and manufacturing criteria with suitable weighing. The evaluation function of the genetic algorithm employs the artificial neural networks constructed as metamodels. The methodology is demonstrated through an illustrative case study, but may encompass further Design-for-X disciplines.
Numerical study of thermal control system for rapid heat cycle injection molding process
Authors: Hammami Moez , Kria Fatma , Baccar Mounir
Published: April 2014

This paper studies heat transfer during rapid heat cycle injection molding process. Actually, the mold is heated and cooled with channels in which steam or water circulates. The purpose of this numerical study is to improve the design of heating/cooling system to ameliorate the quality of the polymer part and the cycle productivity. Transfers in mold, translating thermal phenomena are predicted by the finite volume method and the fractional area volume obstacle representation in cyclic transient regime. It was found that the steady cycle is obtained rapidly (after two or three cycles) for the rapid heat cycle molding process when compared to conventional injection molding. The mathematical modeling was developed to explore the effect of control temperature system characteristics on temperature uniformity of the cavity surface and thermal response efficiency. The three-dimensional simulation results show the limitations of the conventional system when compared to the conformal configuration. This research study also compares three conformal thermal control systems, and shows that the heating energy consumption can be greatly decreased (about 27%) with the amelioration of the temperature distribution by means of the improvement of the channel layout.
Prevalence and risk factors associated with HIV infection, hepatitis and syphilis in a state prison of São Paulo
Authors: El Maerrawi Ilham , Carvalho Heráclito Barbosa
Published: April 2014

Summary

Given the importance of the control of sexually transmitted infections in the general population and specifically in the prison system, we rolled out this cross-sectional study in 2007. Standard questionnaires and blood samples were accessed among 680 prisoners. The protocol was approved by the Ethics Committee. We determined the following seroprevalences: HIV, 1.8% (95%CI = 0.1–3.3); HBV, 21.0% (95%CI = 17.8–25.1); HBV, 5.3% (95%CI = 3.5–7.6) and syphilis 5.3% (95%CI = 3.5–7.6). Logistic regression identified significant associations with ( p < 0.05): HIV: injectable drug use (OR = 15.4), age over 30 years (OR = 13.3), cocaine use (OR = 5.4) and crack-cocaine use (OR = 5.2); HBV: injectable drug use (OR = 3.4), history of previous sexually transmitted infection (OR = 2.3), age over 30 years (OR = 1.9) and more than 5 years in prison (OR = 2.2); HCV: injectable drug use (OR = 9.65), marijuana use in prison (OR = 2.9) and age over 30 years (OR = 8.4) and for syphilis: homosexual relationship (OR = 7.8) and previous syphilis reported (OR = 7.7). These prevalences remain high when compared to the general population, however, HIV infection had decreased compared with previous studies in prisoners while the other studied infections remained unchanged. Preventive actions to reduce sexual and parenteral risk have been advocated. However, measures capable of controlling these infections still have not made an impact.
Sleep disorders in systemic lupus erythematosus. Does vitamin D play a role?
Authors: Gholamrezaei A , Bonakdar Z Sayed , Mirbagher L , Hosseini N
Published: April 2014

Objectives

Sleep disorders are common among patients with systemic lupus erythematosus (SLE) with unclear underlying mechanisms. We assessed the role of vitamin D in sleep quality of patients with SLE.

Methods

A retrospective study was conducted on women with SLE for whom the following data were available at the same time; sleep quality (Pittsburgh Sleep Quality Index (PSQI)), disease activity, cumulative disease damage, psychological state (Hospital Anxiety and Depression Scale (HADS)), and serum vitamin D level. Bivariate and regression analyses were computed to find contributors of sleep quality.

Results

In total, 63 women were studied. Serum vitamin D level was correlated with physical activity ( r = 0.310, p = 0.015), season of assessment ( r = −0.302, p = 0.016), the PSQI global score ( r = −0.262, p = 0.043), anxiety score ( r = −0.298, p = 0.021), and non-significantly with depression score ( r = −0.218, p = 0.094). Including all variables into a linear regression model, vitamin D level was independently associated with the global PSQI score (beta = −0.364, p = 0.042). Association of vitamin D level with psychological state disappeared after controlling for season of assessment (beta = −0.248, p = 0.154).

Conclusions

We found a role for vitamin D in sleep quality of SLE patients. Further studies are warranted to confirm these results and to find possible mechanisms of action.
Book Review: Benny Teh Cheng Guan, ed., Human Security: Securing East Asia’s Future
Authors: Banerjee Somdatta
Published: April 2014

Benny Teh Cheng Guan, ed., Human Security: Securing East Asia’s Future. London: Springer, 2012, pp. 268, Rs 7993/ US $149.
Book Review: Anuradha Bose (Das), ed., SAARC A Quest for Unity: Problems and Prospects
Authors: Roychoudhury Sreya Maitra
Published: April 2014

Anuradha Bose (Das), ed., SAARC A Quest for Unity: Problems and Prospects. Kolkata: Minerva Associates (Publications), 2011, In Association with Nabagram Hiralal Paul College, Political Science Department, Hoogly, pp. 112. Rs 175/$ 6.00.
Regeneration of Common Pool Resources
Authors: Das Abhishek , Mitra Santanu , Mondal Sujit Kumar , Gupta Gautam
Published: April 2014

In this article we present the results of a hybrid experimental game which was constructed by combining the Voluntary Contribution Mechanism of the Public Goods Game with the Trust Game. The new model was used to capture regeneration of Common Pool Resources (CPRs) by community members through voluntary actions, without any binding contract or monitoring. The experiment was conducted with rural subjects from Sagar and Bali Islands of the Indian Sundarbans. The results show that in contradiction to the theoretical predictions, there was high degree of voluntary contribution towards generation of common group funds (representing the CPR) and moderately high return (representing refraining from over-exploitation of the CPR) in the trust game.
The Illness Experiences of Women with Overactive Bladder in Hong Kong
Authors: Siu Judy Yuen-man
Published: April 2014

Overactive bladder (OAB) is a common chronic bladder dysfunction worldwide. However, the illness experiences of women with OAB in Asian countries have not been well documented. In this article, I investigate the illness experiences of women with OAB in Hong Kong. I adopted a qualitative study design by conducting 30 in-depth, semistructured interviews with women who were diagnosed as having OAB and were aged between 28 and 55 years. Negative illness experiences were noted among the participants, including embarrassment, shame, frustration, helplessness, resignation, uselessness, and self-seclusion. These negative experiences were not only the result of the physical symptoms and limitations brought on by the bladder condition, but were also caused by social difficulties such as the flippant attitudes of primary care providers, the tortuous journey of seeking and receiving treatment, and a lack of understanding from social members such as family members and colleagues in the workplace.
Anti-politics in Action? Measurement Dilemmas in the Study of Unconventional Political Participation
Authors: Saunders Clare
Published: April 2014

There are good reasons to test more refined measures of protest to better understand protesters’ disaffection with and disconnection from politics. This article assesses whether disaffection and disconnection predict each of: protest participation (aggregated), participation in demonstrations, and differential participation in demonstrations. Failure to vote does not predict participation in demonstrations but positively predicts participation in “protest” (aggregated). Those who demonstrate more frequently are more likely to participate in electoral politics than less frequent demonstrators. Most protesters are at least moderately engaged with formal politics, despite lacking trust in political institutions. Protest is not, therefore, a straightforward expression of anti-politics.
Parent Perspectives on Outcomes and Satisfaction Levels of Young Adults With Autism and Cognitive Impairments
Authors: Müller Eve , Cannon Lynn
Published: April 2014

This study complements current research on quality of life for individuals with autism and cognitive impairments, by focusing less on objective measures (e.g., employment status, educational attainment, living arrangements) and more on subjective measures such as satisfaction levels. Twenty-three structured interviews were conducted with parents, and qualitative analysis of emergent themes is provided. In spite of limited independence on the part of young adults with autism spectrum disorders and cognitive impairments in terms of both home and community life, satisfaction levels were high across all domains and most parents ranked their children’s overall quality of life as “excellent” or “good.”
The influence of carbon content on the microtribological performance of W-S-C films
Authors: Tomastik Christian , Tomala Agnieszka , Pauschitz Andreas , Roy Manish
Published: April 2014

The layered structure of transition metal dichalcogenides makes them promising materials for self-lubricating films. Transition metal dichalcogenide films can be considered as substitute for carbon-based self-lubricating films in several varieties of environmental conditions. The tribological properties of these films at high load have been studied extensively. However, the tribological behaviour of these films in the milli-Newton load range relevant for micro-electro-mechanical systems has hardly been reported. In the present work, the microtribological response of W-S-C coatings deposited by reactive sputtering is investigated. For that purpose, W-S-C coatings with various concentrations of carbon were deposited on steel substrates using magnetron sputtering. The friction and wear of these coatings are determined as function of applied load and carbon content. The results show that, even though the wear of these films increases with applied load and decreases with carbon content, the friction coefficient is minimum for the films containing the highest amount of carbon at low and intermediate load. It is maximum for the films containing minimum carbon at the highest load. There is no evidence for a transfer layer on the worn surfaces.
Beta2-adrenergic agonist use and the risk of multiple sclerosis: a total population-based case-control study
Authors: Tsai Ching-Piao , Lin Feng-Cheng , Lee Charles Tzu-Chi
Published: April 2014

Objective:

The aim of this study was to investigate whether the use of fenoterol, a beta2-adrenergic agonist, was associated with multiple sclerosis (MS) risk by conducting a total population-based case-control study in Taiwan.

Methods:

A total of 578 patients with newly diagnosed MS who had a severely disabling disease (SDD) certificate between January 1, 2002 and December 1, 2008 comprised the case group. These cases were compared with 2890 gender-, age-, residence-, and insurance premium-matched controls. Fenoterol use was analyzed using a conditional logistic regression model that controlled for asthma, chronic obstructive pulmonary disease (COPD), salbutamol and steroid use.

Results:

Compared with the group of people who did not use fenoterol, the adjusted odds ratios were 0.67 (95% confidence interval (CI) = 0.48–0.93, p = 0.016) for the group prescribed fenoterol below 2.25 cumulative defined daily dose (cDDD) and 0.49 (95% CI = 0.33–0.71, p < 0.001) for the group with a cumulative fenoterol use of more than 2.25 cDDD. The dose-response relationship was similar within the non-asthma patients. The associations were similar between males and females, but differences between age groups were observed.

Conclusions:

The results of this study suggest that fenoterol use may reduce the risk of MS.
How male young adults construe their playing style in violent video games
Authors: Ribbens Wannes , Malliet Steven
Published: April 2014

This study explores the various ways in which male young adults engage with violence in video games. Based on an ethnographic study ( N = 26) with triangulation of diary reports, focus group interviews and a video commentary model, three conceptual axes are distinguished along which players differ in their enactment of video game violence: narration versus action, discovery versus mission-based play and reaction versus strategic play. The results suggest that individual playing styles result in exposure to different quantities and a different quality of virtual violence.
The Coin Will Continue to Fly
Authors: Moreira Claudio , Diversi Marcelo
Published: April 2014

In this performance-theoretical text, we attempt to advance collaborative writing as decolonizing inquiry. Western inquiry has been dominated by the solitary writing of lone rangers of expertise, who are granted disproportionate narrative space to discourse about the Other. We think this exclusionary way of knowing keeps historically marginalized peoples from occupying Western academia as knowledge makers. Building on our collaborative writing experiences, Paulo Freire’s dialogical philosophy, and Della Pollock’s performative writing, we discuss how our collaborations with students and ethnographic partners have allowed us to break away from the expert isolationist writing standpoint and expand our own imaginations of and possibilities for inquiry—one that is more concerned with advancing collaborative ways of knowing and representation than with individual expertise and recognition, with advancing a more serious invitation for those with visceral experience of oppression to collaborate with the learned and cultured in the creation of knowledge that heals.
Impact of the Establishment of a Specialty Hernia Referral Center
Authors: Williams Kristopher B. , Belyansky Igor , Dacey Kristian T. , Yurko Yuliya , Augenstein Vedra A. , Lincourt Amy E. , Horton James , Kercher Kent W. , Heniford B. Todd
Published: April 2014

Background. Creating a surgical specialty referral center requires a strong interest, expertise, and a market demand in that particular field, as well as some form of promotion. In 2004, we established a tertiary hernia referral center. Our goal in this study was to examine its impact on institutional volume and economics. Materials and methods. The database of all hernia repairs (2004-2011) was reviewed comparing hernia repair type and volume and center financial performance. The ventral hernia repair (VHR) patient subset was further analyzed with particular attention paid to previous repairs, comorbidities, referral patterns, and the concomitant involvement of plastic surgery. Results. From 2004 to 2011, 4927 hernia repairs were performed: 39.3% inguinal, 35.5% ventral or incisional, 16.2% umbilical, 5.8% diaphragmatic, 1.6% femoral, and 1.5% other. Annual billing increased yearly from 7% to 85% and averaged 37% per year. Comparing 2004 with 2011, procedural volume increased 234%, and billing increased 713%. During that period, there was a 2.5-fold increase in open VHRs, and plastic surgeon involvement increased almost 8-fold, ( P = .004). In 2005, 51 VHR patients had a previous repair, 27.0% with mesh, versus 114 previous VHR in 2011, 58.3% with mesh ( P < .0001). For VHR, in-state referrals from 2004 to 2011 increased 340% while out-of-state referrals jumped 580%. In 2011, 21% of all patients had more than 4 comorbidities, significantly increased from 2004 ( P = .02). Conclusion. The establishment of a tertiary, regional referral center for hernia repair has led to a substantial increase in surgical volume, complexity, referral geography, and financial benefit to the institution.
Clinical predictors for diabetes screening in the first year postpartum after gestational diabetes
Authors: Peticca Patricia , Shah Baiju R , Shea Alison , Clark Heather D , Malcolm Janine C , Walker Mark , Karovitch Alan , Brazeau-Gravelle Pauline , Keely Erin J
Published: April 2014

Background:

Postpartum screening for diabetes in women with gestational diabetes (GDM) improves with use of reminder systems. Our primary objective was to identify predictors of diabetes screening in the first year after delivery.

Methods:

A retrospective study was performed of 556 women with GDM who received outpatient prenatal care between 2007 and 2009. A mailed reminder system was utilized at two sites. Rates of postpartum glucose testing at 6 and 12 months postpartum were measured.

Results:

Site of care and non-smoking status were identified as the only predictors of postpartum diabetes screening ( p<0.001 and p = 0.02, respectively). Rates of OGTT completion at one year (38% vs. 19% p<0.001) were higher in women who attended clinics with postpartum reminders.

Conclusions:

The site of diabetes care in pregnancy is a major predictor of adherence to diabetes screening postpartum. Health care delivery should be considered in the development of strategies to increase screening rates.
Vieillir en santé en situation minoritaire linguistique au Canada : enjeux, défis et mobilisation collective
Authors: Dupuis-Blanchard Suzanne , Villalon Lita , Alimezelli Hubert Tote
Published: April 2014

Au Canada, la santé des francophones et des anglophones vivant en milieu linguistique minoritaire est un sujet d’intérêt pour plusieurs chercheurs et organismes communautaires. Cet article s’inspire d’un symposium sur le thème concernant le vieillissement en santé en situation minoritaire linguistique présentée lors du 4e Colloque international des programmes locaux et régionaux de santé. Trois volets sont présentés, soit l’identification des facteurs associés à la santé perçue, le maintien à domicile et le dépistage de la malnutrition. Les résultats décrivent 1) les déterminants de la santé perçue tels que les services de santé, la vitalité de la communauté minoritaire et l’éducation ; 2) le peu de changements aux services de maintien à domicile en dépit du vieillissement de la population ; et 3) la haute prévalence de la malnutrition chez les aînés au Nouveau-Brunswick. Enfin, nous suggérons l’élaboration et l’implantation d’une politique publique du vieillissement au Canada afin d’assurer des services de qualité tout au long du continuum santé.
Les systèmes d’information sociosanitaire à l’appui de la planification locale de la santé: défis et enjeux
Authors: Bouchard Louise , Berthelot Jean-Marie , Casteigts Arnaud , Chartier Mariette , Trugeon Alain , Warnke Jan
Published: April 2014

L’information sanitaire est indispensable pour le suivi des progrès accomplis dans l’amélioration et le maintien de la santé des populations et le fonctionnement du système de santé. Dans le contexte des réformes de santé, visant à rapprocher les systèmes de santé au plus près des populations et dans le but de planifier de façon cohérente les services à l’échelle des communautés, la question de l’accès à des données sociosanitaires fiables constitue un enjeu majeur. Le besoin de développement d’outils de traitement spécifique et l’appropriation des résultats par la diversité des acteurs concernés (décideurs, planificateurs, chercheurs et consommateurs) forment la trame des interventions et des échanges du symposium.
Les démarches locales en santé : des ateliers santé ville aux contrats locaux de santé
Authors: Molas Gali Nathalie
Published: April 2014

Après 10 ans de partenariat avec les principales communes du département pour développer les ateliers santé ville, la Délégation Territoriale des Bouches du Rhône de l’Agence Régionale de Santé (ARS) de la région Provence-Alpes Côte d’Azur aborde le dispositif des contrats locaux de santé (CLS). Cela dans le but de passer d’une démarche de programmation et de planification locale en santé, à une démarche transversale à l’ensemble des champs de la santé. La prévalence de la démarche des ateliers santé ville a permis, en 10 années de collaboration avec les communes, d’instaurer des habitudes de partenariat au service d’une démarche conjointe, ainsi qu’une bonne connaissance de champ de la prévention. Le passage à une démarche plus transversale à l’ensemble des champs de la santé sera facilitée par cette riche expérience commune. Les CLS sont à la fois un défi pour l’ARS et un objet de concrétisation du concept nouveau d’animation territoriale.
La co-construction des changements dans l’offre de sante communautaire au Sénégal
Authors: Fall Abdou S. , Cissé Rokhaya
Published: April 2014

L’expérience de collaboration entre chercheurs et le ministère de la santé favorise les usages sociaux des résultats de la recherche sur la santé des communautés. Cette contribution expose l’apport de la recherche partenariale dans la lutte contre les inégalités de santé. À la suite d’un diagnostic partagé avec l’ensemble des acteurs (praticiens et usagers) permettant d’identifier les raisons de la sous fréquentation des structures de santé équipées et rénovées, trois innovations ont été introduites : (a) chirurgie de district, (b) mutuelles de santé et (c) tarification forfaitaire. Dans les quatre régions du centre du Sénégal où cette expérience a été initiée, la recherche effectuée a permis de comprendre les processus et les épreuves permettant une « co-construction » de savoirs entre praticiens et chercheurs, dans un contexte d’accès aux soins relativement faible. Cet article met en relief l’importance de cette co-construction favorisant les engagements concertés pour des changements pertinents en faveur d’une meilleure offre de proximité, plus équitable et davantage accessible aux communautés.
Soutenir les communautés locales dans leurs actions envers les enfants vivant en situation de pauvreté
Authors: Brunet Lyse
Published: April 2014

Avenir d’enfants est né d’un partenariat entre le Gouvernement du Québec et la Fondation Lucie et André Chagnon. L’organisation vise à mettre des ressources à la disposition des communautés locales afin de soutenir la synergie entre les principales organisations qui agissent en petite enfance : les services de garde, les services de santé, les écoles, les organismes communautaires famille et les municipalités. L’article expose le contexte qui a fait naître Avenir d’enfants, explique comment l’organisation contribue à réunir les conditions pour que l’action locale et régionale ait un impact sur le développement global des enfants qui vivent en situation de pauvreté et présente les défis et les conditions de succès de cette approche.
L’évaluation d’impact sur la santé (EIS) : une démarche intersectorielle pour l’action sur les déterminants sociaux, économiques et environnementaux de la santé
Authors: Saint-Pierre Louise , Lamarre Marie-Claude , Simos Jean
Published: April 2014

L’évaluation d’impact sur la santé (EIS) est un courant de pratique qui connaît une popularité croissante partout dans le monde depuis la fin des années 1990. D’abord utilisée dans le cadre des évaluations d’impact environnemental (EIE), elle s’est enrichie des connaissances et des principes portés par le courant des déterminants sociaux de la santé et par celui de l’action sur les inégalités sociales de santé pour être transposée dans le contexte de l’élaboration de politiques publiques et ce, à tous les échelons de prise de décision gouvernementale. Dans les faits, l’EIS poursuit trois objectifs concomitants : estimer les effets potentiels d’un projet de politique sur la santé, favoriser la participation citoyenne et de parties prenantes au processus d’analyse d’impact et informer le processus de décision. L’article définit brièvement ce qu’est l’EIS, sa démarche standardisée en étapes successives, ce qui permet de structurer l’action et d’établir clairement les pas à franchir : dépistage, cadrage, analyse, recommandations, évaluation et contrôle ; et propose trois exemples d’EIS dans trois situations différentes : dans le Canton de Genève en Suisse, à Rennes en France, et en Montérégie au Québec, au Canada. La synthèse de ces illustrations montre que l’EIS est une stratégie intéressante pour influencer les décisions locales et intégrer de la santé dans les projets et politiques du palier local ou régional.
Castration-resistant prostate cancer: latest evidence and therapeutic implications
Authors: Suzman Daniel L. , Antonarakis Emmanuel S.
Published: April 2014

Medical oncologists who treat men with castration-resistant prostate cancer (CRPC) have seen an abundance of new agents approved by the United States Food and Drug Administration in the last decade for a disease that was previously difficult to treat after becoming resistant to androgen-deprivation therapy. Advances in understanding of the mechanisms of castration-resistance and prostate cancer progression have highlighted several pathways and targets that appear promising to better treat CRPC. As the majority of CRPC appears to continue to rely on the androgen receptor for growth and progression, several of these agents directly or indirectly target the androgen receptor. A novel microtubule-targeted agent, cabazitaxel, has demonstrated an overall survival benefit following progression on docetaxel. Other agents target tumor immunogenicity and immune checkpoint pathways to attempt to harness the host immune system. The recently approved radiopharmaceutical, radium-223 dichloride, has demonstrated impressive results in patients with extensive bony metastases with minimal toxicity. Lastly, further understanding of the pathways underlying CRPC progression has led to late-phase clinical trials with the novel agents: custirsen, tasquinimod and cabozantinib. This article reviews the approved therapies for CRPC, the agents currently in late-phase clinical trials, and notable early-phase trials of novel therapies and their combinations, with particular attention to trials incorporating novel biomarkers and intermediate endpoints to better identify those men who may or may not benefit from specific therapies.
Chondral Injury in Patellofemoral Instability
Authors: Lording Timothy , Lustig Sébastien , Servien Elvire , Neyret Philippe
Published: April 2014

Objective:

Patellofemoral instability is common and affects a predominantly young age group. Chondral injury occurs in up to 95%, and includes osteochondral fractures and loose bodies acutely and secondary degenerative changes in recurrent cases. Biomechanical abnormalities, such as trochlear dysplasia, patella alta, and increased tibial tuberosity-trochlear groove distance, predispose to both recurrent dislocations and patellofemoral arthrosis.

Design:

In this article, we review the mechanisms of chondral injury in patellofemoral instability, diagnostic modalities, the distribution of lesions seen in acute and episodic dislocation, and treatments for articular cartilage lesions of the patellofemoral joint.

Results:

Little specific evidence exists for cartilage treatments in patellofemoral instability. In general, the results of reparative and restorative procedures in the patellofemoral joint are inferior to those observed in other compartments of the knee.

Conclusion:

Given the increased severity of chondral lesions and progression to osteoarthritis seen with recurrent dislocations, careful consideration should be given to early stabilisation in patients with predisposing factors.
A retrospective cohort study of patients diagnosed with bladder cancer referred with visible haematuria: the impact of source of referral on prognostic indicators
Authors: Marzouk Sherief , Lamb Benjamin W , Harris Andrew , Mecci Ali Jibran , Gan Jo Han , Allchorne Paula , Green James SA
Published: April 2014

Objective:

Our aim was to establish whether there is a difference in prognostic indicators for bladder urothelial carcinoma (UC) between the patients referred via the 2-week wait (2WW) and those presenting to the emergency department (ED).

Patients and methods:

We performed a retrospective cohort study of all patients referred with visible haematuria, comparing tumour stage and grade between patients diagnosed with bladder UC via the ED and 2WW at two London hospitals.

Results:

From 09/2009−09/2011, 51 patients referred from the ED, and 146 from the 2WW clinic were diagnosed with bladder UC. Regarding tumour stage: 57% of the ED group had muscle-invasive UC compared with 23% from 2WW ( p=0.001). Regarding tumour grade: 82% of the ED group had G3 tumours, versus 54% from 2WW ( p<0.001). ED referrals were significantly older than those from the 2WW ( p<0.001).

Conclusions:

Patients with UC who present as emergencies had worse prognostic indicators and were older than those referred from the 2WW pathway. This supports the need for the inclusion of haematuria in the out-of-hours urology guidelines within the Acute Oncology Service.
Frontline low-dose alemtuzumab with fludarabine and cyclophosphamide prolongs progression-free survival in high-risk CLL
Authors: Geisler Christian H. , van t’ Veer Mars B. , Jurlander Jesper , Walewski Jan , Tjønnfjord Geir , Itälä Remes Maija , Kimby Eva , Kozak Tomas , Polliack Aaron , Wu Ka Lung , Wittebol Shulamiet , Abrahamse-Testroote Martine C. J. , Doorduijn Jeanette , Ghidey Alemayehu Wendimagegn , van Oers Marinus H. J.
Published: April 2014

Key Points

Frontline FCA increases progression-free survival in CLL and, in a post hoc analysis, also survival in younger patients. With the low-dose approach, no increase in treatment related mortality is seen.
Factors associated with functional incapacity in elders living in long stay institutions in Brazil: a cross-sectional study
Authors: Mattos Inês Echenique , do Carmo Cleber Nascimento , Santiago Lívia Maria , Luz Laércio Lima
Published: April 2014

Background

The increase of the elderly population and the high prevalence of chronic diseases have contributed to the increasing importance of functional ability as a global public health problem. This study aimed to assess functional capacity in institutionalized elders, as well as undertake an exploratory analysis of its associated factors.

Methods

This is a cross-sectional study with institutionalized Brazilian elders. Functional capacity was assessed using the Katz Index for Activities of Daily Living (ADL) and the Lawton Scale for Instrumental Activities of Daily Living (IADL). The characteristics of dependent individuals were described and logistic regression models were developed for both scales. Multiple models that included all selected variables were developed using a hierarchical approach. We considered the results from the Wald test (p < 0.05) as a rule for progressing to the next level.

Results

A population of 760 elders was considered. The prevalence of dependence was 50.3% for ADL and 81.2% for IADL. We observed associations between ADL dependence and the following factors: self-report of stroke, difficulty of walking 400 meters, lower total scores in questions related to the temporal orientation section of the cognition test, and self-reports of frequently feeling upset. IADL dependence was associated with educational level, self-report of cancer, difficulty of walking 400 meters, use of glasses, and self-reported memory problems.

Conclusions

Sociodemographic and health conditions were associated with functional incapacity in institutionalized elders. Based on these findings, we emphasize the importance of both prevention and treatment of chronic conditions as well as social support in the maintenance of individuals’ autonomy.
Allergic sensitization: host‐immune factors
Authors: van Ree Ronald , Hummelshøj Lone , Plantinga Maud , Poulsen Lars K , Swindle Emily
Published: April 2014

Allergic sensitization is the outcome of a complex interplay between the allergen and the host in a given environmental context. The first barrier encountered by an allergen on its way to sensitization is the mucosal epithelial layer. Allergic inflammatory diseases are accompanied by increased permeability of the epithelium, which is more susceptible to environmental triggers. Allergens and co‐factors from the environment interact with innate immune receptors, such as Toll‐like and protease‐activated receptors on epithelial cells, stimulating them to produce cytokines that drive T‐helper 2‐like adaptive immunity in allergy‐prone individuals. In this milieu, the next cells interacting with allergens are the dendritic cells lying just underneath the epithelium: plasmacytoid DCs, two types of conventional DCs (CD11b + and CD11b‐), and monocyte‐derived DCs. It is now becoming clear that CD11b+, cDCs, and moDCs are the inflammatory DCs that instruct naïve T cells to become Th2 cells. The simple paradigm of non‐overlapping stable Th1 and Th2 subsets of T‐helper cells is now rapidly being replaced by that of a more complex spectrum of different Th cells that together drive or control different aspects of allergic inflammation and display more plasticity in their cytokine profiles. At present, these include Th9, Th17, Th22, and Treg, in addition to Th1 and Th2. The spectrum of co‐stimulatory signals coming from DCs determines which subset‐characteristics will dominate. When IL‐4 and/or IL‐13 play a dominant role, B cells switch to IgE‐production, a process that is more effective at young age. IgE‐producing plasma cells have been shown to be long‐lived, hiding in the bone‐marrow or inflammatory tissues where they cannot easily be targeted by therapeutic intervention. Allergic sensitization is a complex interplay between the allergen in its environmental context and the tendency of the host's innate and adaptive immune cells to be skewed towards allergic inflammation. These data and findings were presented at a 2012 international symposium in Prague organized by the Protein Allergenicity Technical Committee of the International Life Sciences Institute's Health and Environmental Sciences Institute.
Allergic sensitization: screening methods
Authors: Ladics Gregory S , Fry Jeremy , Goodman Richard , Herouet‐Guicheney Corinne , Hoffmann‐Sommergruber Karin , Madsen Charlotte B , Penninks André , Pomés Anna , Roggen Erwin L , Smit Joost , Wal Jean‐Michel
Published: April 2014

Experimental in silico, in vitro, and rodent models for screening and predicting protein sensitizing potential are discussed, including whether there is evidence of new sensitizations and allergies since the introduction of genetically modified crops in 1996, the importance of linear versus conformational epitopes, and protein families that become allergens. Some common challenges for predicting protein sensitization are addressed: (a) exposure routes; (b) frequency and dose of exposure; (c) dose‐response relationships; (d) role of digestion, food processing, and the food matrix; (e) role of infection; (f) role of the gut microbiota; (g) influence of the structure and physicochemical properties of the protein; and (h) the genetic background and physiology of consumers. The consensus view is that sensitization screening models are not yet validated to definitively predict the de novo sensitizing potential of a novel protein. However, they would be extremely useful in the discovery and research phases of understanding the mechanisms of food allergy development, and may prove fruitful to provide information regarding potential allergenicity risk assessment of future products on a case by case basis. These data and findings were presented at a 2012 international symposium in Prague organized by the Protein Allergenicity Technical Committee of the International Life Sciences Institute's Health and Environmental Sciences Institute.
Phylogenetic analysis of newly isolated grass carp reovirus
Authors: Yan Xiu-ying , Wang Ya , Xiong Ling-fang , Jian Ji-chang , Wu Zao-he
Published: April 2014

Grass carp reovirus (GCRV) is a causative agent of haemorrhagic disease in grass carp that drastically affects grass carp aquaculture. Here we report a novel GCRV isolate isolated from sick grass carp that induces obvious cytopathic effect in CIK cells and name it as GCRV096. A large number of GCRV 096 viral particles were found in the infected CIK cells by electron microscope. The shape, size and the arrangement of this virus were similar to those of grass carp reovirus. With the primers designed according to GCRV 873 genome sequences, specific bands were amplified from sick grass carp and the infected CIK cells. The homology rates among vp4, vp6 and vp7 gene in GCRV 096 and those of some GCRV isolates were over 89%. In this study, the sequences of vp4, vp6 and vp7 were used to analyse sequence variation, phylogenetic relationships and genotypes in twenty five GCRV isolates. The results indicated these twenty five GCRV isolates should be attributed to four genotypes. And there were no obvious characteristics in the geographical distribution of GCRV genotype. The study should provide the exact foundation for developing more effective prevention strategies of grass carp haemorrhagic disease.
A Seismic Retrofit Cost Database for Buildings with a Framed Structure
Authors: Jafarzadeh Reza , Ingham Jason M. , Wilkinson Suzanne
Published: April 2014

A comprehensive database for the specific challenge of cost prediction when undertaking seismic retrofitting of existing buildings is presented. A rigorous data collection effort performed in Iran resulted in the generation of a database of 158 data points, each pertaining to a public school building with a framed structure. The generated database includes the information on the seismic retrofit cost values reflected in construction tender documents, together with the information on 14 variables envisaged to have a degree of influence on this cost. This information for a given building was carefully elicited from the final enacted documents developed through the seismic retrofit study of that particular school. Construction costs include structural costs and the costs of architecture and finishes. The database could be of value to those attempting to determine key variables that influence retrofit cost, or to those comparing retrofit practices and costs in different areas of the world.