bluuebunny/crossref_metadata_2025 huggingface dataset:
Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis
Authors: Mitchell Justin J. , Horan Marilee P. , Greenspoon Joshua A. , Menge Travis J. , Tahal Dimitri S. , Millett Peter J.
Published: August 2016

Background:

There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients.

Purpose:

To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively.

Study Design:

Case series; Level of evidence, 4.

Methods:

The CAM procedure was performed on a consecutive series of 46 patients (49 shoulders) with advanced GHOA who met criteria for shoulder arthroplasty but instead opted for a joint-preserving, arthroscopic surgical option. The procedure included glenohumeral chondroplasty, capsular release, synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture, and biceps tenodesis. Outcome measures included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to total shoulder arthroplasty (TSA).

Results:

Forty-six consecutive patients (49 shoulders) who underwent a CAM procedure at a minimum of 5 years from surgery were included. Two patients were excluded for refusing to participate before study initiation. The mean age at surgery was 52 years (range, 27-68 years) in 15 women and 29 men. All patients were recreational athletes with 7 former collegiate or professional athletes. Twelve shoulders (26%) progressed to TSA at a mean of 2.6 years (range, 0.5-8.2 years). For survivorship analysis, the status of the shoulder (preservation of the native joint or progression to TSA) at a minimum of 5 years was known for 45 of 47 (96%) shoulders. Survivorship was 95.6% at 1 year, 86.7% at 3 years, and 76.9% at 5 years. For surviving shoulders, minimum 5-year subjective outcome data were available for 28 of 32 (87.5%) shoulders at a mean of 5.7 years (range, 5-8 years). The mean (±SD) ASES score was 84.5 ± 17, the mean SANE score was 82 ± 18, the mean QuickDASH score was 15 ± 13, the mean SF-12 PCS score was 51.0 ± 9.1, and median patient satisfaction was 9 of a possible 10 points.

Conclusion:

This study demonstrates significant improvements in midterm clinical outcomes and high patient satisfaction after the arthroscopic CAM procedure for GHOA, with a 76.9% survivorship rate at a minimum of 5 years postoperatively. For patients looking for an alternative to TSA, the CAM procedure can provide reasonable outcomes and should be considered an effective procedure in appropriately selected, young active patients. Further studies are warranted to evaluate long-term outcomes and durability after this procedure.
The Effect of Limited Perioperative Nonsteroidal Anti-inflammatory Drugs on Patients Undergoing Anterior Cruciate Ligament Reconstruction
Authors: Soreide Endre , Granan Lars-Petter , Hjorthaug Geir A. , Espehaug Birgitte , Dimmen Sigbjørn , Nordsletten Lars
Published: August 2016

Background:

The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to patients undergoing anterior cruciate ligament reconstruction (ACLR) is controversial because it may impair tissue healing and clinical outcomes.

Purpose:

To assess the effect of NSAID administration on patients undergoing ACLR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included patients were aged >15 years and were registered in the Norwegian Knee Ligament Registry from 2008 until 2013 after the primary ACLR. Patients with insufficient data regarding administration of NSAIDs and those with associated knee ligament injuries requiring surgical treatment were excluded from this study. Graft survival was estimated using Kaplan-Meier survival curves, and hazard ratios (HRs) for revision were evaluated using Cox regression analysis. Logistic regression analysis was used to calculate the odds ratio (OR) for a Knee Injury and Osteoarthritis Outcome Score (KOOS)–quality of life (QOL) subscale score <44 at 2-year follow-up.

Results:

A total of 7822 patients were included in the analysis for graft survival and assessment for risk of revision. Of these, 4144 patients were administered NSAIDs postoperatively. The mean duration of follow-up was 2.8 years (range, 0-5.9 years). Administration of NSAIDs did not influence graft survival ( P = .568). Adjusted Cox regression analyses demonstrated the same finding regarding risk of revision (HR, 1.0; 95% CI, 0.8-1.3). ACLR using a bone–patellar tendon–bone autograft showed a reduced risk of revision (HR, 0.3; 95% CI, 0.1-0.8) among patients administered NSAIDs. In subgroup analyses of 3144 patients, administration of NSAIDs demonstrated a beneficial effect on the risk of a KOOS-QOL score <44 at 2-year follow-up (OR, 0.8; 95% CI, 0.6-0.9).

Conclusion:

Administration of NSAIDs to patients after ACLR does not have a negative effect on graft survival, risk of revision, or risk of a KOOS-QOL score <44 at 2-year follow-up. We emphasize using caution when administering NSAIDs by keeping the duration and dosage of NSAIDs as short and low as possible to ensure sufficient pain relief while limiting unwanted exposure to any known and unknown adverse effects of these drugs.
Biomechanical Evaluation of Glenoid Version and Dislocation Direction on the Influence of Anterior Shoulder Instability and Development of Hill-Sachs Lesions
Authors: Eichinger Josef K. , Massimini Daniel F. , Kim Jungryul , Higgins Laurence D.
Published: August 2016

Background:

Abnormal glenoid version is a risk factor for shoulder instability. However, the degree to which the variance in version (both anteversion and retroversion) affects one’s predisposition for instability is not well understood.

Purpose:

To determine the influence of glenoid version on anterior shoulder joint stability and to determine if the direction of the humeral head dislocation is a stimulus for the development of Hill-Sachs lesions.

Study Design:

Controlled laboratory study.

Methods:

Ten human cadaveric shoulders (mean age, 59.4 ± 4.3 years) were tested using a custom shoulder dislocation device placed in a position of apprehension (90° of abduction with 90° of external rotation). Glenoid version was adjusted in 5° increments for a total of 6 version angles tested: +10°, +5°, 0°, −5°, −10°, and −15° (anteversion angles are positive, and retroversion angles are negative). Two humeral dislocation directions were tested. The first direction was true anterior through the anterior-posterior glenoid axis. The second dislocation direction was 35° inferior from the anterior-posterior glenoid axis based on the deforming force role of the pectoralis major. The force and energy to dislocate were recorded.

Results:

Changes in glenoid version manifested a linear effect on the dislocation force. The energy to dislocate increased as a second-order polynomial as a function of increasing glenoid retroversion. Glenoid version of +10° anteversion and −15° retroversion was highly unstable, resulting in spontaneous dislocation in one-quarter (10/40) and one-half (25/40) of the specimens anteriorly and posteriorly, respectively, in the absence of an applied dislocation force. The greater tuberosity was observed to engage with the anterior glenoid rim, consistent with Hill-Sachs lesions, 40% more frequently when the dislocation direction was true anterior compared with 35° inferior from the anterior-posterior glenoid axis. The engagement of the greater tuberosity caused an increase in the energy required to dislocate.

Conclusion:

Glenoid version has a direct effect on the force required for a dislocation. An anterior-inferior dislocation direction requires less energy for a dislocation and results in a lower risk of the development of a Hill-Sachs lesion than a direct anterior dislocation direction.

Clinical Relevance:

Consideration should be given to glenoid version when choosing a surgical treatment option for anterior shoulder instability.
Expression of sirtuins 1, 6, tumor necrosis factor, and interferon-γ in psoriatic patients
Authors: Rasheed H , El-Komy MHM , Hegazy RA , Gawdat HI , AlOrbani AM , Shaker OG
Published: August 2016

Sirtuins (SIRT) have been regarded as culprits in the pathogenesis of various diseases. Their exact role has not been explained. This study aimed to assess the expression of SIRT1, SIRT6, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ in psoriatic patients. Thirty psoriatic patients and 22 controls were enrolled. Clinical examination and Psoriasis Area and Severity Index (PASI) were obtained. Two skin biopsies (lesional, peri-lesional) and one from controls were obtained. Tissue levels of SIRT1, SIRT6, TNF-α, and IFN-γ were measured using ELISA. SIRT1 was significantly lower in lesional skin with gradual increase in perilesional followed by control skin ( P <0.001). SIRT6, TNF-α, and IFN-γ were significantly higher in lesional than perilesional and control skin ( P <0.001). Significant positive correlations were found between SIRT1 and TNF-α, IFN-γ and between SIRT6 and TNF-α in peri-lesional skin. SIRT1 and SIRT6 are potentially involved in the pathogenesis of psoriasis. Modulating their action could offer a novel therapy for such disease.
Nothing happens here
Authors: Stratton Jon , Trainer Adam
Published: August 2016

This essay examines Perth as portrayed through the lyrics of popular songs written by people who grew up in the city. These lyrics tend to reproduce the dominant myths about the city: that it is isolated, that it is self-satisfied, that little happens there. Perth became the focus of song lyrics during the late 1970s time of punk with titles such as ‘Arsehole of the Universe’ and ‘Perth Is a Culture Shock’. Even the Eurogliders’ 1984 hit, ‘Heaven Must Be There’, is based on a rejection of life in Perth. However, Perth was also home to Dave Warner, whose songs in the 1970s and early 1980s offered vignettes, which is itself a title of one of Warner’s tracks, of the youthful, male suburban experience. The essay goes on to examine songs by the Triffids, Bob Evans, Sleepy Township and the Panda Band.
The Impact of Community-Based Supports and Services on Quality of Life Among the Elderly in China: A Longitudinal Study
Authors: Zhang Yongkang , Yeager Valerie A. , Hou Shengtian
Published: August 2016

Community-based supports and services (CBSS) have been developing rapidly in China as a new way of satisfying the needs of elderly people. However, it is not clear how pervasive these services are or whether the availability of CBSS impacts quality of life. This study examines trends in CBSS and the impact of the perceived CBSS availability on self-reported quality of life among the elderly in China. We found a significant increase in perceived CBSS availability from 2005 to 2011, but the perceived availability of CBSS varies by the type of CBSS. Multivariate analyses show that home medical visits (β = .181, p = .03), psychological support (β = .332, p = .02), social and recreation activities (β = .231, p = .02), and legal consulting services (β = .271, p = .02) were each significantly associated with a good quality of life. Results from this study provide insight that can inform CBSS strategies and the development of new services for the elderly in China.
The preparation and properties of flame-retardant polyisocyanurate–polyurethane foams based on two DOPO derivatives
Authors: Liu Yanlin , He Jiyu , Yang Rongjie
Published: August 2016

Two types of DOPO (9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide)-based halogen-free flame retardants, ODOPB (2-(6-oxid-6H-dibenzo[c,e][1,2]oxaphosphorin-6-yl)-1,4-benzenediol) and DOPO-PhOH (1,10-bis(4-hydroxyphenyl)-methylene-bispheny-1-oxophosphine oxide), were synthesized and incorporated into polyisocyanurate–polyurethane foams to investigate their effects on the thermal stability and flammability of polyisocyanurate–polyurethane foams. The thermal properties of the foams were determined using thermogravimetric analysis. The results showed that when compared to the polyisocyanurate–polyurethane control sample, the onset degradation temperatures of the foams were the same and the residues improved upon the addition of ODOPB, while for the polyisocyanurate–polyurethane/DOPO-PhOH foams, the onset degradation temperature and the residues were both improved. Furthermore, the physical–mechanical properties, flame retardant behavior, and morphological properties of foams were studied using thermal conductivity tests, compressive strength tests, the limiting oxygen index, cone calorimeter, and scanning electron microscopy. It was confirmed that the polyisocyanurate–polyurethane/DOPO derivative foams had the best physical–mechanical properties and flame retardancy compared to the polyisocyanurate–polyurethane/dimethyl methylphosphonate foam with the same phosphorus content added. The introduction of ODOPB caused a deterioration of the compression strength. However, the compression strength did not change upon the addition of DOPO-PhOH. The limiting oxygen index value showed a linear relationship with the phosphorous content in the foams upon the addition of ODOPB or DOPO-PhOH. Moreover, upon the addition of 20 phr ODOPB, the peak heat release rate of the foam was 25% lower than the polyisocyanurate–polyurethane control sample, while the reduced rate of the polyisocyanurate–polyurethane/20 phr DOPO-PhOH sample was 35%. In addition, for both the polyisocyanurate–polyurethane/ODOPB and polyisocyanurate–polyurethane/DOPO-PhOH foams, a continuous covering formed on the surface of residues was observed, which would obstruct heat and combustible gases from being transferred to the unburned foams.
Full-Time Instructional Staffing and Outcomes of Advanced Adult Learners
Authors: Patterson Margaret Becker
Published: August 2016

Two core adult education outcomes for advanced adult learners in U.S. states under the National Reporting System are learning gains in adult secondary education and entry into postsecondary education (PSE). Advanced learner outcomes are associated with key functions in an adult education programming framework, as well as with adequate instructional staff time, location, or exposure to quality services. In this article, the trend in the relationship of instructional staffing patterns with both outcomes from 2006-2007 to 2011-2012 is examined. With fewer adult secondary learners and rising exposure, outcomes fluctuated. Profile analysis revealed that states with more full-time instructional staff had increasing amounts of PSE enrollment during the 6-year period. Moreover, the positive relationship of full-time instructional staffing with PSE entry appears to have gained strength from 2009-2010 onward. Implications of findings for adult educators and recommendations for future research are discussed.
Carbon monoxide exposure among police officers working in a traffic dense region of Southern India
Authors: Nair AJ , Nandini M , Adappa S , Mahabala C
Published: August 2016

Currently, in India, air pollution is widespread in urban areas where vehicles are major contributors. The aim of this study was to investigate the level of exposure in traffic police officers exposed to vehicle exhaust for less than 8 h/day. The specific objective of the study was to determine the levels of carboxyhaemoglobin (COHb) in these officers. The effect of exposure for 8 h/day is known, but shorter durations of chronic exposure need to be investigated, and there is a need to explore the policy options in this exposed population. This cross-sectional study, included non-smoking traffic police officers between 30 and 50 years of age working for more than 2 years in busy traffic junctions. The cases were sex matched with controls of same age group, working in offices at a teaching hospital. Venous blood was collected at the end of 3 h of duty for estimation of COHb among both the groups. The COHb levels were expressed as percentage values. Differences between the COHb levels among the traffic police officers and office workers were analysed using the Mann-Whitney U test and considered significant at p < 0.05. Traffic police officers had significantly elevated COHb levels compared with the controls; 76.5% of traffic police officers had COHb >2.5% compared with no office workers at this level and 41.2% of the police officers had COHb levels >4%. Overall, 53.8% of officers with COHb >2.5% reported headaches compared with 15.8% of officers with COHb <2.5%.
Carbon monoxide poisoning cases presenting with non-specific symptoms
Authors: Deniz Turgut , Kandis Hayati , Eroglu Oguz , Gunes Harun , Saygun Meral , Kara Ismail Hamdi
Published: August 2016

Carbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with non-specific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED) due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage.
The Nonlinear Effect of Informal Social Control on Repeat Intimate Partner Violence Victimization
Authors: Valentine Colby L. , Stults Brian J. , Hasbrouck Matthew
Published: August 2016

Prior research has examined the effects of neighborhood context on intimate partner violence (IPV) with mixed results. While most studies find that neighborhood disadvantage is positively associated with risk of IPV, the effects are less consistent for characteristics such as social ties and informal social control. One possible explanation for these mixed findings draws from theoretical and empirical literature arguing that a high level of collective efficacy can aid in the control of criminal behavior, but it can also deter residents from acting against crime committed by neighbors. This suggests the possibility of a nonlinear effect of collective efficacy where the risk of IPV may be high in areas with very low levels of collective efficacy because of the inability of neighborhoods to collectively control residents, but it may also be high in areas with very high levels of collective efficacy where residents are less willing to report on the criminal behavior of fellow residents. We test this possibility using survey data for female victims of IPV in Chicago merged with neighborhood characteristics. Findings suggest that the risk of repeat victimization is highest in areas with either very high or very low levels of informal social control.
Different Forms of Relationships Between Vocational Interests and Career Maturity in Chinese Context
Authors: Liu Yan , Peng Kelly Z. , Mao Yina , Wong Chi-Sum
Published: August 2016

This study explores the relationships between vocational interests and career maturity in the context of China. We tentatively hypothesize that realistic, conventional, and artistic interests have negative linear relationships with career maturity, whereas investigative, social, and enterprising interests have positive but curvilinear relationships with career maturity. Analyses of the data collected from 5,474 participants provide support for most of the hypotheses. Specifically, the results demonstrate negative relationships of realistic and conventional interests with career maturity, a U-shaped relationship of artistic interest with career maturity, and concave upward curve relationships of investigative, social, and enterprising interests with career maturity. These findings add to the literature on vocational interests and provide practical suggestions for individuals and career counseling practitioners.
Transnational Class Formations, European Crisis and the Silent Revolution
Authors: Gill Stephen
Published: August 2016

This article analyzes the European crisis and the reconfiguration of neoliberal governance in light of efforts to deepen integration via what European Union President Manuel Barroso (2010) called a ‘Silent Revolution’ to create a new ‘economic government’ that could better manage crises and shape development alternatives. The article places recent developments in a longer-term perspective involving post-Second World War geopolitics, transatlantic class formations, extension of the world market and recent, fundamental crises of capitalism. It argues that in the current situation, the relative unity of Europe’s ruling classes contrasts with the relative fragmentation of subaltern forces, mainly along national-popular lines. This situation shapes (but does not necessarily determine) the ‘limits of the possible’ for political agency in Europe, and it helps explain the persistence of neoliberalism in the European Union in a situation of organic crisis, where the relations of force remain contested, open and politically unstable.
‘Building Us Up’: Supporting Black Male College Students in a Black Male Initiative Program
Authors: Brooms Derrick R.
Published: August 2016

Efforts to enhance the academic performances and educational experiences of Black males in college has exploded in the past 15 years, including institutional, state, system-level, and national programs, policies, and calls to action. Key among these efforts is establishing Black Male Initiative (BMI) programs, which primarily are structured as social cohesion programs and intended to increase students’ retention and graduation rates. Using qualitative interview data from a convenience sample of 40 Black male students at two different institutions, this project explores their engagement and experiences in a BMI program. First, I analyze students’ narratives regarding their participation and meaning-making of BMIs. I find that BMIs play a critical role in supporting students through increased access to social and cultural (sociocultural) capital while simultaneously honoring the cultural wealth students bring to campus. Second, I examine how engagement in the BMI community helped enhance students’ academic experiences and sense of self.
Synthesis and characterization of polyhydrazides and poly(1,3,4-oxadiazole)s containing multiple arylene ether linkages and pendent pentadecyl chains
Authors: Tawade Bhausaheb V , Valsange Nitin G , Wadgaonkar Prakash P
Published: August 2016

A new diacylhydrazide monomer, namely, 4-(4-(4-(4-(hydrazinocarbonyl)phenoxy)-2-pentadecylphenoxy)phenoxy) benzohydrazide (HPPDPB), was synthesized starting from 4-(4-hydroxyphenoxy)-3-pentadecylphenol. HPPDPB was polycondensed with terephthalic acid chloride (TPC), isophthalic acid chloride (IPC) and a mixture of TPC and IPC (50:50 mol%) to obtain polyhydrazides containing multiple arylene ether linkages in the backbone and pendent pentadecyl chains. Polyhydrazides were subsequently cyclized in the presence of phosphorus oxychloride to obtain the corresponding poly(1,3,4-oxadiazole)s. Polyhydrazides and poly(1,3,4-oxadiazole)s exhibited inherent viscosities in the range 0.65–0.72 dL g−1 and 0.54–0.62 dL g−1, respectively, which indicated the formation of reasonably high-molecular weight polymers. Polyhydrazides were soluble in polar aprotic solvents such as N,N-dimethylformamide, N,N-dimethylacetamide (DMAc), 1-methyl-2-pyrrolidinone and pyridine whereas poly(1,3,4-oxadiazole)s exhibited excellent solubility even in common organic solvents such as chloroform, dichloromethane and tetrahydrofuran. Tough, transparent and flexible films of polyhydrazides and poly(1,3,4-oxadiazole)s could be cast from DMAc and chloroform solutions, respectively. X-Ray diffraction studies revealed amorphous nature of polyhydrazides and poly(1,3,4-oxadiazole)s and the formation of layered structure was observed due to ordered packing of pentadecyl chains. The 10% decomposition temperature ( T10) values for poly(1,3,4-oxadiazole)s were in the range 425–440°C indicating their good thermal stability. Glass transition temperature ( Tg) values of polyhydrazides and poly(1,3,4-oxadiazole)s were in the range 175–192°C and 92–103°C, respectively. The excellent solubility characteristics and the large gap between Tg (92–103°C) and T10 (425–440°C) values give poly(1,3,4-oxadiazole)-containing pendent pentadecyl chains better opportunities for processability.
Multi-period disassembly levelling and lot-sizing for multiple product types with parts commonality
Authors: Kim Dong-Hyun , Doh Hyoung-Ho , Lee Dong-Ho
Published: August 2016

Disassembly levelling is to determine disassembly structures that specify components to be obtained from end-of-use/life products, and disassembly lot-sizing is to determine the timing and quantity of disassembling end-of-use/life products to satisfy the demands of their components. As an extension of the previous studies that consider them separately, this study integrates the two problems, especially in the form of multi-period model. Particularly, this study considers a generalized integrated problem in which disassembly levels may be different for the products of the same type. To describe the problem mathematically, we develop an integer programming model that minimizes the sum of setup, operation and inventory holding costs. Then, due to the problem complexity, a heuristic algorithm is proposed that consists of two phases: (a) constructing an initial solution using a priority-based greedy heuristic and (b) improving it by removing unnecessary disassembly operations after characterizing the properties of the problem. To show the performance of the heuristic algorithm, computational experiments were performed on various test instances and the results are reported.
The effect of active surface morphology of grinding wheel with zone-diversified structure on the form of chips in traverse internal cylindrical grinding of 100Cr6 steel
Authors: Nadolny Krzysztof , Kapłonek Wojciech , Królczyk Grzegorz , Ungureanu Nicolae
Published: August 2016

The article presents the results of experimental investigations to determine the effect of active surface morphology of grinding wheels with a zone-diversified structure on the form and size of chips generated during traverse internal cylindrical grinding of 100Cr6 steel. In the grinding process involving grinding wheels with a zone-diversified structure, chip formation phenomena differ in the rough and finish grinding zones of the tool. In order to expand one’s knowledge of this phenomena, the microtopography measurements of the grinding wheel active surface in the rough and finish grinding zones were made, as well as scanning electron microscopic observations of these areas after the dressing cut and following internal cylindrical traverse grinding. The conducted studies showed that chips in the rough grinding zone of the grinding wheel active surface are usually several hundred micrometers in length. In the finish grinding zone, however, mainly micro-chips were generated whose length does not exceed 100 µm (usually around 10 µm in length). In the rough grinding zone, shearing-type and flowing-type chips dominate with a few examples of spherical melted chips. Moreover, in the finish grinding zone, mainly slice-type and knife-type micro-chips were observed.
Quantum-inspired hybrid algorithm for integrated process planning and scheduling
Authors: Liu Mi , Yi Shuping , Wen Peihan
Published: August 2016

Process planning and job shop scheduling problems are the two classical but crucial activities in manufacturing system. With the approach of integrated process planning and scheduling, the two actual activities are combined to conduct operation selection and operation sequencing with the constraints of practical job shop status. In this article, a quantum-inspired hybrid algorithm with the objective of minimum makespan is proposed, aiming to solve integrated process planning and scheduling problems in dynamic manufacturing systems. A hybrid-coding representation is suggested, which is a three-layer structure in numerical representation and Q-bit representation adopted from quantum-inspired evolutionary algorithm. Based on the hybrid-coding representation, customized converting and repairing rules and methods are presented to generate feasible individuals. Q-gate rotation and group leader optimization algorithm are integrated systematically for the population evolution to accelerate the convergence speed of the proposed algorithm. In order to increase the diversity of population, a chaotic map called logistic map is introduced, bringing the stochastic initial individuals. Experiments show that the proposed hybrid algorithm can generate outstanding outcomes for integrated process planning and scheduling instances.
Laser annealing of laser additive–manufactured Ni-Ti structures: An experimental–numerical investigation
Authors: Shiva S , Palani IA , Paul CP , Singh B
Published: August 2016

Tailored structures of Ni-Ti shape memory alloys for micro-electro-mechanical systems can be fabricated using laser additive manufacturing, and requisite homogeneous microstructure for predictive design and fabrication of micro-electro-mechanical systems devices can be achieved by annealing. Investigation has been performed on the laser annealing of laser additive–manufactured Ni-Ti structures using a pulsed green laser through numerical simulation and experimental studies. The parametric dependence showed that a laser energy density of 1100 mJ cm−2 has a considerable influence in annealing of Ni-Ti structures. The surface morphology, phase transformation temperature and microstructure of laser-annealed Ni-Ti structures were studied with scanning electron microscopy, differential scanning calorimetry, X-ray diffraction and atomic force microscopy. Laser energy density of 1100 mJ cm−2 was used for annealing the samples as identified in the simulation. Surface annealing of Ni-Ti led to a uniform surface of the material with an increase in grain size and surface roughness. A decrease in the micro-hardness of the samples was obtained as a result of laser annealing. Thus, the investigations demonstrated the improved properties of laser additive–manufactured Ni-Ti structures by laser annealing.
Factors associated with non-retention in HIV care in an era of widespread antiretroviral therapy
Authors: O’Connell Sarah , O’Rourke Anna , Sweeney Eileen , Lynam Almida , Sadlier Corinna , Bergin Colm
Published: August 2016

In an era of antiretroviral therapy (ART) for all HIV-1-infected patients, our primary aim was to describe prevalence and characteristics of patients disengaged from care at an urban ambulatory HIV clinic. We conducted a nested case–control study. All patients who disengaged from care (defined as being lost to follow-up for at least one year) from 2007 to 2014 inclusive were identified. Cases were matched to controls in a 1:4 ratio. A total of 1250 cases were included; 250/2289 (10.9%) of patients attending our HIV clinic disengaged from 2007 to 2014. One hundred and twenty-six (50.4%) were heterosexual, 81 (32.4%) were men who have sex with men and 40 (16%) were intravenous drug users. On univariate analysis only, patients with heterosexual risk were more likely to disengage from care (50.4% vs. 33.7%, p: <0.001). Those who disengaged were younger, mean age of 39 (p: <0.001). A higher proportion of patients who disengaged from care was not receiving ART and did not have a suppressed HIV-1 viral load (p: <0.001). On multivariable analysis, Irish patients were less likely to disengage from HIV care (odds ratio: 0.567, p: 0.002). Factors associated with non-retention in HIV care have been identified. A semi-structured interview of those patients who re-engaged will take place to further examine reasons for disengagement from care.
Evaluating the utility of provider-recorded clinical status in the medical records of HIV-positive adults in a limited-resource setting
Authors: Stonbraker Samantha , Befus Montina , Nadal Leonel Lerebours , Halpern Mina , Larson Elaine
Published: August 2016

Provider-reported summaries of clinical status may assist with clinical management of HIV in resource poor settings if they reflect underlying biological processes associated with HIV disease progression. However, their ability to do so is rarely evaluated. Therefore, we aimed to assess the relationship between a provider-recorded summary of clinical status and indicators of HIV progression. Data were abstracted from 201 randomly selected medical records at a large HIV clinic in the Dominican Republic. Multivariable logistic regressions were used to examine the relationship between provider-assigned clinical status and demographic (gender, age, nationality, education) and clinical factors (reported medication adherence, CD4 cell count, viral load). The mean age of patients was 41.2 (SD = ±10.9) years and most were female (n = 115, 57%). None of the examined characteristics were significantly associated with provider-recorded clinical status. Higher CD4 cell counts were more likely for females (OR = 2.2 CI: 1.12–4.31) and less likely for those with higher viral loads (OR = 0.33 CI: 0.15–0.72). Poorer adherence and lower CD4 cell counts were significantly associated with higher viral loads (OR = 4.46 CI: 1.11–20.29 and 6.84 CI: 1.47–37.23, respectively). Clinics using provider-reported summaries of clinical status should evaluate the performance of these assessments to ensure they are associated with biologic indicators of disease progression.
Maternal feed restriction during pregnancy in Wistar rats: Evaluation of offspring using classical and immunoteratology protocols
Authors: Gotardo AT , Dipe VV , Hueza IM , Górniak SL
Published: August 2016

Studies have revealed that impairment of the pregnant body weight reduces the fetal body weight and causes minor changes in skeletal development. The aim of the present study was to assess the effects of maternal feed restriction during pregnancy in offspring immune system development. Pregnant Wistar rats were distributed into 5 groups: 1 control in which dams received food ad libitum and 4 experimental groups in which dams were fed restricted amounts of rodent ration (16, 12, 9, or 6 g/rat/day) from the 6th to 17th gestation day. Teratogenicity was assessed using classical teratological evaluation and developmental immunotoxicology protocols. Maternal body weight gain, fetus weight, and placenta weight were reduced for feed-restricted females from the groups fed 12, 9, and 6 g/rat/day ( p < 0.05). No pup mortality was observed immediately after cesarean sections among the groups, and no visceral or skeletal malformations were detected. An immunoteratological study revealed an increase in the relative weight of the thymus and an increase in the phorbol myristate-acetate solution-induced hydrogen peroxide release by inflammatory cells in 21-day-old pups. Alterations in the delayed-type hypersensitivity response and the humoral immune response against sheep red blood cells were observed in pups from feed-restricted mothers. Feed restriction in Wistar rats during organogenesis did not promote structural malformations but resulted in offspring with lower birth weights and promoted significant changes in the immune responses of the rat pups.
Crosstalk between E2f1 and c-Myc mediates hepato-protective effect of royal jelly on taxol-induced damages
Authors: Malekinejad H , Fani M , Shafiee-Roodbari S Kh , Delkhosh-Kasmaie F , Rezaei-Golmisheh A
Published: August 2016

Previous histopathological studies have shown the hepatotoxicity of paclitaxel (TXL). However, there is little known about the molecular pathway(s) of TXL-induced hepatotoxicity. Therefore, this study aimed to uncover the role of two transcription factors in the TXL-induced hepatotoxicity. Moreover, the hepato-protective effect of royal jelly (RJ) on TXL-induced toxicity was investigated. Wistar rats were divided into control and test groups. The test groups along with TXL received various doses of RJ (0, 50, 100 and 150 mg/kg, body weight). Biochemical hepatic functional assays, histopathological studies and hepatic superoxide dismutase level were determined. Additionally, the expression of E2f1 and cellular-myelocytomatosis (c-Myc) at messenger RNA (mRNA) level in the liver was evaluated. The hepatic functional biomarkers showed a significant ( p < 0.05) elevation in the TXL-received animals, while RJ administration for 28 days resulted in a remarkable reduction in TXL-elevated alkaline phosphatase, alanine transaminase and lactate dehydrogenase levels. The TXL-treated animals showed a significant ( p < 0.05) up-regulation of E2f1 and down-regulation of c-Myc at mRNA level, respectively. RJ lowered the expression of E2f1 while enhanced the expression of c-Myc in a dose-dependent manner. Our data suggest the hepato-protective effects of RJ on TXL-induced toxicity, which may attribute to a clear crosstalk between E2f1 and c-Myc as two regulators of liver growth.
Improved strategies for designing lupus trials with targeted therapies: learning from 65 years of experience
Authors: Wallace D J
Published: August 2016

The development of new agents to manage lupus erythematosus has lagged behind other autoimmune rheumatic diseases. This is in large part because lupus is a heterogeneous disorder affecting nine principal domains (organ systems) that are difficult to measure and quantify and can be at variance with each other. Over the last two decades, a variety of guidelines, definitions, candidate surrogate or biomarkers, metrics and composite indices have been presented as benchmarks that can be utilized to assess lupus in clinical trials. Despite this, over 20 agents have failed to achieve their primary outcome measure, some of which are generally believed to be clinically effective. This article presents constructive suggestions and improved strategies in trial design that will hopefully lead to the introduction of new agents for the disease.
A critical review of clinical trials in systemic lupus erythematosus
Authors: Mahieu M A , Strand V , Simon L S , Lipsky P E , Ramsey-Goldman R
Published: August 2016

One challenge in caring for patients with systemic lupus erythematosus (SLE) is a paucity of approved therapeutics for treatment of the diverse disease manifestations. In the last 60 years, only one drug, belimumab, has been approved for SLE treatment. Critical evaluation of investigator initiated and pharma-sponsored randomized controlled trials (RCTs) highlights barriers to successful drug development in SLE, including disease heterogeneity, inadequate trial size or duration, insufficient dose finding before initiation of large trials, handling of background medications, and choice of primary endpoint. Herein we examine lessons learned from landmark SLE RCTs and subsequent advances in trial design, as well as discuss efforts to address limitations in current SLE outcome measures that will improve detection of true therapeutic responses in future RCTs.
T-cell-directed therapies in systemic lupus erythematosus
Authors: Nandkumar P , Furie R
Published: August 2016

Drug development for the treatment of systemic lupus erythematosus (SLE) has largely focused on B-cell therapies. A greater understanding of the immunopathogenesis of SLE coupled with advanced bioengineering has allowed for clinical trials centered on other targets for SLE therapy. The authors discuss the benefits and shortcomings of focusing on T-cell-directed therapies in SLE and lupus nephritis clinical trials.
Patient-reported outcomes in lupus clinical trials with biologics
Authors: Annapureddy N , Devilliers H , Jolly M
Published: August 2016

Therapeutic advances in systemic lupus erythematosus (SLE) are greatly needed. Despite advances in our knowledge of pathogenesis of the disease and targets, treatment remains a significant challenge. Finding effective and relatively safe medications remains one of the top priorities. SLE significantly impairs quality of life (QoL), and patient-reported outcomes (PROs) measure a unique aspect of the disease not captured by disease activity. Inclusion of PRO measurements is encouraged in SLE clinical trials, as they allow capturing benefits of a proposed intervention in language patients can relate to and in areas deemed pertinent and important to and by patients. Availability of patient-reported and patient-centric clinical trials data may facilitate patients in informed and shared decision making, and allow for comparative cost-effectiveness evaluation for future resource allocation and reimbursements. Herein we review clinical trials with biologic therapies wherein PRO tools were included in the study design.
Interferon-targeted therapy in systemic lupus erythematosus: Is this an alternative to targeting B and T cells?
Authors: Kalunian K C
Published: August 2016

Clinical trials of investigational agents in systemic lupus erythematosus (SLE) have focused on targeting dysregulated B and T cells; however, recent translational research findings of the importance of the dysregulation of the innate immune system in SLE have led to clinical trials that target interferon. Three biologics that target type I interferons have been tested for their efficacy and safety in active SLE patients; these phase II trials have tested the hypothesis that down-regulation of interferon-regulated gene expression (the interferon signature) lessen the clinical burden of SLE. Rontalizumab, an anti-interferon-α monoclonal antibody, was studied in patients who had discontinued immunosuppressants. This study failed to show efficacy as assessed by both two outcome assessments; however, in low interferon signature patients, response was higher and corticosteroid usage was less in rontalizumab-treated patients. Sifalimumab, another anti-interferon-α monoclonal antibody, was studied in patients who remained on standard of care therapy. This study showed significantly better efficacy in patients treated with two sifalimumab dosages; significant differences were seen in the high interferon signature group. In a similar design and in a similar population as the sifalimumab study, anifrolumab, a monoclonal antibody that binds to a type I interferon receptor, was studied in patients who remained on standard of care therapy. In this study, one dosage group demonstrated efficacy and statistically significant effects were achieved in both tested dosage groups with secondary end points. Oral corticosteroid reduction to ≤7.5 mg daily was achieved in one of the tested dosage groups and organ-specific outcomes were significantly improved in that same group. For all studies, no significant differences in serious adverse effects were seen; although, herpes zoster infections were increased in sifalimumab- and anifrolumab-treated patients and influenza rates were increased in anifrolumab-treated patients. Anifrolumab is currently in pivotal phase III studies. Data appear to support the concept that targeting type I interferon in SLE patients associates with clinical efficacy and safety. Further data are forthcoming from ongoing phase III clinical trials of anifrolumab. Other drug development efforts should be considered that target plasmacytoid dendritic cells and toll like receptors given the effects these components have on interferon production.
Rethinking biologics in lupus nephritis
Authors: Venuturupalli S
Published: August 2016

Lupus nephritis (LN) is a chronic and devastating complication of systemic lupus erythematosus. Despite advances in our understanding of LN and the availability of effective therapies, LN remains a difficult clinical problem, and progression to end stage renal disease remains a significant challenge. Though the advent of biologics has revolutionized the treatment of many rheumatological conditions, and several clinical trials of biologics have been conducted in LN, the promise of biologics remains unfulfilled. The experience gained from these initial clinical trials can help tailor approaches in future clinical trials, and the lessons learned can be applied to find a cure for this condition.
Drug repositioning in SLE: crowd-sourcing, literature-mining and Big Data analysis
Authors: Grammer A C , Ryals M M , Heuer S E , Robl R D , Madamanchi S , Davis L S , Lauwerys B , Catalina M D , Lipsky P E
Published: August 2016

Lupus patients are in need of modern drugs to treat specific manifestations of their disease effectively and safely. In the past half century, only one new treatment has been approved by the US Food and Drug Administration (FDA) for systemic lupus erythematosus (SLE). In 2014–2015, the FDA approved 71 new drugs, only one of which targeted a rheumatic disease and none of which was approved for use in SLE. Repositioning/repurposing drugs approved for other diseases using multiple approaches is one possible means to find new treatment options for lupus patients. “Big Data” analysis approaches this challenge from an unbiased standpoint whereas literature mining and crowd sourcing for candidates assessed by the CoLTs (Combined Lupus Treatment Scoring) system provide a hypothesis-based approach to rank potential therapeutic candidates for possible clinical application. Both approaches mitigate risk since the candidates assessed have largely been extensively tested in clinical trials for other indications. The usefulness of a multi-pronged approach to drug repositioning in lupus is highlighted by orthogonal confirmation of hypothesis-based drug repositioning predictions by “Big Data” analysis of differentially expressed genes from lupus patient samples. The goal is to identify novel therapies that have the potential to affect disease processes specifically. Involvement of SLE patients and the scientists that study this disease in thinking about new drugs that may be effective in lupus though crowd-sourcing sites such as LRxL-STAT ( www.linkedin.com/in/lrxlstat ) is important in stimulating the momentum needed to test these novel drug targets for efficacy in lupus rapidly in small, proof-of-concept trials conducted by LuCIN, the Lupus Clinical Investigators Network ( www.linkedin.com/in/lucinstat ).