bluuebunny/crossref_metadata_2025 huggingface dataset:
“Autopsychography” as a Form of Self-Narrative Inquiry
Authors: Yuan Yanyue , Hickman Richard
Published: August 2016

In this article, we propose “autopsychography” as a form of self-narrative inquiry. Autopsychography seeks to track the shaping of creative paths when reflecting on lived experience as opposed to simply reporting what happened. We illustrate three major theoretical implications underpinning this concept: its rootedness in humanistic psychology that frames the human subject as the “whole person”; its emphasis on “change” and “growth,” core to educative experience; and its arts-informed features. We situate our discussions of autopsychography in the context of self-narrative approaches and we underscore its distinctiveness through comparisons with autoethnography as an already well-recognized methodology. We then present an autopsychographic study into Yanyue’s experience after submitting the softbound copy of her PhD thesis in which she experimented with an “oral diary” and the use of “found poetry” as ways of presenting data.
Fractions Learning in Children With Mathematics Difficulties
Authors: Tian Jing , Siegler Robert S.
Published: August 2016

Learning fractions is difficult for children in general and especially difficult for children with mathematics difficulties (MD). Recent research on developmental and individual differences in fraction knowledge of children with MD and typically achieving (TA) children has demonstrated that U.S. children with MD start middle school behind their TA peers in fraction understanding and fall further behind during middle school. In contrast, Chinese children, who like the MD children in the United States score in the bottom one third of the distribution in their country, possess reasonably good fraction understanding. We interpret these findings within the framework of the integrated theory of numerical development. By emphasizing the importance of fraction magnitude knowledge for numerical understanding in general, the theory proved useful for understanding differences in fraction knowledge between MD and TA children and for understanding how knowledge can be improved. Several interventions demonstrated the possibility of improving fraction magnitude knowledge and producing benefits that generalize to fraction arithmetic learning among children with MD. The reasonably good fraction understanding of Chinese children with MD and several successful interventions with U.S. students provide hope for the improvement of fraction knowledge among American children with MD.
The 2013 HIV Continuum of Care in Tennessee
Authors: Wester Carolyn , Rebeiro Peter F. , Shavor Thomas J. , Shepherd Bryan E. , McGoy Shanell L. , Daley Benn , Morrison Melissa , Vermund Sten H. , Pettit April C.
Published: August 2016

Objectives:

We measured patient engagement in the human immunodeficiency virus (HIV) continuum of care in Tennessee after implementation of enhanced surveillance activities to assess progress toward 2015 statewide goals. We also examined subgroup disparities to identify groups at risk for poor outcomes.

Methods:

We estimated linkage to care, retention in care, and viral suppression among HIV-infected people in Tennessee in 2013, overall and by subgroup, after implementation of enhanced laboratory reporting, address verification, and death-matching procedures.

Results:

Of 792 people newly diagnosed with HIV infection in 2013, 632 (79.8%) were linked to care, close to the 2015 goal of ≥80%. Of 15 473 people living and diagnosed with HIV infection before 2013, 8458 (54.7%) were retained in care, approaching the 2015 goal of ≥64.0%. A total of 8640 (55.8%) were virally suppressed, surpassing the 2015 goal of ≥51.0%. Compared with people living and diagnosed with HIV infection before 2013, newly diagnosed people were more likely to be younger, male, non-Hispanic black, and men who have sex with men (MSM). For linkage to care, retention in care, and viral suppression, younger and non-Hispanic black people fared worse, whereas females and those enrolled in the Ryan White program fared better. For retention in care and viral suppression, Hispanic people, injection drug users, and East Tennessee residents fared worse than those in Memphis, whereas MSM fared better. Nashville residents fared worse in retention in care than Memphis residents.

Conclusion:

Tennessee’s HIV continuum of care in 2013 showed progress toward 2015 goals. Future efforts to improve the HIV continuum of care should be directed toward vulnerable groups and regions, particularly young, non-Hispanic black, and Hispanic people; injection drug users; and residents of the East Tennessee and Nashville regions.
Understanding Systematic Reviews and Meta‐Analyses
Authors: Koretz Ronald L. , Lipman Timothy O.
Published: August 2016

Systematic reviews should be distinguished from narrative reviews. In the latter, an editor asks an expert to sum up all of the information that is known about a particular topic. However, the expert is under no constraints regarding what he or she does, or does not, choose to include in the review. As a result, his or her bias can influence the final message. A systematic review, which may or may not be written by experts, typically asks a narrower question, and then answers it using the entirety of the medical literature. The systematic review process includes computer searches to identify the pertinent literature, a statement of the inclusion and exclusion criteria for identified studies, a list of items of interest to extract from each study, a method to assess the quality of each study, a summary of the evidence that has been found (which may or may not involve attempts to combine data), a discussion of the evidence and the limitations of the conclusions, and suggestions for future research efforts. If the data are combined, that process is called meta‐analysis. In meta‐analysis, an estimate of the reliability of each study is made, and those that appear to be more reliable are weighed more heavily when the data are combined. While systematic reviews depend on a more preplanned method and thus, unlike narrative reviews, contain sections on method, they can be easily read once the reader becomes familiar with the vocabulary.
Having an impact, making a difference: the Editor’s review of the first 30 years
Authors: Wade Derick T
Published: August 2016

Objectives:

To review publications in Clinical Rehabilitation over the last 30 years, discerning the original goals and whether they were met, and describing major trends over the 30 years.

Methods:

Personal review, backed up by data from ‘most read’ articles and ‘most cited’ articles, from yearly lists of all controlled trials published in the journal and other sources.

Results:

The original goals included making rehabilitation better understood both within and outside the speciality, and more scientific. The first goal is probably not achieved, but the scientific standard of publication is much higher and it routinely recommends the use of guidelines appropriate to the publication. The journal has established a pre-eminent position in publishing randomized controlled trials, systematic reviews and articles on goal-setting. It has developed a series describing rehabilitation interventions. It aims to increase consideration of the theoretical basis of rehabilitation practices. We would like to think its impact has increased – but we cannot prove that!

Conclusion:

The journal has established some credentials as being a source of clinically relevant evidence and guidance across the whole field of rehabilitation and across most disabling conditions.
Search for a new economic optimum in the management of household waste in Tiaret city (western Algeria)
Authors: Asnoune M , Abdelmalek F , Djelloul A , Mesghouni K , Addou A
Published: August 2016

In household waste matters, the objective is always to conceive an optimal integrated system of management, where the terms ‘optimal’ and ‘integrated’ refer generally to a combination between the waste and the techniques of treatment, valorization and elimination, which often aim at the lowest possible cost. The management optimization of household waste using operational methodologies has not yet been applied in any Algerian district. We proposed an optimization of the valorization of household waste in Tiaret city in order to lower the total management cost. The methodology is modelled by non-linear mathematical equations using 28 variables of decision and aims to assign optimally the seven components of household waste (i.e. plastic, cardboard paper, glass, metals, textiles, organic matter and others) among four centres of treatment [i.e. waste to energy (WTE) or incineration, composting (CM), anaerobic digestion (ANB) or methanization and landfilling (LF)]. The analysis of the obtained results shows that the variation of total cost is mainly due to the assignment of waste among the treatment centres and that certain treatment cannot be applied to household waste in Tiaret city. On the other hand, certain techniques of valorization have been favoured by the optimization. In this work, four scenarios have been proposed to optimize the system cost, where the modelling shows that the mixed scenario (the three treatment centres CM, ANB, LF) suggests a better combination of technologies of waste treatment, with an optimal solution for the system (cost and profit).
Comparing Trends Between Food Insecurity and Cigarette Smoking Among Adults in the United States, 1998 to 2011
Authors: Farrelly Matthew C. , Shafer Paul R.
Published: August 2016

Purpose:

Previous studies have shown that cigarette smoking is associated with higher rates and severity of food insecurity but do not address how population-level smoking rates change in response to changes in food security.

Design:

Trend analysis of serial cross-sectional data.

Setting:

Data from a representative survey of US households.

Participants:

Adults within households participating in both the Food Security Supplement and Tobacco Use Supplement of the Current Population Survey during 5 overlapping administrations from 1998 to 2011.

Measures:

A “current smoker” is defined as someone who indicated that they currently smoke on “some days” or “every day.” A household’s food security is coded as “secure” or “insecure,” according to responses to a food security scale, interpreted using a US Department of Agriculture standard.

Analysis:

Descriptive comparison of the roughly triennial trends in the prevalence of food insecurity and current smoking from 1998 to 2011.

Results:

The prevalence of food insecurity increased by 30% among adults overall versus 54% among current smokers, with most of the changes occurring following the economic recession of 2008 and 2009. Over this same period, the prevalence of current smoking declined by 33% among food-secure adults and only 14% among food-insecure adults.

Conclusion:

Food insecurity increased more markedly among adult smokers than nonsmokers, and the prevalence of smoking declined more slowly in food-insecure households, indicating that more low-income smokers are facing hunger, which may at least partly be due to buying cigarettes.
Associations Between Health and Driving in an Older Adult Cohort in Rancho Bernardo
Authors: Hill Linda L. , Laughlin Gail A. , Bettencourt Richele , Barrett-Connor Elizabeth
Published: August 2016

Objective: The purpose of this study was to identify the associations between health and health care utilization with driving patterns in a cohort of older adults. Method: In 2012, a total of 1,826 surviving participants in the Rancho Bernardo cohort were sent a health and driving pattern survey; 1,277 were returned. Results: The majority of the respondents (1,151, 91%) were still driving. Older age, female sex, hospitalizations, emergency department (ED) visits and physical therapy visits, neurological disease, depression, limited vision, and limited hearing were associated with non-driving status. A total of 809 (71%) of drivers reported no citations or crashes in the last 5 years. Discussion: The vast majority of older drivers in this cohort continued to drive, and did so safely. Health care utilization, medications, medical conditions, and self-assessment of health were associated with non-driving status. Prospective studies are needed to clarify the temporal relationships between these factors.
‘An end to the job as we know it’: how an IT professional has experienced the uncertainty of IT outsourcing
Authors: Trusson Clive , Woods Frankie
Published: August 2016

This article foregrounds the voice of an IT professional who is directly employed by a large British company and who, along with colleagues, is experiencing career uncertainty resulting from a management initiative to replace the established workforce with an alternative labour supply provided by a global IT services company. As an account that reflects the uncertainty of the age, the narrative offers insights into current discussions concerning the contemporary nature and experience of work generally. More specifically it tells of a loss of confidence and status of technical professionals as they are methodically undermined by the confident assertion of a ‘shareholder value’ rhetoric. The suggestion is made that the application of commercial–professional rationality to the outsourcing of IT operations may underestimate the commercial risks associated with the loss of embodied technical knowledge gained across time as IT systems evolve to become complex constructions.
Effect of equal-channel angular pressing on the surface roughness of commercial purity aluminum during turning operation
Authors: Abbas Adel Taha , Ragab Adham Ezzat , El-Danaf Ehab Adel , Al Bahkali Essam Ali
Published: August 2016

Aluminum has been increasingly used in automotive and aerospace applications due to its beneficial specific strength and chemical properties. Due to its extensive use, machining of aluminum parts has become specifically significant in recent years. One important aspect of machining is the surface quality represented by the surface roughness values. In this article, the effect of equal-channel angular pressing on the surface roughness (Ra, Rq, Rt and Rz) of commercial purity aluminum machined by turning was studied. Five starting material conditions, defined as the annealed and equal-channel angular pressing processed up to four passes, were investigated. The independent variables were the cutting speed, depth of cut and feed rate. The fourth parameter (number of equal-channel angular pressing passes) was considered as categorical factor and, hence, was not included in the mathematical model. A full central composite circumscribed design matrix was built to allow the optimization of surface roughness using response surface methodology. The significance of process parameters and their interactions in estimating surface roughness was investigated using analysis of variance. The two parameters, with significant effect on surface roughness, were found to be the feed rate and number of equal-channel angular pressing passes. Minimum depth of cut (0.15 mm) and minimum feed rate (0.05 mm/rev) are needed to achieve minimum surface roughness parameters: Ra (0.06 µm), Rq (0.057 µm) and Rz (0.71 µm) and Rt (1.2 µm). The cutting speed, for these optimum roughness values, ranged from 207.5 m/min for Ra to 193 m/min for Rz. The optimum roughness values were generally achieved with the higher strength materials. Optimum values for Ra, Rq and Rz happened at the four equal-channel angular pressing passes–processed material, while the optimum value of Rt happened at the three equal-channel angular pressing passes–processed material.
VII. Moving toward integrative feminist evolutionary behavioral sciences
Authors: Garcia Justin R , Heywood Leslie L
Published: August 2016

There is a long history of mostly antagonist interactions between feminist and evolutionary scholarship in the behavioral sciences. However, recent theoretical and empirical advances have highlighted that “nature” and “nurture” are not mutually exclusive, or even divorceable, levels of explanation. New developments in evolutionary theory, articulated under the name of “the extended synthesis,” show significant promise for integrating feminist and evolutionary approaches to the study of human behavior. The extended synthesis provides feminist inquiry and research an expanded ground on which to enter the conversation, such as with the inclusion of “fast” evolution – the idea that genetic and epigenetic (environmentally influenced gene expression) traits can change within a generation – which demonstrates that there has in fact been evolutionary time to (adaptively) alter behavior and physiology. This integration has the potential to lead to new research paradigms that bridge the old divide between “nature” and “nurture”, resulting in transdisciplinary frameworks that show the interaction effects between each. Feminism and feminist psychology will be more complete descriptors and analyzers of human behavior in this model, and crucial interaction effects historically ignored by both the sciences and humanities may now receive due consideration.
Macroeconomic Determinants of Technological Change in Indian Microfinance Institutions
Authors: Muneer Babu M.
Published: August 2016

Performance of Indian microfinance institutions (MFIs) is crucial to ensure access to financial services by the poor who lack access to finance from banks. Improvement in technology of Indian MFIs over a period of time is vital to ensure higher access and expansion of microfinance services to a large number of poor individuals or households in the economy. Better performance of Indian MFIs is also important, as MFIs are social entrepreneurial in nature, expecting fair returns on their investment. This article analyzes the changing trends of technological change in Indian MFIs by using the technological index, decomposed from the Malmquist total factor productivity index (TFP), employing data envelopment analysis (DEA) for a panel of 34 Indian MFIs during the period 2005–2006 to 2010–2011. We further use a static panel data model, such as random effect model (REM), to examine various macro- economic determinants of technological change in Indian MFIs during the period 2006–2007 to 2010–2011. Our result indicates that the technological change in Indian MFIs is positively driven by macroeconomic factors, namely, GDP growth rate and size of the economy, whereas it is negatively influenced by the rate of inflation.
A renal adenocarcinoma in a corn snake (Pantherophis guttatus) resembling human collecting duct carcinoma
Authors: Kao Chi-Fei , Chen Jiun-Liang , Tsao Wen-Tien , Lee An-Hsing , Liu Chen-Hsuan , Wang Fun-In
Published: August 2016

A 5-year-old male captive corn snake ( Pantherophis guttatus) with caudal coelomic swelling was admitted for surgical treatment. Laparotomy revealed a 5 × 4 × 2.5 cm, firm, expansile, irregularly shaped mass arising from the middle portion of the right kidney with a mild lobulated pattern and mottled white-to-tan. Microscopically, the mass was composed of numerous bizarre angulated tubules of polygonal neoplastic cells separated by a scirrhous stroma with remarkable heterophilic infiltrates. The neoplastic cells were nonciliated and mucin secreting, with abundant brightly eosinophilic cytoplasm. There were marked cellular and nuclear atypia, frequent cell individualization, and stromal invasion, indicative of malignant behavior, which was confirmed by metastasis to the left kidney 1.5 months postoperatively. Both neoplastic epithelial cells and mesenchymal cells contributing to the scirrhous stroma had variable immunopositivity for pan-cytokeratin. The neoplasm was considered a renal adenocarcinoma resembling human collecting duct carcinoma.
Isolation and characterization of atypical Listeria monocytogenes associated with a canine urinary tract infection
Authors: Palerme Jean-Sébastien , Pan Po Ching , Parsons Cameron T. , Kathariou Sophia , Ward Todd J. , Jacob Megan E.
Published: August 2016

Listeria monocytogenes, a well-described cause of encephalitis and abortion in ruminants and of food-borne illness in humans, is rarely associated with disease in companion animals. A case of urinary tract infection associated with an atypical, weakly hemolytic L. monocytogenes strain is described in a diabetic dog. The serotype of the L. monocytogenes isolate was determined to be 1/2a (3a), with the multilocus genotyping pattern 2.72_1/2a. A nucleotide substitution (Gly145Asp) was detected at residue 145 in the promoter prfA region. This residue is within the critical helix-turn-helix motif of PrfA. The source of the L. monocytogenes strain remains unknown, and the dog recovered after a 4-week course of cephalexin (30 mg/kg orally twice daily).
Partial participation towards collective action: To stifle or instigate
Authors: Funcke Alexander , Franke Ulrik
Published: August 2016

In this paper we extend the Granovetter threshold model with partial participation towards a collective action. That is, agents may partake by conducting an action that is less costly than the ultimate collective action, but costly enough to signal a commitment to the cause. We show that it is not just the exact distribution of thresholds, but also the distribution of available actions that determines whether a collective action will be achieved. We suggest and prove propositions for how both an inventive “activist” and a “dictator” may strategically change the signaling value of existing actions, or introduce new ones, in order to either instigate or stifle collective action. Applying the theory to revolutions, we argue that new technology can play a role beyond that of communication and synchronization, viz. that of adding modes of partial, less arduous, participation.
Development and Psychometric Testing of the Iceland–Family Illness Beliefs Questionnaire
Authors: Gisladottir Margret , Svavarsdottir Erla Kolbrun
Published: August 2016

Illness beliefs affect how individuals and families deal with illness. A valid and reliable instrument has not yet been developed to measure “illness beliefs” in family nursing research and clinical practice. This article describes the purpose, reliability, validity, and the potential clinical and research applications of a new instrument, the Iceland–Family Illness Beliefs Questionnaire (ICE-FIBQ). The ICE-FIBQ is a short, self-report measure of an individual’s beliefs about illness. Drawing from an advanced nursing practice model called the Illness Beliefs Model, the instrument was developed to measure illness beliefs about (a) cause of illness, that is, etiology; (b) control of illness on family and control of family on illness; (c) effect of illness on the individual and family; (d) illness suffering; and (e) support received from health care professionals during illness. The instrument was tested on 139 family caregivers of adolescents/youth with an illness or a disorder. Exploratory factor analysis reduced the original questionnaire from eight to seven items with a one-factor solution (Cronbach’s α = .780). Confirmatory factor analysis supported the one-factor solution (Cronbach’s α = .789). Further research is needed to determine concurrent validity with other illness belief/illness perception scales and if the instrument is sensitive to capture change in illness beliefs following family nursing intervention.
Storytelling and cultural family value transmission: Value perception of stories in family firms
Authors: Zwack Mirko , Kraiczy Nils D , von Schlippe Arist , Hack Andreas
Published: August 2016

This study analyses the transmission of cultural family values in family firms through storytelling. Specifically, we investigate whether cultural family values that are intended to be imparted by a story and its teller are also perceived accurately by listeners (i.e. the intended imparted value and the perceived value are congruent). We use a mixed-methods design including a qualitative phase, which identifies stories told in three German family firms, and a quantitative phase, which analyses the value perception (i.e. subjective cognition) of 226 individuals from outside the firm for a selected number of six stories. Results indicate that the intended values of the selected stories are perceived accurately by the individuals. Hence, stories might describe a useful means for transmitting cultural family values in family firms.
Involving incarcerated individuals in the research process: Perspectives of key stakeholders
Authors: Johnson Mark E , Brems Christiane , Mills Michael E , Eldridge Gloria D
Published: August 2016

Given the considerable potential for participatory action research in correctional settings, this study gathered stakeholders’ perspectives on involving adults in custody throughout the research process. Using mixed methods, the study identified participants’ level of interest in involving prisoners in the research process to inform educational efforts to increase correctional participatory action research. Qualitative data were gathered from 94 prison administrators, Institutional Review Board throughout the Abstract section.] members, prisoner representatives, research ethicists, and correctional researchers; quantitative data were collected from 1228 correctional and noncorrectional mental health researchers, correctional and noncorrectional Institutional Review Board members, and prisoner representatives. Qualitative data revealed lack of understanding of participatory action research concepts and advantages along with disagreement about whether prisoner involvement is desirable. Quantitative data revealed that respondents were most supportive of involving incarcerated individuals in contributing ideas for future research, planning recruitment procedures, developing participant protection procedures, and disseminating information to correctional populations. Respondents least supported involving adults in custody in disseminating findings to scientific venues, designing research and protocols, interpreting data, and setting research agendas. Combined, findings indicate efforts are needed to educate stakeholders about participatory action research’s value in correctional settings. This is particularly true related to soliciting prisoner voices in proactive and meaningful ways and moving beyond simply seeking input about measures selection or recruitment advice.
Picture this: Criminology, image and narrative
Authors: Carrabine Eamonn
Published: August 2016

This paper addresses the extent to which the ‘narrative turn’ in criminology can help inform how images should be read and interpreted. It begins by setting out structuralist analyses of narrative, before discussing an influential art historical approach to iconography and then turns to a substantive analysis of medieval penal imaginaries. Here the argument is that the images of extreme violence did not exactly reflect the realities of medieval life, rather they helped to dramatize them. The implications of this anthropological point are explored in the final section where the relationships between art, discourse and narrative are set out in further detail.
Increased unfractionated heparin requirements with decreasing body mass index in pregnancy
Authors: Patil Avinash S , Clapp Tracy , Gaston Piyamas K , Kuhl David , Rinehart Eliza , Meyer Norman L
Published: August 2016

Background

Pregnant women receiving low-molecular-weight heparin for therapeutic anticoagulation are often converted to unfractionated heparin in anticipation of labor. We aim to characterize the impact of maternal body mass index on attainment of target anticoagulation during the conversion process.

Methods

We conducted a five-year retrospective study of a pregnancy cohort converted from low-molecular-weight heparin to unfractionated heparin in the third trimester. Patient demographics, anticoagulation regimens, and clinical outcomes were extracted from the medical record. Nonparametric statistical methods were used for analysis by body mass index (<30, 30–35, and >35).

Results

Thirty-one subjects were evenly distributed by body mass index ( p = 0.97). Linear regression revealed an inverse correlation between patient body mass index and unfractionated heparin dose needed to achieve therapeutic anticoagulation ( p = 0.04). Subjects with body mass index > 35 attained therapeutic activated partial thromboplastin time levels at 18 U (Units)/kg/h, while subjects with body mass index < 30 required 25 U/kg/h ( p = 0.02).

Conclusion

Higher doses of unfractionated heparin are needed to achieve anticoagulation in patients with body mass index < 30 during pregnancy. This paradoxical relationship may be explained by physiologic characteristics that increase unfractionated heparin elimination, including diminished adiposity and increased renal clearance.
Efficacy of varicella (VZV) vaccination: an update for the clinician
Authors: Wang Lili , Zhu Lucy , Zhu Hua
Published: August 2016

Varicella-zoster virus (VZV) infection causes two distinct clinical conditions. Primary varicella infection results in chickenpox, a contagious rash illness typically seen among children. VZV can reactivate years after the initial infection to cause herpes zoster (HZ) and lead to post-herpetic neuralgia, a common complication resulting in persistent pain that may last for years after the zoster rash resolves. A person’s risk of having longer lasting and more severe pain associated with HZ increases with age. Since the introduction of VZV vaccines, the rates of infection, hospitalizations, and mortality have declined. In this review, we discuss in detail current VZV vaccines available for the prevention of VZV and HZ infections. Varilrix (GSK Biologicals, UK), Varivax (Merck, USA) and the combined measles, mumps, rubella, and varicella (MMRV) vaccine contain the live attenuated Oka strain of VZV for routine varicella vaccination. While Zostavax is the only HZ vaccine currently approved for use in the United States and the European Union [EMEA, 2011], a subunit vaccine candidate called HZ/su has recently shown improved efficacy for zoster prevention in two clinical trial phase III studies. VariZIG, a post-exposure prophylactic, uses zoster immune globulin to prevent VZV infection in those who have recently been in contact with VZV but lack evidence of varicella immunity and are contraindicated to receive the varicella vaccine. Further, we discuss the skin tropic and neurotropic factor VZV ORF7 gene and its involvement in varicella infection, reactivation and latency in ganglia. Ultimately, these studies can contribute to the development of a neuroattenuated vaccine candidate against varicella or a vector for delivery of other virus antigens.
Efficacy and safety of aclidinium/formoterolversussalmeterol/fluticasone: a phase 3 COPD study
Authors: Vogelmeier Claus , Paggiaro Pier Luigi , Dorca Jordi , Sliwinski Pawel , Mallet Marcel , Kirsten Anne-Marie , Beier Jutta , Seoane Beatriz , Segarra Rosa Maria , Leselbaum Anne
Published: August 2016

The efficacy and safety of twice-daily aclidinium bromide/formoterol fumarate was compared with that of salmeterol/fluticasone propionate in patients with stable, moderate-to-severe chronic obstructive pulmonary disease (COPD).

AFFIRM COPD (Aclidinium and Formoterol Findings in Respiratory Medicine COPD) was a 24-week, double-blind, double-dummy, active-controlled study. Patients were randomised (1:1) to aclidinium/formoterol 400/12 µg twice-dailyviaGenuair/Pressair or salmeterol/fluticasone 50/500 µg twice-dailyviaAccuhaler. The primary end-point was peak forced expiratory volume in 1 s (FEV1) at week 24. Other end-points included Transition Dyspnoea Index (TDI) focal score at week 24, TDI and St George's Respiratory Questionnaire (SGRQ) responders, COPD Assessment Test and SGRQ scores, assessment of COPD symptoms and exacerbations, use of reliever medication, and device preference. Adverse events were monitored throughout.

In total, 933 patients were eligible (mean age 63.4 years, 65.1% male). Aclidinium/formoterol was superior to salmeterol/fluticasone in peak FEV1and noninferior in TDI. Health status and reduction in exacerbation risk were similar in both groups. While both treatments were well tolerated, pneumonia occurred less frequently with aclidinium/formoterol than salmeterol/fluticasone.

In stable COPD, aclidinium/formoterol significantly improved bronchodilationversussalmeterol/fluticasone, with equivalent benefits in symptom control and reduction in exacerbation risk. Both treatments were well tolerated and treatment-related adverse events were less common with aclidinium/formoterol.
Laparoscopic anti-reflux surgery for idiopathic pulmonary fibrosis at a single centre
Authors: Raghu Ganesh , Morrow Ellen , Collins Bridget F. , Ho Lawrence A.T. , Hinojosa Marcelo W. , Hayes Jennifer M. , Spada Carolyn A. , Oelschlager Brant , Li Chenxiang , Yow Eric , Anstrom Kevin J. , Mart Dylan , Xiao Keliang , Pellegrini Carlos A.
Published: August 2016

We sought to assess whether laparoscopic anti-reflux surgery (LARS) is associated with decreased rates of disease progression in patients with idiopathic pulmonary fibrosis (IPF).

The study was a retrospective single-centre study of IPF patients with worsening symptoms and pulmonary function despite antacid treatment for abnormal acid gastro-oesophageal reflux. The period of exposure to LARS was September 1998 to December 2012. The primary end-point was a longitudinal change in forced vital capacity (FVC) % predicted in the pre-versuspost-surgery periods.

27 patients with progressive IPF underwent LARS. At time of surgery, the mean age was 65 years and mean FVC was 71.7% pred. Using a regression model, the estimated benefit of surgery in FVC % pred over 1 year was 5.7% (95% CI −0.9–12.2%, p=0.088) with estimated benefit in FVC of 0.22 L (95% CI −0.06–0.49 L, p=0.12). Mean DeMeester scores decreased from 42 to 4 (p<0.01). There were no deaths in the 90 days following surgery and 81.5% of participants were alive 2 years after surgery.

Patients with IPF tolerated the LARS well. There were no statistically significant differences in rates of FVC decline pre- and post-LARS over 1 year; a possible trend toward stabilisation in observed FVC warrants prospective studies. The ongoing prospective randomised controlled trial will hopefully provide further insights regarding the safety and potential efficacy of LARS in IPF.
Predictive value of exhaled nitric oxide in the management of asthma: a systematic review
Authors: Lehtimäki Lauri , Csonka Péter , Mäkinen Eeva , Isojärvi Jaana , Hovi Sirpa-Liisa , Ahovuo-Saloranta Anneli
Published: August 2016

The clinical value of measuring fractional exhaled nitric oxide (FeNO) in asthma is not clear. We aimed to assess whetherFeNOcan reliably predict clinical outcomes in asthma treated with inhaled corticosteroids (ICS). We also evaluated whether its predictive role is influenced by different inflammatory phenotypes of asthma.

We conducted a systematic review focusing on five clinically relevant questions. Two authors independently screened search results, extracted data and assessed quality of the included studies. Data were synthesised by qualitative methods.

12 prospective studies were included, answering partly three of the five questions. In steroid-naïve asthma, a highFeNOlevel probably predicts good response to ICS. In ICS-treated asthmatics, a lowFeNOlevel probably predicts low risk of exacerbation, and the patient is unlikely to benefit from increasing ICS dose. There were scarce data to conclude whetherFeNOpredicts exacerbations when ICS treatment is stopped in well-controlled asthma. Only one study reported results separately in different asthma phenotypes.

The current evidence on the predictive value ofFeNOand its role in the management of asthma is incomplete. Future studies should focus on clinically meaningful questions and probably target only eosinophilic phenotypes whereFeNOis best associated with the activity of airway inflammation.
The emerging role of epigenetics in pulmonary hypertension
Authors: Gamen Elisabetta , Seeger Werner , Pullamsetti Soni Savai
Published: August 2016

Epigenetics is usually defined as the study of changes in phenotype and gene expression not related to sequence alterations, but rather the chemical modifications of DNA and of its associated chromatin proteins. These modifications can be acquiredde novo, being inherited, and represent the way in which genome and environment interact. Recent evidence points to the involvement of epigenetic changes in the pathogenesis of pulmonary hypertension, as they can partly explain how environmental and lifestyle factors can impose susceptibility to pulmonary hypertension and can explain the phenotypic alteration and maintenance of the disease state.

In this article, we review the epigenetic regulatory mechanisms that are mediated by DNA methylation, the post-translational modifications of histone tails and noncoding RNAs in the pathogenesis of pulmonary hypertension. Furthermore, pharmacological interventions aimed at epigenetic regulators/modifiers and their outcomes in different cellular and preclinical rodent models are discussed. Lastly, the remaining challenges and future directions in which to explore epigenetic-based therapies in pulmonary hypertension are discussed.
β-Arrestin 1-dependent regulation of Rap2 is required for fMLP-stimulated chemotaxis in neutrophil-like HL-60 cells
Authors: Gera Nidhi , Swanson Kenneth D , Jin Tian
Published: August 2016

β-Arrestins have emerged as key regulators of cytoskeletal rearrangement that are required for directed cell migration. Whereas it is known that β-arrestins are required for formyl-Met-Leu-Phe receptor (FPR) recycling, less is known about their role in regulating FPR-mediated neutrophil chemotaxis. Here, we show that β-arrestin 1 (ArrB1) coaccumulated with F-actin within the leading edge of neutrophil-like HL-60 cells during chemotaxis, and its knockdown resulted in markedly reduced migration within fMLP gradients. The small GTPase Ras-related protein 2 (Rap2) was found to bind ArrB1 under resting conditions but dissociated upon fMLP stimulation. The FPR-dependent activation of Rap2 required ArrB1 but was independent of Gαi activity. Significantly, depletion of either ArrB1 or Rap2 resulted in reduced chemotaxis and defects in cellular repolarization within fMLP gradients. These data strongly suggest a model in which FPR is able to direct ArrB1 and other bound proteins that are required for lamellipodial extension to the leading edge in migrating neutrophils, thereby orientating and directing cell migration.
Longitudinal course of behavioural and psychological symptoms of dementia: systematic review
Authors: van der Linde Rianne M. , Dening Tom , Stephan Blossom C. M. , Prina A. Matthew , Evans Elizabeth , Brayne Carol
Published: August 2016

Background

More information about the pattern of behavioural and psychological symptoms of dementia (BPSD) in the course of dementia is needed to inform patients and clinicians and to design future interventions.

Aims

To determine the persistence and incidence of BPSD and their relation to cognitive function, in individuals with dementia or in cohorts investigated for dementia onset.

Method

A systematic literature review analysed the baseline prevalence, persistence and incidence of 11 symptoms. The review was conducted according to established guidelines with the exception that we could not exclude the possibilities of bias in the studies examined.

Results

The 59 included studies showed considerable heterogeneity in their objectives and methods. The symptoms hyperactivity and apathy showed high persistence and incidence; depression and anxiety low or moderate persistence and moderate incidence; and psychotic symptoms low persistence with moderate or low incidence.

Conclusions

Despite heterogeneity across studies in terms of setting, focus and length of follow-up, there were clinically relevant differences in the longitudinal courses of different BPSD. Apathy was the only symptom with high baseline prevalence, persistence and incidence during the course of dementia.
Exposure-based cognitive–behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial
Authors: Hedman Erik , Axelsson Erland , Andersson Erik , Lekander Mats , Ljótsson Brjánn
Published: August 2016

Background

In DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive–behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility.

Aims

To investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-ICBT) and as unguided bibliotherapy.

Method

A randomised controlled trial (RCT) where participants (n= 132) with a diagnosis of SSD or IAD were randomised to ICBT, U-ICBT, bibliotherapy or to a control condition on a waiting list (trial registration: Clinicaltrials.gov identifier NCT01966705).

Results

Compared with the control condition, all three treatment groups made large and significant improvements on the primary outcome Health Anxiety Inventory (between-groupdat post-treatment was 0.80–1.27).

Conclusions

ICBT, U-ICBT and bibliotherapy can be highly effective in the treatment of SSD and IAD. This is the first study showing that these new DSM-5 disorders can be effectively treated.
The Cultural Production of Consumption as Achievement
Authors: Brooks Ann , Wee Lionel
Published: August 2016

In this article, we identify two models of consumer culture: the more familiar appeasement model where the “customer is king,” as well as a less established and recently emergent achievement model where the consumer’s efforts in consummating the act of consumption are lauded and celebrated. This raises the question of how the two models might be related to each other. Here we argue that the spread of neoliberal ideology, where the neoliberal subject is constituted as one who prides herself or himself on demonstrating entrepreneurial qualities, who thrives under competitive conditions, and who is comfortable displaying these qualities in the context of public scrutiny, has led to the cultivation of the enterprising consumer. We also show how the technologies of government employed in the cultural production of the enterprising consumer differ, and necessarily so, from those employed in the case of the enterprising producer.
Sulfur utilization of corals is enhanced by endosymbiotic algae
Authors: Yuyama Ikuko , Higuchi Tomihiko , Takei Yoshio
Published: August 2016

Sulfur-containing compounds are important components of all organisms, but few studies have explored sulfate utilization in corals. Our previous study found that the expression of a sulfur transporter (SLC26A11) was upregulated in the presence of Symbiodinium cells in juveniles of the reef-building coral Acropora tenuis. In this study, we performed autoradiography using 35S-labeled sulfate ions (35SO4 2−) to examine the localization and amount of incorporated radioactive sulfate in the coral tissues and symbiotic algae. Incorporated 35SO4 2− was detected in symbiotic algal cells, nematocysts, ectodermal cells and calicoblast cells. The combined results of 35S autoradiography and Alcian Blue staining showed that incorporated 35S accumulated as sulfated glycosaminoglycans (GAGs) in the ectodermal cell layer. We also compared the relative incorporation of 35SO4 2− into coral tissues and endosymbiotic algae, and their chemical fractions in dark versus light (photosynthetic) conditions. The amount of sulfur compounds, such as GAGs and lipids, generated from 35SO4 2− was higher under photosynthetic conditions. Together with the upregulation of sulfate transporters by symbiosis, our results suggest that photosynthesis of algal endosymbionts contributes to the synthesis and utilization of sulfur compounds in corals.
Autocrine IL-10 activation of the STAT3 pathway is required for pathological macrophage differentiation in polycystic kidney disease
Authors: Peda Jacqueline D. , Salah Sally M. , Wallace Darren P. , Fields Patrick E. , Grantham Connor J. , Fields Timothy A. , Swenson-Fields Katherine I.
Published: August 2016

Polycystic kidney disease (PKD) is characterized by slow expansion of fluid-filled cysts derived from tubules within the kidney. Cystic expansion results in injury to surrounding parenchyma and leads to inflammation, scarring and ultimately loss of renal function. Macrophages are a key element in this process, promoting cyst epithelial cell proliferation, cyst expansion and disease progression. Previously, we have shown that the microenvironment established by cystic epithelial cells can ‘program’ macrophages, inducing M2-like macrophage polarization that is characterized by expression of markers that include Arg1 and Il10. Here, we functionally characterize these macrophages, demonstrating that their differentiation enhances their ability to promote cyst cell proliferation. This observation indicates a model of reciprocal pathological interactions between cysts and the innate immune system: cyst epithelial cells promote macrophage polarization to a phenotype that, in turn, is especially efficient in promoting cyst cell proliferation and cyst growth. To better understand the genesis of this macrophage phenotype, we examined the role of IL-10, a regulatory cytokine shown to be important for macrophage-stimulated tissue repair in other settings. Herein, we show that the acquisition of the pathological macrophage phenotype requires IL-10 secretion by the macrophages. Further, we demonstrate a requirement for IL-10-dependent autocrine activation of the STAT3 pathway. These data suggest that the IL-10 pathway in macrophages plays an essential role in the pathological relationship between cysts and the innate immune system in PKD, and thus could be a potential therapeutic target.
A high-fat jelly diet restores bioenergetic balance and extends lifespan in the presence of motor dysfunction and lumbar spinal cord motor neuron loss in TDP-43A315T mutant C57BL6/J mice
Authors: Coughlan Karen S. , Halang Luise , Woods Ina , Prehn Jochen H. M.
Published: August 2016

Transgenic transactivation response DNA-binding protein 43 (TDP-43) mice expressing the A315T mutation under control of the murine prion promoter progressively develop motor function deficits and are considered a new model for the study of amyotrophic lateral sclerosis (ALS); however, premature sudden death resulting from intestinal obstruction halts disease phenotype progression in 100% of C57BL6/J congenic TDP-43A315T mice. Similar to our recent results in SOD1G93A mice, TDP-43A315T mice fed a standard pellet diet showed increased 5′ adenosine monophosphate-activated protein kinase (AMPK) activation at postnatal day (P)80, indicating elevated energetic stress during disease progression. We therefore investigated the effects of a high-fat jelly diet on bioenergetic status and lifespan in TDP-43A315T mice. In contrast to standard pellet-fed mice, mice fed high-fat jelly showed no difference in AMPK activation up to P120 and decreased phosphorylation of acetly-CoA carboxylase (ACC) at early-stage time points. Exposure to a high-fat jelly diet prevented sudden death and extended survival, allowing development of a motor neuron disease phenotype with significantly decreased body weight from P80 onward that was characterised by deficits in Rotarod abilities and stride length measurements. Development of this phenotype was associated with a significant motor neuron loss as assessed by Nissl staining in the lumbar spinal cord. Our work suggests that a high-fat jelly diet improves the pre-clinical utility of the TDP-43A315T model by extending lifespan and allowing the motor neuron disease phenotype to progress, and indicates the potential benefit of this diet in TDP-43-associated ALS.