bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Membrane Trapping in Plasma Fractionator on Separative Characteristics
Authors: Mineshima M. , Agishi T. , Hasuo Y. , Kaneko I. , Era K. , Ota K.
Published: April 2018

Several kinds of plasma fractionators have been introduced to actively separate protein fractions between albumin and globulins in double filtration plasmapheresis. However, relatively large molecular weight proteins are known to be partially trapped by the membrane in a plasma fractionator.

In this paper, effects of membrane trapping on separation characteristics in plasma fractionators were examined during in vitro and in vivo studies. All in vitro experiments were done with a closed circuit under constant-flow rate filtration. Protein concentration in feed tank kept constant at no filtration in AS-14H, Evaflux 4A and 2A, while 20-40% of IgG and 40-60% of β-lipoprotein in 2 liter plasma were removed by membrane trapping for 300 min when filtration fraction equaled 0.87. Protein plugging to the membrane seems to be a major factor in these proteins. And, Dead-end and Partially Discarded modalities with relatively high filtration fraction are effective for the separation between albumin and globulin.

Twenty-seven DFPP treatments in 13 patients with autoimmune diseases were done to allow us to estimate the effects of membrane trapping during an in vivo study. All treatments using 6 types of plasma fractionator were performed under constant operating conditions with Partially Discarded modality. In any plasma fractionator, β-lipoprotein was fairly trapped at 30 min after the start of treatment.
Plasma Exchange for the Management of Cyclosporin A-Induced Hypertriglyceridemia
Authors: Valbonesi M. , Occhini D. , Capra C. , Frisoni R. , Fella M. , Quaratino S. , Pittaluga P.A.
Published: April 2018

The Authors report a case of hypertriglyceridemia complicating the course of a patient receiving cyclosporin A after bone marrow transplantation. When the patient was seen at the hemapheresis unit the clinical picture was characterized by headache, increasing visual and neurological disturbances. Plasma triglyceride level was 3215 mg/dl. Two plasma exchange sessions reduced triglycerides to 486 mg/dl and halted the disease progression. This may represent the first plasma exchange treatment of cyclosporin A-induced hypertriglyceridemia.
Mononuclear Cell Phenotyping in a Hemodialysis Population
Authors: Wiener G. Ramirez D. , Murtha D.G. , Brueggemeyer C.D. , Rowlands D. T.
Published: April 2018

A study of peripheral blood mononuclear cell phenotyping and HIV testing was performed in 39 chronic hemodialysis patients. The following abnormalities were found in comparison to a control population: 1) a lower percentage of lymphocytes in the white blood cell differential count, 2) a lower percentage of total T cells, 3) a lower percentage and absolute number of suppressor T cells and 4) a lower percentage and absolute number of B cells. Both increasing age and blood transfusions were associated with reduced helper cells.
Different Buffers for Hemodiafiltration: A Controlled Study
Authors: Biasioli S. , Feriani M. , Chiaramonte S. , Cavallini L. , Cesaro A. , Fazion S. , Petrosino L. , Porena P. , Zambello A.
Published: April 2018

Hemodiafiltration (HDF) is usually performed using a dialytic solution (D) containing acetate (A) or bicarbonate (B) and a replacement fluid (RF) containing lactate (L).

To clarify the role of buffers in HDF, 11 patients underwent different study periods, each three months long: bicarbonate hemodialysis (BHD = Baseline period); HDF with (A) in D and (L) in RF (first period of HDF); HDF with (A) in D and (B) in RF (second HDF); HDF with (B) in D and (L) in RF (third HDF); HDF with (B) in D and (B) in RF (fourth HDF = BHDF).

HDF achieved: 1) an increase in dialytic efficiency (kt/V, 1.28), reducing the time-session (197 min); 2) an improvement in acid-base status (pre-dialytic values in BHDF: pH 7.36; pCO2 39.8 mmHg; HCO−3 21.8 mM/L); 3) better “dry weight” gain (reached in 92.8% of HDF and in 81% of BHD sessions); 4) a significant decrease, in dialytic side-effects (mainly during the third and fourth periods).

On the whole, BHDF (HDF done using only bicarbonate buffer) represents an easy and safe technique, leading to better cardiovascular stability than BHD and HDF without bicarbonate buffer.
Microscopic Observation of Leukocyte Kinesis in the Vascular Bed during Hemodialysis Using the Rabbit Ear Chamber Technique
Authors: Teraoka S. , Sugawara M. , Kitano Y. , Hoshino T. , Takahashi M. , Minagawa Y. , Naganuma S. , Sanaka T. , Mineshima M. , Era K. , Honda H. , Fuchinoue S. , Agishi T. , Ota K.
Published: April 2018

Leukocyte kinesis in the capillary vascular bed during hemodialysis (HD) was investigated to elucidate the mechanism of transient leukopenia. Leukocyte movement was observed microscopically during HD using the rabbit ear chamber (REC) technique, which permits visualization of the movement of blood corpuscles in capillaries. Blood was drawn from the femoral artery and returned into the auricular and/or carotid artery so that the blood passing through the hollow fiber artificial kidney (HFAK) flowed into capillaries in the REC. Leukocyte counts of blood samples taken from the afferent and efferent limbs of the HD circuit, the right jugular vein and the right atrium were determined consecutively during HD. The difference in the leukocyte count was observed between the afferent and efferent limbs for the first 15 minutes and thereafter between the efferent limb and the jugular vein. The “transpulmonary” difference in the leukocyte count was not noticed throughout HD. Between 15 and 90 minutes after the start of HD, scarcely any circulating leukocytes were found in capillaries in the REC and some leukocytes were attached to the endothelial surface. Thereafter circulating leukocytes were seen again and detachment of leukocytes from the endothelial surface was observed. No leukocyte aggregation or embolization of aggregating leukocytes was noticed. This evidence suggests that leukopenia may be attributed to the transient shift of leukocytes to the marginal pool of the vessel lumen and this process may not be specific for the pulmonary vasculature, but may occur in the first capillary bed into which the blood passing through the HFAK flows. The attachment of leukocytes to the surface membrane of the HFAK may contribute to the transient leukopenia especially during the initial period of the HD.
Prerequisites to Salvage Profound Biventricular Failure Patients with Ventricular Assist Devices
Authors: Nakatani T. , Takano H. , Noda H. , Taenaka Y. , Umezu M. , Kinoshita M. , Fukuda S. , Matsuda T. , Iwata H. , Takatani S. , Tatsumi E. , Yagura A. , Sekii Y. , Akutsu T.
Published: April 2018

We conducted chronic experiments to determine how to treat profound biventricular failure systematically with ventricular assist devices (VADs) and to analyze the factors that affect prognoses for this condition. Anoxic arrest was induced in ten goats by aortic cross-clamping under normothermic conditions (38.5° C) for 30 (n= 3), 45 (n= 1), and 60 (n= 6) minutes. A left ventricular assist device (LVAD) was implanted in eight animals, and a biventricular assist device (BVAD) was used in two. Three goats — two of which had undergone anoxic arrest for 30 minutes and one for 60 minutes — whose right atrial pressure (RAP) was approximately 18 mm Hg during the acute stage, recovered in two to three weeks, and the pumps were successfully removed. Pathological findings in these animals showed scattered areas of surviving myocardium, with connective tissue replacing the degenerated myocardium. The remaining five LVAD goats required higher RAPs to maintain circulation and died from various causes. Maintaining circulation without volume loading, even in the presence of arrhythmias, was easier with the BVAD. One BVAD animal that underwent 45 minutes of anoxic arrest recovered from right ventricular failure, and the right pump was removed. The second goat (anoxic arrest, 60 min) on the BVAD failed to recover. Autopsy of the myocardium revealed a thin ventricular wall. Our studies show that the use of VADs allows time for a failing heart to recover, but the potential for healing is affected by the severity of myocardial damage prior to VAD application. We believe that although LVADs can maintain circulation with high RAPs, the use of BVADs might be more beneficial for maintaining systemic organ function in cases of persistent biventricular failure.
Climatic Factors and Peritonitis in CAPD Patients
Authors: Chan M.K. , Chan C.Y. , Cheng I.K.P. , Ng W.S.F.
Published: April 2018

From March 1983 to December 1987 the relation of the occurrence of all episodes of peritonitis in CAPD patients to climatic factors, such as temperature and relative humidity was examined. Altogether 389 episodes were recorded in 239 patients. Peritonitis due to Staphylococcus epidermidis, Gram-negative organisms and culture-negative episodes was most frequent during the hot months of the year, June to October. The occurrence of peritonitis due to Staphylococcus aureus was uniformly distributed throughout the year. Relative humidity did not seem to affect the frequency of peritonitis.
Conceptual and Design Features of a Practical, Clinically Effective Intravenous Mechanical Blood Oxygen/Carbon Dioxide Exchange Device (Ivox)
Authors: Mortensen JD , Berry G.
Published: April 2018

Conceptual and design features of a new intravascular blood gas exchange device include: placing multiple, thin-walled microporous hollow fibers in an elongated arrangement with a small overall outside diameter; covering the outer surface of each microporous hollow fiber with an ultrathin continuous silicone coating; forming the hollow fibers into a configuration that produces disturbed flow of blood over the external surface of each fiber; placing the device in the subject's vena cava through a femoral or jugular venotomy; producing a flow of oxygen through the lumens of the hollow fibers, permitting exchange of oxygen and carbon dioxide between the venous blood outside and the gas inside the hollow fibers. Based on these principles, a practical, easily insertible, disposable, intravenacaval blood gas exchange device (IVOX) has been fabricated. Currently, devices with from 2,000 to 6,000 square centimeters of gas transfer surface area are being placed in the vena cavae of dogs and sheep for up to 7 days without altering the animal's hemodynamics, without producing serious hematologic sequelae, and with the capability of transferring in excess of 100 ml of oxygen and carbon dioxide to and from the venous blood of an intact, awake, standing animal. Clinical trials on human subjects with severe, acute, potentially reversible respiratory failure are in the planning stage.
Lack of Oxidative Damage in Serum Polyunsaturated Fatty Acids before and after Dialysis in Chronic Uremic Patients
Authors: Taccone-Gallucci M. , Lubrano R. , Belli A. , Citti G. , Morosetti M. , Meloni C. , Elli M. , Mazzarella V. , Tozzo C. , Meschini L. , Giardini O. , Casciani C.U.
Published: April 2018

We described previously that in the erythrocytes and mononuclear blood cells from uremic patients on chronic hemodialysis, the membrane concentrations of malonyldialdehyde (MDA), resulting from peroxidation of polyunsaturated fatty acids (PUFA) in the membrane itself increased, and the concentrations of vitamin E (VIT E), the major antioxidizing agent, were lower. In the present study we analysed whether similar oxidative damage is seen in the serum from hemodialysis patients and whether the serum fatty acid pattern is affected. No evidence was found of oxidative damage in the serum during hemodialysis, serum concentrations of MDA and VIT E remaining constant before and after dialysis. No change was observed in serum pattern of PUFA, particularly linoleic acid. We therefore assume that the oxidative damage described in uremic patients is mainly intracellular.
Relationship between Generation and Plasma Concentration of Anorganic Phosphorus. in Vivo Studies on Dialysis Patients and in Vitro Studies on Erythrocytes
Authors: Pogglitsch H. , Estelberger W. , Petek W. , Zitta S. , Ziak E.
Published: April 2018

The plasma concentration of inorganic phosphorus (Pi) was determined before, during and after hemodialysis in 28 patients with chronic renal failure. Pi plasma concentration decreased rapidly when hemodialysis was started but did not fall below normal levels during continued dialysis. These changes of Pi concentration were fitted to a model of Pi kinetics in which Pi delivery to plasma is a nonlinear function of the extracellular Pi concentration. In separate in vitro studies, erythrocytes from six subjects with normal renal function and from 14 patients with chronic renal failure were incubated in homologous plasma with various amounts of Pi added. All other factors known to affect the Pi shift between intra - and extracellular fluid compartments (pH, calcium concentration) were kept constant. The relation between Pi concentration in plasma used for incubation and in red cells after 1h incubation suggested a mechanism in which a high plasma concentration results in movement of Pi into red cells where Pi is stored most probably in glucose esters. At low Pi plasma concentration Pi is delivered to plasma at a rate which cannot be explained solely by passive movement of intracellular Pi to plasma but requires additional generation from intracellular storage forms. The generation and delivery of Pi in patients and in their erythrocytes indicate a simple cell-mediated Pi homeostasis counter-acting abnormal fluctuations of plasma Pi.
Optimization of Heparinization in Clinical Double Filtration Plasmapheresis
Authors: Hosokawa S. , Oyamaguchi A. , Yoshida O.
Published: April 2018

Heparin has generally been used as an anticoagulant during plasmapheresis. In this study plasma heparin levels were studied in nine patients before double filtration plasmapheresis (DFPP), 30, 60 and 120 minutes after the start of DFPP and at the end of DFPP. Prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), plasma fibrinogen levels, FDP and general blood cell examination (CBC) were measured pre and post DFPP. Heparin levels in plasma were lower than 1 (IU/ml) under the dosage of heparin nearly 40 IU/kg/h of heparin administered during DFPP. APTT before DFPP (36.5 ± 8.2 sec) was nearly double the post-DFPP value (61.4 ± 12.2 sec). In two patients who were given 30 IU/kg/h of heparin during DFPP, clotting occurred in the DFPP circuit. In conclusion, the optimized dosage of heparin was 40 IU per kg of body weight per hour during DFPP.
Kinetic Modeling of Intracellular pH and Comparison with 31P NMR Experimental Values in Dialysed Uremic Patients
Authors: Monti J-P. , Sarrazin M. , Gallice P. , Crevat A. , Baz M. , Murisasco A. , Elsen R.
Published: April 2018

Changes in intra-erythrocytic pH values over time, during and after bicarbonate hemodialysis, were studied with 31P Nuclear Magnetic Resonance. Simultaneously, pH values of whole blood were obtained by a gazometric method. A two-compartment model appeared to be the simplest kinetic model to explain the shifts in proton concentrations in extra- and intracellular media. Non-linear regression was used to determine exchange constant values. There was a very good correlation between the experimental and calculated proton concentrations. This model can describe all patients but individual experimental constants must be determined. Under these conditions a single blood pH determination before dialysis will permit determination of the initial intra-erythrocytic pH and monitoring of intra-erythrocytic pH during hemodialysis.
Morphological Features of Blood Access Stenosis and Results of Noninvasive Angioplasty
Authors: Nakane K. , Maeda K.
Published: April 2018

We investigated a connection between the results of noninvasive angioplasty for the blood access stenosis and its morphological features in 37 dialysis cases. In 3 cases presenting stenosis in the original artery, the area could not be dilated by noninvasive techniques. In 4 cases with stenosis in the arterialized vein downstream of the needle insertion points for extracorporeal circulation, 3 showed longterm dilatation by the procedures. In 30 cases having stenosis upstream of the points, 16 showed longterm dilatation. In the unsuccessful cases, the angle formed between the axes of the stenosed portion and the normal vessel was over 39 degrees, and the distance between the anastomosis and the stenosed portion was less than 11 mm.
Cyclophosphamide 4 g/m2 Plus rhG-CSF for Mobilization of Circulating Progenitor Cells in Malignant Lymphomas
Authors: Indovina A. , Liberti G. , Majolino I. , Buscemi F. , Scimè R. , Gentile S. , Vasta S. , Pampinella M. , Cappuzzo V. , Santoro A.
Published: April 2018

We report the preliminary results of a study exploring the possibility of collecting circulating progenitor cells (PBSC) with a protocol based on the administration of single doses (4 g/m2) of cyclophosphamide and G-CSF (5 or 10- μg/kg) in 9 patients with non Hodgkin's lymphoma. The peak level of CD34+ cells occurred after a median of 10 days (range 8-11), generally coinciding with the median peak level of CFU-GM, with a mean 31.27 fold increase above basal levels. 3 (range 2-5) leukaphereses were required to harvest a median number of 25. 1x104/kg (8-105) CFU-GM and of 9.4x106/kg (1.2-25) CD34+cells. No difference was recorded between 5 and 10 μg/kg of G-CSF in terms of PBSC yield. In transplanted patients, a strong correlation was found between CD34+ cells infused/kg and platelet recovery (r= -0.8, p=0.002). No toxicity was observed and apheretic procedures were regularly performed outpatiently. Our conclusion is that this protocol is particularly suitable for an outpatient treatment/collection program.
Therapeutic Plasma Adsorption. A Review
Authors: Cepparrone G. Avanzi F. , Lombardo R. , Di Pietro G.
Published: April 2018

Alternative techniques to the traditional plasma exchange are emerging in clinical practice for the treatment of different pathological conditions, particularly autoimmune diseases. Filtration is a technique used to separate blood cells from plasma, which may be further “treated” with other filters or columns. The case for cascade filtration and absorption onto a column is becoming stronger and stronger and the patient population is increasing. Alongside the “historical” techniques of adsorption onto a column, new systems (pairs of self-regenerating columns) and new products (columns with dextran sulphate, tryptophane, anti-human lipoprotein antibodies) are now available. Protein A in particular seems to open up new horizons; in therapeutic plasmapheresis, there are two versions, one Swedish and the other American, based on different theoretical premises and obtaining different results, with different biocompatibilities but good clinical results.
Thrombotic Thrombocytopenic Purpura Resistant to Plasma-exchange: Salvage Treatment with High-dose IgG or Vincristine
Authors: Porta C. , Bobbio-Pallavicini E. , Centurioni R. , Tacconi F. ,   Italian Cooperative Group for TTP
Published: April 2018

Even though plasmaexchange (PE), either alone or combined with cortisone or platelet anti-aggregating substances is the treatment of choice for TTP, 10-15% of patients is resistant to treatment. Since immunoglobulin (IgG) infusion was reported to cure the clinical symptoms of PE-resistant TTP, and vincristine (VCR) has been recently successful in treating TTP, we reviewed the results obtained with both drugs in 20 PE-resistant patients. Of 12 patients receiving IgG and 8 receiving VCR, 3 (25%) and 4 (50%), respectively, achieved complete remission. Even though no conclusions can be drawn from such results, if complete remission can be achieved in a however small number of PE-resistant patients, the use of these drugs is suggested as a salvage treatment for TTP.
New Options for Multicomponent Collection (MCC) with the Latest Cell Separators
Authors: Bruni R. , Valbonesi M. , Frisoni R. , Lercari G. , Ruzzenenti M.R. , Florio G. , Carlier P.
Published: April 2018

Recently, several new cell separators have become available for high platelet low WBC contamination thrombocytapheresis. In their original configuration, these apparatuses can only collect plasma along with platelets, while no concurrent red cell collection can be carried out. In this study, we present the preliminary results of plasma and/or erythrothrombocytapheresis after the adaptation of the lines of two different cell separators, namely the Fresenius AS 204 and the Baxter Health Care Amicus. In addition, the preliminary results of multicomponent collection using the Dideco Excel will be presented; in the latter a system of plasma recirculation was introduced, to increase the purity and quality of the platelet product. The results of these studies show that erythrothrombocytapheresis can be carried out with all these apparatuses, but only with Dideco-Excel and the Fresenius AS 204 the procedure is totally automated. There are marginal differences in the quality of the RBC product in terms of percent hematocrit, from 65% with the Excel and AS 204 to ∼ 75% with the Amicus and in terms total content of hemoglobin which averages 58 g per RBC concentrate when RBC collection is carried out during the processing of ∼ 420 ml of whole blood. In terms of platelet collection, the differences are presently moderate, as the platelet yield and WBC contamination are not affected by the concurrent RBC collection. The average platelet yield was 3.98-4.1, and 4.01x1011 and the total WBC contamination was 1.2-2.9, and 1.9X105 rerspectively with the Amicus, the AS 204 and the Excel. These represent a new step in the direction of total apheresis for blood and blood component procurement.
Plateletapheresis with the New Baxter-Amicus Blood Cell Separator: An Italian Multicenter Study
Authors: Accorsi P. , Dell'isola M. , Bonfini T. , Valbonesi M. , Avanzi G. , Menichella G. , Politi P. , Salemme L. , Iacone A.
Published: April 2018

The efficiency and quality of platelet (PLT) collection were evaluated in a preliminary study using a new cell separator: Baxter-Amicus. The new fully automated blood cell separator combines centrifugation with elutration to obtain higher PLT efficiency with a lower white blood cell (WBC) contamination. We compared procedures performed with the first software version 2.13 and the more recent 2.37 version, then with and without plasma collection. Data from 262 plateletapheresis procedures were analyzed. The mean value of the PLT yield was 4.5±1.0x1011, collection efficiency: 69.4±12%; WBC contamination: 0.8±2.x106; and procedure time: 73± 19 minutes. The use of the new software vs the former permitted the collection of a higher number of platelets: 4.9± 1.1 vs. 4.5± 1.9 x1011 (=ns), with a lower WBC contamination: 0.6± 1.0 vs 0.7± 1.2 x106 (p=ns), in less time: 63± 10 vs 73± 19 minutes (p=0.002). The efficiency of platelet harvesting with simultaneous plasma collection was higher than the standard procedure: 73± 13 vs. 67± 10% (p=0.003).
Quality Control of Cytapheresis Products
Authors: Conte R. , Giudice V.
Published: April 2018

The Italian government has recently adopted the Council of Europe Recommendation no.R (95)15 on GMP (Good Manufacturing Practice) and quality control of blood components. However, there is still discussion as to which assays are appropriate for the quality control of plateletpheresis concentrate, PBSC concentrate and granulocyte concentrate. The main issues of programs to ensure the delivery of high quality products are discussed.
Plasma Exchange in France: 11 Years Survey
Authors: Korach J-M , Berger Ph. , Chillet P. ,   Group and the French Registry Study
Published: April 2018

The French Registry for Plasma Exchange (PE) was set up in 1985. For 11 years it has allowed the analysis of the techniques used, along with the indications and complications. After a decrease in the number of participating centers, due to the heaviness of the data collection mode, the telematic network, created in 1991, led to a new increase in participants from 26 in 1990 to 68 in 1996. Follow up shows a slight fall in activity since some protocols have ended, while neurological pathologies remain the most frequent indications. The important modifications observed over the years are the increase of the centrifugation technique, the development of plasma treatment and plasma substitution by an association of albumin-pentastarch. The French Registry for plasma exchange is the largest data base dealing with therapeutical hemapheresis. The French-German registry set-up through internet is a first step towards a European data base.
The Therapeutical Hemapheresis National Registry: Computerization Proposals
Authors: Vitaliano E. , Leopardi N. , Russo G.E.
Published: April 2018

The therapeutical hemapheresis National Registry, founded under the patronage of S.I.d.E., is now in its second year. It was set up to meet the need to gather experience from the various Italian groups dealing with hemapheresis and based on the former American and French experience; its future prospective is join to the European Unique Registry which is about to be realized. We have briefly surveyed the main points of “data collecting” and report the methods used.
An improved model for estimating heat release rate in horizontal cable tray fires in open space
Authors: Huang Xianjia , Zhu He , Peng Lan , Zheng Zihui , Zeng Wuyong , Cheng Chihonn , Chow Wanki
Published: April 2018

Electric cable fires in nuclear power plants could be disastrous and have to be studied carefully for safety and economic considerations. Based on the results of previous work on large-scale and bench-scale cable fire testing, the Flame Spread over Horizontal Cable Trays model was modified and improved to estimate the heat release rate of large-scale cable fires using bench-scale measured data. The heat release rate per unit area measured in the cone calorimeter experiment is taken as the input, to avoid introducing any prediction uncertainties caused by inconsistent values of the heat of combustion and char yield of the cable. Cable fire experiments with vertical stacks of trays with one to three layers of cables were conducted in open space to assess the accuracy of the improved model. In comparing with the experimental results, predictions using the improved model are encouraging. The local error of prediction is less than 15% and the global error lies between 19.2% and 35.7%. In addition, three cable tray fire experiments with data available in the literature were used to validate the improved model. It is shown that the improved model had good predictions for these cable tray fires.
Expanding Seniors’ Mobility through Phone Apps: Potential Responses from the Private and Public Sectors
Authors: Shirgaokar Manish
Published: April 2018

Seniors (over 64 years) are a growing demographic. Some seniors risk social exclusion given the lack of transportation options. Using qualitative methods, I investigate how transportation network company (TNC) services such as Lyft and Uber present an alternative for seniors’ mobility in comparison to taxis. I use technology acceptance models as a lens and explore the challenges that TNC services present for seniors. This analysis suggests that emerging transportation services—including self-driving cars—may present a boon for seniors if stakeholders from the private and public sectors can increase the ease of use of these new forms of mobility.
Personal Health Coaching as a Type 2 Diabetes Mellitus Self-Management Strategy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Pirbaglou Meysam , Katz Joel , Motamed Mehras , Pludwinski Sarah , Walker Krista , Ritvo Paul
Published: April 2018

Objective:

Personal health coaching (PHC) programs have become increasingly utilized as a type 2 diabetes mellitus (T2DM) self-management intervention strategy. This article evaluates the impact of PHC programs on glycemic management and related psychological outcomes.

Data Sources:

Electronic databases (CINAHL, MEDLINE, PubMed, PsycINFO, and Web of Science).

Study Inclusion and Exclusion Criteria:

Randomized controlled trials (RCT) published between January 1990 and September 2017 and focused on the effectiveness of PHC interventions in adults with T2DM.

Data Extraction:

Using prespecified format guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework.

Data Synthesis:

Quantitative synthesis for primary (ie, hemoglobin A1c [HbA1c]) and qualitative synthesis for selected psychological outcomes.

Results:

Meta-analyses of 22 selected publications showed PHC interventions favorably impact HbA1c levels in studies with follow-ups at ≤3 months (−0.32% [95% confidence interval, CI = −0.55 to −0.09%]), 4 to 6 months (−0.50% [95% CI = −0.65 to −0.35%], 7 to 9 months (−0.66% [95% CI = −1.04 to −0.28%]), and 12 to 18 months (−0.24% [95% CI = −0.38 to −0.10%]). Subsequent subgroup analyses led to no conclusive patterns, except for greater magnitude of effect size in studies with conventional (2-arm) RCT design.

Conclusions:

The PHC appears effective in improving glycemic control. Further research is required to assess the effectiveness of specific program components, training, and supervision approaches and to determine the cost-effectiveness of PHC interventions.
Social Justice at the Core of Breastfeeding Protection, Promotion and Support: A Conceptualization
Authors: Smith Paige Hall
Published: April 2018

Despite widespread awareness of the health benefits for both mothers and babies we are far from achieving universal breastfeeding. Breastfeeding rates globally are lower than recommended levels and there are concerns that some global breastfeeding efforts have stalled (1, 2). In addition, we see persistent disparities in breastfeeding rates by race, ethnicity, class and status (3). A growing literature documents how a range of injustices, including gender inequality (7), racism (8), poverty (9), and violence (10, 11) shape whether, how exclusive, and for how long mothers and others will be able to breastfeed or feed their infants human milk. These social injustices and inequities work to privilege breastfeeding even as the health message becomes more mainstreamed and human milk more desirable. A social justice approach could help us address the gender, race, and sexuality-based inequities and injustices in opportunities, resources, status, and power that are influencing the patterns of breastfeeding we see today. The 12th Breastfeeding and Feminism International Conference held in 2017 took as its theme Breastfeeding as Social Justice: From Crucial Conversation to Inspired Action. The planning team for that conference identified seven core domains that could help us conceptualize a framework for placing social justice at the core of our work. This paper presents this framework and suggestions for policy and practice that follow.
Is Implicit Theory of Mind a Real and Robust Phenomenon? Results From a Systematic Replication Study
Authors: Kulke Louisa , von Duhn Britta , Schneider Dana , Rakoczy Hannes
Published: April 2018

Recently, theory-of-mind research has been revolutionized by findings from novel implicit tasks suggesting that at least some aspects of false-belief reasoning develop earlier in ontogeny than previously assumed and operate automatically throughout adulthood. Although these findings are the empirical basis for far-reaching theories, systematic replications are still missing. This article reports a preregistered large-scale attempt to replicate four influential anticipatory-looking implicit theory-of-mind tasks using original stimuli and procedures. Results showed that only one of the four paradigms was reliably replicated. A second set of studies revealed, further, that this one paradigm was no longer replicated once confounds were removed, which calls its validity into question. There were also no correlations between paradigms, and thus, no evidence for their convergent validity. In conclusion, findings from anticipatory-looking false-belief paradigms seem less reliable and valid than previously assumed, thus limiting the conclusions that can be drawn from them.
Mice pancreatic islets protection from oxidative stress induced by single-walled carbon nanotubes through naringin
Authors: Ahangarpour A , Alboghobeish S , Oroojan AA , Dehghani MA
Published: April 2018

The growing use of carbon nanotubes (CNTs) emphasizes the importance of its potential toxic effects on the human health. Previous studies proved that CNTs caused oxidative stress and decreased cell viability. On the other hand, reactive oxygen species (ROS) and oxidative stress impaired β-cell functions and reduced the insulin secretion. However, there is not any study on the effects of CNTs on islets and β-cells. Therefore, the present study aimed to evaluate the effects of single-walled CNTs (SWCNTs) on oxidative stress in islets in addition to the protective effects of naringin (NRG) as an antioxidant . We examined the effects of SWCNTs and naringin on islets by 3,4 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay; measurement of insulin secretion, ROS, and malondialdehyde (MDA); activities of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) peroxidase (GSH-Px); and content of GSH and mitochondrial membrane potential (MMP). The MTT assay demonstrated that decreased viability of islets cells was dose-dependent with exposure to SWCNTs. Further studies revealed that SWCNTs decreased insulin secretion and MMP, induced the formation of ROS, increased the level of MDA, and decreased the activities of SOD, GSH-Px, and CAT and content of GSH. Furthermore, the pretreatment of islets with naringin significantly reverted back these changes. These findings revealed that SWCNTs might induce the oxidative stress to pancreatic islets, causing the occurrence of diabetes, and the protective effects of naringin that was mediated by augmentation of the antioxidant defense system of islets. Our research indicated the necessity for further in vivo and in vitro researches on the effects of SWCNTs and naringin on diabetes.
Metabonomic analysis of toxic action of long-term low-level exposure to acrylamide in rat serum
Authors: Cao C , Shi H , Zhang M , Bo L , Hu L , Li S , Chen S , Jia S , Liu YJ , Liu YL , Zhao X , Zhang L
Published: April 2018

This study assessed the effects of long-term, low-dose acrylamide (AA) administration in rats using ultra-performance liquid chromatography–mass spectrometry. Forty male Wistar rats were randomly divided into the following four groups: control, low-dose AA (0.2 mg/kg BW), middle-dose AA (1 mg/kg BW), and high-dose AA (5 mg/kg BW). AA was administered to rats via drinking water ad libitum. After 16-week treatment, rat serum was collected for metabonomic analysis. Biochemical tests were further conducted to verify metabolic alterations. Eleven metabolites were identified with significant changes in intensities (increased or reduced) as a result of treatment. These metabolites included citric acid, pantothenic acid, isobutyryl-l-carnitine, eicosapentaenoic acid, docosahexaenoic acid, sphingosine 1-phosphate, LysoPC(20:4), LysoPC(22:6), LysoPE(20:3), undecanedioic acid, and dodecanedioic acid. Results indicate that chronic exposure to AA at no observed adverse effect level does not exert a toxic effect on rats at the body metabolism level. AA disturbed the metabolism of lipids and energy, affected the nervous system of rats, and induced oxidative stress and liver dysfunction.
The ethics of concurrent care for children: A social justice perspective
Authors: Mooney-Doyle Kim , Keim-Malpass Jessica , Lindley Lisa C
Published: April 2018

Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life—including fatigue, pain, dyspnea, and anxiety—with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments. The Concurrent Care Provision of the United States’ Affordable Care Act eliminated the need to forgo curative therapies in order to enroll in hospice for children in Medicaid or Children’s Health Insurance Program. Concurrent care for children can help mitigate the tension families experience in choosing between essential forms of care, as well as contribute to improved end-of-life outcomes for the child and possibly bereavement outcomes for the family. Understanding concurrent care for children from a social justice perspective has important advocacy and research implications for hospice and palliative care clinicians providing care for children and their families. We apply Powers and Faden’s theory of social justice “as the moral foundation of public health and health policy” to the provision of concurrent care to children near end of life and families in the United States. The goals of applying this theory are to explore additional insights and perspectives into concurrent care policy may provide and to assess the usefulness of this theory when applied to end-of-life health policy. We argue that concurrent care policy is socially just since it has potential to promote well-being in vulnerable children and families and can limit the inequity children at end-of-life experience in access to high-quality hospice care.
The Placing of Identity and the Identification of Place: “Place-Identity” in Community Lifeboating
Authors: Grey Christopher , O’Toole Michelle
Published: April 2018

This paper explores the symbiotic relationship between place and identity. On one hand, it asks what role place plays in the formation of identity. On the other hand, it asks how place itself is invested with meaning by actors. This theoretical concept of “place-identity” is analyzed through the case of volunteer lifeboaters in the Republic of Ireland, to illustrate how place itself is socially constructed so as to acquire a range of social meanings which interact in a recursive relationship with identity over time. The particularity of dangerous maritime places is shown to shape identity, while those places are shown to be bound up with a mosaic of other factors (such as history, family, and community) which make them meaningful. The paper theorizes a more social, temporal, and dynamic relationship between place and identity than is offered by extant literature and offers refinements to the concept of place-identity.
Problem-Based Learning in a Woodwind Methods Course: An Action Research Study
Authors: Blackwell Jennifer A. , Roseth Nicholas E.
Published: April 2018

The purpose of this action research study was to explore the use of problem-based learning (PBL) in a secondary instrument methods course. Six students enrolled in a woodwind methods course and participated in PBL activities—including video assessment, written scenarios, emergent performance scenarios in the classroom, group activities, and structured peer teaching—aimed at improving their ability to diagnose and solve instrument-specific performance problems. We examined students’ perceptions of PBL, including their teaching confidence, retention of course materials, and overall course engagement. The data collected suggest that students perceived themselves to be learning effectively in this PBL environment, and they felt generally confident in their ability to teach woodwinds. In addition, students appreciated opportunities for “real-life” teaching scenarios and expressed high levels of motivation, though they found this approach somewhat haphazard and unstructured. We suggest that PBL may be a viable method for educating preservice music teachers.
Combined Spring and Deltoid Ligament Repair in Adult-Acquired Flatfoot
Authors: Nery Caio , Lemos André Vitor Kerber C. , Raduan Fernando , Mansur Nacime Salomão B. , Baumfeld Daniel
Published: April 2018

Background:

Adult-acquired flatfoot deformity (AAFD) is usually due to a combination of mechanical failure of the osteoligamentous complex that maintains the medial longitudinal arch of the foot and attenuation or complete tear of the posterior tibial tendon. Magnetic resonance imaging studies in patients with flatfoot deformities have reported the posterior tibial tendon to be pathologic in up to 100% of patients, the spring ligament in up to 87%, and the deltoid ligament in 33%. Many studies in the literature describe reconstruction of the spring ligament or the deltoid ligament associated with AAFD, but there is no study in which both (spring and deltoid) ligaments are reconstructed at the same time. We describe a novel technique to reconstruct the deltoid ligament and the spring ligament at the same time.

Methods:

We described the technique and evaluated 10 consecutive patients with AAFD and insufficient ankle and midfoot ligaments.

Results:

We found no postoperative complications, stiffness, or loss of correction.

Conclusion:

We present a novel technique to reconstruct the failed deltoid and spring ligament during flatfoot correction. It is unique in that it uses internal brace augmentation with FiberTape® to help and protect the soft tissue healing. Level of Evidence: Level IV, retrospective case series.
Adherence to Oral Anticoagulants in Atrial Fibrillation: An Australian Survey
Authors: Obamiro Kehinde O. , Chalmers Leanne , Lee Kenneth , Bereznicki Bonnie J. , Bereznicki Luke R.
Published: April 2018

Background:

The aim of this study was to investigate the proportion of patients who have suboptimal adherence to oral anticoagulant (OAC), identify the predictors of adherence, and determine whether patient-related factors vary across adherence levels in Australia.

Methods:

Respondents were recruited for an online survey using Facebook. Survey instruments included the Morisky Medication Adherence Scale, the Anticoagulation Knowledge Tool, the Perception of Anticoagulant Treatment Questionnaires, and a modified Cancer Information Overload scale. Predictors of medication adherence were identified using ordinal regression analysis.

Results:

Of the 386 responses eligible for analysis, only 54.9% reported a high level of adherence. Participants aged 65 years or younger were less likely to have high adherence compared to older participants (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.33-0.88; P = .013), while females were more likely to be highly adherent compared to males (OR, 1.69; 95% CI, 1.08-2.64; P = .023). The analyses showed that age, gender, treatment satisfaction, information overload, concerns about making mistake when taking OACs, and cost of medication were significant predictors of adherence.

Conclusion:

Self-reported suboptimal adherence to OAC is common among patients with atrial fibrillation. A focus on supporting people who are at higher risk of suboptimal adherence is needed to maximize the benefit of OAC therapy in this population.
The Use of Theory-Based Formative Research to Design Suicide Prevention Messaging for U.S. Veterans in Midlife
Authors: Karras Elizabeth , Stokes Cara M. , Warfield Sara C. , Elder Heather , Stephens Brady , Bossarte Robert M.
Published: April 2018

Background. Communication campaigns offer a viable mechanism to promote suicide prevention and reinforce mental health for U.S. veterans in midlife, a group with a high suicide burden. However, little empirical investigation of this type of messaging has been conducted, with formative campaign research conspicuously missing from the limited literature. Aims. Using the theory of planned behavior as a guide, formative research was conducted to inform the design of suicide prevention messaging by (a) describing and measuring several theoretical constructs among our audience and (b) modeling associations between constructs and intentions to seek help for suicidal behaviors and mental health more broadly. Methods. Telephone-based cross-sectional surveys were collected between 2014 and 2016 from a nationally representative sample of veterans with analyses restricted to those aged between 44 and 65 years ( n = 809). Multiple logistic regression was used to identify significant factors associated with intentions to seek help for either suicidal behaviors or mental health. Results. Perceived behavioral control was one of the largest predictors of intentions to seek help for both suicidal behaviors and mental health concerns. Descriptive norms were also significantly associated with suicide-related intentions. Data further suggest several types of attitudes (i.e., discordant beliefs, stereotypes) to consider when designing messages for this group. Discussion. This study represents one of the first efforts to document and describe theoretical constructs and their influence on intentions among veterans in midlife to contribute to the development of evidence-based messaging for veterans informed by a conceptual framework. Conclusion. Findings have important implications as the use of communication strategies for suicide prevention grows increasingly popular.
Reducing communication in parallel graph search algorithms with software caches
Authors: Cicotti Pietro , Shantharam Manu , Carrington Laura
Published: April 2018

In many scientific and computational domains, graphs are used to represent and analyze data. Such graphs often exhibit the characteristics of small-world networks: few high-degree vertexes connect many low-degree vertexes. Despite the randomness in a graph search, it is possible to capitalize on the characteristics of small-world networks and cache relevant information of high-degree vertexes. We applied this idea by caching remote vertex ids in a parallel breadth-first search benchmark. Our experiment with different implementations demonstrated significant performance improvements over the reference implementation in several configurations, using 64 to 1024 cores. We proposed a system design in which resources are dedicated exclusively to caching and shared among a set of nodes. Our evaluation demonstrates that this design reduces communication and has the potential to improve performance on large-scale systems in which the communication cost increases significantly with the distance between nodes. We also tested a memcached system as the cache server finding that its generic protocol, which does not match our usage semantics, hinders significantly the potential performance improvements and suggested that a generic system should also support a basic and lightweight communication protocol to meet the needs of high-performance computing applications. Finally, we explored different configurations to find efficient ways to utilize the resources allocated to solve a given problem size; to this extent, we found utilizing half of the compute cores per allocated node improves performance, and even in this case, caching variants always outperform the reference implementation.
Sequential Observation of Fundus Changes in Patients with Long Standing Membranoproliferative Glomerulonephritis Type II (MPGN type II)
Authors: Leys A. , Vanrenterghem Y. , Van Damme B. , Snyers B. , Pirson Y. , Leys M.
Published: April 2018

Specific fundus changes have been reported in patients with membranoproliferative glomerulonephritis type II (MPGN type II). We studied the clinical course of this retinopathy in four patients who all had a long follow-up with several fundus examinations. Sequential observation was indicative of a slow progression of the retinopathy. Most eyes maintained in the chronic stages a nearly normal visual acuity, and a full visual field despite the existence of marked drusen and atrophic changes. The prognosis however must be somewhat guarded, since choroidal neovascularization developed in three eyes and caused bilateral severe visual loss in one patient