bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunity in Head and Neck Cancer
Authors: Schoenfeld Jonathan D.
Published: January 2015

Head and neck cancers are a diverse group of malignancies that includes an increasing number of virally mediated cancers in addition to tumors caused by tobacco and alcohol use. In both cases, tumor development is intimately related to the host immune system, and the status of an endogenous antitumor response is likely prognostic. Virally mediated cancers provide unique targets for preventive vaccines that generate immune responses directed against virus-associated antigens. Once head and neck tumors develop, they are commonly treated with surgery, radiotherapy, and/or chemotherapy. These treatments are associated with significant toxicities, and despite this, subgroups of patients respond poorly and are likely to relapse and die of their disease. Tumor immunotherapy may allow for improvements in both treatment-associated toxicity and outcome. In addition to providing specific targets for therapeutic vaccines and adoptive therapy, virally associated cancers may also be particularly dependent on immune checkpoints; therefore, immune checkpoint inhibitors are being actively tested for these diseases. Cancers that are not virally mediated may also respond to immunotherapies, and biomarkers that could predict response to immunotherapy irrespective of viral status are being evaluated. Multiple ongoing studies are testing benefits of immunotherapy in the management of metastatic squamous cell carcinoma of the head and neck. Early promising results pave the way for future studies that will expand testing to nonmetastatic diseases and other types of head and neck cancers. Prospects of combining various immunotherapies and more established treatments such as chemotherapy and radiotherapy are very intriguing and may provide synergistic benefits. Cancer Immunol Res; 3(1); 12–17. ©2015 AACR.
T Helper 2 Polarization in Senile Erythroderma with Elevated Levels of TARC and IgE
Authors: Nakano-Tahara Mayuko , Terao Mika , Nishioka Megumi , Kitaba Shun , Murota Hiroyuki , Katayama Ichiro
Published: January 2015

Background: Some cases of senile erythroderma tend to be diagnosed as senile atopic dermatitis (AD) based on elevated levels of immunoglobulin E (IgE) and thymus and activation-regulated chemokine (TARC). However, there are few studies that describe the detailed characteristics of senile erythroderma and senile AD. Objective: We examined the association of erythroderma with AD. Methods: In this retrospective observational study, 68 patients over 65 years of age who presented with erythroderma at Osaka University Hospital were enrolled. Patient data were collected through medical records and descriptive statistics. Results: 47% of the patients were classified as having idiopathic erythroderma and 53% as having secondary erythroderma. In both idiopathic and secondary senile erythroderma patients, serum IgE and TARC levels were elevated. 84% of idiopathic erythroderma patients fulfilled the Japanese Dermatological Associations criteria for AD; however, only 4 patients were finally definitely diagnosed with senile AD. Conclusion: Many senile erythroderma patients showed AD-like symptoms due to T helper 2 polarization.
Anticonvulsant Effectiveness and Hemodynamic Safety of Midazolam in Full-Term Infants Treated with Hypothermia
Authors: van den Broek Marcel P.H. , van Straaten Henrica L.M. , Huitema Alwin D.R. , Egberts Toine , Toet Mona C. , de Vries Linda S. , Rademaker Karin , Groenendaal Floris
Published: January 2015

Background: Midazolam is used as an anticonvulsant in neonatology, including newborns with perinatal asphyxia treated with hypothermia. Hypothermia may affect the safety and effectiveness of midazolam in these patients. Objectives: The objective was to evaluate the anticonvulsant effectiveness and hemodynamic safety of midazolam in hypothermic newborns and to provide dosing guidance. Methods: Hypothermic newborns with perinatal asphyxia and treated with midazolam were included. Effectiveness was studied using continuous amplitude-integrated electroencephalography. Hemodynamic safety was assessed using pharmacokinetic-pharmacodynamic modeling with plasma samples and blood pressure recordings (mean arterial blood pressure) under hypothermia. Results: No effect of therapeutic hypothermia on pharmacokinetics could be identified. Add-on seizure control with midazolam was limited (23% seizure control). An inverse relationship between the midazolam plasma concentration and mean arterial blood pressure could be identified. At least one hypotensive episode was experienced in 64%. The concomitant use of inotropes decreased midazolam clearance by 33%. Conclusions: Under therapeutic hypothermia, midazolam has limited add-on clinical anticonvulsant effectiveness after phenobarbital administration. Due to occurrence of hypotension requiring inotropic support, midazolam is less suitable as a second-line anticonvulsant drug under hypothermia.
Influence of Contact Points on the Performance of Caries Detection Methods in Approximal Surfaces of Primary Molars: An in vivo Study
Authors: Ribeiro Apoena A. , Purger Flávia , Rodrigues Jonas A. , Oliveira Patrícia R.A. , Lussi Adrian , Monteiro Antonio Henrique , Alves Haimon D.L. , Assis Joaquim T. , Vasconcellos Adalberto B.
Published: January 2015

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D₀ = health, D1-D4 = disease; D2: D₀, D1 = health, D2-D4 = disease; D3: D₀-D2 = health, D3, D4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.
Eyelid Lifting for Ectropion and Scleral Show in Facial Palsy Disease
Authors: Di Stadio Arianna
Published: January 2015

Objective: To reduce eye disease, a simple surgical technique for the treatment of ectropion and scleral show was performed in patients affected by monolateral facial palsy. Methods: Fifteen patients affected by facial palsy, degrees IV-VI according to the House-Brackmann grading scale, were evaluated with our surgical procedure, and the results were compared with several other procedures. Results: We used an eye protection technique. Based on this, the dissection of the orbicular muscle was the more important procedure. It was possible to correct the ectropion and the lateral scleral show with only medial or lateral muscle flap sutures. A detailed description of the surgical procedures with a photographic history and instructions is given. Conclusion: Noninvasive surgery yielded good clinical results in 100% of the cases without any risk or subsequent reoccurrence.
Inhibitor development in haemophilia according to concentrate
Authors: Lassila Riita , Peyvandi Flora , Calizzani Gabriele , Gatt Alex , Lambert Thierry , Windyga Jerzy , Iorio Alfonso , Gilman Estelle , Makris Michael , Fischer Kathelijn
Published: January 2015

Inhibitor development represents the most serious side effect of haemophilia treatment. Any difference in risk of inhibitor formation depending on the product used might be of clinical relevance. It was this study’s objective to assess inhibitor development according to clotting factor concentrate in severe haemophilia A and B. The European Haemophilia Safety Surveillance (EUHASS) was set up as a study monitoring adverse events overall and according to concentrate. Since October 2008, inhibitors were reported at least quarterly. Number of treated patients was reported annually, specifying the number of patients completing 50 exposure days (Previously Untreated Patients, PUPs) without inhibitor development. Cumulative incidence, incidence rates and 95 % confidence intervals (CI) were calculated. Data from October 1, 2008 to December 31, 2012 were analysed for 68 centres that validated their data. Inhibitors developed in 108/417 (26 %; CI 22–30 %) PUPs with severe haemophilia A and 5/72 (7 %; CI 2–16%) PUPs with severe haemophilia B. For Previously Treated Patients (PTPs), 26 inhibitors developed in 17,667 treatment years [0.15/100 treatment years; CI 0.10–0.22) for severe haemophilia A and 1/2836 (0.04/100; (CI 0.00–0.20) for severe haemophilia B. Differences between plasma-derived and recombinant concentrates, or among the different recombinant FVIII concentrates were investigated. In conclusion, while confirming the expected rates of inhibitors in PUPs and PTPs, no class or brand related differences were observed.
Genetic and Clinical Risk Prediction Model for Postoperative Atrial Fibrillation
Authors: Kolek Matthew J. , Muehlschlegel J. Daniel , Bush William S. , Parvez Babar , Murray Katherine T. , Stein C. Michael , Shoemaker M. Benjamin , Blair Marcia A. , Kor Kaylen C. , Roden Dan M. , Donahue Brian S. , Fox Amanda A. , Shernan Stanton K. , Collard Charles D. , Body Simon C. , Darbar Dawood
Published: January 2015

Background—

Postoperative atrial fibrillation (PoAF) is common after coronary artery bypass grafting. We previously showed that atrial fibrillation susceptibility single nucleotide polymorphisms (SNPs) at the chromosome 4q25 locus are associated with PoAF. Here, we tested the hypothesis that a combined clinical and genetic model incorporating atrial fibrillation risk SNPs would be superior to a clinical-only model.

Methods and Results—

We developed and externally validated clinical and clinical/genetic risk models for PoAF. The discovery and validation cohorts included 556 and 1164 patients, respectively. Clinical variables previously associated with PoAF and 13 SNPs at loci associated with atrial fibrillation in genome-wide association studies were considered. PoAF occurred in 30% and 29% of patients in the discovery and validation cohorts, respectively. In the discovery cohort, a logistic regression model with clinical factors had good discrimination, with an area under the receiver operator characteristic curve of 0.76. The addition of 10 SNPs to the clinical model did not improve discrimination (area under receiver operator characteristic curve, 0.78;
P
=0.14 for difference between the 2 models). In the validation cohort, the clinical model had good discrimination (area under the receiver operator characteristic curve, 0.69) and addition of genetic variables resulted in a marginal improvement in discrimination (area under receiver operator characteristic curve, 0.72;
P
<0.0001).

Conclusions—

We developed and validated a model for the prediction of PoAF containing common clinical variables. Addition of atrial fibrillation susceptibility SNPs did not improve model performance. Tools to accurately predict PoAF are needed to risk stratify patients undergoing coronary artery bypass grafting and identify candidates for prophylactic therapies.
Who Rules China?
Authors: Rothenberg Mel
Published: January 2015

A new and powerful capitalist class has arisen in China since 1976. Has this capitalist class achieved sufficient domination of Chinese social, economic and political life to qualify as a ruling class? We attempt to clarify this question within the context of current Chinese reality that has resulted from the turbulent historical events and processes shaking China over the last 28 years. The question is difficult to settle definitively because of the atypical, even peculiar, basis of the emergence of capitalism in China, and in particular the crucial, guiding role of the Chinese Communist Party. Given the control of political life in China by the Party, it appears that command of the Party by the new capitalist class would be a pre-requisite for capitalist class rule. A brief examination of the composition, leadership, and politics of the Chinese Communist Party suggests that while a line promoting capitalism has great influence within the Party, such command has not yet been fully achieved.
The Strength of Second-Tier Strategies under Globalization: A Comparative Study of Nanjing and Hangzhou as Burgeoning Second-Tier Cities
Authors: Wang Tianni
Published: January 2015

As a result of the “reform and opening up” of China in the past three decades, the country’s urban landscape has increasingly reflected the changes brought about by global integration. In recent years, the reach of globalization has extended beyond the biggest Chinese cities like Shanghai, Beijing, and Guangzhou to what is known as “second-tier” cities. This article focuses on a comparative study of post-reform Nanjing and Hangzhou, two leading second-tier cities both advantageously situated in the Yangtze River Delta Economic Region. I examine how the introduction of global forces has shaped urban development narratives of each city differently, contingent upon pre-existing relationships of the cities with the state, respective provincial governments, and Shanghai, the neighboring model global city. I assert that although on the whole, second-tier cities are strongly motivated to learn from global cities due to isomorphic pressures, the consequences of a city’s unique self-imaginary can create very different strategies and directions for urban development.
The Asiatic Mode of Production, Indian Land Law, and the Naxalite Movement
Authors: Braud Donovan S.
Published: January 2015

Marx’s views on pre-capitalist non-western societies evolved during his intellectual development and are generally grouped under the (problematic) term “Asiatic Mode of Production.” This article examines the connections between the Asiatic Mode of Production from Marxist economics, post-independence Indian land laws, the violation of those laws after independence and in the period of liberalization, and the continuing popularity of the Naxalite/Maoist insurgency. The contemporary round of globalization seeks to finish what colonization started by forcibly removing Adavasi and Scheduled Tribes in a process similar to primitive accumulation. Understanding this dynamic explains the Naxalites’ continuing appeal in contemporary India.
ww iii: More Interclass than International
Authors: Hossein-Zadeh Ismael
Published: January 2015

Most pundits of historical developments tend to perceive another worldwide war, often called ww iii, in a manner similar to World Wars i and ii; that is, large-scale deployment of military means in pursuit of destruction and/or defeat of international adversaries. While prospects of such an ominous scenario certainly cannot be ruled out, there is reason to believe, however, that the much talked-about ww iii may be of a different form: more inter-class than international. Viewed in this light, ww iii is already here; it has indeed been raging on for years: the unilateral, cross-border neoliberal war of austerity on the 99 percent on a global level.
Internal Violent Conflicts and Overt War among National States?
Authors: del Castillo-Mussot Marcelo , de la Lama Garcia Alfredo
Published: January 2015

We focus on geopolitical tensions, possibilities of internal violent conflicts or overt war among national-states. First, we examine the most important concepts and practices of the neoliberal globalization. The current world situation seems to indicate that neoliberalism is not a theory, a class strategy designed to redistribute wealth upward toward an increasingly narrow fraction of people, despite national contradictions. We review sources of international tensions and some important data of transnational corporations in the North and South. Historical experiences show that crisis can produce different kinds of changes and distinct political responses in societies, such as internal violent conflicts or overt war among national-states. Some of these conflicts can be analyzed by employing two frameworks; national-states framework and global class relations. We argue that in a highly globalized world, the existence of overt war among strong nation-states could seriously damage the globalist bloc transnational commanding class, whereas internal violent conflicts can easily appear almost everywhere as a natural consequence of social and economic inequalities. In order to counterweight the crisis and fascist movements we propose alliances among the dominated classes and other dominated groups.
Poking Holes in the Western Wall: East Germany’s Attempts to Create Counter-Hegemony during the Cold War
Authors: Pelz William A.
Published: January 2015

During its brief existence, East Germany attempted to present an alternative global vision that was sharply in contrast to that of West Germany and her capitalist allies. Although only partially successful, these campaigns nonetheless point to a quest for a different globalization based on non-capitalist international solidarity. Among the issues theddrchampioned were the following: a) an alternative narrative of German, and world, history, b) anti-fascism as a model for national development, c) support for anti-colonial and liberation movements against imperialism, and in fits and starts d) a policy of gender equality.
Notes on the Identity and distribution of Plectranthus subincisus (Lamiaceae)—a poorly known species recollected after 150 years in southern India
Authors: SMITHA KOKKARANIYIL , SUNOJKUMAR PURAYIDATHKANDY
Published: January 2015

Taxonomic identity and distribution of Plectranthus subincisus, a poorly known species recollected recently after 150 years from southern India is discussed. A detailed description, illustration, photographs, distribution map and key to the southern Indian species of the genus are provided.
A new species of Habenaria (Orchidaceae) from Guangxi, China
Authors: ZHANG ZIBIN , YANG MEI , CAI SHUWEI , HUANG BOGAO , WEI YANQING , CHEN QIAOQIAO , ZHAO XIUHAI
Published: January 2015

A new species of Orchidaceae, Habenaria yachangensis, from Yachang National Nature Reserve, Guangxi, China, is described and illustrated. The new species can be distinguished from the other species in genus Habenaria Willd. by having green to greenish white flowers, dorsal sepal and lip tripartite, lateral sepals lobed, petal with 2 ridges in both sides along the middle vein. Habenaria yachangensis is restricted in a single mountaintop in Yachang National Nature Reserve, and is considered as critical endangered.
A new species of the rare nematode genus Paramicrolaimus Wieser, 1954 (Chromadorida: Paramicrolaimidae) from the south eastern Arabian Sea
Authors: JACOB JINI , JALEEL ABDUL K. U. , VIJAYAN ANIL KUMAR
Published: January 2015

A new paramicrolaimid nematode, Paramicrolaimus damodarani sp. nov., is described based on specimens from the continental shelf (95 m) of the south eastern Arabian Sea. Paramicrolaimus damodarani sp. nov. differs from other known species of the genus in having a smaller body size, form of the spicular apparatus, presence of 7 cuticularised protruding precloacal supplements and a strongly cuticularised terminal spinneret. This is the first record of the genus Paramicrolaimus from the northern Indian Ocean. A pictorial key to the four species of Paramicrolaimus is also provided, supplemented with comparative characters, based on published information.
A new aberrant species of Nipponocercyon from the mountains of southeastern China (Coleoptera: Hydrophilidae: Sphaeridiinae)
Authors: FIKÁČEK MARTIN , JIA FENGLONG , RYNDEVICH SERGEY
Published: January 2015

Nipponocercyon satoi sp. nov. is described from the mountains of Zhenjiang and Jiangxi Provinces in Southwest China. Although the species bears all synapomorphies of Nipponocercyon Satô, 1963, it differs substantially from the other two species of the genus by its Pacrillum-like habitus (i.e. small, compact and strongly convex body with reduced surface sculpturing). The new species is compared in detail with the other two Nipponocercyon species as well as with Pacrillum Orchymont, 1941 and Megasternum Mulsant, 1844. The generic diagnosis of Nipponocercyon is adapted, and reasons for assigning the new species to Nipponocercyon are discussed.
Turbulent Mixing in Shallow Trade Wind Cumuli: Dependence on Cloud Life Cycle
Authors: Schmeissner T. , Shaw R. A. , Ditas J. , Stratmann F. , Wendisch M. , Siebert H.
Published: January 2015

Helicopter-borne observations of the impact of turbulent mixing and cloud microphysical properties in shallow trade wind cumuli are presented. The measurements were collected during the Cloud, Aerosol, Radiation and Turbulence in the Trade Wind Regime over Barbados (CARRIBA) project. Basic meteorological parameters (3D wind vector, air temperature, and relative humidity), cloud condensation nuclei concentrations, and cloud microphysical parameters (droplet number, size distribution, and liquid water content) are measured by the Airborne Cloud Turbulence Observation System (ACTOS), which is fixed by a 160-m-long rope underneath a helicopter flying with a true airspeed of approximately 20 m s−1. Clouds at different evolutionary stages were sampled. A total of 300 clouds are classified into actively growing, decelerated, and dissolving clouds. The mixing process of these cloud categories is investigated by correlating the cloud droplet number concentration and cubed droplet mean volume diameter. A significant tendency to more inhomogeneous mixing with increasing cloud lifetime is observed. Furthermore, the mixing process and its effects on droplet number concentration, droplet size, and cloud liquid water content are statistically evaluated. It is found that, in dissolving clouds, liquid water content and droplet number concentration are decreased by about 50% compared to actively growing clouds. Conversely, the droplet size remains almost constant, which can be attributed to the existence of a humid shell around the cloud that prevents cloud droplets from rapid evaporation after entrainment of premoistened air. Moreover, signs of secondary activation are found, which results in a more difficult interpretation of observed mixing diagrams.
A national survey of troponin testing and recommendations for improved practice
Authors: McKeeman Gareth C , Auld Peter W
Published: January 2015

Background

The introduction of troponin assays with higher analytical sensitivity and enhanced performance has produced new challenges for both laboratory and clinician in the optimal investigation of patients with cardiovascular disease. After some years of collective experience with this new generation of assays, this survey aimed to assess the level of consensus that exists regarding their application.

Methods

A questionnaire was designed, based on a review of published evidence and current opinion, to obtain information on a number of key areas relating to troponin analysis and reporting and was circulated to lead laboratory consultants across the UK and Ireland.

Results

Completed questionnaires were received from 94 laboratory contacts. Sixty per cent of those who responded had implemented a high-sensitivity troponin assay, with the Roche Cobas troponin T high sensitivity assay the most widely used. It is evident that some confusion remains regarding the definition of high-sensitivity assays and there was considerable variation in practice, even among those using the same manufacturer’s assay.

Conclusions

There is a need for greater consensus in the approach to the clinical utilization of troponin assays with improved sensitivity and it is important that laboratories are fully aware of the capabilities of their assay and provide useful guidance to users. On the basis of survey findings and the existing evidence base, a number of recommendations have been proposed to improve current practice and enhance patient safety.
Developing occupational therapy students’ practice habits via qualitative inquiry education
Authors: Marterella Abbey L. , Aldrich Rebecca M.
Published: January 2015

Background

Accreditation standards and practice competencies underscore the importance of research for occupational therapy practice, but they do not guide how occupational therapy education addresses research. Despite the prominence of qualitative research in the health professions, there exists a need to articulate how and why qualitative inquiry is taught in occupational therapy education.

Purpose

We discuss how qualitative inquiry education can develop habits of reflection and reflexivity, criticality, and active engagement in preparation for occupational therapy practice.

Key Issues

We hold that our students’ professional abilities to practice in a well-reasoned, ethical, and responsive manner are enhanced by experiences with qualitative inquiry and suggest that there is potential in linking qualitative inquiry experiences to professional habit formation in occupational therapy education.

Implications

In addition to teaching research for its own sake, we suggest that educators can adopt a broader view of how qualitative inquiry functions within occupational therapy education.
Something happened: Spectres of organization/disorganization at the airport
Authors: Knox Hannah , O’Doherty Damian P , Vurdubakis Theo , Westrup Christopher
Published: January 2015

The article explores the practical accomplishment of organization at an international airport during the course of a number of ‘security alerts’ that disrupted routine ‘modes of ordering’ (Law, 1994). Airports, we suggest, invite us to re-think ‘organization’ as the partial, contingent and always-incomplete outcome of complex order(ing)s and disorder(ing)s played out across various spaces, agencies and materials. When ‘something happens’ we begin to see how spaces, agents and materials are subject to unexpected becomings: objects appear treacherous, spaces mutable, agencies ineffectual and informants unreliable. Following the work of Weick we might say that in such moments of uncertainty we are forced to reconsider our customary ways of thinking about objects, subjects and systems. We argue this thinking requires a relational understanding of organization so that we can better grasp how organizations are continuously being made and un-made through an on-going co-creation and dispersal of parts.
Osterix Regulates Tooth Root Formation in a Site-specific Manner
Authors: Kim T.H. , Bae C.H. , Lee J.C. , Kim J.E. , Yang X. , de Crombrugghe B. , Cho E.S.
Published: January 2015

Bone and dentin share similar biochemical compositions and physiological properties. Dentin, a major tooth component, is formed by odontoblasts; in contrast, bone is produced by osteoblasts. Osterix ( Osx), a zinc finger-containing transcription factor, has been identified as an essential regulator of osteoblast differentiation and bone formation. However, it has been difficult to establish whether Osx functions in odontoblast differentiation and dentin formation. To understand the role of Osx in dentin formation, we analyzed mice in which Osx was subjected to tissue-specific ablation under the control of either the Col1a1 or the OC promoter. Two independent Osx conditional knockout mice exhibited similar molar abnormalities. Although no phenotype was found in the crowns of these teeth, both mutant lines exhibited short molar roots due to impaired root elongation. Furthermore, the interradicular dentin in these mice showed severe hypoplastic features, which were likely caused by disruptions in odontoblast differentiation and dentin formation. These phenotypes were closely related to the temporospatial expression pattern of Osx during tooth development. These findings indicate that Osx is required for root formation by regulating odontoblast differentiation, maturation, and root elongation. Cumulatively, our data strongly indicate that Osx is a site-specific regulator in tooth root formation.
Ethnic variations in the provision of biologic therapy for Crohn's disease: a Freedom of Information study
Authors: Farrukh Affifa , Mayberry John F
Published: January 2015

In this study, we investigate whether the provision of biologic therapy for Crohn's disease is equitable across South Asian and English groups in NHS Trusts, which serve areas with significant ethnic variation. Data were requested from 10 NHS Trusts using a Freedom of Information (FOI) approach. Details of numbers of patients by ethnicity treated with infliximab or adalumimab for Crohn's disease between 2010 and 2012 were requested. Using population-based estimates of disease prevalence and Census data on population structure, observed and expected numbers who should have received treatment were calculated. In three Trusts, the number of South Asian patients who received such treatment was significantly less than British/White patients. These were: Pennine Acute Hospitals NHS Trust covering Oldham and North Manchester, Barking, Havering & Redbridge University Hospitals NHS Trust and University Hospitals of Leicester NHS Trust. The study is limited by several factors: The only data available on prevalence in both English and South Asian communities comes from Leicester and was published in 1993. More recent data suggests that the prevalence of Crohn's disease now approaches 150/105 compared to the 76/105 for English patients which was recorded in Leicester. However, the two subsequent studies on prevalence which were published in 2000 from the North of England and 2010 from Scotland do not provide a breakdown by ethnicity. The data were collected by administrative staff using a variety of approaches to their Trust's data bases and so the techniques used in each Trust are not comparable. In addition, studies from elsewhere suggest that the quality of FOI data is affected by the motivation of staff who collect the data. With the exception of Leicester, there was no quality check on the accuracy of the data. In Leicester, 139 patients were on a register of biologic therapy and this compared with 343 patients reported by the FOI request. However, the proportions of patients by type of treatment and by ethnicity were comparable in the two data sets. This suggests that the data on ethnic differences reported by the FOI study reflects real differences. Clearly, there are South Asian communities where patients with Crohn's disease appear not to receive appropriate treatment in the form of biologics, and the reasons behind this need further consideration and investigation. We need to develop robust methods of monitoring the provision of biologic therapy across ethnic groups and communities. It is unacceptable for there to be a difference based on such grounds.
Investigation and evaluation on fine Upland cotton blend yarns made by the modified ring spinning system
Authors: Ying Guo , Jie Feng , Rong Yin , Xungai Wang , van der Sluijs Marinus , Xiaoming Tao
Published: January 2015

A modified ring spinning technology has been successfully applied to the production of yarns with reduced twist level and improved performance. Various US cottons and Chinese cottons have been covered in previous studies. In this paper, three combed rovings with different blending ratios of Upland and Extra Long cottons were adopted in a systematic investigation and evaluation on a fine modified ring yarn produced on a new modified spinning system that was developed to reduce the imperfections of fine yarns. The potentially important spinning parameters were proposed and their individual and interaction effects of spinning system parameters on the properties of fine modified ring yarn were quantitatively examined using the response surface methodology. Then with the optimum parameters, physical properties of the yarns and their knitted fabrics produced from three rovings were evaluated by comparing them with the conventional ones. Experimental results showed that yarns produced in the new modified spinning system had reduced imperfections; at low twist levels, fine modified yarns and resultant fabrics also showed improved performance. Moreover, properties of fiber materials and roving quality influenced the properties of modified yarns and knitted fabrics.
Consultation of traditional bone setters instead of doctors: Is it a sociocultural and educational or social insurance problem?
Authors: Gölge Umut Hatay , Kaymaz Burak , Kömürcü Erkam , Eroğlu Mehmet , Göksel Ferdi , Nusran Gürdal
Published: January 2015

Background

Patients consulting bone setters is common in the eastern and south-eastern regions of Turkey. The reasons for consulting bone setters instead of qualified doctors remains unclear. We investigated the characteristics of such patients who consult traditional bone setters after trauma prior to admission to hospital.

Methods

In the study, 3,422 of 14,080 patients were investigated admitted to hospital between January 2012 and February 2013 with trauma or sequelae of such who were previously treated by bone setters. The characteristics of these patients and the main reasons for consultation of bone setters instead of doctors were recorded.

Results

Most of the patients consulting bone setters were found to be young adults or children. Generally speaking, the poorly educated prefer bone setters despite having social insurance. The most common reason (29.3%) was a general preference and secondarily (27.1%) the fear of being disabled after medical treatment. However, the most common cause of patients’ consultation at hospital subsequently was due to complications of treatment (46.8%); indeed the complication rate after bone setters’ intervention was found to be 54.8%.

Conclusion

Although improvements have occurred in the access to and utilisation of healthcare services, consultation by patients of bone setters seems to be a sociocultural and educational issue rather than a problem of lack of medical insurance.
Register-Contingent Entrenchment of Constructional Patterns
Authors: Kerz Elma , Wiechmann Daniel
Published: January 2015

One of the main assumptions of usage-based constructionist approaches is that linguistic knowledge is best conceived of as a repository of constructions, which emerge from experience with language and whose strength of mental representation (entrenchment) is a function of their usage frequency. On the basis of a multistep statistical procedure geared to identify patterns of adverbial clause constructions in two distinct registers, we argue that a model of language that generalizes over situational contexts is implausible. Instead, a more adequate model of linguistic knowledge comprises a set of subrepositories that are adapted to the discourse-functional needs of situational contexts, in which constructions have register-specific entrenchment values.
Use of Temporary Enteral Access Devices in Hospitalized Neonatal and Pediatric Patients in the United States
Authors: Lyman Beth , Kemper Carol , Northington LaDonna , Yaworski Jane Anne , Wilder Kerry , Moore Candice , Duesing Lori A. , Irving Sharon
Published: January 2015

Background: Temporary enteral access devices (EADs), such as nasogastric (NG), orogastric (OG), and postpyloric (PP), are used in pediatric and neonatal patients to administer nutrition, fluids, and medications. While the use of these temporary EADs is common in pediatric care, it is not known how often these devices are used, what inpatient locations have the highest usage, what size tube is used for a given weight or age of patient, and how placement is verified per hospital policy. Materials and Methods: This was a multicenter 1‐day prevalence study. Participating hospitals counted the number of NG, OG, and PP tubes present in their pediatric and neonatal inpatient population. Additional data collected included age, weight and location of the patient, type of hospital, census for that day, and the method(s) used to verify initial tube placement. Results: Of the 63 participating hospitals, there was an overall prevalence of 1991 temporary EADs in a total pediatric and neonatal inpatient census of 8333 children (24% prevalence). There were 1316 NG (66%), 414 were OG (21%), and 261 PP (17%) EADs. The neonatal intensive care unit (NICU) had the highest prevalence (61%), followed by a medical/surgical unit (21%) and pediatric intensive care unit (18%). Verification of EAD placement was reported to be aspiration from the tube (n = 21), auscultation (n = 18), measurement (n = 8), pH (n = 10), and X‐ray (n = 6). Conclusion: The use of temporary EADs is common in pediatric care. There is wide variation in how placement of these tubes is verified.
Challenging the 48‐Hour Rule‐Out for Central Line–Associated Bloodstream Infections in the Pediatric Intestinal Failure Population
Authors: Chang Melissa I. , Carlson Sarah J. , Nandivada Prathima , O'Loughlin Alison A. , Potemkin Alexis K. , Cowan Eileen , Mitchell Paul D. , Gura Kathleen M. , Puder Mark
Published: January 2015

Introduction: While parenteral nutrition (PN) has revolutionized the management of patients with intestinal failure (IF), central line–associated bloodstream infections (CLABSIs) remain a leading cause of mortality and morbidity in this population. The objective of this study is to characterize the presentation of CLABSIs in pediatric IF and to determine the time to positivity of blood cultures. Methods: A retrospective cohort study of children with IF who presented to our institution for evaluation of a possible CLABSI from January 1, 2012, to December 31, 2012, was performed. Results: Sixty patients with IF were identified. There were 33 cases of CLABSI in 16 patients, with a rate of 1.5 infections per 1000 catheter days. There were no significant differences in age, growth parameters, or catheter days between patients with or without CLABSI. Fever was documented in 85% of patients with CLABSI. These patients demonstrated an increased percentage of neutrophils and higher C‐reactive protein levels compared with patients without CLABSI. The mean time to culture positivity was 13.2 hours, and 97% of cultures were positive within 24 hours. Conclusion: Our data suggest that most pediatric patients with IF who have CLABSI develop positive cultures within 24 hours, and the absence of fever and leukocytosis does not necessarily indicate the absence of infection. These findings may support clinical practice guidelines in favor of shorter hospital stay when CLABSI is suspected; however, a prospective analysis of CLABSI in this population is recommended to determine the safety and appropriate setting prior to any practice change.
Dose of arm activity training during acute and subacute rehabilitation post stroke: a systematic review of the literature
Authors: Hayward Kathryn S , Brauer Sandra G
Published: January 2015

Aim:

To determine the dose of activity-related arm training undertaken by stroke survivors during acute and subacute rehabilitation.

Methods:

A systematic review of PubMed, CINAHL and EMBASE up to December 2014 was completed. Studies were eligible if they defined the dose (time or repetitions) of activity-related arm training using observational methods for a cohort of adult stroke survivors receiving acute or subacute rehabilitation. All studies were quality appraised using an evidence-based learning critical appraisal checklist. Data was analysed by method of documented dose per session (minutes, repetitions), environment (acute or subacute rehabilitation) and therapy discipline (physiotherapy, occupational therapy).

Results:

Ten studies were included: two observed stroke survivors during acute rehabilitation and eight during subacute rehabilitation. During acute rehabilitation, one study reported 4.1 minutes per session during physiotherapy and 11.2 minutes during occupational therapy, while another study reported 5.7 minutes per session during physiotherapy only. During inpatient rehabilitation, activity-related arm training was on average undertaken for 4 minutes per session (range 0.9 to 7.9, n = 4 studies) during physiotherapy and 17 minutes per session (range 9.3 to 28.9, n = 3 studies) during occupational therapy. Repetitions per session were reported by two studies only during subacute rehabilitation. One study reported 23 repetitions per session during physiotherapy and occupational therapy, while another reported 32 repetitions per session across both disciplines.

Conclusion:

The dose of activity-related arm training during acute and subacute rehabilitation after stroke is limited.
Microscopic progressive damage simulation of unidirectional composite based on the elastic–plastic theory
Authors: Han Geng , Guan Zhidong , Li Xing , Zhang Wenchao , Du Shanyi
Published: January 2015

Computational mechanics has been carried out to study the microscopic failure mechanisms of unidirectional fiber-reinforced polymer composites. A representative volume element of fiber random distribution based on molecules random collision model is established, with two dominant damage mechanisms, matrix plastic deformation and interfacial debonding included in the simulation by the extended Drucker–Prager model and cohesive zone model, respectively. The simulation results clearly reveal the damage process of the composites and the interactions of different damage mechanisms. It can be concluded that the transverse tension fracture initiates as interfacial debonding and evolves as a result of interactions between interfacial debonding and matrix plastic deformation, while the compression failure is dominated by matrix plastic damage. The longitudinal tension and compression are both dominated by fiber breakage, but longitudinal tension initiates as matrix plastic damage and longitudinal compression initiates as fiber microbuckling. Finite element method appropriately simulated the process of progressive damage of the fiber buckling failure, which is consistent with the observed result under scanning electron microscopy.
A numerical and experimental investigation of parametric effect on flow ripple
Authors: Xu Bing , Lee Kok-Meng , Song Yuechao , Wang Qiannan , Yang Huayong
Published: January 2015

This paper presents a parametric study on flow ripple for guiding the design of a piston pump. For the purpose of minimizing flow ripple, a detailed simulation model is built. In this simulation model, a modified method for computing precisely leakage flow rate from the oil film between valve plate and cylinder block, the oil film between cylinder block and piston, and the oil film between the slipper and the swash plate is proposed. Then the influence of fluid characteristics, such as the fluid compressibility and viscosity and the air contained in the fluid, is taken into consideration in the simulation model. In addition, the motion of the piston, cylinder, and slipper is referenced in one simulation model making the simulation model closer to a real pump. Validated using test results obtained from the secondary source method, the computational accuracy with the modified simulation has been adequately improved for analyzing the parametric effects on flow ripple and optimizing the design of a piston pump. The findings conclude that for the same working conditions, the fluid compressibility has been identified to be the most significant cause responsible for flow ripple. The leakage flow rate and fluid viscosity play the next important roles on the generation of flow ripple as compared to the effects due to the piston movement. When there is no cavitation in the working conditions, the effect of the air contained in the fluid on flow ripple can be neglected.
Successful use of palifermin following severe anaphylaxis to pegaspargase in a pediatric patient with acute lymphoblastic leukemia
Authors: Kaminski Katie S , Beach Cassidy L , Peden David B , Le Uyenphuong , Roehrs Philip A
Published: January 2015

Palifermin and pegaspargase are Escherichia coli-derived drug products. Hypersensitivity reactions, including anaphylaxis, are frequently reported with pegaspargase. In high-risk acute lymphoblasic leukemia (ALL), patients undergoing allogeneic hematopoietic stem cell transplant may be treated with palifermin as a supportive care measure for mucositis prophylaxis. However, no literature exists documenting the cross-reactivity between palifermin and pegaspargase. We report a case in which a child with very high-risk ALL having experienced severe anaphylaxis with pegaspargase was later successfully treated with palifermin during stem cell transplant conditioning.
Protective Strengths, Risk, and Recidivism in a Sample of Known Sexual Offenders
Authors: Miller Holly A.
Published: January 2015

The relationship between protective strengths and risk, as assessed by the Inventory of Offender Risk, Needs, and Strengths, was examined with respect to the recidivism rate and type of reoffense in a sample of 110 adult males incarcerated for sexual offenses. The sample included offenders who were completing a prison-based sexual offense treatment program during the last 18 months of their incarceration. Approximately 40% of the sample recidivated in some way, including 6% sexually, within the 6-year follow-up time. Self-perceived protective strengths were significantly valid predictors for sexual, violent, and general recidivism. In regression analyses, protective strengths accounted for a unique portion of the variance in sexual recidivism while controlling for overall risk. Consistent with research on the importance of protective strengths with other offender types, the continued study and inclusion of protective strengths in the assessment and treatment of sexual offenders is warranted.
Percutaneous Cholecystostomy is an Effective Definitive Treatment Option for Acute Acalculous Cholecystitis
Authors: Kirkegård J. , Horn T. , Christensen S. D. , Larsen L. P. , Knudsen A. R. , Mortensen F. V.
Published: January 2015

Aims:

Acute acalculous cholecystitis can be treated with percutaneous cholecystostomy in critically ill patients unfit for surgery. However, the evidence on the outcome is sparse. We conducted a retrospective analysis of acute acalculous cholecystitis patients treated with percutaneous cholecystostomy during a 10-year study period.

Methods:

An observational study of 56 consecutive patients treated with percutaneous cholecystostomy for acute acalculous cholecystitis was conducted in the period from 1 June 2002 to 31 May 2012. All data were obtained by review of medical records.

Results:

A total of 56 consecutive patients were treated with percutaneous cholecystostomy for acute acalculous cholecystitis. Six patients (10.7%) died within 30 days after the procedure. Percutaneous cholecystostomy could serve as a definitive treatment option in 45 patients (80.4%), whereas 1 patient (1.8%) required cholecystectomy due to recurrence of cholecystitis. Four patients (7.1%) were treated with percutaneous cholecystostomy as a bridging procedure to subsequent elective laparoscopic cholecystectomy within a median of 8.8 months (range: 7.7–33.4 months). There was no significant difference in the risk of cholecystitis recurrence between patients with (6/37) and without (2/3) contrast passage to the duodenum on cholangiography ( p = 0.096).

Conclusion:

Percutaneous cholecystostomy is successful as a definitive treatment option in the majority of patients with acute acalculous cholecystitis. It is associated with a low rate of mortality and subsequent cholecystectomy.