bluuebunny/crossref_metadata_2025 huggingface dataset:
How Chinese and Caucasian Canadians Conceptualize Creativity: The Mediating Role of Uncertainty Avoidance
Authors: Adair Wendi L. , Xiong Tracy X.
Published: January 2018

The current study examines cultural value mediators of the relationship between culture and the relative weight placed on novelty versus usefulness when conceptualizing creativity. With a sample of Chinese and Caucasian Canadian undergraduate students, we found that uncertainty avoidance, but not power distance or individualism/collectivism, mediated the relationship between culture and preferences toward the novel versus useful dimensions of creativity. We replicated the effect of uncertainty avoidance in a second study with Chinese Canadians’ bicultural identity integration predicting focus on novelty versus usefulness in the predicted direction. We advance prior research by isolating a cultural value mechanism driving cultural variation in the conceptualization of creativity when considering novelty versus usefulness. We discuss theoretical contributions and implications for future research addressing additional creativity domains, situated cognition, and norm salience.
Institutional and Value Support for Cultural Pluralism Is Stronger in Innovative Societies With Demanding Climate
Authors: Kwan Letty Y.-Y.
Published: January 2018

Past research shows that democracy is valued more in affluent societies with challenging climate than in other societies. Building on this finding, the present study examines how the amount of institutional and value support for cultural pluralism in a society is related to its climate and level of innovation performance. Cultural pluralism is defined as the societal condition in which minority groups within a society can maintain their distinctive cultural identities, values, and practices provided that they are consistent with the laws and values of the wider society. Institutions and values that support cultural pluralism include political democracy, tolerance for uncertainty, prioritization of secular-rational values, and openness to foreign cultures. I hypothesize that institutional and value support for cultural pluralism is stronger in societies with more challenging climate and higher innovation performance. I tested this hypothesis using society-level measures of harshness of climatic condition and innovation performance as predictors. The results showed that in societies with demanding climate and high innovation performance, their citizens tend to support democracy, are more tolerant of uncertainty, prioritize secular-rational values, and take more leisure trips outside of their home country. These results illustrate that innovation, through its moderation effect on climate, predicts the amount of institutional and value support for cultural pluralism, highlighting the reciprocal effects of culture and innovation.
Culture, Creativity, and Innovation
Authors: Kwan Letty Y.-Y. , Leung Angela K.-y. , Liou Shyhnan
Published: January 2018

This special issue enriches the study of creativity and innovation as a cultural and social process. Authors of nine articles jointly contribute to a nuanced and systematical inquiry into the cultural perspective of creativity. Their topics of investigation include lay conceptions of creativity in different cultures, different natures and manifestations of creativity and innovation, the influence of cultural values, norms, and multiculturalism on creativity, and the dialogical coevolvement between culture and creativity. The collection of articles in this issue presents cutting-edge evidence and lays the groundwork for an active dialogue about integrating the study of culture and creativity.
Where, when, and how does the UN work to prevent civil war in self-determination disputes?
Authors: White Peter B , Cunningham David E , Beardsley Kyle
Published: January 2018

The UN has placed rhetorical emphasis on the prevention of armed conflict before it starts and has taken selective action toward that end. What determines where the UN gets involved? We examine UN preventive actions by focusing on UN Security Council (UNSC) resolutions in self-determination (SD) disputes. We argue that UN decisionmakers consider at least three factors when deciding where to target preventive action: the dispute’s conflict history, the potential for regional contagion, and the characteristics of the dispute. We further argue that the political dynamics of UNSC decisionmaking constrain the UN’s ability to pay attention to the third factor (the characteristics of the dispute). We test this argument using data on all UNSC resolutions comprising the authorization of diplomatic engagement, condemnation, the authorization of sanctions, and the deployment of force targeted toward SD disputes from 1960 to 2005. We find that the UN is much more likely to act in nonviolent disputes that have a history of violence and in disputes with a potential for regional contagion. The analysis shows that, while political barriers likely restrict the ability for the UNSC to act when dispute-level characteristics suggest armed conflict is more likely, the UN does act proactively to prevent violence, rather than just reactively responding to existing violence.
External Control of Knowledge of Results: Learner Involvement Enhances Motor Skill Transfer
Authors: Figueiredo L. S. , Ugrinowitsch H. , Freire A. B. , Shea J. B. , Benda R. N.
Published: January 2018

Providing the learner control over aspects of practice has improved the process of motor skill acquisition, and self-controlled knowledge of results (KR) schedules have shown specific advantages over externally controlled ones. A possible explanation is that self-controlled KR schedules lead learners to more active task involvement, permitting deeper information processing. This study tested this explanatory hypothesis. Thirty undergraduate volunteers of both sexes, aged 18 to 35, all novices in the task, practiced transporting a tennis ball in a specified sequence within a time goal. We compared a high-involvement group (involvement yoked, IY), notified in advance about upcoming KR trials, to self-controlled KR (SC) and yoked KR (YK) groups. The experiment consisted of three phases: acquisition, retention, and transfer. We found both IY and SC groups to be superior to YK for transfer of learning. Postexperiment participant questionnaires confirmed a preference for receiving KR after learner-perceived good trials, even though performance on those trials did not differ from performance on trials without KR. Equivalent IY and SC performances provide support for the benefits of task involvement and deeper information processing when KR is self-controlled in motor skill acquisition.
Numerical simulation of flow field in the twisting chamber of Murata vortex spinning based on the hollow spindle with different structures
Authors: Yan Linlin , Zou Zhuanyong , Cheng Longdi , Wei Guo , Tang Peijun
Published: January 2018

The novel hollow spindle with spiral guide grooves is introduced into the manufacture of Murata vortex spun yarn for the sake of enhancing the vortex yarn’s strength. By means of numerical simulation, the airflow characteristics in the conventional twisting chamber and novel twisting chamber of Murata vortex spinning are obtained and compared in order to explain yarn formation for adoption of the novel hollow spindle. The airflow distribution near the spiral guide grooves is analyzed, and the influence of airflow changes caused by the groove structure on the movement of the free end fibers and the yarn strength is analyzed. The results show that the spiral guide grooves will influence the pressure and velocity distribution in the twisting chamber, especially near the areas of the guide grooves. The guide grooves can guide the swirling airflow moving down the conical cavity of the twisting chamber, resulting in increases of the tangential, axial, and radial velocities of airflow in the conical cavity. And it is expected to produce fiber migration in the yarn cross-section and the self-twist effect of wrapped fibers. These phenomena will strengthen the wrapping and twisting effect of the free end fibers and inter-fiber cohesive force of vortex spun yarn in the process of yarn formation, and finally improve the strength of vortex spun yarn due to adopting the novel hollow spindle.
Marital Status and Trajectories of Depressive Symptoms Among Older Adults of Mexican Descent
Authors: Monserud Maria A.
Published: January 2018

Little is known about the implications of marital status for the age patterning of depressive symptoms in later life. Drawing on seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, this research uses growth curve models to examine age trajectories of depressive symptoms among continuously married and recently and continuously widowed older adults of Mexican descent (aged 65 years and older; N = 1,452). The findings demonstrate that despite having a higher mean level of depressive symptoms, the recently widowed experienced a similar rate of increase in distress with age to that of their married counterparts. Compared with the married, the continuously widowed had a steeper rise in depressive symptoms with age, although they had fewer symptoms at younger ages in later life. Physical health, financial strain, social support, and church attendance might account to a certain extent for marital status differences in depressive symptoms across later life.
The Policy and Practice of Microcredit in Rural China: Toward a Relational Understanding of Heterogeneous Implementation
Authors: Loubere Nicholas , Shen Qiu
Published: January 2018

Much research on rural development interventions in China has found substantial variation in their implementation at the local level. These studies often analyze the reasons for this heterogeneity by identifying variables responsible for influencing (or distorting) interventions as they travel from central formulation to local implementation. Through an in-depth ethnographic examination of the local implementation of one of China’s largest microcredit programs in three townships in rural Jiangxi province, this article challenges the dominant depiction of external development interventions as reified and linear, and instead proposes a relational approach to understanding local heterogeneity. This approach reveals implementation outcomes to be emergent from negotiations between diverse sets of actors at different levels. At the same time, it becomes clear that microcredit implementation reflects the contradictions implicit in China’s political economy of development. This points to two levels of implementation “relationality,” which results in unpredictable semi-chaotic variation, while simultaneously reproducing wider developmental relations.
Characteristics of organic pores and composition of bio-precursors in the Wufeng and Longmaxi Formation shales, Southern Sichuan Basin, China
Authors: Pang Qian , Hu Guang , Jiao Kun , Tan Xiucheng , Liu Hong , Ye Yuehao , Yan Shun , Zhao Dongfang
Published: January 2018

Bio-precursors of organic matter, referring to formerly living precursors, can influence content and distribution of organic pores significantly. However, insufficient attention has been paid in previous studies. To research the impact of bio-precursors of organic matter on shale organic pores, we conducted palynology and thin section analysis, total organic carbon analysis, and N2 gas absorption experiments on the Wufeng and Longmaxi Formations shales and kerogen samples from the Shuanghe outcrop section in southern Sichuan Basin, China. Generally, there are three bio-precursor assemblages being developed from bottom to top in the Wufeng and Longmaxi Formation, namely benthic algae, benthic–planktonic algae, and planktonic algae assemblages. Porosity in kerogen contributes greatly to shale porosity, accounting for 13 − 53% of total porosity. The total porosity and mesopore volume of samples (kerogen and shale) dominated by benthic algae are higher than those by planktonic algae. Pore size distributions of kerogen samples containing mainly benthic algae and planktonic algae are unimodal and multimodal type, respectively, when the pore diameter is larger than 5 nm. The different features between benthic and planktonic algae assemblages could be attributed to their different hydrocarbon generation potential and biological structure. Smaller fractal dimension of pores in kerogen samples mainly containing planktonic algae suggested that the planktonic algae are responsible for smoother pores in shales.
Vigilant subjects
Authors: Emerson R Guy
Published: January 2018

A vigilant subject foregrounds the terrorist event, working immanently to its development and disrupting its realisation. Individuals are tasked with spotting the antecedents of future attacks in the present so as to ward off catastrophe and with being mindful of processes of radicalisation so as to counsel against extremism. A vigilant subject monitors others – as much as himself or herself – according to proscribed conduct, while at the same time he or she co-evolves with uncertainty in order to prevent emergent threats: be they those yet to materialise (signs of an attack) or yet to be even thought of (signs of radicalisation). This vigilant subject is explored through two cases: the British Transport Police campaign to make commuters aware of, and report, terror-related activity and the Prevent duty that asks university staff to limit students being drawn into terrorism.
Relational practices and reflexivity: Exploring the responses of women entrepreneurs to changing household dynamics
Authors: Meliou Elina , Edwards Tim
Published: January 2018

This qualitative study explores how and why women, positioned as mothers, wives, or carers, navigate changing household dynamics, related to care and reproductive resources, and become entrepreneurial. Drawing on relational reflexivity, we show how women’s embodied, intimate relations with important others in the household form the focal point for entrepreneurial activities and offer evidence of their entrepreneurial agency. Our analysis reveals the emergence of three relational practices that result in a new venture as the entrepreneurial response of women. We critically evaluate normative analyses on gender, entrepreneurship, and household.
Country-level determinants and consequences of overconfidence in the ambitious entrepreneurship segment
Authors: Cieślik Jerzy , Kaciak Eugene , van Stel André
Published: January 2018

Countries vary widely and systematically in the extent to which the ambitions of their entrepreneurs differ from their realisations. We label this discrepancy entrepreneurial overconfidence (EOC). Although a certain level of EOC may be beneficial for an economy, we provide empirical support for the argument that if entrepreneurial ambitions substantially and systematically exceed realisations, this may be at the cost of economic and societal prosperity. Therefore, we need to know more about country levels of EOC and their determinants, particularly with respect to the growth-oriented segment of entrepreneurship. Combining data on entrepreneurial ambitions from Global Entrepreneurship Monitor and data on realisations from Eurostat, we construct a measure of EOC at the country level and correlate its variation across 23 European Union (EU) countries over the period 2004–2015 with a set of economic and cultural factors. Among other findings, our results show that ambitions exceed realisations in almost all countries, but that this discrepancy is significantly greater for new member countries entering the EU since 2004. Policy implications of our results are discussed, particularly for promoting ambitious entrepreneurship in countries at the intermediate development stage.
Patients’ and carers’ perspectives of palliative care in general practice: A systematic review with narrative synthesis
Authors: Green Emilie , Knight Selena , Gott Merryn , Barclay Stephen , White Patrick
Published: January 2018

Background:

General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner’s role.

Aims:

To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner’s capacity to fulfil this perceived role.

Design:

Systematic literature review and narrative synthesis.

Data sources:

Seven electronic databases (MEDLINE, Embase, PsycINFO, BNI, CINAHL, Cochrane and HMIC) were searched from inception to May 2017. Two reviewers independently screened papers at title, abstract and full-text stages. Grey literature, guideline, hand searches of five journals and reference list/citation searches of included papers were undertaken. Data were extracted, tabulated and synthesised using narrative, thematic analysis.

Results:

A total of 25 studies were included: 14 employed qualitative methods, 8 quantitative survey methods and 3 mixed-methods. Five key themes were identified: continuity of care, communication between primary and secondary care, contact and accessibility, communication between general practitioner and patient, and knowledge and competence.

Conclusion:

Although the terminology and context of general practice vary internationally, themes relating to the perceived role of general practitioners were consistent. General practitioners are considered well placed to provide palliative care due to their breadth of clinical responsibility, ongoing relationships with patients and families, and duty to visit patients at home and coordinate healthcare resources. These factors, valued by service users, should influence future practice and policy development.
Building Evidence in Early Childhood Special Education: A Systematic Review of Replication Intervention Studies
Authors: Banerjee Rashida , Movahedazarhouligh Sara , Millen Kaitlyn , Luckner John L.
Published: January 2018

Valid and evidence-informed practices are critical to help young children with disabilities and their families with highly effective interventions and instruction to reach their potentials. Replication research is critical for appraising research and identifying evidence-based practices. The purpose of this study was to replicate the methods used by Cook and colleagues and conduct a systematic review of the quantity, type, and findings of replication research in early childhood special education (ECSE). An intervention study was considered a replication if (a) the stated purpose of the study was to replicate, expand, further investigate, or use a previously conducted study as its basis and (b) the findings of the study were compared with the results of previous studies. Two hundred ninety-seven published articles in three journals relevant to ECSE from 2012 to 2016 were reviewed to identify intervention studies. From the 78 identified intervention studies, we found 44 studies (56%) that met the criteria for replication. Author overlap occurred for 20 studies out of the 44 replication studies (46%). Our investigation revealed that ECSE journals published a significantly larger number of replication studies (56%) than those reported by Cook and colleagues (31%); however, the scarce number of direct replication was concerning. We recommend intentional and proactive steps be taken to promote and value replication research in ECSE.
Patient Variability Seldom Assessed in Cost-effectiveness Studies
Authors: Lavelle Tara A. , Kent David M. , Lundquist Christine M. , Thorat Teja , Cohen Joshua T. , Wong John B. , Olchanski Natalia , Neumann Peter J.
Published: January 2018

Background. Cost-effectiveness analysis (CEA) estimates can vary substantially across patient subgroups when patient characteristics influence preferences, outcome risks, treatment effectiveness, life expectancy, or associated costs. However, no systematic review has reported the frequency of subgroup analysis in CEA, what type of heterogeneity they address, and how often heterogeneity influences whether cost-effectiveness ratios exceed or fall below conventional thresholds. Methods. We reviewed the CEA literature cataloged in the Tufts Medical Center CEA Registry, a repository describing cost-utility analyses published through 2016. After randomly selecting 200 of 642 articles published in 2014, we ascertained whether each study reported subgroup results and collected data on the defining characteristics of these subgroups. We identified whether any of the CEA subgroup results crossed conventional cost-effectiveness benchmarks (e.g., $100,000 per QALY) and compared characteristics of studies with and without subgroup-specific findings. Results. Thirty-eight studies (19%) reported patient subgroup results. Articles reporting subgroup analyses were more likely to be US-based, government funded (v. drug industry- or nonprofit foundation-funded) studies, with a focus on primary or secondary (v. tertiary) prevention (P < 0.05 for comparisons). One or more patient characteristics were used to stratify CEA results 68 times within the 38 studies, with most stratifications using one characteristic (n = 47), most commonly age (n = 35). Among the 23 stratifications reported alongside average ratios in US studies, 13 produced subgroup ratios that crossed a conventional CEA ratio benchmark. Conclusions. Most CEAs do not report any subgroup results, and those that do most often stratify only by patient age. Over half of the subgroup analyses reported could lead to different value-based decision making for at least some patients.
Process improvement methodologies uncover unexpected gaps in stroke care
Authors: Kuner Anthony D , Schemmel Andrew J , Pooler B Dustin , Yu John-Paul J
Published: January 2018

Background

The diagnosis and treatment of acute stroke requires timed and coordinated effort across multiple clinical teams.

Purpose

To analyze the frequency and temporal distribution of emergent stroke evaluations (ESEs) to identify potential contributory workflow factors that may delay the initiation and subsequent evaluation of emergency department stroke patients.

Material and Methods

A total of 719 sentinel ESEs with concurrent neuroimaging were identified over a 22-month retrospective time period. Frequency data were tabulated and odds ratios calculated.

Results

Of all ESEs, 5% occur between 01:00 and 07:00. ESEs were most frequent during the late morning and early afternoon hours (10:00–14:00). Unexpectedly, there was a statistically significant decline in the frequency of ESEs that occur at the 14:00 time point.

Conclusion

Temporal analysis of ESEs in the emergency department allowed us to identify an unexpected decrease in ESEs and through process improvement methodologies (Lean and Six Sigma) and identify potential workflow elements contributing to this observation.
Growth of yield front in thermo-mechanically loaded non-uniform bars using an iterative variational method
Authors: Nayak Priyambada , Saha Kashi Nath
Published: January 2018

The aim of this study is to investigate the growth of yield front in post-elastic domain of a thermo-mechanically loaded non-uniform bar with clamped ends. The problem is solved through an extension of the variational method in post-elastic regime. It is assumed that yield stress is the only physical parameter dependent on temperature variation of the bar and all other material properties remain constant corresponding to the value at ambient temperature. The bar is axisymmetric, and during thermal loading, its plane cross sections remain plane maintaining axisymmetry. This analysis of the energy-based variational formulation is carried out by Galerkin’s principle, using a linear combination of sets of orthogonal coordinate functions which satisfy prescribed boundary conditions. The approximate solution additionally needs an iterative technique to find the growth in yield front for the type of prescribed temperature field. The solution algorithm is actualized with the assistance of MATLAB® computational simulation software. Uniform, linear and parabolic types of temperature distribution over the length of the bar are assumed, and some numerical results in dimensional form are presented and discussed for a clamped-clamped mild steel bar. The temperatures corresponding to onset of yielding and total collapse are considered as markers of yield limit and collapse loads. The temperatures and limit load factors for different bar geometries and temperature distributions are provided. The results reveal that the thermo-elasto-plastic deformation of clamped bar is significantly influenced by the effect of geometry parameters and by the nature of thermal load.
Continuous Veno-Venous Hemodiafiltration or Hemofiltration: Impact on Calcium, Phosphate and Magnesium Concentrations
Authors: Morimatsu H. , Uchino S. , Bellomo R. , Ronco C.
Published: January 2018

Background and Objectives

Different techniques of continuous renal replacement therapy (CRRT) might have different effects on calcium, phosphate and magnesium concentrations. Accordingly, we tested whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous venovenous hemofiltration (CVVH) would achieve better control of these electrolytes.

Design

Retrospective controlled study

Setting

Two tertiary Intensive Care Units

Patients

Critically ill patients with acute renal failure (ARF) treated with CVVHDF (n=49) or CVVH (n=50)

Interventions

Retrieval of daily morning ionized calcium, phosphate and magnesium before and after the initiation of CRRT for up to 2 weeks of treatment.

Measurements and Results

Before treatment, both groups had a high incidence of abnormal ionized calcium concentrations (57.2% for CVVHDF vs 46.0% for CVVH; NS). After treatment, both groups showed a significant increase in serum calcium concentration over the first 48 h (p=0.041 vs p=0.0048) but hypercalcemia was more common during CVVHDF (15.3% vs 0.4%; p<0.0001). However, in both groups, hypocalcemia remained common (30.9% vs 36.7%; NS). Before treatment, abnormal serum phosphate concentrations were also common (65.1% for CVVHDF vs 78.1% for CVVH; NS). After treatment, both groups achieved a significant reduction of serum phosphate within 48 hours (p<0.0001 in both groups). There was no difference in the prevalence of abnormal phosphate levels during treatment (45.5% vs 42.4%; NS). Before treatment, both groups had a high incidence of abnormal magnesium concentrations (50.0% for CVVHDF vs 51.2% for CVVH; NS). During treatment, there was no significant change in serum magnesium concentrations during the first 48 hours or in the prevalence of abnormal magnesium concentrations (56.3% vs 63.4%; p=0.13). However CVVHDF was associated with a higher prevalence of hypomagnesemia (8.1% vs 0.4%; p<0.0001) and a lower incidence of hypermagnesemia (48.2% vs. 63.0%; p=0.0014).

Conclusions

In critically ill patients with ARF, calcium, phosphate and magnesium were commonly abnormal and they were only partly corrected by CRRT. CVVH and CVVHDF had a different effect on serum magnesium concentrations.
Literature Overview on Artificial Liver Support in Fulminant Hepatic Failure: A Methodological Approach
Authors: Bertani H. , Gelmini R. , Del Buono M.G. , De Maria N. , Girardis M. , Solfrini V. , Villa E.
Published: January 2018

Artificial liver support is a therapeutic option for subjects with fulminant hepatic failure. Results of these studies suggest a possible favourable effect on this condition. The aim of the present review is to evaluate not the results of the different artificial systems available but the methodology used to achieve these results.

A computer and manual search of the literature was performed; 832 pertinent references were retrieved. Seventy-seven were full papers reporting the application of artificial liver support in animals or humans (15 RCTs (3 in humans, 12 in animals), 53 uncontrolled phase I trials, 9 case reports).

The results of this review indicate that, although the rationale of artificial liver support as shown by animal studies is acceptable, the widespread use in clinical practice is not justified and a controlled design for the studies on artificial liver support systems is mandatory.
A New Bioassay Including a Small Scale Hepatocyte Bioreactor for Hepato-Mediated Toxicity Testing in a Target Cell Line
Authors: Deglmann C.J. , Metzger R. , Stickel M. , Hoerrlein S. , Schildberg F.W. , Koebe H.G.
Published: January 2018

New approaches for in vitro testing of hepato-mediated toxicity are undertaken to offer alternatives to in vivo animal testing. The described bioassay for hepato-mediated toxicity testing is based on a small scale hepatocyte-bioreactor with pig hepatocytes connected to a silicon sensor based microphysiometer system for monitoring of the extracellular acidification rate (EAR) of cells and the microphysiometer alone. EAR represents the metabolic activity of tested cells (hepatocytes and ZR 751 cells) under the influence of perfused media, compared to controls, which were set to 100%. Cyclophosphamide (CYCL), whose cytostatic effect is dependent on CYP 450 biotransformation was used as a model substrate. CYCL showed decrease of EAR in hepatocytes, but not in ZR 751 cells. Bioreactor supernatant including CYCL was pumped into the microphysiometer and EARs of the target ZR 751 cell line were recorded. After 7 h of bioreactor supernatant perfusion the ZR 751 cell line showed an EAR decrease of 18.68% ± 10.18, as compared to controls (bioreactor supernatant from the identical set-up without CYCL). Thus the presented model of hepato-activated toxicity showed an EAR decrease in the ZR 751 cell line that reflected the toxic activation of CYCL by the bioreactor. This new bioassay serves as an example of future applications for hepatocyte bioreactors in automated toxicity testing devices, e.g. in preclinical drug studies or evaluation of hepato-mediated toxicity, not depending on cell destruction or further assays.
Cultivation of Porcine Hepatocytes in Polyurethane Nonwovens as Part of a Biohybrid Liver Support System
Authors: Linti C. , Zipfel A. , Schenk M. , Dauner M. , Doser M. , Viebahn R. , Becker H.D. , Planck H.
Published: January 2018

Many patients suffering from end-stage liver disease cannot be transplanted within reasonable time due to the shortage of donor organs. Bioartificial liver support systems may contribute to the liver regeneration or bridging the time until a liver graft for transplantation becomes available. Nonwovens with integrated oxygenation capacity have been developed and manufactured by melt blow technology using thermoplastic polyurethane. Capillary membranes for oxygenation were integrated into the nonwoven during the processing. The polyurethane nonwoven structures with adapted pore size and high pore volume allow high cell densities in the hepatocyte culture.

The three-dimensional cell culture was housed by a flow bioreactor system and was integrated in a closed loop circulation with monitoring possibilities for pressure, pH, temperature, ammonia, and oxygen. Hepatocytes were isolated from rats or pigs by collagenase perfusion and infused into the medium-perfused circulation. Cells showed high viability and hepatocyte specific cytochrome P450-dependent metabolic function in culture (MEGX test).
Continuous Venovenous Hemofiltration: Effects on Monocyte and Lymphocyte Immunophenotype in Critically Ill Patients
Authors: Rokyta R. , Holub M. , MatĔjovič M. , Hanzlíková J. , Helcl M. , Novák I. , Šrámek V. , Kroužecky˘ A. , Příhodová J.
Published: January 2018

The aim of this study was to test the hypothesis that continuous venovenous hemofiltration (CVVH) increases HLA-DR expression on monocytes and T lymphocytes in critically ill patients. 24 septic (SP) and 10 non-septic (NSP) medical ICU patients with acute renal failure were studied prospectively. The ultrafiltration rate was 20–30 ml.kg-1.h-1. The total and differential white cell counts were measured and CD3+ lymphocyte count, HLA-DR expression on CD14+ monocytes and CD3+ lymphocytes were analysed by two-colour flow cytometry before, 4 and 24 h after CVVH initiation, respectively. CVVH did not influence leukocyte, granulocyte, total lymphocyte and CD3+ lymphocyte counts in both groups of patients. The percentage of HLA-DR+/CD14+ monocytes in SP revealed no changes, whereas it decreased after 4 h of CVVH in NSP (p<0.05). The percentage of HLA-DR+/CD3+ lymphocytes in SP decreased after 24 h (p< 0.05), whereas it remained unchanged in NSP. We conclude that CVVH initiation is not associated with the increase of HLA-DR expression on CD14+ monocytes and T lymphocytes in critically ill patients with acute renal failure.
Poly(D,L-lactide/∊-Caprolactone)/Hydroxyapatite Composites as Bone Filler: An in Vivo Study in Rats
Authors: şenköylü A. , Ural E. , Kesencì K. , şìmşek A. , Ruacan ş. , Fambri L. , Migliaresi C. , Pìşkìn E.
Published: January 2018

In this study, a novel composite bone substitute was implanted in animal models (rats) and their in vivo characteristics were examined. A D,L-lactide and ∊-caprolactone copolymer (Mw: 80,000; Mn:40,000, and PI:2.00) was synthesized by ring-opening polymerization of the respective dimers using stannous octoate as the catalyst. The final ratio of D,L-lactide to ∊-caprolactone obtained by 1NMR was 60/40. Hydroxyapatite (HA) powder was loaded in the copolymer. The HA/copolymer ratio was 60/40 (w/w). These composites were easily shaped by hand. Animal tests were performed on mature wistar rats (n=30). Defects were created on the proximal, the thickest part of the femur. The bone defects of the first group were filled with polymer/HA composite, the second group filled with only HA and the third group was left empty. Histologic examination of bone tissues showed new bone formation around the yellow-green polymer/HA composite material in the first group of animals whereas no evidence of new bone growth was observed in other groups.
Hepatitis C Therapy with Long Term Remission after Renal Transplantation
Authors: Bunnapradist S. , Fabrizi F. , Vierling J. , Martin P. , Moudgil A. , Kamil E. , Jordan S.
Published: January 2018

Hepatitis C virus infection (HCV) is common in patients with end-stage renal disease (ESRD) and long observation periods have shown the detrimental effect of HCV infection on patient and graft survival after renal transplantation. At present, interferon is the most important agent for the treatment of hepatitis C in ESRD; however, limited information exists concerning the long-term response of patients who undergo renal transplantation after successful antiviral therapy. We describe the evolution of HCV infection in a dialysis patient with hepatitis C who was successfully treated with interferon alpha and then underwent renal transplantation. He received aggressive immunosuppression during the induction phase and for allograft rejection; however, regular screening showed complete absence of biochemical and virological relapse of HCV over a 6-year post-transplantation period. We conclude that interferon can offer excellent response in selected dialysis patients with hepatitis C. Alternative strategies with newer antiviral agents are currently under active investigation.
Pre-HD Dilution Acidosis, without Post-HD Contraction Alkalosis in Uremic Patients
Authors: Agroyannis B. , Fourtounas C. , Tzanatos H. , Kapetanaki A. , Dalamangas A. , Vlahakos D.V.
Published: January 2018

The aim of this study was to verify if the degree of pre-HD acidosis and its correction post-HD is related to body fluid expansion during the interdialytic period.

Twelve uremic patients without major problems, with stable hematocrit, with regular and similar HD-session characteristics, but widely varying amounts of body fluid expansion in the interdialytic period were included.

Blood samples were collected from arterial line pre-and post-HD, anaerobically in heparinized syringes, for determination of HCO3-, pH and PaCO2 (radiometer Copenhagen ABL 300 Acid-Base Laboratory), in two similar HD-sessions for each patient (12 patients, 24 HD-sessions). The percentage (%) of body weight gain in the interdialytic period was also estimated. For each patient, the mean value of parameters studied in the two HD-sessions was used for the evaluation of findings. According to mean values (±SD) of HCO3-, pH and PaCO2 Pre-HD (18.26±1.99 mmol/L, 7.31±0.03, 36.27±2.5 mmHg respectively) and post-HD (26.37±1.7, 7.43±0.03, 38.43±2.10 respectively) patients are acidotic pre-HD and slightly alkalemic post-HD. Correlation between the percentage (%) of interdialytic body weight gain (IBWG) and the values of HCO3-, pH and PaCO2, Pre-HD (r=-0.814, p <0.001; r=-0.931, p <0.001; r=0,100 NS; respectively) and post-HD (r=-0.958, p <0.001; r=-0.937, p <0.001; r=-0.504 NS; respectively) indicates a significant and negative relationship of IBWG% with HCO3- and pH pre- and post-HD, but not with PCO2.

In conclusion, the negative relationship of IBWG% with HCO3- and pH pre- and post-HD indicates that the body fluid expansion during the interdialytic period contributes to a dilutional acidosis pre-HD, but not to a contraction alkalosis post-HD, by the elimination of fluid during the HD-session.
Plasmaexchange in the Treatment of Myasthenia Gravis Associated with Thymoma
Authors: Gogovska L. , Ljapcev R. , Polenakovic M. , Stojkovski L. , Popovska M. , Grcevska L.
Published: January 2018

Background

All patients with thymomatous Myasthenia Gravis (MG) should undergo early and total thymectomy, but controversy abounds in the choice of chronic immunosuppressive agents. The value of plasmaexchange (PE) in MG has been clearly estabilshed in preoperative preparation and treatment of myasthenic crisis. Whether PE may be used in the chronic long-term therapy of patients with thymomatous MG in addition to conventional immunosuppressive agents and cholinesterase inhibitors is yet to be answered.

Case history

We present a 40-year old woman with an 11 year history of MG. Thymectomy was done during the first year of the disease and the histopathologic finding was thymoma. To sustain clinical remission after thymectomy she continued with immunosuppression with methylprednisolone and cyclosporin A (or azathioprine) in addition to cholinesterase inhibitors. Despite the almost continuous immunosuppression, the disease course continued with fluctuating myasthenic weakness which few times progressed to myasthenic crisis requiring mechanical ventilation. During myasthenic crisis we performed 6–8 plasmapheresis at 2–3 day intervals in addition to conventional immunosuppressive therapy. The disease rapidly worsened in January 2000 and we started with intermittent plasmapheresis (3–6 procedures at 2–3 day intervals, every 6–8 weeks) in order to sustain remission. With this therapeutic protocol, during 20 months follow-up we managed to prevent myasthenic crisis and to avoid ventilatory support.

Conclusions

Plasmaexchange could be used as a successful and safe therapeutic tool in chronic long-term therapy in addition to conventional immunosuppressive agents to sustain remission in patients with MG. This is particularly important in the treatment of patients with thymomatous MG because they have an increased frequency of myasthenic crisis and often respond poorly an to immunosuppression with steroids or other immunosuppressants.
An Association between Aortic Pulse Wave Velocity, Blood Pressure and Chronic Inflammation in ESRD Patients on Peritoneal Dialysis
Authors: Stompór T. , Rajzer M. , Sułowicz W. , Dembińska-Kieć A. , Janda K. , Kawecka-Jaszcz K. , Wójcik K. , Tabor B. , Zdzienicka A. , Janusz-Grzybowska E.
Published: January 2018

Increased aortic pulse wave velocity (AoPWV) has been identified as a risk factor for cardiovascular morbidity in the general population and in patients on dialysis. Most of the studies in ESRD patients refer to subjects on hemodialysis. Influence of the inflammatory process on aortic stiffening remains largely unknown. The aim of the present study was to evaluate potential relationships between AoPWV and blood pressure, basic anthropometric parameters, selected growth factors and markers of the inflammatory process in ESRD patients treated with peritoneal dialysis.

The study population consisted of 43 patients (19 F, 24 M) with a mean age of 50.6 ±13.4 years on PD for a mean period of 21.9 ± 20.7 months.

AoPWV was measured using two pressure transducers placed on the carotid and femoral arteries and connected to an automatic processor (Complior® Colson AS, Paris, France). Serum levels of Tumor Necrosis Factor alpha (TNFα), interleukin 6 (IL-6) and plasma basic Fibroblast Growth Factor (bFGF) were measured with ELISA; C-reactive protein and fibrinogen with nephelometry. Serum lipid profile was also assessed. Blood pressure was measured in an outpatient department under standardized conditions.

Mean aortic pulse wave velocity in the study population was 10.7 ±2.1 m/s. No difference in AoPWV was found between men and women. AoPWV correlated significantly with age (R=0.41; p <0.01) but not with time on dialysis. Positive relationship between AoPWV and body weight and BMI was shown (R = 0.31; p < 0.05 and R = 0.35; p < 0.05, respectively). AoPWV correlated significantly with systolic blood pressure (SBP), mean arterial pressure (MAP) and pulse pressure (PP) (R = 0.46, p < 0.005, R = 0.46, p < 0.005 and R = 0.43, p < 0.01, respectively). AoPWV correlated with serum IL-6 and plasma bFGF (R = 0.32, p < 0.05 and R 0.4, p < 0.01; respectively). The correlation with serum CRP was borderline significant (p < 0.53). In multiple regression analysis age (beta 0.38; p < 0.005), plasma bFGF level (beta 0.3; p < 0.05), and systolic blood pressure (beta 0.29; p < 0.05) were independently associated with pulse wave velocity.

Our results suggest that AoPWV values in patients on PD are associated with factors similar to those encountered in the general population. We suggest that increased aortic stiffening may also be related to the chronic inflammatory process in PD patients.
Occurance of Apoptosis during Ischemia in Porcine Pancreas Islet Cells
Authors: Stadlbauer V. , Schaffellner S. , Iberer F. , Lackner C. , Liegl B. , Zink B. , Kniepeiss D. , Tscheliessnigg K.H.
Published: January 2018

Purpose

Pancreas islet transplantation is a potential treatment of diabetes mellitus and porcine organs provide an easily available source of cells. Unfortunately quality and quantity of isolated islets are still not satisfactory. Apoptosis occurs in freshly isolated islets and plays a significant role in early graft loss. We evaluated the influence of four storage solutions on porcine pancreas islets.

Method

After warm ischemia of 15–20 minutes 12 organs were stored in 4 cold preservation solutions: Histidine-Tryptophan-Ketoglutarate solution (HTK), Hank's buffered saline solution (HBSS), University of Wisconsin (UW) solution and Ringer-Lactate (R). After cold ischemia for 100 minutes, organs were fixed in 3% formalin. Apoptotic cells were counted on hematocylin-eosin stainings.

Results

Most apoptotic cells were found in organs stored in R. Low numbers were found in the other groups. The difference between organs stored in R and organs stored in UW, HTK, or HBSS was highly significant. No significant difference could be found between UW, HTK and HBSS.

Conclusion

Cold and warm ischemia of the pancreas seems to induce apoptosis in islet cells. Preservation solutions cause less apoptosis than electrolyte solution. No significant differences could be found among the preservation solutions.
Does Priming Implementation with Low-dose Albumin Reduce Postoperative Bleeding following Cardiopulmonary Bypass?
Authors: Onorati F. , Santarpino G. , Renzulli A. , De Feo M. , De Santo L.S. , Corte A. Della , Galdieri N. , Cotrufo M.
Published: January 2018

This study aimed to assess whether low doses of albumin in the priming solution for cardiopulmonary bypass (CPB) reduce postoperative bleeding.

Three-hundred and seventy-seven patients undergoing CPB were retrospectively assigned to group A (154 patients, CPB primed with 20 ml/kg Ringer Lactate solution + 0.75mg/kg albumin 20%) and group B (223 patients with 20 ml/kg Ringer Lactate).

A significant difference was found in terms of reoperations for bleeding (group A 0/154 versus group B 9/223; P=0.033). The mean number of blood derivatives transfused per patient was higher in group B than in group A (p <0.001). Platelet count after CPB was higher in group A than in group B (175±52×103/μl versus 131±70×103/μl; P=0.045). The amount of postoperative bleeding was 525ml versus 680ml at 24hrs (p <0.001), 819ml versus 1102ml at 48hrs, (p <0.001), 963ml versus 1294ml at 72hrs, (p <0.045) (group A versus group B respectively). Crystalloid priming with low-dose albumin reduces postoperative bleeding.
Effect of Basic Fibroblast Growth Factor on Vascularization in Esophagus Tissue Engineering
Authors: Hori Y. , Nakamura T. , Kimura D. , Kaino K. , Kurokawa Y. , Satomi S. , Shimizu Y.
Published: January 2018

We carried out an experimental study to evaluate the effect of basic fibroblast growth factor (bFGF)-containing collagen gel on vascularization in esophageal tissue engineering. We compared an acellular collagen sponge scaffold and an acellular collagen gel scaffold in combination with bFGF using a canine model. The construct was implanted in the cervical esophagus and the regenerated tissue was evaluated one month after surgery. Histological analysis confirmed a significantly large amount of blood vessels in the bFGF-containing collagen gel group as compared to the collagen gel group without bFGF (bFGF (-)). However, in the collagen sponge groups, no difference was observed between the bFGF (+) group and the bFGF (-) group. These results showed that bFGF-containing collagen gel is suitable not only for an acellular scaffold for tissue engineering but also for an effective tropic factor vehicle in vivo.
L-Carnitine Consecutively Administered to Patients on Hemodialysis Improves Beta-Cell Response
Authors: Vazelov E. , Borissova A-M. , Kirilov G. , Assenova B. , Tchetirska M. , Krivoshiev S.
Published: January 2018

Eight patients with end stage renal disease (ESRD) on chronic hemodialysis (CHD) treatment were supplemented with 1 g L-carnitine intravenously (i.v.) after each dialysis session for one month. A Tolbutamide test was done and blood sugar (BS), serum C-peptide (CP) were measured at 0, 20 and 60 minutes, as well as the plasma L-carnitine level before and after treatment. Delta CP and the area under CP curve were ascertained. After L-carnitine application delta CP was significantly increased (1.33 ± 0.63 vs. 2.24 ± 1.0 nmol/L; p <0.05) and also the area of the stimulated secretion under the CP curve (14.93 ± 11.11 vs. 36.88 ± 25.36 nmol/L × 60 min.; p <0.05). The fasting BS-level was significantly lower after the treatment - 3.85 ± 0.43 vs. 4.76 ± 1.02 mmol/L; p <0.05 and plasma L-carnitine level significantly increased (72.8 ± 43.2 vs. 35.2 ± 18.3 mcmol/L; p <0.05) Improving the oxidative processes in peripheral tissues, L-carnitine increases the peripheral effectiveness of insulin and relieves the overstretched beta-cell apparatus.
Interaction between Fibroblast Cells and Fluorinated Polyimide with Nano-Modified Surface
Authors: Nagaoka S. , Ashiba K. , Okuyama Y. , Kawakami H.
Published: January 2018

In this study, we investigated the effect of surface nano-modification of aromatic fluorinated polyimide (6FDA-6FAP) derived from 2, 2′-bis (3, 4-dicarboxyphenyl) hexafluoropropane dianhydride (6FDA) and 2, 2′- bis (4-aminophenyl) hexafluoropropane (6FAP) on the interaction with proteins and cells. The surface of 6FDA-6FAP was modified by surface-rubbing showed nano-ordered stripes along the rubbing direction. The rat fibroblast FR cells formed multicellular spheroids with high cell density on the rubbed surface then expressed excellent collagen production similarly in vivo, while on the non-modified surface the cells formed two-dimensional monolayers and the collagen production was negligible. The modulation of cell function by the surface nano-modification along with surface micro-modification may be one of the most important considerations during the design and manufacture of novel biochips or tissue engineering materials.