bluuebunny/crossref_metadata_2025 huggingface dataset:
The INNOVance Lexicon: Organisation of terms and concepts about construction products
Authors: Guaglianone Maria Teresa , Aracri Giovanna , Oliveri Elisabetta
Published: January 2017

The construction sector is also a knowledge-intensive domain, in which effective and unambiguous communication and knowledge sharing are, at the same time, both essential yet difficult to accomplish. This is primarily due to the several professionals interacting and facing situations involving diverse resources, processes and activities. Each of them brings a different background and perspective, often generating poorly integrated information. Knowledge Organization Systems (KOSs) are crucial for ensuring completeness, consistency and quality of information. Despite the international trend to encourage the development and use of controlled vocabularies, especially classification systems, until recently in Italy the national coordination policy has not been effective enough. This article describes the first national attempt made, the INNOVance Lexicon that collects and organises knowledge about construction products. It combines taxonomic, terminological and semantic aspects of knowledge and it is a reference language to support information exchange and sharing in collaborative context.
Knowledge sharing in a non-native language context: Challenges and strategies
Authors: Ahmad Farhan
Published: January 2017

Knowledge sharing is a language-based activity. With the rise of multilingual workforces and the adoption of common corporate languages, such as English, knowledge sharing is happening in non-native language contexts more than ever before. This article explores the challenges and strategies of knowledge sharing in a non-native language at the individual level. For this purpose, an exploratory case study was conducted in a multinational organisation. Results show that the use of a non-native language can make knowledge sharing an ambiguous and costly process, eroding some of the benefits of knowledge sharing. It was found that employees adopt three different strategies to deal with problems in the knowledge-sharing process caused using a non-native language. These strategies – namely, discourse adjustment, language adjustment and media adjustment – play an important role in the successful exchange of knowledge between linguistically diverse individuals.
Cellular Mechanisms in the Response of the Arterial Wall to Injury and Repair
Authors: Schwartz Colin J. , Sprague Eugene A. , Valente Anthony J. , Kelley Jim L. , Edwards Ellen H.
Published: January 2017

This synopsis emphasizes the inappropriateness of a “single stimulus-single response” approach in understanding the response of the arterial wall to injury and repair. The outcome of any injurious stimulus is a series of interactive cascades among the endogenous and exogenous cellular and non-cellular components of the arterial wall, and the cellular and non-cellular elements of the blood. Both genetic and hemodynamic factors can further influence this response. The more prominent of the cellular and non-cellular components have been discussed. These include: 1) the vascular endothelium, its dynamic interaction with macromolecules and formed elements of the blood, its role in the transport of plasma proteins, its influence on the function of arterial smooth muscle cells and the recruitment of blood-born monocytes; 2) the arterial smooth muscle cell, its role in the vasomotor function of the artery wall, arterial repair and reconstruction, metabolism of lipids and the secretion of cytokines regulating monocyte recruitment; 3) the mononuclear phagocyte, its role in arterial debridement, metabolism of modified LDLs, a precursor of the cholesteryl ester-rich foam cell, and the secretion of neutral hydrolases, bioactive lipids and cytokines; 4) lymphocytes, as mediators of the inflammatory response and possible autoimmune reactions; 5) platelets, their roles in hemostasis, thrombosis, atherogenesis, and the repair process and 6) plasma LDLs, their oxidative modification by cells of the vessel wall and their roles in the injury process. The interactive processes among arterial and circulating components in both injury and repair is emphasized.
An Idiopathic Febrile Necrotizing Arteritis Syndrome in the Dog: Beagle Pain Syndrome,
Authors: Hayes T. J. , Roberts G. K. S. , Halliwell W. H.
Published: January 2017

The clinical, laboratory, and pathologic features of a syndrome in dogs characterized by intermittent pain, fever, neutrophilia, and necrotizing arteritis are described to alert others involved in toxicity testing to the existence of this disorder. It is considered that this idiopathic syndrome is a latent condition, the expression of which can be precipitated in predisposed dogs by experimental treatment, and thus, its occurrence could complicate interpretation of toxicity studies. We have observed the disorder in 14 beagle dogs. The syndrome is rare and most cases for study were supplied by the breeder. Typical clinical signs observed included evidence of pain when the mouth was opened, grunting when lifted, and standing with an arched back and lowered head. Appetite was usually reduced. Body temperature was elevated (e.g., 104–106°F). There was progressive, bilateral atrophy of temporal and cervical musculature. Such signs have been observed to persist unremittingly or, more commonly, with periods of expression and remission. Neutrophilic leukocytosis and thrombocytosis were present. Hemoglobin and hematocrit were usually slightly decreased. Serum total protein was usually normal but albumin was reduced and alpha-2 globulins were markedly increased. Rheumatoid factor was elevated in several dogs. Arteritis was observed histologically and was characterized by necrosis, intimal proliferation, neutrophil and mononuclear cell infiltration in the media and periarterial tissues, and hemorrhage. Amyloidosis was observed in several dogs. The cause of this disorder is unknown. Knowledge of the distinct features of this syndrome should obviate complication of interpretation of results in toxicity studies and hopefully will lead to studies of this syndrome to provide an understanding of its etiopathogenesis.
Coronary Vascular Lesions in Dogs Treated with Phosphodiesterase III Inhibitors
Authors: Isaacs Kevin R. , Joseph E. Clive , Betton Graham R.
Published: January 2017

A treatment-related coronary arteriopathy has been observed in the dog following the oral or intravenous administration of 4 potent phosphodiesterase type III inhibiting inodilators at high multiples of their ED50 for periods from 1 day to 6 months. A fifth compound of a similar pharmacological class exhibited limiting toxicity at low multiples of its ED50 and this compound failed to induce coronary arterial lesions. The earliest treatment-related findings observed were medial hemorrhage and necrosis with focal breaks in the internal elastic lamina. Later changes, observed from day 9 onwards, included intimal thickening consisting of smooth muscle proliferation with a mucoid ground substance, variable and inconsistent inflammatory changes involving one or more arterial tunics and adventitial hemorrhage, fibrosis and neovascularization. The changes were restricted to the coronary arteries including the extramural and intramural branches. The distribution of lesions varied from widespread, multifocal involvement of both coronary arterial systems to focal lesions with no obvious site of predilection. Induction of this lesion may involve changes in coronary flow and pressure as a result of an exaggerated pharmacological response to this class of compound. The susceptibility of other species (rat, cynomolgus monkey, or pig) to this effect has been investigated with no treatment-related arteriopathy being observed.
A Comparative Study of Minoxidil-Induced Myocardial Lesions in Beagle Dogs and Miniature Swine
Authors: Herman Eugene H. , Ferrans Victor J. , Young Robert S. K. , Balazs Tibor
Published: January 2017

Minoxidil, a long-acting vasodilating antihypertensive agent, reduces arterial blood pressure by a direct action on arteriolar smooth muscle. The present studies examined the gross anatomic, histologic and ultra-structural myocardial alterations produced by 2 daily doses of minoxidil in beagle dogs (0.5, 1, or 3 mg/kg) and miniature swine (1, 3, or 10 mg/kg). Both myocardial necroses and hemorrhages were observed in dogs and pigs 24 hr after the last dose of minoxidil. In both species, the necroses were most frequent in the left ventricular papillary muscles, particularly the posterior one, but were less severe in swine. An ischemic origin of the necroses was suggested by the location of the lesions and by the pharmacologic effects of minoxidil. Gross epicardial or endocardial hemorrhages involving the atria and, to a lesser extent, the ventricles were observed in both species but were more severe in dogs. The atrial lesions were manifested grossly by diffuse redness and microscopically by interstitial edema, extravasated erythrocytes and infiltration of mononuclear cells. Hemorrhages, occurring on the epicardial surfaces, were often associated with lesions that involved small arteries having 3–6 layers of medial smooth muscle cells and were characterized by endothelial injury, intramural accumulations of erythrocytes and platelets, periadventitial hemorrhage, fibrin deposits and an inflammatory cell reaction. These lesions preferentially involved the right atrium in dogs and the left atrium in pigs. Pretreatment of beagle dogs with pyribenzamine (3 doses of 6 mg/kg every 8 hr), cimetidine (3 doses of 15 mg/kg every 8 hr), or both, had no effect on the incidence or severity of minoxidil-induced hemorrhagic lesions. The hemorrhagic lesions may be caused by overstretching of the vascular walls due to excessive, prolonged vasodilatation.
Review of Cardiovascular Findings in Humans Treated with Minoxidil
Authors: Sobota Joseph T.
Published: January 2017

Minoxidil is an antihypertensive vasodilator with no known capability of inducing human cardiovascular pathology; however, the compound does cause a late, canine-specific lesion of the right atrium and acute right atrial and ventricular papillary muscle changes. In all the autopsy cases of minoxidil-treated humans to date, 9 cases were reported with significant right atrial or other cardiac pathology and were carefully reviewed for similarity to either the early or late canine lesion. Three new cases (G, H, and I) were added in this update to 6 cases already described (1). None of the 3 cases newly analyzed in this paper, as well as the previously reported 6 cases, had gross or histologic constellations which could be diagnosed as associated with minoxidil treatment. Further, the examination of autopsy cases of minoxidil-treated hypertensive right atrial histology findings appear no different than those found in the baseline non-minoxidil treated hypertensive and non-hypertensive cases.
Pathogenesis of Arterial Lesions Induced by Dopaminergic Compounds in the Rat
Authors: Kerns William D. , Arena Emanuel , Macia Richard A. , Bugelski Peter J. , Matthews William D. , Morgan D. Gwyn
Published: January 2017

Fenoldopam mesylate (FM), a selective post-junctional dopaminergic (DA1) vasodilator, causes lesions of large caliber splanchnic arteries (100–800 μm) in the rat characterized by necrosis of medial smooth muscle cells and hemorrhage. FM does not induce lesions in other vascular beds of the rat, or in dogs or monkeys. Dopamine, like FM, causes hemorrhagic lesions of large caliber splanchnic arteries in the rat, as well as fibrinoid necrosis of small caliber arteries (<100 μm) of the splanchnic, cerebral, coronary and renal vascular beds. Dopamine is an alpha- and beta-adrenoceptor and a dopaminergic receptor agonist. Because these arterial lesions are thought to result from the pharmacologic activity of these 2 compounds, we sought to ascertain the presence of DA1 receptors in mesenteric arteries of the rat and to determine the role of these or other vascular receptor subtypes in lesion induction. We also studied the process of repair after arterial injury caused by FM or dopamine. The presence of DA1 receptors was confirmed in isolated perfused mesenteric arteries by standard pharmacologic techniques; stimulation by FM resulted in vasodilation which was inhibited by the DA1 receptor antagonist SK&F 83566-C. Likewise, SK&F 83566-C prevented the induction of hemorrhagic lesions of large caliber arteries in rats upon infusion of FM or dopamine. In rats co-exposed to the alpha-adrenoreceptor antagonist phenoxybenzamine (PBZ) and either FM or dopamine, the incidence and severity of hemorrhagic lesions of large caliber arteries were increased, but PBZ prevented the formation of dopamine-induced fibrinoid lesions in arteries of small caliber. Rats exposed concurrently to dopamine, phenoxybenzamine, and SK&F 83566-C were free of all arterial lesions. Thus, the induction of splanchnic arterial lesions in the rat by dopamine and FM is caused by stimulation of, and interaction between, alpha-adrenoceptors and dopaminergic DA1 receptors. Fibrinoid lesions of small arteries (alpha-adrenoceptor-mediated) were repaired, as observed morphologically by 14 d after exposure to dopamine. Hemorrhagic lesions of large caliber arteries (DA1 receptor-mediated) had undergone significant repair by 28 d after exposure to FM but these arteries possessed a thicker media surrounded by adventitial fibrosis. Thus, morphologically distinct receptor-mediated splanchnic arterial lesions induced by dopaminergic and alpha-adrenoceptor agonists follow a markedly different course of repair. Arterial lesions induced by FM or dopamine by activation of post-junctional dopaminergic DA1 receptors may represent a model of polyarteritis nodosa.
Classification and Pathogenesis of Arteritis in Children
Authors: Dillon Michael J.
Published: January 2017

Systemic necrotizing vasculitis in children is a rare but serious disorder. During the past 25 years, 121 children within this disease category have been referred to the Hospital for Sick Children, London (HSC). Classification is difficult but the largest subgroups identified were polyarteritis nodosa (PAN)–-29 children and Kawasaki syndrome (KD)–-42 children. In spite of modern therapy including steroids, cyclophosphamide, anti-platelet medication, plasma exchange, prostacyclin, high dose gamma globulin and cyclosporin, mortality remains high. Overall mortality for HSC patients was 12% (66% for pulmonary vasculitis, 21% for PAN, and 2% for KD). Recent advances are beginning to shed some light on the etiology and pathogenetic mechanisms involved in PAN and KD. There is now good evidence to support roles for platelet immune complex interactions, anti-neutrophil cytoplasmic antibodies, and anti-endothelial cell antibodies in the pathogenesis. It seems likely that, in KD at least, retroviruses may have an etiological role either by directly infecting endothelial cells or indirectly via T-cells, antibody, or immune complex formation.
An Overview of Human Arterial Pathology
Authors: Mcallister Hugh A.
Published: January 2017

In this manuscript the pathology of human arterial disease, including diseases of the aorta, coronary arteries, and peripheral arteries, is reviewed. Common atherosclerotic-related lesions and varied forms of aortitis, arteritis, and dissecting aneurysms are described in terms of their gross and microscopic characteristics. In addition, rarer occurrences, such as congenital hypoplasia of the arteries, are mentioned. Finally, morphologic changes in blood vessels that have been affected by drugs or toxins are summarized.
Iron Resistance of Hepatic Lesions and Nephroblastoma in Rainbow Trout (Salmo gairdneri) Exposed to MNNG
Authors: Lee Brian C. , Hendricks Jerry D. , Bailey George S.
Published: January 2017

Histochemical markers are important for the early detection of chemically initiated neoplasia in experimental animal studies. The marker, iron resistance, was evaluated in the Shasta strain of rainbow trout ( Salmo gairdneri). Twenty-one-day-old trout embryos were exposed to 100 ppm aqueous N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) for 30 min in a static water bath. Fish were fed a semipurified diet, and sampled monthly from the 4th to the 9th month. Two days before sampling, fish were iron-loaded with a single ip dose of 0.30 mg iron dextran/100 g body weight. Livers and kidneys were conventionally processed to paraffin sections for iron, or hematoxylin and eosin (H&E) staining. Normal hepatocytes accumulated iron in pericanalicular locations, but in hepatocytes from carcinogen-altered foci and tumors, iron staining was clearly reduced or absent. Normal renal tubule cells exhibited slight to moderate iron staining, while those from nephroblastoma were iron resistant. These results establish iron resistance as a property of preneoplastic and neoplastic trout hepatocytes and nephroblastoma cells for the first time. Iron resistance may of fer a practical histochemical marker in experimental fish models of hepatocellular carcinoma and nephroblastoma.
Inhibitors of Sterol Synthesis. Morphological Studies in Rats after Dietary Administration of 5α-Cholest-8(14)-en-3β-ol-15-one, a Potent Hypocholesterolemic Compound
Authors: Smith Jerome H. , Kisic Alemka , Diaz-Arrastia Ramon , Pelley Ronald P. , Schroepfer George J.
Published: January 2017

The morphological effects of short-term (9 days) dietary administration (0.1% in a laboratory chow diet) of 5α-cholest-8(14)-cn-3β-ol-15-onc, a novel regulator of cholesterol metabolism with significant hypocholesterolemic activity, has been studied in young male rats. Control animals included rats fed the basal diet ad libitum and a series of rats pair-fed to the individual experimental animals. At the time of necropsy, the morphological changes in rats which have been observed in rats following treatment with other absorbable hypolipidemic agents (myeloid bodies with triparanol, increased peroxisomes with clofibrate, and proliferation of smooth endoplasmic reticulum with compactin and mevinolin) were not apparent on ultrastructural examination of livers of rats treated with the 15-ketosterol. Two changes were observed in the rats fed the 15-ketosterol: a decrease in adipose tissue and enlargement of the small intestine. Diminished fat was also noted in the pair-fed controls and was presumably due to decreased food consumption. The intestines of rats fed the 15-ketosterol were morphometrically most enlarged in the jejunal region. Morphologically, this increase was distinguished by increased depth of crypts of Lieberkuhn and pseudostratification of epithelium at the base of the villi. These changes were qualitatively and quantitatively similar to the adaptive changes reported in the rat after resection of small bowel or following intestinal bypass (segment of bowel remaining in continuity). The morphological changes induced in the rat by administration of the 15-ketosterol were not observed in 4 baboons which received the compound orally at doses of 50, 75, or 100 mg per kilogram of body weight for up to 3 months.
Pathologic Changes in the Accessory Sex Glands of Rats Treated with a Sympatholytic Hypotensive Agent (Losulazine)
Authors: Mesfin G. M. , Factor Sylvia S. , Higgins Michael J.
Published: January 2017

Groups of 25 male Sprague-Dawley rats were treated by gastric intubation with either vehicle control (modified methylcellulose) or a suspension of losulazine at 4, 8, 16, or 32 mg/kg/day for 1 yr. Ten rats/group were killed after 6 months of treatment. Reversibility of drug-induced changes was evaluated in 8 rats/group treated for 6 months and held without treatment for 5 months. Daily clinical signs and weekly body weight changes were monitored. Seminal vesicle/coagulating glands were weighed in rats treated for 6 months. Gross and microscopic evaluation of the accessory sex glands (ampullary glands, prostate, seminal vesicles and coagulating glands) was conducted in all rats killed at 6 months, after the recovery period, and in rats that survived through the one-yr treatment period. Ptosis, somnolence, and fecal softening were detected in all groups treated with losulazine. There was a nonreversible body weight gain retardation in groups treated with 8 to 32 mg/kg/day of losulazine for 6 months or 1 yr. Absolute and relative weights of the seminal vesicle/coagulating glands of treated rats were not significantly different from those of control rats. The ventral prostate in a few rats in all treated groups had yellow to tan granular foci. Treatment, but not dose-related sperm granulomas or glandular impaction with inspissated secretion (formation of corpora amylacia) in the ampullary glands, enhanced cellular exudation into the acini of the ventral prostate, and impaction of the seminal vesicles with altered granular to globular secretion were found in rats treated with losulazine. Exudative prostatic lesions were reversible and ampullary gland sperm granulomas were evident as resolving fibrotic areas 5 months after drug withdrawal. The pathologic changes seen in the accessory sex glands of rats treated with losulazine were considered to have been caused by ejaculatory stasis, apparently related to the sympatholytic effects of the drug on these organs.
3,4,3',4'-Tetrachlorobiphenyl-Induced Effects in the Rat Liver. I. Serum and Hepatic Retinoid Reduction and Morphologic Changes
Authors: Durham Stephen K. , Brouwer Abraham
Published: January 2017

The distribution of 3,4,3',4'-tetrachlorobiphenyl (TCB), its effects on serum and hepatic retinoid content, and liver morphology were investigated in adult female WAG/Rij rats. Animals received a single intraperitoneal injection of either a corn oil vehicle, 15 or 200 mg TCB/kg body weight and were killed at 1, 3, 7, and 14 days after treatment. One rat of the high-dose group that had received 200 mg TCB/kg containing 1.85 mCi of 3H-TCB was sacrificed at each sampling time. There was a significant increase in liver weight when expressed as a percentage of body weight in the high-dose group at day 3 (122% of controls), day 7 (116% of controls), and day 14 (110% of controls). There was a rapid rise in the amount of 3H-TCB present in the liver that peaked at day 7 followed by a rapid decline in the amount of radiolabeled material by day 14. Greater than 90% of the radiolabeled material in the liver was parent compound. TCB treatment induced a significant decrease in serum retinol content in the high-dose group at day 3 (39% of controls) and day 7 (46% of controls) following exposure. There was a significant decrease in hepatic retinol content in the high-dose group at day 3 (34% of controls), day 7 (25% of controls), and day 14 (42% of controls) following exposure. TCB treatment induced a significant decrease in hepatic retinyl palmitatc content in the high-dose group at day 7 (56% of controls) following exposure. Ultrastructural alterations in hepatocytes included the proliferation and vesiculation of endoplasmic reticulum, and mitochondrial enlargement with paracrystalline inclusions. There was an associated change in the number, size, and distribution of lipid droplets in hepatocytes and fat-storing cells following exposure. The results of this study indicate that TCB treatment induces a marked reduction in serum and hepatic retinoid content accompanied by morphologic changes in liver cell populations.
Hypopigmentation in Dogs Treated with an Inhibitor of Platelet Aggregation
Authors: Walsh Kathleen M. , Gough Alexander W.
Published: January 2017

Hypopigmentation was the principal manifestation of systemic toxicity when the experimental platelet aggregation inhibitor, PD-89454, was orally administered to Beagle dogs for 28 days. Pigmentation changes were present in skin of nose, lips and eyelids and mucosa of hard palate. Fontana-Masson stain demonstrated decreased melanin within melanocytes and keratinocytes. Melanocytes were globoid with inconspicuous dendritic processes and had small, incompletely pigmented melanosomes that were quantitatively reduced relative to controls. Toxic mechanism of action of PD-89454, structurally distinct from known depigmenting compounds, was not established but ultrastructural findings suggest an interference in melanosome formation and/or melanization.
Post-bureaucratic encounters: Affective labour in public employment services
Authors: Penz Otto , Sauer Birgit , Gaitsch Myriam , Hofbauer Johanna , Glinsner Barbara
Published: January 2017

This article explores the activation regime in three European countries – Austria, Germany, and Switzerland – and the related transformation of state bureaucracies into customer-oriented service providers. In the case of employment services affective labour tends to characterise the work process, in which public employees seek to guide, motivate, and control jobseekers. Our study focuses on organisational mechanisms, which govern the affect management of employment agents; we ask, how these actors are affectively subjectivated at the workplace and how they develop affective self-technologies to effectively govern jobseekers in counselling sessions. We conclude that state power and social policies increasingly revolve around subtle, affective means of governance, and we regard ‘affective entrepreneurialism’ as the dominant mode to govern public employees as well as citizens. The findings of the study are based on ethnographic fieldwork in three cities, where we conducted interviews, examined training materials, and observed and videotaped interactions at selected employment agencies.
Learning on the job? Exploring first-year experiences of newly-qualified criminal justice social workers in Scotland
Authors: Grant Scott
Published: January 2017

Little is known about the experiences of newly-qualified criminal justice practitioners as they enter the field of community justice for the first time. This article reports on isolated data on newly-qualified criminal justice social workers who participated in a national mixed-method study of readiness to practice in Scotland. Findings suggest that new staff felt well-prepared for practice, but many felt employers failed to provide adequate support and development opportunities. Participants report that disproportionate emphasis is placed on workload management during professional supervision sessions where learning needs and emotions are often underplayed. Professional guidance is often sought from informal sources.
The poet Neruda’s environment: The Isla Negra house
Authors: França Franciney Carreiro de , Greene Margarita
Published: January 2017

On several occasions, the poet Pablo Neruda referred to Isla Negra as his favorite house and, for many years, he worked to transform it into his primary home. The building of this house, an incremental process over time that saw Neruda’s direct participation in its planning, constitutes a perfect case study for understanding the poet’s intention in the construction of his particular environment: the Nerudian space. Much has been written on Neruda’s houses, but the novelty of the approach presented here lies in the configurational perspective that privileges both the totality (instead of the parts) and the historical process behind its construction (instead of the final product). This article presents a morphological study of the Isla Negra house, using the Space Syntax methodology and analyzing the parts and stages of growth of the house in relation to one another and among themselves until Neruda’s last intervention in 1973.
Management of venous ulcers according to their anatomical relationship with varicose veins
Authors: Lin Yun-Nan , Hsieh Tung-Ying , Huang Shu-Hung , Liu Chia-Ming , Chang Kao-Ping , Lin Sin-Daw
Published: January 2017

Background

Adequately excising varicose and incompetent perforating veins is necessary for reducing their recurrence rate of venous ulcer.

Method

In total, 66 venous ulcers (C6) in 1083 legs with primary varicose veins were managed through endoscopic-assisted surgery. In an endoscopic operative view, the nonvaricose, varicose, and incompetent perforating veins were clearly visualized and precisely dissected. The varicose and incompetent perforating veins were divided and completely excised.

Result

The varicose veins were traced to the base or periphery of the 55 ulcers. Moreover, 89.4% of the ulcers healed within 14 weeks. Kaplan–Meier analysis revealed a five-year recurrence rate of 0.0%, and the satisfaction mean score was 4.6.

Conclusion

Endoscopic-assisted surgery can be used to radically excise varicose veins complicated with venous ulcers; the surgery yields low recurrence and high satisfaction rates.
Functional chronic venous disease: A systematic review
Authors: Serra Raffaele , Andreucci Michele , De Caridi Giovanni , Massara Mafalda , Mastroroberto Pasquale , de Franciscis Stefano
Published: January 2017

Objectives

Functional chronic venous disease is an underestimated syndrome quite present in the general population. It affects up to 20% of the general population and is based on the presence of venous symptoms without instrumental evidence of anatomic and morphologic damage. The aim of this review article is to provide the reader with the most updated information on this phenomenon.

Methods

Medline and Scopus databases were searched without time limit using the key-word: ‘Functional chronic venous disease of legs’, C0s patients. We decided to include all the studies conducted about functional chronic venous disease. Randomised trials, cohort studies and reviews were contemplated in order to give a breadth of clinical data. Only publications in English were considered. We excluded all the studies with insufficient statistical analysis, possible biases and contradictions, not clear end-points, inconsistent or arbitrary conclusions.

Results

Of the 326 records found, after removal of 68 duplicates, 143 matched our inclusion criteria. After reading the full-text articles, 133 manuscripts were excluded. Ten full text articles were assessed for eligibility and four studies were excluded because of the following reasons: (a) no specific or important content and (b) insufficient data; the final set included six articles.

Conclusions

Functional chronic venous disease is a complex syndrome and further evidences are needed in order to assess the pathophysiology, the morbidity and the correct treatment of this venous dysfunction.
Rivaroxaban vs. warfarin on extended deep venous thromboembolism treatment: A cost analysis
Authors: Diken Adem İ , Yalçınkaya Adnan , Hanedan Muhammet O , Erol Mehmet E , Ercen Diken Özlem
Published: January 2017

Background

Standard treatment for deep venous thromboembolism involves parenteral anticoagulation overlapping with a vitamin K antagonist, an approach that is effective but associated with limitations including the need for frequent coagulation monitoring. The direct oral anticoagulant rivaroxaban is similarly effective to standard therapy as a single-drug treatment for venous thromboembolism and does not require routine coagulation monitoring. The aim of this analysis was to project the long-term costs and outcomes for rivaroxaban compared to standard of care (tinzaparin/warfarin).

Methods

A total of 184 patients who were under anticoagulant therapy with warfarin or rivaroxaban for extended deep venous thromboembolism were retrospectively evaluated; 59 received rivaroxaban and 125 received warfarin therapy. Assessments were made on age, gender, place of residence, the duration of anticoagulation, mean international normalized ratio value, the effective rate of international normalized ratio (time in the therapeutic range), bleeding-related complication rate, duration of hospitalization due to complications, the number of annual outpatient department admission, cost for drug, cost for hospitalization, cost for outpatient department admission and international normalized ratio measurements.

Results

The annual outpatient cost is higher in warfarin group (147.09 ± 78 vs. 62.32 ± 19.79 USD p < 0.001). But annual drug cost is higher in rivaroxaban group (362.6 vs. 71.55 ± 31.01 USD p < 0.001). Overall cost of rivaroxaban group is higher than warfarin group (476.25 ± 36.78 vs. 364.82 ± 174.44 USD). Warfarin is not cost-effective when non-drug costs (342.5 ± 174.44 vs. 113.65 ± 36.77) and hospital costs (173.85 ± 122.73 vs. 64.9 ± 23.55 USD) were analyzed.

Conclusion

This analysis suggests that rivaroxaban has lower costs than warfarin in terms of outpatient department admission and hospital costs due to complications; however, warfarin was more economic when all cost parameters were considered. Time in the therapeutic range was found as 56% for warfarin that should be taken into account while analyzing costs and benefits.
Randomized controlled study of ultrasound therapy in the management of acute lateral ligament sprains of the ankle joint
Authors: Nyanzi CS , Langridge J. , Heyworth Jrc , Mani R.
Published: January 2017

Objective: To determine the efficacy of a fixed dose of ultrasound energy to treat acute lateral ligament sprains of the ankle joint.

Study design: Double-blind randomised controlled trial.

Setting: Accident and Emergency department of University Teaching Hospital.

Subjects: Patients presenting at Accident and Emergency with ankle injuries.

Intervention: Ultrasound or placebo, and Tubigrip.

Outcome measures: Pain measured with visual analogue scales, swelling using a tape measure, range of movement using a fluid-filled goniometer, and weight bearing using two scales simultaneously.

Results: Patients in both groups improved symptomatically. There were no statistically significant differences between groups in any outcome measure. Within groups, statistically significant differences were detected in pain perceived, and range of movement (dorsiflexion).

Conclusion: At the dose and duration used, ultrasound therapy is no better than placebo in the management of lateral ligament injuries.
An open socket technique for through-knee amputations in relation to skin problems of the stump: an explorative study
Authors: Otter N. , Postema K. , Rijken Raj , van Limbeek J.
Published: January 2017

Objective: To compare the conventional socket for through-knee amputees with an open socket system for skin problems and other relevant items.

Design: All data were collected during three visits to the prosthetic clinic. At the second visit the conventional socket was replaced by the open socket. The use of both socket types was evaluated with a questionnaire and stump inspection.

Setting: The subjects were evaluated at the Rehabilitation Centre, St Maartenskliniek, Nijmegen, the Netherlands.

Subjects: Twenty subjects with a unilateral through-knee amputation were included and 13 subjects had a trial with the open socket.

Results: There is a significant decrease of hyperhydrosis when wearing the open socket, there is no significant decrease in skin irritation or ulcers. The open socket also gives more comfort in sitting position.

Conclusion: A further trial is needed in a selected group of prosthesis users among through-knee amputees to establish the long-term acceptance and benefits of the prosthesis with an open socket.
Feasibility study of a novel approach to sore prevention in patients with spinal cord lesions: the computerized dynamic control Matrix 200 system
Authors: Catz A. , Philo O. , Gilad N. , Barel O. , Geva T.
Published: January 2017

Objective: To evaluate the feasibility of a computerized mattress system based on a novel concept in sore prevention: continuous monitoring and adjustment of the interface pressure in small segments of contact between the skin and the supporting surface.

Design: A preliminary observational study.

Setting: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel.

Subjects: Twelve patients with spinal cord lesions.

Interventions: Patients were examined for signs of impending sores after lying on the mattress for up to 4 successive hours. The pressure within each of the mattress's air cells was continuously measured and adjusted.

Results: No evidence of redness or excessive perspiration was found in any of the areas considered to be high risk for bed sores. Maximal interface pressure was 22-30 mmHg in most of the examinations. Most of the patients felt comfortable on the mattress and the staff adapted easily to its operation.

Conclusions: The system is apparently safe, and at least as efficient as other existing means for preventing sores. In addition, it may allow for increased intervals between bed positionings. We conclude that this approach of pressure control has the potential to improve bed sore prevention in a rehabilitation hospital setting.
Current practice and clinical relevance of somatosensory assessment after stroke
Authors: Winward Charlotte E , Halligan Peter W , Wade Derick T
Published: January 2017

Objective: To examine the perceived clinical relevance, current practice and knowledge of somatosensory testing in three professional groups involved in the management and rehabilitation of stroke.

Design: Structured postal questionnaire sent to therapists and doctors. Subjects: One hundred and eighty occupational therapists from the National Association of Neurological Occupational Therapists (NANOT), 180 physiotherapists from the Association of Chartered Physiotherapists with an Interest in Neurology (ACPIN) and 360 doctors from the Association of British Neurologists (ABN) and the British Geriatrics Society (BSG).

Setting: Hospitals and rehabilitation centres in the UK.

Results: Replies were obtained from 84 occupational therapists (47%), 98 physiotherapists (55%) and 78 doctors (22%). Sixty-four occupational therapists (77%), 82 physiotherapists (84%) and 66 doctors (87%) indicated that they routinely performed somatosensory assessment as part of their clinical assessment. The two most commonly used measures were proprioception and light touch. Seventy-eight occupational therapists (93%), 88 physiotherapists (90%) and 67 doctors (91 %) regarded sensory assessment as clinically significant in determining prognosis after stroke.

Conclusions: Despite published reservations concerning its usefulness and reliability, most therapists and doctors routinely assess somatosensory loss after stroke. All three professions agreed that somatosensory testing presented useful information for prognosis. Furthermore, all professional groups believe somatosensory assessment to be clinically relevant.
‘End of life could be on any ward really’: A qualitative study of hospital volunteers’ end-of-life care training needs and learning preferences
Authors: Brighton Lisa Jane , Koffman Jonathan , Robinson Vicky , Khan Shaheen A , George Rob , Burman Rachel , Selman Lucy Ellen
Published: January 2017

Background:

Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care.

Aims:

To explore hospital volunteers’ end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods.

Design:

Qualitative focus groups.

Setting/participants:

Volunteers from a large teaching hospital were purposively sampled.

Results:

Five focus groups were conducted with 25 hospital volunteers (aged 19–80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to ‘refresh’ training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each.

Conclusion:

Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals.
Relating cause of death with place of care and healthcare costs in the last year of life for patients who died from cancer, chronic obstructive pulmonary disease, heart failure and dementia: A descriptive study using registry data
Authors: van der Plas Annicka GM , Oosterveld-Vlug Mariska G , Pasman H Roeline W , Onwuteaka-Philipsen Bregje D
Published: January 2017

Background:

The four main diagnostic groups for palliative care provision are cancer, chronic obstructive pulmonary disease, heart failure and dementia. But comparisons of costs and care in the last year of life are mainly directed at cancer versus non-cancer or within cancer patients.

Aim:

Our aim is to compare the care and expenditures in their last year of life for Dutch patients with cancer, chronic obstructive pulmonary disease, heart failure or dementia.

Design:

Data from insurance company Achmea (2009–2010) were linked to information on long-term care at home or in an institution, the National Hospital Registration and Causes of Death-Registry from Statistics Netherlands. For patients who died of cancer ( n = 8658), chronic obstructive pulmonary disease ( n = 1637), heart failure ( n = 1505) or dementia ( n = 3586), frequencies and means were calculated, Lorenz curves were drawn up and logistic regression was used to compare patients with high versus low expenditures.

Results:

For decedents with cancer and chronic obstructive pulmonary disease, the highest costs were for hospital admissions. For decedents with heart failure, the highest costs were for the care home (last 360 days) and hospital admissions (last 30 days). For decedents with dementia, the highest costs were for the nursing home.

Conclusion:

Patients with dementia had the highest expenditures due to nursing home care. The number of dementia patients will double by the year 2030, resulting in even higher economic burdens than presently. Policy regarding patients with chronic conditions should be informed by research on expenditures within the context of preferences and needs of patients and carers.
The spatial coefficient of variation in arterial spin labeling cerebral blood flow images
Authors: Mutsaerts Henri JMM , Petr Jan , Václavů Lena , van Dalen Jan W , Robertson Andrew D , Caan Matthan W , Masellis Mario , Nederveen Aart J , Richard Edo , MacIntosh Bradley J
Published: January 2017

Macro-vascular artifacts are a common arterial spin labeling (ASL) finding in populations with prolonged arterial transit time (ATT) and result in vascular regions with spuriously increased cerebral blood flow (CBF) and tissue regions with spuriously decreased CBF. This study investigates whether there is an association between the spatial signal distribution of a single post-label delay ASL CBF image and ATT. In 186 elderly with hypertension (46% male, 77.4 ± 2.5 years), we evaluated associations between the spatial coefficient of variation (CoV) of a CBF image and ATT. The spatial CoV and ATT metrics were subsequently evaluated with respect to their associations with age and sex – two demographics known to influence perfusion. Bland–Altman plots showed that spatial CoV predicted ATT with a maximum relative error of 7.6%. Spatial CoV was associated with age (β = 0.163, p = 0.028) and sex (β = −0.204, p = 0.004). The spatial distribution of the ASL signal on a standard CBF image can be used to infer between-participant ATT differences. In the absence of ATT mapping, the spatial CoV may be useful for the clinical interpretation of ASL in patients with cerebrovascular pathology that leads to prolonged transit of the ASL signal to tissue.
Lickometry: A novel and sensitive method for assessing functional deficits in rats after stroke
Authors: Ahmed Jewel , Dwyer Dominic M , Farr Tracy D , Harrison David J , Dunnett Stephen B , Trueman Rebecca C
Published: January 2017

The need for sensitive, easy to administer assessments of long-term functional deficits is crucial in pre-clinical stroke research. In the present study, we introduce lickometry (lick microstructure analysis) as a precise method to assess sensorimotor deficits up to 40 days after middle cerebral artery occlusion in rats. Impairments in drinking efficiency compared to controls, and a compensatory increase in the number of drinking clusters were observed. This highlights the utility of this easy to administer task in assessing subtle, long-term deficits, which could be likened to oral deficits in patients.
Water apparent diffusion coefficient correlates with gamma oscillation of local field potentials in the rat brain nucleus accumbens following alcohol injection
Authors: Tsurugizawa Tomokazu , Abe Yoshifumi , Le Bihan Denis
Published: January 2017

Ethanol is a vasoactive agent as well as psychoactive drug. The neurovascular response, coupled with neuronal activity, can be disturbed by alcohol intake. Hence, blood oxygenation level-dependent (BOLD) fMRI, which relies on neurovascular coupling, might not be reliable to reflect alcohol-induced neuronal responses. Recently, diffusion fMRI has been shown to be more sensitive to neural activity than BOLD fMRI even when neurovascular coupling is disrupted. Especially, the apparent diffusion coefficient (ADC) is sensitive to changes occurring in the cellular tissue structure upon activation. In the present study, we compared BOLD fMRI signals, ADC, and local field potentials (LFPs) in the nucleus accumbens (NAc) following injection of an ethanol solution (0.4 g/kg body weight) in rats under medetomidine anesthesia. An increase in the gamma oscillation power of LFP and an ADC decrease were observed 5 min after the injection of EtOH. The BOLD signals showed a negative slow drift, similar to mean arterial pressure with a peak approximately 10 min after the injection. These results confirm that DfMRI can be a better marker of the neuronal activity than BOLD fMRI, especially when the brain hemodynamic status is changed by vasoactive drugs such as ethanol.
Intranasal insulin treatment of an experimental model of moderate traumatic brain injury
Authors: Brabazon Fiona , Wilson Colin M , Jaiswal Shalini , Reed John , Frey William H , Byrnes Kimberly R
Published: January 2017

Traumatic brain injury (TBI) results in learning and memory dysfunction. Cognitive deficits result from cellular and metabolic dysfunction after injury, including decreased cerebral glucose uptake and inflammation. This study assessed the ability of intranasal insulin to increase cerebral glucose uptake after injury, reduce lesion volume, improve memory and learning function and reduce inflammation. Adult male rats received a controlled cortical impact (CCI) injury followed by intranasal insulin or saline treatment daily for 14 days. PET imaging of [18F]-FDG uptake was performed at baseline and at 48 h and 10 days post-injury and MRI on days three and nine post injury. Motor function was tested with the beam walking test. Memory function was assessed with Morris water maze. Intranasal insulin after CCI significantly improved several outcomes compared to saline. Insulin-treated animals performed better on beam walk and demonstrated significantly improved memory. A significant increase in [18F]-FDG uptake was observed in the hippocampus. Intranasal insulin also resulted in a significant decrease in hippocampus lesion volume and significantly less microglial immunolabeling in the hippocampus. These data show that intranasal insulin improves memory, increases cerebral glucose uptake and decreases neuroinflammation and hippocampal lesion volume, and may therefore be a viable therapy for TBI.