bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics
Authors: Huddy Jeremy R , Weldon Sharon-Marie , Ralhan Shvaita , Painter Tim , Hanna George B , Kneebone Roger , Bello Fernando
Published: September 2016

Objectives

Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be considered. Sequential simulation (SqS) is a tool to represent patient journeys and the effects of intervention at each and subsequent stages. This case study presents a process evaluation of SqS as a tool for PPE in the development of a volatile organic compound-based breath test POCT for the diagnosis of oesophagogastric (OG) cancer.

Setting

Three 3-hour workshops in central London.

Participants

38 members of public attended a workshop, 26 (68%) had no prior experience of the OG cancer diagnostic pathway.

Interventions

Clinical pathway SqS was developed from a storyboard of a patient, played by an actor, noticing symptoms of oesophageal cancer and following a typical diagnostic pathway. The proposed breath testing strategy was then introduced and incorporated into a second SqS to demonstrate pathway impact. Facilitated group discussions followed each SqS.

Primary and secondary outcome measures

Evaluation was conducted through pre-event and postevent questionnaires, field notes and analysis of audiovisual recordings.

Results

38 participants attended a workshop. All participants agreed they were able to contribute to discussions and like the idea of an OG cancer breath test. Five themes emerged related to the proposed new breath test including awareness of OG cancer, barriers to testing and diagnosis, design of new test device, new clinical pathway and placement of test device. 3 themes emerged related to the use of SqS: participatory engagement, simulation and empathetic engagement, and why participants attended.

Conclusions

SqS facilitated a shared immersive experience for participants and researchers that led to the coconstruction of knowledge that will guide future research activities and be of value to stakeholders concerned with the invention and adoption of POCT.
Modelling study to estimate the health burden of foodborne diseases: cases, general practice consultations and hospitalisations in the UK, 2009
Authors: O'Brien Sarah J , Larose Tricia L , Adak Goutam K , Evans Meirion R , Tam Clarence C
Published: September 2016

Objective

To generate estimates of the burden of UK-acquired foodborne disease accounting for uncertainty.

Design

A modelling study combining data from national public health surveillance systems for laboratory-confirmed infectious intestinal disease (IID) and outbreaks of foodborne disease and 2 prospective, population-based studies of IID in the community. The underlying data sets covered the time period 1993–2008. We used Monte Carlo simulation and a Bayesian approach, using a systematic review to generate Bayesian priors. We calculated point estimates with 95% credible intervals (CrI).

Setting

UK, 2009.

Outcome measures

Pathogen-specific estimates of the number of cases, general practice (GP) consultations and hospitalisations for foodborne disease in the UK in 2009.

Results

Bayesian approaches gave slightly more conservative estimates of overall health burden (∼511 000 cases vs 566 000 cases).Campylobacteris the most common foodborne pathogen, causing 280 400 (95% CrI 182 503–435 693) food-related cases and 38 860 (95% CrI 27 160–55 610) GP consultations annually. Despite this, there are only around 562 (95% CrI 189–1330) food-related hospital admissions due toCampylobacter, reflecting relatively low disease severity.Salmonellacauses the largest number of hospitalisations, an estimated 2490 admissions (95% CrI 607–9631), closely followed byEscherichia coliO157 with 2233 admissions (95% CrI 170–32 159). Other common causes of foodborne disease includeClostridium perfringens, with an estimated 79 570 cases annually (95% CrI 30 700–211 298) and norovirus with 74 100 cases (95% CrI 61 150–89 660). Other viruses and protozoa ranked much lower as causes of foodborne disease.

Conclusions

The 3 models yielded similar estimates of the burden of foodborne illness in the UK and show that continued reductions inCampylobacter,Salmonella,E. coliO157,C. perfringensand norovirus are needed to mitigate the impact of foodborne disease.
Self-reported physical and mental health of Australian carers: a cross-sectional study
Authors: Hussain Rafat , Wark Stuart , Dillon Gina , Ryan Peta
Published: September 2016

Objective

To report on self-reported physical and mental health of informal carers in rural regions of New South Wales, Australia.

Methods

A cross-sectional community-based sample (n=222) of carers completed a questionnaire incorporating self-reported measures of health from validated international instruments including Medical Outcomes Study Scale (SF-36), the Centre for Epidemiology-Depression (CES-D) and Kessler-10 (K-10) Psychological Distress Scales, along with information on participant demographics and other key caregiving characteristics such as health condition of care recipient.

Results

Rural carers’ self-reported health was poor as evident on the SF-36 Physical and Mental Health component scores as well as each individual domain of the SF-36. Results from the CES-D and K-10 scores indicated very high rates of depressive symptoms and psychological distress. Over 70% of carers within the current study had CES-D scores indicative of depressive symptoms. Scores on the K-10 indicate almost half the carers were experiencing high levels of psychological distress, which is over 4 times the rate reported in the general Australian population.

Conclusions and implications

Results from this study were compared to Australian population normative data and were found to be significantly below Australian age-matched population norms for SF-36, CES-D and K-10. These findings illustrate the poor health profile of informal carers relative to the general Australian population, especially in terms of depressive symptoms and psychological distress. This highlights the need for additional support for rural carers in order to ease the accumulated mental and physical health burdens of this group.
Patients’ experiences of a multidisciplinary team-led community case management programme: a qualitative study
Authors: Gowing Alice , Dickinson Claire , Gorman Tom , Robinson Louise , Duncan Rachel
Published: September 2016

Objectives

To explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patients through care planning and regular reviews using primary, community, secondary and social care professionals.

Design

A qualitative study using semistructured interviews, which were digitally recorded, transcribed and subject to thematic analysis.

Setting

Community patients receiving primary care in the county of Northumberland, England.

Participants

23 participants took part, of which 16 were patients enrolled on the NHRPP, and 7 carers. GP practices were selected purposively by size, deprivation and location, and patients identified and invited by General Practitioners to participate.

Results

4 main themes emerged from the data: awareness and understanding of the NHRPP, confidence in the primary healthcare team, limitations of home care and the active role of being a patient. Despite having a low level of awareness of the details of the NHRPP, participants did think that its broad aim made sense. Participants discussed their high level of satisfaction with their care and access to team members. However, some limitations of alternatives to hospital care were identified, including the need to consider psychological as well as medical needs, the importance of overnight care and the needs of those without informal carers. Finally, participants discussed the active nature of being a patient under the NHRPP if they were to contribute fully to planning and managing their own care.

Conclusions

This study has identified that a programme of MDT-led case management was generally very well received by patients and their families. However, a number of factors were identified that could improve the implementation of the programme and further research needs to be undertaken to address these.
Longitudinal cohort study to determine effectiveness of a novel simulated case and feedback system to improve clinical pathway adherence in breast, lung and GI cancers
Authors: Kubal Timothy , Letson Doug G , Chiappori Alberto A , Springett Gregory M , Shimkhada Riti , Tamondong Lachica Diana , Peabody John W
Published: September 2016

Objectives

This study examined whether a measurement and feedback system led to improvements in adherence to clinical pathways.

Design

The M-QURE (Moffitt—Quality, Understanding, Research and Evidence) Initiative was introduced in 2012 to enhance and improve adherence to pathways at Moffitt Cancer Center (MCC) in three broad clinical areas: breast, lung and gastrointestinal (GI) cancers. M-QURE used simulated patient vignettes based on MCC's Clinical Pathways to benchmark clinician adherence and monitor change over three rounds of implementation.

Setting

MCC, located in Tampa, Florida, a National Cancer Institute Comprehensive Cancer Center.

Participants

Three non-overlapping cohorts at MCC (one each in breast, lung and GI) totalling 48 providers participated in this study, with each member of the multidisciplinary team (composed of medical oncologists, radiation oncologists, surgeons and advanced practice providers) invited to participate.

Interventions

Each participant was asked to complete a set of simulated patient vignettes over three rounds within their own cancer specialty. Participants were required to complete all assigned vignettes over each of the three rounds, or they would be excluded from this study.

Primary outcome measure

Increased domain and overall provider care adherence to clinical pathways, as scored by blinded physician abstractors.

Results

We found significant improvements in pathway adherence between the third and first rounds of data collection particularly for workup and treatment of cancer cases. By clinical grouping, breast improved by 13.6% (p<0.001), and lung improved by 12.1% (p<0.001) over baseline, whereas GI showed a decrease of 1.4% (p=0.68).

Conclusions

Clinical pathway adherence improved in a short timeframe for breast and lung cancers using group-level measurement and individual feedback. This suggests that a measurement and feedback programme may be a useful tool to improve clinical pathway adherence.
A practical approach to Events Medicine provision
Authors: Smith Susan P , Cosgrove Joseph F , Driscoll Peter J , Smith Andrew , Butler John , Goode Peter , Waldmann Carl , Vallis Christopher J , Topham Fiona , Mythen Michael (Monty)
Published: September 2016

In the past three decades, mass casualty incidents have occurred worldwide at multiple sporting events and other mass gatherings. Organisational safety and healthcare provision can consequently be scrutinised post-event. Within the UK, such incidents in the 1980s provided incentives to improve medical services and subsequent high profile UK-based international sporting events (London Olympics and Paralympics 2012, Glasgow Commonwealth Games 2014, Rugby World Cup 2015) added a further catalyst for developing services. Furthermore in the aftermath of the abandoned France versus Germany association football match at the Stade de France (Paris Terrorist Attacks,November 2015) and the 2016 UK report from HM Coroner on theHillsborough Inquest, medical cover at sporting events is being further reviewed. Doctors providing spectator cover therefore need to have an awareness of their likely roles at sporting venues. Formal guidance exists in many countries for the provision of such cover but remains generic even though Events Medicine is increasingly recognised as a necessary service. The current evidence base is limited with best practice examples often anecdotally cited by acute care specialists (eg, emergency medicine) who provide cover. This article is therefore intended to present an overview for doctors of the knowledge and skills required to treat ill and injured spectators and enable them to adequately risk-assess venues in cooperation with other health and safety providers, including preparation for a major incident. It also gives guidance on how activity can be adequately assessed and how doctors can have management roles in Events Medicine.
The medical science fiction of James White: Inside and Outside Sector General
Authors: Howard Richard
Published: September 2016

James White was a Northern Irish science fiction author working in the subgenre of medical science fiction from the mid-1950s to the end of the twentieth century. The aim of this article is to introduce White to scholars working in the medical humanities, pointing to features of interest and critiquing the more excessive utopian impulses of the author. The article covers White's Sector General series, set on a vast intergalactic hospital, as well as the author's standalone fictions.
Needle‐tract implantation after fine‐needle aspiration biopsy of a renal cell carcinoma in a dog
Authors: Livet Véronique , Sonet Juliette , Saadeh Daria , Pillard Paul , Carozzo Claude
Published: September 2016

A seven‐year‐old neutered female Cane Corso dog was brought in emergency for black‐coloured urine associated with dysorexia for less than 24 hours. Ultrasound examination and abdominal CT scan showed a heterogeneous right renal mass and local invasion of the adjacent caudal vena cava. A percutaneous ultrasound‐guided fine‐needle aspiration biopsy of the right renal mass was performed and concluded with a renal cell carcinoma. A right nephro‐ureterectomy in conjunction with a partial resection of the vena cava was performed. Eight months postoperatively, needle‐tract implantation was observed. To the authors’ knowledge, the seeding of renal cell carcinoma on the abdominal wall after percutaneous ultrasound‐guided fine‐needle aspiration biopsy has never been reported. This rare complication should not discourage its use in the evaluation of renal mass lesions. However, practitioners should be informed about the risk of a tumour spreading along the needle tract and the need for long‐term follow‐up and control.
Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology
Authors: Magalhães‐Sant'Ana M. , More S. J. , Morton D. B. , Hanlon A.
Published: September 2016

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation.
Visibility Graph from Adaptive Optimal Kernel Time-Frequency Representation for Classification of Epileptiform EEG
Authors: Gao Zhong-Ke , Cai Qing , Yang Yu-Xuan , Dong Na , Zhang Shan-Shan
Published: September 2016

Detecting epileptic seizure from EEG signals constitutes a challenging problem of significant importance. Combining adaptive optimal kernel time-frequency representation and visibility graph, we develop a novel method for detecting epileptic seizure from EEG signals. We construct complex networks from EEG signals recorded from healthy subjects and epilepsy patients. Then we employ clustering coefficient, clustering coefficient entropy and average degree to characterize the topological structure of the networks generated from different brain states. In addition, we combine energy deviation and network measures to recognize healthy subjects and epilepsy patients, and further distinguish brain states during seizure free interval and epileptic seizures. Three different experiments are designed to evaluate the performance of our method. The results suggest that our method allows a high-accurate classification of epileptiform EEG signals.
Complexity and polymorphisms for digraph constraint problems under some basic constructions
Authors: Jackson Marcel , Kowalski Tomasz , Niven Todd
Published: September 2016

The role of polymorphisms in determining the complexity of constraint satisfaction problems is well established. In this context, we study the stability of CSP complexity and polymorphism properties under some basic graph theoretic constructions. As applications we observe a collapse in the applicability of algorithms for CSPs over directed graphs with both a total source and a total sink: the corresponding CSP is solvable by the “few subpowers algorithm” if and only if it is solvable by a local consistency check algorithm. Moreover, we find that the property of “strict width” and solvability by few subpowers are unstable under first-order reductions. The analysis also yields a complete characterization of the main polymorphism properties for digraphs whose symmetric closure is a complete graph.
LIFETIME MODEL OF KNEE WITH DAMAGED CARTILAGE USING BEARING LIFE THEORY
Authors: YANG GUANG , ABDEL-MOHTI AHMED , SHEN HUI
Published: September 2016

The articular cartilage in the human knee plays an important role to ensure a lifetime knee function for an individual. Due to damage of the cartilage in the knee, the coefficient of friction (COF) increases even after treatments for the cartilage, due to the poor self-healing ability of the cartilage, resulting in decreased knee life. As the mechanism of the function of the knee joint is similar to a bearing, a model based on the regression model of cylindrical bearing life has been developed. The model is used to evaluate the effect of the COF on the lifetime of the knee. The results show the correlation between the life of the knee and the COF of the knee cartilage. The knee lifetime depends on the ratio of the COF of the healthy cartilage to the damaged cartilage. The results demonstrate the effect of the COF on the knee lifetime, which is an exponential decrease in the life of the knee for both males and females.
A 3D PRINTING PRACTICE FOR PREOPERATIVE REHEARSAL BASED ON THE ADDITIVE AND SUBTRACTIVE MANUFACTURING
Authors: DING SHENGLAN , BAO XIULAN
Published: September 2016

Preoperative rehearsal is very important before the operation, because of its particularity and difficulty, traditional printing can hardly achieve it, and thus a new kind of fixture for the 3D printing of pelvis model is critical. Fixture design in manufacturing system is very important and directly affects the processing quality, production efficiency and manufacturing costs. As a new method of manufacturing, the alternative style of additive and subtractive manufacturing is potential in market prospect. New requirements on the performance and structure of the fixture were put forward due to the high complexity of product surface in alternative manufacturing, as well as the force characteristics of numerical control (NC) processing. In this paper, we propose a novel type of fixture which is capable of completing printing tasks in preoperative rehearsal. An experiment is performed to validate the rationality and universality of the fixture. A 3D printing practical case of pelvis model before pelvic correction surgery is used to demonstrate the effectiveness of the present fixture.
Using wavelet analysis to uncover the co-movement behavior of multiple energy commodity prices
Authors: Gülerce Mustafa , Ünal Gazanfer
Published: September 2016

This study aims to investigate the dynamic correlations (co-movement) in between energy commodities such as WTI Crude Oil (WOIL), Brent Crude Oil (BOIL), Heating Oil and Electricity prices. To achieve this goal, we employed partial wavelet coherence (PWC) and multiple wavelet coherence (MWC). Wavelet analysis constitutes the core of these methodologies and MWC is essential to determine the dynamic correlation (co-movement) of time intervals and scales between the time series. We have developed a software program to compute PWC and MWC for quadruple data set. Coherent time intervals of the time series are determined. Vector ARMA models are shown to give a good fit due to having low mean squared errors compared to the univariate case. This allowed us to have better forecast performance.
无心插柳柳成荫
Authors: 展 易
Published: September 2016

自千禧年以来，一波接一波的中国新移民到非洲经商，足迹遍布非洲大陆各个角落。学术界对此现象的研究，多聚焦于传统性的问题，即新移民与当地人之间的经济竞争与劳资冲突。对于新移民经济与社会活动所引起的当地社会变迁及其草根大众的收益情况，则甚少关注。本文采用文化融入理论中的双向互动适应观点，探讨因中国新移民商业活动而引起当地社会变迁的三个案例：（一）塞内加尔达喀尔市一居民住宅小区演变成商业闹市区的空间转换过程；（二）加纳阿克拉市中心市场区域社会底层群体与中国商人的互动发展；（三）中国新移民商业行为对所在地既有社会规范的冲击，及其由此而产生的社会变迁的情况。
A Study on the Improvement of ADPI and Ventilation Effectiveness in a Small Theater
Authors: Kwon Yong-Il
Published: September 2016

In the air distribution design of a small theater, either a downward or an upward displacement ventilation is applied generally. The cool air is supplied from openings distributed over the ceiling and extracted beneath the seats for the downward flow and supplied from beneath the seats and extracted from the ceiling for the upward flow system. By the change of air exchange rate (ACH) produced by two divergent ventilation systems inside theater, thermal comfort and ventilation effectiveness around the seats show a different phenomenon. Thereby, it can be seen that the selection of the ventilation system is a significant factor in energy saving. CFD calculations for this study were performed to investigate the effects of various parameters (ADPI and ACE) of air distribution system applied in order to save the cooling energy. This paper focuses mainly on the effect of the varied volume flow rate depending on the ventilation system. The ventilation performances of the downward displacement system are compared quantitatively with the upward displacement system using the concept of the LMA of fresh air.
Are Lock-Free Concurrent Algorithms Practically Wait-Free?
Authors: Alistarh Dan , Censor-Hillel Keren , Shavit Nir
Published: September 2016

Lock-free concurrent algorithms guarantee that some concurrent operation will always make progress in a finite number of steps. Yet programmers prefer to treat concurrent code as if it were wait-free, guaranteeing that all operations always make progress. Unfortunately, designing wait-free algorithms is generally a very complex task, and the resulting algorithms are not always efficient. Although obtaining efficient wait-free algorithms has been a long-time goal for the theory community, most nonblocking commercial code is only lock-free.

This article suggests a simple solution to this problem. We show that for a large class of lock-free algorithms, under scheduling conditions that approximate those found in commercial hardware architectures, lock-free algorithms behave as if they are wait-free. In other words, programmers can continue to design simple lock-free algorithms instead of complex wait-free ones, and in practice, they will get wait-free progress.

Our main contribution is a new way of analyzing a general class of lock-free algorithms under a stochastic scheduler. Our analysis relates the individual performance of processes to the global performance of the system using Markov chain lifting between a complex per-process chain and a simpler system progress chain. We show that lock-free algorithms are not only wait-free with probability 1 but that in fact a general subset of lock-free algorithms can be closely bounded in terms of the average number of steps required until an operation completes.

To the best of our knowledge, this is the first attempt to analyze progress conditions, typically stated in relation to a worst-case adversary, in a stochastic model capturing their expected asymptotic behavior.
Tabulating Pseudoprimes and Tabulating Liars
Authors: Shallue Andrew
Published: September 2016

This article explores the asymptotic complexity of two problems related to the Miller-Rabin-Selfridge primality test. The first problem is to tabulate strong pseudoprimes to a single fixed basea. It is now proven that tabulating up toxrequiresO(x) arithmetic operations andO(xlog x) bits of space. The second problem is to find all strong liars and witnesses, given a fixed odd compositen. This appears to be unstudied, and a randomized algorithm is presented that requires an expectedO((log n)2+ |S(n)|) operations (hereS(n) is the set of strong liars). Although interesting in their own right, a notable application is the search for sets of composites with no reliable witnesses.
A synthetic luciferin improves in vivo bioluminescence imaging of gene expression in cardiovascular brain regions
Authors: Simonyan Hayk , Hurr Chansol , Young Colin N.
Published: September 2016

Bioluminescence imaging is an effective tool for in vivo investigation of molecular processes. We have demonstrated the applicability of bioluminescence imaging to spatiotemporally monitor gene expression in cardioregulatory brain nuclei during the development of cardiovascular disease, via incorporation of firefly luciferase into living animals, combined with exogenous d-luciferin substrate administration. Nevertheless, d-luciferin uptake into the brain tissue is low, which decreases the sensitivity of bioluminescence detection, particularly when considering small changes in gene expression in tiny central areas. Here, we tested the hypothesis that a synthetic luciferin, cyclic alkylaminoluciferin (CycLuc1), would be superior to d-luciferin for in vivo bioluminescence imaging in cardiovascular brain regions. Male C57B1/6 mice underwent targeted delivery of an adenovirus encoding the luciferase gene downstream of the CMV promoter to the subfornical organ (SFO) or paraventricular nucleus of hypothalamus (PVN), two crucial cardioregulatory neural regions. While bioluminescent signals could be obtained following d-luciferin injection (150 mg/kg), CycLuc1 administration resulted in a three- to fourfold greater bioluminescent emission from the SFO and PVN, at 10- to 20-fold lower substrate concentrations (7.5–15 mg/kg). This CycLuc1-mediated enhancement in bioluminescent emission was evident early following substrate administration (i.e., 6–10 min) and persisted for up to 1 h. When the exposure time was reduced from 60 s to 1,500 ms, minimal signal in the PVN was detectable with d-luciferin, whereas bioluminescent images could be reliably captured with CycLuc1. These findings demonstrate that bioluminescent imaging with the synthetic luciferin CycLuc1 provides an improved physiological genomics tool to investigate molecular events in discrete cardioregulatory brain nuclei.
Association of ADAMTS7 gene polymorphism with cardiovascular survival in coronary artery disease
Authors: Pereira A. , Palma dos Reis R. , Rodrigues R. , Sousa A. C. , Gomes S. , Borges S. , Ornelas I. , Freitas A. I. , Guerra G. , Henriques E. , Rodrigues M. , Freitas S. , Freitas C. , Brehm A. , Pereira D. , Mendonça M. I.
Published: September 2016

Recent genetic studies have revealed an association between polymorphisms at the ADAMTS7 gene locus and coronary artery disease (CAD) risk. Functional studies have shown that a CAD-associated polymorphism (rs3825807) affects ADAMTS7 maturation and vascular smooth muscular cell (VSMC) migration. Here, we tested whether ADAMTS7 (A/G) SNP is associated with cardiovascular (CV) survival in patients with established CAD. A cohort of 1,128 patients with angiographic proven CAD, who were followed up prospectively for a mean follow-up period of 63 (range 6–182) mo, were genotyped for rs3825807 A/G. Survival statistics (Cox regression) compared heterozygous (AG) and wild-type (AA) with the reference homozygous GG. Kaplan-Meier (K-M) survival curves were performed according to ADAMTS7 genotypes for CV mortality. Results showed that 47.3% of patients were heterozygous (AG), 36.5% were homozygous for the wild-type allele (AA) and only 16.2% were homozygous for the GG genotype. During the follow-up period, 109 (9.7%) patients died, 77 (6.8%) of CV causes. Survival analysis showed that AA genotype was an independent risk factor for CV mortality compared with reference genotype GG (HR = 2.7, P = 0.025). At the end of follow-up, the estimated survival probability (K-M) was 89.8% for GG genotype, 82.2% for AG and 72.3% for AA genotype ( P = 0.039). Carriage of the mutant G allele of the ADAMTS7 gene was associated with improved CV survival in patients with documented CAD. The native overfunctional ADAMTS7 allele (A) may accelerate VSMC migration and lead to neointimal thickening, atherosclerosis progression and acute plaque events. ADAMTS7 gene should be further explored in CAD for risk prediction, mechanistic and therapeutic goals.
Transcriptome assessment of the Pompe (Gaa−/−) mouse spinal cord indicates widespread neuropathology
Authors: Turner S. M. F. , Falk D. J. , Byrne B. J. , Fuller D. D.
Published: September 2016

Pompe disease, caused by deficiency of acid alpha-glucosidase (GAA), leads to widespread glycogen accumulation and profound neuromuscular impairments. There has been controversy, however, regarding the role of central nervous system pathology in Pompe motor dysfunction. We hypothesized that absence of GAA protein causes progressive activation of neuropathological signaling, including pathways associated with cell death. To test this hypothesis, genomic data (Affymetrix Mouse Gene Array 2.0ST) from the midcervical spinal cord in 6 and 16 mo old Pompe ( Gaa −/−) mice were evaluated (Broad Institute Molecular Signature Database), along with spinal cord histology. The midcervical cord was selected because it contains phrenic motoneurons, and phrenic-diaphragm dysfunction is prominent in Pompe disease. Several clinically important themes for the neurologic etiology of Pompe disease emerged from this unbiased genomic assessment. First, pathways associated with cell death were strongly upregulated as Gaa −/− mice aged, and motoneuron apoptosis was histologically verified. Second, proinflammatory signaling was dramatically upregulated in the Gaa −/− spinal cord. Third, many signal transduction pathways in the Gaa −/− cervical cord were altered in a manner suggestive of impaired synaptic function. Notably, glutamatergic signaling pathways were downregulated, as were “synaptic plasticity pathways” including genes related to neuroplasticity. Fourth, many genes and pathways related to cellular metabolism are dysregulated. Collectively, the data unequivocally confirm that systemic absence of GAA induces a complex neuropathological cascade in the spinal cord. Most importantly, the results indicate that Pompe is a neurodegenerative condition, and this underscores the need for early therapeutic intervention capable of targeting the central nervous system.
Human Mobility Modelling Based on Dense Transit Areas Detection with Opportunistic Sensing
Authors: Terroso-Sáenz Fernando , Valdes-Vela Mercedes , González-Vidal Aurora , Skarmeta Antonio F.
Published: September 2016

With the advent of smartphones, opportunistic mobile crowdsensing has become an instrumental approach to perceive large-scale urban dynamics. In this context, the present work presents a novel approach based on such a sensing paradigm to automatically identify and monitor the areas of a city comprising most of the human transit. Unlike previous approaches, the system performs such detection in real time at the same time the opportunistic sensing is carried out. Furthermore, a novel multilayered grill partitioning to represent such areas is stated. Finally, the proposal is evaluated by means of a real-world dataset.
The Development of Intensive Care Unit Acquired Hypernatremia Is Not Explained by Sodium Overload or Water Deficit: A Retrospective Cohort Study on Water Balance and Sodium Handling
Authors: IJzendoorn M. C. O. van , Buter H. , Kingma W. P. , Navis G. J. , Boerma E. C.
Published: September 2016

Background. ICU acquired hypernatremia (IAH, serum sodium concentration (sNa) ≥ 143 mmol/L) is mainly considered iatrogenic, induced by sodium overload and water deficit. Main goal of the current paper was to answer the following questions: Can the development of IAH indeed be explained by sodium intake and water balance? Or can it be explained by renal cation excretion?Methods.Two retrospective studies were conducted: a balance study in 97 ICU patients with and without IAH and a survey on renal cation excretion in 115 patients with IAH.Results.Sodium intake within the first 48 hours of ICU admission was 12.5 [9.3–17.5] g in patients without IAH (n=50) and 15.8 [9–21.9] g in patients with IAH (n=47),p=0.13. Fluid balance was 2.3 [1–3.7] L and 2.5 [0.8–4.2] L, respectively,p=0.77. Urine cation excretion (urine Na + K) was < sNa in 99 out of 115 patients with IAH. Severity of illness was the only independent variable predicting development of IAH and low cation excretion, respectively.Conclusion. IAH is not explained by sodium intake or fluid balance. Patients with IAH are characterized by low urine cation excretion, despite positive fluid balances. The current paradigm does not seem to explain IAH to the full extent and warrants further studies on sodium handling in ICU patients.
Desafíos regulatorios para la detección y sanción de delitos económicos en Chile
Authors: Nino-Moris Christian
Published: September 2016

Las recientes diligencias investigativas por parte de la Fiscalía en torno a las masivas estafas piramidales, también conocidas como Ponzi Scheme, han reflotado una vieja discusión respecto al rol fiscalizador del regulador financiero. El debate se agudiza ante una evidente limitación de recursos humanos y financieros para hacer frente a estas malas prácticas rentistas, donde su rol se ve truncado ante la ausencia de una tipificación penal que sancione tanto la oferta (réditos exuberantes) como la demanda (inversionistas ávidos del dinero fácil). Este articulo trata de explicar algunas problemáticas subyacentes que fomentan los delitos económicos.
Dual Roles for CXCL4 Chemokines and CXCR3 in Angiogenesis and Invasion of Pancreatic Cancer
Authors: Quemener Cathy , Baud Jessica , Boyé Kevin , Dubrac Alexandre , Billottet Clotilde , Soulet Fabienne , Darlot Florence , Dumartin Laurent , Sire Marie , Grepin Renaud , Daubon Thomas , Rayne Fabienne , Wodrich Harald , Couvelard Anne , Pineau Raphael , Schilling Martin , Castronovo Vincent , Sue Shih-Che , Clarke Kim , Lomri Abderrahim , Khatib Abdel-Majid , Hagedorn Martin , Prats Hervé , Bikfalvi Andreas
Published: September 2016

The CXCL4 paralog CXCL4L1 is a less studied chemokine that has been suggested to exert an antiangiogenic function. However, CXCL4L1 is also expressed in patient tumors, tumor cell lines, and murine xenografts, prompting a more detailed analysis of its role in cancer pathogenesis. We used genetic and antibody-based approaches to attenuate CXCL4L1 in models of pancreatic ductal adenocarcinoma (PDAC). Mechanisms of expression were assessed in cell coculture experiments, murine, and avian xenotransplants, including through an evaluation of CpG methylation and mutation of critical CpG residues. CXCL4L1 gene expression was increased greatly in primary and metastatic PDAC. We found that myofibroblasts triggered cues in the tumor microenvironment, which led to induction of CXCL4L1 in tumor cells. CXCL4L1 expression was also controlled by epigenetic modifications at critical CpG islands, which were mapped. CXCL4L1 inhibited angiogenesis but also affected tumor development more directly, depending on the tumor cell type. In vivo administration of an mAb against CXCL4L1 demonstrated a blockade in the growth of tumors positive for CXCR3, a critical receptor for CXCL4 ligands. Our findings define a protumorigenic role in PDAC development for endogenous CXCL4L1, which is independent of its antiangiogenic function. Cancer Res; 76(22); 6507–19. ©2016 AACR.
Alterations in Cardiomyocyte Differentiation-Related Proteins in Rat Mesenchymal Stem Cells Exposed to Hypoxia
Authors: Choi Jung-Won , Kim Kyung-Eun , Lee Chang Youn , Lee Jiyun , Seo Hyang-Hee , Lim Kyu Hee , Choi Eunhyun , Lim Soyeon , Lee Seahyong , Kim Sang Woo , Hwang Ki-Chul
Published: September 2016

Background/Aims: It is known that mesenchymal stem cells (MSCs) can have variable responses to hypoxic conditions and that hypoxia may specifically stimulate differentiation into osteogenic, chondrogenic, or adipogenic cells. Based on our previous study, we hypothesized that hypoxia may also induce MSC differentiation into cardiomyocytes and/or cells with comparable phenotypes. Methods: The differences in the proteomes were specifically investigated in bone marrow-derived rat MSCs (BM-rMSCs) under normoxic and hypoxic conditions using 2-DE combined with a MALDI-TOF-MS analysis and western blot analysis. In addition, genetic and/or proteomic interactions were assessed using a String network analysis. Results: Among the 35 markedly changed spots from a total of 393 matched spots, 24 were highly up-regulated and 11 were significantly down-regulated in hypoxic rMSCs based on a proteomic analysis. Although hypoxia failed to induce the direct differentiation of rMSCs into cardiomyocytes, several cardiomyocyte differentiation-related genes and proteins were significantly increased by hypoxic stress. Conclusion: We found that BM-rMSCs alter their expression of several cardiomyocyte differentiation-related genes and proteins under hypoxic conditions, and we examined the interactions between these genes and/or proteins, providing new insights for the applicability of MSCs preconditioned by hypoxic stimulation for use in cardiac diseases.
Quantitative Determination of Ceramide Molecular Species in Dendritic Cells
Authors: Makdessi Samar Al , Sweidan Hicham , Schmid Evi , Weimar Udo , Gulbins Erich , Lang Florian
Published: September 2016

Background/Aims: The activation of acid sphingomyelinase by cellular stress or receptors or the de novo synthesis lead to the formation of ceramide (N-acylsphingosine), which in turn modifies the biophysical properties of cellular membrane and greatly amplifies the intensity of the initial signal. Ceramide, which acts by re-organizing a given signalosome rather than being a second messenger, has many functions in infection biology, cancer, cardiovascular syndromes, and immune regulation. Experimental studies on the infection of human cells with different bacterial agents demonstrated the activation of the acid sphingomyelinase/ceramide system. Moreover, the release of ceramide was found to be a requisite for the uptake of the pathogen. Considering the particular importance of the cellular role of ceramide, it was necessary to develop sensitive and accurate methods for its quantification. Methods: Here, we describe a method quantifying ceramide in dendritic cells and defining the different fatty acids (FA) bound to sphingosine. The main steps of the method include extraction of total lipids, separation of the ceramide by thin-layer chromatography, derivatization of ceramide-fatty acids (Cer-FA), and quantitation of these acids in their methyl form by gas chromatography on polar capillary columns. The identification of FA was achieved by means of known standards and confirmed by mass spectrometry. Results: FA ranging between C10 and C24 could be detected and quantified. The concentration of the sum of Cer-FA amounted to 14.88 ± 8.98 nmol/106 cells (n=10). Oleic acid, which accounted for approximately half of Cer-FA (7.73 ± 6.52 nmol/106 cells) was the predominant fatty acid followed by palmitic acid (3.47 ± 1.54 nmol/106 cells). Conclusion: This highly sensitive method allows the quantification of different molecular species of ceramides.
Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?
Authors: Haas Matthias , Günzel Karsten , Miller Kurt , Hamm Bernd , Cash Hannes , Asbach Patrick
Published: September 2016

Prostate volume in multiparametric MRI (mpMRI) is of clinical importance. For 3-Tesla mpMRI without endorectal coil, there is no distinctive standard for volume calculation. We tested the accuracy of the ellipsoid formula with planimetric volume measurements as reference and investigated the correlation of gland volume and cancer detection rate on MRI/ultrasound (MRI/US) fusion-guided biopsy. One hundred forty-three patients with findings on 3-Tesla mpMRI suspicious of cancer and subsequent MRI/US fusion-guided targeted biopsy and additional systematic biopsy were analyzed. T2-weighted images were used for measuring the prostate diameters and for planimetric volume measurement by a segmentation software. Planimetric and calculated prostate volumes were compared with clinical data. The median prostate volume was 48.1 ml (interquartile range (IQR) 36.9-62.1 ml). Volume calculated by the ellipsoid formula showed a strong concordance with planimetric volume, with a tendency to underestimate prostate volume (median volume 43.1 ml (IQR 31.2-58.8 ml); r = 0.903, p < 0.001). There was a moderate, significant inverse correlation of prostate volume to a positive biopsy result (r = -0.24, p = 0.004). The ellipsoid formula gives sufficient approximation of prostate volume on 3-Tesla mpMRI without endorectal coil. It allows a fast, valid volume calculation in prostate MRI datasets.
Clinical and Molecular Characterisation of Children with Pierre Robin Sequence and Additional Anomalies
Authors: Xu Jessie X. , Kilpatrick Nicky , Baker Naomi L. , Penington Anthony , Farlie Peter G. , Tan Tiong Yang
Published: September 2016

Pierre Robin Sequence (PRS) is usually classified into syndromic and nonsyndromic groups, with a further subclassification of the nonsyndromic group into isolated PRS and PRS with additional anomalies (PRS-Plus). The aim of this research is to provide an accurate phenotypic characterisation of nonsyndromic PRS, specifically the PRS-Plus subgroup. We sought to examine the frequency of sequence variants in previously defined conserved noncoding elements (CNEs) in the putative enhancer region upstream of SOX9, the regulation of which has been associated with PRS phenotypes. We identified 141 children with nonsyndromic PRS at the Royal Children's Hospital, Melbourne from 1985 to 2012 using 2 databases. Clinical and demographic data were extracted by file review and children categorized as ‘isolated PRS' or ‘PRS-Plus'. A subset of children with PRS-Plus was selected for detailed phenotyping and DNA sequencing of the upstream SOX9 CNEs. We found 83 children with isolated PRS and 58 with PRS-Plus. The most common PRS-Plus malformations involved the musculoskeletal and ocular systems. The most common coexisting craniofacial malformation was choanal stenosis/atresia. We identified 10 children with a family history of PRS or cleft palate. We found a single nucleotide substitution in a putative GATA1-binding site in one patient, but it was inherited from his phenotypically unaffected mother. PRS-Plus represents a broad phenotypic spectrum with uncertain pathogenesis. Dysmorphology assessment by a clinical geneticist is recommended. SOX9 CNE sequence variants are rare in our cohort and are unlikely to play a significant role in the pathogenesis of PRS-Plus.
ІНФОРМАТИЗАЦІЯ ОХОРОНИ ЗДОРОВ’Я. ОСОБЛИВОСТІ АНАЛІЗУ ІНФОРМАЦІЇ В РЕАБІЛІТАЦІЙНОМУ ПРОЦЕСІ
Authors: Mintser O. P. , Babintseva L.Yu. , Panchenko О. А.
Published: September 2016

Innovative processes in modem society, of course, touched and medicine. Caused by their structural and organizational changes in health care require a rethinking of many postulates, increased reserves, and most importantly - bringing the most advanced technology.

Particular attention is drawn to the area such as Rehabilitology and its practical implementation - Rehabilitation of patients. The success of the solutions of problems of rehabilitation is defined as the presence of the appropriate material and technical base and a sufficient level of training of medical personnel and methodological level of medicine in general. Therefore, a permanent modification of scientific and practical problems of rehabilitation under the influence of processes occurring in health care is inevitable.

Purpose - conceptual generalization prospects of Rehabilitation in modern medicine on the basis of extensive use of information technology. The goal of rehabilitation should be not only to restore health, but also in restoring the dignity of man, his social and social independence. Such judgments are more and more in the latest definitions of the concept of rehabilitation.

Information technology - this is the provision that allows you to raise the level of rehabilitation care through the introduction of new organizational methods, new ways and means of rehabilitation. Knowledge of current trends of information Rehabilitation, of course, is a basis for determining further ways to improve the industry. Conventionally, there are three main areas of information technology in Rehabilitation: the automation of diagnostic and therapeutic techniques of medical information to support decision-making, telerehabilitation.

The authors propose a new concept of rehabilitation. Its main differences are the three concepts: the rehabilitation program should be considered, ranging from inpatient treatment period, patient risk monitoring of the pathological process is the link that unites medical monitoring strategy and the impact on the patient, the need for analysis and standardization of variants of the rehabilitation period on the basis of principles of medical ontology. In the new coordinate system created becomes relevant issue is not the etiology and pathogenesis of the disease, and the mechanisms of the transition state of the body from illness to health.

The paper also proposed the original division of the rehabilitation period, into 4 stages: clinical, sanatorium, residual, adaptation.

Given that rehabilitation programs are individually designed for each patient, taking into account the general condition, the characteristics of the disease, the initial level of physical condition, the patient’s personality, age, gender, occupation, etc., they can be viewed as a project or pre-plan the system of measures.