bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffuse Alveolar Hemorrhage in Systemic Lupus Erythematosus: Histopathologic Features and Clinical Correlations
Authors: Ta Robert , Celli Romulo , West A. Brian
Published: April 2017

The case of a 16-year-old African-American girl with systemic lupus erythematosus, who developed diffuse alveolar hemorrhage with fatal consequences, is described. Diffuse alveolar hemorrhage is a rare but serious complication of systemic lupus. It occurs in three distinct but overlapping phenotypes, acute capillaritis, bland pulmonary hemorrhage, and diffuse alveolar damage, each of which is associated with a different group of underlying conditions. Diffuse alveolar hemorrhage is a medical emergency: choice of treatment depends on early diagnosis and determination of the underlying etiology. Acute infection, superimposed on diffuse alveolar hemorrhage in the setting of immune compromise, is often a terminal event, as in this case.
ULMAP: Ultralightweight NFC Mutual Authentication Protocol with Pseudonyms in the Tag for IoT in 5G
Authors: Fan Kai , Song Panfei , Yang Yintang
Published: April 2017

As one of the core techniques in 5G, the Internet of Things (IoT) is increasingly attracting people’s attention. Meanwhile, as an important part of IoT, the Near Field Communication (NFC) is widely used on mobile devices and makes it possible to take advantage of NFC system to complete mobile payment and merchandise information reading. But with the development of NFC, its problems are increasingly exposed, especially the security and privacy of authentication. Many NFC authentication protocols have been proposed for that, some of them only improve the function and performance without considering the security and privacy, and most of the protocols are heavyweight. In order to overcome these problems, this paper proposes an ultralightweight mutual authentication protocol, named ULMAP. ULMAP only uses Bit and XOR operations to complete the mutual authentication and prevent the denial of service (DoS) attack. In addition, it uses subkey and subindex number into its key update process to achieve the forward security. The most important thing is that the computation and storage overhead of ULMAP are few. Compared with some traditional schemes, our scheme is lightweight, economical, practical, and easy to protect against synchronization attack.
Performance of Sorghum Varieties under Variable Rainfall in Central Tanzania
Authors: Msongaleli Barnabas M. , Tumbo S. D. , Kihupi N. I. , Rwehumbiza Filbert B.
Published: April 2017

Rainfall variability has a significant impact on crop production with manifestations in frequent crop failure in semiarid areas. This study used the parameterized APSIM crop model to investigate how rainfall variability may affect yields of improved sorghum varieties based on long-term historical rainfall and projected climate. Analyses of historical rainfall indicate a mix of nonsignificant and significant trends on the onset, cessation, and length of the growing season. The study confirmed that rainfall variability indeed affects yields of improved sorghum varieties. Further analyses of simulated sorghum yields based on seasonal rainfall distribution indicate the concurrence of lower grain yields with the 10-day dry spells during the cropping season. Simulation results for future sorghum response, however, show that impacts of rainfall variability on sorghum will be overridden by temperature increase. We conclude that, in the event where harms imposed by moisture stress in the study area are not abated, even improved sorghum varieties are likely to perform poorly.
Endometriosis Nodule Causing Spontaneous Haemoperitoneum in Pregnancy: A Case Report and Literature Review
Authors: Rafi Junaid , Mahindrakar Geetha , Mukhopadhyay Debjani
Published: April 2017

Spontaneous haemoperitoneum in pregnancy (SHiP) due to endometriosis is a very rare condition and this is a case of a 41-year-old primigravida, who presented at 32 weeks with sudden onset of severe lower abdominal pain without any uterine activity. This was a dichorionic-diamniotic twin pregnancy, following in vitro fertilisation for subfertility secondary to severe endometriosis. On admission, pain score was eight, with ten being the maximum of the scale. The vital signs were stable. Abdominal palpation revealed generalised tenderness with no guarding or palpable contraction. There was no evidence of bleeding and the cervical os was closed on speculum examination. The cardiotocograph (CTG) was pathological and a plan was made to deliver the babies with emergency caesarean section. Intraoperatively, there was massive haemoperitoneum which was managed successfully with the involvement of multidisciplinary input from general surgeons and urologists with optimum maternal and fetal outcome.
Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion
Authors: Wu Candace , Shemisa Kamal
Published: April 2017

Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure. Four months prior to admission, he was started on sorafenib. Results. Our patient was treated with intravenous furosemide and guideline directed therapy. Clinical status was complicated by the development of low cardiac output and shock requiring inotropic support. Careful titration of heart failure medication led to hemodynamic improvement and discontinuation of dobutamine. Conclusion. Greater awareness of sorafenib cardiotoxicity is essential. As TKI usage grows for treatment of cancers, heart failure-related complications will increase. In our patient, routine heart failure management and cessation of sorafenib led to clinical improvement. Future studies on the treatment of sorafenib cardiotoxicity should be explored further in this unique patient population.
Neutrophilic Inflammation in the Immune Responses of Chronic Obstructive Pulmonary Disease: Lessons from Animal Models
Authors: Huang Gang , Xu Xu-Chen , Zhou Jie-Sen , Li Zhou-Yang , Chen Hai-Pin , Wang Yong , Li Wen , Shen Hua-Hao , Chen Zhi-Hua
Published: April 2017

Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, which is characterized by chronic bronchitis, destruction of small airways, and enlargement/disorganization of alveoli. It is generally accepted that the neutrophilic airway inflammation observed in the lungs of COPD patients is intrinsically linked to the tissue destruction and alveolar airspace enlargement, leading to disease progression. Animal models play an important role in studying the underlying mechanisms of COPD as they address questions involving integrated whole body responses. This review aims to summarize the current animal models of COPD, focusing on their advantages and disadvantages on immune responses and neutrophilic inflammation. Also, we propose a potential new animal model of COPD, which may mimic the most characteristics of human COPD pathogenesis, including persistent moderate-to-high levels of neutrophilic inflammation.
Time-Efficient Cloning Attacks Identification in Large-Scale RFID Systems
Authors: Zhao Ju-min , Feng Ding , Li Deng-ao , Gong Wei , Liu Hao-xiang , Huo Shi-min
Published: April 2017

Radio Frequency Identification (RFID) is an emerging technology for electronic labeling of objects for the purpose of automatically identifying, categorizing, locating, and tracking the objects. But in their current form RFID systems are susceptible to cloning attacks that seriously threaten RFID applications but are hard to prevent. Existing protocols aimed at detecting whether there are cloning attacks in single-reader RFID systems. In this paper, we investigate the cloning attacks identification in the multireader scenario and first propose a time-efficient protocol, called the time-efficient Cloning Attacks Identification Protocol (CAIP) to identify all cloned tags in multireaders RFID systems. We evaluate the performance of CAIP through extensive simulations. The results show that CAIP can identify all the cloned tags in large-scale RFID systems fairly fast with required accuracy.
Microwave Ablation and Immune Activation in the Treatment of Recurrent Colorectal Lung Metastases: A Case Report
Authors: Bäcklund Magnus , Freedman Jacob
Published: April 2017

We present a patient with colorectal metastases confined to the lungs and treated with multiple resections until this was not an option anymore, followed by stereotactic body radiation therapy until this option was drained. Then, the patient was successfully treated with multiple microwave ablations combined with immunological activation targeting the programmed cell death 1 receptor (PD-1), possibly instigating a powerful abscopal effect. Techniques, doses, and radiological findings are presented.
Antioxidant and Hepatoprotective Effect of Swertiamarin on Carbon Tetrachloride-Induced Hepatotoxicity via the Nrf2/HO-1 Pathway
Authors: Wu Tao , Li Jingjing , Li Yong , Song Hongping
Published: April 2017

Background/Aims: Swertiamarin (STM), the main bioactive component in Swertia mussotii Franch (Gentianaceae), has been shown to exert hepatoprotective effects on experimental liver injury. However, the effects and exact mechanisms of STM on carbon tetrachloride (CCl4) causing hepatotoxicity are still unknown. This study investigated the potential protective effects and mechanisms of STM on CCl4-induced liver injury in rats. Methods: Adult male Sprague-Dawley (SD) rats were exposed to CCl4 with or without STM co-administration for consecutive eight weeks. Results: STM significantly ameliorated CCl4-induced increase in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels and histopathological changes in the liver. Hepatic oxidative stress was repressed by STM, as evidenced by the decrease in malondialdehyde (MDA), with concomitant increase in antioxidase activity (e.g. superoxide dismutase (SOD); glutathione peroxidase (GPx)), glutathione (GSH) level. STM also obviously attenuated inflammatory response in CCl4-lesioned livers as evidenced by the decrease in inflammatory cytokines/ chemokines (e.g. inducible nitric oxide synthase (iNOS), interleukin-1β (IL-1β)). Additionally, STM significantly induced the expression of CYPs, efflux transporters and PDZK1 as compared with the CCl4 group. Moreover, co-administration of STM with CCl4 remarkably up-regulated the expression of Nrf2, HO-1 and NQO1 compared with the CCl4 group. Conclusions: The present study demonstrates that STM exerts a protective effect against CCl4-induced liver injury and inflammation with its antioxidant effects and induction of hepatic detoxification enzymes and efflux transporters expression, at least in part, via the Nrf2/HO-1 pathway in rats.
Atrial Fibrillation
Authors: Staerk Laila , Sherer Jason A. , Ko Darae , Benjamin Emelia J. , Helm Robert H.
Published: April 2017

The past 3 decades have been characterized by an exponential growth in knowledge and advances in the clinical treatment of atrial fibrillation (AF). It is now known that AF genesis requires a vulnerable atrial substrate and that the formation and composition of this substrate may vary depending on comorbid conditions, genetics, sex, and other factors. Population-based studies have identified numerous factors that modify the atrial substrate and increase AF susceptibility. To date, genetic studies have reported 17 independent signals for AF at 14 genomic regions. Studies have established that advanced age, male sex, and European ancestry are prominent AF risk factors. Other modifiable risk factors include sedentary lifestyle, smoking, obesity, diabetes mellitus, obstructive sleep apnea, and elevated blood pressure predispose to AF, and each factor has been shown to induce structural and electric remodeling of the atria. Both heart failure and myocardial infarction increase risk of AF and vice versa creating a feed-forward loop that increases mortality. Other cardiovascular outcomes attributed to AF, including stroke and thromboembolism, are well established, and epidemiology studies have championed therapeutics that mitigate these adverse outcomes. However, the role of anticoagulation for preventing dementia attributed to AF is less established. Our review is a comprehensive examination of the epidemiological data associating unmodifiable and modifiable risk factors for AF and of the pathophysiological evidence supporting the mechanistic link between each risk factor and AF genesis. Our review also critically examines the epidemiological data on clinical outcomes attributed to AF and summarizes current evidence linking each outcome with AF.
Randomized Controlled Trial of High‐Volume Energy Drink Versus Caffeine Consumption on ECG and Hemodynamic Parameters
Authors: Fletcher Emily A. , Lacey Carolyn S. , Aaron Melenie , Kolasa Mark , Occiano Andrew , Shah Sachin A.
Published: April 2017

Background

Caffeine in doses <400 mg is typically not considered arrhythmogenic, but little is known about the additional ingredients in energy drinks. We evaluated the ECG and blood pressure (
BP
) effects of high‐volume energy drink consumption compared with caffeine alone.

Methods and Results

This was a randomized, double‐blind, controlled, crossover study in 18 young, healthy volunteers. Participants consumed either 946 mL (32 ounces) of energy drink or caffeinated control drink, both of which contained 320 mg of caffeine, separated by a 6‐day washout period.
ECG
, peripheral
BP
, and central
BP
measurements were obtained at baseline and 1, 2, 4, 6, and 24 hours post study drink consumption. The time‐matched, baseline‐adjusted changes were compared. The change in corrected
QT
interval from baseline in the energy drink arm was significantly higher than the caffeine arm at 2 hours (0.44±18.4 ms versus −10.4±14.8 ms, respectively;
P
=0.02). The
QT
c changes were not different at other time points. While both the energy drink and caffeine arms raised systolic
BP
in a similar fashion initially, the systolic
BP
was significantly higher at 6 hours when compared with the caffeine arm (4.72±4.67 mm Hg versus 0.83±6.09 mm Hg, respectively;
P
=0.01). Heart rate, diastolic
BP
, central systolic
BP
, and central diastolic
BP
showed no evidence of a difference between groups at any time point. Post energy drink, augmentation index was lower at 6 hours.

Conclusions

The corrected QT interval and systolic
BP
were significantly higher post high‐volume energy drink consumption when compared with caffeine alone. Larger clinical trials validating these findings and evaluation of noncaffeine ingredients within energy drinks are warranted.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
02023723.
On the taxonomy of the Barsine delineata species-complex (Lepidoptera, Erebidae, Arctiinae)
Authors: VOLYNKIN ANTON V. , ČERNÝ KAREL
Published: April 2017

Taxa of the Barsine delineata (Walker, 1854) species-complex are examined, the synonymy of Ammatho figuratus Walker, 1855, Cyme chinensis C. Felder & R. Felder, 1862 and Ammatho fuscescens Butler, 1877 with Hypoprepia? delineata Walker, 1854 is revised. The new synonymy is introdiced: Barsine delineata (Walker, 1854) = Miltochrista dimidiata Fang, 1991, syn. nov. A new species, Barsine sublucana Volynkin & Černý, sp. nov. is described from northern Thailand. Adults, male and female genitalia of B. delineata and B. sublucana sp. nov. are illustrated.
A new species of the fangblenny Adelotremus from Indonesia, with supplemental description of A. leptus (Teleostei: Blenniidae: Nemophini)
Authors: SMITH-VANIZ WILLIAM F.
Published: April 2017

A new fangblenny, Adelotremus deloachi, is described on the basis of three specimens, 29‒35 mm SL, from Bali and Lembeh Strait, Indonesia. All these specimens were collected in 10‒17 m depth on sandy slopes. The new species differs from Adelotremus leptus, its Red Sea and only congener, in having a pair of mid-dorsal supratemporal pores (vs. a single pore), dorsal-fin spines X (vs. IX) and precaudal and caudal vertebra 12 + 23 (vs. 13 + 19). The discovery of a second species requires slight modification of the diagnosis of the genus. Unlike the five other nemophine genera, Adelotremus differs most notably in having the third infraorbital bone and associated sensory pores absent, and the combination of ventral margin of gill opening opposite the dorsalmost 5th or 6th pectoral-fin ray, total dorsal-fin elements 28‒29 and interorbital pores 2. With a total of four specimens of Adelotremus, it is now apparent that several features of the cephalic pore arrangement of the genus are different from that found in Petroscirtes, its presumed sister genus. Recent color photographs indicate that both species of Adelotremus exhibit marked sexual dichromatism with males having a conspicuous ocellus anteriorly in the dorsal fin that is absent in females.
Introduction: Connecting Student Loan Research and Federal Policy
Authors: Hillman Nicholas , Orosz Kata
Published: April 2017

This article introduces this volume, which is dedicated to expanding a theory- and evidence-based understanding of student loan problems. The authors review evidence to address fundamental questions related to student loan research: who borrows, why, and the consequences of debt for specific student populations. The authors outline how the articles collected in the volume address these fundamental questions, and discuss ways in which federal policy-makers may build on the insights that can be gained from this volume as they work on the reauthorization of the Higher Education Act.
Effects of a Family-based Diabetes Intervention on Behavioral and Biological Outcomes for Mexican American Adults
Authors: McEwen Marylyn Morris , Pasvogel Alice , Murdaugh Carolyn , Hepworth Joseph
Published: April 2017

Purpose

The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM).

Methods

Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects.

Results

Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress.

Conclusions

Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.
Daily Autonomy Support and Sexual Identity Disclosure Predicts Daily Mental and Physical Health Outcomes
Authors: Legate Nicole , Ryan Richard M. , Rogge Ronald D.
Published: April 2017

Using a daily diary methodology, we examined how social environments support or fail to support sexual identity disclosure, and associated mental and physical health outcomes. Results showed that variability in disclosure across the diary period related to greater psychological well-being and fewer physical symptoms, suggesting potential adaptive benefits to selectively disclosing. A multilevel path model indicated that perceiving autonomy support in conversations predicted more disclosure, which in turn predicted more need satisfaction, greater well-being, and fewer physical symptoms that day. Finally, mediation analyses revealed that disclosure and need satisfaction explained why perceiving autonomy support in a conversation predicted greater well-being and fewer physical symptoms. That is, perceiving autonomy support in conversations indirectly predicted greater wellness through sexual orientation disclosure, along with feeling authentic and connected in daily interactions with others. Discussion highlights the role of supportive social contexts and everyday opportunities to disclose in affecting sexual minority mental and physical health.
Status, Networks, and Opinion Change: An Experimental Investigation
Authors: Dippong Joseph , Kalkhoff Will , Johnsen Eugene C.
Published: April 2017

This study evaluates two prominent sociological theories of interpersonal influence: status characteristics theory and social influence network theory. In application to status settings, we test social influence network theory and its established measurement model as well as a recent “modular integration” that operationalizes social influence network theory’s central constructs by incorporating assumptions from status characteristics theory. The two formulations are systematically examined within an open interaction experiment where groups of two, three, and four participants discussed their initial opinions and formed final opinions on two separate issues. Participants were randomly assigned to status positions, which status characteristics theory emphasizes as normative foundations of influence in small task-oriented groups. Analyses of group-level and individual-level opinion change support social influence network theory as it has been used in the past and suggest that status characteristics theory shows promise in modeling the influence networks that drive opinion change at the individual level.
Hydrothermal and mechanochemical synthesis of crystalline CaCO3
Authors: Skubiszewska-Zięba J , Charmas B , Waniak-Nowicka H
Published: April 2017

Mechanochemical and microwave-assisted hydrothermal (MicroWave Treatment [MWT]) procedures were applied to prepare crystalline CaCO3. Mechanochemical process was carried out at different speeds of rotation (500 or 850 rpm/min), different duration times (30 or 60 min) and in the aqueous suspensions or in dry state. MWT synthesis was conducted in a saturated water vapour or under the layer of water. The crystalline and porous structures of the prepared samples as well as their morphology were investigated using N2 adsorption, X-ray diffraction and scanning electron microscopy methods. As a result, the calcium carbonate samples in the form of calcite were obtained. The materials prepared by the mechanochemical route performed in the aqueous suspension are characterized by smaller crystallite sizes as compared to those obtained without the addition of water. The samples obtained hydrothermally have the largest size of crystallites. Powders prepared by energetical milling possess higher values of specific surface area in relation to the parameter for those synthesized hydrothermally. In the process of hydrothermal treatment, macroporous structure of the prepared materials is created. With the increasing specific surface area of the sample, the size of the crystallites decreased.
“The Good Ole’ Girls’ Nursing Club”: The Male Student Perspective
Authors: Carnevale Teresa , Priode Kimberly
Published: April 2017

Background: Diversity in nursing remains limited with little progress made in the recruitment of males. The purpose of this research was to garner the male nursing students’ perspectives of their lived experiences while enrolled in their undergraduate program. Method: A phenomenological group focus approach was utilized with male nursing students regarding their lived experiences of what factors support or negate their being successful in completing a nursing program. Results: Four themes were interpreted: exclusion, gender bias, career expectations, and acceptance. Exclusion and gender bias were seen as negative impact factors, while career expectations was both a motivating factor and a negating factor. Acceptance was interpreted as an important positive factor. Conclusion: A call for change to the profession of nursing from a culture of the “good ole’ girls’ nursing club” to one of “great nurses from both genders and all ethnicities” is critical for the future growth of the profession.
Adapting and developing a video-feedback intervention for co-parents of infants at risk of externalising behaviour problems (VIPP-Co): A feasibility study
Authors: Iles Jane E , Rosan Camilla , Wilkinson Esther , Ramchandani Paul G
Published: April 2017

Background:

Recent research on early interventions with parents of infants at risk of externalising behaviour problems indicates that focusing on co-parenting and involving fathers in treatment may enhance effectiveness. This article reports the development and preliminary evaluation of a brief intervention: video-feedback intervention to promote positive parenting and sensitive discipline for co-parents (VIPP-Co).

Methods:

Families who reported to be struggling with their infant’s behaviour were recruited from the community and received six home-based sessions of VIPP-Co. The primary outcome was feasibility of the adapted intervention, assessed using semi-structured questionnaires and interviews post-intervention. Preliminary clinical outcome measures were also recorded.

Results:

In total, five families with infants between 10 and 24 months completed the intervention. Feedback data documented high rates of acceptability and feasibility. All fathers and mothers completing the intervention reported that it positively impacted their understanding of their child’s thoughts and feelings, as well as their approach to individual parenting and co-parenting. Additional preliminary outcome data indicated positive changes in parent–chid interaction and a positive trend was found for infant behaviour, parental well-being and parent relationship adjustment across the intervention.

Conclusions:

The overall results of this study are encouraging, but VIPP-Co must be evaluated with larger samples to explore its efficacy.
PACE trial authors continue to ignore their own null effect
Authors: Vink Mark
Published: April 2017

Protocols and outcomes for the PACE trial were changed after the start of the trial. These changes made substantial differences, leading to exaggerated claims for the efficacy of cognitive behavior therapy and graded exercise therapy in myalgic encephalomyelitis/chronic fatigue syndrome. The small, self-reported improvements in subjective measures cannot be used to say the interventions are effective, particularly in light of the absence of objective improvement. Geraghty’s criticism of the trial was reasonable and supported by the evidence.
Ethnic/Diasporic/Transnational: The Rise and Fall of ImaginAsian TV
Authors: Han Benjamin
Published: April 2017

This article examines the rise and fall of ImaginAsian TV to illustrate the travails of imagining a broadcast community of Asian Americans and the potential effect this has on the politics of representation. Drawing on institutional politics, media history, and oral interviews, the article analyzes the problematic conceptualization of a homogeneous Asian American audience, and further explicates how the usage of the English language in ImaginAsian’s programming strategy, despite its syndicated programs in different Asian languages, could not accommodate the disparate but interconnected cultural logics of transnationalism, race and ethnicity, and diaspora which structure Asian and Asian American identities.
Self-Knowledge Creation Through Collective Poetic Inquiry: Cultivating Productive Resistance as University Academics
Authors: Pillay Daisy , Pithouse-Morgan Kathleen , Naicker Inbanathan
Published: April 2017

We explore how using the literary arts-based methodology of collective poetic inquiry deepened our own self-knowledge as South African academics who choose to resist a neoliberal corporate model of higher education. Increasingly, poetry is recognized as a means of representing the distinctiveness, complexity and plurality of the voices of research participants and researchers. Also, poetry is understood as a mode of research analysis that can intensify creativity and reflexivity. Using found poetry in the pantoum and tanka formats, we provide an example of a poetic inquiry process in which we started off by exploring other university academics’ lived experiences of working with graduate students and came to a turning point of reflexivity and self-realization. The escape highlights our evolving understanding that collaborative creativity and experimentation in research can be acts of self-knowledge creation for nurturing productive resistance as university academics.
The Effectiveness of Calf Muscle Electrostimulation on Vascular Perfusion and Walking Capacity in Patients Living With Type 2 Diabetes Mellitus and Peripheral Artery Disease
Authors: Ellul Christian , Formosa Cynthia , Gatt Alfred , Hamadani Auon Abbas , Armstrong David G.
Published: April 2017

The aim of the study was to explore calf muscle electrostimulation on arterial inflow and walking capacity in claudicants with peripheral artery disease and diabetes mellitus. A prospective, 1-group, pretest-posttest study design was used on 40 high-risk participants (n = 40) who exhibited bilateral limb ischemia (ankle brachial pressure index [ABPI] <0.90), diabetes mellitus, and calf muscle claudication. A program of calf muscle electrical stimulation with varying frequency (1-250 Hz) was prescribed for 1 hour per day for 12 weeks. Spectral waveforms analysis, ABPI, absolute claudication distance (ACD), and thermographic temperature patterns across 4 specified regions of interest (hallux, medial forefoot, lateral forefoot, heel) at rest and after exercise, were recorded at baseline and following intervention to evaluate for therapeutic outcomes. A significant improvement in ACD and ABPI was registered following the intervention ( P = .000 and P = .001, respectively). Resting foot temperatures increased significantly ( P = .000) while the postexercise temperature drops were halved across all regions at follow-up, with hallux ( P = .005) and lateral forefoot ( P = .038) reaching statistical significance. Spectral Doppler waveforms were comparable ( P = .304) between both serial assessments. Electrical stimulation of varying frequency for 1 hour per day for 12 consecutive weeks registered statistically significant improvement in outcome measures that assess arterial inflow and walking capacity in claudicants with diabetes mellitus. These results favor the use of electrostimulation as a therapeutic measure in this high-risk population.
Demographic characteristics of Australian health consumers who were early registrants for opt-in personally controlled electronic health records
Authors: Torrens Emma , Walker Sue M
Published: April 2017

Background:

Differential uptake of, or access to, personal electronic health records (PEHRs) has the potential to impact on health disparities among certain social groups. In 2012, the Australian Government introduced the Personally Controlled Electronic Health Record (PCEHR), an opt-in system operated by the then National E-Health Transition Authority (NEHTA). In July 2016, the My Health Record (MyHR), an opt-out model, operated by the Australian Digital Health Agency replaced the PCEHR, providing additional support for consumers.

Objective:

This research was carried out between 2012 and 2015, covering the opt-in PCEHR phase. The aim of the study was to explore demographic characteristics of Australian health consumers who were first to register for a PEHR, and to identify the age and gender populations less likely to register for a PEHR in the opt-in format. The study aimed to provide early data on registrants and potential methods to encourage individuals to register for a PEHR.

Method:

A cross-sectional study investigated differences in registrations for PEHRs from 2012 to 2015 by age and sex.

Results:

Results revealed that males were less likely to register than females, and adolescents of both sexes were the least likely to register when compared with any other age group. Similarly, middle-aged males had among the lowest reported registrations, as did older females.

Conclusion:

While e-health has the potential to improve health outcomes and PEHRs the potential to empower consumers to better manage their health and improve their access health services, evidence from this study suggested that some population groups that experience health inequalities (e.g. older people) were underrepresented among registrants for PEHRs. As income, ethnicity and education are major drivers for health disparities in Australia, future research should focus on uptake and use of PEHRs (now the MyHR) from the perspective of these variables.
Chemical and biological assessment of metal organic frameworks (MOFs) in pulmonary cells and in an acute in vivo model: relevance to pulmonary arterial hypertension therapy
Authors: Mohamed Nura A. , Davies Robert P. , Lickiss Paul D. , Ahmetaj‐Shala Blerina , Reed Daniel M. , Gashaw Hime H. , Saleem Hira , Freeman Gemma R. , George Peter M. , Wort Stephen J. , Morales‐Cano Daniel , Barreira Bianca , Tetley Teresa D. , Chester Adrian H. , Yacoub Magdi H. , Kirkby Nicholas S. , Moreno Laura , Mitchell Jane A.
Published: April 2017

Pulmonary arterial hypertension (PAH) is a progressive and debilitating condition. Despite promoting vasodilation, current drugs have a therapeutic window within which they are limited by systemic side effects. Nanomedicine uses nanoparticles to improve drug delivery and/or reduce side effects. We hypothesize that this approach could be used to deliver PAH drugs avoiding the systemic circulation. Here we report the use of iron metal organic framework (MOF) MIL‐89 and PEGylated MIL‐89 (MIL‐89 PEG) as suitable carriers for PAH drugs. We assessed their effects on viability and inflammatory responses in a wide range of lung cells including endothelial cells grown from blood of donors with/without PAH. Both MOFs conformed to the predicted structures with MIL‐89 PEG being more stable at room temperature. At concentrations up to 10 or 30 µg/mL, toxicity was only seen in pulmonary artery smooth muscle cells where both MOFs reduced cell viability and CXCL8 release. In endothelial cells from both control donors and PAH patients, both preparations inhibited the release of CXCL8 and endothelin‐1 and in macrophages inhibited inducible nitric oxide synthase activity. Finally, MIL‐89 was well‐tolerated and accumulated in the rat lungs when given in vivo. Thus, the prototypes MIL‐89 and MIL‐89 PEG with core capacity suitable to accommodate PAH drugs are relatively non‐toxic and may have the added advantage of being anti‐inflammatory and reducing the release of endothelin‐1. These data are consistent with the idea that these materials may not only be useful as drug carriers in PAH but also offer some therapeutic benefit in their own right.
Time for caring? Elderly care employees’ occupational activities in the cross draft between their work priorities, ‘must-do’s’ and meaningfulness
Authors: Nilsson Emma , Nilsson Kerstin
Published: April 2017

An increasing number of older people in the population will bring new challenges for the society and care coordination. One of the most important questions in care coordination is the employees’ work performance. The overall aim of this study was to examine care employees’ experience of factors that rule how they allocate their time and tasks in the care work. The study was qualitative and consists of focus group interviews with 36 employees in elderly care in five Swedish municipalities. Much of the work that care employees perform is controlled by others in the municipality organised health care. The employees had a limited possibility to decide what should be given priority in their work. However, the employees who participated in the focus group interviews did not want to prioritise tasks and duties they felt were faulty or in direct conflict with their own convictions. When employees experienced that the assistance assessments were correct and helpful to the individual elderly patient this contributed to the employees’ priority and performance of the task. The formal and informal control systems caused the employees’ priority to be mainly quantitative and visible work tasks, rather than more qualitative tasks and care giving to the elderly. In the intention to organise good care coordination that fit each elderly patients’ need it is important that those who work closest to the patient to a greater extent are given the opportunity to make their voice heard in decisions of care planning and assistance assessments.
Do children with neurological disabilities use more inpatient resources: an observational study
Authors: Yuan Jin-Xi , McGowan Marian , Hadjikoumi Irene , Pant Buddhi
Published: April 2017

Background

Advances in healthcare have improved the survival of children with neurological disabilities (ND). Studies in the US have shown that children with ND use a substantial proportion of resources in children’s hospitals, however, little research has been conducted in the UK. We aimed to test the hypothesis that children with neurological disabilities use more inpatient resources than children without neurological disabilities, and to quantify any significant differences in resource use.

Methods

A retrospective observational study was conducted, looking at the number of hospital admissions, total inpatient days and the reason for admissions for paediatric inpatients from January 1st to March 31st 2015. Inpatients were assigned into one of three groups: children without ND, children with one ND, and children with more than one ND.

Results

The sample population included 942 inpatients (mean age 6y 6mo). Children with at least one ND accounted for 15.3% of the inpatients, 17.7% of total hospital inpatient admission episodes, and 27.8% of the total inpatients days. Neurological disability had a statistically significant effect on total hospital admissions (p < 0.001). Neurological disability also had a statistically significant effect on total inpatient days (p < 0.001). Neurological disability increased the length of inpatient stay across medicine, specialties, and surgery.

Conclusions

Children with ND had more frequent hospital admission episode and longer inpatient stays. We identified a smaller group within this population, with arguably more complex neurological disabilities, children with more than one ND. This group had the highest number of admissions and longest inpatient stays. More frequent hospital admissions and longer inpatient stays may place children with ND at greater risk of the adverse effects of hospitalisations. We recommend further investigations looking at each the effects of the different categories of ND on inpatient resource use, and repeat of this study at a national level and over a longer period of time.
Characteristics of Esophageal Cancer Cases in Tanzania
Authors: Mmbaga Elia J. , Deardorff Katrina V. , Mushi Beatrice , Mgisha William , Merritt Megan , Hiatt Robert A. , Mwaiselage Julius , Zhang Li , Van Loon Katherine
Published: April 2017

Purpose

Age-standardized incidence rates for esophageal cancer (EC) in East Africa have been reported as disproportionately high compared with the worldwide incidence of nine per 100,000 population. This study aimed to characterize EC cases seen at Muhimbili National Hospital and Ocean Road Cancer Institute in Dar es Salaam, Tanzania.

Methods

Demographic, clinical, and treatment variables were abstracted from charts of patients who received care for a diagnosis of EC at one or both institutions between 2011 and 2013. Categorical data were summarized as frequency counts and percentages. Continuous data were presented as medians and ranges. To compare men and women, Pearson’s χ2 and two-sample t tests were applied.

Results

Seven hundred thirty-eight unique cases of EC were identified, of whom 68% were men and the median age was 60 years (range, 19 to 95 years). Notably, 93 cases (13%) were ≤ 40 years old at diagnosis. Squamous cell carcinoma was the dominant histology, comprising 90% of cases with documented histopathology. However, 34% of cases with a diagnosis of EC were not pathologically confirmed. The stage was documented as locoregional in 4% of cases, locally advanced in 20% of cases, metastatic in 14% of cases, and unknown in 63% of cases. Of 430 patients who received treatment at Ocean Road Cancer Institute, 76% were treated with radiation, 44% were treated with chemotherapy, 3% underwent a cancer-related surgical procedure, and 10% of cases received no cancer-directed therapy. The median overall survival for all patients was 6.9 months (95% CI, 5.0 to 12.8), regardless of stage at presentation.

Conclusion

Between 2011 and 2013, cases of EC represented a large clinical burden at both institutions.
Early-Onset Obesity: Unrecognized First Evidence for GNAS Mutations and Methylation Changes
Authors: Grüters-Kieslich Annette , Reyes Monica , Sharma Amita , Demirci Cem , DeClue Terry J , Lankes Erwin , Tiosano Dov , Schnabel Dirk , Jüppner Harald
Published: April 2017

Context

Early-onset obesity, characteristic for disorders affecting the leptin–melanocortin pathway, is also observed in pseudohypoparathyroidism type 1A (PHP1A), a disorder caused by maternal GNAS mutations that disrupt expression or function of the stimulatory G protein α-subunit (Gsα). Mutations and/or epigenetic abnormalities at the same genetic locus are also the cause of pseudohypoparathyroidism type 1B (PHP1B). However, although equivalent biochemical and radiographic findings can be encountered in these related disorders caused by GNAS abnormalities, they are considered distinct clinical entities.

Objectives

To further emphasize the overlapping features between both disorders, we report the cases of several children, initially brought to medical attention because of unexplained early-onset obesity, in whom PHP1B or PHP1A was eventually diagnosed.

Patients and Methods

Search for GNAS methylation changes or mutations in cohorts of patients with early-onset obesity.

Results

Severe obesity had been noted in five infants, with a later diagnosis of PHP1B due to STX16 deletions and/or abnormal GNAS methylation. These findings prompted analysis of 24 unselected obese patients, leading to the discovery of inherited STX16 deletions in 2 individuals. Similarly, impressive early weight gains were noted in five patients, who initially lacked additional Albright hereditary osteodystrophy features but in whom PHP1A due to GNAS mutations involving exons encoding Gsα was diagnosed.

Conclusions

Obesity during the first year of life can be the first clinical evidence for PHP1B, expanding the spectrum of phenotypic overlap between PHP1A and PHP1B. Importantly, GNAS methylation abnormalities escape detection by targeted or genome-wide sequencing strategies, raising the question of whether epigenetic GNAS analyses should be considered for unexplained obesity.
Intrathecal Morphine Versus Extended-Release Epidural Morphine for Postoperative Pain Control in Pediatric Patients Undergoing Posterior Spinal Fusion
Authors: Cohen Mindy , Zuk Jeannie , McKay Nancy , Erickson Mark , Pan Zhaoxing , Galinkin Jeffrey
Published: April 2017

BACKGROUND:

Posterior spinal fusion for scoliosis is one of the most painful elective pediatric surgeries. Good postoperative pain control allows early ambulation and return of ability to tolerate oral intake. Options for analgesia in this patient population are suboptimal. We hypothesized that extended-release epidural morphine (EREM) would provide better pain control and less adverse effects compared to intrathecal (IT) morphine.

METHODS:

The primary outcome was total IV morphine consumption during 0–48 hours postoperatively. Secondary outcomes included time until first patient-controlled analgesia (PCA) demand, pain scores, and adverse opioid effects. After institutional review board approval, 71 subjects undergoing posterior spinal fusion for idiopathic scoliosis completed the study. The subjects were randomly allocated to 7.5 μg/kg IT morphine or 150 μg/kg EREM. The final IT morphine and EREM groups contained 37 and 34 subjects, respectively. Postoperative pain was treated with morphine PCA, ketorolac, oral oxycodone, and acetaminophen. Morphine consumption, pain scores, nausea and vomiting, pruritus, and respiratory depression were measured every 4 hours. Parents completed a caregiver questionnaire about their child’s pain control regimen after the first postoperative day.

RESULTS:

There was no difference in total morphine consumption over the first 48 hours between subjects in the EREM and IT morphine groups: median (range) 42.2 (5.5–123.0) and 34.0 (4.5–128.8) mg, respectively (P = .27). EREM and IT morphine groups had no difference in time until first PCA demand. Pain scores were no different between the groups from 8 to 24 hours after surgery. Compared to IT morphine, EREM subjects had lower pain scores from 28 to 36 hours after surgery. The reported incidence of pruritus was lower in the EREM subjects.

CONCLUSIONS:

There was no difference in total morphine consumption or time until first PCA demand between the EREM and IT morphine groups. EREM provides a longer duration of analgesia after posterior spinal fusion for scoliosis and may be associated with less opioid-induced pruritus.
Between the Interior and the Artifactual: Reading the Ci Space
Authors: Chen Lei
Published: April 2017

This article ventures a new approach to capture the subtlety of the shi/ci distinctions by reading and comparing the representation of space in shi and ci, an approach that avoids traditional Chinese impressionism, on the one hand, and superficial Western formalism, on the other. The author focuses on two basic loci of “private” space as represented in shi and ci, the boudoir and garden—one sexualized, forbidden, and private, and the other natural, culturally sanctioned, and constructed, but also private in certain ways regarding ownership. These two major categories alone, though not sufficient to cover the entire spectrum of the ci space, could provide a meaningful framework to show how the generic qualities of ci are most sharply and immediately distinguished as effects of a lyrical construction of certain “private” space.
Survival of Listeria Monocytogenes in Tomato Juice at 5 and 30°C Storage
Authors: Diakogiannis Ioannis , Proestos Charalampos , Varzakas Theodoros , Markaki Panagiota
Published: April 2017

Listeria monocytogenes is a food-borne pathogen and has been associated with a variety of food products including fruits and vegetables, which are important for a healthy human diet. L. monocytogenes survives and grows at low temperatures and thus it can be multiplied to dangerous levels in a product which is kept at refrigeration temperatures. This work examines the ability of L. monocytogenes to survive, in a product of high consumption frequency, such as tomato juice, in correlation to storage temperature. The results indicate that a significant number of cells survived in tomato juice whether the storage temperature was 30°C or 5°C, although the refrigerator temperature slightly reduces the survival of L. monocytogenes cells. An understanding of the cold stress response of the pathogen will be helpful in the design of effective methods to control L. monocytogenes in freezing foods in order to provide consumers with a safe product.