bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammation and cancer: The role of the human neutrophil
Authors: Anderson Ronald , Tintinger Gregory R. , Feldman Charles
Published: February 2014

Chronic inflammation of both infective and non-infective origin has been implicated in the aetiology of

approximately 30% of all human epithelial malignancies. The primary carcinogens are reactive oxygen species

(ROS) derived from activated, infiltrating cells of the innate immune system, especially neutrophils, which

inflict oxidative damage on the DNA of bystander epithelial cells. The consequence is gene modifications which

initiate cellular transformation. The process of tumourigenesis is exacerbated by the sustained generation of

pro-proliferative ROS, as well as by the release of neutrophil-derived cytokines and proteases, all of which

contribute to tumour promotion and progression. It is now well recognised that, in addition to inflammation

causing cancer, many cancers per se induce an inflammatory response, with a high magnitude of neutrophil

influx being indicative of a poor prognosis. In this setting, CXC chemokines produced by tumours not only

promote neutrophil influx and hyperreactivity, but also cause autocrine activation of the proliferation of the

chemokine-producing tumour cells. These various mechanisms of inflammation-mediated tumourigenesis

are the primary focus of this review, together with a consideration of neutrophil-targeted anti-inflammatory

strategies with potential as adjunctive cancer therapy.
Quality assurance of diaphragm walls by sonar measurements – model study
Authors: Niederleithinger Ernst , Ranz Garcia Javier
Published: February 2014

Diaphragm walls are used to provide a stable and water-tight confinement for the construction of tunnels, underground railway stations, deep basements and other structures requiring deep excavations. These walls consist of individual panels, cast piece-wise in the ground, separated by water-tight joints. There are several methods to improve the water tightness of these joints, including rubber bands, metal sheets or precast concrete elements. In most cases, diaphragm walls perform very well. Quality problems, which occur in a few occasions, may be due to uncontrolled concrete flow between the joints, unexpected geological conditions or poor workmanship. Different methods of quality assurance are applied on construction sites. Sonar instruments can be used in a bentonite-filled trench to evaluate the shape of the excavation. An improved prototype instrument has been developed, including digital data-processing features, which allow the detection of even small anomalies at the stop-end surface before concreting the adjacent panel. The sonar sensor can be used in depths up to 200 m. Model experiments show that a centimetre resolution can be achieved. Set-up, model experiments and their results are shown. The prototype might be the basis of an easy-to-use commercial device.
Comparison of CANWET and HSPF for water budget and water quality modeling in rural Ontario
Authors: Ahmed Syed I. , Singh Amanjot , Rudra Ramesh , Gharabaghi Bahram
Published: February 2014

This study comparatively evaluates the Hydrological Simulation Program-FORTRAN (HSPF) model and the Canadian ArcView Nutrient and Water Evaluation Tool (CANWET) for non-point source pollution (NPS) management in rural Ontario watersheds. Both models were calibrated, validated, and applied to a 52 km2 headwater rural watershed known as the Canagagigue Creek near Elmira in the Grand River basin, Ontario, Canada. A comparison of the simulated and observed values for stream flow, surface runoff, subsurface runoff, evapotranspiration, and sediment yield showed that (Better Assessment Science Integrating Point and Nonpoint Sources) BASINS/HSPF and CANWET models have similar capabilities to simulate various hydrological processes at the watershed scale. The seasonal stream flow comparison between observed and simulated values from HSPF and CANWET showed Nash-Sutcliffe efficiency (Nash-E) coefficients of 0.80 and 0.72, respectively. The monthly comparison between the simulated and observed stream flow yielded Nash-E coefficients of 0.88 and 0.94 for HSPF and CANWET, respectively. Overall, both models predicted the components of the annual, seasonal, and monthly water budget accurately. There was a considerable difference in the monthly simulated sediment yield by both models. This difference is consistent with the surface runoff variation predicted by both models. Both models predicted sediment yield with early winter and spring storms which is typical for southern Ontario.
Protecting our Great Lakes: assessing the effectiveness of wastewater treatments for the removal of chemicals of emerging concern
Authors: Arvai Antonette , Klecka Gary , Jasim Saad , Melcer Henryk , Laitta Michael T.
Published: February 2014

The Great Lakes and their connecting channels form the largest fresh surface water system on earth. Over the past 10 years, focus on environmental monitoring has shifted to an array of recently discovered compounds known as ‘chemicals of emerging concern’ (CEC). These chemicals are found in products used daily in households, businesses, agriculture and industry, such as flame retardants, pharmaceuticals, personal care products, and pesticides. Wastewater treatment plants are among the important pathways by which CEC enter the Great Lakes, with concentrations highest in the vicinity of wastewater discharges. Treated sewage is often discharged into the nearshore waters, which also provide a source of drinking water to the public. In 2009–2011, the International Joint Commission addressed the need to assess the effectiveness of existing wastewater treatment technologies in the basin to remove CEC, as well as to gain insight on potential advanced technologies to improve their removal. This assessment encompassed three major activities, development of an inventory of municipal wastewater treatment plants that discharge in the basin; a survey of detailed operational data for selected wastewater facilities; and a comprehensive literature review and analysis of the effectiveness of various wastewater treatment technologies to remove chemicals of emerging concern.
Political Learning among Youth: Exploring Patterns of Students' First Political Awakening
Authors: Solhaug Trond , Kristensen Niels Nørgaard
Published: February 2014

This article focuses on students' first political learning and explores the research question, ‘What dynamic patterns of political learning can be explored among a sample of young, diverse Danish students' first political interests?’ The authors use theories of learning in their analytical approach to students' stories. A group of 10 young students who claimed a certain political interest and attended a social studies course in Danish upper secondary school were selected for interview. A ‘life story approach’ was used in the interviews and in the analytical approach. The findings show that, contrary to many ‘single-agent’ studies in the tradition of political socialisation, all of the students display a complex pattern of political influence. The influence from various agents like school, family, the media and peers is also rather complex. The students are not passive recipients of influence, but active constructors of their political life. Their emotions and social environment are highly important for their political orientation. It is recommended that further research focus on dynamic learning and arenas for political learning, rather than on ‘single-agent’ studies. Recommendations for teaching are made.
Community Involvement in School Management in Portugal
Authors: Veloso Luísa , Craveiro Daniela , Rufino Isabel
Published: February 2014

This article discusses the ways in which the community is involved in Portuguese school management. It is based on an analysis of the external evaluation reports of 298 Portuguese schools for the academic years 2006–07, 2007–08 and 2008–09. The corpus analysed allowed the identification of two main aspects of the participation processes: (1) local community involvement in school life and (2) the processes and limitations on the involvement of two groups of actors – parents/guardians and pupils. Although the growing involvement of different actors in school management activities has been verified, the participation processes are not consolidated in the same way in different school organisations and in the different territories in which they are located. The presence and involvement of different actors in the schools studied is congruent with a larger understanding of the school community including pupils, teachers, parents/guardians and other actors from the local community to which the school belongs. This involvement increasingly implies in-depth knowledge of the construction processes of cultural learning taking place in school organisations.
Insulin Resistance Modulates Iron-Related Proteins in Adipose Tissue
Authors: Moreno-Navarrete José María , Novelle Marta G. , Catalán Victoria , Ortega Francisco , Moreno Maria , Gomez-Ambrosi Javier , Xifra Gemma , Serrano Marta , Guerra Ester , Ricart Wifredo , Frühbeck Gema , Diéguez Carlos , Fernández-Real José Manuel
Published: February 2014

OBJECTIVE

Circulating markers of iron overload are associated with insulin resistance. Less is known about the impact of iron overload on adipose tissue (AT). We hypothesized that gene expression markers of iron metabolism in AT could be associated with insulin action.

RESEARCH DESIGN AND METHODS

The AT expression of ferroportin (SLC40A1), transferrin (TF), TF receptor (TFRC), ferritin (FT) heavy polypeptide 1 (FTH1), and FT light polypeptide (FTL) was analyzed cross-sectionally in three independent cohorts and also after weight loss–induced changes in insulin sensitivity (clamp M value) in an independent fourth cohort.

RESULTS

In human AT, TF mRNA and protein levels were decreased with obesity and insulin resistance in the three cohorts and were positively associated with adipogenic mRNAs and insulin action. Otherwise, FTL mRNA and protein and SLC40A1 transcripts were positively associated with BMI and negatively linked to adipogenic genes and insulin action. Bariatric surgery–induced weight loss led to increased TF and decreased TFRC, FTH1, FTL, and SLC40A1 in subcutaneous AT in parallel to improved insulin action.

CONCLUSIONS

These results suggest that iron overload impacts on AT in association with insulin resistance.
Viewing Vehicular Violence through a Wide Angle Lens: Contributing Factors and a Proposed Framework
Authors: Carroll Linda J. , Rothe J. Peter
Published: February 2014

Although vehicular violence is prevalent in North America, it is difficult to document because it is typically recorded as a violent act, without reference to the use of a vehicle, or as an “accident” or a traffic violation. It occurs anywhere in the motor vehicle transportation system when the vehicle is intentionally used as a weapon; as the supporting environment for violent acts; or as a platform for creating suffering, injury, or death. Vehicular violence can be directed outward, as, for example, in a carjacking or physical assault; or inward, as in deliberately crashing a vehicle in a suicide act. Common targets of vehicular violence include police officers and transportation workers like taxi drivers. Vehicles are also used as platforms for sexual assault or drive-by shootings. Social, psychological, and traffic-specific conditions contribute to vehicular violence; for example, competition for the roadway, stress, depression, anger, rage, vengefulness, and alcohol consumption. In the present article, a proposed framework for viewing vehicular violence is presented with three zones of immediacy – the mediate (tangential use of the vehicle in the violent act), intermediate (where the vehicle is used to facilitate the violence), and immediate (where the vehicle is the actual weapon). These zones reflect a continuum that reflects the proximity of the vehicle to the aggressive intent.
Factors Associated with High-Frequency Cannabis Use and Driving among a Multi-site Sample of University Students in Ontario
Authors: Fischer Benedikt , Ivsins Andrew , Rehm Jürgen , Webster Cheryl , Rudzinski Katherine , Rodopoulos Jenny , Patra Jayadeep
Published: February 2014

Cannabis use and driving (CUD) is a growing public health concern. This study’s main objective was to identify distinguishing characteristics associated with high-frequency CUD (HFCUD) activity (i.e., CUD > 12 times) in a multi-site sample of university students who had self-identified as having driven a car within 4 hours of cannabis use in the past year. Participants for the study (n = 248; age 18–28 years) were recruited by mass advertising at five universities in Ontario. Participants were screened for eligibility and assessed by an anonymous interview between April 2005 and March 2006. Bivariate analyses determined factors associated with HFCUD (i.e., > 12 times) vs. a low frequency of CUD (LFCUD); significant factors were subsequently entered into a discriminant function analysis model. HFCUD was associated with several variables, including frequent (i.e., at least weekly) cannabis use; daily driving; perception of own ability to drive not being impaired by cannabis use; and expectation of CUD in the next 12 months (all p < 0.0001). CUD among young drivers is an important health and safety risk requiring effective interventions. Given the strong association of HFCUD with frequent cannabis use, these phenomena need to be addressed conjointly. Furthermore, preventive interventions responsive to the specific socio-cultural contexts of possible CUD need to be developed and implemented.
Impact of Ontario’s Remedial Program for Drivers Convicted of Drinking and Driving on Substance Use and Problems
Authors: Stoduto Gina , Mann Robert E. , Flam-Zalcman Rosely , Sharpley Justin , Brands Bruna , Butters Jennifer , Smart Reginald G. , Wickens Christine M. , Ilie Gabriela , Thomas Rita K.
Published: February 2014

In 1998, Ontario passed legislation requiring that all drivers convicted of drinking and driving complete a remedial program, called Back on Track (BOT), before their driver’s licences could be reinstated. Based on an assessment, clients are assigned to complete either an “education” program or a “treatment” program, depending on levels of substance-related problems. Several months following completion of their program, participants complete a follow-up interview. We report substance use and related outcome measures on 22,277 BOT participants who completed follow-up between 2000 and 2005. Completion of BOT was associated with significant reductions in the frequency of alcohol and other drug use, number of drinks consumed per drinking occasion, total numbers of substance users, and negative consequences resulting from substance use. A large number of participants became “non-users” of various substances over the course of the program. These findings provide evidence that the remedial program has beneficial effects for participants in both the education and treatment components of BOT.
Cannabis Impaired Driving: An Evaluation of Current Modes of Detection
Authors: Owusu-Bempah Akwasi
Published: February 2014

Due to the growing concern with motorists driving under the influence of drugs, the Canadian government has recently implemented legislation to tackle this issue. The new legislation compels drivers to submit to a series of tests, by a police officer, if/when a motorist is suspected of drug impairment. The aim of this paper is to present a review of scientific studies that have evaluated the effectiveness of three methods to detect cannabis use in motorists. These methods include the Drug Evaluation and Classification (DEC) Program, on-site oral fluid screening devices, and on-site urine screening devices. Only studies that included appropriate measures of reliability (i.e., sensitivity, specificity, and accuracy) were included in this review. Given their increasing reliability, on-site oral fluid devices appear to show the most promise for the detection of cannabis use in motorists. Despite the promising results, however, there is still a need to establish standard levels of impairment for cannabis, like the blood alcohol content (BAC) cut-off levels for alcohol, before these devices can be meaningfully utilized and implemented.
Parental Ease in Asking Others Not to Smoke and Respiratory Symptoms and Illness among Children
Authors: Spangler John , Csákányi Zsuzsanna , Rogers Todd , Katona Gábor
Published: February 2014

Objective: Childhood exposure to secondhand tobacco smoke (SHS) increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods: The study was performed at the Heim Pal National Children’s Hospital, Ear, Nose and Throat (ENT) Department (Budapest, Hungary) from July to November, 2010. A consecutive series of children’s caregivers were approached to participate in a survey measuring household smoking bans, upper and lower respiratory tract symptoms and illnesses, and socioeconomic factors. Bivariate and multivariate logistic regression analyses were performed. Results: Of the 215 caregivers recruited for the study, 208 agreed to participate (response rate of 96.7%). More than half of the children were male (54%), and 39% lived in a household with at least one member who smoked. Smoking was frequently banned inside the car (91.3%) and home (85.1%). Respondents felt it easiest to ask friends (97.1%) and family members not living in the household (98.1%) to refrain from smoking inside the home. Respondents also found it easier to ask a stranger (81.7%) or a family member (61.1%) not to smoke around the child. Logistic regression showed that respondents for children with a history of pneumonia found it less difficult to ask visitors in the home not to smoke compared to children without pneumonia (OR = 0.23, 95% CI = 0.06–0.98). Conversely, respondents for children who had had adenoidectomy found it over three times more difficult to ask strangers not to smoke near the child compared to those of children without adenoidectomy (OR = 3.20, 95% CI = 1.43–6.38). Conclusions: In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS. The ease with which caregivers felt towards asking others not to smoke predicted specific respiratory conditions. Since the ENT clinic offers a wonderful opportunity for clinicians to counsel parents on tobacco cessation, increased tobacco education of these providers is needed.
The Influence of Centre-Based Childcare on Preschoolers’ Physical Activity Levels: A Cross-Sectional Study
Authors: Vanderloo Leigh , Tucker Patricia , Johnson Andrew , Van Zandvoort Melissa , Burke Shauna , Irwin Jennifer
Published: February 2014

The childcare environment represents an appropriate avenue to support physical activity among preschoolers. The aim of this study was two-fold: (1) to measure the physical activity levels of a sample of preschoolers during childcare hours; and (2) to assess which attributes (e.g., space, equipment, policies) within centre-based childcare environments influenced physical activity. Thirty-one preschoolers from 5 childcare centres across London, Canada participated. Actical accelerometers were worn by participants for one day during childcare hours to assess activity levels using a 15 second epoch length. The Environment and Policy Assessment and Observation instrument was used to conduct a full-day evaluation of the childcare environment. On average, participants engaged in 1.54 min/h of moderate-to-vigorous physical activity and 17.42 min/h of total physical activity. Sedentary opportunities, portable and fixed play equipment, and staff behaviour accounted for 49.3% of the variability in moderate-to-vigorous physical activity and 14.1% of the variability in total physical activity, with sedentary opportunities, fixed play equipment, and staff behaviours displaying an inverse relationship. Results emphasize the critical role the childcare environment plays in supporting physical activity among preschoolers.
Isolation and Molecular Characterization of Biofouling Bacteria and Profiling of Quorum Sensing Signal Molecules from Membrane Bioreactor Activated Sludge
Authors: Lade Harshad , Paul Diby , Kweon Ji
Published: February 2014

The formation of biofilm in a membrane bioreactor depends on the production of various signaling molecules like N-acyl homoserine lactones (AHLs). In the present study, a total of 200 bacterial strains were isolated from membrane bioreactor activated sludge and screened for AHLs production using two biosensor systems, Chromobacterium violaceum CV026 and Agrobacterium tumefaciens A136. A correlation between AHLs production and biofilm formation has been made among screened AHLs producing strains. The 16S rRNA gene sequence analysis revealed the dominance of Aeromonas and Enterobacter sp. in AHLs production; however few a species of Serratia, Leclercia, Pseudomonas, Klebsiella, Raoultella and Citrobacter were also identified. The chromatographic characterization of sludge extract showed the presence of a broad range of quorum sensing signal molecules. Further identification of sludge AHLs by thin layer chromatography bioassay and high performance liquid chromatography confirms the presence of C4-HSL, C6-HSL, C8-HSL, 3-oxo-C8-HSL, C10-HSL, C12-HSL, 3-oxo-C12-HSL and C14-HSL. The occurrence of AHLs in sludge extract and dominance of Aeromonas and Enterobacter sp. in activated sludge suggests the key role of these bacterial strains in AHLs production and thereby membrane fouling.
Detoxification of Toxic Phorbol Esters from Malaysian Jatropha curcas Linn. Kernel by Trichoderma spp. and Endophytic Fungi
Authors: Najjar Azhar , Abdullah Norhani , Saad Wan , Ahmad Syahida , Oskoueian Ehsan , Abas Faridah , Gherbawy Youssuf
Published: February 2014

The presence of phorbol esters (PEs) with toxic properties limits the use of Jatropha curcas kernel in the animal feed industry. Therefore, suitable methods to detoxify PEs have to be developed to render the material safe as a feed ingredient. In the present study, the biological treatment of the extracted PEs-rich fraction with non-pathogenic fungi (Trichoderma harzianum JQ350879.1, T. harzianum JQ517493.1, Paecilomyces sinensis JQ350881.1, Cladosporium cladosporioides JQ517491.1, Fusarium chlamydosporum JQ350882.1, F. chlamydosporum JQ517492.1 and F. chlamydosporum JQ350880.1) was conducted by fermentation in broth cultures. The PEs were detected by liquid chromatography-diode array detector-electrospray ionization mass spectrometry (LC-DAD-ESIMS) and quantitatively monitored by HPLC using phorbol-12-myristate 13-acetate as the standard. At day 30 of incubation, two T. harzianum spp., P. sinensis and C. cladosporioides significantly (p < 0.05) removed PEs with percentage losses of 96.9%–99.7%, while F. chlamydosporum strains showed percentage losses of 88.9%–92.2%. All fungal strains could utilize the PEs-rich fraction for growth. In the cytotoxicity assay, cell viabilities of Chang liver and NIH 3T3 fibroblast cell lines were less than 1% with the untreated PEs-rich fraction, but 84.3%–96.5% with the fungal treated PEs-rich fraction. There was no inhibition on cell viability for normal fungal growth supernatants. To conclude, Trichoderma spp., Paecilomyces sp. and Cladosporium sp. are potential microbes for the detoxification of PEs.
Inhibitory Activity of Synthesized Acetylated Procyanidin B1 Analogs against HeLa S3 Cells Proliferation
Authors: Okamoto Syuhei , Ishihara Sayaka , Okamoto Taisuke , Doi Syoma , Harui Kota , Higashino Yusuke , Kawasaki Takashi , Nakajima Noriyuki , Saito Akiko
Published: February 2014

Proanthocyanidins, also known as condensed tannins and/or oligomeric flavonoids, occur in many edible plants and have various interesting biological activities. Previously, we reported a synthetic method for the preparation of various procyanidins in pure form and described their biological activities. Here, we describe the synthesis of procyanidin B1 acetylated analogs and discuss their inhibition activities against HeLa S3 cell proliferation. Surprisingly, the lower-unit acetylated procyanidin B1 strongly inhibited the proliferation of HeLa S3 cells. This molecule showed much stronger inhibitory activity than did epigallocatechin-3-O-gallate (EGCG), green tea polyphenol, and dimeric compounds that included EGCG as a unit. This result suggests that the phenolic hydroxyl groups of the upper-units in flavan-3-ols are important for their inhibitory activity against cancer cell proliferation and that a hydrophobic lower unit dimer enhances this activity.
More than 97% of Human Papilloma Virus Type 16 (HPV-16) was Found with Chrysotile Asbestos & Relatively Smooth Round Tumor Outline, and Less than 3% was found with HPV-18 and Tremolite Asbestos & Irregular Sawtooth-like Zigzag Outline in Breast Cancer Tissues in Over 500 Mammograms
of Female Patients: Their Implications in Diagnosis, Treatment, and Prevention of Breast Cancer
Authors: Omura Yoshiaki , Jones Marilyn K , Nihrane Abdallah , Duvvi Harsha , Shimotsuura Yasuhiro , Ohki Motomu
Published: February 2014

In the past, Human Papillomavirus Type 16 (HPV-16) was considered to be the main cause of cancer in the oropharynx and genital organs. Cervical cancer of the uterus is the most well-known cancer associated with HPV-16. Among the oncogenic HPVs, types 16 and 18 are most responsible for
the majority of the HPV-caused cancers. Recently, using EMF Resonance Phenomenon between 2 identical substances, we non-invasively measured HPV-16 and HPV-18 among 25 physicians and 25 dentists and found that all 50 have HPV-16 in oral cavities and oropharynx but not HPV-18. However most dentists
have a stronger infection than physicians. Among them were 2 female dentists with breast cancer containing HPV-16 and strong infections of HPV-16 in the oral cavities and oropharynx. When the author checked their breast cancer positive areas as well as the mammograms of cancer positive areas,
Chrysotile Asbestos co-existed with an infection of HPV-16. We then examined over 500 published mammograms of women with malignant breast cancer published by other institutes, and we found HPV-16 in more than 97% and HPV-18 in less than 3% of the breast cancer mammograms examined. Less than
0.4% of cases were found as a variety of combination of HPV-16 & HPV-18. We also discovered that breast cancer with HPV-16 always co-exists with increased Chrysotile Asbestos deposits, and the outline of the breast cancer positive area is a relatively smooth and round or oval shape, and
breast cancer with HPV-18 always co-exists with increased Tremolite Asbestos, where the tumor outline is an irregular saw-tooth like zigzag pattern. Based on these findings, better methods of diagnosis, treatment and prevention with a vaccine can be developed.
Exit-Site Infection of Peritoneal Catheter is Reduced by the Use of Polyhexanide. Results of a Prospective Randomized Trial
Authors: Núñez-Moral M. , Sánchez-Álvarez E. , González-Díaz I. , Peláez-Requejo B. , Fernández-Viña A. , Quintana-Fernández A. , Rodríguez-Suárez C.
Published: February 2014

Background

One of the most common and severe complications affecting peritoneal dialysis (PD) patients is exit-site infection of the peritoneal catheter; it is therefore of vital importance to prevent it. This complication has a negative impact on the success of the technique. In spite of this, there are no clear guidelines concerning how to take care of the exit site. The objective of this study was to assess the efficacy of polyhexanide in preventing exit-site infection over a 12-month period.

Methods

We designed a single-center, prospective, open-labeled, randomized controlled clinical trial with parallel groups. Requirements for participation in the study included implantation of the peritoneal catheter at least six weeks before entering the study and no infectious complications requiring either hospital admission or antibiotic treatment for at least three months before entering into the study. Patients were randomized to be daily cured as follows: Group A: traditional care with saline serum and povidone-iodine; and Group B: polyhexanide solution. Exit sites were evaluated at baseline and every four to six weeks or if any event occurred, according to the Twardowski criteria.

Results

Of the 60 included patients, 46 completed the 12-month follow-up period. Six underwent transplantation, five died and three were transferred to hemodialysis (HD). The treatment was well tolerated, with no side effects nor abandonments due to such effects. Throughout the study period, six patients (20%) undergoing traditional care and only two (6,7%) receiving polyhexanide developed an exit-site infection ( p = 0.032). There were a total number of 12 infections; nine occurred in patients following the traditional approach and only three in patients treated with polyhexanide ( p = 0.037). The germs responsible for the infections were: S. aureus (six cases), Corynebacterium jeikeium (two cases) and P. aeruginosa (one case) in the saline serum and povidone-iodine group and P. aeruginosa (three cases) in the polyhexanide group. The mean rate of exit-site infection was 1 episode/36.6 patient-months for the traditional care group and 1 episode/102.7 patient-months for the polyhexanide group ( p = 0.017). Patients following the traditional treatment required fewer days to get infected than those using polyhexanide ( p = 0.033; log rank: 4.2).

Conclusions

These results show that using polyhexanide is efficient for the prevention of exit-site infections. Patients treated with this product suffer from fewer infections and need more time to become infected. Polyhexanide application is painless, no allergies have been described and it is well tolerated by patients. We therefore propose that it may be used routinely from now on for the care of healthy exit site.
Can Dialysis Patients be Accurately Identified using Healthcare Claims Data?
Authors: Taneja Charu , Berger Ariel , Inglese Gary W. , Lamerato Lois , Sloand James A. , Wolff Greg G. , Sheehan Michael , Oster Gerry
Published: February 2014

Background

While health insurance claims data are often used to estimate the costs of renal replacement therapy in patients with end-stage renal disease (ESRD), the accuracy of methods used to identify patients receiving dialysis — especially peritoneal dialysis (PD) and hemodialysis (HD) — in these data is unknown.

Methods

The study population consisted of all persons aged 18 – 63 years in a large US integrated health plan with ESRD and dialysis-related billing codes (i.e., diagnosis, procedures) on healthcare encounters between January 1, 2005, and December 31, 2008. Using billing codes for all healthcare encounters within 30 days of each patient's first dialysis-related claim (“index encounter”), we attempted to designate each study subject as either a “PD patient” or “HD patient.” Using alternative windows of ± 30 days, ± 90 days, and ± 180 days around the index encounter, we reviewed patients’ medical records to determine the dialysis modality actually received. We calculated the positive predictive value (PPV) for each dialysis-related billing code, using information in patients’ medical records as the “gold standard.”

Results

We identified a total of 233 patients with evidence of ESRD and receipt of dialysis in healthcare claims data. Based on examination of billing codes, 43 and 173 study subjects were designated PD patients and HD patients, respectively (14 patients had evidence of PD and HD, and modality could not be ascertained for 31 patients). The PPV of codes used to identify PD patients was low based on a ± 30-day medical record review window (34.9%), and increased with use of ± 90-day and ± 180-day windows (both 67.4%). The PPV for codes used to identify HD patients was uniformly high — 86.7% based on ± 30-day review, 90.8% based on ± 90-day review, and 93.1% based on ± 180-day review.

Conclusions

While HD patients could be accurately identified using billing codes in healthcare claims data, case identification was much more problematic for patients receiving PD.
Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients
Authors: Tang Wen , Grace Blair , McDonald Stephen P. , Hawley Carmel M. , Badve Sunil V. , Boudville Neil C. , Brown Fiona G. , Clayton Philip A. , Johnson David W.
Published: February 2014

♦Background

The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis.

♦Methods

Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO).

♦Results

7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 – 9; IRSD deciles 4 – 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer.

♦Conclusions

In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories.
Living with Encapsulating Peritoneal Sclerosis (Eps): The Patient's Perspective
Authors: Hurst Helen , Summers Angela , Beaver Kinta , Caress Ann-Louise
Published: February 2014

Background

Although relatively rare, encapsulating peritoneal sclerosis (EPS) is nonetheless a major concern within the renal community. Risk of developing EPS is associated with long-term peritoneal dialysis (PD). High mortality was previously reported, although surgery has since improved outcomes. Research into EPS focuses on imaging and early detection methods, genetics, biomarkers and preventive strategies. No previous studies have examined patients’ experiences of EPS.

Aims

The aim of the present study was to explore the experience of patients who have undergone surgery for EPS in one center in the North of England.

Methods

A qualitative phenomenological approach, involving in-depth interviews, was adopted. Nine participants were recruited out of a total of 18 eligible. Most participants were interviewed twice over a 12-month period (October 2009 to October 2010).

Analysis

Interpretive data analysis was conducted, following the philosophical tradition of hermeneutics, to draw out themes from the data. Data collection and analysis took place concurrently and participants were sent a summary of their first interview to allow a period of reflection prior to the subsequent interview.

Results

EPS presented the most serious challenge participants had faced since developing chronic kidney disease (CKD). Three major themes were identified, each with subcategories. The key issues for patients were related to identification of early symptoms and lack of understanding. The patients’ sense of ‘not being heard’ by health care professionals led to a loss of trust and enhanced their feelings of uncertainty. The enormity of the surgery, the suffering, and what they had to endure had an enormous impact, but an overriding aspect of this experience was also the loss they felt for their independence and for the PD therapy over which they had control.

Conclusions

The findings of this study highlight a number of important issues relevant to clinical practice, including lack of information and understanding of EPS, particularly its early symptoms At the time patients transfer from peritoneal to hemodialysis, the provision of adequate information about the risks and potential early signs of EPS may not only improve their experiences, but may also assist in early detection.
Predictors of Residual Renal Function Decline in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Authors: Szeto Cheuk-Chun , Kwan Bonnie Ching-Ha , Chow Kai-Ming , Chung Sebastian , Yu Vincent , Cheng Phyllis Mei-Shan , Leung Chi-Bon , Law Man-Ching , Li Philip Kam-Tao
Published: February 2014

Background

Residual renal function (RRF) is an important prognostic indicator in continuous ambulatory peritoneal dialysis (CAPD) patients. We determined the predictors of RRF loss in a cohort of incident CAPD patients.

Methods

We reviewed the record of 645 incident CAPD patients. RRF loss is represented by the slope of decline of residual glomerular filtration rate (GFR) as well as the time to anuria.

Results

The average rate of residual GFR decline was -0.083 ± 0.094 mL/min/month. The rate of residual GFR decline was faster with a higher proteinuria (r = -0.506, p < 0.0001) and baseline residual GFR (r = -0.560, p < 0.0001). Multivariate analysis showed that proteinuria, baseline residual GFR, and the use of diuretics were independent predictors of residual GFR decline. Cox proportional hazard model showed that proteinuria, glucose exposure, and the number of peritonitis episodes were independent predictors of progression to anuria, while a higher baseline GFR was protective. Each 1 g/day of proteinuria is associated with a 13.2% increase in the risk of progressing to anuria, each 10 g/day higher glucose exposure is associated with a 2.5% increase in risk, while each peritonitis episode confers a 3.8% increase in risk.

Conclusions

Our study shows that factors predicting the loss of residual solute clearance and urine output are different. Proteinuria, baseline residual GFR, and the use of diuretics are independently related to the rate of RRF decline in CAPD patients, while proteinuria, glucose exposure, and the number of peritonitis episodes are independent predictors for the development of anuria. The role of anti-proteinuric therapy and measures to prevent peritonitis episodes in the preservation of RRF should be tested in future studies.
Viridans Streptococci in Peritoneal Dialysis Peritonitis: Clinical Courses and Long-Term Outcomes
Authors: Chao Chia-Ter , Lee Szu-Ying , Yang Wei-Shun , Chen Huei-Wen , Fang Cheng-Chung , Yen Chung-Jen , Chiang Chih-Kang , Hung Kuan-Yu , Huang Jenq-Wen
Published: February 2014

Background

The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear.

Methods

We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined.

Results

A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01).

Conclusions

VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes.
ON THE RELATIONSHIP BETWEEN KNOWLEDGE CREATION AND ECONOMIC PERFORMANCE
Authors: VILA Luis E. , CABRER Bernardí , PAVÍA Jose M.
Published: February 2014

An empirical two-equation dynamic panel-data model system with fixed effects is proposed to analyze the relationship between knowledge creation and economic performance across regions over time. Estimates of the model for Spanish regions show that (i) knowledge creation depends on local R&D effort, on the amount of knowledge in use, and on knowledge creation in neighboring regions; and (ii) assimilation of new knowledge depends on local knowledge creation and on assimilation of knowledge in neighboring regions. Both processes include region-specific context fixed effects and region-specific time effects, representing region-specific dynamic influences. The results imply that (a) efficiency gains at regional level may be achieved by investing locally in the creation of new knowledge, either technological or organizational; (b) creation of knowledge in a region may be promoted by using greater amounts of already existing knowledge, as well as by increasing local R&D effort; (c) both knowledge creation and knowledge assimilation spread to/from neighboring regions; and (d) regional contexts influence both knowledge creation and knowledge assimilation separately.
INSTALLATION OF FINE-GRAINED ORGANIC DREDGED MATERIALS IN COMBINATION WITH GEOSYNTHETICS IN THE GERMAN DREDGDIKES RESEARCH DIKE FACILITY
Authors: Cantré Stefan , Saathoff Fokke
Published: February 2014

In the project DredgDikes with partners from Poland and Germany different dredged materials from the South Baltic Sea region are investigated with respect to their application in dike construction. Two large-scale experimental dikes have been built, one in Germany and one in Poland. Additionally, an extensive laboratory testing programme has been realised and a considerable monitoring test programme will be followed. Based on a short general description of the project this paper covers the issue of installation technology for the dredged materials used and a discussion of geotechnical parameters to be determined for material evaluation and quality control. Due to the high and variable natural water contents of the organic soils together with their inhomogenous composition the compactability is difficult to predict and proctor values may not be reliably determined. During the installation three different compaction technologies were compared and no extreme differences could be found, which is why the compaction with a caterpillar was chosen for efficiency on site. The critical analysis of the data, however, shows slightly better compaction results for the roller compactors. In general the degree of compaction was comparably low. Therefore, different possibilities to improve compaction are discussed in this paper, such as the homogenisation of the dredged material by simple in situ mixing technologies, which will be issues for further research.
THE BEHAVIOR OF COLD FORMED STEEL STRUCTURE CONNECTIONS / ŠALTAI FORMUOTŲ PLIENINIŲ KONSTRUKCIJŲ MAZGŲ ELGSENA
Authors: Bučmys Žilvinas , Šaučiuvėnas Gintas
Published: February 2014

Nowadays, there is a growing tendency in the use of cold formed constructions, which may be explained by good strength to cost ratio. Thus, the goal of this paper is to review the behaviour of cold formed steel connection. The article reviews most up to date publications on testing and description of beam-tobeam, beam-to-column and truss connections. In brief, the properties of cold formed steel connections have been found to be semi rigid, where the main factor affecting stiffness is bearing forces around the bolthole. The article also focuses on the technique to increase stiffness of cold formed connections.

Santrauka

Apžvelgti mokslinės literatūros Šaltiniai apie Šaltai formuotų profiliuočių naudojimą ir jų jungtis. Kadangi Šie profiliuočiai yra gerų stiprumo savybių ir pigiau atsieina, tad nūdienos statyboje taikomi vis dažniau. Apibendrinami naujausi sijos su sija, sijos ir kolonos bei santvaros mazgų elgsenos tyrimai. Šaltai formuotų elementų jungčių elgsena yra kaip pusiau standžių mazgų. Pagrindinis veiksnys, turintis įtaką mazgo standžiui, yra varžtų glemžiamasis poveikis plonasienių elementų skerspjūvių sienelei. Pateikiama rekomendacijų, kaip didinti Šaltai formuotų profiliuočių jungčių standumą.
INTERACTION BETWEEN SANDY DEPOSITS AND MULTIMOLECULAR ORGANIC SOLUTIONS BY STABILISATION OF SOIL / SĄVEIKA TARP SMĖLIO NUOSĖDŲ IR DAUGIAMOLEKULIŲ ORGANINIŲ TIRPALŲ STABILIZUOJANT GRUNTĄ
Authors: Mackevičius Rimantas
Published: February 2014

The paper presents the state of the art in grouting technologies for underpinning of old foundations, the analysis of grouting with multimolecular organic solutions and the results of investigations of dispersive soils stabilised with organic polymers over a period of one year. It describes the comparison between properties of unmodified carbamide resins and properties of modified carbamide resins. The following properties of resin solutions were investigated: density, viscosity, pH (alkalinity level) and evaporation of components from solution. The next stage of investigations involved the comparison of properties of alluvial medium dense sand stabilised with unmodified and modified resins.

Santrauka

Straipsnyje pateikta injekcijos technologijų taikymo senų pamatų pagrindui stiprinti apžvalga, injekcijų daugiamolekuliais organiniais tirpalais analizė ir dispersinių gruntų, stabilizuotų organiniais polimerais, vienerių metų laikotarpio tyrimų rezultatai. Buvo palygintos nemodifikuotų ir modifikuotų karbamidinių dervų savybės, tiriamos tokios dervos tirpalų savybės, kaip tankis, klampumas, pH (vandenilio jonų rodiklis) ir komponentų iŠgaravimas iŠ tirpalo. Kitame tyrimų etape lyginamos aliuvinio vidutiniŠkai tankaus smėlio, stabilizuoto nemodifikuotomis ir modifikuotomis dervomis, savybės.
Three Models of Noncooperative Oligopoly in Markets with a Continuum of Traders
Authors: Busetto Francesca , Codognato Giulio , Ghosal Sayantan
Published: February 2014

Trois modèles d’oligopole en équilibre général avec un continu d’agents Cet article propose une reconstruction de la théorie de l’oligopole en équilibre général en univers non coopératif. Trois types de modèles en échange pur sont étudiés : le modèle de Cournot-Walras analysé dans Codognato et Gabszewicz (1991) ; le modèle de jeu de marché à la Cournot-Nash proposé initialement par Shapley ; et le modèle de Cournot-Walras étudié par Busetto et al. (2008). Nous établissons la relation qui existe entre les équilibres de ces trois modèles avec l’équilibre concurrentiel walrassien. Ensuite, nous analysons les relations entre les trois équilibres stratégiques associés à ces trois modèles. Classification JEL : C72, D51.