bluuebunny/crossref_metadata_2025 huggingface dataset:
U–Pb zircon provenance of Moldanubian metasediments in the Bohemian Massif
Authors: Košler Jan , Konopásek Jiří , Sláma Jiří , Vrána Stanislav
Published: October 2013

Detrital zircon U–Pb age data from the Moldanubian part of the Bohemian Massif obtained by laser ablation inductively coupled plasma mass spectrometry show variations between the lithotectonic units and point to their formation in spatially close but separated basins that were supplied by detritus from somewhat different source areas, possibly over different periods of time. The youngest detrital zircon component in metasediments of the Monotonous and Varied Units is Early Ordovician and Mid- to Late Devonian in age, respectively, suggesting their deposition in Palaeozoic times. Reliable interpretation of the Mid- to Late Devonian zircons recovered from metasediments of the Gföhl Unit is precluded by their high metamorphic grade and presence of anatectic melt. The Early Carboniferous zircons from the Gföhl Unit are interpreted as being of metamorphic origin. Comparison of detrital zircon age spectra from the Moldanubian, Teplá–Barrandian and Moravo-Silesian metasediments suggests that these were deposited in separate basins but the overall similarity of the Neoproterozoic and Palaeoproterozoic age maxima and sparse Neo- and Mesoarchaean ages suggest that the three crustal segments must have been spatially related prior to the Variscan orogeny. Future tectonic models of the Variscan assembly of the Bohemian Massif must account for nearly synchronous evolution of the Moldanubian, Teplá–Barrandian and Moravo-Silesian Palaeozoic sedimentary basins that shared a common crust and most of their sedimentary sources, as well as for a rapid burial of the Moldanubian sediments to mid- and lower crustal levels that was followed by their rapid exhumation to the upper crust in Mid-Devonian to Early Carboniferous times.

Supplementary material:

Results of LA-ICP-MS U–Pb analyses of zircons extracted from the Moldanubian and Moravo-Silesian metasediments are available at
www.geolsoc.org.uk/SUP18676
.
Study on the Stress Relaxation Behavior of Large Diameter B-GFRP Bars Using FBG Sensing Technology
Authors: Guo-wei Li , Hua-Fu Pei , Cheng-yu Hong
Published: October 2013

Corrosion of steel tendons in certain aggressive environments could lead to durability problems of civil engineering. More recently, fiber-reinforced polymer (FRP) rods have been introduced in the market as tendons for prestressed concrete structures because of their lower modulus behavior. However, previous studies on the FRP mechanical time dependent behavior regarding the stress relaxation of large diameter GFRP have not been well understood. This paper investigates the influence of stress levels on the relaxation behavior of a GFRP bar griped with a seamless pipe under sustained deformations ranging from 30% to 60% of its ultimate strain. In order to study the behavior of stress relaxation, two basalt-glass fiber hybrid composite (B-GFRP) bars were developed and instrumented with fiber Bragg grating (FBG) strain sensors. It can be found that the test results reveal that the seamless pipe grip method can undertake 70% of ultimate tensile load of the B-GFRP bar, which can satisfy the requirement of stress relaxation of B-GFRP bar subjected to prestress. The model proposed for evaluating stress relaxation ratio can reflect the influences of the nature of B-GFRP bar and the property of grip method.
Kinetics and Photodegradation Study of Aqueous Methyltert-Butyl Ether Using Zinc Oxide: The Effect of Particle Size
Authors: Seddigi Zaki S. , Ahmed Saleh A. , Ansari Shahid P. , Danish Ekram , Abu Alkibash Abdullah , Ahmed Shakeel
Published: October 2013

Zinc oxide of different average particle sizes 25 nm, 59 nm, and 421 nm as applied in the photodegradation of MTBE. This study was carried out in a batch photoreactor having a high pressure mercury lamp. Zinc oxide of particle size of 421 nm was found to be the most effective in degrading MTBE in an aqueous solution. On using this type of ZnO in a solution of 100 ppm MTBE, the concentration of MTBE has decreased to 5.1 ppm after a period of five hours. The kinetics of the photocatalytic degradation of MTBE was found to be a first order reaction.
Robust Delay Independent Stability Analysis for the Switched Interval Time-Delay Systems with Time-Driven Switching Strategy
Authors: Chiou Juing-Shian , Li Jen-Hsing
Published: October 2013

Some new criteria of delay independent stability for the switched interval time-delay systems are deduced. The switching structure does depend on time-driven switching strategies. The total activation time ratio of the switching law can be determined to guarantee that the switched interval time-delay system is exponentially stable.
Static Testing of a Bridge Using an Interferometric Radar: The Case Study of “Ponte degli Alpini,” Belluno, Italy
Authors: Dei Devis , Mecatti Daniele , Pieraccini Massimiliano
Published: October 2013

Ground‐based radar interferometry is an increasingly popular technique for monitoring civil infrastructures. In this paper, the static testing of a bridge is reported. It was an 8‐span bridge, 297 m long, named “Ponte degli Alpini,” crossing the valley of the Ardo River. The radar has been used for testing a lateral span and a central span. The obtained results present elements of novelty not previously reported in the literature. In fact, some displacement measurements of the lateral span have been affected by a horizontal shift that has to be taken into account for a correct interpretation of the measured data. Furthermore, the measurements of the central span have been carried out with the radar positioned transversally with respect to the bridge deck; this unusual arrangement has allowed for obtaining displacement maps less geometrically distorted with respect to other cases reported in the literature.
An Analysis of the Flow of a Newtonian Fluid between Two Moving Parallel Plates
Authors: Zeb A. , Siddiqui A. M. , Ahmed M.
Published: October 2013

We consider flow of an incompressible Newtonian fluid produced by two parallel plates, moving towards and away from each other with constant velocity. Inverse solutions of the equations of motion are obtained by assuming certain forms of the stream function. Analytical expressions for the stream function, fluid velocity components, and fluid pressure are derived.
Numerical Analysis of Ridged-Circular Nanoaperture for Near-Field Optical Disk
Authors: Kitamura Toshiaki
Published: October 2013

A ridged-circular nanoaperture is investigated through three-dimensional (finite-difference time-domain) FDTD method. The motion equations of free electrons are inserted to analyze a metallic material. The electromagnetic field distributions of optical near-field around the aperture are investigated. The phase change disk illuminated by a near-field optical light through a ridged-circular nanoaperture is also analyzed. The far-field scattering patterns from the phase change disk and the crosstalk characteristics between plural marks are studied.
Mixed Medullary-Follicular Carcinoma of the Thyroid
Authors: Tohidi Maasumeh , Pourbehi Gholamreza , Bahmanyar Mohammad , Eghbali Seyed Sajjad , Kalantar Hormozi Mohammadreza , Nabipour Iraj
Published: October 2013

Introduction. Mixed medullary-follicular thyroid carcinoma is an uncommon tumor that consists of both follicular and parafollicular cells.Case. We report a 43-year-old woman with a palpable mass in the right side of the neck. Fine needle aspiration suggested a diagnosis of high grade anaplastic carcinoma that has been associated with papillary features. Total thyroidectomy was done in which histopathological examination showed diagnosis of medullary carcinoma. Immunohistochemical staining was positive for chromogranin, calcitonin, and thyroglobulin in tumoral cells.Conclusion. Mixed medullary-follicular thyroid carcinoma is a rare tumor. Diagnosis of these tumors with fine needle aspiration is very difficult and may lead to misdiagnosis. It is necessary to correlate the cytological finding with serum calcitonin and thyroglobulin. Also immunostaining for calcitonin and thyroglobulin confirms diagnosis.
Development of Gas Safety Management System for Smart-Home Services
Authors: Park Gyoutae , Lyu Geunjun , Jo Youngdo , Gu Jaheon , Eun Jongbu , Kim Hiesik
Published: October 2013

We propose a system for improving gas safety management through the use of wireless communication modules and intelligent gas safety appliances. Our system configuration consists of an automatic extinguishing system, detectors, a wall-pad, and a microcomputer controlled micom gas meter to monitor gas flow and pressure as well as the occurrence of earthquakes. The automatic fire-extinguishing system checks for both combustible gaseous leaks and monitors the environmental temperature, while the detector array measures smoke and CO gas concentrations. Depending on detected conditions, the micom gas meter cuts off an inner valve and generates a warning, the automatic fire-extinguishing system cuts off an external valve and sprays extinguishing materials, or the sensors generate signals and take further action when smoke or CO is detected. Information on intelligent measures taken by the gas safety appliances and sensors is transmitted to the wall-pad, which in turn relays this as real time data to a server that can be monitored via an external network (BcN) connection to a web or mobile application for the management of gas safety. To validate this smart-home gas management system, we field-tested its suitability for use in Korean apartments under several scenarios.
Dendrimers as Carriers for siRNA Delivery and Gene Silencing: A Review
Authors: Wu Jiangyu , Huang Weizhe , He Ziying
Published: October 2013

RNA interference (RNAi) was first literaturally reported in 1998 and has become rapidly a promising tool for therapeutic applications in gene therapy. In a typical RNAi process, small interfering RNAs (siRNA) are used to specifically downregulate the expression of the targeted gene, known as the term “gene silencing.” One key point for successful gene silencing is to employ a safe and efficient siRNA delivery system. In this context, dendrimers are emerging as potential nonviral vectors to deliver siRNA for RNAi purpose. Dendrimers have attracted intense interest since their emanating research in the 1980s and are extensively studied as efficient DNA delivery vectors in gene transfer applications, due to their unique features based on the well‐defined and multivalent structures. Knowing that DNA and RNA possess a similar structure in terms of nucleic acid framework and the electronegative nature, one can also use the excellent DNA delivery properties of dendrimers to develop effective siRNA delivery systems. In this review, the development of dendrimer‐based siRNA delivery vectors is summarized, focusing on the vector features (siRNA delivery efficiency, cytotoxicity, etc.) of different types of dendrimers and the related investigations on structure‐activity relationship to promote safe and efficient siRNA delivery system.
Feasibility Study on Crack Detection of Pipelines Using Piezoceramic Transducers
Authors: Du Guofeng , Kong Qingzhao , Lai Timothy , Song Gangbing
Published: October 2013

Damage detection of pipelines is of great significance in terms of safety in the oil and gas industry. Currently, lead zirconate titanates (PZTs) are the most popular piezoceramic materials and show great potential in the applications of structural health monitoring. In this paper, the authors present a feasibility study on the crack detection and severity monitoring of pipelines using PZT transducers. Due to their electromechanical properties, the piezoceramic transducers can be either as an actuator or a sensor to generate or detect the stress wave. The active sensing approach was applied to monitor the crack severity of pipelines. The crack in the stress wave propagation path can be regarded as a stress relief, which reduces the received energy by the sensors. In the test, eight different operating conditions were tested in which one artificial crack was created ranging from 0 mm to 10.5 mm. A wavelet packet-based crack severity index was also built to quantitatively identify the pipeline damage condition at various crack depths.
Video Genre Classification Using Weighted Kernel Logistic Regression
Authors: Hamed Ahmed A. M. , Li Renfa , Xiaoming Zhang , Xu Cheng
Published: October 2013

Due to the widening semantic gap of videos, computational tools to classify these videos into different genre are highly needed to narrow it. Classifying videos accurately demands good representation of video data and an efficient and effective model to carry out the classification task. Kernel Logistic Regression (KLR), kernel version of logistic regression (LR), proves its efficiency as a classifier, which can naturally provide probabilities and extend to multiclass classification problems. In this paper, Weighted Kernel Logistic Regression (WKLR) algorithm is implemented for video genre classification to obtain significant accuracy, and it shows accurate and faster good results.
Association between Waste Management and HBV among Solid Municipal Waste Workers: A Systematic Review and Meta‐Analysis of Observational Studies
Authors: Corrao Carmela Romana Natalina , Del Cimmuto Angela , Marzuillo Carolina , Paparo Emanuele , La Torre Giuseppe
Published: October 2013

Aim. To conduct a systematic review of this relationship using available published observational studies in the field of solid municipal waste treatment. Methods. The review of the scientific literature was based on Medline and Scopus databases up to December 2012, using the keywords HBV, waste, solid, treatment, workers, disposal, and refuse in different combinations. Results. 160 studies were found and checked. Finally, 5 observational studies were considered suitable, all cross‐sectional. The pooled proportion of HBs‐Ag considering all the studies was 11% (95% CI: 5–21%), and considering the high quality studies only, this proportion was 14% (95% CI: 6–24%). The pooled proportion of HBs‐Ab positivity among waste workers considering all the studies was 14.2% (95% CI: 1.4–37.2%), and considering the high quality studies only, this proportion was 24% (95% CI: 18–30%). The pooled proportion of HBc‐Ab positivity among waste workers considering all the studies was 24% (95% CI: 6–49%). The pooled estimation of the risk of HBV positivity (HBsAg) among exposed was OR = 2.39 (95% CI: 0.88–6.52). Conclusion. In conclusion, waste workers need to be vaccinated against HBV infection since they are at risk of acquiring this infection through the exposure to potentially infected waste.
Preserved Imitation of Known Gestures in Children with High-Functioning Autism
Authors: Carmo Joana C. , Rumiati Raffaella I. , Siugzdaite Roma , Brambilla Paolo
Published: October 2013

It has been suggested that children with autism are particularly deficient at imitating novel gestures or gestures without goals. In the present study, we asked high-functioning autistic children and age-matched typically developing children to imitate several types of gestures that could be either already known or novel to them. Known gestures either conveyed a communicative meaning (i.e., intransitive) or involved the use of objects (i.e., transitive). We observed a significant interaction between gesture type and group of participants, with children with autism performing known gestures better than novel gestures. However, imitation of intransitive and transitive gestures did not differ across groups. These findings are discussed in light of a dual-route model for action imitation.
A Generalized Gradient Projection Filter Algorithm for Inequality Constrained Optimization
Authors: Wang Wei , Hua Shaoli , Tang Junjie
Published: October 2013

A generalized gradient projection filter algorithm for inequality constrained optimization is presented. It has three merits. The first is that the amount of computation is lower, since the gradient matrix only needs to be computed one time at each iterate. The second is that the paper uses the filter technique instead of any penalty function for constrained programming. The third is that the algorithm is of global convergence and locally superlinear convergence under some mild conditions.
Efficacy of Memantine, Donepezil, or Their Association in Moderate‐Severe Alzheimer’s Disease: A Review of Clinical Trials
Authors: Molino Ivana , Colucci Luisa , Fasanaro Angiola M. , Traini Enea , Amenta Francesco
Published: October 2013

Background. Acetylcholinesterase (AChE)/cholinesterase (ChE) inhibitors (Is) and memantine are licensed for symptomatic treatment of mild‐moderate and moderate‐severe forms of Alzheimer’s disease (AD), respectively. High doses of the AChE‐I donepezil were licensed in the USA for moderate‐severe AD, and the association AChE/ChE‐Is plus memantine was proposed for AD at this stage. Objectives. This paper has reviewed evidence from clinical trials of the effectiveness of memantine, donepezil, or the two drugs in association in managing moderate‐severe AD. Method. Double‐blind, placebo‐controlled randomized trials (RCTs) using memantine or donepezil alone or in association versus placebo in moderate‐severe AD were reviewed. Analysis done in January 2013 considered the years 2007–2012. Results and Conclusion. Only 83 of the 941 papers selected were considered relevant, and only 13 met the criterion of “adequacy and representativeness.” Memantine and donepezil lead to improvements in moderate‐to‐severe AD and the choice between the compounds should be based on their contraindications more than on disease severity. No evidence was found of advantages of the association of memantine‐donepezil. The heterogeneity of conditions explored by RCTs, the relatively short time of observation (24–52 weeks), and the different cognitive assessment tools used did not allow comparing properly different trials.
Functional TLR5 Genetic Variants Affect Human Colorectal Cancer Survival
Authors: Klimosch Sascha N. , Försti Asta , Eckert Jana , Knežević Jelena , Bevier Melanie , von Schönfels Witigo , Heits Nils , Walter Jessica , Hinz Sebastian , Lascorz Jesus , Hampe Jochen , Hartl Dominik , Frick Julia-Stefanie , Hemminki Kari , Schafmayer Clemens , Weber Alexander N.R.
Published: October 2013

Toll-like receptors (TLR) are overexpressed on many types of cancer cells, including colorectal cancer cells, but little is known about the functional relevance of these immune regulatory molecules in malignant settings. Here, we report frequent single-nucleotide polymorphisms (SNP) in the flagellin receptor TLR5 and the TLR downstream effector molecules MyD88 and TIRAP that are associated with altered survival in a large cohort of Caucasian patients with colorectal cancer (n = 613). MYD88 rs4988453, a SNP that maps to a promoter region shared with the acetyl coenzyme-A acyl-transferase-1 (ACAA1), was associated with decreased survival of patients with colorectal cancer and altered transcriptional activity of the proximal genes. In the TLR5 gene, rs5744174/F616L was associated with increased survival, whereas rs2072493/N592S was associated with decreased survival. Both rs2072493/N592S and rs5744174/F616L modulated TLR5 signaling in response to flagellin or to different commensal and pathogenic intestinal bacteria. Notably, we observed a reduction in flagellin-induced p38 phosphorylation, CD62L shedding, and elevated expression of interleukin (IL)-6 and IL-1β mRNA in human primary immune cells from TLR5 616LL homozygote carriers, as compared with 616FF carriers. This finding suggested that the well-documented effect of cytokines like IL-6 on colorectal cancer progression might be mediated by TLR5 genotype-dependent flagellin sensing. Our results establish an important link between TLR signaling and human colorectal cancer with relevance for biomarker and therapy development. Cancer Res; 73(24); 7232–42. ©2013 AACR.
The Role of Protein Kinase CK2 in Glioblastoma Development
Authors: Ji Haitao , Lu Zhimin
Published: October 2013

Glioblastoma is the most prevalent and malignant primary brain tumor in adults, and its response to current therapies is limited. Protein kinase CK2 is overexpressed in glioblastoma and regulates glioblastoma cell survival, proliferation, and migration and brain tumorigenesis. Targeting CK2 for glioblastoma treatment may benefit patients with glioblastoma. Clin Cancer Res; 19(23); 6335–7. ©2013 AACR.
Prospective Relationship between Hemispheric Lateralisation and CD4+ T Cells in Human Immunodeficiency Virus Type 1
Authors: Sumner Rachel C. , Nowicky Alexander V. , Parton Andrew , Wylock Carolien , Cserjesi Renata , Fischler Benjamin , Lacor Patrick , Gidron Yori
Published: October 2013

Objectives: Neuromodulation of the immune system has been proposed to be influenced by hemispheric lateralisation (HL). The present study tested whether HL predicted CD4+ levels, statistically controlling for confounders. Methods: Employing two assessments of HL, 68 human immunodeficiency virus (HIV)-1+ patients were followed prospectively. Numerous exclusion criteria and confounder assessments were employed (e.g. age/medication). Results: Left HL significantly positively predicted CD4+ levels at follow-up, and this was qualified by medication (HAART) status: only in HAART-naïve patients did HL predict CD4 levels. Furthermore, HL significantly predicted whether patients had clinically significantly high/low CD4+ counts. Conclusions: Using a more rigorous methodology than a previous study, the present work partly corroborated the theory of HL influences on immunity, extended it to HIV immunity and identified a possible moderator: HAART medication. Implications for future research and treatments are provided.
Cultural Adaptation, Standardization and Clinical Validity of the Test Your Memory Dementia Screening Instrument in Greek
Authors: Iatraki Eliza , Simos Panagiotis G. , Lionis Christos , Zaganas Ioannis , Symvoulakis Emmanouil K. , Papastefanakis Emmanouil , Panagiotakis Simeon , Pantelidakis Heraklis , Papadopoulos Konstantinos , Tziraki Chariklia
Published: October 2013

Background/Aims: To adapt and standardize the Test Your Memory (TYM) dementia screening instrument in Greek. Methods: Normative data on the Greek version of the TYM were obtained from a community sample of 239 adults aged 21-92 years. Clinical validity was assessed in a cohort of 134 Neurology Clinic patients. Concurrent validity was examined through comparisons with the Mini-Mental State Examination (MMSE) and the Greek Everyday Function Scale. Results: Correlations between the TYM and the MMSE were 0.73 and 0.82 in the community and patient samples, respectively. Scores on both tests were moderately associated with everyday functional capacity. Using age- and education-corrected cutoff scores ranging from 26/50 to 45/50 points, the sensitivity of the TYM for Alzheimer's disease detection was found to be higher than that of the MMSE (0.82 vs. 0.70), although its specificity was lower (0.71 vs. 0.90). Conclusion: Findings are consistent with previous reports in a variety of cultural settings supporting the potential utility of the TYM as a dementia screening tool.
Prevalence of Depression among Recently Admitted Long-Term Care Patients in Norwegian Nursing Homes: Associations with Diagnostic Workup and Use of Antidepressants
Authors: Iden Kristina Riis , Engedal Knut , Hjorleifsson Stefan , Ruths Sabine
Published: October 2013

Aims: We aimed to establish the prevalence of depression among recently admitted long-term care patients and to examine associations with diagnostic initiatives and treatment as recorded in patients' medical records. Materials and Methods: Eighty-eight long-term care patients were included. Depression was diagnosed according to the ICD-10 criteria; patients were screened for depression using the Cornell Scale for Depression in Dementia (CSDD) and for dementia with the Clinical Dementia Rating (CDR) scale. Results: Depression was found in 25% of the patients according to the ICD-10 criteria and in 31% according to a CSDD sum score of ≥8. Diagnostic initiatives were documented in the medical records of half of the patients with depression. Forty-four percent of the patients were prescribed antidepressants and 23% actually received them for the treatment of depression. Conclusion: Depression was prevalent among recently admitted long-term care patients, but diagnostic initiatives were too rarely used. Antidepressants were commonly prescribed, but depression was the indication for treatment in only half of the cases. Screening for depression should be mandatory on admission.
Increased levels of lysosomal cysteinyl cathepsins in human varicose veins: A histology study
Authors: Xu Na , Zhang Yuan-Yuan , Lin Yan , Bao Bin , Zheng Lei , Shi Guo-Ping , Liu Jian
Published: October 2013

Varicose veins are a major chronic venous disease characterised by extensive remodelling of the extracellular matrix architecture in the vascular wall. Although matrix metalloproteinases have been implicated in these pathologic events, little is known about the functional relevance of other protease family members. Here, we studied the distribution of lysosomal cysteine proteases, cathepsins B, L, K, and S, and their endogenous inhibitor, cystatin C, in long saphenous vein specimens from nine normal donors and 18 patients with varicose veins (VVs). Immunohistochemical analysis demonstrated increased levels of cathepsins L, K, B, and S and reduced levels of cystatin C in VVs. This imbalance between cysteinyl cathepsins and cystatin C may favour VV remodelling. To investigate the inflammatory mechanism of their expression, we examined a detailed inflammatory cell profile in VVs, including macrophages, T lymphocytes, and mast cells. Increased numbers of CD3-positive T cells and tryptase-positive mast cells were found in VVs, and enhanced levels of cysteinyl cathepsins were detected from lesion CD3-positive T cells, chymase-positive mast cells, endothelial cells, and smooth-muscle cells. Elevated cathepsins, and their co-localisation to infiltrated inflammatory cells and to vascular cells, suggest that these proteases participate in extracellular matrix degradation in response to inflammation during VV pathogenesis.
Use of proton pump inhibitors and the risk of coronary events in new users of low-dose acetylsalicylic acid in UK primary care
Authors: Johansson Saga , Nagy Péter , Soriano Lucía Cea , Rodríguez Luis A. García
Published: October 2013

This study evaluated the risk of cardiovascular events associated with the use of proton pump inhibitors (PPIs) in new users of acetylsalicylic acid (ASA) for the secondary prevention of cardiovascular events. Two cohorts of patients aged 50–84 years were identified from UK primary care databases: individuals with a first prescription for ASA (75−300 mg/day) for secondary prevention of cardiovascular events (n = 39,513; CVD cohort) or with a record of hospitalisation for an acute coronary event (n = 42,542; ACS cohort) in 2000–2007. Cases of nonfatal myocardial infarction (MI) and coronary death were identified: 1,222 in the CVD cohort and 604 among new users of ASA in the ACS cohort. A nested case–control analysis estimated the relative risk (RR) of non-fatal MI or coronary death associated with use vs non-use of PPI therapy. Current continuous use of PPI therapy was not associated with a significant increase in RR overall: in the CVD cohort (RR = 1.14 [95% confidence interval = 0.91−1.43]); in the ACS cohort (0.88 [0.66−1.18]); or among current continuous users of ASA as antiplatelet monotherapy (CVD cohort: 1.15 [0.80−1.66]; ACS cohort: 0.73 [0.43−1.23]; pooled analysis of both cohorts: 0.96 [0.62−1.48]). In conclusion, among first-time users of ASA for the secondary prevention of cardiovascular events, PPI use was not shown to be associated with an increased risk of non-fatal MI or coronary death.
Benefit-to-harm ratio of thromboprophylaxis for patients undergoing major orthopaedic surgery
Authors: Liang Jane , Bergqvist David , Yusen Roger D. , Hull Russell D.
Published: October 2013

Surgeons consider the benefit-to-harm ratio when making decisions regarding the use of anticoagulant venous thromboembolism (VTE) prophylaxis. We evaluated the benefit-to-harm ratio of the use of newer anticoagulants as thromboprophylaxis in patients undergoing major orthopaedic surgery using the likelihood of being helped or harmed (LHH), and assessed the effects of variation in the definition of major bleeding on the results. A systematic literature search was performed to identify phase II and phase III studies that compared regulatory authority-approved newer anticoagulants to the low-molecularweight heparin enoxaparin in patients undergoing major orthopaedic surgery. Analysis of outcomes data estimated the clinical benefit (number-needed-to-treat [NNT] to prevent one symptomatic VTE) and clinical harm (number-needed-to-harm [NNH] or the NNT to cause one major bleeding event) of therapies. We estimated each trial’s benefitto-harm ratio from NNT and NNH values, and expressed this as LHH = (1/NNT)/(1/NNH) = NNH/NNT. Based on reporting of efficacy and safety outcomes, most studies favoured enoxaparin over fondaparinux, and rivaroxaban over enoxaparin. However, when using the LHH metric, most trials favoured enoxaparin over both fondaparinux and rivaroxaban when they included surgical-site bleeding that did not require reoperation in the definition of major bleeding. The exclusion of bleeding at surgical site which did not require reoperation shifted the benefit-to-harm ratio in favour of the newer agents. Variations in the definitions of major bleeding may change the benefit-to-harm ratio and subsequently affect its interpretation. Clinical trials should attempt to improve the consistency of major bleeding reporting.
A non-interventional comparison of rivaroxaban with standard of care for thromboprophylaxis after major orthopaedic surgery in 17,701 patients with propensity score adjustment
Authors: Haas Sylvia , Kreutz Reinhold , Mantovani Lorenzo G. , Pattanayak Cassandra W. , Holberg Gerlind , Jamal Waheed , Schmidt André , Eickels Martin van , Lassen Michael R. , Turpie Alexander G. G.
Published: October 2013

Rivaroxaban demonstrated superior efficacy and a similar safety profile to enoxaparin for the prevention of venous thromboembolism in the phase III RECORD programme in patients undergoing elective hip or knee replacement surgery. The XAMOS study investigated adverse events, including bleeding and thromboembolic events, in patients receiving rivaroxaban for thromboprophylaxis in routine clinical practice. XAMOS was a non-interventional, open-label cohort study in patients undergoing major orthopaedic surgery of the hip or knee (predominantly elective arthroplasty), in which rivaroxaban was compared with other pharmacological thromboprophylaxis. All adverse events were documented, including symptomatic thromboembolic and bleeding events. Crude and adjusted incidences based on propensity score subclasses were calculated and compared between the rivaroxaban and standard-of-care groups. A total of 17,701 patients were enrolled from 252 centres in 37 countries. Crude incidences of symptomatic thromboembolic events three months after surgery in the safety population were 0.89% in the rivaroxaban group (n=8,778) and 1.35% in the standard-of-care group (n=8,635; odds ratio [OR] 0.65; 95% confidence interval [CI] 0.49–0.87), and 0.91% and 1.31% (weighted) in the propensity score-adjusted analysis (OR 0.69; 95% CI 0.56–0.85), respectively. Treatment-emergent major bleeding events (as defined in the RECORD studies) occurred in 0.40% and 0.34% of patients in the rivaroxaban and standard-of-care groups in the safety population (OR 1.19; 95% CI 0.73–1.95), and in 0.44% versus 0.33% (weighted) in the propensity score-adjusted analysis (OR 1.35; 95% CI 0.94–1.93), respectively. This study in unselected patients confirmed the favourable benefit–risk profile of rivaroxaban seen in the RECORD programme.
Impact of Preoperative Moderate/Severe Mitral Regurgitation on 2-Year Outcome After Transcatheter and Surgical Aortic Valve Replacement
Authors: Barbanti Marco , Webb John G. , Hahn Rebecca T. , Feldman Ted , Boone Robert H. , Smith Craig R. , Kodali Susheel , Zajarias Alan , Thompson Christopher R. , Green Philip , Babaliaros Vasilis , Makkar Raj R. , Szeto Wilson Y. , Douglas Pamela S. , McAndrew Tom , Hueter Irene , Miller D. Craig , Leon Martin B.
Published: October 2013

Background—

The effect of preoperative mitral regurgitation (MR) on clinical outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) is controversial. This study sought to examine the impact of moderate and severe MR on outcomes after TAVR and surgical aortic valve replacement (SAVR).

Methods and Results—

Data were drawn from the randomized Placement of Aortic Transcatheter Valve (PARTNER) Trial cohort A patients with severe, symptomatic aortic stenosis undergoing either TAVR (n=331) or SAVR (n=299). Both TAVR and SAVR patients were dichotomized according to the degree of preoperative MR (moderate/severe versus none/mild). At baseline, moderate or severe MR was reported in 65 TAVR patients (19.6%) and 63 SAVR patients (21.2%). At 30 days, among survivors who had isolated SAVR/TAVR, moderate/severe MR had improved in 25 SAVR patients (69.4%) and 30 TAVR patients (57.7%), was unchanged in 10 SAVR patients (27.8%) and 19 TAVR patients (36.5%), and worsened in 1 SAVR patient (2.8%) and 4 TAVR patients (5.8%; all
P
=NS). Mortality at 2 years was higher in SAVR patients with moderate or severe MR than in those with mild or less MR (49.8% versus 28.1%; adjusted hazard ratio, 1.73; 95% confidence interval, 1.01–2.96;
P
=0.04). In contrast, MR severity at baseline did not affect mortality in TAVR patients (37.0% versus 32.7%, moderate/severe versus none/mild; hazard ratio, 1.14; 95% confidence interval, 0.72–1.78;
P
=0.58;
P
for interaction=0.05).

Conclusions—

Both TAVR and SAVR were associated with a significant early improvement in MR in survivors. However, moderate or severe MR at baseline was associated with increased 2-year mortality after SAVR but not after TAVR. TAVR may be a reasonable option in selected patients with combined aortic and mitral valve disease.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00530894.
Changes in Lipoprotein‐Associated Phospholipase A2 Activity Predict Coronary Events and Partly Account for the Treatment Effect of Pravastatin: Results From the Long‐term Intervention with Pravastatin in Ischemic Disease Study
Authors: White Harvey D. , Simes John , Stewart Ralph A. H. , Blankenberg Stefan , Barnes Elizabeth H. , Marschner Ian C. , Thompson Peter , West Malcolm , Zeller Tanja , Colquhoun David M. , Nestel Paul , Keech Anthony C. , Sullivan David R. , Hunt David , Tonkin Andrew ,   The LIPID Study Investigators
Published: October 2013

Background

Lipoprotein‐associated phospholipase A2 (Lp‐
PLA
2
) levels are associated with coronary heart disease (
CHD
) in healthy individuals and in patients who have had ischemic events.

Methods and Results

The Long‐term Intervention with Pravastatin in Ischemic Disease (
LIPID
) study randomized 9014 patients with cholesterol levels of 4.0 to 7.0 mmol/L to placebo or pravastatin 3 to 36 months after myocardial infarction or unstable angina and showed a reduction in
CHD
and total mortality. We assessed the value of baseline and change in Lp‐
PLA
2
activity to predict outcomes over a 6‐year follow‐up, the effect of pravastatin on Lp‐
PLA
2
levels, and whether pravastatin treatment effect was related to Lp‐
PLA
2
activity change. Lp‐
PLA
2
was measured at randomization and 1 year, and levels were grouped as quartiles. The prespecified end point was
CHD
death or nonfatal myocardial infarction. Baseline Lp‐
PLA
2
activity was positively associated with
CHD
events (
P
<0.001) but not after adjustment for 23 baseline factors (
P
=0.66). In 6518 patients who were event free at 1 year, change in Lp‐
PLA
2
was a significant independent predictor of subsequent
CHD
events after adjustment for these risk factors, including
LDL
cholesterol and
LDL
cholesterol changes (
P
<0.001). Pravastatin reduced Lp‐
PLA
2
by 16% compared with placebo (
P
<0.001). After adjustment for Lp‐
PLA
2
change, the pravastatin treatment effect was reduced from 23% to 10% (
P
=0.26), with 59% of the treatment effect accounted for by changes in Lp‐
PLA
2
. Similar reductions in treatment effect were seen after adjustment for
LDL
cholesterol change.

Conclusion

Reduction in Lp‐
PLA
2
activity during the first year was a highly significant predictor of
CHD
events, independent of change in
LDL
cholesterol, and may account for over half of the benefits of pravastatin in the
LIPID
study.
Jesuit Schools in Europe. A Historiographical Essay
Authors: Grendler Paul F.
Published: October 2013

The article surveys recent scholarship on Jesuit schools and universities in Europe from 1548 to 1773. It focuses on the period after the death of Ignatius of Loyola because that is when crucial decisions that shaped Jesuit schools were made. Diego Laínez made the most important decision in 1560 when he ordered that all Jesuits would teach. The goal of Jesuit teaching went beyond saving souls: Jesuit schools had the secular purpose of improving civil society by educating boys to earn a living and to fill leadership positions. Much recent scholarship has focused on Jesuit mathematical scholarship and teaching while insufficient attention has been devoted to philosophy. The Jesuits oversaw and taught in boarding schools for noble boys with considerable success. However, their attempts to become professors in universities often met with strong resistance and sometimes failed. The Jesuits devoted considerable time and effort to catechetical instruction using a variety of catechisms and approaches across Europe and the rest of the world. A major scholarly lacuna is the lack of attention paid to the financing of Jesuit colleges and schools, largely because of its complexity. A mix of subsidies from ruler or city council, designated taxes, private bequests of property or income, donations, living annuities, and other devices supported Jesuit schools. Lawsuits were a byproduct.
Exploring the occupations of homeless adults living with mental illnesses in Toronto / Explorer les occupations d’adultes sans-abri atteints de maladies mentales vivant à Toronto
Authors: Illman Sarah C. , Spence Sandy , O’Campo Patricia J. , Kirsh Bonnie H.
Published: October 2013

Background.

The nature of occupational engagement for homeless people living with mental illnesses is not well understood, and there are few studies to date that examine the occupational lives of these individuals.

Purpose.

This research study seeks to understand how this group of individuals engages in occupations. The central question is ‘‘What is the nature of occupational engagement by homeless adults living with mental illnesses in Toronto?’’

Method.

A constant comparative method of analysis was used in a secondary analysis of 60 interviews with homeless adults experiencing mental illness.

Findings.

Four themes emerged that describe the nature of occupational engagement for this group: occupations as enjoyment, occupations as survival/risk, occupations as passing time, and occupations as self-management.

Implications.

This research informs occupational therapy interventions aimed at optimizing engagement, health, and well-being for homeless adults living with mental illnesses.
Effects of Mental Fatigue on the Development of Physical Fatigue
Authors: Mehta Ranjana K. , Parasuraman Raja
Published: October 2013

Objective:

The present study used a neuroergonomic approach to examine the interaction of mental and physical fatigue by assessing prefrontal cortex activation during submaximal fatiguing handgrip exercises.

Background:

Mental fatigue is known to influence muscle function and motor performance, but its contribution to the development of voluntary physical fatigue is not well understood.

Method:

A total of 12 participants performed separate physical (control) and physical and mental fatigue (concurrent) conditions at 30% of their maximal handgrip strength until exhaustion. Functional near infrared spectroscopy was employed to measure prefrontal cortex activation, whereas electromyography and joint steadiness were used simultaneously to quantify muscular effort.

Results:

Compared to the control condition, blood oxygenation in the bilateral prefrontal cortex was significantly lower during submaximal fatiguing contractions associated with mental fatigue at exhaustion, despite comparable muscular responses.

Conclusion:

The findings suggest that interference in the prefrontal cortex may influence motor output during tasks that require both physical and cognitive processing.

Application:

A neuroergonomic approach involving simultaneous monitoring of brain and body functions can provide critical information on fatigue development that may be overlooked during traditional fatigue assessments.
Lessons on Stigma
Authors: Lichtenstein Bronwen , DeCoster Jamie
Published: October 2013

Teaching about the sociology of HIV/AIDS involves teaching about the causes and effects of stigma. We describe a Sociology of HIV/AIDS course at the University of Alabama in which stigma reduction was assessed as a primary objective. The syllabus involved theory-based instruction, class visits, service learning, and student research on community attitudes toward HIV/AIDS. We report on how stigma affected the service learning and other elements of the course, calling for adjustments to our pedagogical approach. We also report how the course was evaluated in a pretest/posttest assessment on attitudes toward people living with HIV/AIDS [PLWHA] (enacted stigma) and hypothetical reactions to being diagnosed with HIV (felt stigma). The results indicated greater tolerance for PLWHA following the class but also greater awareness of HIV stigma and its outcomes. We offer recommendations to help instructors avoid stigma-related materials and events that could jeopardize service learning and course objectives for sensitive topics such as HIV/AIDS.
Otolaryngological Progression of Granulomatosis with Polyangiitis after Systemic Treatment with Rituximab
Authors: Malm Ian‐James , Mener David J. , Kim Jean , Seo Philip , Kim Young J.
Published: October 2013

Objective

Rituximab is used for the treatment of granulomatosis with polyangiitis (GPA), historically known as Wegener's granulomatosis. However, the otolaryngological progression of GPA after systemic treatment with rituximab (Rituxan) is unclear. We therefore examined the disease sequelae of patients with GPA who were treated with rituximab.

Study Design

Case series with chart review.

Setting

Tertiary care medical center.

Subjects and Methods

Patients with a diagnosis of GPA who were treated with rituximab between 2006 and 2012 were included in this study. Systemic and otolaryngological symptomatology, prednisone usage, and procedural interventions following B‐cell depletion were analyzed.

Results

We identified 11 patients who met our inclusion criteria. The average length of follow‐up after treatment with rituximab was 23.5 months. After treatment with rituximab, there was a significant decrease in daily prednisone dose at 3, 12, and 18 months postinfusion (P <. 05). However, there was no observed improvement in patients’ otolaryngological complaints as measured by the Birmingham Vasculitis Activity Score. Furthermore, patients treated with rituximab underwent numerous otolaryngological interventions during follow‐up. Patients with a history of subglottic stenosis (n = 6) underwent an average of 3.40 laryngoscopies and 0.58 dilations per year during rituximab remission, and patients with sinusitis also underwent multiple nasal endoscopies (4.54 per year, n = 9) and nasal debridements (1.34, n = 9).

Conclusions

While rituximab has been shown to be noninferior to cyclophosphamide with respect to remission from systemic GPA, these patients continue to have chronic otolaryngological manifestations of their disease. Otolaryngologists must continue to play a supportive role throughout their maintenance period.
Winking and Giggling at Creeping Death: Thanatophobia and the Rhetoric of Save the Ta-Tas
Authors: Duerringer Christopher M.
Published: October 2013

This article offers an examination of the rhetoric of Save the Ta-Tas, a breast cancer awareness and fund-raising organization whose breast cancer advocacy products are highly sexualized, flirtatious, cheeky, and irreverent, especially in contrast to traditional discourses about breast cancer that have tended to render the afflicted as brave warriors or infantile and docile. Reading the organization’s range of merchandise as a discourse, I argue for a post-Marxist perspective that understands these texts as part of an important moment where breast cancer advocacy is disarticulated from the specter of death in order to appeal to a thanatophobic public.
Grasp analysis tools for synergistic underactuated robotic hands
Authors: Gabiccini Marco , Farnioli Edoardo , Bicchi Antonio
Published: October 2013

Despite being a classical topic in robotics, the research on dexterous robotic hands still stirs a lively research activity. The current interest is especially attracted by underactuated robotic hands where a high number of degrees of freedom (DoFs), and a relatively low number of degrees of actuation co-exist. The correlation between the DoFs obtained through a wise distribution of actuators is aimed at simplifying the control with a minimal loss of dexterity. In this sense, the application of bio-inspired principles is bringing research toward a more conscious design. This work proposes new, general approaches for the analysis of grasps with synergistic underactuated robotic hands.

After a review of the quasi-static equations describing the system, where contact preload is also considered, two different approaches to the analysis are presented. The first one is based on a systematic combination of the equations. The independent and the dependent variables are defined, and cause–effect relationships between them are found. In addition, remarkable properties of the grasp, as the subspace of controllable internal force and the grasp compliance, are worked out in symbolic form. Then, some relevant kinds of tasks, such as pure squeeze, spurious squeeze and kinematic grasp displacements, are defined, in terms of nullity or non-nullity of proper variables. The second method of analysis shows how to discover the feasibility of the pre-defined tasks, operating a systematic decomposition of the solution space of the system. As a result, the inputs to be given to the hand, in order to achieve the desired system displacements, are found. The study of the feasible variations is carried out arriving at the discovery of all the combinations of nullity and/or non-nullity variables which are allowed by the equations describing the system. Numerical results are presented both for precision and power grasps, finding forces and displacements that the hand can impose on the object, and showing which properties are preserved after the introduction of a synergistic underactuation mechanism.