bluuebunny/crossref_metadata_2025 huggingface dataset:
A Pragmatic Optimization Method for Motor Train Set Assignment and Maintenance Scheduling Problem
Authors: Li Jian , Lin Boliang , Wang Zhongkai , Chen Lei , Wang Jiaxi
Published: March 2016

With the rapid development of high-speed railway in China, the problem of motor train set assignment and maintenance scheduling is becoming more and more important for transportation organization. This paper focuses on considering the special maintenance items of motor train set and mainly meets the two maintenance cycle limits on aspects of mileage and time for each item. And then, a 0-1 integer programming model for motor train set assignment and maintenance scheduling is proposed, which aims at maximizing the accumulated mileage before each maintenance and minimizing the number of motor train sets. Restrictions of the model include the matching relation between motor train sets and routes as well as that between motor train sets and maintenance items and maintenance capacity of motor train set depot. A heuristic solution strategy based on particle swarm optimization is also proposed to solve the model. In the end, a case study is designed based on the background of Beijing south depot in China, and the result indicates that the model and algorithm proposed in this paper could solve the problem of motor train set assignment and maintenance scheduling effectively.
Antiaging Effect of Inula britannica on Aging Mouse Model Induced by D‐Galactose
Authors: Chen Hui , Long Yuanyuan , Guo Lei
Published: March 2016

The antiaging effect of Inula britannica flower total flavonoids (IBFTF) on aging mice induced by D‐galactose and its mechanism was examined in this study. From the results, the biochemical indexes and histological analysis of skin tissues showed that IBFTF could effectively improve the antioxidant enzyme activity of the aging mice, enhance the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH‐Px) of skin tissue, and decrease the malondialdehyde (MDA) content. Besides, IBFTF could maintain the skin collagen, hydroxyproline (Hyp), dermal thickness, and moisture content. Meanwhile, IBFTF could significantly reduce the number of cells arrested in G0/G1 phase, and from the point of view of protein and mRNA expression level in skin tissue, IBFTF could significantly increase the expression of Sirt1 and CyclinD1 but decrease the expression of p16 and p21, and its effect was not less than that of the well‐known vitamin E (VE). Overall, these results seem to be implying that IBFTF is a potential natural anti‐skin aging agent with great antioxidant ability.
Comparing the Analgesic Efficacy of Intrathecal Bupivacaine Alone with Intrathecal Bupivacaine Midazolam or Magnesium Sulphate Combination in Patients Undergoing Elective Infraumbilical Surgery
Authors: Attia Josef , Abo Elhussien Amany , Zaki Mostafa
Published: March 2016

Background.Spinal anaesthesia, which is one of the techniques for infraumbilical surgeries, is most commonly criticized for limited duration of postoperative analgesia.Aim of the Work.The aim of this study was to decrease bupivacaine dose used in spinal anesthesia in patients undergoing orthopedic lower limb surgery and reduce its possible side effects.Patient and Methods.Sixty adult patients of both sexes, divided into three.Group Creceived 2.5 mL bupivacaine and 0.5 mL saline 0.9%.Group Areceived 2.5 mL bupivacaine and 0.5 mL midazolam.Group Breceived 2.5 mL bupivacaine and 0.5 mL magnesium sulphate.Results.As regards onset of both motor and sensory blockade, there are a significant decrease in group A and a significant increase in group B as compared to group C, with a significant decrease in duration of motor blockade and significant increase in duration of sensory blockade in both group A and group B, respectively, as compared to group C, with a significant decrease in the duration of sensory blockade in group B as compared to group C.Conclusions.These results suggested that intrathecal midazolam as an adjuvant for bupivacaine increases the duration of both sensory and motor blockade more than that of magnesium sulphate.
Moving beyond Karnofsky and ECOG Performance Status Assessments with New Technologies
Authors: Kelly Ciara M. , Shahrokni Armin
Published: March 2016

Progress in cancer research is coupled with increased treatment complexity reliant upon accurate patient selection. Oncologists rely upon measurement instruments of functional performance such as the Karnofsky or Eastern Cooperative Oncology Group Performance Status scales that were developed over fifty years ago to determine a patient’s suitability for systemic treatment. These standard assessment tools have been shown to correlate with response to chemotherapy, chemotherapy tolerability, survival, and quality of life of cancer patients. However, these scales are subjective, subject to bias and high interobserver variability. Despite these limitations important clinical decisions are based on PS including eligibility for clinical trials, the “optimal” therapeutic approach in routine practice, and the allocation of healthcare resources. This paper reviews the past, present, and potential future of functional performance status assessment in an oncology setting. The potential ability of electronic activity monitoring systems to provide an objective, accurate measurement of patient functional performance is explored. Electronic activity monitoring devices have the potential to offer positive health-related opportunities to patients; however their introduction to the healthcare setting is not without difficulty. The potential role of this technology in healthcare and the challenges that these new innovations pose to the healthcare industry are also examined.
Multiple Congenital Colonic Stenosis: A Rare Gastrointestinal Malformation
Authors: Elisa Zambaiti , Cinzia Chiaramonte , Sergio Salerno , Giuseppe Li Voti , Fortunato Siracusa
Published: March 2016

Congenital colonic stenosis is a rare pediatric condition. Since 1968, only 16 cases have been reported in the literature. To the authors’ knowledge, multiple congenital colonic stenosis has not been previously reported in the literature. We report the case of a 2-month-old male, presented at our Neonatal Intensive Care Unit with a suspicion of intestinal malrotation. Clinical examination revealed persistent abdominal distension. During the enema examination, the contrast medium appeared to fill the lumen of the colon up to three stenotic segments and could not proceed further. Intraoperatively we confirmed the presence of four types of colonic atresia, located in the ascending, transverse, and descending colon, respectively, plus appendix atresia. First surgical steps consisted in resection of proximal stenotic segment, appendix removal, proximal cecostomy, and distal colostomy on ascending colon in order to preserve colonic length. Histopathological examination confirmed the diagnosis of colonic stenosis. Final surgical step consisted in multiple colocolostomy and enteroplasty. A planned two-stage procedure, consisting of resection with colostomy for decompression as the first step and a later anastomosis, is recommended in order to allow bowel length preservation.
Theoretical and Experimental Study on Electromechanical Coupling Properties of Multihammer Synchronous Vibration System
Authors: Lai Xin , Xie Wanjun
Published: March 2016

Industrial simulation of real external load using multiple exciting points or increasing exciting force by synchronizing multiple exciting forces requires multiple vibration hammers to be coordinated and work together. Multihammer vibration system which consists of several hammers is a complex electromechanical system with complex electromechanical coupling. In this paper, electromechanical coupling properties of such a multihammer vibration system were studied in detail using theoretical derivation, numerical simulation, and experiment. A kinetic model of multihammer synchronous vibration system was established, and approximate expressions for electromechanical coupling strength were solved using a small parameter periodic averaging method. Basic coupling rules and reasons were obtained. Self-synchronization and frequency hopping phenomenon were also analyzed. Subsequently, numerical simulations were carried out and electromechanical coupling process was obtained for different parameters. Simulation results verify correctness of the proposed model and results. Finally, experiments were carried out, self-synchronization and frequency hopping phenomenon were both observed, and results agree well with theoretical deduction and simulation results. These results provide theoretical foundations for multihammer synchronous vibration system and its synchronous control.
Benign Cystic Peritoneal Mesothelioma Revealed by Small Bowel Obstruction
Authors: Bray Madoué Kaimba , Boniface Moifo , Annick Laure Edzimbi , Pierre Herve
Published: March 2016

Benign cystic peritoneal mesothelioma is a rare tumor which frequently occurs in women of reproductive age. Abdominal pain associated with pelvic or abdominal mass is the common clinical presentation. We report the case of a 22-year-old woman with a pathological proved benign cystic mesothelioma of the peritoneum revealed by a small bowel obstruction and a painful left-sided pelvic mass with signs of psoitis. Contrast enhanced abdominal CT-scan demonstrated a large pelvic cystic mass with mass effect on rectosigmoid and pelvic organs. The patient underwent surgical removal of the tumor. Pathological examination revealed the diagnosis of benign cystic mesothelioma of the peritoneum. The outcome was excellent with a 12-month recoil.
A New Approach for Studying Bond Rupture/Closure of a Spiro Benzopyran Photochromic Material: Reactivity Descriptors Derived from Frontier Orbitals and DFT Computed Electrostatic Potential Energy Surface Maps
Authors: Abdel-Mottaleb M. S. A. , Ali Sarah N.
Published: March 2016

This paper focuses on computations technique within the framework of the TD-DFT theory for studying the relationship between structure-properties of reversible conversion of photochromic materials. Specifically, we report on 1′,3′-dihydro-8-methoxy-1′,3′,3′-trimethyl-6-nitrospiro[2H-1-benzopyran-2,2′-(2H)-indole] (SP) and its isomers. TD-DFT calculated UV-Vis electronic spectra of the closed and open isomers of this photochromic material are in excellent agreement with the experimental results. Moreover, this paper reports on the results of theoretical investigations of reactivity indices that may govern the conversion between spiropyrans and its isomers. In addition, the solvent and rigidity of the medium significantly control the thermal bleaching of the photogenerated colored isomers and hence the switch ability pattern of the photochromic material. The effect of molecular structure computed by DFT in gas-phase and solvents onCspiro-Obond length has been shown to correlate with photochromic properties. For this compound, DFT optimized geometry could be used to predict photochromism. Furthermore, in an attempt to predict the driving force for MC → SP, this work explores, for the first time, profitable exploitation of the calculated and visualized mapped electrostatic potential energy surfaces (ESP map). Interestingly, it seems that the electrostatic potential forces over the molecular fragments govern spirobond rupture/closure reactions. Thermodynamically, all-trans-colored isomer (CTT) is the most stable merocyanine-like form.
The Long Term Role of Anxiety Sensitivity and Experiential Avoidance on Pain Intensity, Mood, and Disability among Individuals in a Specialist Pain Clinic
Authors: Mehta S. , Rice D. , Janzen S. , Serrato J. , Getty H. , Shapiro A. P. , Morley-Forster P. , Sequeira K. , Teasell R. W.
Published: March 2016

Background.Anxiety sensitivity (AS) and experiential avoidance (EA) have been shown to have an interactive effect on the response an individual has to chronic pain (CP) potentially resulting in long term negative outcomes.Objective.The current study attempted to (1) identify distinct CP subgroups based on their level of EA and AS and (2) compare the subgroups in terms of mood and disability.Methods.Individuals with CP were recruited from an academic pain clinic. Individuals were assessed for demographic, psychosocial, and personality measures at baseline and 1-year follow-up. A cluster analysis was conducted to identify distinct subgroups of patients based on their level of EA and AS. Differences in clinical outcomes were compared using the Repeated Measures MANOVA.Results.From a total of 229 participants, five clusters were formed. Subgroups with lower levels of AS but similar high levels of EA did not differ in outcomes. Mood impairment was significantly greater among those with high levels of EA compared to lower levels (p<0.05). Significant improvement in disability (p<0.05) was only seen among those with lower levels of EA and AS.Conclusions.This cluster analysis demonstrated that EA had a greater influence on mood impairment, while both EA and AS levels affected disability outcomes among individuals with CP.
Propagation Channel Comparison between 23.5 and 45 GHz in Conference Scenario
Authors: Dou Jianwu , Zhang Nan , Tian Li , Yang Xiaoyi , Yuan Xi , Mei Suping , Wang Haiming
Published: March 2016

The characteristics of propagation channel at 23.5 and 45 GHz in an indoor conference room are studied based on hybrid approach. A ray-based simulator which includes the reflection, penetration, diffraction, and diffuse scattering is adopted to generate the massive channel realizations. This platform is well calibrated in path and power delay profile (PDP) levels according to some specified measurements at different frequencies. Subsequently, according to the simulated channel samples, the statistical channel model for both the large and small scale characteristics is established based on the alpha-beta approach and extended Saleh-Valenzuela (S-V) structure, respectively. Results show that the slope of fitted path loss (PL) is less than free space due to the waveguide effect for both 23.5 and 45 GHz in indoor scenario and larger PL is experienced at higher frequency. Additionally, the cluster is more centralized with less spreads and decaying faster in delay domain at 45 GHz.
Synthesis of Highcis-1,4-BR with Neodymium for the Manufacture of Tires
Authors: Méndez-Hernández Maria Leonor , Rivera-Armenta José Luis , Páramo-García Ulises , Corona Galvan Sergio , García-Alamilla Ricardo , Salazar-Cruz Beatriz Adriana
Published: March 2016

The salt of neodymium has been widely used in industrial polymerization of 1,3-butadiene. We used the ternary catalytic system neodymium versatate/diethylaluminum chloride/triisobutylaluminum (NdV3/DEAC/TIBA) with 0.5 mM NdV3/100 g Bd, NdV3 : DEAC = 1 : 9 mol : mol, and TIBA = 25, 50, 100, and 200 mM. The number-average molecular weight (Mn), weight-average molecular weight (Mw), and polydispersity index (PDI) were analyzed by GPC; the rheological properties were analyzed by DMA. The formulations were prepared with carbon black (IRB6) as reinforcing filler and the mechanical properties were compared to behavior of the different elastomeric compounds. The elastomeric compounds were characterized by their rheological properties, tensile strength, abrasion resistance, tear strength, permanent set, resilience, and fatigue properties. The highcis-1,4 polybutadiene (highcis-1,4-BR) was obtained with a percentage ofcis-1,4 ≥97%. The weight-average molecular weight (Mw) was from 150 × 103to 900 × 103 g/mol and polydispersity index (PDI) was from 3.1 to 5.1. This work is based on evaluation of the effect of the catalyst system on the final properties of the synthesized polybutadiene.
An Attempt for an Emergent Scenario with Modified Chaplygin Gas
Authors: Dutta Sourav , Mukerji Sudeshna , Chakraborty Subenoy
Published: March 2016

The present work is an attempt for emergent universe scenario with modified Chaplygin gas. The universe is chosen as spatially flat FRW space-time with modified Chaplygin gas as the only cosmic substratum. It is found that emergent scenario is possible for some specific (unrealistic) choice of the parameters in the equation of state for modified Chaplygin gas.
Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain
Authors: Tetsunaga Tomoko , Tetsunaga Tomonori , Tanaka Masato , Nishida Keiichiro , Takei Yoshitaka , Ozaki Toshifumi
Published: March 2016

Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear.Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen.Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n=36) and celecoxib (n=37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment.Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief.Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.
Radical Structures of Fuzzy Polynomial Ideals in a Ring
Authors: Kim Hee Sik , Kim Chang Bum , So Keum Sook
Published: March 2016

We investigate the radical structure of a fuzzy polynomial ideal induced by a fuzzy ideal of a ring and study its properties. Given a fuzzy idealβofRand a homomorphismf:R→R′, we show that iffxis the induced homomorphism off, that is,fx(∑i=0naixi)=∑i=0nf(ai)xi, thenfx-1[(β)x]=(f-1(β))x.
Singular Differential Equations and g-Drazin Invertible Operators
Authors: Abdeljabbar Alrazi , Tran Trung Dinh
Published: March 2016

We extend results of Favini, Nashed, and Zhao on singular differential equations using the g-Drazin inverse and the order of a quasinilpotent operator in the sense of Miekka and Nevanlinna. Two classes of singularly perturbed differential equations are studied using the continuity properties of the g-Drazin inverse obtained by Koliha and Rakočević.
A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic
Authors: Rennert-May Elissa , Hansen Elisabeth , Zadeh Toktam , Krinke Valerie , Houston Stan , Cooper Ryan
Published: March 2016

Objectives.Approximately 65 percent of tuberculosis (TB) cases in Canada each year occur from reactivation in foreign-born individuals. Refugees are at high risk after immigration. Routine screening of this population for latent TB infection (LTBI) is generally considered infeasible. We evaluated the outcome of LTBI screening and treatment amongst refugees.Methods.Government-sponsored refugees in Edmonton are seen at the New Canadians’ Clinic and screened for TB and LTBI. We reviewed records of patients between 2009 and 2011. Completeness of initial assessment, diagnosis of latent infection, and completion of LTBI treatment were evaluated. Treatment for LTBI was offered when patients had a positive Tuberculin Skin Test (TST) and risk factors for progression to TB. An Interferon-Gamma Release Assay (IGRA) was performed on all other TST positives; treatment is only offered if it was positive.Results.949 refugees were evaluated. 746 TSTs were read, with 265 positive individuals. IGRA testing was performed in 203 TST positive individuals without other TB risk factors; 110 were positive. LTBI treatment was offered to 147 of 151 eligible patients, 141 accepted, and 103 completed a treatment course.Conclusion.We observed high proportions of patient retention, completion of investigations, and treatment. This care model promises to be a component of effective TB prevention in this high-risk population.
Ovarian Torsion in the Third Trimester of Pregnancy Leading to Iatrogenic Preterm Delivery
Authors: Koumoutsea Evangelia Vlachodimitropoulou , Gupta Manish , Hollingworth Antony , Gorry Anwen
Published: March 2016

Ovarian torsion in the third trimester of pregnancy leading to a midline laparotomy and caesarean section for the delivery of a preterm baby is an uncommon event. As the woman is likely to present with nonspecific symptoms of lower abdominal pain, nausea, and vomiting, ovarian torsion can often be misdiagnosed as appendicitis or preterm labour. Treatment and the opportunity to preserve the tube and ovary may consequently be delayed. We report the case of a multiparous woman who had undergone two previous caesarean sections at term, presenting at 35 weeks of gestation with a presumptive diagnosis of acute appendicitis. Ultrasonography described a cystic lesion 6 × 3 cm in the right adnexa, potentially a degenerating fibroid or a torted right ovary. MRI of the pelvis was unable to provide further clarity. The patient was managed by midline laparotomy and simultaneous detorsion of the ovarian pedicle and ovarian cystectomy together with caesarean section of a preterm infant. This report describes that prompt recognition and ensuring intraoperative access can achieve a successful maternal and fetal outcome in this rare and difficult scenario. Furthermore, we would like to emphasise that the risk for a pregnant woman and her newborn could be reduced by earlier diagnosis and management of ovarian masses (Krishnan et al., 2011).
Evaluation of Analytical Modeling Functions for the Phonation Onset Process
Authors: Petermann Simon , Kniesburges Stefan , Ziethe Anke , Schützenberger Anne , Döllinger Michael
Published: March 2016

The human voice originates from oscillations of the vocal folds in the larynx. The duration of the voice onset (VO), called the voice onset time (VOT), is currently under investigation as a clinical indicator for correct laryngeal functionality. Different analytical approaches for computing the VOT based on endoscopic imaging were compared to determine the most reliable method to quantify automatically the transient vocal fold oscillations during VO. Transnasal endoscopic imaging in combination with a high-speed camera (8000 fps) was applied to visualize the phonation onset process. Two different definitions of VO interval were investigated. Six analytical functions were tested that approximate the envelope of the filtered or unfiltered glottal area waveform (GAW) during phonation onset. A total of 126 recordings from nine healthy males and 210 recordings from 15 healthy females were evaluated. Three criteria were analyzed to determine the most appropriate computation approach: (1) reliability of the fit function for a correct approximation of VO; (2) consistency represented by the standard deviation of VOT; and (3) accuracy of the approximation of VO. The results suggest the computation of VOT by a fourth-order polynomial approximation in the interval between 32.2 and 67.8% of the saturation amplitude of the filtered GAW.
Circulating Endothelial Microparticles: A Key Hallmark of Atherosclerosis Progression
Authors: Paudel Keshav Raj , Panth Nisha , Kim Dong-Wook
Published: March 2016

The levels of circulating microparticles (MPs) are raised in various cardiovascular diseases. Their increased level in plasma is regarded as a biomarker of alteration in vascular function. The prominent MPs present in blood are endothelial microparticles (EMPs) described as complex submicron (0.1 to 1.0 μm) vesicles like structure, released in response to endothelium cell activation or apoptosis. EMPs possess both physiological and pathological effects and may promote oxidative stress and vascular inflammation. EMPs release is triggered by inducer like angiotensin II, lipopolysaccharide, and hydrogen peroxide leading to the progression of atherosclerosis. However, there are multiple physiological pathways for EMPs generation like NADPH oxidase derived endothelial ROS formation, Rho kinase pathway, and mitogen-activated protein kinases. Endothelial dysfunction is a key initiating event in atherosclerotic plaque formation. Atheroemboli, resulting from ruptured carotid plaques, is a major cause of stroke. Increasing evidence suggests that EMPs play an important role in the pathogenesis of cardiovascular disease, acting as a marker of damage, either exacerbating disease progression or triggering a repair response. In this regard, it has been suggested that EMPs have the potential to act as biomarkers of disease status. This review aims to provide updated information of EMPs in relation to atherosclerosis pathogenesis.
Cervical Paraganglioma Mimicking Thyroid Nodule: A Rare Clinical Case
Authors: Aydoğan Berna İmge , Dizbay Sak Serpil , Güllü Sevim
Published: March 2016

Objective. Paraganglioma is a rare neuroendocrine tumor. When it is located in the neck, it is commonly misdiagnosed as other thyroid neoplasms.Case Report. We report a case of cervical paraganglioma in a 55-year-old female. Patient was admitted to our clinic with goiter and neck pain. Thyroid ultrasonography revealed a 20 mm solitary, heterogeneous nodule located in the upper pole of left thyroid lobe. Fine needle aspiration cytology was nondiagnostic. She underwent left lobectomy and histopathology showed paraganglioma.Discussion. Cervical paragangliomas should be considered in the differential diagnosis of thyroid nodules.
Study of Baffle Boundary and System Parameters on Liquid-Solid Coupling Vibration of Rectangular Liquid-Storage Structure
Authors: Jing Wei , Cheng Xuansheng , Shi Wei , Fan Jin , Feng Huan
Published: March 2016

In order to study the vibration problem of liquid-solid coupling of rectangular liquid-storage structure with horizontal elastic baffle, ignoring the influence of surface gravity wave, two different velocity potential functions corresponding to the liquid above and below the elastic baffle are assumed; based on the theory of mathematical equation and energy method, the formulas of basic frequency of liquid-solid coupling vibration system are derived, the baffle joined to the tank wall with 3 kinds of boundary conditions, namely, four edges simply supported, two opposite edges clamped and two opposite edges simply supported, and four edges clamped; the influence rules of baffle length-width ratio, the ratio of baffle height to liquid level, baffle elastic modulus, baffle density, baffle thickness, and liquid density on the coupling vibration performance are studied. The results show that the frequency of the clamped boundary is minimum; the influences of baffle length-width ratio and relative height on the basic frequency are much greater than that of the other system parameters; the relation between baffle length-width ratio and the frequency is exponential, while baffle relative height has a parabola relation with the frequency; the larger the baffle length-width ratio, the closer the baffle to the liquid level; the coupling frequency will be reduced more obviously.
Plasma Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Cardiovascular Events in Patients with Chronic Kidney Disease
Authors: Hasegawa Midori , Ishii Junichi , Kitagawa Fumihiko , Takahashi Hiroshi , Sugiyama Kazuhiro , Tada Masashi , Kanayama Kyoko , Takahashi Kazuo , Hayashi Hiroki , Koide Shigehisa , Nakai Shigeru , Ozaki Yukio , Yuzawa Yukio
Published: March 2016

Background. Our aim was to assess plasma neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of cardiovascular (CV) events in patients with chronic kidney disease (CKD) and no history of CV events.Methods. This was a prospective observational cohort study of 252 patients with predialysis CKD. CV events were defined as CV death, acute coronary syndrome, and hospitalization for worsening heart failure, stroke, and aortic dissection.Results. During a median follow-up period of 63 months, 36 CV events occurred. On Cox stepwise multivariate analysis, plasma NGAL and B-type natriuretic peptide (BNP) were significant predictors of CV events. Kaplan-Meier incidence rates of CV event-free survival at 5 years were 96.6%, 92.9%, 85.9%, and 61.3%, respectively, among quartiles of plasma NGAL (P<0.0001). The C-index for the receiver-operating characteristic curves for CV events was greater when plasma NGAL was added to an established risk model (0.801, 95% CI 0.717–0.885), compared to the model without plasma NGAL (0.746, 95% CI 0.653–0.840,P=0.021).Conclusion. Elevated plasma NGAL could predict future CV events in CKD patients with no history of CV events and add incremental value to the established risk model.
Ramipril and Losartan Exert a Similar Long-Term Effect upon Markers of Heart Failure, Endogenous Fibrinolysis, and Platelet Aggregation in Survivors of ST-Elevation Myocardial Infarction: A Single Centre Randomized Trial
Authors: Marinšek Martin , Sinkovič Andreja
Published: March 2016

Introduction. Blocking the renin-angiotensin-aldosterone system in ST-elevation myocardial infarction (STEMI) patients prevents heart failure and recurrent thrombosis. Our aim was to compare the effects of ramipril and losartan upon the markers of heart failure, endogenous fibrinolysis, and platelet aggregation in STEMI patients over the long term.Methods. After primary percutaneous coronary intervention (PPCI), 28 STEMI patients were randomly assigned ramipril and 27 losartan, receiving therapy for six months with dual antiplatelet therapy (DAPT). We measured N-terminal proBNP (NT-proBNP), ejection fraction (EF), plasminogen-activator-inhibitor type 1 (PAI-1), and platelet aggregation by closure times (CT) at the baseline and after six months.Results. Baseline NT-proBNP ≥ 200 pmol/mL was observed in 48.1% of the patients, EF < 55% in 49.1%, and PAI-1 ≥ 3.5 U/mL in 32.7%. Six-month treatment with ramipril or losartan resulted in a similar effect upon PAI-1, NT-proBNP, EF, and CT levels in survivors of STEMI, but in comparison to control group, receiving DAPT alone, ramipril or losartan treatment with DAPT significantly increased mean CT (226.7 ± 80.3 sec versus 158.1 ± 80.3 sec,p<0.05).Conclusions. Ramipril and losartan exert a similar effect upon markers of heart failure and endogenous fibrinolysis, and, with DAPT, a more efficient antiplatelet effect in long term than DAPT alone.
Unusual Spread of Renal Cell Carcinoma to the Clivus with Cranial Nerve Deficit
Authors: Okudo Jerome , Anusim Nwabundo
Published: March 2016

Renal cell carcinoma (RCC) has unusual presentation affecting elderly males with a smoking history. The incidence of RCC varies while the incidence of spread of RCC to the clivus is rare. The typicality of RCC presentation includes hematuria, flank pain, and a palpable flank mass; however, RCC can also present with clival metastasis. The unique path of the abducens nerve in the clivus makes it susceptible to damage in metastasis. We report a case of a 54-year-old African American female that was evaluated for back pain, weakness, numbness, and tingling of bilateral lower extremities and subsequently disconjugate gaze and diplopia. Brain MRI confirmed metastasis to the clivus. She was started on radiotherapy and was planned for chemotherapy and transfer to a nursing home. When a patient presents with sudden unusual cranial nerve pathology, the possibility of metastatic RCC should be sought.
Thrombin Maybe Plays an Important Role in MK Differentiation into Platelets
Authors: Yang Xiao-Lei , Ge Meng-Kai , Mao De-Kui , Lv Ying-Tao , Sun Shu-Yan , Yu Ai-Ping
Published: March 2016

Objectives. After development and differentiation, megakaryocytes (MKs) can produce platelets. As is well known, thrombopoietin (TPO) can induce MKs to differentiate. The effect of thrombin on MKs differentiation is not clear. In this study, we used a human megakaryoblastic leukemia cell line (Meg-01) to assess the effect of thrombin on MKs differentiation.Methods. In order to interrogate the role of thrombin in Meg-01 cells differentiation, the changes of morphology, cellular function, and expression of diverse factors were analyzed.Results. The results show that thrombin suppresses Meg-01 cells proliferation and induces apoptosis and cell cycle arrest. Thrombin upregulates the expression of CD41b, which is one of the most important MK markers. Globin transcription factor 1 (GATA-1), an important transcriptional regulator, controls MK development and maturation. The expression of GATA-1 is also upregulated by thrombin in Meg-01 cells. The expression of B-cell lymphoma 2 (Bcl-2), an apoptosis-inhibitory protein, is downregulated by thrombin. Phosphorylated protein kinase B (p-AKT) and phosphorylated extracellular signal-regulated kinase (p-ERK) were upregulated by thrombin in Meg-01 cells. All the results are consistent with Meg-01 cells treated with TPO.Discussion and Conclusion. In conclusion, all these data indicate that thrombin maybe plays an important role in MK differentiation into platelets. However, whether the platelet-like particles are certainly platelets remains unknown.
Predictors of Poor Outcomes in Critically Ill Adults with Hematologic Malignancy
Authors: Cornish Marion , Butler Michael B. , Green Robert S.
Published: March 2016

Background. Patients with hematologic malignancy (HM) often require intensive care unit (ICU) admission due to organ failure through disease progression or treatment-related complications.Objective. To determine mortality and prognostic variables in adult patients with HM who were admitted to ICU.Methods. Structured chart review of all adult patients (age ≥ 18 years) with HM admitted to ICU of a Canadian tertiary care hospital between 2004 and 2014. Outcome measures included mortality (ICU, 30-day, 60-day, and 12-month). Logistic regression was performed to determine predictors of mortality.Results. Overall, there were 206 cases of HM admitted to the ICU during the study (mean age: 51.3 ± 13.6 years; 60% male). Median stay was 3 days, with 14.1% requiring prolonged ICU admission. ICU mortality was 45.6% and increased to 59.2% at 30 days, 62.6% at 60 days, and 74.3% at 12 months. Predictors of increased ICU mortality included mechanical ventilation requirement and vasopressor therapy requirement, while admission to ICU postoperatively and having myeloma were associated with decreased mortality.Conclusions. Patients admitted to ICU with HM have high mortality (45.6%), which increased to 74.3% at 1 year. Analysis of multiple variables identified critical illness, postsurgical admission, and myeloma as predictors of patient outcomes.
Acetylcarnitine Is a Candidate Diagnostic and Prognostic Biomarker of Hepatocellular Carcinoma
Authors: Lu Yonghai , Li Ning , Gao Liang , Xu Yong-Jiang , Huang Chong , Yu Kangkang , Ling Qingxia , Cheng Qi , Chen Shengsen , Zhu Mengqi , Fang Jinling , Chen Mingquan , Ong Choon Nam
Published: March 2016

The identification of serum biomarkers to improve the diagnosis and prognosis of hepatocellular carcinoma has been elusive to date. In this study, we took a mass spectroscopic approach to characterize metabolic features of the liver in hepatocellular carcinoma patients to discover more sensitive and specific biomarkers for diagnosis and progression. Global metabolic profiling of 50 pairs of matched liver tissue samples from hepatocellular carcinoma patients was performed. A series of 62 metabolites were found to be altered significantly in liver tumors; however, levels of acetylcarnitine correlated most strongly with tumor grade and could discriminate between hepatocellular carcinoma tumors and matched normal tissues. Post hoc analysis to evaluate serum diagnosis and progression potential further confirmed the diagnostic capability of serum acetylcarnitine. Finally, an external validation in an independent batch of 58 serum samples (18 hepatocellular carcinoma patients, 20 liver cirrhosis patients, and 20 healthy individuals) verified that serum acetylcarnitine was a meaningful biomarker reflecting hepatocellular carcinoma diagnosis and progression. These findings present a strong new candidate biomarker for hepatocellular carcinoma with potentially significant diagnostic and prognostic capabilities. Cancer Res; 76(10); 2912–20. ©2016 AACR.
Prevalência de transtornos mentais e comportamentais nas instituições públicas federais de Rondônia
Authors: Schlindwein Vanderléia De Lurdes Dal Castel , Morais Paulo Rogério
Published: March 2016

Este artigo tem por objetivo avaliar a prevalência de transtornos mentais e comportamentais nas instituições públicas federais, registrados no Subsistema Integrado de Atenção à Saúde do Servidor Público Federal/SIASS de Rondônia. O estudo do tipo descritivo-exploratório transversal propôs-se analisar os prontuários das licenças no trabalho por motivos de saúde, enquadradas no grupo F, de acordo com a Classificação Internacional de Doenças CID-10. Foram estudadas vinte e três instituições públicas federais deste estado no ano de 2011. Foram concedidos 3.079 afastamentos por licença saúde, aos servidores públicos federais sendo que destes, 296 (9,6%) foram motivados por transtornos mentais e comportamentais. Observou-se diferenças na prevalência de afastamentos entre os sexos, as licenças saúde concedidas às mulheres (70,6%) foram superiores ao número concedido aos homens (29%), entretanto houve diferença nos diagnósticos entre os sexos. O uso de substâncias psicoativas foi superior entre os homens (10,3%) em relação às mulheres (1,4%), já para as mulheres prevaleceram os transtornos de humor associados aos transtornos neuróticos (11,4%) em relação aos homens (1,5%).
Trabalho e trabalhadores dos canaviais: perfil dos cortadores de cana da região de Ribeirão Preto (SP)¹
Authors: Rosa Leandro Amorim , Navarro Vera Lucia
Published: March 2016

A cultura de cana-de-açúcar é uma das mais importantes atividades da agroindústria do Brasil e atualmente encontra-se em expansão. Na agroindústria canavieira ocorreram mudanças no processo produtivo que, por um lado resultaram em aumento significativo da produtividade, competitividade e melhoria na qualidade dos produtos e, por outro, são relacionadas à maior precarização e intensificação do ritmo de trabalho. A pesquisa que resultou neste artigo teve por objetivo conhecer o perfil dos trabalhadores envolvidos nesta atividade e investigar as suas condições de trabalho no corte da cana-de-açúcar na região de Ribeirão Preto, SP. Foram entrevistados 13 trabalhadores, migrantes, empregados no corte da cana, um membro da Pastoral do Migrante de Guariba, SP, o presidente do Sindicato dos Empregados Rurais da mesma localidade e dois psicólogos funcionários da área de Recursos Humanos de uma usina processadora de açúcar e álcool da região pesquisada. Os dados obtidos demonstraram que os trabalhadores, em sua maioria migrantes, para serem contratados são avaliados segundo sua capacidade de produção, sua resistência física e sua subordinação aos superiores. O salário por produção implica a superexploração da força de trabalho que repercute nas condições laborais e de saúde dos trabalhadores.
Redes sociais e capital social na formação de redes socioprodutivas: Estudo em uma feira de confecções de Fortaleza
Authors: Maciel Regina Heloisa de Oliveira , Santos João Bosco Feitosa dos , Matos Tereza Gláucia Rocha , Maia Luciana Maria , Fontenelle Marselle Fernandes
Published: March 2016

Este ensaio discute as noções de trabalho informal, redes sociais e capital social na busca pela proposição de uma reflexão para o que se denomina de redes socioprodutivas, tendo como campo empírico as feiras do Centro de Fortaleza. Para marcar os aspectos da informalidade e as características das redes que sustentam esse tipo de atividade, foi realizada uma entrevista em profundidade com um produtor/feirante. Também se incluíram observações in loco e pesquisa bibliográfico-documental, que auxiliaram na contextualização histórica das feiras e na descrição da informalidade em Fortaleza, tendo como fontes matérias de jornais e dados dos órgãos oficiais do Governo. Nas considerações finais, mostra-se que o estudo das feiras, com suporte nesse ponto de vista, pode melhor esclarecer as vivências dos trabalhadores, produtores/feirantes, que vivem e sobrevivem da informalidade e discute-se o potencial desse enfoque para o entendimento das atividades que ocorrem nas feiras e das relações sociais e produtivas que ali se estabelecem, propondo a expressão "rede socioprodutiva" para instigar o debate que deve ser considerado em outros estudos.
O projeto profissional de jovens das classes médias: orientações normativas e estratégias de inserção
Authors: Souza Marina Gomes Coelho de , Castro Lucia Rabello de
Published: March 2016

A partir das transformações econômicas e sociais das últimas décadas, como a flexibilização e a precarização das condições de trabalho decorrentes da reestruturação produtiva, alteram-se os modos como os indivíduos planejam seu futuro profissional. Este artigo apresenta uma discussão sobre juventude e sua relação com o mundo do trabalho, em especial sobre a construção do projeto profissional no contexto da modernidade tardia, marcada pela imprevisibilidade e individualização das trajetórias. Pretendeu-se investigar de forma exploratória as principais orientações normativas, entendidas como valores centrais que norteiam as ações e alicerçam a construção de projetos profissionais. Foram realizadas entrevistas semiestruturadas com nove jovens universitários pertencentes às classes média e alta do Rio de Janeiro, de diferentes cursos superiores e em busca da primeira contratação profissional. Entre os principais resultados destacam-se as seguintes orientações normativas: a busca pela "qualidade de vida" e pela realização pessoal por meio do trabalho; a constante ascensão e qualificação profissional e a individualização das trajetórias de vida.
Quando diferentes maneiras de cuidar se tornam problema: o ofício descuidado, uma experiência com a metodologia de instrução ao sósia
Authors: Brandão Giselle Reis
Published: March 2016

Este artigo resume uma intervenção realizada com os cuidadores de pessoas com deficiências intelectuais em uma organização privada, em Minas Gerais, sob a abordagem da Clínica da Atividade e que, posteriormente, originou a pesquisa para o doutorado da autora em Psicologia do Trabalho. A intervenção aconteceu com seis cuidadores, entre 2010 e 2011, sob os princípios da metodologia histórico-desenvolvimental de Vygotsky, associados ao método de instrução ao sósia. Adotou-se a análise de conteúdo dos diálogos, inspirada em trabalhos de autores da área, orientada pela relação dialética entre a atividade e o ofício. Além das várias evidências de que um enquadre metodológico pôde ser instalado, levando-os a discutir sobre a problemática posta, foram selecionados dois resultados que enfatizam o potencial metodológico da instrução ao sósia: o desenvolvimento da atividade de um cuidador, ilustrado por um trecho extraído dos diálogos, e os argumentos que indicam a ausência (disfunção) da função psicológica do coletivo de trabalho (o gênero profissional) para aqueles profissionais.
Influencia de los estereotipos de género en la valoración del incivismo laboral
Authors: Carmona-Cobo Isabel , Garrosa Eva , Moreno-Jiménez Bernardo , Barrio Elena Del
Published: March 2016

Influencia de los estereotipos de género en la valoración del incivismo laboral
Fatores de estresse relacionado ao trabalho: as vozes dos atendentes de telemarketing
Authors: Lucca Sérgio Roberto de , Zanatta Aline Bedin , Rodrigues Marcelo Scarpari , Coimbra Igor Benedick , Queiroz Felipe Seixas , Correa Beatriz
Published: March 2016

A elevada rotatividade e o crescimento do número de casos de transtornos mentais entre os atendentes de telemarketing é resultado do trabalho penoso a que esses trabalhadores são submetidos. Este artigo teve por objetivo analisar os fatores organizacionais e psicossociais relacionados ao estresse e sofrimento psíquico percebidos pelos atendentes de uma empresa de telemarketing. Foi aplicado um questionário de avaliação do estresse no trabalho e criou-se um grupo focal para a discussão e identificação das principais categorias relacionadas com o sofrimento psíquico desses trabalhadores. A falta de controle e a falta de autonomia foram os principais fatores de estresse e sofrimento psíquico nos dois instrumentos, tanto no quantitativo, quanto nos grupos focais (qualitativo), ambos adotados neste estudo. Na percepção dos atendentes, a falta de transparência nos critérios de promoção e reconhecimento, a precariedade do suporte e o apoio da chefia e os relacionamentos conflitantes na organização pesquisada também influenciam negativamente a saúde mental destes sujeitos.
Adrenal Venous Sampling in Patients With Positive Screening but Negative Confirmatory Testing for Primary Aldosteronism
Authors: Umakoshi Hironobu , Naruse Mitsuhide , Wada Norio , Ichijo Takamasa , Kamemura Kohei , Matsuda Yuichi , Fujii Yuichi , Kai Tatsuya , Fukuoka Tomikazu , Sakamoto Ryuichi , Ogo Atsushi , Suzuki Tomoko , Nanba Kazutaka , Tsuiki Mika
Published: March 2016

Adrenal venous sampling is considered to be the most reliable diagnostic procedure to lateralize aldosterone excess in primary aldosteronism (PA). However, normative criteria have not been established partially because of a lack of data in non-PA hypertensive patients. The aim of the study was to investigate aldosterone concentration and its gradient in the adrenal vein of non-PA hypertensive patients. We retrospectively studied the results of cosyntropin-stimulated adrenal venous sampling in 40 hypertensive patients who showed positive screening testing but negative results in 2 confirmatory tests/captopril challenge test and saline infusion test. Plasma aldosterone concentration, aldosterone/cortisol ratio, its higher/lower ratio (lateralization index) in the adrenal vein with cosyntropin stimulation were measured. Median plasma aldosterone concentration in the adrenal vein was 25 819 pg/mL (range, 5154–69 920) in the higher side and 12 953 (range, 1866–36 190) pg/mL in the lower side (
P
<0.001). There was a significant gradient in aldosterone/cortisol ratio between the higher and the lower sides (27.2 [5.4–66.0] versus 17.3 [4.0–59.0] pg/mL per μg/dL;
P
<0.001) with lateralization index ranging from 1.01 to 3.87. The aldosterone lateralization gradient was between 1 to 2 in 32 patients and 2 to 4 in 8 patients. None of the patients showed lateralization index ≥4. The present study demonstrated that plasma aldosterone concentration in the adrenal veins showed significant variation and lateralization gradient even in non-PA hypertensive patients. Adrenal venous sampling aldosterone lateralization gradients between 2 and 4 should be interpreted with caution in patients with PA because these gradients can be found even in patients with negative confirmatory testing for PA.