bluuebunny/crossref_metadata_2025 huggingface dataset:
No Evidence for an Association Between Renal Function and Serious Bleeding Events in Patients Treated With Coumarins: A Population-Based Study
Authors: Houben Eline , Smits Elisabeth , Overbeek Jetty A. , Penning-van Beest Fernie J. A. , Herings Ron M. C. , van Herk-Sukel Myrthe P. P. , Teichert Martina , de Smet Peter A. G. M.
Published: October 2017

Background: Although anticoagulation therapy is closely monitored in the Netherlands, coumarin-induced serious bleeding events are still observed. Current literature suggests that renal impairment may contribute to this. Objective: To explore the association between renal function and bleeding events during coumarin treatment. Methods: A nested case-control study was conducted using data from the PHARMO Database Network. Patients hospitalized for a bleeding event during coumarin treatment were selected as cases and matched on sex, birth year, and geographic region to up to 2 controls using coumarins without hospitalization for bleeding. All values of estimated glomerular filtration rates (eGFRs) were selected in the year before index date (case hospitalization date) and compared between cases and controls using logistic regression analyses. Results: In total, 2224 cases were matched to 4398 controls (61% male; mean ± SD age 75 ± 11 and 78 ± 11 years among cases and controls, respectively). Availability of eGFR values was higher among cases compared with controls (mean ± SD eGFR values 4.5 ± 7.1 vs 3.2 ± 5.5), reflected in the significantly shorter time since last eGFR value (at index date, mean ± SD = 2.7 ± 3.0 vs 3.8 ± 3.1 months; odds ratio [OR] = 0.91, 95%CI = 0.89-0.92). No statistically significant difference was found for the mean eGFR value in the year before index date (mean ± SD 65.7 ± 22.8 vs 64.6 ± 20.9 mL/min/1.73 m2; OR per 10 units [95%CI] = 0.99 [0.96-1.02]). Conclusions: No association between renal function and serious bleeding events during coumarin treatment was observed.
De Novo Unclassifiable CD20-Negative Diffuse Large B-Cell Lymphoma: A Diagnostic and Therapeutic Challenge
Authors: AbdullGaffar Badr , Seliem Rania M.
Published: October 2017

CD20-negative diffuse large B-cell lymphomas (DLBCLs) constitute a rare and heterogeneous group of aggressive lymphomas. Known well-documented variants include plasmablastic lymphomas, primary effusion lymphomas, anaplastic kinase-positive large B-cell lymphomas, and large B-cell lymphomas arising in human herpesvirus 8 (HHV8)–associated multicentric Castleman disease. They impose diagnostic challenges for pathologists and therapeutic confrontations for clinicians. CD20 loss in B-cell lymphomas is a well-known phenomenon after rituximab therapy. De novo loss of CD20 has been reported in human immunodeficiency virus (HIV)–positive patients. Rare cases of primary CD20-negative DLBCLs that did not meet the criteria of the well-established subtypes of CD20-negative DLBCLs have been reported. This might expand the spectrum of unclassifiable CD20-negative DLBCLs with aberrant genetic and immunophenotypes. This imposes further diagnostic and therapeutic challenges. We report a case of a primary CD20-negative DLBCL in an HIV-infected female patient with an Epstein Barr virus (EBV) coinfection, who presented with generalized lymphadenopathy and fever. The nodal neoplastic immunoblasts were positive for LCA, PAX5, CD30, OCT2, BOB1, MUM1, CD79a, and CD19. Ki67 proliferation index was 100%. They were negative for CD20, CD3, ALK, EMA, CD138, CD38, EBV, and HHV8. Our case did not meet the criteria of the known variants of CD20-negative DLBCLs. The aim of this study is to highlight the diagnostic challenges associated with CD20-negative DLBCLs. De novo unclassifiable CD20-negative DLBCLs might raise an insight into the complex genetic mechanisms of CD20 concealment with variable immunoprofiles and resistance to conventional chemotherapies.
Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity
Authors: Saunders Stuart M. , Ellis Scott J. , Demetracopoulos Constantine A. , Marinescu Anca , Burkett Jayme , Deland Jonathan T.
Published: October 2017

Background:

The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy.

Methods:

We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years. Preoperative and postoperative radiographs were analyzed for the amount of deformity correction. Computed tomography (CT) was used to analyze osteotomy healing. The Foot and Ankle Outcome Scores (FAOS) and lateral pain surveys were used to assess clinical outcomes. Mann-Whitney U tests were used to assess nonnormally distributed data while χ2 and Fisher exact tests were used to analyze categorical variables (α = 0.05 significant).

Results:

The Evans group used a larger graft size ( P < .001) and returned more often for hardware removal ( P = .038) than the SLCO group. SLCO union occurred at a mean of 8.77 weeks ( P < .001), which was significantly lower compared with the Evans group ( P = .02). The SLCO group also had fewer nonunions ( P = .016). FAOS scores improved equivalently between the 2 groups. Lateral column pain, ability to exercise, and ambulation distance were similar between groups.

Conclusion:

Following SLCO, patients had faster healing times and fewer nonunions, similar outcomes scores, and equivalent correction of deformity. SLCO is a viable technique for lateral column lengthening.

Level of Evidence:

Level III, retrospective cohort study.
Effectiveness of the Simultaneous Stretching of the Achilles Tendon and Plantar Fascia in Individuals With Plantar Fasciitis
Authors: Engkananuwat Phoomchai , Kanlayanaphotporn Rotsalai , Purepong Nithima
Published: October 2017

Background:

Since the plantar fascia and the Achilles tendon are anatomically connected, it is plausible that stretching of both structures simultaneously will result in a better outcome for plantar fasciitis.

Methods:

Fifty participants aged 40 to 60 years with a history of plantar fasciitis greater than 1 month were recruited. They were prospectively randomized into 2 groups. Group 1 was instructed to stretch the Achilles tendon while group 2 simultaneously stretched the Achilles tendon and plantar fascia.

Results:

After 4 weeks of both stretching protocols, participants in group 2 demonstrated a significantly greater pressure pain threshold than participants in group 1 ( P = .040) with post hoc analysis. No significant differences between groups were demonstrated in other variables ( P > .05). Concerning within-group comparisons, both interventions resulted in significant reductions in pain at first step in the morning and average pain at the medial plantar calcaneal region over the past 24 hours, while there were increases in the pressure pain threshold, visual analog scale–foot and ankle score, and range of motion in ankle dorsiflexion ( P < .001). More participants in group 2 described their symptoms as being much improved to being completely improved than those in group 1.

Conclusion:

The simultaneous stretching of the Achilles tendon and plantar fascia for 4 weeks was a more effective intervention for plantar fasciitis. Patients who reported complete relief from symptoms at the end of the 4-week intervention in the simultaneous stretching group (n = 14; 56%) were double that of the stretching of the Achilles tendon–only group (n = 7; 28%).

Level of Evidence:

II, lesser quality RCT or prospective comparative study.
Shear horizontal waves in composite materials: Behavior under rotation and initial stress
Authors: Abd-alla Abo-el-nour N , Othman MIA , Hasbullah NF
Published: October 2017

The main scope of this paper is to present in a simple and concise way a mathematical model of composite materials able to describe the propagation of shear horizontal waves in the case where composite is rotating and subjected to an initial stress. This work is aimed at the relevant possibility to apply the obtained results for the establishment of high-achievement applications of piezoelectric and semiconductor composites and surface acoustic waves devices. We conclude by analyzing numerical computations in which the influence of the rotation, initial stress and electromagnetic boundary conditions are graphically observed.
Imperfect interfaces with graded materials and unilateral conditions: theoretical and numerical study
Authors: Dumont Serge , Lebon Frédéric , Rizzoni Raffaella
Published: October 2017

In this paper a composite body is considered. This body is made of three solids: two linear elastic adherents and a piecewise linear thin adhesive. The composite occupies a bounded domain depending naturally on a small parameter [Formula: see text], which is the thickness, assumed constant, of the adhesive. Classically, it is possible to derive an interface imperfect law using asymptotic expansions as the thickness [Formula: see text] tends to zero. In this work, the material in the interphase is assumed to be graded, i.e. its elasticity properties vary along the thickness. Moreover, an unilateral condition is considered to avoid penetrations. A first result of the paper is that it is possible to apply the above methodology based on asymptotic expansions to this kind of material. Then, a finite element method is introduced to solve the initial problem (with three layers) and the limit problem (with two layers in imperfect contact). Various types of graded materials are numerically analyzed. In particular, different types of stiffness distributions are studied in detail.
Training Peer Models to Promote Social Skills: Considerations for Practice
Authors: Mathews Therese L. , Vatland Christopher , Lugo Ashley M. , Koenig Elizabeth A. , Gilroy Shawn P.
Published: October 2017

Social skills training programs have increasingly enlisted same-age typical peers as instructors in the teaching of social skills to children with high-functioning autism spectrum disorder (ASD). The inclusion of peers in the teaching process has been found to be a critical component in these programs. Despite strong support for incorporating peers in social skills programs, there are few guidelines for training peers. The present study examined a treatment package to teach typical school-aged children skills to become peer models. A multiple baseline across behaviors research design was implemented using components of behavioral skills training to teach (a) initiating verbal interactions, (b) prompting for targeted skills, and (c) delivery of praise. The peer models quickly acquired the skill of initiating verbal interactions; however, posting of data, prompting, and additional contingencies were needed to maintain and generalize prompting for targeted skills and delivery of praise with novel children.
The Global Jihadist Movement: The Most Lethal Ideology?
Authors: Carson Jennifer Varriale , Suppenbach Matthew
Published: October 2017

Prior research has established a link between ideology and lethality, both within the homicide and terrorism literatures. We examine this relationship as it pertains to the Global Jihadist Movement (GJM). Using a series of logit and negative binomial models with a sample from the Global Terrorism Database, we find that the GJM is indeed more deadly. However, this relationship does not seem to differentially affect Americans, despite their role as the GJM’s defined “other.”
Simultaneous pain intensity rating and quantification of ischemia throughout exercise and recovery in proximal versus distal arterial claudication
Authors: Fouasson-Chailloux Alban , Abraham Pierre , Colas-Ribas Christophe , Feuilloy Mathieu , Vielle Bruno , Henni Samir
Published: October 2017

Data on simultaneous hemodynamic changes and pain rating estimation in arterial claudication while walking are lacking. This study was conducted to determine if a difference in transcutaneous oxygen pressure (tc pO2) exists between proximal and distal localization at pain appearance (PAINapp), maximal pain (PAINmax) and pain relief (PAINrel) in proximal or distal claudication and if a relationship exists between tc pO2 changes and pain intensity. We analyzed the pain rating (Visual Analog Scale (VAS)) to lower limb ischemia, measured with the decrease from rest of oxygen pressure (DROP) tc pO2 index during constant-load treadmill tests in patients with calf ( n = 41) or buttock ( n = 19) claudication. Calves versus buttocks results were analyzed with ANOVA tests. The R2 correlation coefficient between individual VAS versus DROP was calculated. Ischemia intensity versus pain rating changes were correlated. Significant ischemia was required for pain appearance, but pain disappeared despite the persistence of ischemia. We observed no statistical difference for DROP at PAINapp, PAINmax or PAINrel between proximal or distal claudication. A significant correlation between pain rating versus DROP was found: from PAINapp to PAINmax, R2 = 0.750 (calves) and 0.829 (buttocks), and from PAINmax to PAINrel, R2 = 0.608 (calves) and 0.560 (buttocks); p<0.05. Pain appeared after a significant decrease of hemodynamic parameters but disappeared while parameters were not normalized. No difference in pain rating was found in proximal versus distal claudication.
Free vibration of summation and difference resonance of the vertical cable and other coupled structural members
Authors: Dong Chunguang , Wang Ronghui , Zhen Xiaoxia , Ni Haonan
Published: October 2017

Free vibration of summation and difference resonance of the vertical cable and other coupled structural members were investigated in this article. A model of a vertical cable and two mass–springs was built, with the sling considered to be geometrically nonlinear, and the upper and lower connecting structural members were taken as two mass–springs. Assuming the displacement of the sling, modal superposition method and D’Alembert principle were used to derive the dynamic equilibrium equations of the coupled structure. The nonlinear dynamic equilibrium equations were studied by means of multiple scales method, and the second-order approximation solutions of single-modal motion of the system were obtained. Numerical examples were presented to discuss the amplitude responses as functions of time of free vibration, with and without damping, respectively. Additionally, fourth-order Runge–Kutta method was directly used for the nonlinear dynamic equilibrium equations to complement and verify the analytical solutions. The results show that the coupled system performs strongly nonlinear and coupled characteristics, which is useful for engineering design.
Healthcare in the news media: The privileging of private over public
Authors: Lewis Sophie , Collyer Fran , Willis Karen , Harley Kirsten , Marcus Kanchan , Calnan Michael , Gabe Jon
Published: October 2017

This article reports on a discourse analysis of the representation of healthcare in the print news media, and the way this representation shapes perspectives of healthcare. We analysed news items from six major Australian newspapers over a three-year time period. We show how various framing devices promote ideas about a crisis in the current public healthcare system, the existence of a precarious balance between the public and private health sectors, and the benefits of private healthcare. We employ Bourdieu’s concepts of field and capital to demonstrate the processes through which these devices are employed to conceal the power relations operating in the healthcare sector, to obscure the identity of those who gain the most from the expansion of private sector medicine, and to indirectly increase health inequalities.
Of counter spaces of provisioning
Authors: Roux Dominique , Guillard Valérie , Blanchet Vivien
Published: October 2017

This article considers the concept of heterotopia in the context of public space. Based on the observations and interviews with 19 disposers and/or gleaners operating on bulky item collection days, it shows that the sidewalk is (1) a liminal space for unwanted objects that are in transition between disposal and destruction or reappropriation; (2) a regularly practiced space, the meaning of which is redefined by disposers (for depositing) and gleaners (for provisioning); (3) a place of illusion that mirrors the profusion of goods produced by the linear economy; and (4) a space of compensation for the pitfalls of the consumer society. These findings provide a theoretical basis for the new concept of parasite heterotopia, a term that refers to a space that is appropriated by a tactical use of a regulated place, which both reflects and contests a dominant ordering on its own territory. The article adds to previous literature on heterotopias and sustainability by questioning how this “time–space” is involved in the dialectics of capitalism and criticism.
Botanical Sources for Alzheimer’s: A Review on Reports From Traditional Persian Medicine
Authors: Hosseinkhani Ayda , Sahragard Ali , Namdari Aida , Zarshenas Mohammad M.
Published: October 2017

Herbal medicines for the treatment of Alzheimer’s disease (AD) have attracted considerable attention nowadays. Alzheimer’s disease is described in traditional Persian medicine (TPM) by the term Nesyān. In this study, 5 main medicinal medieval Persian manuscripts were reviewed to filter plants reported for the treatment of Nesyān. Databases were searched for related possible mechanisms of action of these medicinal plants. Each herb was searched for along with these keywords: “acetyl and butyryl cholinesterase inhibition,” “antioxidant,” “anti-inflammatory,” and “anti-amyloidogenic.” In Total, 44 herbs were used for the treatment of Nesyān; 40 of those were authenticated. Also, 30 plants had at least one of the mechanisms of action that were searched for or related pharmacological functions known for the treatment of AD. In this work, we introduce promising candidates in TPM that could undergo further investigation for identification of their active compounds and clinical validation in the treatment of AD.
Evidence of bias in randomized clinical trials of hepatitis C interferon therapies
Authors: Tinè Fabio , Attanasio Massimo , Muggeo Vito M R , Crainiceanu Ciprian M.
Published: October 2017

Introduction:

Bias may occur in randomized clinical trials in favor of the new experimental treatment because of unblinded assessment of subjective endpoints or wish bias. Using results from published trials, we analyzed and compared the treatment effect of hepatitis C antiviral interferon therapies experimental or control.

Methods:

Meta-regression of trials enrolling naïve hepatitis C virus patients that underwent four therapies including interferon alone or plus ribavirin during past years. The outcome measure was the sustained response evaluated by transaminases and/or hepatitis C virus-RNA serum load. Data on the outcome across therapies were collected according to the assigned arm (experimental or control) and to other trial and patient-level characteristics.

Results:

The overall difference in efficacy between the same treatment labeled experimental or control had a mean of +11.9% (p < 0.0001). The unadjusted difference favored the experimental therapies of group IFN-1 (+6%) and group IFN-3 (+10%), while there was no difference for group IFN-2 because of success rates from large multinational trials. In a meta-regression model with trial-specific random effects including several trial and patient-level variables, treatment and arm type remained significant (p < 0.0001 and p = 0.0009 respectively) in addition to drug-schedule-related variables.

Conclusion:

Our study indicates the same treatment is more effective when labeled “experimental” compared to when labeled “control” in a setting of trials using an objective endpoint and even after adjusting for patient and study-level characteristics. We discuss several factors related to design and conduct of hepatitis C trials as potential explanations of the bias toward the experimental treatment.
Against the current: The emergence of a media democratization policy agenda in Latin America
Authors: Kitzberger Philip
Published: October 2017

In Latin America, the role of the media in democratic societies has recently become the subject of public debates, struggles and political mobilizations that have denaturalized the existing media order and established a distinct policy agenda oriented towards media democratization. This region-wide trend – a counter-tendency to the globally dominant market-driven orientation of media and telecommunication policies – requires explanation. This article stresses that it cannot be attributed to a spontaneous reaction to market concentration or media elitism, just as it cannot be reduced to a top-down process driven by populist leaders seeking to control the media. Drawing on social movement literature, the article traces four interacting processes – domestic network mobilization, reframing processes, transnational activism and changes in political elite alignments – that have brought about the unprecedented politicization of the Latin American media order.
Descriptive Epidemiology of Injuries Sustained in National Collegiate Athletic Association Men’s and Women’s Volleyball, 2013-2014 to 2014-2015
Authors: Baugh Christine M. , Weintraub Gil S. , Gregory Andrew J. , Djoko Aristarque , Dompier Thomas P. , Kerr Zachary Y.
Published: October 2017

Background:

There were 18,844 volleyball players in the National Collegiate Athletic Association (NCAA) in the 2014-2015 academic year. Little research has examined sex-based differences among these athletes.

Purpose:

To examine injury epidemiology in NCAA men’s and women’s volleyball athletes.

Study Design:

Descriptive epidemiology study.

Level of Evidence:

Level 3.

Methods:

Injury surveillance data from the 2013-2014 through 2014-2015 academic years were obtained from the NCAA Injury Surveillance Program for 6 men’s and 33 women’s collegiate volleyball teams. Injury rates per 1000 athlete-exposures (AEs) and injury rate ratios (IRRs) with 95% CIs were calculated. Time-loss (TL) injuries resulted in participation restriction for at least 24 hours, and non-time-loss (NTL) injuries resulted in participation restriction of less than 24 hours.

Results:

Overall, 83 and 510 injuries were reported in men and women, respectively, leading to injury rates of 4.69 and 7.07 per 1000 AEs. The injury rate was greater in women than men (IRR, 1.51; 95% CI, 1.19-1.90). TL injury rates were 1.75 and 2.62 per 1000 AEs for men and women, respectively. The ankle was the most commonly injured body part among TL injuries (men, 25.8%; women, 24.3%); the knee was the most commonly injured body part among NTL injuries (men, 25.5%; women, 16.3%). Among TL injuries, common diagnoses included sprains (men, 25.8%; women, 31.2%) and concussions (men, 19.4%; women, 14.8%). Most TL concussions were due to ball contact (men, 83.3%; women, 53.6%). Compared with men, women had a greater NTL overuse injury rate (IRR, 3.47; 95% CI, 1.61-7.46). Compared with women, men had a greater TL injury rate associated with ball contact (IRR, 2.24; 95% CI, 1.07-4.68).

Conclusion:

There are differences in injury patterns and rates between male and female intercollegiate volleyball players. Although a limited-contact sport, a notable number of concussions were sustained, mostly from ball contact.

Clinical Relevance:

Understanding injury patterns may aid clinicians in injury diagnosis, management, and prevention.
Characterization of Prepractice Injury Prevention Exercises of High School Athletic Teams
Authors: Slauterbeck James R. , Reilly Autumn , Vacek Pamela M. , Choquette Rebecca , Tourville Timothy W. , Mandelbaum Bert , Johnson Robert J. , Beynnon Bruce D.
Published: October 2017

Background:

Static and dynamic exercises are performed before activity to decrease injury risk and increase performance. Although evidence supports using dynamic over static stretching and performing Fédération Internationale de Football Association (FIFA) 11+ as a dynamic prepractice routine, we do not know the frequency at which these exercises are utilized in high school populations.

Hypothesis:

We hypothesize that there is a wide variety of preparticipation exercises performed by high school athletes, and that few high school teams perform FIFA 11+ as an injury prevention program in its entirety.

Study Design:

Observational study.

Level of Evidence:

Level 4.

Methods:

High school prepractice routines were observed for 185 teams (football, soccer, basketball, and lacrosse) over 1 season. The percentages of team warm-up routines that included components of FIFA 11+ were calculated, and the chi-square test was used to compare sex, sport, and level of competition.

Results:

Of a total 644 warm-up observations, 450 (69.9%) included only non–FIFA 11+ exercises, 56 (8.7%) included at least 1 FIFA 11+ exercise, and 38 (5.9%) included only jogging; 69 (10.6%) consisted only of sport-specific activities. The type of warm-up differed significantly between males and females ( P = 0.002), sports ( P < 0.001), and level of competition ( P < 0.001). Static stretching and athletes stretching on their own were observed in 14% and 15% of all observations. No team performed the FIFA 11+ injury prevention routine in its entirety.

Conclusion:

The type of warm-up differed by sex, sport, and level of competition. Static stretching was performed more frequently than anticipated, and an entire FIFA 11+ warm-up was never performed.

Clinical Relevance:

We need to identify the exercises that decrease injury and increase performance and better inform the athletic population about the risks and benefits of static and dynamic warm-up programs.
Making microenvironments: A look into incorporating macromolecular crowding into in vitro experiments, to generate biomimetic microenvironments which are capable of directing cell function for tissue engineering applications
Authors: Benny Paula , Raghunath Michael
Published: October 2017

Biomimetic microenvironments are key components to successful cell culture and tissue engineering in vitro. One of the most accurate biomimetic microenvironments is that made by the cells themselves. Cell-made microenvironments are most similar to the in vivo state as they are cell-specific and produced by the actual cells which reside in that specific microenvironment. However, cell-made microenvironments have been challenging to re-create in vitro due to the lack of extracellular matrix composition, volume and complexity which are required. By applying macromolecular crowding to current cell culture protocols, cell-made microenvironments, or cell-derived matrices, can be generated at significant rates in vitro. In this review, we will examine the causes and effects of macromolecular crowding and how it has been applied in several in vitro systems including tissue engineering.
Impact of expansion and redifferentiation under hypothermia on chondrogenic capacity of cultured human septal chondrocytes
Authors: von Bomhard Achim , Faust Joseph , Elsaesser Alexander F , Schwarz Silke , Pippich Katharina , Rotter Nicole
Published: October 2017

A critical limitation in the cultivation of cartilage for tissue engineering is the dedifferentiation in chondrocytes, mainly during in vitro amplification. Despite many previous studies investigating the influence of various conditions, no data exist concerning the effects of hypothermia. Our aim has been to influence chondrocyte dedifferentiation in vitro by hypothermic conditions. Chondrocytes were isolated from cartilage biopsies and seeded in monolayer and in three-dimensional pellet-cultures. Each cell culture was either performed at 32.2°C or 37°C during amplification. Additionally, the influence of the redifferentiation of chondrocytes in three-dimensional cell culture was examined at 32.2°C and 37°C after amplification at 32.2°C or 37°C. An 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was used to measure cell proliferation in monolayer, whereas the polymerase chain reaction and immunohistochemical and histological staining were used in three-dimensional pellet-cultures. Real-time polymerase chain reaction was employed to measure the relative expression of the target genes collagen II, collagen I, aggrecan and versican. Ratios were estimated between collagen II/collagen I and aggrecan/versican to evaluate differentiation. A higher value of these ratios indicated an advantageous status of differentiation. In monolayer, hypothermia at 32.2°C slowed down the proliferation rate of chondrocytes significantly, being up to two times lower at 32.2°C compared with culture at 37°C. Simultaneously, hypothermia in monolayer decelerated dedifferentiation. The ratio of aggrecan/versican was significantly higher at 32.2°C compared with that at 37°C. In three-dimensional pellet-culture, the chondrocytes redifferentiated at 32.2°C and at 37°C, and this process is more distinct at 37°C than at 32.2°C. Similar results were obtained for the ratios of collagen II/collagen I and aggrecan/versican and were supported by immunochemical and histological staining. Thus, hypothermic conditions for chondrocytes are mainly advantageous in monolayer culture. In three-dimensional pellet-culture, redifferentiation predominates at 37°C compared with at 32.2°C. In particular, the results from the monolayer cultures show potential in the avoidance of dedifferentiation.
The 9p21 Rs 1333040 polymorphism is associated with coronary microvascular obstruction in ST-segment elevation myocardial infarction treated by primary angioplasty
Authors: Fracassi Francesco , Niccoli Giampaolo , Vetrugno Vincenzo , Cauteruccio Michele , Buffon Antonino , Gatto Ilaria , Giarretta Igor , Tondi Paolo , Pola Roberto , Crea Filippo
Published: October 2017

Background:

Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI.

Methods:

We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI. The Rs1333040 polymorphism was evaluated by polymerase chain reaction-restriction fragment length polymorphism using restriction endonucleases (Bsml). Two expert operators unaware of the patients’ identity performed the angiographic analysis; collaterals were assessed applying Rentrop’s classification. Angiographic MVO was defined as a post-pPCI Thrombolysis In Myocardial Infarction (TIMI)<3 or TIMI 3 with myocardial blush grade 0 or 1, whereas electrocardiographic MVO was defined as ST segment resolution <70% one hour after pPCI.

Results:

Among our 133 STEMI patients (mean age 63 ± 11 years, men 72%), 35 (26%) and 53 (40%) respectively experienced angiographic or electrocardiographic MVO. Angiographic and electrocardiographic MVO were different among the three variants ( p= 0.03 and p=0.02 respectively). In particular, T/T genotype was associated with a higher incidence of both angiographic and electrocardiographic MVO compared with C/C genotype ( p=0.04 and p=0.03 respectively). Moreover, Rentrop score <2 detection rate differed among the three genotypes ( p=0.03). In particular T/T genotype was associated with a higher incidence of a Rentrop score <2 as compared with C/C genotype ( p= 0.02).

Conclusion:

Rs1333040 polymorphism genetic variants portend different MVO incidence. In particular, T/T genotype is related to angiographic and electrocardiographic MVO and to worse collaterals towards the culprit artery.
The role of halofuginone in fibrosis: more to be explored?
Authors: Luo Yin , Xie Xiaoyan , Luo Di , Wang Yuan , Gao Yijun
Published: October 2017

Fibrosis, which can be defined as an abnormal or excessive accumulation of extracellular matrix (ECM), particularly fibrillar collagens, is a key driver of progressive organ dysfunction in many inflammatory and metabolic diseases, including idiopathic pulmonary fibrosis (IPF), cirrhosis, nephropathy, and oral submucous fibrosis (OSF). It has been estimated to contribute to ∼45% of deaths in the developed world. Therefore, agents that target specific fibrotic pathways, with the consequence of slowing, arresting, or even reversing the progression of tissue fibrogenesis, are urgently needed. 7-Bromo-6-chloro-3-[3-(3-hydroxy-2-piperidinyl)-2-oxopropyl]-4(3H)-quinazolinone (halofuginone), an analog of febrifugine, which specifically targets the pathogenesis of ECM proteins, inhibits tissue fibrosis and regeneration and even affects the development of tumors in various tissues. Four modes of actions of halofuginone against fibrosis have been presented: 1) Inhibition of mothers against decapentaplegic homolog 3 (Smad3) phosphorylation downstream of the TGF-β signaling pathway, 2) reduction of collagen amounts, 3) decreases in ECM protein, and 4) selective prevention of Th17 cell differentiation. In this review, we will mainly focus on the rationale for halofuginone against fibrosis.
Fast and robust common-reflection-surface parameter estimation
Authors: Waldeland Anders U. , Zhao Hao , Faccipieri Jorge H. , Schistad Solberg Anne H. , Gelius Leiv-J.
Published: October 2017

The common-reflection-surface (CRS) method offers a stack with higher signal-to-noise ratio at the cost of a time-consuming semblance search to obtain the stacking parameters. We have developed a fast method for extracting the CRS parameters using local slope and curvature. We estimate the slope and curvature with the gradient structure tensor and quadratic structure tensor on stacked data. This is done under the assumption that a stacking velocity is already available. Our method was compared with an existing slope-based method, in which the slope is extracted from prestack data. An experiment on synthetic data shows that our method has increased robustness against noise compared with the existing method. When applied to two real data sets, our method achieves accuracy comparable with the pragmatic and full semblance searches. Our method has the advantage of being approximately two and four orders of magnitude faster than the semblance searches.
S-wave velocity prediction in unconventional shale reservoirs
Authors: Vernik Lev , Castagna John , Omovie Sheyore John
Published: October 2017

In unconventional reservoirs with significant organic content, the Greenberg-Castagna (GC) S-wave velocity prediction method does not yield accurate S-wave velocity predictions, with observed mean errors varying from 6% to 16% in a variety of unconventional reservoirs rich in organic content. This is because kerogen content is not explicitly taken into account in the GC S-wave velocity prediction method. Two alternative approaches for bedding-normal S-wave velocity prediction from P-wave velocity and other well logs in relatively straight holes drilled in unconventional reservoirs are investigated. The first method is purely empirical, requiring minimal information such as P-wave velocity and total organic carbon content. This approach implicitly accounts for compositional and stress effects on mudrock elasticity. The second method can be classified as a hybrid technique, comprising the following three steps: (1) computing a nonkerogen phase P-wave velocity using the Vernik-Kachanov (VK) model, (2) determination of the nonkerogen S-wave velocity from the GC approach, and (3) using a simplified VK model to mix the nonkerogen matrix with nanoporous kerogen to predict the bedding-normal S-wave velocity of the organic mudrock. The second method explicitly takes into account all the variables that control elastic properties of organic mudrock reservoirs. Tests in nine wells from seven different oil and gas shale reservoirs indicate that both methods have prediction accuracy better than 3% error when input data are accurate.
Changing the obesogenic environment to improve cardiometabolic health in residential patients with a severe mental illness: cluster randomised controlled trial
Authors: Looijmans Anne , Stiekema Annemarie P. M. , Bruggeman Richard , van der Meer Lisette , Stolk Ronald P. , Schoevers Robert A. , Jörg Frederike , Corpeleijn Eva
Published: October 2017

Background

For patients with severe mental illness (SMI) in residential facilities, adopting a healthy lifestyle is hampered by the obesity promoting (obesogenic) environment.

Aims

To determine the effectiveness of a 12-month lifestyle intervention addressing the obesogenic environment with respect to diet and physical activity to improve waist circumference and cardiometabolic risk factors v. care as usual (Dutch Trial Registry: NTR2720).

Method

In a multisite cluster randomised controlled pragmatic trial, 29 care teams were randomised into 15 intervention (365 patients) and 14 control teams (371 patients). Intervention staff were trained to improve the obesogenic environment.

Results

Waist circumference decreased 1.51 cm (95% CI −2.99 to −0.04) in the intervention v. control group after 3 months and metabolic syndrome z-score decreased 0.22 s.d. (95% CI −0.38 to −0.06). After 12 months, the decrease in waist circumference was no longer statistically significantly different (–1.28 cm, 95% CI −2.79 to 0.23, P = 0.097).

Conclusions

Targeting the obesogenic environment of residential patients with SMI has the potential to facilitate reduction of abdominal adiposity and cardiometabolic risk, but maintaining initial reductions over the longer term remains challenging.
Cholesterol and triglyceride levels in first-episode psychosis: systematic review and meta-analysis
Authors: Pillinger Toby , Beck Katherine , Stubbs Brendon , Howes Oliver D.
Published: October 2017

Background

The extent of metabolic and lipid changes in first-episode psychosis (FEP) is unclear.

Aims

To investigate whether individuals with FEP and no or minimal antipsychotic exposure show lipid and adipocytokine abnormalities compared with healthy controls.

Method

We conducted a meta-analysis of studies examining lipid and adipocytokine parameters in individuals with FEP and no or minimal antipsychotic exposurev.a healthy control group. Studies reported fasting total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and leptin levels.

Results

Of 2070 citations retrieved, 20 case–control studies met inclusion criteria including 1167 patients and 1184 controls. Total cholesterol and LDL cholesterol levels were significantly decreased in patientsv.controls, corresponding to an absolute reduction of 0.26mmol/L and 0.15mmol/L respectively. Triglyceride levels were significantly increased in the patient group, corresponding to an absolute increase of 0.08 mmol/L However, HDL cholesterol and leptin levels were not altered in patientsv.controls.

Conclusions

Total and LDL cholesterol levels are reduced in FEP, indicating that hypercholesterolaemia in patients with chronic disorder is secondary and potentially modifiable. In contrast, triglycerides are elevated in FEP. Hypertriglyceridaemia is a feature of type 2 diabetes mellitus, therefore this finding adds to the evidence for glucose dysregulation in this cohort. These findings support early intervention targeting nutrition, physical activity and appropriate antipsychotic prescription.
Personal well-being networks, social capital and severe mental illness: exploratory study
Authors: Sweet Daryl , Byng Richard , Webber Martin , Enki Doyo Gragn , Porter Ian , Larsen John , Huxley Peter , Pinfold Vanessa
Published: October 2017

Background

Connectedness is a central dimension of personal recovery from severe mental illness (SMI). Research reports that people with SMI have lower social capital and poorer-quality social networks compared to the general population.

Aims

To identify personal well-being network (PWN) types and explore additional insights from mapping connections to places and activities alongside social ties.

Method

We carried out 150 interviews with individuals with SMI and mapped social ties, places and activities and their impact on well-being. PWN types were developed using social network analysis and hierarchicalk-means clustering of this data.

Results

Three PWN types were identified: formal and sparse; family and stable; and diverse and active. Well-being and social capital varied within and among types. Place and activity data indicated important contextual differences within social connections that were not found by mapping social networks alone.

Conclusions

Place locations and meaningful activities are important aspects of people's social worlds. Mapped alongside social networks, PWNs have important implications for person-centred recovery approaches through providing a broader understanding of individual's lives and resources.

Declaration of interest

None.
Repair Costs of Existing RC Buildings Damaged by the L'Aquila Earthquake and Comparison with FEMA P-58 Predictions
Authors: Del Vecchio Ciro , Di Ludovico Marco , Pampanin Stefano , Prota Andrea
Published: October 2017

Recent seismic events are a unique opportunity to monitor and collect details of direct repair costs and the downtimes associated with massive reconstruction processes. This paper focuses on the actual repair costs of five RC buildings damaged by the 2009 L'Aquila earthquake. The repair costs for structural and nonstructural components that experienced different types of earthquake damage are discussed and then used as a benchmark for the predictions. The comparison at both the building and component levels revealed that the FEMA P-58 methodology is suitable, in general, for application to different types of building stock. Ad hoc upgrades to the FEMA fragility database for components that are typical of the Mediterranean area are required. When implementing the proposed modifications, a reasonable level of consistency is achieved in terms of actual and predicted repair costs (differences in the range of 30–48%). A discussion on the actual repair costs and the main differences with the predicted costs for infills and partitions, structural subassemblies, floor finishes, and other acceleration-sensitive nonstructural components is provided, along with suggestions for further improving.
A Survey Evaluating Burnout, Health Status, Depression, Reported Alcohol and Substance Use, and Social Support of Anesthesiologists
Authors: Hyman Steve Alan , Shotwell Matthew S. , Michaels Damon R. , Han Xue , Card Elizabeth Borg , Morse Jennifer L. , Weinger Matthew B.
Published: October 2017

BACKGROUND:

Burnout affects all medical specialists, and concern about it has become common in today’s health care environment. The gold standard of burnout measurement in health care professionals is the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures emotional exhaustion, depersonalization (DP), and personal accomplishment. Besides affecting work quality, burnout is thought to affect health problems, mental health issues, and substance use negatively, although confirmatory data are lacking. This study evaluates some of these effects.

METHODS:

In 2011, the American Society of Anesthesiologists and the journal Anesthesiology cosponsored a webinar on burnout. As part of the webinar experience, we included access to a survey using MBI-HSS, 12-item Short Form Health Survey (SF-12), Social Support and Personal Coping (SSPC-14) survey, and substance use questions. Results were summarized using sample statistics, including mean, standard deviation, count, proportion, and 95% confidence intervals. Adjusted linear regression methods examined associations between burnout and substance use, SF-12, SSPC-14, and respondent demographics.

RESULTS:

Two hundred twenty-one respondents began the survey, and 170 (76.9%) completed all questions. There were 266 registrants total (31 registrants for the live webinar and 235 for the archive event), yielding an 83% response rate. Among respondents providing job titles, 206 (98.6%) were physicians and 2 (0.96%) were registered nurses. The frequency of high-risk responses ranged from 26% to 59% across the 3 MBI-HSS categories, but only about 15% had unfavorable scores in all 3. Mean mental composite score of the SF-12 was 1 standard deviation below normative values and was significantly associated with all MBI-HSS components. With SSPC-14, respondents scored better in work satisfaction and professional support than in personal support and workload. Males scored worse on DP and personal accomplishment and, relative to attending physicians, residents scored worse on DP. There was no significant association between MBI-HSS and substance use.

CONCLUSIONS:

Many anesthesiologists exhibit some high-risk burnout characteristics, and these are associated with lower mental health scores. Personal and professional support were associated with less emotional exhaustion, but overall burnout scores were associated with work satisfaction and professional support. Respondents were generally economically satisfied but also felt less in control at work and that their job kept them from friends and family. The association between burnout and substance use may not be as strong as previously believed. Additional work, perhaps with other survey instruments, is needed to confirm our results.
Patient Blood Management in Pediatric Cardiac Surgery: A Review
Authors: Cholette Jill M. , Faraoni David , Goobie Susan M. , Ferraris Victor , Hassan Nabil
Published: October 2017

Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population. Despite these challenges, safe conservative blood management practices spanning the pre-, intra-, and postoperative periods are being developed and are associated with reduced blood product transfusions. This review summarizes the available evidence regarding anemia management and blood transfusion practices in the perioperative care of these critically ill children. The evidence suggests that adoption of a comprehensive blood management approach decreases blood transfusions, but the impact on clinical outcomes is less well studied and represents an area that deserves further investigation.