bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI assessment of pituitary iron accumulation by using pituitary-R2 in β-thalassemia patients
Authors: Bozdağ Mustafa , Bayraktaroğlu Selen , Aydınok Yeşim , Çallı Mehmet Cem
Published: September 2017

Background

Patients with thalassemia major (TM) require repeated blood transfusions, which leads to accumulation of iron in a wide variety of tissues. Accumulation of iron in the pituitary gland can lead to irreversible hypogonadotropic hypogonadism (HH) in this group of patients.

Purpose

To investigate the reliability of pituitary-R2 as a marker to estimate the extent of pituitary iron load by comparing the pituitary magnetic resonance imaging (MRI) findings with hepatic iron load and serum ferritin levels.

Material and Methods

A total of 38 β-TM patients were classified into HH (group A, n = 18) and non-HH (group B, n = 17) groups. A third group, group C, consisted of 17 healthy participants. Each participant underwent 1.5-T MRI examinations. Pituitary gland heights (PGH), pituitary-R2 values, and liver-R2 values were measured by using multi-echo spin-echo sequences.

Results

Pituitary-R2 values were significantly higher in group A compared with group B ( P < 0.05). A positive correlation was detected between the pituitary-R2 values and serum ferritin levels in TM patients ( P < 0.01). A threshold value of 14.1 Hz for pituitary-R2 was found to give a high specificity and sensitivity in distinguishing the TM patients with HH from those with normal pituitary functions. PGH measurements were significantly lower in group A compared with group B ( P < 0.05).

Conclusion

MRI-assessed pituitary-R2 seems to be a reliable marker for differentiating the TM patients with normal pituitary function from those with secondary hypogonadism due to iron toxicity.
MRI evaluation of ligaments and tendons of foot arch in talar dome osteochondral lesions
Authors: Koç Ali , Karabiyik Özgür
Published: September 2017

Background

There are no publications in literature describing an association between disorders of the ligaments and tendons supporting the foot arch and osteochondral lesions of the talus (OCLT). We believe there may be a correlation between the damage of these structures.

Purpose

To investigate the pathologies of main ligaments and tendons that support the foot arch in sprained ankles, by reviewing magnetic resonance imaging (MRI) studies and comparing the results in two groups of patients, with and without OCLT.

Material and Methods

MR images from 316 patients examined in the orthopedic clinic for ankle sprain were evaluated for pathologic findings of the plantar fascia, short and long plantar ligaments, spring ligament, sinus tarsi, and ankle tendons supporting the foot arch. Findings were compared between two groups of patients: 158 patients with OCLT and 158 patients without OCLT.

Results

Plantar fascia, short plantar ligament, and spring ligament abnormalities were seen in 50 (31.6%), 28 (17.7%), and 60 (38%) patients with OCLT, and in nine (5.6%), three (1.9%), and 18 (11.4%) patients without OCLT, respectively ( P < 0.05). Sinus tarsi and tendon abnormalities were seen in 11 (6.7%) and nine (5.7%) patients with OCLT, and in eight (5%) and eight (5%) patients without OCLT, respectively ( P > 0.05). Two or more associated abnormalities were present in 50 (31.6%) patients with OCLT and in 11 (6.7%) without OCLT ( P < 0.05).

Conclusion

Plantar fascia, short plantar ligament, and spring ligament abnormalities were commonly seen in patients with OCLT on MRI, while sinus tarsi and tendon abnormalities were not. Concomitant pathologies have an increased incidence in patients with OCLT.
The effect of tannic acid on bone mechanical and geometric properties, bone density, and trabecular histomorphometry as well as the morphology of articular and growth cartilages in rats co-exposed to cadmium and lead is dose dependent
Authors: Tomaszewska Ewa , Dobrowolski Piotr , Winiarska-Mieczan Anna , Kwiecień Małgorzata , Muszyński Siemowit , Tomczyk Agnieszka
Published: September 2017

Cadmium (Cd) and lead (Pb) are toxic elements that accumulate to the largest extent in bones. Rats were used to investigate whether tannic acid (TA; 0.5%, 1.0%, 1.5%. 2.0%, or 2.5%) would have a protective effect on the structure and properties of bones in the case of exposure to Cd and Pb (diet: 7 mg Cd/kg and 50 mg Pb/kg) for 6 weeks. The effects of administration of TA in Cd- and Pb-poisoned rats on bone characteristics and the morphology of articular and growth cartilages were determined. All the rats administered Cd and Pb had an enhanced Cd and Pb concentration in blood plasma and bone and reduced bone Ca content irrespective of the TA administration. Cd and Pb alone reduced the mechanical endurance and histomorphometric parameters of trabecular bone and the thickness of the growth plate and articular cartilage. Tannic acid improved cancellous bone parameters in the rat exposed to Cd and Pb. A diet rich in TA improved articular cartilage constituents in heavy metal-poisoned rats. These results suggest that alimentary TA supplementation can counteract in a dose-dependent manner some of the destructive changes evoked by Cd and Pb possibly by reducing the exposure.
Chitosan modified with 1,3,4-oxa(thia)diazole derivatives with high efficacy to heal burn infection by Staphylococcus aureus
Authors: Salahuddin Nehal , Elbarbary Ahmed , Allam Nanis G , Hashim Ayat F
Published: September 2017

Chitosan has been modified through the reaction of chitosan with 5-phenyl-1,3,4-oxadiazole-2-thiol (I); 5-amino-1,3,4-thiadiazole-2-thiol (II); and 5-(4 chlorophenyl)-1,3,4-thiadiazole-2-thiol (III). Fourier transform infrared spectroscopy spectra and 1H-NMR demonstrated the interaction between 1,3,4-oxa(thia)diazoles and chitosan. The Gram-negative bacteria ( Escherichia coli ATCC 8739, Aeromonas hydrophila, Shegilla sp.), Gram-positive bacteria ( Staphylococcus aureus, Bacillus subtilis ATCC 6633), yeast ( Candida albicans), and the filamentous fungi ( Aspergillus niger) were used to examine the antimicrobial activity of the modified chitosan by well diffusion method. The results indicated that modified chitosan possess better inhibitory property than chitosan. Furthermore, in vivo study was performed on burned mouse model wound infection by S. aureus NCTC 6356. Modified chitosan improved antimicrobial efficacy against fatal burn infections in comparison with chitosan.
Influence of neutral surface position on dynamic characteristics of in-homogeneous piezo-magnetically actuated nanoscale plates
Authors: Ebrahimi Farzad , Barati Mohammad Reza
Published: September 2017

Based on exact position of neutral surface, vibrational behavior of smart nanoplates made of magneto-electro-elastic functionally graded materials is examined by implementing a Galerkin method for the first time. Magneto-electro-elastic properties of nanoplate vary in transverse direction via power-law model. The nonlocal governing equations of functionally graded plate under magneto-electrical field are formulated through Hamilton’s principle and nonlocal elasticity theory based on a four-variable refined plate theory, which avoids the use of shear correction factors by capturing shear deformation influences. Importance of various parameters including magnetic potential, electric voltage, various boundary conditions, nonlocality, material distribution, and plate thickness on natural frequencies of the magneto-electro-elastic functionally graded nanoplate are explored. It is elucidated that these parameters play significant roles on the dynamic behavior of magneto-electro-elastic functionally graded nanoplates.
Study on the compound transmission mechanism of the curve-face gear based on screw theory
Authors: Lin Chao , Wei Yanqun , Cai Zhiqin
Published: September 2017

The compound transmission mechanism of curve-face gear is a new type of gear transmission based on the cam mechanism and the curve-face gear pair. It combines the transmission characteristics of the cam mechanism and noncircular bevel gear. When the compound transmission mechanism of curve-face gear is engaged in the meshing transmission, the rotating center of the cylindrical gear is fixed and used as the driving wheel, and the curve-face gear can generate the helical motion around the axis. In this paper, the meshing characteristics and motion laws of the compound transmission mechanism of the curve-face gear are studied based on the theory of screw. Based on the meshing theory of gears, the coordinate system of conjugate surfaces is established, the basic meshing theory and equation are obtained. On this basis, combined with the principle of the cam, the transmission principle is analyzed by the screw theory. The tooth surface equation of the compound transmission mechanism of curve-face gear is deduced based on the meshing theory and the related knowledge of geometry. The motion law of the curve-face gear and the change of the motion law with the change of the basic parameters of the gear pair with different design parameters are calculated and analyzed. An experimental platform is built to verify the law of motion, and the experimental results are compared with the theoretical values. The correctness of the theoretical analysis is verified, which provides a new way for the research of the compound transmission mechanism of the curve-face gear.
Financial Structure, Interest Rate, Trade Openness and Growth: Time Series Analysis of Indian Economy
Authors: Sehrawat Madhu , Giri A. K.
Published: September 2017

The aim of this study is to construct a financial development index for Indian economy and to examine the impact of financial development index and trade openness on economic growth in India using annual data from 1982 to 2014. The results of autoregressive distributed lag (ARDL) approach to co-integration confirm the long-run relationship between financial development index, trade openness and economic growth in Indian economy. The results of Granger non-causality show that there is a unidirectional causality running from financial development to economic growth and bi-directional causality runs between economic growth and trade openness. The analysis of variance decomposition shows that influence of trade openness exerts the largest influence, whose steady contribution level for economic growth changes approaches to 15.48 per cent in India.
Dapagliflozin/Saxagliptin Fixed-Dose Tablets: A New Sodium-Glucose Cotransporter 2 and Dipeptidyl Peptidase 4 Combination for the Treatment of Type 2 Diabetes
Authors: Coppenrath Valerie Azzopardi , Hydery Tasmina
Published: September 2017

Objective: To review the pharmacology, pharmacokinetics, efficacy, safety, and place in therapy of the fixed-dose combination (FDC) product, QTERN (dapagliflozin/saxagliptin) tablets. Data Sources: Searches of MEDLINE (1946 to July 1, 2017) were conducted using the keywords QTERN, saxagliptin, and dapagliflozin. Additional data were obtained from the prescribing information, the product dossier, and Clinicaltrials.gov . Study Selection and Data Extraction: All English language articles related to pharmacology, pharmacokinetics, efficacy, or safety of the combination therapy in human subjects were reviewed. Data Synthesis: The pharmacokinetics of saxagliptin and dapagliflozin were not affected significantly when administered as an FDC product. Saxagliptin may suppress the increased secretion of glucagon associated with dapagliflozin. The combination dapagliflozin/saxagliptin has been studied as add-on therapy to metformin in patients with uncontrolled type 2 diabetes mellitus (T2DM). The difference in hemoglobin A1C (A1C) between saxagliptin + dapagliflozin + metformin (triple therapy) and saxagliptin + metformin was −0.59 (95% CI = −0.81 to −0.37, P < 0.0001), and the difference between triple therapy and dapagliflozin + metformin was −0.27 (95% CI = −0.48 to −0.05, P = 0.0166). The combination was well tolerated when added to metformin. Conclusion: QTERN (dapagliflozin/saxagliptin) tablets are a reasonable option for patients with T2DM not controlled on metformin, but cost, insurance coverage, and a lackluster reduction in A1C will likely limit its use until more data regarding its effects on complications of diabetes and cardiovascular outcomes become available.
An image-based pattern recognition approach to condition monitoring of reciprocating compressor valves
Authors: Kolodziej Jason R , Trout John N
Published: September 2017

This work presents the development of a vibration-based condition monitoring method for early detection and classification of valve wear within industrial reciprocating compressors through the combined use of time-frequency analysis with image-based pattern recognition techniques. Two common valve related fault conditions are spring fatigue and valve seat wear and are seeded on the crank-side discharge valves of a Dresser-Rand ESH-1 industrial compressor. Operational data including vibration, cylinder pressure, and crank shaft position are collected and processed using a transformed time-frequency domain approach. The results are processed as images with features extracted using 1st and 2nd order image texture statistics and binary shape properties. Feature reduction is accomplished by principal component analysis and a Bayesian classification strategy is employed with accuracy rates greater than 90%.
Racial/Ethnic Disparities in Quality of Care for Cardiovascular Disease in Ambulatory Settings: A Review
Authors: Dong Liming , Fakeye Oludolapo A. , Graham Garth , Gaskin Darrell J.
Published: September 2017

Racial and ethnic disparities in cardiovascular disease (CVD) outcomes are widely reported, but research has largely focused on differences in quality of inpatient and urgent care to explain these disparate outcomes. The objective of this review is to synthesize recent evidence on racial and ethnic disparities in management of CVD in the ambulatory setting. Database searches yielded 550 articles of which 25 studies met the inclusion criteria. Reviewed studies were categorized into non-interventional studies examining the association between race and receipt of ambulatory CVD services with observational designs, and interventional studies evaluating specific clinical courses of action intended to ameliorate disparities. Based on the Donabedian framework, this review demonstrates that significant racial/ethnic disparities persist in process and outcome measures of quality of ambulatory CVD care. Multimodal interventions were most effective in reducing disparities in CVD outcomes.
Witnessing the End of a Family Farm: Twenty-Five Ways to Say Goodbye
Authors: Quinney Richard
Published: September 2017

This family farm in Wisconsin was started in 1868 by my great-grandparents and farmed by the generations that followed. My brother and I inherited the farm and tried to keep its 160 acres as a working farm, even as we lived in other places and pursued other careers. What is a family farm, we finally asked, if there is no family on the land to farm it? My way of letting go of this childhood home and family farm is to tell the tale as a witness to the ending of another family farm.
Measles Lymphadenopathy in a Child With PFAPA Syndrome
Authors: Terry Jefferson , Brown Kelly , Hiebert Joanne , Al-Rawahi Ghada N , Moxham J Paul , Krajden Mel , Jassem Agatha N , Tucker Lori
Published: September 2017

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a common cause of periodic fever in children. The pathogenesis of PFAPA is unknown but likely involves immune system dysregulation and may be initiated by an environmental trigger. Tonsillectomy resolves or improves symptoms in some patients, but the reason for this is unknown; moreover, specific abnormalities in tonsillectomy specimens from PFAPA patients have not been described. Here, we report measles virus in tonsil from a child with PFAPA. Measles-type viral cytopathic effect was discovered on histological examination of tonsillar tissue after therapeutic tonsillectomy for PFAPA. Molecular testing showed the left tonsil was positive for measles RNA by reverse transcription polymerase chain reaction (RT-PCR) while the right tonsil was inconclusive (weakly positive). Real-time RT-PCR specific for measles vaccine strain RNA (genotype A) was weakly reactive in the left tonsil tissue when tested in 3 independent replicates, but this result could not be confirmed with conventional genotyping by sequencing. The relationship and clinical significance between measles virus and PFAPA in this case is unclear but may be related to PFAPA-associated immune dysregulation. Additional investigation of measles virus in PFAPA patients would be helpful in further exploring this potential association.
Borrowing from Femininity: The Caring Man, Hybrid Masculinities, and Maintaining Male Dominance
Authors: Eisen Daniel B. , Yamashita Liann
Published: September 2017

Prevalent cultural representations of masculinity depict men as aggressive, emotionally distant individuals whose hard and muscular bodies epitomize these traits. These traditional representations of masculinity have also been linked to sexism and male dominance, which has encouraged many men to distance themselves from these representations. This study employed grounded theory methods to analyze interviews with twenty-five men about their understanding and construction of their masculinity. The analysis revealed that some men construct a hybrid masculinity by describing themselves as caring or being in touch with their feminine side to create social distance between themselves and men who adhere to traditional representations of masculinity. While men incorporated what they viewed as feminine characteristics into their identities, they reinforced, rather than challenged, the symbolic boundaries of gender and the resulting gender hierarchy. Ultimately, the men in this study were able to co-opt the language of caring to gain more prestige while reinforcing gender inequality and male dominance.
Diplomacy, agency, and the logic of improvisation and virtuosity in practice
Authors: Cornut Jérémie
Published: September 2017

Immersed in the flow of activities, diplomats and other international practitioners are simultaneously influenced by past experiences and constantly innovating in response to situations that are never exactly the same. The conceptual tools of International Relations scholars must be capable of capturing this practical reality. To that end, I introduce in this article a relational approach to agency that can make sense of practitioners’ innovative ways of doing things in practice. Practice theorists in IR often emphasize hierarchies, struggle, and the role of habitus in shaping practices. Both building on and departing from them, I dig into the logic of practical sense and discuss Pierre Bourdieu’s concepts of regulated improvisations, virtuosos/amateurs, and illusio to grasp agency in practice. I develop the idea that international actors are primarily practical and put improvisations and virtuosity — rather than rationality, cognitive processes, emotions, norm-compliance, path-dependency or even habits/habitus — in the foreground. I contend that this approach holds broader promise for the analysis of international politics than existing conceptions. We have much to gain by focusing on how international practitioners in their local contexts actually improvise in the moment. These improvisations in specific sites are constitutive of the ‘big picture’ of international politics. I take diplomatic practices in embassies and in permanent representations as an illustration.
TF-DMB: A traffic flow theory-based dynamic multi-hop broadcast protocol
Authors: Ding Weiguang , Wu Hao , Wang Jin
Published: September 2017

In order to ensure traffic safety, the emergency warning message should be transmitted quickly and reliably in vehicular ad hoc networks by multi-hop broadcast. In this article, we propose a traffic flow theory-based dynamic multi-hop broadcast protocol to address the issue of emergency warning message dissemination in vehicular ad hoc networks. The main goal of our protocol is to reduce delay and enhance reliability no matter the traffic density is high or low. First, according to the simulations of the distribution of vehicles under different traffic densities, a method of dynamically dividing the communication range is proposed, which, to a large extent, could find the candidate forwarders by one non-uniform partition. Next, a mechanism of dynamically adjusting the contention window size and boundary is designed, and the minimum waiting time difference is considered. The complete execution process of theory-based dynamic multi-hop broadcast protocol and corresponding retransmission strategies are included for high reliability. Through extensive simulations, we demonstrate the superior performance of our protocol in terms of one-hop delay, one-hop message processing, and delivery ratio compared with other existing schemes.
Research and performance analysis on multi-point light-emitting diodes-array intra-vehicle visible light communication systems with DC-biased optical–orthogonal frequency-division multiplexing
Authors: Song Xiaoqing , Zhao Zixu , Wei Youcai , Wang Muyu
Published: September 2017

In this article, a DC-biased optical–orthogonal frequency-division multiplexing visible light communication systems based on multi-point light-emitting diodes-array sources in the special-type vehicle is investigated. The novel lighting layout based on optical power evenly distribution principle is proposed to meet the desired lighting and communication requirement. Meanwhile, in order to resist the inter-symbol interference caused by multipath dispersion, DC-biased optical–orthogonal frequency-division multiplexing modulation strategy is suggested. The performance parameters of signal-to-noise ratio, the root-mean-square delay spread, and maximum transmission rate have been analyzed and calculated theoretically based on direct and multipath reflected channel models of visible light communication. The validity of the visible light communication system is demonstrated by simulation experiments results as follows: the received optical power range of −0.73 to 0.56 dBm in vehicle for approximately 2 m × 2 m × 1.5 m cube space, uniform illumination rate is 80.5%, average signal-to-noise ratio is 20.92 dB. Moreover, the maximum data rate can be improved from 107.8 to 477.4 Mb/s with the bit error rate at approximately 10−5, which meet the illumination and data transmission rate requirement for the special-type vehicle.
Sonic encounters and intensive politics: The immanent emergence and structuration of affective publics at a live music event, and beyond
Authors: Szarecki Artur
Published: September 2017

The article concerns the ways sound can afford the formation and recomposition of affective publics by acting directly on bodies, prior to the discursive framing of acoustic experience. In particular, it focuses on a violent altercation that broke out during a live hip hop concert in Poland in 2009, arguing that the deployment of sound might have affectively primed the audience to participate in the incident. In this sense, sound is conceived as a complex of intensive forces that pass across and in-between bodies triggering immanent processes of emergence and structuration, thus affording incipient and fragmentary publics to come into being.
Formal Labeling, Deviant Peers, and Race/Ethnicity: An Examination of Racial and Ethnic Differences in the Process of Secondary Deviance
Authors: Chavez Jorge M. , Rocheleau Gregory C.
Published: September 2017

The present study examines racial and ethnic variation in the intervening effects of deviant peers on the relationship between receiving a formal label and subsequent deviance. We build on earlier research by distinguishing between violent and nonviolent deviance, drawing on peer network data to directly measure peer deviant behavior, and stratifying analyses for White, Black, and Hispanic adolescents. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we find that overall, receiving a formal label, in the form of school sanctions, is associated only with later violent deviance but not associated with nonviolent deviance and there was no evidence of mediation by peer deviance or peer violent deviance. Results from stratified analyses for White, Black, and Hispanic adolescents are mixed. Among both White and Hispanic adolescents receiving a formal label was significantly associated with engaging in violent deviance, but this relationship was only partially mediated by peer nonviolent deviance among White adolescents. However, neither peer nonviolent deviance nor peer violence were related to violent deviance among Hispanic adolescents. In further contrast, among Black adolescents receiving a formal label was not significantly associated with engaging in violent deviance, but peer violent deviance did show a positive and significant main effect on violent deviance. Implications for theory and future research are discussed.
Validating Service Locus of Control Scale for Hotels in Sample of Indian Business Travelers
Authors: Maggon Mohita , Chaudhry Harish
Published: September 2017

The purpose of this study was to validate the service locus of control (SLOC) scale in the hospitality sector in India. This article validated the SLOC scale (Bradley & Sparks, 2002) with a sample of Indian business travelers. The study aimed at examining reliability and validity of the scale. The validation of the scale was done through confirmatory factor analysis and discriminant as well as convergent validity was observed. The scale was administered to a sample of 304 business travelers (males = 173, females = 131). Results showed that the scale had high reliability and acceptable construct validity among Indian business travelers. The study offers implications for marketers to effectively customize the service offering by understanding the importance of locus of control in service settings. This is the first study to validate the SLOC scale among Indian business travelers. Besides, this is the first study to implement this scale in the hospitality sector.
Recurrent Inflammatory Flares in HIV-Infected Patients: Consider Castleman Disease!
Authors: Jegerlehner Sabrina , Rauch Andri , Novak Urban
Published: September 2017

Background. Transient inflammatory flares are common in clinical care of human immunodeficiency virus (HIV)–infected patients. In-depth investigations are not performed routinely because patients often recover without therapeutic interventions, and therefore, the etiologies of these inflammatory flares frequently remain unknown. Case. We report a case of an HIV-infected patient with recurrent inflammatory flares during several years in whom diagnostic workup with a lymph node biopsy finally revealed multicentric Castleman disease (MCD). The patient was treated with etoposide and rituximab until November 2013 and achieved ongoing complete clinical remission. Conclusion. Recent effective therapeutic regimens offer an opportunity to prevent serious complications of MCD including its malignant transformation, provided that the diagnosis is established early enough. Therefore, clinicians should consider MCD in the differential diagnosis of self-limiting inflammatory flares, especially in HIV-infected patients.
Bullous Skin Manifestations of Mycoplasma pneumoniae Infection: A Case Series
Authors: Bhoopalan Senthil Velan , Chawla Vonita , Hogan Mary Beth , Wilson Nevin W. , Das Samrat U.
Published: September 2017

Bullous skin lesions are uncommon in children. While it is well known that Mycoplasma infections are associated with papular skin manifestations, bullous skin lesions are not commonly reported. Mycoplasma pneumoniae is a very common bacterial pathogen causing respiratory tract infection in children and adults. We report 2 children with serology-confirmed Mycoplasma infection who were hospitalized for blistering skin lesions. Both of our patients responded well to corticosteroids and one of them required intravenous immunoglobulin. The aim of this case report is to raise awareness that Mycoplasma pneumoniae infection can present with bullous skin lesions, and to briefly review the pathophysiology, diagnosis, and management of the skin manifestation of Mycoplasma infection.
Allopurinol-Induced Granulomatous Hepatitis: A Case Report and Review of Literature
Authors: Iqbal Umair , Siddiqui Hafiz Umair , Anwar Hafsa , Chaudhary Ahmad , Quadri Abdulhadi Affan
Published: September 2017

Liver enzyme elevation is a common reason for referral to a gastroenterologist. Drugs are one of the most common reasons for asymptomatic elevation of liver enzymes. We present here a case of granulomatous hepatitis (GH) secondary to long-term use of allopurinol. An 83-year-old male with a history of chronic gout and hypertension was evaluated for elevation of liver enzymes. He denies any complaints of abdominal pain, nausea, fever, chills, weight loss, night sweats, or yellowness of skin. He denies any use of herbal medications. He was on losartan and allopurinol for years. No new medications reported. Physical examination was unremarkable. Labs showed aspartate transaminase 101 U/L, alanine transaminase 81 U/L, and alkaline phosphatase 645 U/L. Ultrasound of the abdomen showed coarse liver texture. Liver biopsy was done that showed mixed GH. Given negative autoimmune and viral serologies, allopurinol-induced GH was suspected. Allopurinol was held, and repeat liver enzymes were checked in 3 months, which showed improvement in transaminase and alkaline phosphatase levels. This case highlights the importance of reviewing medications carefully when evaluating a patient with liver enzymes elevation, as stopping the offending drug can normalize the abnormalities in liver chemistries and can prevent subsequent expensive testing.
Obesity Cardiometabolic Comorbidity Prevalence in Children in a Rural Weight-Management Program
Authors: O’Hara Valerie , Browne Nancy , Fathima Samreen , Sorondo Barbara , Bayleran Janet , Johnston Starr , Hastey Kathrin
Published: September 2017

This descriptive study examines the prevalence of obesity-related cardiometabolic (CM) risk factors using CM laboratory metrics, in 3 to 19 year olds presenting to a rural American Academy of Pediatrics stage 3 multidisciplinary weight management clinic based on gender, age ranges, and obesity classes. From 2009 to 2016, 382 children (body mass index ≥85th percentile) enrolled. Multiple logistic regression determined the effects of age, gender, or obesity class on CM risk factors. Odds of elevated insulin were more significant in 15 to 19 year olds than in 3 to 5 year olds, or in 6 to 11 year olds. Obesity class III had higher odds than class II, class I, and overweight in having elevated insulin; twice likely than class II for having low high-density lipoprotein; and twice as likely than class I for high triglycerides. Adolescents and obesity class III categories have significant CM risk but the burden in younger and less severe obesity cohorts cannot be underestimated.
Cytoprotective activated protein C averts Nlrp3 inflammasome–induced ischemia-reperfusion injury via mTORC1 inhibition
Authors: Nazir Sumra , Gadi Ihsan , Al-Dabet Moh’d Mohanad , Elwakiel Ahmed , Kohli Shrey , Ghosh Sanchita , Manoharan Jayakumar , Ranjan Satish , Bock Fabian , Braun-Dullaeus Ruediger C. , Esmon Charles T. , Huber Tobias B. , Camerer Eric , Dockendorff Chris , Griffin John H. , Isermann Berend , Shahzad Khurrum
Published: September 2017

Key Points

aPC protects from myocardial and renal IRIs by restricting mTORC1-mediated activation of the Nlrp3 inflammasome. Nlrp3 inflammasome suppression by aPC is independent of its anticoagulant effect, depends on PAR-1, and can be mimicked by parmodulin-2.
Plane-wave least-squares reverse time migration with a preconditioned stochastic conjugate gradient method
Authors: Li Chuang , Huang Jianping , Li Zhenchun , Wang Rongrong
Published: September 2017

This study derives a preconditioned stochastic conjugate gradient (CG) method that combines stochastic optimization with singular spectrum analysis (SSA) denoising to improve the efficiency and image quality of plane-wave least-squares reverse time migration (PLSRTM). This method reduces the computational costs of PLSRTM by applying a controlled group-sampling method to a sufficiently large number of plane-wave sections and accelerates the convergence using a hybrid of stochastic descent (SD) iteration and CG iteration. However, the group sampling also produces aliasing artifacts in the migration results. We use SSA denoising as a preconditioner to remove the artifacts. Moreover, we implement the preconditioning on the take-off angle-domain common-image gathers (CIGs) for better results. We conduct numerical tests using the Marmousi model and Sigsbee2A salt model and compare the results of this method with those of the SD method and the CG method. The results demonstrate that our method efficiently eliminates the artifacts and produces high-quality images and CIGs.
Prenatal brain MRI samples for development of automatic segmentation, target-recognition, and machine-learning algorithms to detect anatomical structures
Authors: Gentillon Hugues , Stefańczyk Ludomir , Strzelecki Michał , Respondek-Liberska Maria
Published: September 2017

In this data note, we present a sorted pool of fetal magnetic resonance imaging (MRI) specimens. These were selected for a project seeking to further develop computer vision software called MaZda, which was originally created for magnetic resonance (MR) image analysis. A link to download the samples is provided in the manuscript herein. This data descriptor further explains how and why these fetal MRI samples were selected. Firstly, thousands of cross-sectional images obtained from fetal MRI scans were processed and sorted semi-manually with other software. We did so because a built-in “samplesort” (sorting algorithm) is missing in MaZda version 5. Additionally, the software is unfortunately lacking effective and efficient algorithms to allow automatic identification and segmentation of anatomical structures in fetal MRI samples. Hence, the final sorting steps were carried out manually via time-consuming methods (i.e., human visual detection and classifications by the gestational age of pregnancy and the rotational plane of the MR scanner). Thus, the latter correlates with the anatomical plane of the mother, rather than the hypothetical plane used to transect the fetus. In brief, we collated these fetal MRI samples in an effort to facilitate future research and discovery, especially to aid the improvement of MaZda.
Blinding in trials of interventional procedures is possible and worthwhile
Authors: Wartolowska Karolina , Beard David , Carr Andrew
Published: September 2017

In this paper, we have used evidence from our earlier review of surgical randomised controlled trials with a placebo arm to show that blinding in trials of interventional procedures is feasible, and that many creative methods can be used to make the active and the placebo procedure as similar as possible. We give examples of ingenious strategies used to simulate the active procedure and make the placebo control indistinguishable from the active treatment. We discuss why it is important to blind of patients, assessors, and caregivers and the types of bias that may occur in interventional trials. Finally, we describe the benefits of blinding, from the obvious ones such as avoiding bias, as well as less evident benefits such as avoiding patient drop out in the control arm.
Decisions and assumptions
Authors: Allingham Sue
Published: September 2017

The school term is upon us and all summer teachers and educators have been preparing their learning environments while taking on board the latest policy changes, buzz phrases and top-down pressures.
Puppy dog tales: working with children and animals
Authors: Lewis Helen
Published: September 2017

One setting in west Wales has been providing young children with opportunities to interact regularly with a dog called Honey, boosting self-esteem, independence, emotional stability, and much more.
Too small to profit, too big to fail
Authors: Merrick Beatrice
Published: September 2017

The government claims to put social mobility at the top of its agenda, with early years education a key factor, but there is enough evidence available to suggest that funding models will undermine progress.
Provide the right balance
Authors: Revel Edwina , Leach Georgia
Published: September 2017

Last month, we looked at how to provide a nutritious breakfast and why this was so important; this month, we look at the other two main mealtimes and offer best practice advice on what to serve.
Off-label prescribing by nurse prescribers: Best practice?
Authors: Kendrew Melanie S
Published: September 2017

Off-label prescribing is the use of a medicinal product outside the conditions set out in the summary of product characteristics and should only be undertaken if there is no licensed alternative available to achieve the best outcome. New evidence that emerges after a licence has been prescribed does not necessarily mean there will be an application for the licence to be extended. Randomised controlled trials based on a homogenised population may not represent the complexities of an individual patient. Therefore, prescribers need to consider a definition of evidence-based prescribing that extends beyond best research evidence to incorporate clinical expertise and individual needs and perspectives of patients. Nurse prescribers should ensure that their competence and expertise to prescribe off-label is addressed to deliver true evidence-based prescribing. An audit of off-label prescribing by nurse prescribers is a potential wealth of evidence yet to be discovered.
A comparative analysis between the quick response manufacturing and time-based competition methodologies
Authors: Emboava Fábio Nogueira , Cardoso Rodolfo , Tammela Iara
Published: September 2017

This article compares the Quick Response Manufacturing and Time-Based Competition methodologies and identifies their similarities and differences. This investigation deepens our understanding in terms of Quick Response Manufacturing pursuing a theoretical framework for applications in Brazilian companies. Data was collected from publications aimed at presenting and discussing the tactics and approaches of the methodologies. Similarity and difference classification tables are presented. The results reveal that 67% of all approaches compared were classified as analogous and 19% were not analogous. In addition, 14% of approaches presented the non-existence of similarities.
Comparison of mastery learning model and WhatsApp assisted learning in teaching psychomotor skills: A triangulation study
Psikomotor beceri öğretiminde tam öğrenme modeli ve WhatsApp destekli öğretim yöntemlerinin karşılaştırılması: Bir triangülasyon çalışması
Authors: Turaç Nilay , Çalışkan Nurcan , Gülnar Emel
Published: September 2017

Aim: The purpose of this study is to comparison the effect of mastery learning model and WhatsApp assisted learning on teaching psychomotor skills.Material and method: The study was conducted as a triangulation study between 8 March- 16 December, 2016. The students were divided into two groups in a randomized way. One of the groups (n:30) was instructed with mastery learning model concerning the skill of inserting nasogastric catheter; whereas, the other group (n:30) was assisted through WhatsApp. While the quantitative data were collected by using “Nasogastric Catheter Insertion Skill Check List”, the qualitative data were collected through the focus group interview. The data were analyzed by using number, percentage, student-t test, and descriptive analysis method.Results: The skill mean scores for the students learning the skill of nasogastric catheter insertion through WhatsApp assistance were (26.27±5.70) significantly higher than the mean scores of those learning this skill with mastery learning model (22.07±4.06). However, it was found that students learning with mastery learning experienced less stress during the practice.  Conclusion: It is considered that in teaching of psychomotor skills, the use of means of social media such as WhatsApp as a support to the courses together with the mastery learning model would be beneficial. Extended English abstract is in the end of PDF (TURKISH) file. ÖzetAmaç: Araştırma, tam öğrenme modeli ile WhatsApp destekli öğretimin psikomotor beceri öğretimine etkilerinin karşılaştırılması [sbf1] amacıyla yapılmıştır.Materyal Metot: Araştırma, Mart- Aralık 2016 tarihleri arasında triangülasyon çalışması olarak yapılmıştır. Öğrenciler, randomize olarak iki gruba ayrılmıştır. Bir gruba (n:30), nazogastrik sonda takma becerisiyle ilgili tam öğrenme modeliyle destek verilirken diğer gruba (n:30) WhatsApp ile destek verilmiştir. “Nazogastrik Sonda Takma Becerisi Kontrol Listesi” kullanılarak nicel veriler, odak grup görüşmesiyle nitel veriler toplanmıştır. Veriler sayı, yüzdelik, student-t testi ve betimsel analiz yöntemiyle analiz edilmiştir.Bulgular: Nazogastrik sonda takma becerisini WhatsApp desteğiyle öğrenen öğrencilerin beceri puan ortalamaları (26.27±5.70), tam öğrenme modeliyle öğrenen öğrencilerin ortalamalarından (22.07±4.06) anlamlı derecede yüksek bulunmuştur. Ancak, tam öğrenme modeliyle öğrenen öğrencilerin uygulamada daha az stres yaşadıkları saptanmıştır.  Sonuç:WhatsApp gibi sosyal medya araçlarının, beceri eğitiminde tam öğrenme modeliyle birlikte derslere destek olarak kullanılmasının yararlı olacağı düşünülmektedir.// Annotate Highlight // Annotate Highlight // Annotate Highlight // Annotate Highlight // Annotate Highlight // Annotate Highlight // Annotate Highlight // Annotate Highlight
Pengaruh Desa Wisata Kampoeng Batik Laweyan terhadap Fungsi Permukiman di Kelurahan Laweyan Kota Surakarta
Authors: Mangedaby Eva Artmey , Setioko Bambang , Sari Suzanna Ratih
Published: September 2017

Kota Surakarta merupakan salah satu sentra produksi batik di Jawa Tengah yang terkenal karena batik berkualitas, salah satu nya adalah sentra batik yang berada di Kampung Batik Laweyan. Kampung batik yang terletak di Kelurahan Laweyan ini tengah marak di Indonesia karena merupakan salah satu daerah tujuan wisata. Sebagai kampung batik yang saat ini tengah popular, membuat kawasan permukiman di Kelurahan Laweyan juga mengalami perubahan. Hal ini terlihat dari bentuk dan tata ruang rumah itu sendiri. Perubahan ini tidak hanya terjadi pada kampung batik Laweyan saja tetapi satu Kelurahan Laweyan, sehingga mengakibatkan tidak tersedianya ruang terbuka hijau di Kelurahan Laweyan. Penelitian ini bertujuan untuk mencari pengaruh desa wisata Desa Kampung Batik Laweyan terhadap fungsi permukiman di Kelurahan Laweyan serta untuk menentukan seberapa besar pengaruh desa wisata Kampung Batik Laweyan terhadap fungsi permukiman di Kelurahan Laweyan Kota Surakarta dan bagaimana pengaruhnya. Metode penelitian yang digunakan adalah metode kuantitatif dengan pendekatan korelasi memakai analisis likerts serta analisis skoring berdasarkan asumsi yang sudah ditetapkan kemudian di uji dengan analisa regresi linear berganda menggunakan uji SPSS. Teknik analisis data dalam penelitian ini menggunakan statistik deskriprif untuk mengambil kesimpulan dari sampel yang diuji. Proses penelitian ini melalu tiga tahapan yaitu kompilasi data, pemberian kode variabel dan pengolahan data dengan analisa regresi. Hasil temuan studi yang didapat setelah melalui tahapan-tahapan tersebut adalah desa wisata Kampung Batik Laweyan mempengaruhi fungsi permukiman di Kelurahan Laweyan Kota Surakarta sebesar 81,6% sedangkan sisanya 18,4% dipengaruhi oleh faktor lain diluar model. Pengaruh desa wisata Kampung Batik Laweyan terhadap fungsi permukiman di Kelurahan Laweyan Kota Surakarta adalah dengan berubahnya fungsi permukiman di Kelurahan Laweyan yang dulunya hanya sebagai hunian sekarang berubah menjadi hunian dan tempat usaha, serta penambahan fasilitas pendukung wisata lainnya, selain itu juga terdapat penambahan street furniture yang menjadi ciri khas desa wisata Kampung Batik Laweyan. Sedangkan untuk faktor lain yang memperngaruhi diluar model adalah sejarah kawasan dan perubahan tata guna lahan. Peran stakeholders yang terkait seperti pemerintah, swasta dan masyarakat sangat diperlukan. Pemerintah berperan sebagai pengelola dan fasilitator, swasta sebagai pembantu pelaksana program pemerintah sedangkan masyarakat bisa berpartisipasi dalam pengembangan desa wisata Kampung Batik Laweyan.  Kata Kunci: Kampung Batik, Desa Wisata, Permukiman, Fungsi Permukiman
DRUGAS: implantable telemetric system for measuring the portal venous pressure: assembly aspects
Authors: Fischer Roland , Weidenmüller Jens , Görtz Michael , Goettsche Thorsten , Mokwa Wilfried
Published: September 2017

Developing an implantable, telemetric pressure measuring system for venous applications makes a high degree of miniaturization necessary. Thus the influence on the measurement environment is minimized and the risk of thrombosis at small flow blood velocities is decreased. But these systems are limited in terms of accuracy and resolution. The asked system requirements could only be reached by optimising the assembly and encapsulation techniques. To achieve the high degree of miniaturization numerical simulations were performed on the shape and size of the implant and led to the development of a specific metal housing consisting of two main components. A small measuring chamber will be placed into the portal vein and is rigidly fixed to a flat circular part that contains the pressure sensor chip and a transponder board and will be located outside on top of the vein. The main focus of the assembly process was based on a stress-free design and mounting of the components.
Intention recognition for FES in a grasp-and-release task using volitional EMG and inertial sensors
Authors: Salchow Christina , Dorn Andreas , Valtin Markus , Schauer Thomas
Published: September 2017

Functional Electrical Stimulation (FES) facilitates the motor recovery of the hand function after stroke. The integration of biofeedback and other strategies to actively in-volve a patient in the therapy is important for the rehabili-tation progress. We introduce a combined control approach for a FES-driven neuroprosthesis using volitional electromyo-graphy (vEMG) and motion capturing via a novel inertial sensor network for patients that still possess a residual activity in the paralyzed muscles. A real-time vEMG measurement and signal processing in between stimulation pulses has been realized during active FES. Experiments showed that our system allows for quick adaption to individual users.
Determination of EPID convolution kernels for portal imaging using carbon target bremsstrahlung
Authors: Lüdeke Sascha , Wyrwoll Vanessa , Stelljes Tenzin S. , Looe Hui Khee , Harder Dietrich , Poppe Björn
Published: September 2017

Improving the accuracy and reproducibility during patient positioning is of paramount importance. Hence, the goal of this work is to characterize the aspects of image blurring occurring during carbon target bremsstrahlung portal imaging and to assess the applicability of a deconvolution algorithm. Blurring effects involved in this method of portal imaging are electron scattering inside the EPID, geometric blurring due to the photon source size and photon scattering inside the patient. These effects can all be described by convolutions using as the convolutional kernel a Lorentz function, whose FWHM is 2λ. The λ values measured for these effects range from 0.2 mm to 0.45 mm, and an iterative 2D-deconvolution of carbon target portal images was performed accordingly. A significant decrease in the image blurring of test objects has been achieved and confirmed by analyzing the RMTF. However for clinical images, the deconvolution method is presently faced with the problem of the associated increase of image noise.