bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Outcomes in Patients With Generalized Ligamentous Laxity and Without Generalized Laxity in the Arthroscopic Modified Broström Operation for Chronic Lateral Ankle Instability
Authors: Yeo Eui Dong , Park Ji Young , Kim Jin Hyeung , Lee Young Koo
Published: October 2017

Background:

The arthroscopic modified Broström operation (MBO) has been frequently used to treat chronic lateral ankle instability (CLAI). However, no reports comparing the clinical outcomes between patients with or without generalized ligamentous laxity (laxity or no laxity, respectively) currently exist. The purpose of this study was to compare the clinical outcomes of the 2 groups with CLAI.

Methods:

Between January 2013 and November 2015, arthroscopic MBO was performed on 99 patients with CLAI. Patients were divided into 2 groups: the laxity group (24 ankles) and no laxity group (75 ankles). Generalized ligamentous laxity was defined as a Beighton score of 4 or more points. Evaluation tools included the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot ankle score, a pain visual analog scale (VAS), and talar tilt angle.

Results:

The change in talar tilt angle from preoperative to 12 months postoperative was significantly greater in the laxity group (–6.9 ± 5.2) compared with the no-laxity group (–4.2 ± 4.2) ( P = .03). The final follow-up AOFAS hindfoot ankle score and pain VAS in both groups showed improvement compared with the preoperative values.

Conclusion:

All groups achieved successful clinical and radiological final follow-up outcomes. Arthroscopic MBO should be considered a reasonable method in patients who have chronic lateral ankle instability, regardless of generalized ligamentous laxity.

Level of Evidence:

III, comparative study.
Social Media, Science, and Attack Discourse: How Twitter Discussions of Climate Change Use Sarcasm and Incivility
Authors: Anderson Ashley A. , Huntington Heidi E.
Published: October 2017

Conflict in online discussions of science has the potential to polarize individuals’ perceptions of science, yet science communication scholarship has paid little attention to systematic study of how verbal attacks play out in online discussions of science. This study analyzes sarcasm and incivility in Twitter discussions of climate change during an extreme weather event ( n = 4,094). We found instances of incivility and sarcasm were low overall. Incivility was used in association with political topics, and both incivility and sarcasm were used alongside skeptical perspectives of climate change and by those who mention right-leaning politics in their profiles.
Solution of contact problems for Gao beam and elastic foundation
Authors: Machalová Jitka , Netuka Horymír
Published: October 2017

This paper presents mathematical formulations and a solution for contact problems that concern the nonlinear beam published by Gao (Nonlinear elastic beam theory with application in contact problems and variational approaches, Mech Res Commun 1996; 23: 11–17) and an elastic foundation. The beam is subjected to a vertical and also axial loading. The elastic deformable foundation is considered at a distance under the beam. The contact is modeled as static, frictionless and using the normal compliance contact condition. In comparison with the usual contact problem formulations, which are based on variational inequalities, we are able to derive for our problem a nonlinear variational equation. Solution of this problem is realized by means of the so-called control variational method. The main idea of this method is to transform the given contact problem to an optimal control problem, which can provide the requested solution. Finally, some results including numerical examples are offered to illustrate the usefulness of the presented solution method.
Society for the Advancement of Transplant Anesthesia: Liver Transplant Anesthesia Fellowship—White Paper Advocating Measurable Proficiency in Transplant Specialties Training
Authors: Chadha Ryan M. , Crouch Cara , Zerillo Jeron , Pretto Ernesto A. , Planinsic Raymond , Kim Sang , Nicolau-Raducu Ramona , Adelmann Dieter , Elia Elia , Wray Christopher L. , Srinivas Coimbatore , Mandell M. Susan
Published: October 2017

The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers. Yet there is evidence that patient outcome is affected by the experience of the anesthesiologist with liver transplants as part of a multidisciplinary care team. Requests for a formal review of the inequities in training opportunities and requirements led the Society for the Advancement for Transplant Anesthesia (SATA) to begin the task of developing post-graduate fellowship training recommendations. In this article, members of the SATA Working Group on Transplant Anesthesia Education present their reasoning for specialized education and conclusions about which pathways can better prepare trainees to care for complex transplant patients.
Additional Visualization via Smart Glasses Improves Accuracy of Wire Insertion in Fracture Surgery
Authors: Tsubosaka Masanori , Hiranaka Takafumi , Okimura Kenjiro , Nakanishi Yuta , Shibata Yosaku , Hida Yuichi , Fujishiro Takaaki , Uemoto Harunobu
Published: October 2017

Background. Smart glasses (SG) are a wearable device consisting of a small computer built into a head-mounted monitor (HMM) that can display various kinds of information. Lateral side visualization is displayed on the HMM of SG so the operator may also see it and the anteroposterior (AP) direction simultaneously. The present pilot study aimed to investigate the usefulness of SG in wire insertion for bone fracture. Methods. We marked both the front and lateral sides of the shaft of an artificial femur bone. From the tip of the greater trochanter, we inserted a 2.4-mm Kirschner wire (K-wire) so that it could be directed toward the marks in both planes. Three surgeons enrolled in the study each performed 10 trials, both with SG (SG arm) and without (direct vision arm). We defined the error angle as the angle between the K-wire and the line connecting the marking point from the insertion point in both the front and lateral view images. We also measured the time it took to insert the K-wire in both arms. Results. The SG had a significantly reduced (mean = 3.2°) error angle ( P = .02) when compared to the direct vision group (mean = 4.8°). However, no significant difference was found between direct vision (mean = 17.5 seconds) and SG arms (mean = 14.9 seconds) in the insertion time. Conclusion. While keeping the AP image view in primary focus, simultaneously viewing the lateral side of the surgical field using SG helps achieve more accurate wire insertion in surgery.
Effect of Gender on Mechanical Properties of the Plantar Fascia and Heel Fat Pad
Authors: Taş Serkan
Published: October 2017

Background. The purpose of the study was to investigate the plantar fascia and heel fat pad stiffness and thickness parameters in females and compare these values with those of males. Methods. This study was carried out in 60 healthy sedentary participants (30 female, 30 male) between the ages of 19 and 50 years. Shear wave velocity (SWV) and thickness of the plantar fascia and heel fat pad were measured with an ultrasonography device. Results. Males had a higher plantar fascia ( P = .037) and heel fat pad ( P = .001) thickness compared with females, but SWV of the plantar fascia ( P = .673), heel fat pad microchamber layer ( P = .240), and heel fat pad macrochamber layer ( P = .636) were similar in both groups. Body mass had a strong correlation with the plantar fascia ( r = 0.64, P < .001) and heel fat pad thickness ( r = 0.68, P < .001). Height had a moderate correlation with the plantar fascia ( r = 0.44, P < .001) and heel fat pad thickness ( r = 0.42, P = .001). Conclusion. Plantar fascia and heel fat pad stiffness were similar in both genders; however, females had a lower plantar fascia and heel fat pad thickness compared with males. Correlation analysis results suggest that higher plantar fascia and heel fat pad thickness in males may be related to higher body mass and height.

Levels of Evidence: Level III: Retrospective comparative study
Patient’s Utilization of Primary Care: A Profile of Clinical and Administrative Reasons for Visits in Israel
Authors: Adar Tamar , Levkovich Inbar , Castel Orit Cohen , Karkabi Khaled
Published: October 2017

Background: Data on patients’ utilization of health services in primary care is relevant to planning healthcare. Data may be collected by numerous methods, but obtaining a true picture of content of care has practical difficulties. Objectives: To describe patient’s reasons for visits to primary care physicians (PCPs) as presented by the patient; and to examine the effect of patient-, doctor- and clinic-related variables on the reasons for the visit. Methods: Visits to PCPs were observed by peer doctors during 2014, at primary care clinics in Israel. Data were collected on characteristics of physicians, patients, clinics, type of visit, and reasons for visit. Results: Eleven physicians from 7 clinics participated in the study. Data were gathered from 327 visits. Patients visited for a wide variety of reasons. The most common acute complaints were upper respiratory symptoms, gastrointestinal, skin symptoms, and back and neck problems. The most common chronic complaints were hypertension and diabetes. Patients presented with administrative requests in 36% of visits; 15% were for solely administrative issues. A total of 26.6% of visits included requests for blood tests or discussion of tests. Patients initiated preventive medicine issues in 5% of visits. Visits for chronic problems were directly correlated with patient age and the extent of acquaintance with the physician. Gender-associated differences were also found: women were more likely to visit for a new medical problem than men, while men were more likely to visit for known or chronic problems. Conclusions: Patients visit their PCP for a wide variety of reasons, often during the same visit. Patients refer for administrative requests in about a third of visits. They initiate preventive care infrequently (1 out of 20 visits). To further characterize patient utilization of primary care, a broader study needs to be performed.
The effect of plasma auto-IgGs on CD4+ T cell apoptosis and recovery in HIV-infected patients under antiretroviral therapy
Authors: Luo Zhenwu , Zhou Zejun , Ogunrinde Elizabeth , Zhang Tao , Li Zhen , Martin Lisa , Wan Zhuang , Wu Hao , Qin Zhiqiang , Ou Tongwen , Zhang Jiafeng , Ma Lei , Liao Guoyang , Heath Sonya , Huang Lei , Jiang Wei
Published: October 2017

Although effective antiretroviral therapy (ART) suppresses HIV viral replication, prevents AIDS-related complications, and prolongs life, a proportion of patients fails to restore the patients’ CD4+ T cell number to the level of healthy individuals. Increased mortality and morbidity have been observed in these patients. In the current study, we have investigated the role of auto-IgGs in CD4+ T cell apoptosis and recovery in a cross-sectional study. All HIV+ subjects were on viral-suppressive ART treatment with a different degree of CD4+ T cell reconstitution. Total auto-IgG binding on CD4+ T cell surfaces and its associated apoptosis and CD4+ T cell recovery were analyzed by flow cytometry ex vivo. Total IgGs from plasma were tested for their binding capacities to CD4+ T cell surfaces and their mediation to CD4+ T cell death through NK cell cytotoxicity in vitro. HIV+ subjects had increased surface binding of auto-IgGs on CD4+ T cells compared with healthy controls, and IgG binding was associated with elevated CD4+ T cell apoptosis in HIV+ subjects but not in healthy controls. Plasma IgGs from HIV+ subjects bound to CD4+ T cells and induced cell apoptosis through NK cytotoxicity in vitro. Soluble CD4 (sCD4) preincubation prevented NK cell-mediated CD4+ T cell death. Our results suggest that plasma autoantibodies may play a role in some HIV+ patients with poor CD4+ T cell recovery under viral-suppressive ART.
The Association Between IGF-I and IGFBP-3 and Incident Diabetes in an Older Population of Men and Women in the Cardiovascular Health Study
Authors: Aneke-Nash Chino S , Xue Xiaonan , Qi Qibin , Biggs Mary L , Cappola Anne , Kuller Lewis , Pollak Michael , Psaty Bruce M , Siscovick David , Mukamal Kenneth , Strickler Howard D , Kaplan Robert C
Published: October 2017

Context

Insulin-like growth factor-I (IGF-I) has structural and functional similarities to insulin and may play a role in glucose homeostasis, along with insulin-like growth factor binding protein-3 (IGFBP-3), which binds the majority of circulating IGF-I.

Objective

To assess whether IGF-I and IGFBP-3 are associated with a higher risk of incident diabetes in older adults.

Design

Participants in the Cardiovascular Health Study (n = 3133), a cohort of adults aged ≥65 years, were observed for 16 years (n = 3133) for the development of incident diabetes. Statistical models were fit separately for men and women because of interactions with sex (P interaction: IGF-I, 0.02; IGFBP-3, 0.009) and were adjusted for relevant covariates.

Setting

General community.

Participants

Older adults who were nondiabetic at baseline and who did not develop diabetes within the first year of follow-up.

Interventions

Not applicable.

Main Outcome Measure

Incident diabetes as measured by fasting plasma glucose (FPG) ≥126 mg/dL, non-FPG ≥200 mg/dL, use of pharmacological treatment of diabetes, or existence of two or more inpatient or three or more outpatient or (at least one inpatient and at least one outpatient) Centers for Medicare & Medicaid Services claims with the diagnostic International Classification of Diseases, Ninth Revision, Clinical Modification code of 250.xx.

Results

In women, higher IGFBP-3 (hazard ratio tertile 3 vs tertile 1 = 2.30; 95% confidence interval, 1.55 to 3.40; P trend < 0.0001) was significantly associated with incident diabetes. Total IGF-I was not significantly associated with incident diabetes. In men, neither IGF-I nor IGFBP-3 was significantly associated with incident diabetes.

Conclusions

We confirmed a previously reported association between circulating IGFBP-3 and diabetes risk in the older adult population, establishing that this association is present among women but could not be shown to be associated in men.
Advanced wound healing and NPWT: overcoming the challenges
Authors: Bunce Nicholas
Published: October 2017

Nicholas Bunce, Editor of Nursing and Residential Care, discusses some highlights of the recent Hartmann LINK for Wound Healing Congress, which was organised in collaboration with the Journal of Wound Care
Trust clinical negligence claims: the problem of escalating costs
Authors: Tingle John
Published: October 2017

John Tingle, Associate Professor (Teaching and Scholarship), Nottingham Trent University, discusses a recent report by the National Audit Office on managing the costs of clinical negligence in trusts
Integrating charity work into our role as future nurses
Authors: Gilbert Gabriella
Published: October 2017

Gabriella Gilbert, a student nurse based in Gibraltar, has done some voluntary work that enhanced her understanding of care outside of the acute and primary care settings
How to approach changing jobs
Authors: Foster Sam
Published: October 2017

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the process of taking on a new role—from leaving a job to building relationships with new colleagues—and on empowering teams to promote staff retention
Factors influencing black men and their partners' knowledge of prostate cancer screening: a literature review
Authors: Ahiagba Phyllis , Alexis Obrey , Worsley Aaron James
Published: October 2017

Prostate cancer is the most commonly diagnosed cancer in men in the UK, with 46 690 new cases in 2014. While there is sufficient research on this topic in the USA, there is no review in the UK regarding both black men and their significant others' perspective on prostate cancer screening.

Aim:

To identify and explore factors that may influence black men and their significant others' knowledge and awareness of prostate cancer screening.

Method:

A literature search revealed seven relevant articles.

Results:

Six of the seven articles were conducted in the USA. The results are described using four themes: perception of prostate cancer screening, fear, anxiety and discomfort, misinformation about prostate cancer screening procedures and communication and decision-making.

Conclusion:

The evidence suggests that some black men and their significant others had knowledge and awareness of prostate cancer screening. However, their views were influenced by misperceptions, misinformation, fear and anxiety around screening procedures and mortality. Communication and spousal support were important in decision making.
Female genital mutilation: implications for clinical practice
Authors: von Rège Inez , Campion Daniel
Published: October 2017

Female genital mutilation (FGM) is an established cultural practice in over 30 countries. It has no health benefits, carries a high risk of physical and psychological harm, and is illegal in many countries including the UK. A sensitive approach is required, both in the management of complications and prevention of this practice. This article discusses the prevalence and classification of FGM, and offers practical advice to nurses and midwives involved in general and obstetric care. Legal aspects, including safeguarding responsibilities and the mandatory duty to report FGM in England and Wales, are outlined.
Reducing anti-psychotic prescribing for care home residents with dementia
Authors: Latham Isabelle , Brooker Dawn
Published: October 2017

This article reports on the outcome and evaluation of the focused intervention training and support (FITS) into practice programme, a training and support programme for care home staff aimed at reducing inappropriate anti-psychotic prescribing for people living with dementia by implementing alternative psychosocial interventions. This programme was adapted from an original randomised-controlled trial that successfully reduced the prescribing of anti-psychotic medications in care homes. The aim of the new programme was to replicate the impact of the original trial, but using a less resource-intense model, so that it could be implemented across care homes in the UK within existing resource conditions.

The programme successfully reduced anti-psychotic prescribing and improved staff knowledge and attitudes. Barriers and facilitators of implementation were identified at four key levels: the dementia care coach; the care home; the organisation; and external relationships. Crucial to success was the provision of dedicated time for dementia care coaches to implement, the ongoing support provided by the expert-practitioner role, and the quality of relationships with prescribers. The implications of these for the FITS into practice programme, other similar interventions, and the work of prescribers with care homes are discussed.
Side effects and adverse drug reactions
Authors: Robertson Deborah
Published: October 2017

This article will look at the pharmacological aspects surrounding side effects of drugs, adverse drug reactions and the key differences between the two. It will also touch on the concept of drug ‘allergy’ and its meaning from a pharmacological perspective. Using examples, common and rare side effects will be illustrated and how side effects are classified discussed. The main types of adverse drug reactions will be examined and examples of each given, highlighting when a side effect becomes an adverse effect.
Managing the health of migrants in general practice
Authors: Frazer Dionne
Published: October 2017

Dionne Frazer outlines work by teams at Walsall Healthcare NHS Trust to improve GP services for migrant populations who experience difficulty in accessing healthcare
The good news or the bad?
Authors: Ainsworth Steve
Published: October 2017

Newspaper reports this summer were full of tales of woe as it was revealed that the NHS falls short of the standards of healthcare provided in many other countries. But is it all bad news, asks Steve Ainsworth
Important steps to keep finances healthy
Authors: Burwood Andrew
Published: October 2017

Specialist medical accountant Andrew Burwood has some ideas for practice managers on how to deal with the relentless squeeze on practice finances
Upcoming changes to data protection
Authors: Fry Elliot
Published: October 2017

Data protection requirements are getting stricter for GPs, writes Elliot Fry, an associate at law firm Cripps
To quit or not to quit?
Authors: Jones-Tinsley Lisa
Published: October 2017

A survey of practice managers in 2014 found that more than two thirds had recently contemplated quitting their job due to increased hours, stress and complexity of the role
Three questions for new headteachers
Authors: Donnison Liam
Published: October 2017

What can you expect as you step-up to headship? Liam Donnison speaks to executive principal Peter Rubery, who offers three key questions to help you reflect on the challenges ahead
Analisis kesesuaian dan daya dukung lingkungan untuk pengembangan wisata bahari di Pulau Bawean Kabupaten Gresik Provinsi Jaya Timur
Authors: Sukandar Sukandar , Dewi Citra S. U. , Handayani Muliawati
Published: October 2017

Bawean Island has potency as a ecotourism destination in Gresik District, Province of Jaya timur. This island is one of the popular destination for local tourist, and the visitors are increasing over the years; but there was no study on the suitability and carrying capacity of the island for marine ecotourism activities. The purpose of this study was to analysis the suitability and carrying capacity of Bawean Island for marine tourism. The Results of the analysis showed that the area of marine ocotourism in Bawean is Suitable (S1) for marine ecotourism development with a value for leisure travel 88.33%, snorkeling activity was 84.21%; and diving 81.48%. The total value carrying capacity of region was 398 persons/day.Pulau Bawean memiliki potensi sebagai daerah tujuan wisata bahari di kabupaten Gresikproins Jaya timur. Pulau ini telah menjadi tujuan wisata lokal bagi masyarakat Jaya timur dan jumlah kunjungan wisatawan semakin meningkat dari tahun ke tahun. Namu belum ada kajian mengenai kesesuaian dan daya dukung lingkungan di Pulau Bawean sebagai kawsan wisata bahari. Oleh karena itu penelitian ini bertujuan untuk mengkaji kesesuaian dan daya dukung Pulau Bawean sebagai kawasan wisata bahari. Hasil analisis menunjukkan bahwa Pulau Bawean sesuai (S1) untuk dikembangkan sebagai kawasan wisata bahari  dengan nilai untuk wisata rekreasi pantai sebesar 88,33%, wisata snorkeling sebesar 84,21% dan wisata selam sebesar 81,48%. Nilai total daya dukung kawasan sebesar 398 orang/hari.
Hubungan panjang berat dan faktor kondisi ikan belodok (Famili: Gobiidae) pada ekosistem mangrove di Desa Pulau Sembilan Kabupaten Langkat Provinsi Sumatera Utara
Authors: Bidawi Bill Maulana , Desrita Desrita , Yunasfi Yunasfi
Published: October 2017

The aims of the research was to examine the lenght weight relationships, growth pattern and condition factor of mudskipper (Family: Gobiidae) at the mangrove ecosystem. The research was conducted for two months from March to April 2016 at the mangrove ecosystem in the Sembilan Island village. The result showed that there are three species of mudskipper found in study area, namely Periophthalmus chrysospilos, Periophthalmus gracilis, and Boleophthalmus boddarti.  The growth pattern of mudskipper with a value b 3,  indicate a allometrik negative growth pattern and the condition factor was between 1-2.Penelitian ini bertujuan untuk menganalisis hubungan panjang bobot, pola pertumbuhan dan faktor kondisi ikan belodok (Famili: Gobiidae) pada ekosistem mangrove di di desa Pulau Sembilan Langkat. Penelitian dilaksanakan selama dua bulan yaitu Maret sampai April 2016. Penelitian ini menggunakan metode purposive random sampling. Hasil penelitian ditemukan 3 spesies ikan belodok di lokasi penelitian yaitu Periophthalmus chrysospilos, Periophthalmu sgracilis, dan Boleophthalmus boddarti. Pola pertumbuhan ikan belodok dengan nilai b 3, mengindikasikan pola pertumbuhan allometrik negatif. Faktor kondisi dari Ikan Belodok berkisar 1 – 2.
Status klorofil-a di Perairan Teluk Pria Laot Sabang, Provinsi Aceh
Authors: Agustina Sri , Musman Musri , Ishaq Muhammad
Published: October 2017

Study about chlorophyll-a state in Teluk Pria Laot Sabang has been done in October 2016. The objective of this study was to analyze the chlorophyll-a concentration and phytoplankton abundance in Teluk Pria Laot Sabang. Samples were collected at a station located at 5,84653oN and 95,29001oE during 4 days (4, 6, 8, and 10th October 2016) which each day had 4 sampling times (07:00 am, 10:00 am, 01:00 pm, and 04:00 pm). Chlorophyll-a, phytoplankton, and nutrient analysis were conducted at chemistry laboratory of Teacher Training and Education Faculty, Syiah Kuala University, marine chemistry laboratory of Marine and Fisheries Faculty, Syiah Kuala University, and Unit of Environment Research and Development, Banda Aceh. The result showed that chlorophyll-a concentration ranged 0,02  – 1,7 µg/L withthe highest average (0,64 µg/L) was obtained at 01:00 pm. In addition,phytoplankton abundance was found ranged3539,4 ind/L – 8687,3 ind/L andthe highest average (6435,0 ind/L) appeared at 10:00 am. Nitrate and phosphate concentration which were above the minimum value of threshold revealed that this area was rich in nutrient availabilityto support the phytoplankton growth. Chlorophyll-a concentrations are likely influenced by light intensity with rich nutrient availability than phytoplankton abundance. According to chlorophyll-a concentration, Teluk Pria Laot Sabang is categorized as Oligothropic area.Penelitian tentang status klorofil-a di Teluk Pria Laot Sabang telah dilakukan pada Bulan Oktober 2016. Tujuan dari penelitian ini adalah untuk mengetahui konsentrasi klorofil-a dan kelimpahan fitoplankton di Teluk Pria Laot Sabang. Sampel dikumpulkan pada stasiun yang terletak pada koordinat 5,84653oLU dan 95,29001oBT selama 4 hari dengan 4 kali waktu pengambilan per hari (pukul 07.00, 10.00, 13.00, dan 16.00 WIB). Analisis klorofil-a, fitoplankton dan nutrien dilakukan di Laboratorium FKIP – kimia Unsyiah, Laboratorium Kimia Laut, FKP Unsyiah, Balai Penelitian dan Pengembangan Lingkungan (BPPL) Banda Aceh. Hasil penelitian menunjukkan bahwa konsentrasi klorofil-a berkisar 0,02– 1,7µg/Ldengan nilai rata – rata konsentrasi klorofil-a tertinggi 0,64µg/L didapatkan pada waktu pengambilan pukul 13:00 WIB. Kelimpahan fitoplankton yang diperoleh berkisar 3539,4 ind/L – 8687,3 ind/L dengan rata – rata tertinggi dengan nilai 6435,0 ind/L diperoleh pada pukul 10:00 WIB. Konsentrasi nitrat dan fosfat yang berada di atas ambang batas minimal menggambarkan bahwa daerah ini menyuplai nutrien yang cukup untuk pertumbuhan fitoplankton. Fluktuasi konsentrasi klorofil-a lebih cenderung mengikuti perubahan intensitas cahaya matahari dengan ketersediaan nutrien (nitrat dan fosfat) yang cukup. Berdasarkan konsentrasi klorofil-a yang diperoleh, Perairan Teluk Pria Laot Sabang dikategorikan sebagaidaerah oligotrofik.
Perception of nursing homes as accomodation units
Konaklama birimi olarak huzurevi algısı
Authors: Aktaş Polat Semra , Hira İsmail
Published: October 2017

The purpose of this study is to determine how nursing homes are perceived as accomodation units by the age of 60 and above elderly people living at home and whether there is a relationship between these people’s perceptions and their gender, the cities they live and the people they live with. Research area includes Sinop, Kastamonu and Çankırı cities located in the TR82 region in Turkey. Research data were collected through face to face questionnaires from 400 elderly people aged 60 and over residing in the TR82 region. The data were analyzed by frequency analysis and the chi-square (x2) test.According to the results a nursing home is perceived as reassuring units besides the feel of abandonment, not to be a burden to anyone, a place for the lonely and poor old, reducing future anxiety for the old, a place for helpless people to stay, a result of loneliness in a sense that might be a solution to some problems.According to chi-square (x2) test results it is determined that although there is no relationship between perception of nursing homes and gender, there is a statistically significant relationship between some phrases related to perception of nursing homes and inhabited city and people the old live with. Extended English abstract is in the end of PDF (TURKISH) file. ÖzetBu çalışmanın amacı, bir konaklama birimi olarak huzurevlerinin, 60 yaş ve üzeri evde yaşayan yaşlılar tarafından nasıl algılandığını ve bu yaşlıların, huzurevlerine yönelik düşünceleri ile cinsiyetleri, ikamet ettikleri şehirler ve birlikte yaşadıkları kişiler arasında bir ilişkinin olup olmadığını tespit etmektir. Araştırma alanı Sinop, Kastamonu ve Çankırı’yı içeren TR82 Bölgesi’dir. Araştırma verileri, 60 yaş ve üzeri 400 yaşlıdan yüz yüze anket tekniği ile toplanmış, frekans analizi ve ki-kare (x2) testi ile analiz edilmiştir.Araştırma sonuçlarına göre huzurevleri; terk edilmişliği hissettiren, kimseye yük olmamayı sağlayan, kimsesiz ve yoksul yaşlıların kaldığı bir yer, yaşlıların gelecek kaygılarını azaltan, çaresiz insanların kalmayı tercih ettiği, bir anlamda da yalnızlığın bir sonucu, bazı sorunlara bir çözüm olabilecek, güven veren birimler olarak algılanmaktadır.Yapılan ki-kare (x2) testi sonucuna göre; huzurevleri algısı ile cinsiyet arasında bir ilişki olmamasına rağmen, huzurevi algısına yönelik bazı ifadeler ile ikamet edilen şehir ve yaşlının beraberinde yaşadığı kişiler arasında istatistiksel açıdan anlamlı bir ilişki tespit edilmiştir.
Intragenic hypomethylation of DNMT3A in patients with myelodysplastic syndrome
Authors: Zhang Ying-Ying , Zhou Jing-Dong , Yang Dong-Qin , He Pin-Fang , Yao Dong-Ming , Qian Zhen , Yang Jing , Xu Wen-Rong , Lin Jiang , Qian Jun
Published: October 2017

Background:

DNMT3A is a DNA methyltransferase that acts in de novo methylation. Aberrant expression of DNMT3A has been reported in several human diseases, including myelodysplastic syndrome (MDS). However, the pattern of DNMT3A methylation remains unknown in MDS.

Methods:

The present study was aimed to investigate the methylation status of DNMT3A intragenic differentially methylated region 2 (DMR2) using real-time quantitative methylation-specific PCR and analyze its clinical significance in MDS.

Results:

Aberrant hypomethylation of DNMT3A was found in 57% (51/90) MDS cases. There were no significant differences in age, sex, white blood cell counts, platelet counts, hemoglobin counts and World Health Organization, International Prognostic Scoring System and karyotype classifications between DNMT3A hypomethylated and DNMT3A hypermethylated groups. However, the patients with DNMT3A hypomethylation had shorter overall survival time than those without DNMT3A hypomethylation (11 months vs. 36 months, p=0.033). Multivariate analysis confirmed the independent adverse impact of DNMT3A hypomethylation in MDS.

Conclusions:

Our data suggest that DNMT3A DMR2 hypomethylation may be a negative prognostic hallmark in MDS.
The venous thromboembolic risk and the clot wave analysis: a useful relationship?
Authors: Ruberto Maria Filomena , Marongiu Francesco , Mandas Antonella , Mameli Antonella , Porru Mariagrazia , Cianchetti Elisabetta , Barcellona Doris
Published: October 2017

Background:

Hospitalized patients with acute medical conditions have higher venous thromboembolism (VTE) risk. A patient with a final Padua Prediction Score (PPS) of ≥4 is considered to be at high risk for VTE. The aim of this study was to investigate on a possible relationship between PPS, the dynamics of the clot formation, i.e. the clot waveform analysis (CWA) of aPTT, fibrinogen and D-Dimer in a large group of medical patients.

Methods:

CWA in terms of velocity (first derivative), acceleration (second derivative), density (Delta) of aPTT, fibrinogen, D-Dimer and PPS for VTE were determined in 801 medical patients divided in three groups (without antithrombotic prophylaxis and high PPS, without antithrombotic prophylaxis and low PPS, with antithrombotic prophylaxis and high PPS) and a group of healthy subjects.

Results:

CWA, fibrinogen and D-Dimer values were higher in the medical patients with high PPS with or without antithrombotic prophylaxis when compared with patients without antithrombotic prophylaxis with low PPS and healthy subjects. The second derivative, fibrinogen and D-Dimer were significantly associated with a high PPS score (≥4): odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.03–2.28; OR = 1.91, 95% CI = 1.3–2.79; OR = 3.16, 95% CI = 2.29–4.36, respectively. Interactions between first derivative and D-Dimer (OR = 2.14, 95% CI = 1.23–3.72) and first derivative and fibrinogen (OR = 1.75, 95% CI = 1.02–2.98) were found.

Conclusions:

CWA could give useful information to recognize a hypercoagulable state in patients admitted to a medical ward with high and low PPS. First and second derivative aPTT, D-Dimer and fibrinogen levels could be added to PPS to better assess the global thromboembolic risk of these patients.
How to reduce scientific irreproducibility: the 5-year reflection
Authors: Fiala Clare , Diamandis Eleftherios P.
Published: October 2017

We discuss in depth six causes of scientific irreproducibility and their ramifications for the clinical sciences: fraud, unfounded papers published by prominent authorities, bias, technical deficiencies, fragmented science and problems with big data. Some proposed methods to combat this problem are briefly described, including an effort to replicate results from some high impact papers and a proposal that authors include detailed preclinical data in papers with supposedly high translational value. We here advocate for a 5-year reflection on papers with seemingly high clinical/translational potential, published alongside the original paper where authors reflect on the quality, reproducibility and impact of their findings. These reflections can be used as a benchmark for credibility, and begin a virtuous cycle of improving the quality of published findings in the literature.
Strategies to define performance specifications in laboratory medicine: 3 years on from the Milan Strategic Conference
Authors: Panteghini Mauro , Ceriotti Ferruccio , Jones Graham , Oosterhuis Wytze , Plebani Mario , Sandberg Sverre
Published: October 2017

Measurements in clinical laboratories produce results needed in the diagnosis and monitoring of patients. These results are always characterized by some uncertainty. What quality is needed and what measurement errors can be tolerated without jeopardizing patient safety should therefore be defined and specified for each analyte having clinical use. When these specifications are defined, the total examination process will be “fit for purpose” and the laboratory professionals should then set up rules to control the measuring systems to ensure they perform within specifications. The laboratory community has used different models to set performance specifications (PS). Recently, it was felt that there was a need to revisit different models and, at the same time, to emphasize the presuppositions for using the different models. Therefore, in 2014 the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) organized a Strategic Conference in Milan. It was felt that there was a need for more detailed discussions on, for instance, PS for EQAS, which measurands should use which models to set PS and how to set PS for the extra-analytical phases. There was also a need to critically evaluate the quality of data on biological variation studies and further discussing the use of the total error (TE) concept. Consequently, EFLM established five Task Finish Groups (TFGs) to address each of these topics. The TFGs are finishing their activity on 2017 and the content of this paper includes deliverables from these groups.
(Non) Compliance with the International Health Regulations of the WHO from the Perspective of the Law of International Responsibility
Authors: Spagnolo Andrea
Published: October 2017

International Health Regulations (IHR) of the World Health Organization (WHO) are fundamental to ensure an adequate response of the international community to health emergencies such as the spread of the virus Ebola in 2014. This notwithstanding, WHO's Member States appear reluctant to comply with the IHR and in particular they violate the ban on unnecessary trade and travel restrictions. After having presented the lack of compliance with the IHR, the present article analyses the means at the disposal of the WHO for sanctioning the behaviour of its Member States, both from the perspective of WHO's internal rules and from the perspective of the law of international responsibility, evaluating if countermeasures might represent a viable solution. The conclusions will offer a broad reflection on the codification process of the rules on the responsibility of international organisations concluded by the International Law Commission in 2011.
Fetal analysis with invasive method (FA-I) and fetal analysis with non-invasive method (FA-NI): replacing current, deceptively imprecise clinical nomenclature
Authors: Chervenak Frank A. , McCullough Laurence B. , Dudenhausen Joachim
Published: October 2017

There is a problem with the current nomenclature of prenatal evaluation. The current nomenclature of “prenatal testing” and “prenatal screening” – along with their subsets of “ultrasound testing,” “ultrasound screening,” “non-invasive prenatal testing,” “non-invasive prenatal screening,” and “prenatal diagnosis” – has become so imprecise that clinical misinterpretation and distortion of the informed consent process are increasingly difficult to avoid. To remedy this problem, we propose a new, precise nomenclature: “fetal analysis with invasive method” (FA-I) and “fetal analysis with non-invasive method,” (FANI) using various techniques. This new nomenclature is designed to be precise and therefore facilitate effective communication among physicians and with pregnant women. For ease of use the new nomenclature can be formulated as an abbreviation: FA-I and FA-NI.
Molecular architecture of pterin deaminase from Saccharomyces cerevisiae NCIM 3458
Authors: Murugesan Thandeeswaran , Velliayadevar Karuppuswamy , Easwaran Murugesh , KG Kiran , KA Ayub Nawaz , Ramasamy Mahendran , Muthusamy Palaniswamy , Jayaraman Angayarkanni
Published: October 2017

As early as 1974, reports have confirmed the anticancer activity of pterin deaminase isolated from fungi. The enzyme has also been reported in bacteria, fungi and slime mold genera, but the enzyme characterization was effetely done. The present study attempted to purify and characterize pterin deaminase enzyme from Saccharomyces cerevisiae NCIM 3458. The protein was extracted from the extracellular extract by using the ethanol precipitation method. Partial purification of pterin deaminase enzyme was achieved by ion exchange chromatography (Hi-Trap QFF) by fast protein liquid chromatography (AKTA purifier). The molecular weight of the protein was apparently determined by SDS-PAGE, and the presence of pterin deaminase was confirmed by activity staining. The purified enzyme was further biochemically characterized. Molecular docking studies showed higher binding affinity towards folic acid interaction. The structural characterization of this protein may open the windows for new drug targets for cancer therapy.
Effect of chemical treatment on thermal properties of hair fiber-based reinforcement of HF/HDPE composites
Authors: Srivastava Prashant , Sinha Shishir
Published: October 2017

The present study deals with the effects of fiber loading and alkali treatment (AT) on thermal behavior of a hair fiber (HF)-reinforced high-density polyethylene (HDPE) composite. The HF/HDPE-reinforced polymer composite has been prepared through a compression molding technique, which provided optimum thermal stability at 15 wt% of the fiber in the reinforced composite. The thermal stability of the composite has been investigated using a thermal analyzer [thermogravimetric analysis (TGA), derivative thermogravimetric analysis (DTG) and differential scanning calorimetry (DSC)]. The ATs of HF-reinforced composites have affected the thermal stability of the material, in which the observed optimum thermal stability is 0.25 N AT 15% HF/HDPE-reinforced composites. Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM) and tensile test played an important role in the study of the thermal stability of the material. FTIR analysis was used to investigate the chemical groups between the fiber and matrix. The morphology of the fiber is beneficial for the study of the surface treatment effect on the HF. The tensile test examined the optimum strength at 0.25 N AT 15% HF/HDPE composite, and a good relationship between the thermal and mechanical properties was also observed.
Qualification of a Small Gas Turbine Engine as a Starter Unit
Authors: Mishra R. K. , Kumar Prashant , Jayasihma K. S. , Mistry S. N.
Published: October 2017

The certification philosophy plays an important role in ensuring the airworthiness qualification of a small gas turbine engine designed as a starter unit. The small and compactness of the engine, high rotational speed of the rotors, requirements of torque and starting capability at sea level to high altitude airfields and consecutive starts within stipulated time impose a great challenge from airworthiness point of view. This paper presents the methodology adopted and various stages of qualification, standards followed and results based on which the starter unit has been qualified for fitment on the designated aircraft.
Action Monitoring Cortical Activity Coupled to Submovements
Authors: Pereira Michael , Sobolewski Aleksander , Millán José del R.
Published: October 2017

Numerous studies have examined neural correlates of the human brain’s action-monitoring system during experimentally segmented tasks. However, it remains unknown how such a system operates during continuous motor output when no experimental time marker is available (such as button presses or stimulus onset). We set out to investigate the electrophysiological correlates of action monitoring when hand position has to be repeatedly monitored and corrected. For this, we recorded high-density electroencephalography (EEG) during a visuomotor tracking task during which participants had to follow a target with the mouse cursor along a visible trajectory. By decomposing hand kinematics into naturally occurring periodic submovements, we found an event-related potential (ERP) time-locked to these submovements and localized in a sensorimotor cortical network comprising the supplementary motor area (SMA) and the precentral gyrus. Critically, the amplitude of the ERP correlated with the deviation of the cursor, 110 ms before the submovement. Control analyses showed that this correlation was truly due to the cursor deviation and not to differences in submovement kinematics or to the visual content of the task. The ERP closely resembled those found in response to mismatch events in typical cognitive neuroscience experiments. Our results demonstrate the existence of a cortical process in the SMA, evaluating hand position in synchrony with submovements. These findings suggest a functional role of submovements in a sensorimotor loop of periodic monitoring and correction and generalize previous results from the field of action monitoring to cases where action has to be repeatedly monitored.
Cadherin-10 Maintains Excitatory/Inhibitory Ratio through Interactions with Synaptic Proteins
Authors: Smith Katharine R. , Jones Kelly A. , Kopeikina Katherine J. , Burette Alain C. , Copits Bryan A. , Yoon Sehyoun , Forrest Marc P. , Fawcett-Patel Jessica M. , Hanley Jonathan G. , Weinberg Richard J. , Swanson Geoffrey T. , Penzes Peter
Published: October 2017

Appropriate excitatory/inhibitory (E/I) balance is essential for normal cortical function and is altered in some psychiatric disorders, including autism spectrum disorders (ASDs). Cell-autonomous molecular mechanisms that control the balance of excitatory and inhibitory synapse function remain poorly understood; no proteins that regulate excitatory and inhibitory synapse strength in a coordinated reciprocal manner have been identified. Using super-resolution imaging, electrophysiology, and molecular manipulations, we show that cadherin-10, encoded byCDH10within the ASD risk locus 5p14.1, maintains both excitatory and inhibitory synaptic scaffold structure in cultured cortical neurons from rats of both sexes. Cadherin-10 localizes to both excitatory and inhibitory synapses in neocortex, where it is organized into nanoscale puncta that influence the size of their associated PSDs. Knockdown of cadherin-10 reduces excitatory but increases inhibitory synapse size and strength, altering the E/I ratio in cortical neurons. Furthermore, cadherin-10 exhibits differential participation in complexes with PSD-95 and gephyrin, which may underlie its role in maintaining the E/I ratio. Our data provide a new mechanism whereby a protein encoded by a common ASD risk factor controls E/I ratios by regulating excitatory and inhibitory synapses in opposing directions.

SIGNIFICANCE STATEMENTThe correct balance between excitatory/inhibitory (E/I) is crucial for normal brain function and is altered in psychiatric disorders such as autism. However, the molecular mechanisms that underlie this balance remain elusive. To address this, we studied cadherin-10, an adhesion protein that is genetically linked to autism and understudied at the cellular level. Using a combination of advanced microscopy techniques and electrophysiology, we show that cadherin-10 forms nanoscale puncta at excitatory and inhibitory synapses, maintains excitatory and inhibitory synaptic structure, and is essential for maintaining the correct balance between excitation and inhibition in neuronal dendrites. These findings reveal a new mechanism by which E/I balance is controlled in neurons and may bear relevance to synaptic dysfunction in autism.