bluuebunny/crossref_metadata_2025 huggingface dataset:
Decadal Changes in Multiscale Water Vapor Transport and Atmospheric River Associated with the Pacific Decadal Oscillation and the North Pacific Gyre Oscillation
Authors: Liu Xu , Ren Xuejuan , Yang Xiu-Qun
Published: September 2015

This study investigates the features of atmospheric circulation and moisture transport associated with two modes of decadal variability in the North Pacific: the Pacific decadal oscillation (PDO) and the North Pacific Gyre Oscillation (NPGO), with emphasis on the multiscale water vapor transport and atmospheric river (AR) over the North Pacific region. During the positive phase of PDO, the geopotential height anomaly at 500-hPa exhibits a Pacific–North American-like pattern. During the positive phase of NPGO, the geopotential height anomaly at 500 hPa features a dipole pattern with a negative anomaly north of 40°N and a positive anomaly south of 40°N over the North Pacific. Associated with the positive PDO phase, the ocean-to-land moisture transport is enhanced between 25° and 35°N and reduced over the northeastern Pacific (25°–62°N, 180°–110°W) for the time-mean integrated vapor transport (IVT). The synoptic poleward transport is suppressed north of 40°N and enhanced south of 40°N. In the positive NPGO phase, the zonal moisture transport is intensified south of 20°N and between 40° and 50°N for the time-mean IVT and weakened over the west coast of North America for the low-frequency (10–100 days) IVT. The synoptic poleward transport is suppressed south of 30°N. The eastern part of the North Pacific AR belt moves southward during positive PDO as the entire North Pacific AR belt shifts slightly northward during positive NPGO. An investigation of AR anomalies during a period over which the PDO and NPGO coexist demonstrates that the AR frequency over the North American western coastal regions is significantly influenced by the conjunction of the PDO and NPGO modes.
The Image of God and Human Uniqueness: Challenges from the Biological and Information Sciences
Authors: Burdett Michael S.
Published: September 2015

The image of God is the doctrinal home of human uniqueness. Indeed, the Genesis text indicates that the image of God is decisively what separates human beings from the rest of creation and helps to define the human being as a special creature in the order of creation. Recent work in the biological and information sciences is eroding the centuries-old conviction that we are unique as creatures. How does this affect how we understand the image of God? Should we experience this loss of human uniqueness as damaging to the Christian faith? These questions are addressed by first calling attention to the various ways the image of God have been interpreted throughout Christian history. Employing the four views of the image of God—substantive, functional, relational and dynamic—I argue that this loss of human uniqueness need not threaten the image of God in each of these cases, but rather helps provide clarity to the doctrine itself.
When Humans are Not Unique: Perspectives on Suffering and Redemption
Authors: Sollereder Bethany
Published: September 2015

This paper explores how two realms in which humans have traditionally been thought to hold unique capacities, in suffering and in redemption, are increasingly challenged. With scientific evidence pointing strongly towards the reality of non-human suffering, new questions are also raised in theodicy. Part of the solution to the problem of suffering is redemption, and the latter half of this paper introduces and critiques several different models of creaturely redemption. These perspectives cause us to recognise the deep continuities between human and non-human animals, and they therefore encourage us to define human uniqueness more in terms of role rather than capacity.
Deregulation, Distrust, and Democracy: State and Local Action to Ensure Equitable Access to Healthy, Sustainably Produced Food
Authors: Wiley Lindsay F.
Published: September 2015

Environmental, public health, alternative food, and food justice advocates are working together to achieve incremental agricultural subsidy and nutrition assistance reforms that increase access to fresh fruits and vegetables. When it comes to targeting food and beverage products for increased regulation and decreased consumption, however, the priorities of various food reform movements diverge. This article argues that foundational legal issues, including preemption of state and local authority to protect the public's health and welfare, increasing First Amendment protection for commercial speech, and eroding judicial deference to legislative policy judgments, present a more promising avenue for collaboration across movements than discrete food reform priorities around issues like sugary drinks, genetic modification, or organics. Using the Vermont Genetically Modified Organism (GMO) Labeling Act litigation, the Kauai GMO Cultivation Ordinance litigation, the New York City Sugary Drinks Portion Rule litigation, and the Cleveland Trans Fat Ban litigation as case studies, I discuss the foundational legal challenges faced by diverse food reformers, even when their discrete reform priorities diverge. I also explore the broader implications of cooperation among groups that respond differently to the “irrationalities” (from the public health perspective) or “values” (from the environmental and alternative food perspective) that permeate public risk perception for democratic governance in the face of scientific uncertainty.
Transparency for Food Consumers: Nutrition Labeling and Food Oppression
Authors: Freeman Andrea
Published: September 2015

Transparency for consumers through nutrition labeling should be the last, not the first, step in a transformative food policy that would reduce dramatic health disparities and raise the United States to the health standards of other nations with similar resources. Nonetheless, transparency in the food system is a key focal point of efforts to improve health by providing consumers with necessary information to make good nutritional choices, as well as to achieve sustainable food chains and ensure food safety and quality. In fact, nutrition labeling on packaging and in restaurants is the centerpiece of policy designed to decrease obesity, a condition many health advocates consider to be the most urgent public health crisis of the twenty-first century. The resulting increased transparency about food ingredients has led to some changes in industry practices and allowed many middle- and upper-income consumers to make informed choices about the products they purchase and consume. Unfortunately, however, research reveals that increased nutritional information does not improve health.
Addressing Consumer Confusion Surrounding “Natural” Food Claims
Authors: Parasidis Efthimios , Hooker Neal , Simons Christopher T.
Published: September 2015

Use of “natural” and “all natural” claims on food and beverage products has increased exponentially over the last decade. Studies have consistently found that the claims influence consumer behavior—consumers seek out and are willing to pay a premium for products that make Natural claims. Not surprisingly, the Natural market has grown significantly, surpassing $40 billion in annual revenues. Despite strong consumer demand for Natural products, a majority of consumers have mistaken beliefs about the meaning of Natural claims.
Whole Foods: The FSMA and the Challenges of Defragmenting Food Safety Regulation
Authors: Tai Stephanie
Published: September 2015

With respect to addressing food safety—and food system issues in a more general sense—coordination in regulatory approaches can be critical. As a recent Washington Post article stated,

Diet-related chronic disease, food safety, marketing to children, labor conditions, wages for farm and food-chain workers, immigration, water and air quality, greenhouse gas emissions, and support for farmers: These issues are all connected to the food system. Yet they are overseen by eight federal agencies. Amid this incoherence, special interests thrive and the public good suffers.
Shielding Parenteral Nutrition From Light Improves Survival Rate in Premature Infants
Authors: Chessex Philippe , Laborie Sophie , Nasef Nehad , Masse Benoit , Lavoie Jean‐Claude
Published: September 2015

Background: Intravenous nutrition preparations that are not photoprotected generate oxidants, which are deleterious for cell survival. The question remains: are these observations of clinical relevance in individuals receiving parenteral nutrition (PN), especially in those who exhibit immature antioxidant defenses such as premature infants? Objective: To review clinical trials reporting the effect of light‐exposed vs light‐protected PN to determine whether photoprotection reduces neonatal mortality in preterm infants. Data source: Electronic databases, abstracts in relevant journals, and references in manuscripts between 1980 and 2014. Selection criteria: Newborn, premature infants, PN, photoprotection, shielding from light, randomization, mortality, death. Methods: Consensus for inclusion reached by 2 reviewers; meta‐analysis of trials and observational studies reporting mortality at 36 weeks' gestational age or hospital discharge. Results: Four trials meeting selection criteria, which involved a total of 800 newborn premature infants, were included. Across trials, gestational age (mean ± SD) ranged from 26 ± 1 to 31 ± 2 weeks, birth weight from 775 ± 161 to 1588 ± 366 g, and mortality from 5%–32%. Mortality in the light‐protected group was half of that in the light‐exposed group (95% confidence interval, 0.32–0.87) and twice as high in males compared with females (χ2, P = .01). Conclusion: Shielding PN from light has vital repercussions that call for action to provide photoprotected delivery systems and infusion sets in premature infants. Further studies should be extended to the increasing number of children and adults receiving long‐term home PN to evaluate the effects of light protection on severe complications that impede their quality of life.
Abnormal Sleep Duration Is Associated with a Higher Risk of Accidental Injury
Authors: Bhattacharyya Neil
Published: September 2015

Objective

Develop normative data for adult sleep duration and determine if nonstandard sleep time relates to the likelihood of accidental injury.

Study Design

Cross‐sectional analysis.

Setting

National health information database.

Methods

The National Health Interview Survey, 2004‐2013, was examined for adult sleep time and accidental injury within the past 3 months. The mean hours slept per night was determined. The relationship between sleep time and incidence of accidental injury was determined for any injury, injury while driving, and injury while working, adjusting for demographic variables.

Results

Among 221.4 million adults (raw sample, N = 282,692), the mean sleep time was 7.17 hours (95% confidence interval [95% CI], 7.16‐7.18 hours). Men and women slept very similar times (7.14 vs 7.17 hours, respectively), and sleep time decreased until the fifth decade (minimum, 6.99 hours), increasing each decade thereafter; 2.81% of adults reported being accidentally injured in the preceding 3 months. Too little sleep and excessive sleep times were both associated with higher rates of accidental injury (odds ratio per hour of deviation from mean, 1.16 [95% CI, 1.12‐1.19]), adjusting for age, sex, marital status, and education level. Similar increased odds ratios were noted for injury while driving (1.11 [95% CI, 1.01‐1.22]) and injury while at work (1.12 [95% CI, 1.04‐1.20]) with sleep time deviation.

Conclusion

Most adults sleep between 7 and 8 hours nightly. Adults with sleep time outside this range, with either less or more sleep, have increased rates of accidental injury. These data highlight the need for sufficient quantity and quality of sleep in preventing accidental injury.
The Effects of Preoperative Embolization on Carotid Body Paraganglioma Surgery
Authors: Jackson Ryan S. , Myhill Jeffrey A. , Padhya Tapan A. , McCaffrey Judith C. , McCaffrey Thomas V. , Mhaskar Rahul S.
Published: September 2015

Objective

There is no definitive consensus on the impact of preoperative embolization on carotid body paraganglioma management. The purpose of this study was to assess the effects of preoperative embolization on carotid body paraganglioma excision.

Data Sources

A systematic search was conducted without limits, and it included studies published on or before July 2013 from PubMed, CINAHL, Web of Knowledge, and the Cochrane Library. Relevant synonyms for the search terms “paraganglioma,”“carotid body tumor,” and “embolization” were applied.

Review Methods

Studies evaluating patients undergoing surgical intervention with embolization for carotid body tumors were included. Two reviewers independently assessed the titles and abstracts for inclusion and extracted the data. The guidelines set forth by the Cochrane Collaboration were followed in the process of data extraction. Data were pooled with a fixed effects model, and standardized mean difference (SMD) and 95% confidence intervals (95% CIs) are reported.

Results

A total of 22 studies (15 nonrandomized studies with a comparator, 7 single‐arm studies) were included, enrolling 578 patients with 607 tumors. Patients undergoing preoperative embolization had significantly less estimated blood loss compared with those of surgical excision only (12 studies; 295 tumors; SMD: –0.52; 95% CI: –0.77, –0.28). Patients undergoing preoperative embolization had less operative time compared with that of surgical excision only (6 studies; 174 tumors; SMD: –0.46; 95% CI: –0.77, –0.14).

Conclusion

Surgical excision with preoperative embolization appears to decrease estimated blood loss and operative time when compared with that without preoperative embolization for carotid body paragangliomas.
Advancing marginalisation of Roma and forms of segregation in East Central Europe
Authors: Kovács Katalin
Published: September 2015

The thematic focus of this article is on school segregation and its relationship to residential segregation as manifested in six villages and two towns in adjacent lagging regions of Hungary and Slovakia. The strong correlation of the two was evident in village ghettos but turned out not to be straightforward in mixed communities where a ghetto school can be created through ‘white flight’ of the non-Roma children even if the proportion of Roma in the community is low. Approximately 60% of Roma in these countries live in segregated neighbourhoods, and their children are taught in segregated schools or classes. These two circumstances already indicate overlap in aspects of marginalisation, which reaches an advanced stage in village and town ghettos. The causes leading to advanced marginality, severe poverty and social exclusion of Roma in the studied research sites were found to be similar on the two sides of the border, as were forms of school segregation. Successive waves of exodus of non-Roma from rural to urban areas were identified as common background patterns to ghettoisation in rural spaces. The wide educational gap between Roma and non-Roma that has been maintained and even grown after the fall of state socialism is also a shared disadvantage of Roma in the two countries, restricting the most skilled to precarious wage labour and the least skilled to virtual joblessness. Research results in rural contexts confirmed that if social and spatial (residential) forms of marginalisation overlap, children of segregated neighbourhoods are becoming trapped with rare exceptions by the separating aspirations of non-Roma parents and the segregating practices of the educational systems.
Green chemicals from pulp production black liquor by partial wet oxidation
Authors: Muddassar Hassan Raja , Melin Kristian , de Villalba Kokkonen Daniela , Riera Gerard Viader , Golam Sarwar , Koskinen Jukka
Published: September 2015

To reduce greenhouse gas emissions, more sustainable sources of energy, fuel and chemicals are needed. Biomass side streams such as black liquor, which is a by-product of pulp production, has the potential to be used for this purpose. The aim of the study was the production of carboxylic acids, such as lactic acid, formic acid and acetic acid, from kraft and non-wood black liquor. The processes studied were partial wet oxidation (PWO) and catalytic partial wet oxidation (CPWO). The results show that the yield of carboxylic acid is higher when treated by PWO than the results from CPWO at temperatures of 170°C and 230°C. The results shows that the PWO process can increase the yield of carboxylic acids and hydroxy acids in black liquor, reduce lignin content and decrease pH, which makes further separation of the acids more favourable. The hydroxy acids are valuable raw materials for biopolymers, and acetic acid and formic acid are commonly used chemicals conventionally produced from fossil feedstock.
The Impact of Strategic Human Resource Management on Employee Outcomes in Private and Public Limited Companies in Malaysia
Authors: Vui-Yee Koon
Published: September 2015

This study investigates the interaction effects of two business strategies (differentiation and low cost) and human resource (HR) management (HRM) practices (recruitment and selection, training and development, compensation, performance management, employment security and work–life balance) on employee outcomes (organizational commitment, turnover intention, employee involvement and job satisfaction). These relationships are further analyzed on the extent of differences between public and private limited companies in Malaysia. Structural equation modelling (SEM) is used to examine the effect of the three variables and the invariance effect of the two types of companies. The results show that HRM practices mediate the interaction of business strategy and employee outcomes. Furthermore, the effects of business strategy and HRM practices on employee outcomes in public limited companies are only slightly different from the ones implemented in private limited companies. Specifically, the moderation analysis shows invariance between differentiation strategy and variance in low-cost strategy.
Everyday Lessons on Sharing
Authors: Saxena Vatsala , Babu Nandita
Published: September 2015

This study investigates the value of sharing. The primary data are the parent–child (3–5 years) discourses regarding the value of sharing. The discourses are subsequently subjected to discourse analyses. The study also involves a semi-structured interview with the same parents who were a part of the discursive study as well. The data of the interview were subjected to thematic analyses. The aim of conducting the interview was to validate the discursive findings. The study provides exemplary discourses highlighting the issues of (i) sacrifice and (ii) reciprocity in sharing.
A Conceptual Framework for Exploring the Impacts of Corporate Social Responsibility on Employee Attitudes and Behaviour
Authors: Santhosh Manimegalai , Baral Rupashree
Published: September 2015

This article develops a conceptual framework that explains how organizations can influence employees’ attitudes and behaviour through their corporate social responsibility (CSR) activities. There are plenty of studies to suggest the financial benefits of CSR. However, studies are scarce to link CSR with non-financial measures of organizational effectiveness, such as, affective commitment, job engagement and organizational citizenship behaviour (OCB). Moreover, studies are rare to delineate the process through which CSR can bring positive attitudes. Thus, this article focuses on organizational prosocial identity as a mediating variable. The role of communicating CSR activities is almost negligible and to address this gap, this article considers CSR communication as a moderating variable. Drawing from literature, this article argues that the success of an organization lies in enhancing positive attitudes among employees and probably, one of the ways to promote this is through CSR. Based on this assertion, the framework identifies CSR activities towards four stakeholders (employees, customers, community and environment) and its impacts on employees. Several research implications are proposed based on the propositions highlighted in this article.
Volatility Clustering and Leverage Effect in the Indian Forex Market
Authors: Zabiulla
Published: September 2015

Understanding the patterns of volatility in financial assets is immensely useful in portfolio management process. They are the critical inputs for portfolio selection, asset allocation, asset pricing, portfolio diversification and risk management. This study examines the phenomenon of volatility clustering and leverage effect in exchange rates of four major currencies, namely, US dollar (USD), euro, Japanese yen and pound sterling vis-à-vis Indian rupee (INR) from the vantage point of view of volatility modelling and to assess the forecasting ability using generalized autoregressive conditional heteroskedasticity (GARCH)-class models. Besides, it evaluates the models in terms of out-of-sample forecast accuracy. The study spans for a period of 13 years from 3 January 2000 to 31 December 2012. GARCH (1, 1), exponential GARCH (EGARCH) (1, 1), threshold autoregressive conditional heteroskedasticity (TARCH) (1, 1) and power ARCH (1, 1) models are used in this context. The results show the existence of volatility clustering. No significant leverage effects were evident. Volatility seems to be persistent in nature.
Impact of Agility, Adaptability and Alignment on Humanitarian Logistics Performance: Mediating Effect of Leadership
Authors: Dubey Rameshwar , Singh Tripti , Gupta Omprakash K.
Published: September 2015

Even though researchers have immensely contributed in the field of supply chain agility, supply chain adaptability and supply chain alignment, their impact on humanitarian supply chain performance and their relationship is not well known. Leadership is the most discussed and one of the most debated dimensions and little is known about leadership integration with a humanitarian supply chain network design. We carried out a systematic literature review (SLR) to identify variables and their items to design a structured questionnaire, which was pretested with experts in the humanitarian supply chain. We conducted an empirical study on a sample of 306 responses that were collected by us during Allahabad Kumbh from senior officials of the police department, Indian Railways, nongovernmental organizations (NGOs), Uttar Pradesh State Road Transport Corporation and third-party logistics (3PL) companies. We have used the exploratory factor analysis followed by the confirmatory factor analysis to check the construct validity of scales and goodness of fit. We further tested our hypotheses using regression analysis and mediation effect using Baron and Kenny’s (1986) proposed steps. We further checked the mediation significance using the Sobel test. We found that supply chain alignment is a strong determinant of logistics performance and human performance. The supply chain agility is found to completely mediate between supply chain adaptability and human performance and partially mediate between supply chain adaptability and logistics performance. Leadership has a partial mediation effect between supply chain alignment and human performance.
Job Embeddedness: A Ten-year Literature Review and Proposed Guidelines
Authors: Ghosh Debjani , Gurunathan L.
Published: September 2015

Job embeddedness (JE) construct is a construct that is relatively new and still somewhat ‘hazy’ in its definition. A clearer understanding of what we know and what we still do not know about JE and its relationships would lend a better suggestion to future research directions for testing the JE construct. This study reviews 37 papers published between 2001 and 2011 that met the criteria of being quantitative and qualitative studies on JE. Through an inductive review, we unravel a model of (a) antecedents to JE that explains what factors affect JE, (b) moderating and mediating effect of JE and (c) an outcome of JE. Based on our review, we propose directions for future research that will bring greater understanding of the relationship between JE and other constructs.
Exploring the role of brand identification and brand love in generating higher levels of brand loyalty
Authors: Alnawas Ibrahim , Altarifi Shadi
Published: September 2015

The aim of this study is to develop a model that integrates brand identity, brand-life congruence, customer hotel brand identification (CHBI), and brand love into one model and to test its predictive power in explaining brand loyalty. The survey data were gathered from (432) guests who were staying in seven well-known hotels located in Jordan. Data were analyzed using a structural equation modeling SmartPLS2.0. Four key findings emerged from the current research. First, compared to brand identity, brand-lifestyle congruency appears to have a stronger and more significant relationship with CHBI. Second, CHBI contributes only to the development of brand love. Third, CHBI appears to influence brand loyalty only indirectly via brand love. Fourth, the current research provides an empirical support on the applicability of Sternberg’s love theory in the hotel industry. This research adds to the body of knowledge on hotel brand loyalty through examining its relationship with four key constructs, whose effect either had been examined in isolation or had never been examined. It tests for the first time how brand identity and brand-lifestyle congruence contribute to the development of CHBI, which in turn, engenders a powerful emotional experience with hotel brands and cultivates affection and passion to that brand. Those heavy emotional feelings in turn provide an important basis upon which hotel brand loyalty is established.
Comparisons of Online Recruitment Strategies for Convenience Samples
Authors: Antoun Christopher , Zhang Chan , Conrad Frederick G. , Schober Michael F.
Published: September 2015

The rise of social media websites (e.g., Facebook) and online services such as Google AdWords and Amazon Mechanical Turk (MTurk) offers new opportunities for researchers to recruit study participants. Although researchers have started to use these emerging methods, little is known about how they perform in terms of cost efficiency and, more importantly, the types of people that they ultimately recruit. Here, we report findings about the performance of four online sources for recruiting iPhone users to participate in a web survey. The findings reveal very different performances between two types of strategies: those that “pull in” online users actively looking for paid work (MTurk workers and Craigslist users) and those that “push out” a recruiting ad to online users engaged in other, unrelated online activities (Google AdWords and Facebook). The pull-method recruits were more cost efficient and committed to the survey task, while the push-method recruits were more demographically diverse.
An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries
Authors:   The TASC Steering Committee*, Jaff Michael R. , White Christopher J. , Hiatt William R. , Fowkes Gerry R. , Dormandy John , Razavi Mahmood , Reekers Jim , Norgren Lars
Published: September 2015

The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.
Meta-analysis of the Effect of Stent Design on 30-Day Outcome After Carotid Artery Stenting
Authors: Kouvelos George N. , Patelis Nikolaos , Antoniou George A. , Lazaris Andreas , Matsagkas Miltiadis I.
Published: September 2015

Purpose: To review the contemporary literature and analyze whether stent cell design plays a role in 30-day outcomes after carotid artery stenting (CAS). Methods: A systematic review of the literature was undertaken that identified 9 studies comparing the effect of different cell design on 30-day outcome in patients undergoing CAS. Random-effects models were applied to calculate pooled outcome data for mortality and cerebrovascular morbidity. Results are reported as the odds ratio (OR) and 95% confidence interval (CI). Results: The 9 studies included 8018 patients who underwent 8028 CAS procedures (4018 open-cell stents, 4010 closed-cell stents). Six studies were retrospective in design, one was a registry, and only two studies prospectively compared the effect of different cell designs. Nearly half of the patients (3452, 43.1%) were symptomatic, with no significant difference between the closed- and open-cell stent groups (p=0.93). During the first month after the procedure, there were no significant differences in mortality (OR 0.69, 95% CI 0.39 to 1.24, p=0.21), transient ischemic attacks (OR 0.95, 95% CI 0.69 to 1.30, p=0.74), or strokes (OR 1.17, 95% CI 0.83 to 1.66, p=0.37). Conclusion: This meta-analysis showed that 30-day cerebrovascular complications after CAS were not significantly different for the open-cell group in comparison to the closed-cell group. Future prospective clinical trials comparing different free cell areas and other stent design properties are still needed to further investigate whether stent design plays a significant role in the results of carotid stenting.
Primary Self-EXPANDing Nitinol Stenting vs Balloon Angioplasty With Optional Bailout Stenting for the Treatment of Infrapopliteal Artery Disease in Patients With Severe Intermittent Claudication or Critical Limb Ischemia (EXPAND Study)
Authors: Schulte Karl-Ludwig , Pilger Ernst , Schellong Sebastian , Tan Kong Ten , Baumann Frederic , Langhoff Ralf , Torsello Giovanni , Zeller Thomas , Amendt Klaus , Brodmann Marianne
Published: September 2015

Purpose: To compare primary placement of a self-expanding nitinol stent to percutaneous transluminal angioplasty (PTA) with bailout stenting in infrapopliteal arteries of patients with severe intermittent claudication or critical limb ischemia (CLI). Methods: In the EXPAND trial ( ClinicalTrials.gov; identifier NCT00906022), 92 patients (mean age 72.9±9.5 years; 62 men) undergoing treatment for infrapopliteal stenosis in 11 European centers were randomized 1:1 to either self-expanding nitinol stenting with the Astron Pulsar/Pulsar-18 nitinol stent or PTA with bailout stenting. The primary endpoint was sustainable clinical improvement after 12 months, defined as a ≥1-category increase for Rutherford category 3 patients or a ≥2-category increase for CLI patients (Rutherford categories 4/5) compared with baseline. Furthermore, target lesion revascularization (TLR), mortality, and amputation were assessed after 12 months. Results: Sustained clinical improvement at 1 year was observed in 74.3% of the patients treated with primary stenting and in 68.6% of the patients treated with PTA and bailout stenting (p>0.05). Kaplan-Meier estimates of freedom from TLR (76.6% and 77.6%), mortality (7.4% vs 2.1%), and amputation [8.9% (major 6.7%) vs 13.2% (major 8.7%)] at 1 year were not significantly different. Conclusion: Primary self-expanding nitinol stenting did not show statistically different clinical outcomes compared to angioplasty with bailout stenting for infrapopliteal lesions.
A Comparison of Clinical Outcomes for Diabetic and Nondiabetic Patients Following Directional Atherectomy in the DEFINITIVE LE Claudicant Cohort
Authors: Garcia Lawrence A. , Jaff Michael R. , Rocha-Singh Krishna J. , Zeller Thomas , Bosarge Christopher , Kamat Suraj , McKinsey James F.
Published: September 2015

Purpose: To report a subset analysis that evaluated the hypothesis that directional atherectomy for peripheral artery disease in diabetic claudicants has noninferior primary patency at 12 months compared with nondiabetic claudicants. Methods: DEFINITIVE LE, a US/European multicenter study, assessed the effectiveness of directional atherectomy using SilverHawk/TurboHawk systems for treatment of peripheral artery disease in the superficial femoral, popliteal, and infrapopliteal arteries. Of the 800 patients enrolled in the study, only the 598 claudicant patients (mean age 69.5±10.4 years; 336 men) who were classified at baseline as Rutherford category 1–3 were eligible for this subset analysis. Of these, 46.8% (280/598) had diabetes. Follow-up to 12 months included duplex ultrasound examination, functional assessments, and adverse event evaluations. Independent angiographic and duplex ultrasound core laboratories assessed primary patency and secondary endpoints; a clinical events committee adjudicated adverse events. Results: Although diabetics had significantly more baseline comorbidities, 12-month primary patency (77.0%) was no different than for nondiabetics (77.9%; superiority p=0.98; noninferiority p<0.001) across all anatomic territories treated. Freedom from clinically driven target lesion revascularization was no different between diabetics (83.8%) and nondiabetics (87.5%) overall (p=0.19) or by lesion locations. Secondary clinical outcomes (Rutherford category, ankle-brachial index, and walking impairment) improved at 12 months for both diabetics and nondiabetics. Conclusion: Noninferior 12-month patency rates demonstrate that directional atherectomy is an effective treatment in diabetic as well as nondiabetic claudicants. Directional atherectomy remains an attractive treatment option, improving luminal diameters without stents, which preserves future treatment options for both diabetic and nondiabetic patients with progressive, diffuse vascular disease.
Outcomes of Isolated Tibial Endovascular Interventions for Tissue Loss in CLI Patients on Hemodialysis
Authors: Davies Mark G. , El-Sayed Hosam F.
Published: September 2015

Purpose: To compare the objective performance goals (OPGs) and patient-centered outcomes of isolated tibial interventions in patients with tissue loss who were on hemodialysis (HD) to patients with tissue loss who were not on HD. Methods: Interrogation of a prospectively maintained database identified 242 critical limb ischemia (CLI) patients who underwent isolated tibial interventions for tissue loss in a single limb between 2007 and 2012. The 78 patients (mean age 66±12 years; 44 men) on HD were compared with 164 patients (mean age 50±13 years; 82 men) who were not on HD. There was an equal distribution of the tibial vessels treated; 152 (63%) patients had more than one treated tibial vessel. Patient-centered outcomes of clinical efficacy (absence of recurrent symptoms, maintenance of ambulation, and no major amputation), amputation-free survival (AFS), and freedom from major adverse limb events (MALE) were evaluated. The Society for Vascular Surgery OPGs were defined at 30 days and 1 year. Results: The 30-day major adverse cardiac events was significantly higher (p=0.004) in the HD group (5, 5%) compared with the no-HD group (0%), but both remained under the stated OPG of ≤10%. The 30-day MALE rates were significantly higher than the stated ≤9% OPG at 13% and 18% for the no-HD and HD groups, respectively. At 1 year, the rates for AFS, freedom from MALE, limb salvage, and survival did not achieve the stated Society for Vascular Surgery OPGs in the HD group. Clinical efficacy was 61% and 25% at 3 years for the no-HD and HD groups, respectively (p<0.01). Overall, AFS was 54% and 22% and freedom from MALE was 56% and 27% at 3 years for the no-HD and HD groups, respectively (both p<0.01). Conclusion: Tibial intervention for tissue loss in patients on HD is a valid treatment option but is associated with a high MALE rate. Three-year outcomes remain relatively poor, with <25% success in terms of clinical efficacy and AFS.
Evaluation of Dynamic Optical Projection of Acquired Luminescence for Sentinel Lymph Node Biopsy in Large Animals
Authors: Ringhausen Elizabeth , Wang Tylon , Pitts Jonathan , Sarder Pinaki , Akers Walter J.
Published: September 2015

Open surgery requiring cytoreduction still remains the primary treatment course for many cancers. The extent of resection is vital for the outcome of surgery, greatly affecting patients’ follow-up treatment including need for revision surgery in the case of positive margins, choice of chemotherapy, and overall survival. Existing imaging modalities such as computed tomography, magnetic resonance imaging, and positron emission tomography are useful in the diagnostic stage and long-term monitoring but do not provide the level of temporal or spatial resolution needed for intraoperative surgical guidance. Surgeons must instead rely on visual evaluation and palpation in order to distinguish tumors from surrounding tissues. Fluorescence imaging provides high-resolution, real-time mapping with the use of a contrast agent and can greatly enhance intraoperative imaging. Here we demonstrate an intraoperative, real-time fluorescence imaging system for direct highlighting of target tissues for surgical guidance, optical projection of acquired luminescence (OPAL). Image alignment, accuracy, and resolution was determined in vitro prior to demonstration of feasibility for operating room use in large animal models of sentinel lymph node biopsy. Fluorescence identification of regional lymph nodes after intradermal injection of indocyanine green was performed in pigs with surgical guidance from the OPAL system. Acquired fluorescence images were processed and rapidly reprojected to highlight indocyanine green within the true surgical field. OPAL produced enhanced visualization for resection of lymph nodes at each anatomical location. Results show the optical projection of acquired luminescence system can successfully use fluorescence image capture and projection to provide aligned image data that is invisible to the human eye in the operating room setting.
Pirt Contributes to Uterine Contraction-Induced Pain in Mice
Authors: Wang Changming , Wang Zhongli , Yang Yan , Zhu Chan , Wu Guanyi , Yu Guang , Jian Tunyu , Yang Niuniu , Shi Hao , Tang Min , He Qian , Lan Lei , Liu Qin , Guan Yun , Dong Xinzhong , Duan Jinao , Tang Zongxiang
Published: September 2015

Uterine contraction-induced pain (UCP) represents a common and severe form of visceral pain. Nerve fibers that innervate uterine tissue express the transient receptor potential vanilloid channel 1 (TRPV1), which has been shown to be involved in the perception of UCP. The phosphoinositide-interacting regulator of TRP (Pirt) may act as a regulatory subunit of TRPV1. The intraperitoneal injection of oxytocin into female mice after a 6-day priming treatment with estradiol benzoate induces writhing responses, which reflect the presence of UCP. Here, we first compared writhing response between Pirt+/+ and Pirt−/− mice. Second, we examined the innervation of Pirt-expressing nerves in the uterus of Pirt−/− mice by immunofluorescence and two-photon microscopy. Third, we identified the soma of dorsal root ganglion (DRG) neurons that innerve the uterus using retrograde tracing and further characterized the neurochemical properties of these DRG neurons. Finally, we compared the calcium response of capsaicin between DRG neurons from Pirt+/+ and Pirt−/− mice. We found that the writhing responses were less intensive in Pirt−/− mice than in Pirt+/+ mice. We also observed Pirt-expressing nerve fibers in the myometrium of the uterus, and that retrograde-labeled cells were small-diameter, unmyelinated, and Pirt-positive DRG neurons. Additionally, we found that the number of capsaicin-responding neurons and the magnitude of evoked calcium response were markedly reduced in DRG neurons from Pirt−/− mice. Taken together, we speculate that Pirt plays an important role in mice uterine contraction-induced pain.
Common fixed point theorems for generalized cyclic contraction pairs in b-metric spaces with applications
Authors: Yamaod Oratai , Sintunavarat Wutiphol , Cho Yeol Je
Published: September 2015

In this paper, we introduce the notion of generalized cyclic contraction pairs in b-metric spaces and establish some fixed point theorems for such pairs. Also, we give some examples to illustrate the main results which properly generalizes some results given by some authors in literature. Further, by using the main results, we prove some common fixed point results for generalized contraction pairs in partially ordered b-metric spaces. Our results generalize and improve the result of Shatanawi and Postolache (Fixed Point Theory Appl. 2013:60, 2013) and several well-known results given by some authors in metric and b-metric spaces.
Assessment of knowledge and practice of community pharmacy personnel on diabetes mellitus management in Kathmandu district: a cross sectional descriptive study
Authors: Shrestha M. , Maharjan R. , Prajapati A. , Ghimire S. , Shrestha N. , Banstola A.
Published: September 2015

Background

Pharmacists are the most reachable healthcare professionals to many chronically ill patients. It has been found that pharmacists see patients with diabetes up to five times more often than any other healthcare provider. Therefore, to provide quality health care to patients it is important that they have appropriate knowledge and practice on diabetes mellitus management. Thus, this study was conducted to assess the knowledge and practice of diabetes mellitus management among community pharmacy personnel involved in retail community pharmacies of Kathmandu.

Methods

Three hundred and fifteen community pharmacies, selected by systematic random sampling were surveyed by using pre-validated self-administered questionnaires. The first set of questionnaire evaluated the community pharmacy personnel’s diabetes knowledge based on a pre-validated 20-item questionnaire. The second set of questionnaire documented about the practice of community pharmacy personnel on diabetes mellitus management which contained 22 questions. Data was entered in EPI Data and analyzed by using SPSS version 20.

Results

This survey demonstrated that 76.5 % respondents had poor knowledge and 86.4 % had negative practice on diabetes mellitus (DM) management. Only 26.2 % respondents had good knowledge as well as good practice. 31.4 % of respondents had poor knowledge as well as poor practice on DM management.

Conclusions

Laws and regulations regarding community pharmacy personnel need to be implemented. There should be more advanced and experiment based training. Additionally, the provision for further education curriculum in pharmacy education should be implemented which should intensively include disease and proper management. Guidelines covering diabetes care should be distributed and implemented throughout community pharmacies.
Draft genome sequence of ‘Treponema phagedenis’ strain V1, isolated from bovine digital dermatitis
Authors: Mushtaq Mamoona , Manzoor Shahid , Pringle Märit , Rosander Anna , Bongcam-Rudloff Erik
Published: September 2015

‘Treponema phagedenis’ is considered to be a key agent in the pathogenesis of bovine digital dermatitis, an infectious foot condition of economic and animal welfare importance. We hereby report the draft sequence of ‘T. phagedenis’ strain V1. The draft genome assembly consists of 51 scaffolds comprising 3,129,551 bp and a GC-content of 39.9 %. Putative pathogenicity related factors have been identified in the genome that can be used in future studies to gain insight into the pathogenic mechanisms of ‘T. phagedenis’.
Biocompatibility of a polymer based on Off-Stoichiometry Thiol-Enes + Epoxy (OSTE+) for neural implants
Authors: Ejserholm Fredrik , Stegmayr John , Bauer Patrik , Johansson Fredrik , Wallman Lars , Bengtsson Martin , Oredsson Stina
Published: September 2015

Background

The flexibility of implantable neural probes has increased during the last 10 years, starting with stiff materials such as silicone to more flexible materials like polyimide. We have developed a novel polymer based on Off-Stoichiometry Thiol-Enes + Epoxy (OSTE+, consisting of a thiol, two allyls, an epoxy resin and two initiators), which is up to 100 times more flexible than polyimide. Since a flexible neural probe should be more biocompatible than a stiff probe, an OSTE+ probe should be more biocompatible than one composed of a more rigid material. We have investigated the toxicity of OSTE+ as well as of OSTE+ that had been incubated in water for a week (OSTE+H
2
O) using MTT assays with mouse L929 fibroblasts. We found that OSTE+ showed cytotoxicity, but OSTE+H
2
O did not. Extracts were analyzed using LC-MS and GC-MS in order to identify leaked chemicals.

Results

Most constituents were found in extracts of OSTE+, whereas only initiators were found in OSTE+H
2
O extracts. The detected levels of each chemical found in the LC-MS and the GC-MS analysis were below the toxicity level when compared to MTT assays of all the individual chemicals, except for one of the initiators that had an IC
50
value close to the detected levels.

Conclusion

Our notion is that the toxicity of OSTE+ was caused by one of the initiators, by impurities in the constituents or by synergistic effects of low doses of leaked chemicals. However, our conclusion is that if OSTE+ is incubated for one week in water, OSTE+ is not cytotoxic and suitable for further
in vivo
studies.
Disrupted TSH Receptor Expression in Female Mouse Lung Fibroblasts Alters Subcellular IGF-1 Receptor Distribution
Authors: Atkins Stephen J. , Lentz Stephen I. , Fernando Roshini , Smith Terry J.
Published: September 2015

A relationship between the actions of TSH and IGF-1 was first recognized several decades ago. The close physical and functional associations between their respective receptors (TSHR and IGF-1R) has been described more recently in thyroid epithelium and human orbital fibroblasts as has the noncanonical behavior of IGF-1R. Here we report studies conducted in lung fibroblasts from female wild-type C57/B6 (TSHR+/+) mice and their littermates in which TSHR has been knocked out (TSHR−/−). Flow cytometric analysis revealed that cell surface IGF-1R levels are substantially lower in TSHR−/− fibroblasts compared with TSHR+/+ fibroblasts. Confocal immunofluorescence microscopy revealed similar divergence with regard to both cytoplasmic and nuclear IGF-1R. Western blot analysis demonstrated both intact IGF-1R and receptor fragments in both cellular compartments. In contrast, IGF-1R mRNA levels were similar in fibroblasts from mice without and with intact TSHR expression. IGF-1 treatment of TSHR+/+ fibroblasts resulted in reduced nuclear and cytoplasmic staining for IGF-1Rα, whereas it enhanced the nuclear signal in TSHR−/− cells. In contrast, IGF-1 enhanced cytoplasmic IGF-1Rβ in TSHR−/− fibroblasts while increasing the nuclear signal in TSHR+/+ cells. These findings indicate the intimate relationship between TSHR and IGF-1R found earlier in human orbital fibroblasts also exists in mouse lung fibroblasts. Furthermore, the presence of TSHR in these fibroblasts influenced not only the levels of IGF-1R protein but also its subcellular distribution and response to IGF-1. They suggest that the mouse might serve as a suitable model for delineating the molecular mechanisms overarching these two receptors.