bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Bypassing Agents and Risk of Thromboembolic Events in Patients with Haemophilia and Inhibitors
Authors: Bykov Katsiaryna , Bohn Rhonda , Ewenstein Bruce , Seeger John , Avorn Jerry , Bateman Brian
Published: December 2017

Patients with haemophilia and inhibitors to factors VIII or IX require bypassing therapy. The primary safety concern of bypassing agents is thromboembolism; however, the incidence of thromboembolic adverse events (TAEs) in haemophilia patients with inhibitors remains poorly characterized. The aim of this study was to assess the incidence of TAEs following exposure to bypassing agents in patients with haemophilia. Using U.S. Medicaid database (2000–2010), we identified a cohort of 719 males (mean age: 10 years at cohort entry) with haemophilia A or B and use of either recombinant factor VIIa (rFVIIa) or activated prothrombin complex concentrate (aPCC). Patients were followed up until loss of insurance eligibility, end of study period, or the first occurrence of TAE. Exposure was assessed on as-treated basis, and outcomes were adjudicated through review of healthcare claims. During the observation of a total of 2,823 person-years (py; mean follow-up: 3.9 years), 22 TAEs were identified, leading to incidence rates of 4.2 events (95% confidence interval [CI]: 1.8–8.3) per 1,000 unexposed py; 15.4 events (95% CI: 6.7–30.3) per 1,000 aPCC-exposed py; 18.2 events (95% CI: 8.3–34.6) per 1,000 rFVIIa-exposed py; and 29.7 events (95% CI: 6.1–86.7) per 1,000 py of concomitant exposure to both agents. The results were consistent across sensitivity analyses. In conclusion, we found no difference in the rate of TAEs across agents, but the data are compatible with a possibly increased rate associated with a combination therapy, highlighting the need for continuing safety monitoring through prospective registries or observational data.
Potential years of life lost and mortality trend in the adult population in a municipality of Triângulo Mineiro, 1996-2013
Authors: Garcia Luan Augusto Alves , Camargo Fernanda Carolina , Pereira Gilberto de Araújo , Ferreira Lúcia Aparecida , Iwamoto Helena Hemiko , Santos Álvaro da Silva , Rezende Marina Pereira
Published: December 2017

Introduction: the epidemiological analysis of mortality is an important process for the recognition of the living conditions and health of the population, offering support to the planning of actions, prioritization, and allocation of resources to specific health problems, especially when considering populations with greater expression of the adult age group. With this, the concern to recognize the main causes of death and analysis of the Potential Years of Lost Life emerges. Study model: observational, ecological, temporal trend, by identifying the main causes of death, through accumulated frequency and analysis of epidemiological indicators: mortality rate per 100,000 inhabitants and Potential Years of Lost Life, by adult age and Sex, from 1996 to 2013. Aim of the study: analyze trend of deaths in the adult population in a municipality of Triângulo Mineiro, Brazil. Results: 9,595 deaths occurred for adults, with diseases of the circulatory system (n = 2.244) being the most prevalent cause of death and death due to external causes, the most premature (mean of 37.84 years, 95% CI:36.25-38.58). There is an upward trend in deaths due to neoplasia, both sexes and age range from 40 to 59 years, in addition to the group of External Causes and Respiratory System Diseases. Conclusions: despite the limitations, the use of information systems should be encouraged in studies that may support local management in the best outline of actions and the back-up of care for the prevention of premature deaths.
Microorganisms present after use of Unna’s boot from ulcers venous patient
Authors: Melo Flávio Antônio de , Damasceno Carlos Américo Veiga , Medeiros Mauricéia Lins de , Fernandes Rogério Cássio , Mendonça Adriana Rodrigues dos Anjos , Loyola Ana Beatriz Alkmim Teixeira
Published: December 2017

Model Study: A special analytical observational prospective longitudinal and controlled study of concurrent cohort was conducted from April 2013 to November 2014. Objective: To evaluate the microbiota present in the secretion of venous ulcer patients with “Unna Boot” and their resistance to antimicrobials. Methods: secretion samples were collected from wounds of patients with and without the use of “Unna Boot” and topic therapy during the dressing change and after seven days. The isolated microorganisms were identified and tested for antimicrobial susceptibility: Result: The isolated Gram-positive microorganisms were: S. aureus, E. faecalis, S. haemolyticus and S. xylosus. Gram-negative microorganisms were E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A. baumannii, E. cloacae and Tatumella sp. The growth percentage and the microbiota in the secretion of the ulcer after seven days was not significant between the two types of dressing. The resistance of Gram-positive cocci to antimicrobials in patients using the “Unna Boot” was higher than in patients without boot (p = 0.0093). Conclusion: The number of microorganisms in microbial secretion venous ulcer after dressing change is higher regardless of the type of dressing. The positive cocci increased antimicrobial resistance in patients using the “Unna Boot”.
Prevalence of high blood pressure among adolescents and association with anthropometric indicators
Authors: Pinto André de Araújo , Claumann Gaia Salvador , Amaral Lohana Cardoso , Pelegrini Andreia
Published: December 2017

Introduction: Physical inactivity, sedentary behavior and poor nutrition are behaviors currently adopted by adolescents, which have facilitated the development of cardiovascular diseases such as high blood pressure. Study design: This is a school-based epidemiological study with a cross-sectional design. Objective: A analyze the high blood pressure (HBP) prevalence and its association with anthropometric indicators. Methods: Participants were 202 adolescents from Sao José-SC. Measures of body weight, height and waist circumference (WC) were used to calculate the anthropometric indicators of Body Mass Index (BMI), Conicity Index (C index) and Waist-to-Height Ratio (WHR). Blood pressure was measured by a digital Omrom HEM 742. Results: The prevalence of HBP among the adolescents was 10.9%. Overweight adolescents (OR= 5.68; 95%CI= 1.99-16.24) and those with high WC (OR= 7.67; 95%CI= 2.54-23.19) and high WHR (OR= 5.88; 95%CI= 1.71-20.25) were more likely to present HBP than their normal weight and with healthy WC and WHR peers. Conclusion: The results of the present study demonstrated that one in ten adolescents presented HBP. Body Mass Index (overweight), WC and WHR (unhealthy conditions) were associated to the outcome.
Adverse drug reaction: a comparative analysis of protocols used for treatment of colorectal cancer
Authors: Melo Marcela Maciel , Cardoso Rafael Marques , Silva Mario Jorge Sobreira da
Published: December 2017

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups.
Mycosis fungoides preceding lymphomatoid papulosis
Authors: Fernandes Larissa Starling de Albuquerque , Aguiar Fernanda Costa , Lima Ricardo Barbosa , Lupi Omar , Martins Carlos José
Published: December 2017

Lymphomatoid papulosis (LyP) is defined as a chronic, recurrent, self-healing papulonecrotic or papulonodular skin disease with histologic features suggestive of a (CD30-positive) malignant lymphoma. In up to 20% of patients, LyP are preceded by, associated with, or followed by another type of cutaneous or systemic lymphoma, generally mycosis fungoides (MF), primary cutaneous anaplastic large cell lymphoma (C-ALCL). In this case, we describe a case of MF that preceded and continued to coexist with LyP type C.
Implementation and development of the Simulation Laboratory (SimLab) of Ribeirao Preto Medical School of University of Sao Paulo (RPMS-USP)
Authors: Pazin-Filho Antonio , Carlotti Ana Paula de Carvalho Panzeri , Scarpelini Sandro
Published: December 2017

Introduction: simulation is a technique that has gained great acceptance for teaching skills and professional behavior in several areas. To overcome the limitations imposed by the high cost of the materials involved and the need for specific training, higher education institutions have implemented dedicated laboratories. Ribeirao Preto Medical School of University of Sao Paulo (RPMS-USP) has recently installed its Simulation Lab (LabSim) with the following goals: 1) To centralize, facilitate, train and coordinate didactic activities involving Simulation; 2) To promote self-directed learning among undergraduate students; 3) To develop research in Simulation in Healthcare. Objectives: to describe the process of LabSim implementation to preserve the RPMS-USP history; to analyze this process to outline new goals for its continued development. This is a descriptive study, based on revised historical documents. Methodology: the process of LabSim development is described in chronological order, highlighting the motivations for the decisions made. Results: 1) Simulation is a teaching methodology and not the simple use of technology, being necessary the training of personnel besides the incorporation of technology. 2) The physical structure is an important component to explore the methodology in its entirety. One should consider the principles of Flexibility, Space Utilization, Flow Management, Connectivity and Immersion. Consider Benchmarking to evaluate the solutions of other laboratories so you can contextualize them into your reality. 3) Individualize the addition of new simulator according to the disciplines that already use the methodology and link this acquisition with personnel training. 4) The self-learning potential of new simulators can maximize the exposure time and individualize the feedback. Conclusions: the RPMS-USP’s LabSim future goals include teacher training, strengthening the inclusion of disciplines, seeking multidisciplinary action in accordance with the standards of the Undergraduate Committee, the development of research in the field of Simulation and the national and international projection of the laboratory through accreditation processes. Nevertheless, based on the evidence provided, the implementation of the LabSim is a very successful and evolving experience.
Critérios pragmáticos da definição de near miss neonatal: um estudo comparativo
Authors: Kale Pauline Lorena , Jorge Maria Helena Prado de Mello , Laurenti Ruy , Fonseca Sandra Costa , Silva Kátia Silveira da
Published: December 2017

OBJETIVO: Testar a validade dos critérios pragmáticos de definições de near miss neonatal, estendendo-as para todo o período infantil, e estimar indicadores de assistência perinatal em maternidades públicas. MÉTODOS: Constituiu-se uma coorte de nascidos vivos de seis maternidades dos municípios de São Paulo, Niterói e Rio de Janeiro em 2011. Foram realizadas entrevistas e consultas aos cartões de pré-natal e prontuários. Critérios pragmáticos (peso ao nascer, idade gestacional e escore de Apgar 5’) das definições de near miss de Pileggi et al., Pileggi-Castro et al., Souza et al. e Silva et al. foram comparados. Foram calculados sensibilidade, especificidade (padrão-ouro: óbito infantil), percentual de óbitos entre recém-nascidos com ameaça à vida e taxas de near miss, mortalidade e desfechos graves por 1.000 nascidos vivos. RESULTADOS: Foram analisados 7.315 recém-nascidos (completude das informações > 99%). A sensibilidade da definição de Pileggi-Castro et al. foi maior, resultando em um maior número de casos de near miss; a de Souza et al. apresentou menor valor, e as de Pileggi et al. e de Silva et al. apresentaram valores intermediários. Há um aumento da sensibilidade quando se estende o período de 0–6 para 0–27 dias, e um declínio quando se amplia para 0–364 dias. Especificidades foram elevadas (≥ 97%) e superiores às sensibilidades (54% a 77%). Uma maternidade de São Paulo e outra de Niterói apresentaram, respectivamente, as menores e as maiores: taxas de mortalidade infantil, near miss, e frequência de nascimentos em situação de ameaça à vida, independentemente da definição. CONCLUSÕES: As definições de near miss baseadas exclusivamente em critérios pragmáticos são válidas e podem ser utilizadas para fins de monitoramento. Com base na literatura perinatal, os pontos de corte adotados por Silva et al. foram mais adequados. Estudos periódicos poderiam aplicar uma definição mais completa, com incorporação de critérios clínicos, laboratoriais e de manejo, incluindo as anomalias congênitas preditoras do óbito infantil.
MicroRNA-221/222 Family Counteracts Myocardial Fibrosis in Pressure Overload–Induced Heart Failure
Authors: Verjans Robin , Peters Tim , Beaumont Francisco Javier , van Leeuwen Rick , van Herwaarden Tessa , Verhesen Wouter , Munts Chantal , Bijnen Mitchell , Henkens Michiel , Diez Javier , de Windt Leon J. , van Nieuwenhoven Frans A. , van Bilsen Marc , Goumans Marie José , Heymans Stephane , González Arantxa , Schroen Blanche
Published: December 2017

Pressure overload causes cardiac fibroblast activation and transdifferentiation, leading to increased interstitial fibrosis formation and subsequently myocardial stiffness, diastolic and systolic dysfunction, and eventually heart failure. A better understanding of the molecular mechanisms underlying pressure overload–induced cardiac remodeling and fibrosis will have implications for heart failure treatment strategies. The microRNA (miRNA)-221/222 family, consisting of miR-221-3p and miR-222-3p, is differentially regulated in mouse and human cardiac pathology and inversely associated with kidney and liver fibrosis. We investigated the role of this miRNA family during pressure overload–induced cardiac remodeling. In myocardial biopsies of patients with severe fibrosis and dilated cardiomyopathy or aortic stenosis, we found significantly lower miRNA-221/222 levels as compared to matched patients with nonsevere fibrosis. In addition, miRNA-221/222 levels in aortic stenosis patients correlated negatively with the extent of myocardial fibrosis and with left ventricular stiffness. Inhibition of both miRNAs during AngII (angiotensin II)–mediated pressure overload in mice led to increased fibrosis and aggravated left ventricular dilation and dysfunction. In rat cardiac fibroblasts, inhibition of miRNA-221/222 derepressed TGF-β (transforming growth factor-β)–mediated profibrotic SMAD2 (mothers against decapentaplegic homolog 2) signaling and downstream gene expression, whereas overexpression of both miRNAs blunted TGF-β–induced profibrotic signaling. We found that the miRNA-221/222 family may target several genes involved in TGF-β signaling, including JNK1 (c-Jun N-terminal kinase 1), TGF-β receptor 1 and TGF-β receptor 2, and ETS-1 (ETS proto-oncogene 1). Our findings show that heart failure–associated downregulation of the miRNA-221/222 family enables profibrotic signaling in the pressure-overloaded heart.
Peak Blood Pressure Responses During Maximum Cardiopulmonary Exercise Testing
Authors: Sabbahi Ahmad , Arena Ross , Kaminsky Leonard A. , Myers Jonathan , Phillips Shane A.
Published: December 2017

The objective of this study is to expand on previous efforts in establishing normative standards of exercising blood pressure (BP) at maximal physical exertion derived from treadmill cardiopulmonary exercise testing in the United States. Four experienced laboratories in the United States with established quality control procedures contributed data from September 1, 1986, to February 1, 2015. A total of 2917 maximal (peak respiratory exchange ratio ≥1.00) treadmill cardiopulmonary exercise testing responses from apparently healthy men and women (aged 20–79 years) without cardiovascular disease were submitted to FRIEND (Fitness Registry and the Importance of Exercise: A National Database). Percentiles of maximal systolic and diastolic BP were determined for each decade. Our results show a continued increase in peak systolic BP with age in both men and women to the sixth decade, followed by a plateau between the sixth and seventh decades. However, the trajectory of peak diastolic BP with age is different between men and women. Men showed an increase in peak systolic BP until the fifth decade, which plateaued by the seventh decade. In contrast, women showed a continued increase in peak diastolic BP across each decade. Existing reference data for exercising BP have not been updated for >20 years. Normative peak exercising BP values from FRIEND can be used to provide a more current representation of maximal BP during exercise testing in the US population.
Compounding Compound Creatures
Authors: Kelly Peter
Published: December 2017

In Tristia 4.7, Ovid describes a series of mythological hybrid creatures. This paper will argue that this catalogue of hybrids alludes to scientific accounts of the primitive creatures that existed in the early stages in the evolution of living beings, as well as literary depictions of monstrous creatures. In particular it will argue that Ovid alludes to his own Metamorphoses, Vergil’s catalogue of insubstantial monsters at A. 6.285-289, Lucretius’ account of primitive creatures at DRN 5.890-894 (a model for both the Metamorphoses and the Vergilian catalogue), and most significantly Empedocles (fr. 60 DK). It will demonstrate that Ovid ‘remythologises’ this passage from Empedocles through the use of multiple allusions to both scientific and mythological discourse, in such a way as to question a series of distinctions, such as that between science and mythology. It will also discuss whether Ovid’s catalogue of hybrids could aid a reinterpretation of the compound creatures described by Empedocles.
A report of infestation by phytoplasmas in Astraea (Euphorbiaceae) and its taxonomic implications in Astraea douradensis
Authors: DA SILVA OTÁVIO LUIS MARQUES , BANZATO TICYANA CARONE , BEDENDO IVAN PAULO , CORDEIRO INÊS
Published: December 2017

Phytoplasmas infestations are widely documented in angiosperms, especially in ornamental species (Chaturverdi et al. 2010). Infestations by these phloem-limited plant pathogenic bacteria may induce several symptoms such as loss of floral meristem determinacy and abnormal flower development, including virescence of floral organs and phyllody, i.e., replacement of floral organs by leaf-like structures (Lee et al. 2000, Chatuverdi et al. 2010). However, symptoms may also vary according to the plant host and other factors, such as localization of phytoplasmas in host tissues (Bertaccini 2007). Some species may be infested but remain asymptomatic by seasonal dormancy and they may act as reservoirs for the further spread of the phytoplasmas, involving insect vectors (Dermastia et al. 2017). Developments in the detection methods of phytoplasmas have contribute to a better understanding of these intriguing bacteria, and nowadays identification of these organisms rely mostly in molecular methods such as polymerase chain reaction of selected phytoplasma-specific gene regions (Dermastia et al. 2017). Our current understanding about phytoplasmas includes knowledge on how the phenotypes linked to the infestation by phytoplasmas are triggered: Kitazawa et al. (2017) presented results which suggest that these changes in floral organs are caused by the interactions of phyllogen (a virulence factor conserved in phytoplasmas) with ABCE-class MADS domains transcription factor (MTFs), which is known as key regulator of floral organs development in angiosperms.
Leaf insects from Luzon, Philippines, with descriptions of four new species, the new genus Pseudomicrophyllium, and redescription of
Phyllium (Phyllium) geryon Gray, 1843, (Phasmida: Phylliidae)
Authors: CUMMING ROYCE T. , LEONG JING V. , LOHMAN DAVID J.
Published: December 2017

Examination of unidentified Phylliidae specimens revealed a number of undescribed species from the island of Luzon, Philippines. Morphological and molecular study of specimens from the obscure phasmid genus Microphyllium Zompro, 2001, revealed a new species, which we describe as Microphyllium haskelli Cumming sp. nov.. It is here described and differentiated from the two other species in the genus, both currently only known from adults of a single sex. Pseudomicrophyllium Cumming gen. nov. is described as a new genus within Phylliidae with the type species Pseudomicrophyllium faulkneri Cumming gen. et sp. nov. as the sole known species in the genus. As is unfortunately often the case in the leaf-mimicking family Phylliidae, this new genus and species is only known from a single specimen. In addition to the new genus, two new Phyllium (Phyllium) species from the siccifolium species-group are named and described as Ph. (Ph.) antonkozlovi Cumming sp. nov. and Ph. (Ph.) bourquei Cumming & Le Tirant sp. nov.. In addition to the newly described species, Phyllium (Phyllium) geryon Gray, 1843 is redescribed from a nearly perfect specimen, completing some of the morphological knowledge gaps currently missing because of the severely damaged holotype specimen. A key to all known species of Phylliidae from Luzon is included. Holotype specimens for all four new species will be deposited in the National Museum of the Philippines type collection and paratype specimens will be deposited into the San Diego Natural History Museum collection or retained within the first author’s collection.
Review of the genus Gnorimoschema Busck, 1900 (Lepidoptera, Gelechiidae) in China
Authors: LI HOUHUN , BIDZILYA OLEKSIY V.
Published: December 2017

Nine species of the genus Gnorimoschema are recorded from China. Five new species are described: G. cinerella sp. nov. (China: Yunnan), G. gilvella sp. nov. (China: Ningxia), G. fuscescens sp. nov. (China: Gansu, Inner Mongolia; Russia: Altai, Zabaikalskiy krai), G. rufomaculata sp. nov. (China: Ningxia and Inner Mongolia; Russia: Zabaikalskiy krai), G. piskunovi sp. nov. (China: Hebei, Shanxi). G. cinctipunctella (Erschoff, 1877) sp. rev. is removed from synonymy. Three new synonyms are established: G. mongolorum Povolný, 1969 syn. nov. of G. cinctipunctella (Erschoff, 1877), G. herbichii mongoliae Povolný, 1973 and G. herbichii kamchaticum Povolný, 1977 syn. nov. of G. herbichii herbichii (Nowicki, 1864). Data on species distribution in the Palaearctic region are supplemented with new records and revised in accordance with new taxonomic data proposed in the present contribution.
Mormolyce matejmiciaki sp. nov. (Coleoptera: Carabidae: Lebiinae) from Borneo
Authors: ĎURÍČEK MAREK , KLÍCHA MIROSLAV
Published: December 2017

Mormolyce matejmiciaki sp. nov. from Borneo (Kalimantan Utara province) is described and illustrated. The new species is also compared with other members of the genus Mormolyce Hagenbach, 1825, and a key to species of this genus is provided.
North Pacific Influences on Long Island Sound Temperature Variability
Authors: Schulte Justin A. , Georgas Nickitas , Saba Vincent , Howell Penelope
Published: December 2017

Climate indicators related to Long Island Sound (LIS) water and air temperature variability were investigated. The Pacific decadal oscillation (PDO) and east Pacific/North Pacific (EP/NP) patterns are found to be strongly correlated with LIS air temperature anomalies during most seasons, especially during the winter. Additionally, the winter EP/NP index is strongly correlated with subsequent spring and summer LIS water temperature anomalies, potentially rendering the EP/NP index useful in extended LIS water temperature outlooks. Such lagged relationships are found to be related largely to the decorrelation time scale of seasonal water temperature anomalies. The atmospheric circulation pattern associated with anomalous LIS water temperature conditions is consistent with atmospheric Rossby wave trains emanating from the western equatorial Pacific. The EP/NP index has a characteristic time scale of approximately 5 to 10 years and such fluctuations are termed the quasi-decadal mode, the mode identified as varying coherently with LIS air and water temperature anomalies. Apparent PDO and EP/NP regime shifts in 1997 are found to coincide with a LIS water temperature regime shift. This result suggests that not all LIS warming experienced during recent decades is solely due to anthropogenic causes but rather is to some extent a result of natural variability. The results from this study provide a useful framework for both seasonal and decadal prediction of LIS water temperature variability.
How Does the Evaluation of the GPM IMERG Rainfall Product Depend on Gauge Density and Rainfall Intensity?
Authors: Tian Fuqiang , Hou Shiyu , Yang Long , Hu Hongchang , Hou Aizhong
Published: December 2017

This study investigates the dependency of the evaluation of the Integrated Multisatellite Retrievals for Global Precipitation Measurement (IMERG) rainfall product on the gauge density of a ground-based rain gauge network as well as rainfall intensity over five subregions in mainland China. High-density rain gauges (1.5 gauges per 100 km2) provide exceptional resources for ground validation of satellite rainfall estimates over this region. Eight different gauge networks were derived with contrasting gauge densities ranging from 0.04 to 4 gauges per 100 km2. The evaluation focuses on two warm seasons (April–October) during 2014 and 2015. The results show a strong dependency of the evaluation metrics for the IMERG rainfall product on gauge density and rainfall intensity. A dense rain gauge network tends to provide better evaluation metrics, which implies that previous evaluations of the IMERG rainfall product based on a relatively low-density gauge network might have underestimated its performance. The decreasing trends of probability of detection with gauge density indicate a limited ability to capture light rainfall events in the IMERG rainfall product. However, IMERG tends to overestimate (underestimate) light (heavy) rainfall events, which is a consistent feature that does not show strong dependency on gauge densities. The results provide valuable insights for the improvement of a rainfall retrieval algorithm adopted in the IMERG rainfall product.
Achieving High Quality Through Transformational Leadership: A Qualitative Multilevel Analysis of Transformational Leadership and Perceived Professional Quality
Authors: Andersen Lotte Bøgh , Bjørnholt Bente , Bro Louise Ladegaard , Holm-Petersen Christina
Published: December 2017

Professional quality is an important performance criterion in the public sector, but professionals can have very different understandings of what constitutes professional quality. Leadership is often emphasized as a key element in giving direction to employees, thus enabling the promotion of shared understandings of what professional quality is. Although several studies show a positive relationship between transformational leadership and performance, professional quality is seldom investigated, and too little is known about how transformational leadership is linked to shared understandings among employees and leaders. This article applies a qualitative multilevel comparative case design to investigate the transformational leadership–professional quality relationship for child care centers. We find that transformational leadership is positively associated with the degree of shared understanding of professional quality among professionals and that a shared understanding of quality is positively associated with high levels of professional quality. Moreover, transformational leadership seems to be more prevalent in medium-sized spans of control.
Impairment of amyloid precursor protein alpha-processing in cerebral microvessels of type 1 diabetic mice
Authors: He Tongrong , Sun Ruohan , Santhanam Anantha VR , d'Uscio Livius V , Lu Tong , Katusic Zvonimir S
Published: December 2017

The mechanisms underlying dysfunction of cerebral microvasculature induced by type 1 diabetes (T1D) are not fully understood. We hypothesized that in cerebral microvascular endothelium, α-processing of amyloid precursor protein (APP) is impaired by T1D. In cerebral microvessels derived from streptozotocin (STZ)-induced T1D mice protein levels of APP and its α-processing enzyme, a disintegrin and metalloprotease 10 (ADAM10) were significantly decreased, along with down-regulation of adenylate cyclase 3 (AC3) and enhanced production of thromboxane A2 (TXA2). In vitro studies in human brain microvascular endothelial cells (BMECs) revealed that knockdown of AC3 significantly suppressed ADAM10 protein levels, and that activation of TXA2 receptor decreased APP expression. Furthermore, levels of soluble APPα (sAPPα, a product of α-processing of APP) were significantly reduced in hippocampus of T1D mice. In contrast, amyloidogenic processing of APP was not affected by T1D in both cerebral microvessels and hippocampus. Most notably, studies in endothelial specific APP knockout mice established that genetic inactivation of APP in endothelium was sufficient to significantly reduce sAPPα levels in the hippocampus. In aggregate, our findings suggest that T1D impairs non-amyloidogenic processing of APP in cerebral microvessels. This may exert detrimental effect on local concentration of neuroprotective molecule, sAPPα, in the hippocampus.
Comparison of ultrasound shear wave elastography with magnetic resonance elastography and renal microvascular flow in the assessment of chronic renal allograft dysfunction
Authors: Marticorena Garcia Stephan R , Guo Jing , Dürr Michael , Denecke Timm , Hamm Bernd , Sack Ingolf , Fischer Thomas
Published: December 2017

Background

Monitoring of renal allograft function is essential for early identification of dysfunction and improvement of kidney transplant (KTX) outcome.

Purpose

To non-invasively assess renal stiffness in KTX recipients using ultrasound shear wave elastography (USE) in correlation with multifrequency magnetic resonance elastography (MRE), renal allograft function, and renal microvascular flow determined using a novel ultrasound microvascular imaging technique.

Material and Methods

This prospective study investigated 25 KTXs (functional KTX [FCT], n = 14; chronic KTX insufficiency [DYS], n = 11) in 20 KTX recipients (mean age = 43 ± 14 years). USE was performed using a high-frequency broadband linear transducer and compared with MRE. Shear wave velocity (SWV) was correlated with the estimated glomerular filtration rate (eGFR). Qualitative differences in renal microvascular flow were obtained using SMI.

Results

FCT had higher SWV than DYS in both cortex and pyramids (cortex, FCT: 3.75 ± 0.82 m/s vs. DYS: 2.79 ± 0.73 m/s, P = 0.0002; pyramid, FCT: 2.89 ± 0.46 m/s vs. DYS: 2.39 ± 0.34 m/s, P = 0.044). Cutoff values of 3.265 m/s for cortex, 2.535 m/s for pyramids, and 2.985 m/s for combined non-hilar parenchyma provided sensitivities of 72.7%, 77.8%, and 90.9% and specificities of 71.4%, 78.6%, and 85.7% for detecting renal allograft dysfunction with area under the receiver operating characteristic curve (AUC) values of 0.831, 0.841, 0.925 (95% confidence interval [CI] = 0.67–0.99, 0.66–1.02, 0.83–1.03). USE correlated positively with eGFR ( r = 0.741, P = 0.0004) and with MRE-derived SWV ( r = 0.562, P = 0.004). Renal microvascular flow was decreased in DYS.

Conclusion

USE is sensitive to renal allograft dysfunction, which is characterized by reduced SWV and renal perfusion. USE has higher image resolution than MRE, while MRE has slightly better diagnostic accuracy.
Sensory processing styles and eating behaviors in healthy adults
Authors: Hebert Karen R
Published: December 2017

Introduction

Engagement in unhealthy eating behaviors is a significant risk factor for the development of obesity. These eating behaviors include uncontrolled and mindless eating in response to emotional and sensory cues. This study examines the relationship between sensory processing styles and eating behaviors in typical adults.

Method

One hundred and fifty healthy individuals aged 18–60 completed the Adolescent/Adult Sensory Profile, the Dutch Eating Behaviors Questionnaire, and a rating task of 40 healthy and unhealthy food images.

Findings

Sensory processing styles characterized by passive self-regulation strategies (low registration and sensory sensitivity) were positively correlated with rates of emotional and external eating behaviors. Sensory seeking was positively correlated with ratings of desirability of healthy food images.

Conclusion

Individuals whose sensory processing styles are characterized by passive self-regulation strategies are more likely to engage in unhealthy eating behaviors, including consuming food in relation to internal emotional and external sensory cues. Occupational therapists should consider the role of sensory factors when working with clients who engage in unhealthy food overconsumption.
The Role of Meniscal Tears in Spontaneous Osteonecrosis of the Knee: A Systematic Review of Suspected Etiology and a Call to Revisit Nomenclature
Authors: Hussain Zaamin B. , Chahla Jorge , Mandelbaum Bert R. , Gomoll Andreas H. , LaPrade Robert F.
Published: December 2017

Background:

The cause of spontaneous osteonecrosis of the knee (SONK) and postarthroscopic osteonecrosis of the knee is unknown, and the mechanisms involved have been poorly characterized.

Hypothesis/Purpose:

The purpose of this study was to perform a detailed systematic review of the literature to examine proposed etiological mechanisms for SONK in order to establish an improved understanding of the processes involved. We hypothesized that the etiology of SONK would be multifactorial.

Study Design:

Systematic review.

Methods:

A systematic review of the literature was performed by searching PubMed, Medline, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. Inclusion criteria were all original research articles presented in the English language that reported on the suspected etiology of SONK. Reviews, case reports with fewer than 3 patients, cost-effectiveness studies, technical reports, editorial articles, surveys, special topics, letters to the editor, personal correspondence, and studies that only proposed factors for the progression of SONK were excluded.

Results:

After a comprehensive review of 255 articles, 26 articles were included for final analysis. Twenty-one (80.7%) of 26 articles implicated the role of the meniscus in the development of SONK, in an association with either meniscal tears or its development after meniscectomy. The medial meniscus and posterior meniscal root tears were implicated more frequently. All 4 studies incorporating histological findings supported the insufficiency fracture hypothesis as a pathological basis of SONK.

Conclusion:

Physicians should be cognizant of the high prevalence of medial meniscus root tears in patients with SONK. Meniscectomy and meniscal tears, particularly of the medial meniscus posterior root, increase contact pressures and create an environment from which insufficiency fractures can emanate. We believe the term SONK is a misrepresentation of the etiology and pathogenesis of the condition and should be replaced with subchondral insufficiency fractures of the knee. Further elucidation of the etiology is required.
Testamentary Capacity Assessment: Legal, Medical, and Neuropsychological Issues
Authors: Voskou Panagiota , Douzenis Athanasios , Economou Alexandra , Papageorgiou Sokratis G.
Published: December 2017

Introduction:

The increase in the aging population and the number of patients with dementia led to the research in older adults’ capacity assessment over the last 3 decades. Many cases of contested wills occur due to lack of testamentary capacity (TC), especially in cases of dementia.

Aim:

Purpose of the present study was to overview the legal, medical, and neuropsychological aspects of TC as well as the instruments used for TC assessment.

Findings:

The testator/testatrix with intact TC has realistic perception of his or her property value, lack of psychopathology affecting contact with reality, and intact intention of how and to whom he or she will dispose his or her assets. It is frequent for the health practitioners to serve as “gold standards assessors” by examining an individual’s ability to make a valid will and giving evidence to the court to support or not a will contest. The TC assessment is a complex process of clinical and legal practice requiring usually a variety of methods, that is, interviews, evaluation of clinical records, and administration of neuropsychological instruments.

Conclusion:

The evaluation of TC is a multidimensional process that integrates both the legal and medical field, requiring a collaborative approach to its definition and assessment.
Human Olfactory Ensheathing Cell Transplantation Improves Motor Function in a Mouse Model of Type 3 Spinocerebellar Ataxia
Authors: Hsieh Jeanne , Liu Jen-Wei , Harn Horng-Jyh , Hsueh Kuo-Wei , Rajamani Karthyayani , Deng Yu-Chen , Chia Chih-Min , Shyu Woei-Cheang , Lin Shinn-Zong , Chiou Tzyy-Wen
Published: December 2017

Spinocerebellar ataxia (SCA) is a progressive neurodegenerative disease that affects the cerebellum and spinal cord. Among the 40 types of SCA, SCA type 3 (SCA3), also referred to as Machado–Joseph disease, is the most common. In the present study, we investigated the therapeutic effects of intracranial transplantation of human olfactory ensheathing cells (hOECs) in the ATXN3-84Q mouse model of SCA3. Motor function begins to decline in ATXN3-84Q transgenic mice at approximately 13 weeks of age. ATXN3-84Q mice that received intracranial hOEC transplantation into the dorsal raphe nucleus of the brain exhibited significant improvements in motor function, as measured by the rotarod performance test and footprint pattern analysis. In addition, intracranial hOEC transplantation alleviated cerebellar inflammation, prohibited Purkinje cells from dying, and enhanced the neuroplasticity of cerebellar Purkinje cells. The protein levels of tryptophan hydroxylase 2, the rate-limiting enzyme for serotonin synthesis in the cerebellum, and ryanodine receptor (RYR) increased in mice that received intracranial hOEC transplantation. Because both serotonin and RYR can enhance Purkinje cell maturation, these effects may account for the therapeutic benefits mediated by intracranial hOEC transplantation in SCA3 mice. These results indicate that intracranial hOEC transplantation has potential value as a novel strategy for treating SCA3.
Small and large deformation models of post-buckled beams under lateral constraints
Authors: Jiao Pengcheng , Alavi Amir H , Borchani Wassim , Lajnef Nizar
Published: December 2017

This study aims at theoretically and experimentally investigating the buckling behavior of bilaterally constrained beams with respect to different geometric parameters and conditions. The theoretical models are developed based on small and large deformation theories, respectively. The nonlinear Euler–Bernoulli beam theory is used to form the governing equations. An energy method is introduced to solve the equilibrium beams by minimizing the total potential energy with respect to the weight coefficients of the buckling modes. The theoretical models are compared with experiments. Good agreements are obtained with respect to the force–displacement relationship and deformed beam shape configuration. This study indicates that the small deformation model is insufficient in predicting beam end shortening since the longitudinal displacement is negligible in the model. The large deformation model effectively predicts severe deflection of beams in terms of end shortening and rotation. Parametric studies are carried out to indicate the applicability of the presented models. In particular, the small deformation model is defined as “more applicable” when the difference of the post-buckling response between the small and large deformation models is less than 5% (Diff < 5%), given that its computational cost is generally smaller than the large model. In contrast, when the difference is greater than 5%, the large deformation model is suggested. In the end, a polynomial function is fitted to define the relationship between the ratio of net gap-to-beam length η and highest achievable buckling mode Φ. The presented small and large deformation models are effective in understanding and predicting the post-buckling responses of laterally confined beams under different conditions.
Long working hours and stroke among employees in the general workforce of Denmark
Authors: Hannerz Harald , Albertsen Karen , Burr Hermann , Nielsen Martin Lindhardt , Garde Anne Helene , Larsen Ann Dyreborg , Pejtersen Jan Hyld
Published: December 2017

Aims: A systematic review and meta-analysis have found that long working hours were prospectively associated with an increased risk of overall stroke. The primary aim of the present study was to test if this finding could be reproduced in a sample that has been randomly selected from the general workforce of Denmark. A secondary aim was to estimate the association for haemorrhagic and ischaemic stroke separately. Methods: Individual participant data on 20- to 64-year-old employees were drawn from the Danish Labour Force Survey, 1999–2013, and linked to data on socio-economic status (SES), migrations, hospitalisations and deaths from national registers. The participants were followed from the time of the interview until the end of 2014. Poisson regression was used to estimate age-, sex- and SES-adjusted rate ratios for stroke as a function of weekly working hours. Results: With 35–40 working hours per week as reference, the estimated rate ratios for overall stroke were 0.97 (95% confidence interval (CI) 0.83–1.13) for 41–48 working hours, 1.10 (95% CI 0.86–1.39) for 49–54 working hours and 0.89 (95% CI 0.69–1.16) for ≥55 working hours. The estimated rate ratios per one category increase in working hours were 0.99 (95% CI 0.93–1.06) for overall stroke, 0.96 (95% CI 0.88–1.05) for ischaemic stroke and 1.15 (95% CI 1.02–1.31) for haemorrhagic stroke. Conclusions: Our analysis does not support the hypothesis that long working hours are associated with increased rates of overall stroke. It suggests, however, that long working hours might be associated with increased rates of haemorrhagic stroke.
Application of lattice Boltzmann methods for the multiphase fluid pipe flow on graphical processing unit
Authors: Cheng Pengxin , Gui Nan , Yang Xingtuan , JiyuanTu  , Jiang Shengyao
Published: December 2017

In this paper, we employ the lattice Boltzmann method implemented on compute unified device architecture-enabled graphical processing unit to investigate the multiphase fluid pipe flow. The basics of lattice Boltzmann method as well as the Shan–Chen multiphase model and the fundamentals of graphical processing unit with compute unified device architecture are thoroughly introduced. The procedure of implementation of lattice Boltzmann method on graphical processing unit and the comparison of the computing performance between graphical processing unit and CPU are presented. It is demonstrated that the graphical processing unit-based lattice Boltzmann method has remarkable advantages over CPU especially with selected appropriate parameters. The results of validation cases agree well with previous numerical results or analytical solutions. The vertical and horizontal multiphase pipe flow are simulated and discussed.
Use of Decision Support Software to Titrate Multiple Daily Injections Yielded Sustained A1c Reductions After 1 Year
Authors: Bode Bruce , Clarke John G. , Johnson Joseph
Published: December 2017

Purpose:

The purpose was to improve the quality of care of at-risk patients through the addition of connected BG meters and CDSS to improve workflow and thus provide more efficient titration of patient’s insulin regimens remotely between office visits in an attempt to treat them to their glucose targets faster and efficiently, and maintain that improvement over time.

Methods:

Hardware and software included a real-time cellular-enabled blood glucose (BG) meter and Glytec’s Glucommander™ clinical decision support software (CDSS). A quality improvement (QI) project with retrospective before-and-after comparison was conducted. The training period was 90 days and then the project ran for another 11 months. A protocol comprised Glytec CDSS software, which recommends titration intervals from 3 to 28 days as a function of glycemic control, specifically, longer intervals for better control. There were 46 clinic patients.

Results:

A1C decreased from a baseline average of 10.2% to 7.8% at 3 months, 7.8% at 6 months, 7.8% at 9 months, and 7.2% at 12 months. The baseline-to-final A1C decrease shows a P < .00001 by paired t-test. Out of 36 315 BGs, the average number of BG tests per day was 3.03 during the first 3 months and 2.47 during the final 3 months. The percentage of BGs < 54 mg/dL was 0.33% and the percentage of BGs < 40 mg/dL was 0.05%.

Conclusions:

This QI project demonstrated the use of CDSS including its built-in feature of titration interval recommendation can safely and effectively lower A1C for at-risk patients, treat patients to target safely, and maintain those improvements over 12 months of follow-up.
Riociguat, a soluble guanylate cyclase stimulator, ameliorates right ventricular contraction in pulmonary arterial hypertension
Authors: Murata Mitsushige , Kawakami Takashi , Kataoka Masaharu , Kohno Takashi , Itabashi Yuji , Fukuda Keiichi
Published: December 2017

Riociguat is a soluble guanylate cyclase stimulator used for pulmonary hypertension (PH) treatment. We evaluated right ventricular (RV) contractile function in 27 PH patients receiving riociguat. A comparison of pre‐ and post‐administration echocardiographic studies demonstrated significantly improved RV strain after riociguat treatment, even after adjusting for RV afterload.