bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-Reported Executive Functioning in Everyday Life in Parkinson’s Disease after Three Months of Subthalamic Deep Brain Stimulation
Authors: Pham Uyen Ha Gia , Andersson Stein , Toft Mathias , Pripp Are Hugo , Konglund Ane Eidahl , Dietrichs Espen , Malt Ulrik Fredrik , Skogseid Inger Marie , Haraldsen Ira Ronit Hebolt , Solbakk Anne-Kristin
Published: June 2015

Objective. Studies on the effect of subthalamic deep brain stimulation (STN-DBS) on executive functioning in Parkinson’s disease (PD) are still controversial. In this study we compared self-reported daily executive functioning in PD patients before and after three months of STN-DBS. We also examined whether executive functioning in everyday life was associated with motor symptoms, apathy, and psychiatric symptoms.Method. 40 PD patients were examined with the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), the Symptom Checklist 90-Revised (SCL-90-R), and the Apathy Evaluation Scale (AES-S).Results. PD patients reported significant improvement in daily life executive functioning after 3 months of STN-DBS. Anxiety scores significantly declined, while other psychiatric symptoms remained unchanged. The improvement of self-reported executive functioning did not correlate with motor improvement after STN-DBS. Apathy scores remained unchanged after surgery. Only preoperative depressed mood had predictive value to the improvement of executive function and appears to prevent potentially favorable outcomes from STN-DBS on some aspects of executive function.Conclusion. PD patients being screened for STN-DBS surgery should be evaluated with regard to self-reported executive functioning. Depressive symptoms in presurgical PD patients should be treated. Complementary information about daily life executive functioning in PD patients might enhance further treatment planning of STN-DBS.
Serum Soluble Adhesion Molecules and Markers of Systemic Inflammation in Elderly Diabetic Patients with Mild Cognitive Impairment and Depressive Symptoms
Authors: Gorska-Ciebiada Malgorzata , Saryusz-Wolska Malgorzata , Borkowska Anna , Ciebiada Maciej , Loba Jerzy
Published: June 2015

The aim of the study was to determine the serum levels of soluble adhesion molecules and hs-CRP in elderly diabetics with mild cognitive impairment (MCI) alone or with depressive symptoms.Methods. 219 diabetics elders were screened for psychiatric disorders and divided: group 1, MCI without depressive mood; group 2, MCI with depressive mood; group 3, controls. Data of biochemical parameters and biomarkers were collected.Results. In groups 1 and 2 levels of all biomarkers were significantly higher as compared to controls. The highest level of hs-CRP and sICAM-1 was detected in group 2. SVCAM-1 and sE-selectin levels were also the highest in group 2; however they did not significantly differ as compared to group 1. MoCA score was negatively correlated with all biomarkers in group 1. The logistic regression model showed that variables which increased the likelihood of having depressive syndrome in MCI patients were older age, stroke, neuropathy, increased number of comorbidities, and higher sICAM-1 level.Conclusions. We first demonstrated that elderly diabetic patients with MCI, particularly those with depressive mood have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation. Coexisting depressive syndrome in patients with MCI through common inflammatory pathways may result in augmentation of psychiatric disorders.
Three-Dimensional Vibration Analysis of Isotropic and Orthotropic Open Shells and Plates with Arbitrary Boundary Conditions
Authors: Jin Guoyong , Ye Tiangui , Shi Shuangxia
Published: June 2015

This paper presents elasticity solutions for the vibration analysis of isotropic and orthotropic open shells and plates with arbitrary boundary conditions, including spherical and cylindrical shells and rectangular plates. Vibration characteristics of the shells and plates have been obtained via a unified three-dimensional displacement-based energy formulation represented in the general shell coordinates, in which the displacement in each direction is expanded as a triplicate product of the cosine Fourier series with the addition of certain supplementary terms introduced to eliminate any possible jumps with the original displacement function and its relevant derivatives at the boundaries. All the expansion coefficients are then treated equally as independent generalized coordinates and determined by the Rayleigh-Ritz procedure. To validate the accuracy of the present method and the corresponding theoretical formulations, numerical cases have been compared against the results in the literature and those of 3D FE analysis, with excellent agreements obtained. The effects of boundary conditions, material parameters, and geometric dimensions on the frequencies are discussed as well. Finally, several 3D vibration results of isotropic and orthotropic open spherical and cylindrical shells and plates with different geometry dimensions are presented for various boundary conditions, which may be served as benchmark solutions for future researchers as well as structure designers in this field.
Patient Acceptable Symptom State in Self-Report Questionnaires and Composite Clinical Disease Index for Assessing Rheumatoid Arthritis Activity: Identification of Cut-Off Points for Routine Care
Authors: Salaffi Fausto , Carotti Marina , Gutierrez Marwin , Di Carlo Marco , De Angelis Rossella
Published: June 2015

Objective. To provide information on the value of Patient Acceptable Symptom State (PASS) in rheumatoid arthritis (RA) by the identification of PASS thresholds for patient-reported outcomes (PROs) composite scores.Methods. The characteristics of RA patients with affirmative and negative assignment to PASS were compared. Contributors to physician response were estimated by logistic regression models and PASS thresholds by the 75th percentile and receiver-operating characteristic (ROC) curve methods.Results. 303 RA patients completed the study. All PROs were different between the PASS (+) and PASS (−) groups (p<0.0001). The thresholds with the 75th percentile approach were 2.0 for the RA Impact of Disease (RAID) score, 2.5 for the PRO-CLinical ARthritis Activity (PRO-CLARA) index, and 1.0 for the Recent-Onset Arthritis Disability (ROAD) questionnaire. The cut-off values for Clinical Disease Activity Index (CDAI) were in the moderate range of disease activity. Assessing the size of the logistic regression coefficients, the strongest predictors of PASS were the disease activity (p=0.0007) and functional state level (0.006).Conclusion. PASS thresholds were relatively high and many patients in PASS had moderate disease activity states according to CDAI. Factors such as disease activity and physical function may influence a negative PASS.
An Update on the Inflammatory Response after Endovascular Repair for Abdominal Aortic Aneurysm
Authors: Arnaoutoglou Eleni , Kouvelos George , Koutsoumpelis Andreas , Patelis Nikolaos , Lazaris Andreas , Matsagkas Miltiadis
Published: June 2015

Postimplantation syndrome (PIS) is the clinical and biochemical expression of an inflammatory response following endovascular repair of an aortic aneurysm (EVAR). The goal of this review is to provide an update on the inflammatory response after endovascular repair of abdominal aortic aneurysm, discussing its causes and effects on the clinical outcome of the patient. PIS concerns nearly one‐third of patients after EVAR. It is generally a benign condition, although in some patients it may negatively affect outcome. The different definitions and conclusions drawn from several studies reveal that PIS needs to be redefined with standardized diagnostic criteria. The type of the endograft’s material seems to play a role in the inflammatory response. Future studies should focus on a better understanding of the underlying pathophysiology, predictors, and risk factors as well as determining whether effective preventive strategies are necessary.
Idiopathic Intrahepatic Cholestasis as an Unusual Presentation of Hodgkin’s Disease
Authors: Atalay Hande , Boyuk Banu , Ates Muhammet , Celebi Aslan , Ekizoglu Ismail , Didik Arzu A. , Igdem Aysenur A.
Published: June 2015

Intrahepatic cholestasis in the form of paraneoplastic phenomena is an uncommon presentation of Hodgkin’s lymphoma (HL). Herein we report the diagnosis of mixed type HL-related idiopathic intrahepatic cholestasis in a 73-year-old man presenting with jaundice, after the inguinal lymph node biopsy indicative of mixed cellular type HL and liver biopsy consistent with intrahepatic cholestasis, following several diagnostic interventions including surgery for suspected extrahepatic obstructive cholestasis. Our findings emphasize the value of early liver biopsy in the diagnostic algorithm along with consideration of HL-related idiopathic intrahepatic cholestasis as a diagnosis of exclusion in cholestatic jaundice of obscure origin.
Plasma Autoantibodies Associated with Basal-like Breast Cancers
Authors: Wang Jie , Figueroa Jonine D. , Wallstrom Garrick , Barker Kristi , Park Jin G. , Demirkan Gokhan , Lissowska Jolanta , Anderson Karen S. , Qiu Ji , LaBaer Joshua
Published: June 2015

Background: Basal-like breast cancer (BLBC) is a rare aggressive subtype that is less likely to be detected through mammographic screening. Identification of circulating markers associated with BLBC could have promise in detecting and managing this deadly disease.

Methods: Using samples from the Polish Breast Cancer study, a high-quality population-based case–control study of breast cancer, we screened 10,000 antigens on protein arrays using 45 BLBC patients and 45 controls, and identified 748 promising plasma autoantibodies (AAbs) associated with BLBC. ELISA assays of promising markers were performed on a total of 145 BLBC cases and 145 age-matched controls. Sensitivities at 98% specificity were calculated and a BLBC classifier was constructed.

Results: We identified 13 AAbs (CTAG1B, CTAG2, TP53, RNF216, PPHLN1, PIP4K2C, ZBTB16, TAS2R8, WBP2NL, DOK2, PSRC1, MN1, TRIM21) that distinguished BLBC from controls with 33% sensitivity and 98% specificity. We also discovered a strong association of TP53 AAb with its protein expression (P = 0.009) in BLBC patients. In addition, MN1 and TP53 AAbs were associated with worse survival [MN1 AAb marker HR = 2.25, 95% confidence interval (CI), 1.03–4.91; P = 0.04; TP53, HR = 2.02, 95% CI, 1.06–3.85; P = 0.03]. We found limited evidence that AAb levels differed by demographic characteristics.

Conclusions: These AAbs warrant further investigation in clinical studies to determine their value for further understanding the biology of BLBC and possible detection.

Impact: Our study identifies 13 AAb markers associated specifically with BLBC and may improve detection or management of this deadly disease. Cancer Epidemiol Biomarkers Prev; 24(9); 1332–40. ©2015 AACR.
Molecular Pathways: Sensitivity and Resistance to Anti-EGFR Antibodies
Authors: Bertotti Andrea , Sassi Francesco
Published: June 2015

Monoclonal antibodies targeting the EGF receptor (EGFR) tyrosine kinase, such as cetuximab and panitumumab, achieve clinically meaningful responses in patients affected by head and neck and colorectal cancers. Despite this evidence of efficacy, no genomic abnormalities that robustly predict sensitivity to EGFR blockade have been yet identified. This suggests that, in some tumor contexts, EGFR dependency is not acquired during neoplastic transformation and rather reflects an aberrant declination of physiologic traits typical of normal tissue counterparts. Indeed, EGFR signals are crucial for the reconstitution of damaged mucosa in the context of acute inflammation, and their sustained activation is likely to turn into a pro-oncogenic cue during chronic inflammation. Although positive predictors of response to anti-EGFR antibodies remain unknown, multiple determinants of resistance have been described, including alterations interfering with antibody–receptor interaction, deregulation of parallel signaling pathways, and mutations in downstream transducers. These findings provide new opportunities for the optimization of therapeutic strategies based on drug combinations. However, the emerging notion that genetic interactions and compensatory mechanisms may affect—both positively and negatively—the efficacy of targeted therapies complicates the rational design of combinatorial approaches and implies a rethinking of the criteria required to prioritize laboratory findings for clinical validation in investigational trials. Clin Cancer Res; 21(15); 3377–83. ©2015 AACR.
High-Dose Sirolimus and Immune-Selective Pentostatin plus Cyclophosphamide Conditioning Yields Stable Mixed Chimerism and Insufficient Graft-versus-Tumor Responses
Authors: Mossoba Miriam E. , Halverson David C. , Kurlander Roger , Schuver Bazetta Blacklock , Carpenter Ashley , Hansen Brenna , Steinberg Seth M. , Ali Syed Abbas , Tageja Nishant , Hakim Frances T. , Gea-Banacloche Juan , Sportes Claude , Hardy Nancy M. , Hickstein Dennis D. , Pavletic Steven Z. , Khuu Hanh , Sabatini Marianna , Stroncek David , Levine Bruce L. , June Carl H. , Mariotti Jacopo , Rixe Olivier , Fojo Antonio Tito , Bishop Michael R. , Gress Ronald E. , Fowler Daniel H.
Published: June 2015

Purpose: We hypothesized that lymphoid-selective host conditioning and subsequent adoptive transfer of sirolimus-resistant allogeneic T cells (T-Rapa), when combined with high-dose sirolimus drug therapy in vivo, would safely achieve antitumor effects while avoiding GVHD.

Experimental Design: Patients (n = 10) with metastatic renal cell carcinoma (RCC) were accrued because this disease is relatively refractory to high-dose conditioning yet may respond to high-dose sirolimus. A 21-day outpatient regimen of weekly pentostatin (P; 4 mg/m2/dose) combined with daily, dose-adjusted cyclophosphamide (C; ≤200 mg/d) was designed to deplete and suppress host T cells. After PC conditioning, patients received matched sibling, T-cell–replete peripheral blood stem cell allografts, and high-dose sirolimus (serum trough target, 20–30 ng/mL). To augment graft-versus-tumor (GVT) effects, multiple T-Rapa donor lymphocyte infusions (DLI) were administered (days 0, 14, and 45 posttransplant), and sirolimus was discontinued early (day 60 posttransplant).

Results: PC conditioning depleted host T cells without neutropenia or infection and facilitated donor engraftment (10 of 10 cases). High-dose sirolimus therapy inhibited multiple T-Rapa DLI, as evidenced by stable mixed donor/host chimerism. No antitumor responses were detected by RECIST criteria and no significant classical acute GVHD was observed.

Conclusions: Immune-selective PC conditioning represents a new approach to safely achieve alloengraftment without neutropenia. However, allogeneic T cells generated ex vivo in sirolimus are not resistant to the tolerance-inducing effects of in vivo sirolimus drug therapy, thereby cautioning against use of this intervention in patients with refractory cancer. Clin Cancer Res; 21(19); 4312–20. ©2015 AACR.
One Year's Observational Study of Acute Kidney Injury Incidence in Primary Care; Frequency of Follow-Up Serum Creatinine and Mortality Risk
Authors: Barton Anna L. , Mallard Angela S. , Parry Rob G.
Published: June 2015

Background/Aims: Publications on acute kidney injury (AKI) have concentrated on the inpatient population. We wanted to determine the extent of AKI in the community, its follow-up and patient impact. Method: Primary Care creatinine results for May 2012-April 2013 from Cornwall, United Kingdom, were screened for AKI. Results: Over 12 months, 991 AKI episodes were identified (0.4% of all Primary Care creatinine requests); 51% were AKI1, 29% AKI2 and 10% AKI3. Of these, 51% AKI1s, 72% AKI2s and 77% AKI3s had a repeat creatinine requested within 14 days as per National Institute for Health and Care Excellence (NICE) guidelines. Admissions (May 2012-July 2013) were identified on 46% AKI1s, 58% AKI2s and 65% AKI3s (p < 0.05). The median time from AKI identification to hospital admission was 33 days for AKI1, 12 days for AKI2 and 1 day for AKI3 (p < 0.05); with a median length of stay of 2, 4 and 7 days, respectively (p < 0.05). The 90-day mortality from AKI identification for the admitted patients was 12% AKI1s, 20% AKI2s and 27% AKI3s (p < 0.05) vs. 11, 21 and 65% (p < 0.05) for those that were not admitted. There was no significant difference in mortality for admitted patients vs. non-admitted patients, except for the AKI3s. Conclusion: AKI is associated with increased admission and mortality rates; although a large proportion of patients had repeat creatinine testing within 14 days, there was still a significant number with delayed follow-up. Education within Primary Care is required on how to prevent, identify, follow-up and manage AKI.
Successful Treatment of Idiopathic Eosinophilic Peritonitis by Oral Corticosteroid Therapy in a Continuous Ambulatory Peritoneal Dialysis Patient
Authors: Xu Yaowen , Gao Chenni , Xu Jing , Chen Nan
Published: June 2015

Eosinophilic peritonitis is a well-described complication of peritoneal dialysis and is often associated with either a reaction to the dialysis system constituent (tubing, sterilant or solution) or an underlying bacterial or fungal reaction. We report a case of eosinophilic peritonitis, which is treated by oral prednisone acetate therapy. A 43-year-old female patient developed end-stage renal disease and underwent continuous ambulatory peritoneal dialysis for 2.5 years. The patient received 2,000 ml of 1.5% dialysis solution (PD2) with three exchanges daily and 2,000 ml of 2.5% PDF overnight (PD2). She went to the consultation because of a constant turbid peritoneal dialysis effluent for 3 months without abdominal pain. Repeated peritoneal effluent samples showed an elevated white blood cell count of 500 cells/mm3, with 87% eosinophils. The peripheral blood test revealed a white blood cell count of 3.8 × 109/l, with 32.2% eosinophils. Etiology like bacterial and fungal infection was excluded by peritoneal fluid culture. Turbidness persisted in spite of diagnostic antibiotic treatment. Given the fact that we found a significant elevation of eosinophils in the peripheral blood and an absolute increase in the eosinophil count of >30/mm3 in dialysis fluid (up to 400/mm3 in our patient), obvious dialysate effluent turbidness, negative results of repeated peritoneal fluid cultures, inefficacy of antibiotic therapy, and negativity of serum tumor and immunological markers, we drew the conclusion that the patient had idiopathic eosinophilic peritonitis. Oral corticosteroid was administered at once (20 mg prednisone acetate daily), which was gradually weaned off and stopped over an 8-week period. Afterwards, the dialysis effluent became clear, and the cytological analysis showed that the white blood cell count decreased to 1 × 106/l, with no eosinophils. This case reminds us that the diagnosis of eosinophilic peritonitis should be considered when repeated cultures are always negative and the turbidness of peritoneal dialysis effluent persists in spite of an antibiotic therapy.
Loss of Cardiomyocyte Integrin-Linked Kinase Produces an Arrhythmogenic Cardiomyopathy in Mice
Authors: Quang Khai Le , Maguy Ange , Qi Xiao-Yan , Naud Patrice , Xiong Feng , Tadevosyan Artavazd , Shi Yan-Fen , Chartier Denis , Tardif Jean-Claude , Dobrev Dobromir , Nattel Stanley
Published: June 2015

Background—

Integrin-linked kinase (ILK), a serine/threonine protein kinase, has roles in cell signaling and molecular scaffolding. ILK mutation/deletion causes cardiomyopathic phenotypes, but the functional and electrophysiological features have not been characterized. This study investigated the structural, functional, ion channel, and electrophysiological changes associated with cardiomyocyte-directed ILK deletion in mice.

Methods and Results—

Adult mice with cardiomyocyte-directed ILK knockout were compared with littermate controls. Knockout mice showed markedly increased mortality, with sudden death beginning after 5 weeks and 100% mortality at 18 weeks. In 10-week-old knockout mice, spontaneous and inducible ventricular tachyarrhythmias were common, occurring in 60% and 86%, respectively, and absent in controls (
P
<0.001,
P
<0.05 versus knockout mice). Ventricular refractoriness was prolonged, along with both QRS and QT interval. Action potentials were prolonged and displayed triggered activity. A wide range of ion currents were downregulated, including total, fast and slow components of transient outward K
+
current and inward rectifier K
+
current, along with corresponding ion channel subunit genes, providing a plausible explanation of action potential prolongation. At 5 weeks, only voltage-dependent K
+
currents were reduced, possibly related to direct ILK-Kv4.2 subunit interactions. Action potentials were prolonged, but no arrhythmias or cardiac dysfunction were noted. Structural remodeling was prominent at 10 weeks: connexin-43 was downregulated and redistributed to lateral cell margins, and left ventricular fibrosis occurred, with a strong regional distribution (predominating in the basal left ventricle). Conduction was slowed. High-throughput quantitative polymerase reaction gene-expression studies in 10-week-old ILK knockout showed upregulation of structural, remodeling and fibrosis-related genes, and downregulation of a wide range of ion channel and transporter subunits.

Conclusions—

Cardiomyocyte ILK deletion produces a lethal arrhythmogenic cardiomyopathy associated with important ion channel and structural remodeling.
Loss of the Mechanotransducer Zyxin Promotes a Synthetic Phenotype of Vascular Smooth Muscle Cells
Authors: Ghosh Subhajit , Kollar Branislav , Nahar Taslima , Suresh Babu Sahana , Wojtowicz Agnieszka , Sticht Carsten , Gretz Norbert , Wagner Andreas H. , Korff Thomas , Hecker Markus
Published: June 2015

Background

Exposure of vascular smooth muscle cells (
VSMC
s) to excessive cyclic stretch such as in hypertension causes a shift in their phenotype. The focal adhesion protein zyxin can transduce such biomechanical stimuli to the nucleus of both endothelial cells and
VSMC
s, albeit with different thresholds and kinetics. However, there is no distinct vascular phenotype in young zyxin‐deficient mice, possibly due to functional redundancy among other gene products belonging to the zyxin family. Analyzing zyxin function in
VSMC
s at the cellular level might thus offer a better mechanistic insight. We aimed to characterize zyxin‐dependent changes in gene expression in
VSMC
s exposed to biomechanical stretch and define the functional role of zyxin in controlling the resultant
VSMC
phenotype.

Methods and Results

DNA
microarray analysis was used to identify genes and pathways that were zyxin regulated in static and stretched human umbilical artery–derived and mouse aortic
VSMC
s. Zyxin‐null
VSMC
s showed a remarkable shift to a growth‐promoting, less apoptotic, promigratory and poorly contractile phenotype with ≈90% of the stretch‐responsive genes being zyxin dependent. Interestingly, zyxin‐null cells already seemed primed for such a synthetic phenotype, with mechanical stretch further accentuating it. This could be accounted for by higher RhoA activity and myocardin‐related transcription factor‐A mainly localized to the nucleus of zyxin‐null
VSMC
s, and a condensed and localized accumulation of F‐actin upon stretch.

Conclusions

At the cellular level, zyxin is a key regulator of stretch‐induced gene expression. Loss of zyxin drives
VSMC
s toward a synthetic phenotype, a process further consolidated by exaggerated stretch.
Pneumatic tube transport of blood-stained cerebrospinal fluid specimens has no clinically relevant effect on rates of haemolysis compared to manual transport
Authors: Jones Liz , Isbister Geoff , Chesher Douglas , Gillett Mark
Published: June 2015

Background

Pneumatic tube transport of pathology specimens from the emergency department to the laboratory for analysis is a widely used practice. When compared to manual specimen transport, it results in savings in both time and labour. Sampling of cerebrospinal fluid still forms part of the workup of patients with suspected subarachnoid haemorrhage. There are claims in the literature that transport of cerebrospinal fluid samples by pneumatic tube results in excess haemolysis, which interferes with cerebrospinal fluid analysis for the presence of bilirubin. The aim of our study was to ascertain whether pneumatic tube transport of blood-stained cerebrospinal fluid to the laboratory, results in clinically significantly higher levels of haemolysis compared with manual transport of the same specimens.

Methods

Stored cerebrospinal fluid was spiked with varying amounts of red blood cells creating 72 specimens of varying red cell concentration. Half of these specimens were transported to the laboratory manually while the other half were sent by pneumatic tube transport. The rates of haemolysis were compared between the pneumatic tube and manual transport samples.

Results

There was no clinically significant difference in the rates of haemolysis between the samples transported to the laboratory by pneumatic tube compared with those moved manually.

Conclusions

Pneumatic tube transport of cerebrospinal fluid to the laboratory is not associated with clinically significantly higher rates of haemolysis when compared to manual transport.
Pub congregations, coffee house communities, tall-steeple churches, and sacred space: The missional church movement and architecture
Authors: Effa Allan
Published: June 2015

Some popular missional church literature portrays the institutional church as a stale and mostly unattractive entity focused on maintaining its programs and buildings and increasingly unable to reach a secular society. Rather than reform or reboot church in its present structure, new missional communities need to be established in places where unchurched people are comfortable gathering. This article examines some of these assumptions in conversation with some of the critics of the missional church literature. It calls for a robust ecclesiology that takes into account the rich historical heritage of the church and the role aesthetics and rituals play in the formation of authentic missional communities.
The Politics of Affirmation Theory
Authors: Ehrlich Gaven A. , Gramzow Richard H.
Published: June 2015

It has been well established in the literature that affirming the individual self reduces the tendency to exhibit group-favoring biases. The limited research examining group-affirmation and bias, however, is inconclusive. We argue that group-affirmation can exacerbate group-serving biases in certain contexts, and in the current set of studies, we document this phenomenon directly. Unlike self-affirmation, group-affirmation led to greater ingroup-favoring evaluative judgments among political partisans (Experiment 1). This increase in evaluative bias following group-affirmation was moderated by political party identification and was not found among those who affirmed a non-political ingroup (Experiment 2). In addition, the mechanism underlying these findings is explored and interpreted within the theoretical frameworks of self-categorization theory and the multiple self-aspects model (Experiments 2 and 3). The broader implications of our findings for the understanding of social identity and affirmation theory are discussed.
Revisiting Rousseau’s Civil Religion
Authors: Karant Joshua
Published: June 2015

As divisive as the work undoubtedly remains, ‘On Civil Religion’ merits renewed attention. Possessing the courage of Jean-Jacques Rousseau’s convictions and contradictions both, it offers a flawed yet productive confrontation with still-enduring politico-theological tensions and, more broadly, a compelling case for the pedagogical value of provocation. By pressing these debates upon our collective attention, he alerts us, in no uncertain terms, to the vital role contentiousness plays in civic affairs. And in potentially fanning the flames of this still-burning fire, Rousseau’s ‘purely civil profession of faith’ provokes us once again to reconsider the theoretical and practical reconciliation of religious and political institutions, all while pushing us – insistently, at times even unreasonably – down a path towards some form of democratic rapprochement. ‘On Civil Religion’ therefore reflects a tense dialectic between piety and profanity, pessimism and idealism, civility and intolerance, civic-mindedness and individualism, reason and emotion. Yet in striking so many dissonant chords, it prods us even now to revisit the relationship between religious and civic institutions as they are, and envision how it might be.
Increased Resident Research over an 18‐Year Period
Authors: Chen Jenny X. , Kozin Elliott D. , Sethi Rosh K. V. , Remenschneider Aaron K. , Emerick Kevin S. , Gray Stacey T.
Published: June 2015

Objectives

(1) To evaluate changes in the resident publications over time, including before and after duty hour restrictions, and (2) to identify factors statistically associated with publications during residency.

Study Design

Retrospective review of bibliometric data.

Subjects and Methods

Residents who graduated from an otolaryngology residency program from 1996 to 2013 were evaluated. Thomson Reuters Web of Science was searched to determine the number of indexed peer‐reviewed publications before and after implementation of resident duty hour restrictions in 2003. Resident demographics, PhD degrees, training tracks, and postgraduation plans were collected to determine factors associated with publication rate using multivariable regression analysis.

Results

During the studied period, 75 residents completed otolaryngology residency training and published a total of 294 papers, averaging 3.92 publications per resident during training. After work hour restrictions were implemented, the mean number of publications increased from 1.21 to 5.10 (P <. 0001). First author publications, clinical publications, and basic science publications all increased (P <. 001). In regression analysis, T32 grants (β = 6.98, standard error [SE] = 1.87, P =. 0004) and the time period after duty hour restrictions were introduced (β = 4.72, SE = 1.73, P =. 0083) were positively associated with resident publications. Gender, PhD degree, and pursuit of fellowship training were not associated with increased publications (P >. 05).

Conclusion

There has been a significant increase in resident publications over time, coinciding with the implementation of work hour restrictions. T32 grants were most predictive of increased resident publications, while PhD degrees were not significantly associated.
In Vitro Treatment with 2‐APB Inhibits the Inflammation in Nasal Polyps
Authors: Lin Lin , Dai Fei , Chen Zhongchun , Cai Lihui
Published: June 2015

Objective

Glucocorticoids are considered the main treatment option for chronic rhinosinusitis with nasal polyps (CRSwNP), but their effect rate ranges from 60.9% to 80%. Novel therapeutic means should be studied. The purpose of this study was to investigate the expression of Orai1 in nasal polyps (NPs) and the influence of intervention of Orai1 on NPs after in vitro treatment of 2‐aminoethoxydiphenyl borate (2‐APB).

Study Design

Prospective cross‐sectional study.

Setting

University hospital.

Subjects and Methods

Nasal biopsy samples were obtained from normal subjects or subjects with CRSwNP. We studied the localization of Orai1 protein in NPs by using immunohistochemistry. Then these tissues in cultures were maintained in the absence or presence of dexamethasone (DEX) or 2‐APB. Orai1 was examined by Western blot, enzyme‐linked immunosorbent assay (ELISA), and real‐time reverse transcription‐polymerase chain reaction (RT‐PCR). Inflammatory mediators including interleukin (IL)‐1β, IL‐5, eosinophil cation protein (ECP), leukotriene (LT)C4, interferon (IFN)‐γ, and dermatophagoides pteronyssinus (DP)‐specific immunoglobulin E (sIgE) as well as mucins (MUCs) including MUC5B and MUC7 in cultures were analyzed with ELISA and real‐time RT‐PCR.

Results

The expression of Orai1 was localized to cytoplasmic membrane of inflammatory cells and submucosal glandular cells and was upregulated in NPs compared with normal nasal mucosa. Orai1 was decreased in NPs after in vitro treatment of 2‐APB but not after DEX intervention. The levels of inflammatory mediators and mucins were reduced more after 2‐APB treatment when compared with those after DEX treatment.

Conclusion

Orai1 may play crucial roles in NP formation, and the intervention of Orai1 may inhibit NP development.
Sentinel Lymph Node Biopsy Provides Prognostic Value in Thick Head and Neck Melanoma
Authors: Monroe Marcus M. , Pattisapu Prasanth , Myers Jeffrey N. , Kupferman Michael E.
Published: June 2015

Objectives

Sentinel lymph node biopsy (SLNB) is standard practice for intermediate‐thickness head and neck melanoma (HNM) but remains controversial for melanomas more than 4 mm in thickness. The objectives of this study were to evaluate (1) the diagnostic accuracy and (2) the prognostic value of SLNB in patients with thick HNM.

Study Design

Case series with chart review.

Setting

Large cancer center between June 2000 and December 2012.

Subjects

77 patients undergoing SLNB for T4 HNM without in‐transit, regional, or distant metastatic disease at presentation.

Methods

Univariate and multivariate analyses of prognostic factors were performed.

Results

77 patients underwent attempted SLNB for T4 HNM without in‐transit, regional, or distant metastatic disease at presentation. The mean patient age was 62 years (range, 4‐87 years) and there was a male predominance (80%). Mean Breslow thickness was 6.1 mm (range, 4‐21 mm). Of the 77 patients undergoing attempted SLNB, 7 had no identifiable sentinel lymph node (9%). For the remaining 91% with 1 or more identifiable sentinel lymph nodes, the mean number of nodes identified was 3.3 (range, 1‐13). The sentinel lymph node positivity rate was 24%. A false‐negative SLNB occurred in 2 patients (3.8%). With a median follow‐up of 36 months, the estimated 5‐year disease‐free, disease‐specific, and overall survival rates were 47%, 74%, and 69%, respectively. A positive sentinel lymph node was significantly linked to shortened disease‐free survival (74 vs 36 months, P =. 026) and disease‐specific survival (121 vs 59 months, P =. 035).

Conclusion

SLNB provides accurate staging of the regional node basin and important prognostic information for patients with thick HNM.
Discharge of thoracic patients on portable digital suction: Is it cost-effective?
Authors: Southey Dawn , Pullinger Diane , Loggos Spiros , Kumari Nelam , Lengyel Emma , Morgan Ian , Yiu Patrick , Nandi Jayanta , Luckraz Heyman
Published: June 2015

Objectives

A portable suction drainage device for patients undergoing thoracic surgical procedures was introduced into our service in January 2010. Patients who met strict discharge criteria were allowed to continue their treatment at home with the device. They were monitored in a designated follow-up clinic. Data were collected to identify the impact of this service in relation to the duration of follow-up required, bed-days saved, and potential cost/benefits.

Methods

All patients who underwent a thoracic procedure from March 2012 to April 2014 and required suction postoperatively for air leak were included in the study. Patients were identified as suitable according to the discharge criteria. Data regarding patient demographics were collected prospectively on the thoracic database, and data on the drainage device were logged in a specific data sheet. Visits to the follow-up clinic were also recorded.

Results

During the study period, 50 patients stayed a total 1125 days on the portable suction system. Twenty were discharged home, equating to 772 bed-days saved (GBP 270,000 cost-saving). Clinic attendance totalled 162 visits (GBP 24,300 cost reimbursement for attendance). Six (30%) patients were readmitted on 9 occasions due to device malfunction or inability to cope at home.

Conclusion

Careful identification of patients suitable for discharge with a portable suction device achieved a significant cost-saving and freed hospital beds, thus allowing increased surgical activity. Patients were also able to be cared for within their home environment and maintain their quality of life.
Effects of gadolinium-based contrast agent concentrations (0.5 M or 1.0 M) on the diagnostic performance of magnetic resonance imaging examinations: systematic review of the literature
Authors: Lancelot Eric , Froehlich John , Heine Oliver , Desché Pierre
Published: June 2015

Background

To date there is no agreement as to what is the optimal concentration for gadolinium-based contrast agents (GBCAs).

Purpose

To assess whether diagnostic performance differences exist between 0.5 M and 1.0 M GBCAs used for magnetic resonance imaging (MRI).

Material and Methods

A PubMed literature search identified 21 clinical studies published between 2005 and 2013 which evaluated the diagnostic efficacy of both types of GBCAs. Study design, type of procedure, GBCA administration mode, imaging performances, impact on patient management, study limitations, and biases were analyzed. No statistical test was performed on pooled data.

Results

Sixteen comparative and five non-comparative studies were analyzed, involving 2183 patients who underwent MRI procedures for various indications. In 67% of the studies, 0.5 M and 1.0 M GBCAs were injected at equimolar gadolinium amounts per kg body weight. Only 33% applied the same molar flow rate for delivery of the GBCAs. No significant differences between GBCAs were reported for 23 out of 27 qualitative endpoints (mainly image quality, lesion, and vessel visualization) and 29 out of 40 quantitative endpoints. Three out of four studies with non-equimolar delivery rates showed better contrast-to-noise and signal-to-noise ratios for 1.0 M gadobutrol, without showing an impact on diagnostic performance. Methodological biases were identified in several studies impairing the interpretation of comparisons.

Conclusion

Imaging differences between 0.5 M and 1.0 M GBCAs were essentially observed under non-equimolar delivery rates. However, they did not result into greater diagnostic efficacy when performed under equimolar conditions.
The application of pneumatic jigging in the recovery of metallic fraction from shredded printed wiring boards
Authors: Wang Zheng , Hall Philip , Miles Nicholas J , Wu Tao , Lambert Peter , Gu Fu
Published: June 2015

Waste electrical and electronic equipment (WEEE) is one of the fastest growing waste streams worldwide with volumes increasing by 40% each year. WEEE has attracted increasing concern worldwide due to its high metal content and the potential environmental threat which results from uncontrolled recycling practices. Innovative physical separation techniques for WEEE recycling are preferential compared with chemical methods because of the reduction of energy and chemical consumption as well as potential environmental threats. Pneumatic jigging is a dry separation process capable of achieving good separation of coarse material within a very narrow density range, which makes it suitable as a pretreatment process for WEEE recycling. The work presented in this paper investigates the potential application of pneumatic jigging in metal recovery from WEEE. A pilot scale pneumatic jig has been developed by University of Nottingham Ningbo to separate shredded printed wiring boards into two streams: a light fraction (mainly non-metallic fraction consisting of glass fiber, fluffs, and plastic pieces) and dense fraction (metallic fraction). The novelty of work presented in this paper is the application of a dry separation technique in WEEE recycling for metal recovery. Compared with conventional wet separation processes involved in WEEE recycling industry, dry separation has the advantage of zero secondary pollution. The results of this experimental program show pneumatic jigging to be an effective and environmental friendly technique as a pretreatment process for the recovery of the metallic fraction from shredded WEEE.
Editors Use Social Media Mostly to Post Story Links
Authors: Bullard Sue Burzynski
Published: June 2015

A survey of senior editors of U.S. print broadcast and online news outlets found that while 98 percent of the 376 respondents say they use social media, they primarily use it to post links to stories on Facebook and Twitter. Far fewer use social media to interact with audiences by posing questions and responding to comments.
Lanthanum enhances glutamate–nitric oxide–3′,5′-cyclic guanosine monophosphate pathway in the hippocampus of rats
Authors: Du Yanqiu , Yang Jinghua , Yan Bo , Bai Yan , Zhang Lifeng , Zheng Linlin , Cai Yuan
Published: June 2015

Lanthanum (La) appears to impair learning and memory and increase the toxicity of excitatory amino acids in the central nervous system. The mechanism underlying excitotoxicity induced by La is still unclear. The purpose of this study was to investigate the hippocampal impairment of La exposure and possible mechanism involving the glutamate–nitric oxide (NO)–3′-5′-cyclic guanosine monophosphate (cGMP) pathway. In this study, lactating rats were exposed to 0, 0.25, 0.50, and 1.0% lanthanum chloride (LaCl3) in drinking water, respectively. Their offsprings were exposed to LaCl3 by parental lactation and then administrated with 0, 0.25, 0.50, and 1.0% LaCl3 in drinking water for 1 month. The results showed that La exposure impaired the neuronal ultrastructure and significantly increased the glutamate level, intracellular calcium ion concentrations, and NR1 and NR2B expression in the hippocampi. La exposure significantly enhanced messenger RNA expression and activity levels of inducible NO synthase and increased NO and cGMP levels in the hippocampi in a dose-dependent manner. These results indicate that the mechanism underlying excitotoxicity induced by La is possibly due to alterations of the glutamate–NO–cGMP signaling pathway in the hippocampus. The study provides new findings that may help prevent and improve treatments for La-induced neurotoxicity.
Management of Hyperglycemia and Enteral Nutrition in the Hospitalized Patient
Authors: Davidson Patricia , Kwiatkowski Cynthia Ann , Wien Michelle
Published: June 2015

There has been increased attention on the importance of identifying and distinguishing the differences between stress‐induced hyperglycemia (SH), newly diagnosed hyperglycemia (NDH), and hyperglycemia in persons with established diabetes mellitus (DM). Inpatient blood glucose control is now being recognized as not only a cost issue for hospitals but also a concern for patient safety and care. The reasons for the increased incidence of hyperglycemia in hospitalized patients include preexisting DM, undiagnosed DM or prediabetes, SH, and medication‐induced hyperglycemia with resulting transient blood glucose variability. It is clear that identifying and documenting hyperglycemia in hospitalized patients with and without a previous diagnosis of DM and initiating prompt insulin treatment are important. Agreement on the optimum treatment goals for hyperglycemia remains quite controversial, and the benefits of intensive glucose management may be lost at the cost of hypoglycemia in intensive care unit patients. Nutrition support in the form of enteral nutrition (EN) increases the risk of hyperglycemia in both critical and non–critically ill hospitalized patients. Reasons for beginning a tube feeding are the same whether a person has NDH or DM. What differs is how to incorporate EN into the established insulin management protocols. The risk for hyperglycemia with the addition of EN is even higher in those without a previous diagnosis of DM. This review discusses the incidence of hyperglycemia, the pathogenesis of hyperglycemia, factors contributing to hyperglycemia in the hospitalized patient, glycemic management goals, current glycemic management recommendations, and considerations for EN formula selection, administration, and treatment.
Hardware-in-the-loop testing of bypass valve actuation system: Design and validation of a simplified real time model
Authors: Pugi Luca , Galardi Emanuele , Carcasci Carlo , Lucchesi Nicola
Published: June 2015

During the start-up and shut-down phases of steam power plants many components are subjected to pressure and temperature transients that have to be carefully regulated both for safety and reliability reasons. For this reason, there is a growing interest in the optimization of turbine bypass controllers and actuators which are mainly used to regulate the plant during this kind of operations. In this work, a numerically efficient model for real-time simulation of a steam plant is presented. In particular, a modular Simulink™ library of components such as valves, turbines, and heaters has been developed. In this way, it is possible to easily assemble and customize models able to simulate different plants and operating scenarios. The code, which is implemented for a fixed, discrete step solver, can be easily compiled for a RT target (such as a Texas Instrument DSP) in order to be executed in real time on a low-cost industrial hardware. The proposed model has been used for quite innovative applications such as the development of a hardware-in-the-loop test rig of turbine bypass controllers and valve positioners. Preliminary experimental activities and results of the proposed test rig developed for Velan ABV are introduced and discussed.
Statistical challenges in assessing potential efficacy of complex interventions in pilot or feasibility studies
Authors: Wilson Duncan T , Walwyn Rebecca EA , Brown Julia , Farrin Amanda J , Brown Sarah R
Published: June 2015

Early phase trials of complex interventions currently focus on assessing the feasibility of a large randomised control trial and on conducting pilot work. Assessing the efficacy of the proposed intervention is generally discouraged, due to concerns of underpowered hypothesis testing. In contrast, early assessment of efficacy is common for drug therapies, where phase II trials are often used as a screening mechanism to identify promising treatments. In this paper, we outline the challenges encountered in extending ideas developed in the phase II drug trial literature to the complex intervention setting. The prevalence of multiple endpoints and clustering of outcome data are identified as important considerations, having implications for timely and robust determination of optimal trial design parameters. The potential for Bayesian methods to help to identify robust trial designs and optimal decision rules is also explored.
Factors Affecting Willingness to Use Hospice in Racially/Ethnically Diverse Older Men and Women
Authors: Park Nan Sook , Jang Yuri , Ko Jung Eun , Chiriboga David A.
Published: June 2015

Racial/ethnic minorities tend to underutilize hospice services. Guided by Andersen behavioral health model, the purpose of this study was to explore the predictors of the willingness to use hospice services in racially/ethnically diverse older men and women. Data were drawn from the Survey of Older Floridians: 504 non-Hispanic whites, 360 African Americans, 328 Cuban Americans, and 241 non-Cuban Hispanics. In each group, logistic regression models of the willingness to use hospice were estimated. A greater likelihood of willingness was observed among younger non-Hispanic whites and among African Americans with fewer functional disabilities. In non-Cuban Hispanics, English proficiency increased the willingness by 3.1 times. Findings of the study identified group-specific factors contributing to the willingness to use hospice services and hold implications for tailored intervention programs.