bluuebunny/crossref_metadata_2025 huggingface dataset:
Knightly Masculinity, Court Games and Material Culture in Late‐medieval Portugal: The Case of Constable Afonso (c.1480–1504)
Authors: Carvalhal Hélder , Guimarães Sá Isabel dos
Published: July 2016

This article explores the ways in which gender was used in order to transform an exiled and uneducated illegitimate child into a prince. Our study revolves around a member of the royal family, Afonso (c.1480–1504), who was brought up in hiding by peasants and who later, as a teenager, was reincorporated into the court. We argue that the keys to this process of rehabilitation were, on one hand, family politics centred around different configurations and on the other, his introduction into a court environment marked by the ideals of chivalry. Within this dynamic, material culture played a key role, because it gave the prince all the visual attributes of his new status, as well as allowing him the means to create a new self. We shall briefly introduce Afonso and his family context in order to give an insight into his life within changing political and dynastic contexts. Then, we will analyse the expression of manhood in the Portuguese court, using the spectacles at the court as a basis for observation, thus relating gender to material culture in a courtly environment.
The ethics of ambulance ramping
Authors: Perry Matthew , Carter Drew
Published: July 2016

Ramping is the practice of requiring paramedics to continue to care for patients rather than hand over clinical responsibility to the ED. It arose as an alternative to admitting patients to EDs that are deemed to be already operating at or beyond capacity. This paper analyses the ethics of ramping.

Ramping has been embraced by some ED practitioners and policymakers as a solution to the problem of ED patients suffering increased risks of harm as a result of waiting times within ED. However, this perspective fails to adequately consider the implications, especially the opportunity cost of requiring paramedics to remain at the hospital rather than make themselves available for other patients. From this perspective, ramping negatively impacts the wider provision of emergency medical services, with potentially serious consequences for people's health. Advocates of ramping must consider people in the community who require a medical emergency response.
Autonomic nervous infiltration positively correlates with pathological risk grading and poor prognosis in patients with lung adenocarcinoma
Authors: Shao Jing‐Xin , Wang Bo , Yao Yi‐Nan , Pan Zhi‐Jie , Shen Qian , Zhou Jian‐Ying
Published: July 2016

Background

Perineural invasion has been found in several types of human tumors, and is associated with poor prognosis; however, few studies have examined perineural invasion in lung cancer. We evaluated the relationship between autonomic nervous densities, pathological risk grading, and prognosis in patients with lung adenocarcinoma (LADC).

Methods

Neural fiber expression was examined by immunofluorescence in resected lung specimens in control patients (n = 30), and low‐risk (n = 22), and high‐risk LADC patients (n = 43). The nerve densities of normal lung tissue and abnormal lung tissues in the tumor and surrounding tissues were evaluated by a semi‐quantitative score method.

Results

Increased sympathetic fibers mainly infiltrated the paratumoral area, while increased parasympathetic fibers were largely restricted to the tumor (paratumor vs. tumor,
P
= 0.000 in high,
P
= 0.034 in low; each). In addition, high‐risk patients presented the highest density of neural fibers, followed by low‐risk and control patients (
P
= 0.000; each). In Kaplan–Meier survival analysis, the densities of sympathetic fibers in paratumoral tissue and parasympathetic fibers in the tumor, respectively, correlated with poor recurrence‐free survival in patients who were not treated with adjuvant therapy (
P
< 0.001; each). Further multivariate analysis showed that these two factors were associated with poor prognosis in all LADC patients (
P
= 0.024 sympathetic fibers;
P
= 0.037 parasympathetic fibers).

Conclusion

These findings reveal a positive correlation between nervous infiltration and risk of poor prognosis in patients with LADC.
Forty years of structural imaging in psychosis: promises and truth
Authors: Fusar‐Poli P. , Meyer‐Lindenberg A.
Published: July 2016

Objective

Since the first study published in the Lancet in 1976, structural neuroimaging has been used in psychosis with the promise of imminent clinical utility. The actual impact of structural neuroimaging in psychosis is still unclear.

Method

We present here a critical review of studies involving structural magnetic resonance imaging techniques in patients with psychosis published between 1976 and 2015 in selected journals of relevance for the field. For each study, we extracted summary descriptive variables. Additionally, we qualitatively described the main structural findings of each article in summary notes and we employed a biomarker rating system based on quality of evidence (scored 1–4) and effect size (scored 1–4).

Results

Eighty studies meeting the inclusion criteria were retrieved. The number of studies increased over time, reflecting an increased structural imaging research in psychosis. However, quality of evidence was generally impaired by small samples and unclear biomarker definitions. In particular, there was little attempt of replication of previous findings. The effect sizes ranged from small to modest. No diagnostic or prognostic biomarker for clinical use was identified.

Conclusions

Structural neuroimaging in psychosis research has not yet delivered on the clinical applications that were envisioned.
Comparative effectiveness and safety of antipsychotic drugs in schizophrenia treatment: a real‐world observational study
Authors: Vanasse A. , Blais L. , Courteau J. , Cohen A. A. , Roberge P. , Larouche A. , Grignon S. , Fleury M.‐J. , Lesage A. , Demers M.‐F. , Roy M.‐A. , Carrier J.‐D. , Delorme A.
Published: July 2016

Objective

The objective was to compare, in a real‐world setting, the risk of mental and physical health events associated with different antipsychotic drugs (clozapine, olanzapine, risperidone, quetiapine and first‐generation antipsychotics) in patients with SZ.

Methods

This is a retrospective cohort study using administrative data. Outcome measures included any mental health event (suicide, hospitalization or emergency visit for mental disorders) and physical health event (death other than suicide, hospitalization or emergency visit for physical disorders). Cox proportional hazard models were used to estimate the hazard ratios of the events associated with the use of the different antipsychotic drugs.

Results

The cohort included 18 869 adult patients living in the province of Quebec (Canada) with SZ and starting antipsychotic drugs between January 1998 and December 2005. Results show that quetiapine and not using any antipsychotics were associated with an increased risk of mental and physical health events as compared to other drugs. The second finding is the confirmation of better performance of clozapine. The results were robust across sensitivity analyses.

Conclusion

Both findings call for an international public health and drug agencies surveillance of ‘real‐world’ antipsychotic medication to ensure the optimal choices in treatment guidelines for SZ.
Vertical coordination and farm performance: evidence from the catfish sector in Vietnam
Authors: Trifković Neda
Published: July 2016

Using an original dataset from the Vietnamese catfish sector, I analyze the impact of vertical coordination options, namely, contract farming and vertical integration, on farm performance, which is measured in terms of yields and revenue per hectare. The effects of vertical coordination are estimated using a maximum simulated likelihood estimator and a two‐stage least square regression with instrumental variables to account for endogenous farm and household characteristics and selection on unobservable characteristics. The results show that vertically integrated farms have substantially higher yields and revenue per hectare than nonintegrated farms. The levels of gains that can be attributed to integration are large and consistent under different estimation procedures, and there is no difference between nonintegrated and contract farms in terms of farm performance.
Using an economic experiment to estimate willingness‐to‐pay for a new maternal nutrient supplement in Ghana
Authors: Adams Katherine P. , Lybbert Travis J. , Vosti Stephen A. , Ayifah Emmanuel
Published: July 2016

Scaling up access to supplements designed to prevent undernutrition, such as new small‐quantity lipid‐based nutrient supplements (SQ‐LNS), may require distribution via both public channels and retail markets. The viability of SQ‐LNS retail markets will hinge on household‐level demand. We use an economic experiment to characterize initial willingness‐to‐pay (WTP) for a maternal SQ‐LNS product in Ghana. WTP is positive for most participants, though below the estimated cost of production for many. WTP varies depending on income, assets, and parity status. These findings have implications for the design of public health policy and hybrid public–private delivery mechanisms.
Circulating MicroRNAs and Life Expectancy Among Identical Twins
Authors: Wu Shenghui , Kim Taek‐Kyun , Wu Xiaogang , Scherler Kelsey , Baxter David , Wang Kai , Krasnow Ruth E , Reed Terry , Dai Jun
Published: July 2016

Human life expectancy is influenced not only by longevity assurance mechanisms and disease susceptibility loci but also by the environment, gene–environment interactions, and chance. MicroRNAs (miRNAs) are a class of small noncoding RNAs closely related to genes. Circulating miRNAs have been shown as promising noninvasive biomarkers in the development of many pathophysiological conditions. However, the concentration of miRNA in the circulation may also be affected by environmental factors. We used a next‐generation sequencing platform to assess the association of circulating miRNA with life expectancy, for which deaths are due to all causes independent of genes. In addition, we showed that miRNAs are present in 41‐year archived plasma samples, which may be useful for both life expectancy and all‐cause mortality risk assessment. Plasma miRNAs from nine identical male twins were profiled using next‐generation sequencing. The average absolute difference in the minimum life expectancy was 9.68 years. Intraclass correlation coefficients were above 0.4 for 50% of miRNAs. Comparing deceased twins with their alive co‐twin brothers, the concentrations were increased for 34 but decreased for 30 miRNAs. Identical twins discordant in life expectancy were dissimilar in the majority of miRNAs, suggesting that environmental factors are pivotal in miRNAs related to life expectancy.
Association of interleukin‐10 gene promoter polymorphisms with recurrent miscarriage: a meta‐analysis
Authors: Su Duo , Zhang Yeye , Wang Qingqin , Wang Jing , Jiao Baoquan , Wang Gang , Wu Xiaohua
Published: July 2016

Problem

The association between IL‐10 gene promoter polymorphisms and the risk of recurrent miscarriages (RM) remains controversial. The present meta‐analysis was performed to derive a precise estimate of the relationship.

Method of study

We searched the PubMed and EMBASE for studies related to the association between the IL‐10 gene polymorphism and the risk of RM. Summary odds ratio (OR) with 95% confidence interval (CI) was estimated to assess the associations.

Results

Thirteen studies, including 2047 RM cases and 2055 control samples, were identified. The results showed a significant association between rs1800896, rs1800871 and RM risk (for rs1800896: GA+GG vs AA: OR=1.20, 95% CI=1.04–1.39, P=.02; for rs1800871: CT+TT vs CC: OR=1.64, 95% CI=1.13–2.36, P=.009). No evidence of association was noted between rs1800872 haplotype and RM risk.

Conclusion

IL‐10 gene promoter polymorphisms, rs1800896 and rs1800871, play a potential role in increasing the risk of RM.
Inherited thrombophilia in women with poor aPL‐related obstetric history: prevalence and outcomes. Survey of 208 cases from the European Registry on Obstetric Antiphospholipid Syndrome cohort
Authors: Alijotas‐Reig Jaume , Ferrer‐Oliveras Raquel , Esteve‐Valverde Enrique , Ruffatti Amelia , Tincani Angela , Lefkou Elmina , Bertero Maria Tiziana , Espinosa Gerard , Coloma Emmanuel , de Carolis Sara , Rovere‐Querini Patrizia , Canti Valentina , Picardo Elisa , Fredi Micaela , Mekinian Arsene ,   the EUROAPS Study Group
Published: July 2016

Aim

To analyse the prevalence and effects of inherited thrombophilic disorders (ITD) on maternal–foetal outcomes in cases of antiphospholipid antibody related to obstetric complications.

Methods

Women with obstetric complaints who tested positive for aPL and with inherited thrombophilia were prospectively and retrospectively included.

Results

ITD data were available in 208 of 338: 147 had obstetric antiphospholipid syndrome (OAPS) and 61 aPL‐related obstetric morbidity (OMAPS). 24.1% had ITD. Laboratory categories I and IIa were more related to OAPS‐ITD and IIb and IIc to OMAPS‐ITD. No significant differences in obstetric complaints were observed. Regarding ITD carriers, treatment rates were higher in OAPS than in OMAPS for LMWH and LDA plus LMWH (P=.002).

Conclusion

Cases with aPL‐related OAPS/OMAPS showed no differences in maternal–foetal outcomes regardless of the presence of one ITD. Maternal thrombotic risk was low, with ITD‐positive cases included. Registry data concur with Sydney criteria, whereby aPL‐ITD‐positive patients are classified as having antiphospholipid syndrome.
Mechanism of Self‐Regulation and In Vivo Performance of the Cleveland Clinic Continuous‐Flow Total Artificial Heart
Authors: Horvath David , Byram Nicole , Karimov Jamshid H. , Kuban Barry , Sunagawa Gengo , Golding Leonard A.R. , Moazami Nader , Fukamachi Kiyotaka
Published: July 2016

Cleveland Clinic's continuous‐flow total artificial heart (CFTAH) provides systemic and pulmonary circulations using one assembly (one motor, two impellers). The right pump hydraulic output to the pulmonary circulation is self‐regulated by the rotating assembly's passive axial movement in response to atrial differential pressure to balance itself to the left pump output. This combination of features integrates a biocompatible, pressure‐balancing regulator with a double‐ended pump. The CFTAH requires no flow or pressure sensors. The only control parameter is pump speed, modulated at programmable rates (60–120 beats/min) and amplitudes (0 to ±25%) to provide flow pulses. In bench studies, passive self‐regulation (range: −5 mm Hg ≤ [left atrial pressure – right atrial pressure] ≤ 10 mm Hg) was demonstrated over a systemic/vascular resistance ratio range of 2.0–20 and a flow range of 3–9 L/min. Performance of the most recent pump configuration was demonstrated in chronic studies, including three consecutive long‐term experiments (30, 90, and 90 days). These experiments were performed at a constant postoperative mean speed with a ±15% speed modulation, demonstrating a totally self‐regulating mode of operation, from 3 days after implant to explant, despite a weight gain of up to 40%. The mechanism of self‐regulation functioned properly, continuously throughout the chronic in vivo experiments, demonstrating the performance goals.
Early Opacifiers In The Glaze Industry Of First Millennium bc Persia: Persepolis And Tepe Rabat
Authors: Holakooei P. , Ahmadi M. , Volpe L. , Vaccaro C.
Published: July 2016

This study characterizes the opacifiers and colouring agents used in the glazed bricks of Persepolis (mid‐first millennium bc) and the Mannean site of Tepe Rabat in north‐western Iran (eighth to seventh centuries bc). Various analytical studies show that lead antimonate and brizziite (NaSbO3) were used as the yellow and white opacifiers in the glazes of Persepolis and Tepe Rabat. Brizziite is shown to be incorporated in the white, green and turquoise glazes, and is also associated with lead antimonate and CaSb2O6 in some yellow and white opacifiers. The simultaneous formation of these opacifiers in one glaze might have been accidental. A possible connection between the Achaemenid glaze industry and the Mannean glaze production at Tepe Rabat is discussed.
Drug‐Mediated Gene Regulation of Vitamin D3 Metabolism in Primary Human Dermal Fibroblasts
Authors: Norlin Maria , Lundqvist Johan , Ellfolk Maria , Hellström Pigg Maritta , Gustafsson Jan , Wikvall Kjell
Published: July 2016

Vitamin D metabolism was studied in primary human dermal fibroblasts with focus on drug‐mediated gene regulation related to adverse side effects of antiretroviral drugs used in HIV therapy. The fibroblasts expressed mRNA for cytochrome P450 (CYP) enzymes catalysing bioactivating (CYP2R1, CYP27A1 and CYP27B1) and catabolic reactions (CYP24A1). The cells produced both 25‐hydroxyvitamin D3 and 1α,25‐dihydroxyvitamin D3. The results demonstrate that primary dermal fibroblasts have an active vitamin D3‐metabolizing system. High incidence of low bone mineral density is a concern for HIV‐infected patients treated with antiretroviral drugs. Osteomalacia and severe vitamin D deficiency have been reported. We investigated whether drug‐mediated gene regulation could be a possible mechanism behind these adverse drug effects. Fibroblasts were treated with different drugs used in HIV therapy, and the 1α,25‐dihydroxyvitamin D3 levels and relative mRNA levels for crucial enzymes were determined. Efavirenz, stavudine and ritonavir significantly down‐regulated the bioactivating CYP2R1 and up‐regulated the catabolic CYP24A1. The drugs reduced bioactivating enzyme activities and cellular levels of 1α,25‐dihydroxyvitamin D3. The current results indicate that effects on gene expression may lead to disturbed vitamin D metabolism and decreased cellular levels of active vitamin D3. The data are consistent with the impaired bone health in patients treated with certain antiretroviral drugs.
Limited‐information goodness‐of‐fit testing of diagnostic classification item response models
Authors: Hansen Mark , Cai Li , Monroe Scott , Li Zhen
Published: July 2016

Despite the growing popularity of diagnostic classification models (e.g., Rupp et al., 2010, Diagnostic measurement: theory, methods, and applications, Guilford Press, New York, NY) in educational and psychological measurement, methods for testing their absolute goodness of fit to real data remain relatively underdeveloped. For tests of reasonable length and for realistic sample size, full‐information test statistics such as Pearson's X2 and the likelihood ratio statistic G2 suffer from sparseness in the underlying contingency table from which they are computed. Recently, limited‐information fit statistics such as Maydeu‐Olivares and Joe's (2006, Psychometrika, 71, 713) M2 have been found to be quite useful in testing the overall goodness of fit of item response theory models. In this study, we applied Maydeu‐Olivares and Joe's (2006, Psychometrika, 71, 713) M2 statistic to diagnostic classification models. Through a series of simulation studies, we found that M2 is well calibrated across a wide range of diagnostic model structures and was sensitive to certain misspecifications of the item model (e.g., fitting disjunctive models to data generated according to a conjunctive model), errors in the Q‐matrix (adding or omitting paths, omitting a latent variable), and violations of local item independence due to unmodelled testlet effects. On the other hand, M2 was largely insensitive to misspecifications in the distribution of higher‐order latent dimensions and to the specification of an extraneous attribute. To complement the analyses of the overall model goodness of fit using M2, we investigated the utility of the Chen and Thissen (1997, J. Educ. Behav. Stat., 22, 265) local dependence statistic for characterizing sources of misfit, an important aspect of model appraisal often overlooked in favour of overall statements. The statistic was found to be slightly conservative (with Type I error rates consistently below the nominal level) but still useful in pinpointing the sources of misfit. Patterns of local dependence arising due to specific model misspecifications are illustrated. Finally, we used the M2 and statistics to evaluate a diagnostic model fit to data from the Trends in Mathematics and Science Study, drawing upon analyses previously conducted by Lee et al., (2011, IJT, 11, 144).
Effects of a novel potent melanin‐concentrating hormone receptor 1 antagonist, AZD1979, on body weight homeostasis in mice and dogs
Authors: Ploj Karolina , Benthem Lambertus , Kakol‐Palm Dorota , Gennemark Peter , Andersson Liselotte , Bjursell Mikael , Börjesson Jenny , Kärrberg Lillevi , Månsson Marianne , Antonsson Madeleine , Johansson Anders , Iverson Suzanne , Carlsson Björn , Turnbull Andrew , Lindén Daniel
Published: July 2016

Background and Purpose

Melanin‐concentrating hormone (MCH) is an orexigen, and while rodents express one MCH receptor (MCH1 receptor), humans, non‐human primates and dogs express two MCH receptors (MCH1 and MCH2). MCH1 receptor antagonists have been developed for the treatment of obesity and lower body weight in rodents. However, the mechanisms for the body weight loss and whether MCH1 receptor antagonism can lower body weight in species expressing both MCH receptors are not fully understood.

Experimental Approach

A novel recently identified potent MCH1 receptor antagonist, AZD1979, was studied in wild type and Mchr1 knockout (KO) mice and by using pair‐feeding and indirect calorimetry in diet‐induced obese (DIO) mice. The effect of AZD1979 on body weight was also studied in beagle dogs.

Key Results

AZD1979 bound to MCH1 receptors in the CNS and dose‐dependently reduced body weight in DIO mice leading to improved homeostasis model assessment‐index of insulin sensitivity. AZD1979 did not affect food intake or body weight in Mchr1 KO mice demonstrating specificity for the MCH1 receptor mechanism. In DIO mice, initial AZD1979‐mediated body weight loss was driven by decreased food intake, but an additional component of preserved energy expenditure was apparent in pair‐feeding and indirect calorimetry studies. AZD1979 also dose‐dependently reduced body weight in dogs.

Conclusion and Implications

AZD1979 is a novel potent MCH1 receptor antagonist that affects both food intake and energy expenditure. That AZD1979 also lowers body weight in a species expressing both MCH receptors holds promise for the use of MCH1 receptor antagonists for the treatment of human obesity.
Short (6‐mm) dental implants versus sinus floor elevation and placement of longer (≥10‐mm) dental implants: a randomized controlled trial with a 3‐year follow‐up
Authors: Bechara Souheil , Kubilius Ricardas , Veronesi Giovanni , Pires Jefferson T. , Shibli Jamil A. , Mangano Francesco G.
Published: July 2016

Objectives

To investigate whether short (6‐mm) dental implants could be an alternative to sinus floor elevation (SFE) and placement of longer (≥10‐mm) implants in the posterior maxilla.

Materials and methods

Over a 3‐year period, all patients presenting with partial edentulism in the posterior maxilla were considered for inclusion in this randomized controlled trial. Patients were randomly chosen either to receive short (6‐mm) implants (test group [TG]) or to undergo SFE with simultaneous placement of standard‐length (≥10‐mm) implants (control group [CG]). SFE was performed using the lateral technique. In both groups, tapered implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. All implants were loaded after 4 months of healing. At each annual follow‐up session, clinical and radiographic parameters were assessed. Primary outcomes were implant survival, stability (measured with the implant stability quotient [ISQ]), marginal bone loss (MBL), and complications; secondary outcomes were patient satisfaction and treatment time and cost.

Results

Thirty‐three patients were assigned to the TG and 20 to the CG. Forty‐five implants were inserted in each group. At 3 years, implant survival rates were 100% and 95.0% for the TG and CG, respectively; this difference was not statistically significant (P = 0.38). The mean ISQ values of the TG and CG did not differ at placement (68.2 vs. 67.8, P = 0.1), at delivery of the final restoration (69.5 vs. 69.4, P = 0.9), and after 1 year (71.0 vs. 71.5, P = 0.1); at 3 years, the CG had a significantly higher mean ISQ than the TG (72.4 vs. 71.6, P = 0.004). Mean MBL was significantly higher in the CG than in the TG, both at 1 year (0.14 mm vs. 0.21 mm, P = 0.006) and at 3 years (0.20 mm vs. 0.27 mm, P = 0.01). A few complications were reported. Surgical time and cost were significantly higher in the CG than in the TG (P < 0.0001). Patient satisfaction was high in both groups.

Conclusions

In this randomized controlled trial, results for short (6‐mm) implants were similar to those for longer (≥10‐mm) implants in augmented bone. Short implants might be preferable to SFE, because the treatment is faster and less expensive. Long‐term randomized controlled trials are required to confirm these results.
Preoperative endoscopy may reduce the need for revisional surgery for gastro‐oesophageal reflux disease following laparoscopic sleeve gastrectomy
Authors: Madhok B. M. , Carr W. R. J. , McCormack C. , Boyle M. , Jennings N. , Schroeder N. , Balupuri S. , Small P. K.
Published: July 2016

Laparoscopic sleeve gastrectomy is a safe and effective bariatric operation, but postoperative reflux symptoms can sometimes necessitate revisional surgery. Roux‐en‐Y gastric bypass is the preferred operation in morbidly obese patients with gastro‐oesophageal reflux disease. In 2011, we introduced preoperative endoscopy to assess for hiatus hernia or evidence of oesophagitis in conjunction with an assessment of gastro‐oesophageal reflux symptoms for all patients undergoing bariatric surgery with a view to avoid sleeve gastrectomy for these patients. A prospectively maintained database was used to identify patients who underwent sleeve gastrectomy before and after we changed the unit policy. The need for revisional surgery in patients with troublesome gastro‐oesophageal reflux disease was examined. Prior to 2011, 130 patients underwent sleeve gastrectomy, and 11 (8.5%) of them required conversion to Roux‐en‐Y gastric bypass for symptomatic reflux disease. Following the policy change, 284 patients underwent sleeve gastrectomy, and to date, only five (1.8%) have required revisional surgery (p = 0.001). Baseline demographics were comparable between the groups, and average follow‐up period was 47 and 33 months, respectively, for each group. Preoperative endoscopy and a detailed clinical history regarding gastro‐oesophageal reflux symptoms may improve patient selection for sleeve gastrectomy. Avoiding sleeve gastrectomy in patients with reflux disease and/or hiatus hernia may reduce the incidence of revisional surgery.
Prognostic role of liver X receptor‐alpha in resected stage II and III non‐small‐cell lung cancer
Authors: Melloni Giulio , Muriana Piergiorgio , Bandiera Alessandro , Fontana Raffaella , Maggioni Daniela , Russo Vincenzo , Doglioni Claudio , Zannini Piero
Published: July 2016

Introduction

In the search of new therapeutical strategies against non‐small‐cell lung cancer (NSCLC), the identification of new prognostic factors is crucial.

Objectives

In this study, we analyzed the prognostic value of the liver X receptor‐alpha (LXR‐alpha), a nuclear receptor of a family of cholesterol derivatives called oxysterols, in patients with radically resected NSCLC.

Methods

We retrospectively reviewed 140 stage II and III surgically treated NSCLC patients that were grouped by percentage of LXR‐alpha‐positive cells value above or below its median value. Tumor‐related survival was evaluated as primary end point.

Results

The 5‐year overall and tumor‐related survival rates were 40% and 46%, respectively. The median percentage of LXR‐alpha‐positive cells was 20%. Patients with stage II NSCLC had higher LXR‐alpha values than those with stage III (P = .04). Univariate analysis demonstrated that both TNM stage and LXR‐alpha were significantly related to tumor‐related survival (P = .006 and P = .004, respectively). The 5‐year tumor‐related survival rates in stage II and III NSCLC were 56% and 34%, respectively. The 5‐year tumor‐related survival rates in high and low LXR‐alpha value were 57% and 32%, respectively. The multivariate analysis showed that both TNM stage and LXR‐alpha were independent prognostic factors (P = .01 and P = .007, respectively) with hazard ratio of 1.92 and 0.49, respectively.

Conclusion

LXR‐alpha seems to be an independent prognostic factor indicating a better survival in completely resected stage II and III NSCLC patients.
Self‐reported reasons for treatment non‐adherence in Chinese asthma patients: A 24‐week prospective telephone follow‐up study
Authors: Ma Qianli , Luo Guangming , Zhou Xiangdong , Huang Ying , Liu Enmei , Hong Xin , Mao Liangping , Wu Yamei , Chen Xumei , Liao Xiuqing , Qin Guangmei , Wang Daoxin , Li Lian , Zhang Shifu , Wang Changzheng
Published: July 2016

Background

Treatment non‐adherence is a challenge to achieve asthma control. However, few prospective studies were done for exploring asthma patient adherence in real world.

Objectives

To evaluate treatment adherence and causes of non‐adherence in a large asthma Chinese population. To analyze newly‐diagnosed patients' adherence first time.

Methods

About 1582 asthma patients' data were collected from 12 study centers in China from February, 2012 to October, 2012. Disease and treatment information of subjects were collected were at first clinic visit, at 4, 12, and 24 weeks after that, follow‐up phone calls were carried out for recording subjects' treatment adherence based on their self‐reports. Subjects who reported non‐adherence were additionally asked to choose the primary non‐adherence cause from a list of nine potential causes.

Results

Treatment adherence rate of all subjects markedly decreased from 83.3% at week 4 to 42.0% at week 24 after the first clinic visit. Significantly, at week 24, good treatment adherence rate in newly‐diagnosed patients was lower than those patients with asthma history (22.9% vs. 63.9%, P < .001). Newly‐diagnosed patients were three times more likely to become non‐adherence than those patients with asthma history. Female patients had lower treatment adherence rate than male patients (38.3% vs. 45.6%, P = .006). Subjects in 30‐39 year age group had the worst treatment adherence (27.3%). The most commonly chosen cause for non‐adherence was “relief of symptoms after short‐term controller medication use” (43.8%).

Conclusions

Asthma patients' treatment adherence could be improved by improving patient education, doctor/patient partnership, and level of medical service in Chinese population.
Swyer–James–Macleod syndrome mimicking an acute pulmonary embolism: a report of six adult cases and a retrospective analysis
Authors: Akgedik Recep , Karamanli Harun , Aytekin İlknur , Kurt Ali Bekir , Öztürk Hasan , Dağlı Canan Eren
Published: July 2016

Background and Aim

In patients with pulmonary embolism (PE), a pulmonary radiograph may reveal oligemic fields (the Westermark sign) associated with sites of occlusion of the pulmonary arteries, interruption or loss of the artery line (the knuckle sign), and even unilateral hyperlucency attributable to reduced overall lung vascularity. In Swyer–James–Macleod syndrome (SJMS), which develops as a result of bronchiolitis obliterans, unilateral hyperlucency is evident because of emphysema and hypoplasia of the pulmonary artery and its branches. Therefore, SJMS cases with clinical and laboratory data compatible with PE may in fact be confused with PE. The cases of six adult patients who were initially presumed to have PE but on further investigation were diagnosed with SJMS are presented in this report, which thus can serve as a guide for diagnosis of similar cases in future.

Methods

We studied six adult patients who presented with dyspnea. Their pulmonary radiographs revealed lobar/unilateral hyperlucency and PE was initially suspected. The pulmonary artery and branches thereof exhibited parenchymal emphysema and hypoplasia, and we thus diagnosed SJMS.

Results

We studied 4 males and 2 females with a mean age of 51 years (range, 20–73 years). Left lung involvement was evident in five cases.

Conclusion

Unilateral hyperlucency may be a feature of both PE and SJMS. Although these conditions are very different, both present similarly in radiographic terms and may be easily confused when the clinical data and the anamnesis raise a suspicion of PE, causing unnecessary testing and treatment.
Perforating pseudoxanthoma elasticum with secondary elastosis perforans serpiginosa‐like changes: dermoscopy, confocal microscopy and histopathological correlation
Authors: Nasca Maria Rita , Lacarrubba Francesco , Caltabiano Rosario , Verzì Anna Elisa , Micali Giuseppe
Published: July 2016

Pseudoxanthoma elasticum is a rare congenital inherited elastolytic disorder that has sometimes been observed in association with transepidermal elimination of altered and calcified elastic fibers resulting in elastosis perforans serpiginosa‐like changes. In this case, histopathology is usually performed to rule out other conditions. The case of a 38‐year‐old woman with two slowly enlarging asymptomatic plaques occurring on the neck and surrounded by coalescing yellowish papules with a typical cobblestone appearance, evaluated by polarized light dermoscopy and reflectance confocal microscopy with histopathologic correlations, is described. Noteworthy, with reflectance confocal microscopy, the transepidermal elimination of the altered elastic fibers in the plaques was detected as hyperreflective material filling the dermal papillae, whereas the transversal cleavage of the calcified elastic fibers yielded a peculiar ‘eggs‐in‐the‐basket’ feature.
Operations Course Icebreaker: Campus Club Cupcakes Exercise
Authors: Snider Brent , Southin Nancy
Published: July 2016

Campus Club Cupcakes is an in‐class ‘introduction to operations management’ experiential learning exercise which can be used within minutes of starting the course. After reading the one‐page mini case, students are encouraged to meet each other and collaborate to determine if making and selling cupcakes to fellow business students would be a viable fundraising activity for a student club interested in completing a community development project in a developing country. The exercise is a variation and extension of the popular Kristen's Cookie Co. Harvard case which addresses capacity and bottlenecks. Campus Club additionally incorporates supply chain management and risk management concepts while also revealing how operations management integrates with the functional areas of marketing, accounting, and finance.
An Active Learning Exercise for Product Design from an Operations Perspective
Authors: Hill Stephen , Baker Elizabeth
Published: July 2016

Product design is a topic that is regularly covered in introductory operations management courses. However, a pedagogical challenge exists related to the presentation of introductory‐level product design in a way that promotes active learning. The hands‐on exercise presented in this article provides instructors with an activity that gives students an open‐ended opportunity to quickly develop a realistic product from conception to prototype. A unique material is used that allows students the flexibility to freely form a product prototype. A description of the exercise and an assessment of its efficacy in promoting student understanding of product design from an operations perspective are presented. Opportunities for future work are also identified.
Embryonic development of the larval eyes of the Sunburst Diving Beetle, Thermonectus marmoratus (Insecta: Dytiscidae): a morphological study
Authors: Stecher Nadine , Stowasser Annette , Stahl Aaron , Buschbeck Elke K.
Published: July 2016

Stemmata, the larval eyes of holometabolous insects are extremely diverse, ranging from full compound eyes, to a few ommatidial units as are typical in compound eyes, to sophisticated and functionally specialized image‐forming camera‐type eyes. Stemmata evolved from a compound eye ommatidial ancestor, an eye type that is morphologically well conserved in regards to cellular composition, and well studied in regards to development. However, despite this evolutionary origin it remains largely unknown how stemmata develop. In addition, it is completely unclear how development is altered to give rise to some of the functionally most complex stemmata, such as those of the sunburst diving beetle, Thermonectus marmoratus. In this study, we used histological methods to investigate the embryonic development of the functionally complex principal stemmata Eye 1 and Eye 2 of the larval visual system of T. marmoratus. To gain insights into how cellular components of their sophisticated camera‐type eyes might have evolved from the cellular components of ommatidial ancestors, we contrast our findings against known features of ommatidia development, which are particularly well understood in Drosophila. We find many similarities, such as the early presence of a pseudostratified epithelium, and the order in which specific cell types are recruited. However, in Thermonectus each cell type is represented by a large number of cells from early on and major tissue re‐orientation occurs as eye development progresses. This study provides insights into the timing of morphological features and represents the basis for future molecular studies.
Juvenile social status predicts primary sex allocation in a sex changing fish
Authors: Solomon‐Lane Tessa K. , Shvidkaya Polina , Thomas Alma , Williams Megan M. , Rhyne Andrew , Rogers Lock , Grober Matthew S.
Published: July 2016

Both individual sex and population sex ratio can affect lifetime reproductive success. As a result, multiple mechanisms have evolved to regulate sexual phenotype, including adult sex change in fishes. While adult sex change is typically socially regulated, few studies focus on the non‐chromosomal mechanisms regulating primary sex allocation. We investigated primary sex determination in the bluebanded goby (Lythrypnus dalli), a bidirectionally sex‐changing fish. Of the studies investigating primary sex determination in species with adult sex change, this is the first to incorporate the roles of social status and size, key factors for determining adult sex allocation. For L. dalli, adult sex is regulated by social status: dominants are male; subordinates are female. In social groups of laboratory‐reared juveniles, we demonstrate that status also predicts primary sex. Dominant juveniles developed male‐typical genitalia, and their gonads contained significantly less ovarian tissue than subordinates, which developed female‐typical genitalia. To better understand natural development, we quantified the distribution of juveniles and adults on the reef and analyzed genital papilla and gonad morphology in a sample of wild‐caught juveniles. Juveniles were observed in various social environments, and most grouped with other juveniles and/or adults. The majority of field‐caught juveniles had female‐typical genitalia and bisexual, female‐biased gonads. These data are consistent with a single mechanism that regulates sexual phenotype throughout life. Social status could first cause and then maintain through adulthood a female‐biased population, allowing individuals to regulate sex based on local conditions, which is important for optimizing lifetime reproductive success.
A life‐history perspective on the demographic drivers of structured population dynamics in changing environments
Authors: Koons David N. , Iles David T. , Schaub Michael , Caswell Hal
Published: July 2016

Current understanding of life‐history evolution and how demographic parameters contribute to population dynamics across species is largely based on assumptions of either constant environments or stationary environmental variation. Meanwhile, species are faced with non‐stationary environmental conditions (changing mean, variance, or both) created by climate and landscape change. To close the gap between contemporary reality and demographic theory, we develop a set of transient life table response experiments (LTREs) for decomposing realised population growth rates into contributions from specific vital rates and components of population structure. Using transient LTREs in a theoretical framework, we reveal that established concepts in population biology will require revision because of reliance on approaches that do not address the influence of unstable population structure on population growth and mean fitness. Going forward, transient LTREs will enhance understanding of demography and improve the explanatory power of models used to understand ecological and evolutionary dynamics.
Experimental and numerical analysis of thermal striping in automotive brake discs
Authors: Augustins L. , Hild F. , Billardon R. , Boudevin S.
Published: July 2016

In the present study, thermal striping development on friction bands of brake discs is investigated through an experimental and numerical analysis. A test consisting of a series of several hundred severe brakings was carried out on a specific bench at PSA Peugeot Citroën. The experimental observations of the crack network evolution and a numerical analysis of a brake disc with a single crack helped to propose a macroscopic criterion capable of predicting the criticality of the network, namely its ability to lead to the complete failure of the structure. In addition, a numerical analysis of the crack shielding process is developed, whose results are compared with experimental findings.
Bloom or bust: synchrony in jellyfish abundance, fish consumption, benthic scavenger abundance, and environmental drivers across a continental shelf
Authors: Smith Brian E. , Ford Michael D. , Link Jason S.
Published: July 2016

Increases in gelatinous zooplankton (GZ) populations, their dominance of some ecosystems, their impacts to other taxa, and their questionable trophic value remain global concerns, but they are difficult to quantify. We compared trends in GZ abundance from direct sampling for the northeast U.S. continental shelf and tested their association with GZ consumption by spiny dogfish (Squalus acanthias); the abundance of two benthic scavengers: Atlantic hagfish (Myxine glutinosa) and grenadiers (Family: Macrouridae); and four environmental indices: Atlantic Multidecadal Oscillation, North Atlantic Oscillation, and sea surface and bottom temperatures. Defined as scyphozoans, siphonophores, ctenophores, and salps, the abundance of GZ on the shelf has oscillated with blooms approximately every 10–15 yr. Conservative estimates of annual removal of GZ by spiny dogfish ranged from approximately 0.3–298 g individual−1 with spiny dogfish being the primary GZ feeder sampled on the shelf. The examination of three abundance series for GZ identified one shelf‐wide trend and strong relationships with 2‐yr lagged consumption and scavenger abundance (namely hagfish), and sea surface temperature. With multimodel inference, these covariates led to an optimal model of GZ abundance. Blooms of GZ abundance on this shelf were influenced by environmental change, provide surges of food for spiny dogfish, and may offer ‘food falls’ for scavenging fishes. The bioenergetic tradeoffs of consuming greater amounts of GZ compared to other major prey (e.g., fishes) remain unknown; however, these surges of food in the northwest Atlantic appear to be important for fishes, including support for benthic scavenger productivity.
Humic acid can mitigate the toxicity of small copper oxide nanoparticles to microbial decomposers and leaf decomposition in streams
Authors: Pradhan Arunava , Geraldes Paulo , Seena Sahadevan , Pascoal Cláudia , Cássio Fernanda
Published: July 2016

As the use of copper oxide nanoparticles (nanoCuO) in consumer products grows, aquatic ecosystems are likely to receive increasing amounts of these nanomaterials. Dissolved organic matter (DOM) may interact with nanoparticles and reduce their reactive surface area, which, in turn, can influence the impact of nanoCuO on organisms and ecological processes.

We conducted a microcosm experiment to investigate the impacts of three size classes of nanoCuO (12, 50 and 80 nm mean diameter of the primary particles; five levels up to 400 mg L−1) and humic acid (three levels up to 100 mg L−1), as a major component of DOM, on microbial decomposers and leaf decomposition as an important ecosystem process in forest streams.

Exposure to nanoCuO for 20 days reduced decomposition rate and fungal and bacterial biomass, fungal sporulation and spore diversity associated with the decomposing leaves. The effects were stronger as nanoparticle size decreased and the specific surface area increased. More dissolved ionic copper was released from the small nanoparticles, suggesting that Cu2+ could have played a role in the observed size‐dependent toxicity of nanoCuO.

Bacteria appeared to be more sensitive to nanoCuO than fungi since nanoparticles reduced the biomass of bacteria at lower concentrations than that of fungi (EC20 was 22 times lower for small and medium‐sized nanoparticles, and five times lower for large particles). However, fungal sporulation was the variable most sensitive to nanoCuO exposure (EC20 = 0.2 mg L−1 for the small nanoparticles).

Microbial activity on the decomposing leaves was also inhibited by exposure to humic acid alone. However, humic acid also mitigated the adverse effects of the small and medium‐sized nanoCuO on both the microbial decomposers and leaf decomposition.

Overall, our microcosm experiment indicates that nanoCuO toxicity to microbial decomposers and leaf decomposition depends on particle size and the presence of DOM. This highlights the importance of considering environmental context and the specific properties of particles to assess toxicity of nanomaterials in stream ecosystems.
Age‐specific risk factors for incident disability in activities of daily living among middle‐aged and elderly community‐dwelling Japanese women during an 8–9‐year follow up: The Hizen‐Oshima study
Authors: Okabe Takuhiro , Abe Yasuyo , Tomita Yoshihito , Mizukami Satoshi , Kanagae Mitsuo , Arima Kazuhiko , Nishimura Takayuki , Tsujimoto Ritsu , Tanaka Natsumi , Goto Hisashi , Horiguchi Itsuko , Aoyagi Kiyoshi
Published: July 2016

Aim

The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle‐aged and older women, and to determine whether there are differences in risk factors according to age groups.

Methods

The participants were 264 Japanese women aged 40 years and older. A self‐administered questionnaire was used to survey participants about difficulty in carrying out selected basic and instrumental ADL at baseline and at follow up. ADL disability was defined as difficulty carrying out three or more ADL. Information on knee joint or back pain and comorbidities (heart disease, lung disease, stroke or diabetes mellitus) was obtained using a self‐administered questionnaire at baseline. Physical performance measurements (grip strength, chair stand time, rapid walking speed and functional reach) were also carried out at baseline.

Results

The prevalence of incident ADL disability was 44 (27.5%) in women aged 40–64 years, and 57 (54.8%) in women aged ≥65 years (P < 0.001). Multiple logistic regression analysis showed that decreased grip strength and having pain were significantly associated with a higher risk for incident ADL disability among women aged 40–64 years. For women aged ≥65 years, decreased rapid walking speed, having a comorbidity and having pain were associated with incident ADL disability.

Conclusions

The present study showed that a different set of risk factors was associated with incident ADL disability among women aged 40–64 years and women aged ≥65 years. Age‐specific screening and intervention strategies are necessary for effective prevention of incident ADL disability. Geriatr Gerontol Int 2017; 17: 1096–1101.