bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the effects of mindfulness-based interventions for informal palliative caregivers: A systematic literature review
Authors: Jaffray Linda , Bridgman Heather , Stephens Miranda , Skinner Timothy
Published: August 2015

Background:

There is a need to identify proactive, evidence-based interventions to support informal palliative caregivers. Mindfulness-based interventions, evidenced in the literature as providing physical and mental health benefits for diverse populations, may have application in the setting of palliative caregiving.

Aim:

To describe, evaluate and synthesise the peer-reviewed literature on the effects of mindfulness-based interventions for informal palliative caregivers.

Design:

A Systematic Literature Review according to the Preferred Reporting Items for Systematic Review and Meta Analyses guidelines and a Narrative synthesis.

Data sources:

The Cochrane Library, CINAHL, MEDLINE, PsycINFO and EMBASE databases, searched from inception to February 2014 and references of included studies.

Results:

A total of 13 articles, reporting 10 studies ( n = 432 participants) were included. All studies were conducted in the last 5 years. Dementia caregivers were the most frequently researched population ( n = 7). Results suggest that mindfulness-based interventions are feasible and acceptable to offer to informal palliative caregivers and may provide benefit, particularly in terms of reducing depression and caregiver burden and increasing quality of life. However, effects were not as robust as findings in the wider mindfulness intervention literature.

Conclusion:

This is the first systematic literature review on this topic. Results suggest both feasibility and potential benefit. Further qualitative research is required to explore the outcomes identified by informal caregivers themselves as the reduced magnitude of effect may suggest that we are not measuring the right outcomes in this context. This would inform more sensitive outcome measures for future intervention studies and guide the development and application of mindfulness-based models in this area.
Eye Movements as Indicators of Vestibular Dysfunction
Authors: Menshikova Galina Ya. , Kovalev Artem I. , Klimova Oxana A. , Chernorizov Alexander M.
Published: August 2015

Virtual reality technologies are in wide use in sport psychology. An advantage of this kind of technology is the possibility to assess sportspeople’s readiness to perform complex movements. This study is aimed at developing a method for the evaluation of vestibular function disturbances in young skaters. Such disturbances may occur while skaters are performing rotation movements. To achieve this goal, we induced a vection illusion, accompanied by virtual environment rotation in a CAVE virtual reality system. Vestibular disturbances were tested for two groups—professional skaters and people who had very little or no skating experience. The quantitative evaluation of vestibular dysfunction was based on eye movement characteristics, which were recorded in subjects experiencing a vection illusion.
Patellofemoral Pressure Changes After Static and Dynamic Medial Patellofemoral Ligament Reconstructions
Authors: Rood Akkie , Hannink Gerjon , Lenting Anke , Groenen Karlijn , Koëter Sander , Verdonschot Nico , van Kampen Albert
Published: August 2015

Background:

Reconstructing the medial patellofemoral ligament (MPFL) has become a key procedure for stabilizing the patella. Different techniques to reconstruct the MPFL have been described: static techniques in which the graft is fixed rigidly to the bone or dynamic techniques with soft tissue fixation. Static MPFL reconstruction is most commonly used. However, dynamic reconstruction deforms more easily and presumably functions more like the native MPFL.

Purpose/Hypothesis:

The aim of the study was to evaluate the effect of the different MPFL fixation techniques on patellofemoral pressures compared with the native situation. The hypothesis was that dynamic reconstruction would result in patellofemoral pressures closer to those generated in an intact knee.

Study Design:

Controlled laboratory study.

Methods:

Seven fresh-frozen knee specimens were tested in an in vitro knee joint loading apparatus. Tekscan pressure-sensitive films fixed to the retropatellar cartilage measured mean patellofemoral and peak pressures, contact area, and location of the center of force (COF) at fixed flexion angles from 0° to 110°. Four different conditions were tested: intact, dynamic, partial dynamic, and static MPFL reconstruction. Data were analyzed using linear mixed models.

Results:

Static MPFL reconstruction resulted in higher peak and mean pressures from 60° to 110° of flexion ( P < .001). There were no differences in pressure between the 2 different dynamic reconstructions and the intact situation ( P > .05). The COF in the static reconstruction group moved more medially on the patella from 50° to 110° of flexion compared with the other conditions. The contact area showed no significant differences between the test conditions.

Conclusion:

After static MPFL reconstruction, the patellofemoral pressures in flexion angles from 60° to 110° were 3 to 5 times higher than those in the intact situation. The pressures after dynamic MPFL reconstruction were similar as compared with those in the intact situation, and therefore, dynamic MPFL reconstruction could be a safer option than static reconstruction for stabilizing the patella.

Clinical Relevance:

This study showed that static MPFL reconstruction results in higher patellofemoral pressures and thus enhances the chance of osteoarthritis in the long term, while dynamic reconstruction results in more normal pressures.
Use of Optimization Modeling for Selecting National Micronutrient Intervention Strategies
Authors: Brown Kenneth H. , Engle-Stone Reina , Kagin Justin , Rettig Erica , Vosti Stephen A.
Published: August 2015

Vitamin and mineral (micronutrient [MN]) deficiencies are common in lower income countries, especially among young children and women of reproductive age. These deficiencies are cause for serious concern because of their high prevalence and their associated complications, which include depressed immune function and increased risk and severity of infections, impaired neurocognitive development, and anemia, which together result in elevated mortality and reduced human productive capacity. A broad range of different intervention strategies are available to control MN deficiencies. At present, these interventions are usually implemented at a national scale through different public and private sector entities, often with little coordination. We have developed a set of models based on the estimated ability of different interventions to achieve effective coverage and the necessary financial resources required to deploy these interventions. The models provide a unified and transparent framework for considering different options using the common indicator of effective coverage. More specifically, information on nutritional benefits and costs are analyzed using an economic optimization model to identify the mix of interventions that could be delivered to specific target groups in particular geographic areas to achieve a desired level of effective coverage at lowest cost. Alternatively, these optimization models can be developed to identify the combination of interventions needed to achieve the maximum effective coverage, given specified budgetary limitations. The results of these models can be useful input into policy-making processes. To introduce this analytical approach, the set of papers in this volume addresses the problem of vitamin A deficiency among young children in Cameroon.
The Subjective Court Experiences of Intimate Partner Violence Victims: Does Motherhood Matter?
Authors: Calton Jenna M. , Grossmann Jessica L. , Cattaneo Lauren Bennett
Published: August 2015

Many women with children experience intimate partner violence (IPV). These survivors are particularly important to assist, because countless have complex safety concerns related to their children. Mothers’ concerns about their children have been shown to impact their decision making related to abuse, but researchers have not closely explored what happens during mothers’ interactions with help sources. This study examined whether women with (n = 98) and without (n = 44) children differ in a) their court experiences through their perceptions of procedural and distributive justice, and b) the context of their lives surrounding the court experience. We also explored the relationship between contextual factors and procedural and distributive justice. Results indicate participants were relatively satisfied with their court experiences, despite experiencing reabuse, danger, and fear throughout court processes. Mothers reported significantly higher levels of distributive justice and contact with the abusive partner than non-mothers. However, mothers did not differ significantly from non-mothers with regard to procedural justice, fear, danger, reabuse or reliance on the abusive partner. Results of multiple regression analyses indicated the interaction between fear and motherhood significantly predicted participants’ perceptions of distributive justice, as did the interaction between danger and motherhood. In these interactions, mothers’ fear and perceptions of danger were not related to their perception of distributive justice. However, non-mothers who reported higher levels of fear and danger perceived less distributive justice. Results suggest mothers and non-mothers enter the system with similar life contexts, and that these contextual factors impact their perceptions of court outcomes differently.
Multi-criteria optimization and predictive modeling of turning forces in high-speed machining of yttria based zirconia toughened alumina insert using desirability function approach
Authors: Mandal Nilrudra , Doloi B , Mondal Biswanath , Singh BK
Published: August 2015

An attempt has been made to apply the Taguchi parameter design method and multi-response optimization using desirability analysis for optimizing the cutting conditions (cutting speed, feed rate and depth of cut) on machining forces while finish turning of AISI 4340 steel using developed yttria based zirconia toughened alumina inserts. These zirconia toughened alumina inserts were prepared through wet chemical co-precipitation route followed by powder metallurgy process. The L9 (4) orthogonal array of the Taguchi experiment is selected for three major parameters, and based on the mean response and signal-to-noise ratio of measured machining forces, the optimal cutting condition arrived for feed force is A1, B1 and C3 (cutting speed: 150 m/min, depth of cut: 0.5 mm and feed rate: 0.28 mm/rev) and for thrust and cutting forces is A3, B1 and C1 (cutting speed: 350 m/min, depth of cut: 0.5 mm and feed rate: 0.18 mm/rev) considering the smaller-the-better approach. Multi-response optimization using desirability function has been applied to minimize each response, that is, machining forces, simultaneously by setting a goal of highest cutting speed and feed rate criteria. From this study, it can be concluded that the optimum parameters can be set at cutting speed of 350 m/min, depth of cut of 0.5 mm and feed rate of 0.25 mm/rev for minimizing the forces with 78% desirability level.
Effects of flushing on electrical discharge machining and electro-arc machining
Authors: Zhang Min , Zhang Qinhe , Dou Liya , Liu Qingyu , Dong Chunjie
Published: August 2015

Both electrical discharge machining and electro-arc machining are non-contact machining processes, which use high temperatures produced by discharges to erode material. The gap between the tool and the workpiece is usually filled with liquid dielectric medium. Moreover, liquid flushing is commonly used in the machining processes of electrical discharge machining and electro-arc machining. Much research has been conducted to study the effects of flushing on these processes. However, there has been little study on the mechanism of the flushing procedure for these machining processes. In this article, electrical discharge machining and electro-arc machining experiments adopting different polarities and flow rates were designed and implemented. The plasma tunnel and crater morphology were studied. It was found that the plasma tunnel was lengthened, compressed and broken by flushing in the electro-arc machining experiment; however, the electrical discharge machining experiment did not produce this result. Similarly, tailing discharge craters and polarity effects caused by flushing were observed in the electro-arc machining experiment, while no such performances caused by flushing were found in the electrical discharge machining experiment. The flushing in electro-arc machining was able to reduce the material removal rate, tool wear rate and surface roughness simultaneously, while the effects of flushing in electrical discharge machining were inconspicuous. Moreover, the characteristics of the plasma tunnels of the electro-arc machining experiment were similar to those of arcs, which were different from those of the electrical discharge machining experiment. These results help to verify that the electro-arc machining process adopts arcs, while the electrical discharge machining process adopts sparks, during their respective material removal processes.
Parametric studying of low-profile vortex generators flow control in an aggressive inter-turbine duct
Authors: Zhang Yanfeng , Lu Xingen , Lei Zhijun , Han Ge , Zhu Junqiang , Hu Shuzhen
Published: August 2015

This paper presents a study of low-profile vortex generators flow control on the effect of casing boundary layer separation in an aggressive inter-turbine duct. Counter-rotating and co-rotating vortex generators configurations were tested parametrically to obtain the optimum low-profile vortex generators’ setup within the aggressive inter-turbine duct, in terms of the axial location, height, angle of attack and streamwise vortices per swirl vane pitch. Surface oil flow visualization was used to qualitatively examine the low-profile vortex generators eliminating the casing separation and subsequently the detailed seven-hole probe measurements were carried out to evaluate the loss reduction quantitatively. The inter-turbine duct examined for this study was more aggressive compared with the geometries found in the most current modern engine designs. Measurements were made inside the aggressive inter-turbine duct annulus at Reynolds number of 150,000. The flow structures within the aggressive inter-turbine duct were found to be dominated by counter-rotating vortices evolved by the swirl vanes and boundary layer separation in both casing and hub regions. A massive casing boundary layer separation extending from the duct first bend to the second bend was found within the aggressive inter-turbine duct. The primary source of pressure loss in the aggressive inter-turbine ducts was the result of the extensive casing boundary layer separation. Flow control by utilizing the low-profile vortex generators installed on the casing was conducted to eliminate the casing separation. Regardless of the vortex generator mitigating the casing separation associated with consequential loss reduction, a pair of casing counter-rotating vortices was always evident at the duct second bend in all cases. Among the tested low-profile vortex generator configurations, two of the most effective low-profile vortex generator configurations, one counter-rotating and one co-rotating low-profile vortex generator configurations, were acquired as a result of successfully eliminating the casing separation. Despite that the inter-turbine duct is aggressively designed, it is concluded that this duct associated with proper flow control techniques is considered as a potential candidate for weight saving in a high bypass ratio engine.
Glucose uptake through translocation and activation of GLUT4 in PI3K/Akt signaling pathway by asiatic acid in diabetic rats
Authors: Ramachandran V , Saravanan R
Published: August 2015

In this study, we examined the in vivo effect and the mechanism of asiatic acid (AA) on glucose uptake in an insulin target skeletal muscle. Diabetic rats showed significantly increased levels of plasma glucose, thiobarbituric acid reactive substances, and lipid hydroperoxides, decreased levels of insulin and antioxidants, and impairment in insulin-signaling proteins such as insulin receptor (IR), insulin receptor substrate (IRS)-1/2, phosphoinositide 3-kinase (PI3K), Akt, and glucose transporter 4 (GLUT4) proteins. Oral treatment with AA (20 mg/kg body weight) showed near-normalized levels of plasma glucose, lipid peroxidation products, and antioxidants and improved insulin, IR, IRS-1/2, PI3K, Akt, and GLUT4 proteins. These findings suggest that AA improves glucose response by increasing GLUT4 in skeletal muscle through Akt and antioxidant defense in plasma and it also improves glucose homeostasis.
Business in the Work and World of David Foster Wallace
Authors: Michaelson Christopher
Published: August 2015

Arguably, no author, scholar, or other commentator has depicted the condition of turn-of-the-century American capitalism as entertainingly and insightfully as David Foster Wallace. His central concern was the allure of the gifts of commercial production and the unwitting complicity of both producers and consumers in perpetuating entertainment at the expense of the examined life. This article uses ethical criticism and literary critical theory to explore the subjective experience of business in Wallace’s work, in correspondence with scholarship on institutional theory and marketing ethics, to point toward normative conclusions about how, in Wallace’s words, to live consciously.
Coronary Microembolization Induces Cardiomyocyte Apoptosis in Swine by Activating the LOX-1-Dependent Mitochondrial Pathway and Caspase-8-Dependent Pathway
Authors: Liu Tao , Zhou You , Wang Jiang-You , Su Qiang , Tang Zhong-Li , Liu Yang-Chun , Li Lang
Published: August 2015

Background:

Cardiomyocyte apoptosis by coronary microembolization (CME) contributes to myocardial dysfunction, in which mitochondrial pathway and death receptor pathway are activated. Lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1) is a membrane protein involved in apoptosis. The study aimed to explore the role of LOX-1 in the activation of these 2 major apoptotic pathways.

Methods:

Twenty Bama miniature swine were randomized into 4 groups (n = 5 per group). The groups were Sham, CME, LOX-1 small-interfering RNA (siRNA), and control siRNA. Microspheres were injected into the left anterior descending artery of swine to establish CME model. Twelve hours after operation, cardiac function, serum c-troponin I level, microinfarct, and apoptotic index were examined. The levels of LOX-1, Bcl-2, Bax, cytochrome c as well as cleaved caspase 9, -8, and -3 were detected.

Results:

Myocardial dysfunction, enhanced serum c-troponin I, microinfarct, and apoptosis were induced following CME. Moreover, CME induced increased expression of LOX-1, Bax, cytochrome c, cleaved caspase 9, -8, and -3 as well as decreased Bcl-2 expression levels. The LOX-1 siRNA reversed these effects by CME except cleaved caspase 8 expression, while the control siRNA had no effect.

Conclusion:

Coronary microembolization induces cardiomyocyte apoptosis via the LOX-1-dependent mitochondrial pathway and caspase 8-dependent pathway.
Developing Moral Maturity
Authors: Auger Giselle A. , Gee Charlie
Published: August 2015

The purpose of this study was to add to the limited body of knowledge on the effect of the media ethics course, specifically to investigate the effect of the course on the growth in moral judgment reasoning of students through a quasi-experimental pre-test, post-test analysis using the Defining Issues Test 2 (DIT-2). Results demonstrated significant advances in such reasoning among students in one section of the media ethics course but not in the other. It is difficult to determine the exact cause that led to significant increases in moral judgment reasoning in one section of a course and not the other, but the effect of different educational interventions seems clear. Although we cannot know which techniques or combination of techniques were successful, it would seem that interactive and experiential activities that require demonstrated application of principles in the classroom are more successful than traditional Socratic lecture and reflection essay methods.
High-performance conjugate-gradient benchmark: A new metric for ranking high-performance computing systems
Authors: Dongarra Jack , Heroux Michael A , Luszczek Piotr
Published: August 2015

We describe a new high-performance conjugate-gradient (HPCG) benchmark. HPCG is composed of computations and data-access patterns commonly found in scientific applications. HPCG strives for a better correlation to existing codes from the computational science domain and to be representative of their performance. HPCG is meant to help drive the computer system design and implementation in directions that will better impact future performance improvement.
Association Between Daily Time Spent in Sedentary Behavior and Duration of Hyperglycemia in Type 2 Diabetes
Authors: Fritschi Cynthia , Park Hanjong , Richardson Andrew , Park Chang , Collins Eileen G. , Mermelstein Robin , Riesche Lauren , Quinn Laurie
Published: August 2015

Exercise and sedentary behavior have different physiologic effects, which have yet to be fully explained. Time spent in sedentary behavior has been associated with glucose intolerance in adults at risk for type 2 diabetes, but these data have come largely from cross-sectional studies that have not explored this relationship in adults with diabetes. The specific aim of this study was to examine the relationship between time spent in sedentary behavior and glucose levels in adults diagnosed with type 2 diabetes over 3–5 days.

Methods:

Using continuous and concurrent data gathered from wrist accelerometry and a Continuous Glucose-Monitoring Sensor (CGMS), we conducted a longitudinal, descriptive study involving 86 patients with type 2 diabetes.

Results:

More time spent in sedentary behavior was predictive of significant increases in time spent in hyperglycemia ( B = 0.12, p < .05).

Conclusions:

These findings highlight the relationship between time spent sedentary and time spent in hyperglycemia, as identified through our use of objective, continuous data collection methods for both sedentary behavior and glucose levels across multiple days (Actiwatch, CGMS). For patients with type 2 diabetes, these findings emphasize the need for the development of individualized interventions aimed at decreasing the amount of time spent in hyperglycemia by reducing sedentary time.
Decreased Ankle/Brachial Indices in Relation to Morbidity and Mortality in Patients with Peripheral Arterial Disease
Authors: Sikkink Cornells JJM , van Asten Willem NJC , van ‘t Hof Martin A , van Langen Herman , van der Vliet J Adam
Published: August 2015

To determine the relationship between ankle/brachial indices (ABIs) and morbidity and mortality in patients with peripheral arterial disease (PAD), a historical cohort study was performed. A total of 154 patients who had undergone noninvasive arterial assessment of the lower extremities in 1989 and 1990 were selected for this purpose. Selection criteria were age >40 years at the time of investigation, a resting ABI <0.90 and the availability of an ABI after exercise or arterial occlusion. Mortality and vascular events were recorded after an average follow-up period of 6 years. A vascular event was defined as an intervention because of PAD, the occurrence of a nonfatal myocardial infarction or stroke, a transient ischaemic attack or a coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) procedure. During the period studied, 44 patients died and 111 patients suffered a vascular event. The relative risk for mortality was 3.1 per 0.50 decrease of the ABI at rest (95% confidence interval (CI) 1.1–8.7, p = 0.03) and 2.4 per 0.50 decrease of the ABI after exercise or arterial occlusion (95% CI 0.9–6.4, p = 0.08). The relative risk for mortality or the occurrence of a vascular event was 3.3 per 0.50 decrease of the resting ABI (95% CI 1.7–6.3, p<0.001) and 2.5 per 0.50 decrease of the ABI after exercise or occlusion (95% CI 1.5–4.4, p<0.001). After standardization, the prognostic power of the two types of ABIs was equivalent. The cumulative survival after 5 years was 63% for patients with resting ABIs <0.50, 71% for patients with ABIs 0.50–0.69 and 91% for those with ABIs of 0.70–0.89. There were obvious differences between the mean initial ABIs of patients who suffered a vascular event and/or died and those of survivors, who did not suffer an event. A relatively simple measurement like the determination of the resting ABI can give valuable information about the prognosis for vascular related morbidity and mortality. This can be of help in the approach of patients with PAD and assist in therapeutical decision making. Determination of the ABI after exercise or occlusion has no additional value for this purpose.
Oxygen Uptake During Constant-Intensity Exercise in Patients with Peripheral Arterial Occlusive Disease
Authors: Womack Christopher J , Sieminski Debra J , Katzel Leslie I , Yataco Alberto , Gardner Andrew W
Published: August 2015

The purpose of the present study was to evaluate the oxygen uptake (V̇O2) response to walking in patients with peripheral arterial occlusive disease (PAOD) at a constant velocity and to determine whether the oxygen uptake observed during constant-intensity exercise in this population is associated with the severity of PAOD. Forty-nine PAOD patients with intermittent claudication were recruited (values are mean ± SD) [age = 66.4 ± 8.0 years, weight = 83.3 ± 16.0 kg, body mass index = 28.8 ± 5.6, ankle/brachial systolic blood pressure index (ABI) = 0.63 ± 0.18, V̇O2peak = 13.02 ± 2.99 ml/kg/min]. Patients were evaluated during a 2.0 miles/h walk on a treadmill until maximal claudication pain or for a maximum of 20 minutes. On average, patients walked for a duration of 10.3 ± 5.8 min. Despite the constant absolute intensity during the exercise bout, there was a significant ( p<0.01) 4.0% increase in V̇O2 from min 3 of exercise (10.58 ± 2.02 ml/kg/min) to min 5 (11.01 ± 2.18 ml/kg/min) and a further 4.0% increase from min 5 to the end of exercise (11.46 ± 2.32 ml/kg/min). Expressed as relative exercise intensity, this represented an increase from 80.8 ± 18.3% to 87.1 ± 18.0% of V̇O2 peak from min 3 to the end of exercise. The magnitude of increase in V̇O2 during the exercise bout was not correlated with resting ABI ( r = 0.00, p = 0.68) or post-exercise ABI ( r = 0.04, p = 0.73). There was a nonsignificant trend towards a correlation between the time to onset of claudication pain and the magnitude of increase in V̇O2 ( r = 0.25, p = 0.08). Results of this study suggest that an increase in V̇O2 occurs during constant-velocity walking at a high relative intensity in PAOD patients. This increase in V̇O2 does not appear to be related to the severity of PAOD.
Mechanisms of Neointima Formation—Lessons from Experimental Models
Authors: De Meyer Guido RY , Bult Hidde
Published: August 2015

The lamina intima of an artery is the region between the endothelial cell surface and the internal elastic lamina, which forms the luminal margin of the media. In humans the intima of atherosclerosis-prone arteries becomes thicker due to accumulation of smooth muscle cells, which originate from the media. The introduction of percutaneous transluminal coronary angioplasty (PTCA) boosted scientific interest in intimal thickening, because restenosis remains an unresolved problem of this intervention. In order to unravel the mechanisms of intimal thickening there is a need for appropriate animal models. A brief overview of these models is given together with factors that control proliferation and/or migration.

Despite intensive research on neointima formation, an effective therapy for restenosis has not emerged to date. This may be due to the fact that other processes, such as acute elastic recoil and chronic constrictive remodeling may contribute to lumen narrowing as well. Other limitations of neointima models are related to species and anatomical differences. Most studies are performed in arteries that are either lesion-free, or contain relatively mild plaques, in contrast to the complicated, stenotic lesions that are the substrate for human PTCA. Other differences are the severity of the injury and incorporation of a mural fibrin-rich thrombus. Nevertheless, studies based on superficial injury, like the frequently used balloon denudation model, are useful. There are similarities with angioplasty, such as endothelial cell damage and proliferation of medial and intimal smooth muscle cells.

The use of techniques such as differential display, gene transfer and application of antisense oligonucleotides may provide new therapeutic approaches to reduce neointima formation.
The Microcirculation in Venous Hypertension
Authors: Smith Philip D Coleridge
Published: August 2015

Venous ulceration is a common problem in western countries and results in large costs to healthcare systems. A number of hypotheses of the mechanisms of development of venous ulceration have been advanced, but this question has not been fully resolved. In recent years research effort has focused on the microcirculation of the skin and many methods of investigation have been employed to study this. Some of the principal findings described in published work are reviewed in this article.

It seems unlikely from the available evidence that venous ulceration is attributable solely to failure of diffusion of oxygen and other small nutritional molecules to the tissues of the skin. The microvascular changes in the skin are characterised by activated endothelium and perivascular inflammatory cells. It is much more likely that leucocytes attach themselves to the cutaneous microcirculation, become activated and produce endothelial injury. Repeated over many months or years, this chronic inflammatory process leads to be tissues changes of lipodermatosclerosis.

Although there is evidence of leucocyte involvement in the pathogenesis of venous ulceration, the exact mechanisms remain to be resolved. Improved treatment for patients may be devised once a better understanding of the basic causes of this condition has been reached.
The Pathophysiology of Peripheral Arterial Disease: Rational Targets for Drug Intervention
Authors: Cooke John P
Published: August 2015

The most common cause of peripheral arterial disease (PAD) is atherosclerosis, which begins with an alteration in endothelial biology due to hypercholesterolemia, diabetes mellitus, hypertension, tobacco use, elevated levels of lipoprotein(a) or homocystinemia. With chronic and severe arterial disease, changes begin to occur in the microcirculation, including obstruction at the microvascular level and tissue injury. Based on insights into the vascular biology of PAD, new therapies have been developed and are at various stages of clinical trials. Future pharmacotherapy for PAD will include agents that have one or more of the following attributes: (1) reduce, or even reverse, the progression of atherosclerosis; (2) inhibit plaque rupture; (3) inhibit thrombosis by a novel mechanism; (4) induce angiogenesis; (5) reverse microvascular derangements; (6) affect blood rheology; and (7) enhance skeletal muscle's ability to use available nutrients.
Clinical Assessment of the Patient with Claudication: The Role of the Vascular Laboratory
Authors: Creager Mark A
Published: August 2015

The noninvasive vascular laboratory aids in the evaluation of patients with peripheral arterial disease (PAD). Several qualitative and quantitative noninvasive tests are useful for diagnosing PAD and monitoring patients' response to treatment. These tests include Doppler ultrasonography, pulse volume recording, segmental blood pressure measurement, exercise testing, post-occlusive reactive hyperemia testing, transcutaneous oximetry and color-assisted ultrasound imaging. Each test has specific utility and can be used either individually or in combination with other noninvasive tests to obtain information about the hemodynamic and functional severity of peripheral atherosclerosis in patients with claudication.
The Relationship between Free-Living Daily Physical Activity and the Severity of Peripheral Arterial Occlusive Disease
Authors: Sieminski Debra J , Gardner Andrew W
Published: August 2015

The purposes of this study were to assess the magnitude of the reduction in free-living daily physical activity of claudicants compared with age-matched controls, and to examine the relationship between the severity of peripheral arterial occlusive disease (PAOD) and free-living daily physical activity. Eighty-five PAOD patients with intermittent claudication and 59 non-PAOD subjects with a resting ankle/brachial index (ABI) of 0.63 ± 0.20 and 1.21 ± 0.08, respectively, were monitored for 2 consecutive weekdays with an accelerometer and pedometer worn on each hip. The times to onset and to maximal claudication pain were also measured in the claudicants during a graded treadmill test to assess the functional limitations imposed by PAOD. The PAOD group had a 42% lower energy expenditure as measured from the accelerometer (357 ± 238 kcal/day versus 616 ± 363 kcal/day; p < 0.001) and a 45% lower pedometer reading (4737 ± 2712 steps/day versus 8672 ± 4235 steps/day; p < 0.001) than the non-PAOD group. Furthermore, the relationship between free-living daily physical activity and ABI in PAOD patients was significant for both the accelerometer ( r = 0.41; p < 0.001) and the pedometer ( r = 0.41; p < 0.001). The rate of decline in free-living daily activity was 42 kcal/day and 612 steps/day per 0.10 drop in ABI. The correlation between free-living daily physical activity and time to maximal claudication pain (6:25 ± 3:30 min:s) in the PAOD group was significant for both the accelerometer ( r = 0.30; p = 0.05) and the pedometer ( r = 0.36; p = 0.03). However, the time to onset of claudication pain (3:02 ± 2:22 min:s) in the PAOD group was not related to either the accelerometer ( r = −0.02; p = 0.86) or the pedometer ( r = 0.18; p = 0.28) activity values. In conclusion, free-living daily physical activity was 42% to 45% lower in PAOD patients with intermittent claudication than in apparently healthy subjects of similar age. Moreover, claudicants were progressively more sedentary with an increase in PAOD severity.
Primary Angioplasty for Acute Myocardial Infarction
Authors: Juergens Craig P , Whitbourn Robert J , Yeung Alan C , Oesterle Stephen N
Published: August 2015

The use of thrombolytic therapy has been widely accepted for the treatment of acute myocardial infarction. Despite improving mortality, thrombolytic therapy may be contraindicated in many patients presenting with myocardial infarction and is associated with a small, yet significant risk of hemorrhagic sequelae. This article outlines the rationale behind reperfusion therapy, the use of pharmacological thrombolysis and the role of adjunctive angioplasty. The potential advantages of a therapeutic strategy of primary angioplasty, instead of thrombolysis, are discussed. These include anatomical definition, risk stratification, reduced recurrent ischemia, enhanced coronary perfusion and improved coronary patency. The randomized trials in which primary angioplasty and thrombolytic therapy were compared are reviewed. We conclude that angioplasty results in a reduction of short-term mortality and nonfatal reinfarction and therefore advocate the routine use of coronary angioplasty as a primary reperfusion strategy for acute myocardial infarction. The potential limitations of primary angioplasty in the community hospital setting are discussed. Finally, we examine the roles of adjunctive mechanical (e.g. stents) and pharmacological (e.g. Abciximab) means of further enhancing outcomes after primary angioplasty.
‘Nappy bags instead of handbags’: Young motherhood and self-identity
Authors: Shea Rebecca , Bryant Lia , Wendt Sarah
Published: August 2015

This article presents the findings of an Australian study that aimed to explore how young women construct their self-identity while negotiating motherhood and the associated transition to adulthood. Teenage motherhood, within contemporary discourse, often attracts negative assumptions about young women’s worth and ability to parent. This study used a combination of semi-structured interviews and memory work to draw out women’s stories and give voice to their experiences of becoming mothers. Three key themes were induced from the findings: pride and self, autonomy and change, and resilience. This article explores these themes that are, in many ways, a resistance and challenge to dominant public discourse, and relates them to how young women ascribe positive meaning to their experiences of becoming mothers. The findings demonstrate women’s autonomy in shaping their lives in the way they forge relationships and raise their children. The article concludes by examining the implications of meaning-making in relation to self-identity for young mothers to inform service provision.
Aldosterone effects on glomerular structure and function
Authors: Bernardi Stella , Toffoli Barbara , Zennaro Cristina , Bossi Fleur , Losurdo Pasquale , Michelli Andrea , Carretta Renzo , Mulatero Paolo , Fallo Francesco , Veglio Franco , Fabris Bruno
Published: August 2015

Objective:

Experimental evidence suggests that aldosterone directly contributes to organ damage by promoting cell growth, fibrosis, and inflammation. Based on these premises, this work aimed to assess the glomerular effects of aldosterone, alone and in combination with salt.

Methods:

After undergoing uninephrectomy, 75 rats were allocated to five groups: control, salt diet, aldosterone, aldosterone + salt diet, aldosterone + salt diet and eplerenone, and they were all studied for four weeks. We focused on glomerular structural, functional, and molecular changes, including slit diaphragm components, local renin–angiotensin system activation, as well as pro-oxidative and profibrotic changes.

Results:

Aldosterone significantly increased systolic blood pressure, led to glomerular hypertrophy, mesangial expansion, and it significantly increased the glomerular permeability to albumin and the albumin excretion rate, indicating the presence of glomerular damage. These effects were worsened by adding salt to aldosterone, while they were reduced by eplerenone. Aldosterone-induced glomerular damage was associated with glomerular angiotensin-converting enzyme (ACE) 2 downregulation, with ACE/ACE2 ratio increase, ANP decrease, as well as with glomerular pro-oxidative and profibrotic changes.

Conclusions:

Aldosterone damages not only the structure but also the function of the glomerulus. ACE/ACE2 upregulation, ACE2 and ANP downregulation, and pro-oxidative and profibrotic changes are possible mechanisms accounting for aldosterone-induced glomerular injury.
Correlation between renin-angiotensin system gene polymorphisms and essential hypertension in the Chinese Yi ethnic group
Authors: Yang Yu-Ling , Mo Yan-Ping , He Yong-Shu , Yang Fang , Xu Yan , Li Cheng-Cheng , Wang Jiao , Reng Hao-Ming , Long Li
Published: August 2015

Introduction:

The renin-angiotensin system (RAS) has been considered to play an important role in the regulation of blood pressure. This study aimed to investigate the correlation between RAS gene polymorphisms and essential hypertension (EH) in the Chinese Yi ethnic group.

Materials and methods:

A total of 244 EH subjects and 185 normotensive individuals from the Chinese Yi ethnic group were genotyped for AGT M235T (rs699), AT1R A1166C (rs5186), ACE I/D (rs4340) and ACE G2350A (rs4343) polymorphisms by the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method.

Results:

Significant differences in the allele and genotype frequency of ACE G2350A were observed between the EH cases and controls ( p=0.001, 0.002). After being grouped by gender, significant differences in the allele and genotype frequency of ACE G2350A and AT1R A1166C were observed between females of the EH cases and controls ( ACE G2350A: p=0.000, 0.002; AT1R A1166C: p=0.008, 0.011). After excluding the influence of multifactorial interactions, the ACE G2350A polymorphism is significantly associated with the pathogenesis of EH in the Chinese Yi ethnic group (odds ratio ( OR)=1.656, 95% confidence interval (CI) 1.807–2.524, p=0.019).

Conclusions:

The RAS-related ACE G2350A polymorphism is associated with the pathogenesis of EH in the Chinese Yi ethnic group.
Fighting eviction: Local learning and the experience of inequality among India’s adivāsi
Authors: Buckles Daniel , Khedkar Rajeev , Ghevde Bansi
Published: August 2015

This article examines pivotal moments in the unfolding of a 5-year action-oriented inquiry into a concrete problem: the enclosure and eviction of the Katkari, a former “criminal tribe” and “particularly vulnerable tribal group” in rural Maharashtra, India. A property boom driven by Mumbai’s economic growth broke the patron–client relationship that provided some security for the landless Katkari, leaving them exposed to eviction from private lands and deepening their experience of inequalities grounded in practices of exclusion, exploitation, and deep-seated hierarchies. Participatory action research with and by the Katkari helped to make sense of the experience of rising inequality and guide actions that were mutually meaningful and useful. Achieving this outcome could not rely simply on mobilizing local knowledge understood as a fixed body of community views and ready-made assumptions about the problems at hand. The experience suggests that the challenge for action researchers committed to knowledge democracy is to facilitate emergent learning within and across social and cultural boundaries, building on what people know but also their capacity to learn, discover, and act on reality. This may also require scaling up participatory analysis through more advanced tools as a response to complexity and unpredictability.
Industrial participatory action research, emergence of a research-knowledge democracy project with metal workers
Authors: Cova Milagros I , Rodríguez Monroy Carlos , Arzola Minerva , Dávila Jesús
Published: August 2015

Participatory action research has been used by Latin American social sciences researchers in order to deal with social and community problems to encourage social changes. Participatory action research experiences with industrial workers have been less visible. This paper focuses on workers’ research experience at state-owned Venezuelan metallurgical industries. The methodological approach is based on workers’ educational needs with participation in their own emancipation process. Workers and researchers share experiences, knowledge, and set the basis for increased democracy at industry through workshops, meetings, and other educational activities. These experiences allowed the emergence of an industrial participatory action research project that is being deepened through participatory appraisal and education research programs with readings, “generating questions,” working roundtables, consensus and dissent, experience systematization, and a living language of participation to strengthen local and national education-research network with people, especially workers, increasing their voice through knowledge democracy and technology democracy which implies industrial democracy too.
Despite knowledge democracy and community-based participatory action research: Voices from the global south and excluded north still missing
Authors: Openjuru George Ladaah , Jaitli Namrata , Tandon Rajesh , Hall Budd
Published: August 2015

The primary purpose for this special issue of Action Research Journal ( ARJ) focusing on knowledge democracy, community-based participatory action research (CBPAR) was to draw attention to and raise debate about knowledge exclusion of and alternative forms of knowing in the global South as well as to bring to the fore the perspective of authors from the global South. We understand the global South to include the excluded epistemologies from the global North such as Indigenous Researchers from the First Nations People from Canada. Reflecting on the 12 submissions that were made for this special issue reveals how even within supportive knowledge and research paradigms that are meant to promote marginalized scholarships, the global South and excluded North still remains excluded.
Association Between the CYP1B1 Polymorphisms and Lung Cancer Risk
Authors: Chen Pei-Fen , He Xiao-Feng , Huang Guo-Hua , Wang Wei , Qiu Zhi-Hui
Published: August 2015

The previously published data on the association between the cytochrome P450 1B1 Leu432Val, Asn453Ser, and Ala119Ser polymorphisms and lung cancer risk have remained controversial. Hence, we performed a meta-analysis to investigate the association between cytochrome P450 1B1 Leu432Val, Asn453Ser, and Ala119Ser polymorphisms and lung cancer risk under different inheritance models. A total of 22 studies were identified, including 2881 cases and 3653 controls for Leu432Val polymorphism (from 13 studies), 3009 cases and 3887 controls for Asn453Ser polymorphism (from 5 studies), and 1301 cases and 2045 controls for Ala119Ser polymorphism (from 4 studies). Overall, significant association was observed between cytochrome P450 1B1 Leu432Val polymorphism and lung cancer risk (dominant model: odds ratio = 1.29, 95% confidence interval = 1.08-1.53; recessive model: odds ratio = 1.21, 95% confidence interval = 1.05-1.39; additive model: odds ratio = 1.43, 95% confidence interval = 1.21-1.69) when all the eligible studies were pooled into the meta-analysis. In the further stratified and sensitivity analyses, significantly increased lung cancer risk was also observed in caucasians and smokers. No significant association was observed between cytochrome P450 1B1Asn453Ser and Ala119Ser polymorphisms and lung cancer risk in overall analysis. In summary, this meta-analysis suggests that cytochrome P450 1B1Leu432Val polymorphism is associated with increased lung cancer risk in caucasians and smokers.
Board Games and the Construction of Cultural Memory
Authors: Begy Jason
Published: August 2015

Although much has been written about the potential of games for historical representation and their status as historical texts, there is little research placing games into a broader “cultural memory” framework. In this article, I argue that one unique way games as a medium can participate in constructing cultural memory is by simulating historically situated structural metaphors. To do so, I first introduce the concept of cultural memory and link it to material culture studies. I argue that games can be cultural memory “objectivations,” but in order to fully analyze them in this respect insights from game studies, namely, the meaning potential of rules, need to be applied as well. I then discuss how three board games, 1830: Railways and Robber Barons , Age of Steam, and Empire Builder simulate the structural metaphors identified by Wolfgang Schivelbusch that were used by contemporary observers to understand the experiential changes wrought by the railroad. I close by arguing that this type of research is valuable in that it opens up new understandings of how games influence the way a culture thinks about and remembers its past.
Game-Inspired Design
Authors: Aguilar Stephen J. , Holman Caitlin , Fishman Barry J.
Published: August 2015

This paper describes research and development around two gameful courses that reimagined their assessment systems to better support student autonomy and promote engagement. We present results from an ongoing classroom-based research study that signals the success of these designs and, in so doing, explore key elements of what we call gameful design: the process of redesigning core elements of a learning environment to better support intrinsic motivation. We describe this process and discuss a set of promising practices for the design of gameful courses. Results from three studies indicate that gameful course design is positively related to students working harder and feeling more in control of their class performance.