bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term clinical safety and efficacy of brodalumab in the treatment of Japanese patients with moderate‐to‐severe plaque psoriasis
Authors: Umezawa Y. , Nakagawa H. , Niiro H. , Ootaki K. ,   the Japanese Brodalumab Study Group
Published: June 2016

Background

Brodalumab (KHK4827) is a human anti‐interleukin‐17‐receptor A monoclonal antibody. In Japanese patients with moderate‐to‐severe plaque psoriasis, brodalumab showed rapid and robust efficacy and a favourable safety profile in a 12‐week, phase 2, double‐blind, randomized controlled trial.

Objectives

To evaluate the long‐term safety and efficacy of brodalumab, an extension of a phase 2 trial of Japanese patients with moderate‐to‐severe psoriasis was performed.

Methods

Patients received open‐label brodalumab 210 or 140 mg subcutaneously every 2 weeks for 52 weeks. Efficacy was measured using the Psoriasis Area and Severity Index (PASI) score and the static physician global assessment (sPGA) instrument. The endpoint of psoriatic arthritis was 20% improvement in American College of Rheumatology response criteria (ACR 20). The patients were also monitored for treatment‐emergent adverse events (AEs), including serious AEs (SAEs).

Results

Of 145 patients, 133 completed the study. The percentage of patients with ≥75% reduction of PASI scores (PASI 75), ≥90% (PASI 90) and 100% (PASI 100) at Week 52 (the last observation carried forward) were 94.4%, 87.5% and 55.6%, respectively, in the 210‐mg group, and the corresponding values in the 140‐mg group were 78.1%, 71.2% and 43.8%. At Week 52, 75.0% patients in 210‐mg group achieved ACR 20, compared with 37.5% patients in 140‐mg group. The most commonly reported AEs were nasopharyngitis (35.2%), upper respiratory tract inflammation (10.3%) and contact dermatitis (9.7%).

Conclusion

Brodalumab showed a sustained clinical response and an acceptable safety profile through 52 weeks in Japanese patients with moderate‐to‐severe plaque psoriasis in this open‐label extension study.
Multimorbidity, P4 medicine and holism
Authors: Marcum James A
Published: June 2016

Rationale, aims and objectives

Multimorbidity is a serious challenge to providing patients with quality health care. Sturmberg et al. propose a P4 or whole‐person medical model based on a holistic approach to deliver such care. The aim of this commentary is to examine critically their P4 model and holistic approach.

Methods

The P4 model and holistic approach of Sturmberg et al. are analysed conceptually in terms of an effective strategy or sequence for framing P4 medicine and with respect to different philosophical notions of holism for grounding it.

Results

Instead of a P4 medicine strategy or sequence that emphasizes the predictive and preventive aspects of health care from a biomedical perspective, as Sturmberg et al. do, a more effective strategy or sequence for framing P4 medicine to deliver quality health care is to accentuate the personalized and participatory aspects from a humanistic perspective. The basis of this proposed strategy for P4 medicine is not a technoscientific holism that emphasizes mechanisms to define the whole utilizing bottom‐up causation, as Sturmberg et al. ground their biomedical P4 model, but rather a phenomenological holism that also incorporates the person's illness experience and top‐down causation.

Conclusions

The proposal of Sturmberg et al. to treat patient multimorbidity through P4 medicine and a holistic approach is certainly a move in the right direction. However, to achieve their goal requires an alternative strategy for P4 medicine and a more robust notion of holism.
Some Engineering Properties of Composite Corn‐Banana Custard Flour
Authors: Alimi B.A. , Sibomana M.S. , Workneh T.S. , Oke M.O.
Published: June 2016

Engineering properties of composite corn‐banana custard flour (CF) products developed by incorporating native, heat‐moisture treated or annealed banana starch (BS) as a percentage (15, 25 or 35%) of the composite were determined. Morphological study showed bigger oval BS granules occupying void spaces in the matrix resulting in more compact composite CF structure and in turn, higher bulk density with increasing level of BS inclusion. Experimental variables had marked effect on the pasting properties of the CF samples. Incorporation of BS led to significant (P < 0.05) reduction of the swelling power of the CF samples from 1.85 to 1.16 g/g. Gelling and boiling points varied significantly (P < 0.05) between 73.00–81.67°C and 78.33–88.33°C, respectively. Moisture adsorption isotherm showed a type II sigmoidal shaped curve. Experimental variables and granules orientation in the matrices are suggested to be the major influence on the trends observed in the studied engineering properties.

Practical Applications

This study was proposed to enhance the health functionality of corn based custard through the incorporation of native and hydrothermally modified banana starch as a percentage of the resulting composite custard flour. The established health enhancing functionality of unripe green banana and further improvement of its functional properties through hydrothermal modifications could add value to the composite custard flour. It is hoped that the products developed would appeal to health conscious people and be useful for the management of type II diabetes and cardiovascular diseases which are normally aggravated by the consumption of energy dense foods.
From cradle to grave via the dissection room: the role of foetal and infant bodies in anatomical education from the late 1700s to early 1900s
Authors: Dittmar Jenna M. , Mitchell Piers D.
Published: June 2016

The preponderance of men in the narrative of anatomical education during the 1800s has skewed the historical perception of medical cadavers in favour of adult men, and stifled the conversation about the less portrayed individuals, especially children. Although underrepresented in both the historical literature and skeletal remains from archaeological contexts dated to the 1800s, these sources nevertheless illustrate that foetal and infant cadavers were a prized source of knowledge. In the late 1700s and 1800s foetal and infant cadavers were acquired by anatomists following body snatching from graveyards, from the child's death in a charitable hospital, death from infectious disease in large poor families, or following infanticide by desperate unwed mothers. Study of foetal and infant remains from the 1800s in the anatomical collection at the University of Cambridge shows that their bodies were treated differently to adults by anatomists. In contrast to adults it was extremely rare for foetal and infant cadavers to undergo craniotomy, and thoracotomy seems to have been performed through costal cartilages of the chest rather than the ribs themselves. However, many infants and foetuses do show evidence for knife marks on the cranium indicating surgical removal of the scalp by anatomists. These bodies were much more likely to be curated long term in anatomical collections and museums than were adult males who had undergone dissection. They were prized both for demonstrating normal anatomical development, but also congenital abnormalities that led to an early death. The current findings show that the dissection of foetal and infant cadavers was more widespread than previous research on anatomical education suggests. This research details the important role of the youngest members of society in anatomical education during the long 19th century, and how the social identity of individuals in this subgroup affected their acquisition, treatment and disposal by elite medical men of the time.
COMMUNICATION ABOUT FUTURE POLICY RATES IN THEORY AND PRACTICE: A SURVEY
Authors: Moessner Richhild , Jansen David‐Jan , de Haan Jakob
Published: June 2016

We discuss the theoretical rationale for central bank communication about future policy rates, either as part of inflation targeting or in the form of forward guidance. We also summarize both actual central bank communication about future policy rates and empirical evidence on the effectiveness of these types of communication. We argue that there is a disconnect between the theory and practice of forward guidance, as theory assumes commitment on the part of the central bank, while in practice central banks generally do not commit. Future theoretical research on forward guidance should therefore take the absence of commitment by central banks into account.
Comparison of TR Band™ and VasoStat™ Hemostasis Devices following Transpedal Catheterization for Lower Extremity Revascularization for Peripheral Arterial Disease
Authors: Kwan Tak W. , Patel Apurva , Parikh Roosha , Auguste Uschi , Rosero Hugo , Huang Yili , Liou Michael , Ratcliffe Justin , Puma Joseph
Published: June 2016

Background

Transpedal access is increasingly utilized for peripheral vascular catheterization. There is a paucity of data on the use of radial hemostasis devices as an alternative to manual compression for achievement of hemostasis after this approach.

Objective

To compare safety and efficacy of two hemostasis devices following transpedal catheterization for lower extremity revascularization for peripheral arterial disease.

Methods

A consecutive cohort of patients with bilateral Rutherford 2–5 disease who underwent transpedal catheterization for peripheral vascular interventions were retrospectively analyzed. In each patient, retrograde tibial artery access was obtained, a 4 French sheath was placed, and all revascularization was performed via tibial access. In all patients, a TR Band™ (Terumo Medical, n = 215) and/or VasoStat™ (Forge Medical, n = 99) were used to apply puncture site compression, following removal of the tibial sheath until hemostasis was achieved. Safety and efficacy of each device was compared.

Results

Puncture site hemostasis was achieved in all patients within 2 hours of sheath removal facilitating early discharge. Two access site pseudoaneurysms occurred within 30 days of revascularization, one of which followed TR Band™ placement and the other following VasoStat™ placement (P = 0.53). Each patient was successfully treated with ultrasound‐guided thrombin injection. Loss of access site patency by duplex ultrasound occurred in 2 patients following the TR Band™ and a single patient following the VasoStat™ (P = 1.0).

Conclusion

Both the TR Band™ and the VasoStat™ were effective in achieving hemostasis following transpedal catheterization with low rates of complications.
Diffusion Tensor Imaging to Map Brain Microstructural Changes in CADASIL
Authors: Mascalchi Mario , Pantoni Leonardo , Giannelli Marco , Valenti Raffaella , Bianchi Andrea , Pracucci Giovanni , Orsolini Stefano , Ciulli Stefano , Tessa Carlo , Poggesi Anna , Pescini Francesca , Inzitari Domenico , Diciotti Stefano
Published: June 2016

BACKGROUND AND PURPOSE

Diffusion tensor imaging (DTI) is sensitive to brain microstructural changes. The aims of this DTI study were to map voxelwise the spatial distribution of brain microstructural changes in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to investigate any correlation between DTI‐derived indices and extension of T2 hyperintensity.

METHODS

Eighteen patients with CADASIL and 18 age‐, sex‐, and education‐level‐matched healthy controls underwent magnetic resonance imaging at 3 T. Differences in DTI‐derived indices (mean diffusivity [MD], fractional anisotropy [FA], axial [AD] and radial [RD] diffusivities, and mode of anisotropy [MO]) of brain white matter (WM) between CADASIL patients and healthy subjects were assessed through tract‐based spatial statistics. Then, DTI‐derived indices were correlated with the patient's score on the extended Fazekas visual scale of the T2 hyperintensity.

RESULTS

When compared to healthy controls, CADASIL patients showed extensive symmetric areas of increased MD/RD and decreased AD/FA/MO that involved almost the entire hemispheric cerebral WM (internal and external capsule, WM of the temporal poles, superior and inferior longitudinal fasciculus, inferior frontal‐occipital fasciculus, uncinate fasciculus, cingulum, forceps major and minor, corticospinal tracts, and thalamic radiations), thalami, and corpus callosum. Additional areas of increased RD were observed in pons, midbrain, cerebellar peduncles, and cerebellar WM. Only FA was negatively correlated with extended Fazekas visual score.

CONCLUSIONS

Our results indicate that brain damage in CADASIL is associated with extensive microstructural changes implying impairment of intra‐ and inter‐hemispheric cerebral, thalamocortical, and cerebrocerebellar connections. Severity of microstructural changes correlates with extension of T2 hyperintensity.
The Impact of Menu Label Design on Visual Attention, Food Choice and Recognition: An Eye Tracking Study
Authors: Reale Sophie , Flint Stuart William
Published: June 2016

Nutritional labeling on menus has been found to promote informed food choices and reduce information asymmetry between manufacturers and consumers. However, lack of attention to nutritional labels limits their effectiveness. This study manipulated the way in which nutritional information was provided on menus in aim of enhancing visual attention to the most health relevant information. A between‐subject design was implemented with three experimental conditions (nondirective label; directive label; semidirective label). A total of 84 participants chose meals off a starter, main and desert menu whilst their eye movements were tracked using Tobii eye tracking software. Results showed that the menu labels did not significantly differ in their attentional gaining properties, however, the use of color and health logos led participants to choose meals containing significantly less calories compared to when nutritional information was presented in black text alone. These findings indicate that nutritional information should be provided in color or as health logos as this has the largest impact on food choice.

Practical Applications

A factor contributing to the rise in obesity prevalence is the obesogenic environment that we live in. The population has become increasingly reliant on convenience foods and dining out which has led to excess calorie consumption. Menu labeling has been identified as a possible intervention that could be employed by policy makers to guide informed food choices. However, there are calls for further actions and intervention to improve food choice as menu labeling has had mixed effects on consumer choice and consumption. This study suggests that menu labeling is a viable option when the nutritional information is presented in a visually salient way. The use of colors and health logos attracts consumer's attention to the most health relevant information which could contribute to efforts in reducing obesity and other illnesses linked to unhealthy consumption.
Owners’ attitudes and practices regarding nutrition of dogs diagnosed with cancer presenting at a referral oncology service in Ontario, Canada
Authors: Rajagopaul S. , Parr J. M. , Woods J. P. , Pearl D. L. , Coe J. B. , Verbrugghe A.
Published: June 2016

OBJECTIVES

To investigate owner attitudes and dietary practices following cancer diagnosis in a dog.

METHODS

A retrospective cross‐sectional survey of 75 dog owners presenting with their dogs to a tertiary referral oncology service through a demographic questionnaire and in‐person or telephone interviews regarding the dog's nutrition.

RESULTS

Conventional diets (71%) were most commonly fed as a single diet to canine cancer patients followed by homemade cooked (7%) and homemade raw (4%). Several owners (18%) provided combinations of these diets. Owners reported some distrust towards conventional diets (51%). Appetite loss occurred in 35% of dogs and diet changes reported for 25% of dogs in the study involved exclusion of a conventional (63%) and/or inclusion of a homemade (54%) component. 90% of owners noted the diet change was associated with the cancer diagnosis. Supplements were given by 39% of owners. 85% of owners highly valued veterinary nutritional advice.

CLINICAL RELEVANCE

Following a cancer diagnosis, dog owners appear to change their approach to managing their dog's nutrition. Given the value owners place on veterinary nutritional advice, veterinarians have a key role in guiding nutritional management of the canine cancer patient.
Exceptionalism or Chinamerica: Measuring Religious Change in the Globalizing World Today
Authors: Yang Fenggang
Published: June 2016

Religion is changing fast in this era of globalization. Major global trends include the growth of Muslims, the shrinking percentage of unaffiliated, and the rapid rise of Christianity in global China. By 2030, China is likely to become the largest Christian country in the world while retaining large numbers of Buddhists, Muslims, and folk religious believers. To capture religious changes more accurately, social scientists of religion must sharpen their measurement tools regarding religiosity; pay more attention to the reality of nonalignment among religious identity, belief, and practice; and acknowledge the reality of nonexclusive/multiple religious beliefs, practices, and identities. Scholars must also take responsibility for developing a clear and nuanced definition of religion, abandon exceptionalist thinking, and seek to discover common patterns of religious change across societies. Conceptual and measurement tools at the disposal of social scientists of religion should enable us to perceive and understand the converging changes of religion in China, the United States, and other societies, without ignoring their historical differences and contemporary particularities.
Echocardiographic Assessment of Left Atrial Size and Function in Warmblood Horses: Reference Intervals, Allometric Scaling, and Agreement of Different Echocardiographic Variables
Authors: Huesler I.M. , Mitchell K.J. , Schwarzwald C.C.
Published: June 2016

Background

Echocardiographic assessment of left atrial (LA) size and function in horses is not standardized.

Objectives

The aim of this study was to establish reference intervals for echocardiographic indices of LA size and function in Warmblood horses and to provide proof of concept for allometric scaling of variables and for the clinical use of area‐based indices.

Animals

Thirty‐one healthy Warmblood horses and 91 Warmblood horses with a primary diagnosis of mitral regurgitation (MR) or aortic regurgitation (AR).

Methods

Retrospective study. Echocardiographic indices of LA size and function were measured and scaled to body weight (BWT). Reference intervals were calculated, the influence of BWT, age, and valvular regurgitation on LA size and function was investigated and agreement between different measurements of LA size was assessed.

Results

Allometric scaling of variables of LA size allowed for correction of differences in BWT. Indices of LA size documented LA enlargement with moderate and severe MR and AR, whereas most indices of LA mechanical function were not significantly altered by valvular regurgitation. Different indices of LA size were in fair to good agreement but still lead to discordant conclusions with regard to assessment of LA enlargement in individual horses.

Conclusions and Clinical Importance

Allometric scaling of echocardiographic variables of LA size is advised to correct for differences in BWT among Warmblood horses. Assessment of LA dimensions should be based on an integrative approach combining subjective evaluation and assessment of multiple measurements, including area‐based variables. The clinical relevance of indices of LA mechanical function remains unclear when used in horses with mitral or aortic regurgitation.
Much Ado about Something Important: How do Exchange Rate Movements Affect Inflation?
Authors: Forbes Kristin
Published: June 2016

Understanding how exchange rate movements ‘pass‐through’ to prices and inflation is critically important for monetary policy. Yet key tenets of our standard framework for analyzing this ‘pass‐through’ have recently not performed well in the UK. Instead, a new framework is needed—of incorporating the cause of the exchange rate movement when analyzing its effects. This new framework can explain why sterling's movements have had such different effects on import prices and inflation over time. It should also improve the ability of central banks to predict inflation and set monetary policy appropriately.
Effects of maternal vitamin B12 supplementation on early infant neurocognitive outcomes: a randomized controlled clinical trial
Authors: Srinivasan Krishnamachari , Thomas Tinku , Kapanee Aruna Rose Mary , Ramthal Asha , Bellinger David C. , Bosch Ronald J. , Kurpad Anura V. , Duggan Christopher
Published: June 2016

Maternal nutritional status during pregnancy impacts fetal brain development. Vitamin B12 plays a vital role in neuronal development. However, findings from studies on the association between maternal B12 status and child cognitive functions have been inconsistent. We performed a randomized, placebo‐controlled clinical trial of oral B12 supplementation (50 µg) beginning at <14 weeks of gestation through a 6‐week post‐partum. In the present study, we report the effects of maternal B12 supplementation on cognitive development in infants at 9 months of age on Bayley Scales of Infant Development‐III (BSID‐III). One hundred eighty‐three pregnant women received vitamin B12, and 183 received placebo. Nine‐month BSID‐III development score was available in 178 infants. There were no significant differences in maternal sociodemographic characteristics and baseline biochemical measures between infants who underwent BSID‐III evaluation and infants who were not evaluated. There were no significant differences in any of the subscales of BSID‐III between infants born to mothers who received B12 supplementation (n = 78) vs. placebo (n = 100). On multiple regression analysis, elevated maternal total homocysteine (tHcy) levels adjusted for treatment group, birthweight, parity, income and home environment at second trimester of pregnancy were significantly negatively associated with expressive language (β = 3.13 points,P < 0.001), and in third trimester of pregnancy with expressive language (β = −2.29 points,P < 0.001) and fine motor (β = −1.41 points,P = 0.005) domains of BSID‐III. While no significant effects of maternal B12 supplementation were seen on cognitive development in infants at 9 months of age, elevated maternal tHcy levels were associated with poorer cognitive performance in some of the subdomains of BSID‐III. In pregnant women with elevated tHcy levels and or B12 deficiencies, it may be worthwhile to study the impact of longer term maternal supplementation on infant cognitive outcomes.
A resurrection experiment finds evidence of both reduced genetic diversity and potential adaptive evolution in the agricultural weed Ipomoea purpurea
Authors: Kuester Adam , Wilson Ariana , Chang Shu‐Mei , Baucom Regina S.
Published: June 2016

Despite the negative economic and ecological impact of weeds, relatively little is known about the evolutionary mechanisms that influence their persistence in agricultural fields. Here, we use a resurrection approach to examine the potential for genotypic and phenotypic evolution in Ipomoea purpurea, an agricultural weed that is resistant to glyphosate, the most widely used herbicide in current‐day agriculture. We found striking reductions in allelic diversity between cohorts sampled nine years apart (2003 vs. 2012), suggesting that populations of this species sampled from agricultural fields have experienced genetic bottleneck events that have led to lower neutral genetic diversity. Heterozygosity excess tests indicate that these bottlenecks may have occurred prior to 2003. A greenhouse assay of individuals sampled from the field as seed found that populations of this species, on average, exhibited modest increases in herbicide resistance over time. However, populations differed significantly between sampling years for resistance: some populations maintained high resistance between the sampling years whereas others exhibited increased or decreased resistance. Our results show that populations of this noxious weed, capable of adapting to strong selection imparted by herbicide application, may lose genetic variation as a result of this or other environmental factors. We probably uncovered only modest increases in resistance on average between sampling cohorts due to a strong and previously identified fitness cost of resistance in this species, along with the potential that nonresistant migrants germinate from the seed bank.
Comparing total body lipid content of young‐of‐the‐year Steller sea lions among regions of contrasting population trends
Authors: Rea Lorrie D. , Fadely Brian S. , Farley Sean D. , Avery Julie P. , Dunlap‐Harding Wendy S. , Stegall Vicki K. , Eischens Carrie A. B. , Gelatt Tom S. , Pitcher Kenneth W.
Published: June 2016

Steller sea lion (Eumetopias jubatus) young‐of‐the‐year (YOY) are nutritionally dependent upon their dam through the majority of their first year. Several indices of body condition were measured in YOY 1.5–9 mo of age captured in Southeast Alaska (n = 122), the Gulf of Alaska (n = 182), and the Aleutian Islands (n = 38) to test the hypothesis that nutritional stress impacted the ability of adult female Steller sea lions to adequately nourish their late gestation YOY in the central Aleutian Islands in the early 2000s. Body mass (kg) and percent total body lipid content (%TBL) increased with age in all three regions of Alaska that were sampled (P < 0.05). Young‐of‐the‐year 7–9 mo of age were leaner in Southeast Alaska (27.6% ± 1.0%) and Gulf of Alaska (29.5% ± 0.8%) than in the Aleutian Islands (35.7% ± 1.2%, P < 0.001). Condition indices calculated from morphometric measures did not strongly predict the %TBL measured by isotope dilution. The trend for Aleutian Island YOY to have larger body mass and larger body fat reserves are counter to what would be expected if dams were unable to adequately provision their late lactation YOY due to inadequate food availability in the central Aleutian Islands.
Terrestrial habitat preferences and segregation of four pinniped species on the islands off the western coast of the Baja California Peninsula, Mexico
Authors: Arias‐del‐Razo Alejandro , Heckel Gisela , Schramm Yolanda , Pardo Mario A.
Published: June 2016

Coastal habitats are crucial to pinnipeds for resting, molting, and reproduction. We examined terrestrial habitat preferences of four pinniped species (California sea lion, Guadalupe fur seal, harbor seal, and northern elephant seal) on the islands off the western coast of the Baja California Peninsula, Mexico. Boat‐based surveys were conducted while circumnavigating 10 islands or archipelagos during summer and winter in 2009 and 2010. Habitat selection was inferred based on generalized linear models using animal counts and four habitat descriptors (substrate type, tide pools, bathymetry, and surf protection). The interspecific overlapping was analyzed using the Morisita index. Sea lions, fur seals, and harbor seals used sheltered beaches and rocky platforms as breeding sites. Cobblestone and sandy beaches were the most important substrates for elephant seals. Cliffs were the least preferred habitat by all species. Although substrate preferences were similar among species, segregation was observed in most islands except at the San Benito Archipelago, where sea lions co‐inhabit with elephant seals and fur seals. In the context of a recolonization process, these results could provide insights about the location of future colonies and information on habitat use, which can be used when designing conservation strategies for the islands.
Can Destination Therapy be implemented in children with heart failure? A study of provider perceptions
Authors: Char Danton S. , Lee Sandra S.‐J. , Ikoku Alvan A. , Rosenthal David , Magnus David
Published: June 2016

DT is an established final therapeutic choice in adult patients with severe heart failure who do not meet criteria for cardiac transplantation. Patients are given VADs, without the prospect of care escalation to transplantation. VADs are now established therapy for children and are currently used as a bridge until transplantation can be performed or heart failure improves. For children who present in severe heart failure but do not meet transplantation criteria, the question has emerged whether DT can be offered. This qualitative study aimed to elicit the perspectives of early adopters of DT at one of the few institutions where DT has been provided for children. Responses were recorded and coded and themes extracted using grounded theory. Interviewees discussed: envisioning of the DT candidate; approach to evaluation for DT; contraindications to choosing DT; and concerns about choosing DT. Providers articulated two frameworks for conceptualizing DT: as a long bridge through resolution of problems that would initially contraindicate transplantation or, alternatively, as a true destination instead of transplantation. True destination, however, may not be the lasting concept for long‐term VAD use in children given improvement in prognosis for current medical contraindications and improving VAD technology.
Employment status among the Singapore elderly and its correlates
Authors: Tan Min‐En , Sagayadevan Vathsala , Abdin Edimansyah , Picco Louisa , Vaingankar Janhavi , Chong Siow Ann , Subramaniam Mythily
Published: June 2016

Aim

It has been hypothesized that working beyond retirement age may have a protective effect on various aspects of well‐being in the elderly. This paper aims to examine the relationship between employment status of elderly Singaporeans and indicators of well‐being.

Methods

As part of the Well‐being of the Singapore Elderly study, data relating to sociodemographics, social networks, medical history, physical activity, cognitive function, and disability were collected from 2534 participants aged 60 years and older. Participants included full‐time workers (n = 483), part‐time workers (n = 205), the unemployed (n = 32), homemakers (n = 808), and retirees (n = 1006). The data were analyzed by multiple logistic regression.

Results

Likelihood of being employed decreased with age, and employment was higher among men. Paid workers had significantly higher levels of physical activity, more extensive social networks, better cognitive function, less disability, and lower risk of dementia than retirees and homemakers. Paid workers had significantly lower chronic disease burden than retirees and rated their health to be better than retirees and the unemployed.

Conclusions

These findings show that meaningful employment is associated with better psychological and physiological well‐being among the elderly, highlighting the importance of studying likely protective effects of employment and creating employment opportunities for elderly Singaporeans.
Applying orthodontic tooth extrusion in a patient treated with bisphosphonate and irradiation: a case report
Authors: Morita Hiromitsu , Imai Yuko , Yoneda Masahiro , Hirofuji Takao
Published: June 2016

Bisphosphonates and irradiation are useful medical treatments, but can often cause oral complications such as medication‐related oral necrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) during oral surgery, including tooth extraction. Therefore, we should take all risks into consideration carefully before choosing dental treatment for patients with a medical history of such therapies. A 55‐year‐old woman who underwent cord blood transplantation to treat extranodal natural killer T (NK/T) cell lymphoma (nasal type IVB) had a medical history of bisphosphonate and irradiation treatments. We treated her residual tooth root by applying orthodontic extrusion to avoid extraction and successfully restored the tooth. Application of an orthodontic tooth extrusion technique for conservative treatment of a residual tooth is a useful means of avoiding MRONJ or ORN in patients who have a medical history of bisphosphonate and irradiation treatments.
Mindfulness‐based cognitive therapy is effective as relapse prevention for patients with recurrent depression in Scandinavian primary health care
Authors: Lilja Josefine L. , Zelleroth Clara , Axberg Ulf , Norlander Torsten
Published: June 2016

This study examined the effectiveness of mindfulness‐based cognitive therapy (MBCT) in primary care for patients with recurrent depression (major depressive disorder: MDD). According to the World Health Organization (WHO), MDD is now the leading cause of disease burden in middle‐ and high‐income countries. Patients (N = 45) with three or more previous depressive episodes were recruited to participate in MBCT as a preventative intervention. Using a benchmarking approach, outcome data was compared with data from a recent efficacy study. The methodology is a rigorous approach to assessing effectiveness when evidence‐based UK protocols are transferred into the existing Scandinavian service delivery. Additionally, a person‐centred methodological approach was used to assess clinical significance on the Reliable Change Index (RCI). The analysis revealed comparable or larger effects from pre‐test to post‐test in reduced psychiatric symptoms, increased quality of life and level of mindfulness, and the effects were maintained over 14 months. Analysis of the relapse rate in the current study (16%) compared to the TAU in the efficacy study (68%) yielded an h value of 0.78, a moderate effect size. Only 13% dropped out of the treatment. According to the RCI findings, 65% to 67% of participants in the clinical group improved, no individual worsened, and women showed a significantly greater improvement of depression and anxiety than men. Therapeutic alliance and motivation had no impact on the outcome. The overall result suggests that MBCT can be implemented successfully in Scandinavian primary health care as a preventive intervention for patients with recurrent depression.
Examining Innovation for Sustainability from the Bottom Up: An Analysis of the Permaculture Community in England
Authors: Maye Damian
Published: June 2016

This article applies the transition approach to a novel food production context, via an examination of the food production side of permaculture. More specifically, it examines attempts by the permaculture community in England to interact and influence the Agriculture Knowledge System of the mainstream agro‐food regime. Strategic Niche Management and Communities of Practice theory are combined to examine the ways in which the permaculture community has evolved and has sought to develop its agro‐ecology message and influence the agro‐food regime. Evidence of second order learning and networking with stakeholders outside the community of practice is limited. A tension between internal activities that reinforce a boundary between the permaculture knowledge system and the wider Agriculture Knowledge System are evident. Some external activities designed to cross boundaries are noted. However, activities designed to translate permaculture ideas into mainstream agriculture have had limited success. There is some evidence of interaction and lateral linkage with sub‐regimes to enhance capacity but this is usually in individual capacities. Examining the evolution of radical niche innovations such as permaculture thus reveals the way that beliefs, values and epistemologies make the process of sustainability transition challenging and complex, particularly when different knowledge systems clash with one another.
A New Combined Assessment of Mixed Uncertainty in Spatial Models: Conceptualization and Implementation
Authors: Rios J. Fernando , Renschler Chris S.
Published: June 2016

Uncertainty quantification is not often performed in spatial modeling applications, especially when there is a mixture of probabilistic and non‐probabilistic uncertainties. Furthermore, the effect of positional uncertainty is often not assessed, despite its relevance to geographical applications. Although there has been much work in investigating the aforementioned types of uncertainty in isolation, combined approaches have not been much researched. This has resulted in a lack of tools for conducting mixed uncertainty analyses that include positional uncertainty. This research addresses the issue by first presenting a new, flexible, simulation‐oriented conceptualization of positional uncertainty in geographic objects called F‐Objects. F‐Objects accommodates various representations of uncertainty, while remaining conceptually simple. Second, a new Python‐based framework is introduced, termed Wiggly and capable of conducting mixed uncertainty propagation using fuzzy Monte Carlo simulation (FMCS). FMCS combines both traditional Monte Carlo with fuzzy analysis in a so‐called hybrid approach. F‐Objects is implemented within the Wiggly framework, resulting in a tool capable of considering any combination of: (1) probabilistic variables; (2) fuzzy variables; and (3) positional uncertainty of objects (probabilistic/fuzzy). Finally, a realistic GIS‐based groundwater contamination problem demonstrates how F‐Objects and Wiggly can be used to assess the effect of positional uncertainty.
Whole blood for the acutely haemorrhaging civilian trauma patient: a novel idea or rediscovery?
Authors: Bahr M. P. , Yazer M. H. , Triulzi D. J. , Collins R. A.
Published: June 2016

The concept of whole blood (WB) as a treatment modality for trauma patients requiring transfusion therapy is not new. Successfully employed in the early 20 century, WB was the product of choice for military trauma resuscitation until the advent of component therapy changed the landscape of transfusion medicine. However, the recognition of the success of WB in the military operational setting has provided some enthusiasm to explore its revival as a cold‐stored option in the civilian trauma resuscitation sector. Concerns continue to exist over potential limitations for its application in regards to the efficacy of platelets after cold storage, the risk of haemolytic transfusion reactions following the transfusion of un‐cross‐matched WB and the logistical issues for civilian blood banks in providing WB. This review aims to reconcile these concerns with data available in the literature, with a view to establishing that there is in vitro evidence supporting the haemostatic effects of cold‐stored WB as a potential therapeutic option in both the pre‐hospital and in‐hospital civilian trauma resuscitation settings.
Risk of transfusion‐transmitted chikungunya infection and efficacy of blood safety implementation measures: experience from the 2009 epidemic in Songkhla Province, Thailand
Authors: Appassakij Hatsadee , Promwong Charuporn , Rujirojindakul Pairaya , Khuntikij Paiwon , Silpapojakul Khachornsakdi
Published: June 2016

BACKGROUND

To date, neither is there a standard guideline for maintaining a safe blood supply during a chikungunya fever (CHIKF) outbreak nor has a study been performed on actual transfusion‐transmitted CHIKF to recipients. This study estimated the potential incidence of transfusion‐transmitted CHIKF and compared the efficacies of various blood safety intervention strategies to mitigate the transfusion‐transmitted CHIKF risk.

STUDY DESIGN AND METHODS

A Web‐based tool named the European Up‐Front Risk Assessment Tool (EUFRAT) was used to estimate the risk of transfusion‐transmitted CHIKF using data inputs from the 2009 Songkhla epidemic in Thailand.

RESULTS

The mean and maximal risks of viremic donations during the entire epidemic period were estimated to be 0.9 (95% confidence interval [CI], 0.0‐2.7) and 4.8 (95% CI, 0.5‐9.1), respectively. This meant that the potential risk of transfusion‐transmitted CHIKF to recipients receiving all infective end products in the absence of blood safety measures was from 10.9 (95% CI, 1.8‐20.4) to 57.6 (95% CI, 36.4‐79.5). Based on experience from the 2009 Thai epidemic, the proportion of 10% asymptomatic cases, for instance, with predonation screening for CHIKF‐related symptoms and follow‐up observation in donors at risk was estimated to be 88.4% (95% CI, 69.9%‐100.0%) to 99.1% (95% CI, 79.6%‐100.0%) effective in reducing this transfusion risk compared to 83.7% (95% CI, 65.8%‐100.0%) to 90.7% (95% CI, 72.1%‐100.0%) by predonation screening for donors at risk of chikungunya virus infection alone.

CONCLUSION

This study suggests that prompt blood screening measures can reduce the risk of transfusion‐transmitted CHIKF and maintain a safe blood supply during an outbreak.
Feasibility of Stifle Medial Meniscal Release in Toy Breed Dogs with and without a Joint Distractor
Authors: Kim Kwan , Lee Haebeom , Ragetly Guillaume R.
Published: June 2016

Objective

To investigate the feasibility of medial meniscal release (MMR) during stifle arthroscopy in toy breed dogs with and without a joint distractor.

Study Design

Experimental cadaveric study.

Sample Population

Stifles (n = 40) from 20 canine cadavers (1.8–5.1 kg).

Methods

Paired stifles were randomly assigned to the joint distractor group and the control group (n = 20 each). All stifles underwent arthroscopic transection of the cranial cruciate ligament followed by a release of the caudomedial meniscotibial ligament. After the procedures, all stifles were disarticulated. The degree of released meniscus was recorded subjectively by 5% increments. A MMR success was defined as a complete transection. The areas of femoral and tibial articular cartilage damage were calculated using india ink staining and digital imaging. The results were compared between groups and odds ratios were calculated.

Results

All stifle arthroscopies were successful. The success rate of MMR was significantly higher (P = .013) with a joint distractor than without a joint distractor. MMR was 7.4 times more likely to succeed with a joint distractor than without a joint distractor. The distal femoral articular cartilage was significantly more damaged (P = .011) in the stifles without a joint distractor than in the stifles with a distractor. No difference was found between the 2 groups for damage to the tibial cartilage (P = .058).

Conclusion

Stifle arthroscopic MMR is feasible in toy breed dogs. Using a joint distractor is recommended for arthroscopic treatment based on our results because it significantly reduced the rate of incomplete release as well as iatrogenic cartilage damage.
Complication Rates After Bilateral versus Unilateral Total Ear Canal Ablation with Lateral Bulla Osteotomy for End‐Stage Inflammatory Ear Disease in Dogs: 79 Ears
Authors: Coleman Kristin A. , Smeak Daniel D.
Published: June 2016

Objective

To determine whether perioperative complication rates are different between unilateral (ULS) versus single‐stage bilateral (BLSS) total ear canal ablation‐lateral bulla osteotomy (TECA‐LBO) surgeries.

Study Design

Retrospective case series.

Animals

Fifity‐seven dogs (79 ears) undergoing TECA‐LBO at a single institution over 14 years.

Methods

Medical records of dogs undergoing TECA‐LBO for end‐stage inflammatory non‐neoplastic ear disease from March 1999 to September 2013 at the Colorado State University Veterinary Teaching Hospital were evaluated for intraoperative and early postoperative complications associated with the procedure. Inclusion criteria were clinical and/or histopathologic diagnosis of chronic otitis externa, surgical treatment by TECA‐LBO, and a minimum of 2 week follow‐up data.

Results

Twenty dogs (40 ears) underwent BLSS and 37 dogs (39 ears) had ULS. Complications were recorded for 29 of 40 ears (72.5%) in the BLSS group (40.0% facial nerve, 15.0% ocular, and 32.5% minor incisional complications) and 25 of 39 ears (64.1%) in the ULS group (33.3% facial nerve, 12.8% ocular, and 23.1% minor incisional complications). Dogs undergoing BLSS did not have a significantly higher total complication rate, or higher neurologic, ocular, or incisional complication rates, than the ULS procedure. No major anesthetic complications affecting outcome were recorded for either group.

Conclusion

Anesthetic and early surgical complication rates after ULS and BLSS were not significantly different in our study. Offering single‐stage bilateral TECA‐LBO procedures for otherwise healthy dogs with end‐stage inflammatory otitis externa is a viable treatment option without additional risk for complication.
Expert Opinion to Identify High‐Risk Entry Routes of Canine Rabies into Papua New Guinea
Authors: Brookes V. J. , Ward M. P.
Published: June 2016

The proximity of Papua New Guinea (PNG) to canine rabies‐endemic countries in South‐East Asia presents a risk of incursion of this disease into PNG and the rest of the Oceanic region. The objective of this study was to identify the highest risk routes for entry of dogs – associated with movement of people – into PNG from canine rabies‐endemic countries. A structured, in‐country expert‐elicitation workshop was used, and 20 entry routes were identified. The highest risk routes were three land routes from Papua, Indonesia (hunters, traditional border crossers and unregulated, unchecked ‘shopper‐crossers’) and two sea routes (fishing and logging). These results will be used to direct more detailed risk assessments to develop surveillance strategies and incursion response plans.
A NOVEL MODEL OF PZT ACTUATOR AND ITS APPLICATION IN HYSTERESIS AND VIBRATION CONTROLS
Authors: Muhammad Bashir Bala , Rahman Md Habibur , Ahmad Mohd Ridzuan , Bashir Muhammad
Published: June 2016

The piezoelectric actuator is a voltage spring system that behaves in a similar characteristic to mechanical mass spring system. The displacements profile of the piezoelectric actuator shifts due to hysteresis and creep during actuation. The static (non-dynamics) models of piezoelectric actuator developed in the past consisted of a number of equations which could not be simplified in the form of a single transfer function. Furthermore, the modelling of dynamic (vibrating) piezoelectric actuator was not considered.  In this work, we present the behaviour of the piezoelectric actuator in terms of mechanical displacement from applied electric potential. The single transfer function mathematical model is generated representing the actuator characteristics. The dynamic (vibration) model that can vibrate at a desired frequency of the actuator is also developed. The models are developed by system identification from experimental results. A high resolution microscope together with the image processing technique were used to obtain the system characteristics. Simulation using Matlab Simulink is used to validate the experiment (The hysteresis was reduced by 90 % and the vibration was reduced to 97 %).
ACCURACY AND QUICKNESS CRITERION-BASED DRIVING SKILL METRIC FOR HUMAN ADAPTIVE MECHATRONICS SYSTEM
Authors: Badrul Hisham Amirah ‘Aisha , Aujih Ahmad Bukhari , Ishak Mohamad Hafis Izran , Zainal Abidin Mohamad Shukri
Published: June 2016

Previous studies on driving skill algorithm have combined tracking error and time related variables into algorithm formulation. This method however does not include a car orientation and lateral speed information as an integral part of the algorithm. Two new variables are introduced into the algorithm structure, namely, orientation angle and lateral speed. Nine participants were carefully recruited for a driving test to validate the algorithm. A simulated driving environment was specifically devised for this experiment. A driving track used in this experiment was segmented into five different severities for data analysis. Two fundamental goals have led to the collection and subsequent analysis of the data. The first is analysing the variables in relation to the driving task. The second involves data analysis being further extended into analysing the algorithm performance over estimating the driving skill index. The results reveal that the proposed variables are well correlated with the driving task, and improvement in algorithm performance is found to be almost double compared to the previous algorithm.