bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Mesenchymal Stem Cell-Enriched β-Tricalcium Phosphate Scaffold Processed by the Screen-Enrich-Combine Circulating System Promotes Regeneration of Diaphyseal Bone Non-Union
Authors: Wang Xin , Chu WenXiang , Zhuang YiFu , Shi DingWei , Tao HaiRong , Jin Chen , Dai KeRong , Zhao Jie , Gan YaoKai
Published: December 2018

Bone non-union after fracture, considered a therapeutic challenge for orthopedics, always needs a reversion surgery, including autograft transplantation (AGT). However, adverse events related to autograft harvest cannot be ignored. Our group designed a novel system called the bone marrow stem cell Screen-Enrich-Combine Circulating System (SECCS) by seeding mesenchymal stem cells (MSCs) into β-tricalcium phosphate (β-TCP) during surgery to thereafter rapidly process bioactive bone implantation. In this retrospective case-control study, 30 non-union patients who accepted SECCS therapy and 20 non-union patients who accepted AGT were enrolled. By SECCS therapy, the MSC-enriched β-TCP particles were implanted into the non-union gap. During the enrichment procedure, a significant proportion of MSCs were screened and enriched from bone marrow into porous β-TCP particles, and the cells possessed the capacity for three-line differentiation and were CD90+/CD105+/CD34-/CD45-. Approximately 82.0±10.7% of MSCs were enriched from 60 mL bone marrow without damaging cell viability, and approximately 11,444.0±6,018 MSCs were transplanted per patient. No implant-related infections occurred in any case. After 9 months of follow-up, 27 patients (90%) in the SECCS group acquired clinical union, compared with 18 patients (90%) in the AGT group (clinical union time, P = 0.064), and postoperative radiographic union score at 9 months post-operation was similar between the two groups. In conclusion, the SECCS could concentrate a large proportion of MSCs from bone marrow to acquire enough effective cells for therapy without in vitro cell culture. Bone substitutes processed by SECCS demonstrated encouraging promotion of bone regeneration and showed a satisfactory clinical curative effect for diaphyseal bone non-union, which was non-inferior to AGT.
Consumers’ Preference on Imported and Locally Made Furniture in Dar es Salaam and Arusha, Tanzania
Authors: Kumburu Neema P. , Kessy John Francis
Published: December 2018

This study was designed to assess the consumer’s preference between imported and locally made furniture in Dar es Salaam and Arusha in Tanzania. Primary and secondary data for the study were collected from furniture consumers in the study area. A total of 134 consumers were surveyed. Questionnaires and documentary reviews were used for data collection. Descriptive statistics and binary logistic regression were used in the analysis of data. The result of the study revealed significant differences on the levels of consumers’ preference for furniture products. Imported furniture seems to be far preferred by consumers. It was observed that the major differences in consumers’ preference for furniture were due to quality and design. This study provides valuable implications for local small-scale manufacturers if they want to compete in the globalized market. It is, therefore, recommended that local furniture manufacturers should acquire adequate skills, technology and innovation in order to produce competitive products.
Urban Service Delivery in West Bengal: Current Scenario and New Challenges
Authors: Chattopadhyay Soumyadip , Das Maumita
Published: December 2018

Size class-wise analysis of state’s urban services in West Bengal reveals that, in spite of improvement in provision of urban services in 2011 over 2001, service deficits and inter-category variations did persist. Service coverage increased systematically with the size class of the urban local bodies (ULBs), and intra-category disparities were higher for smaller ULBs. Mainly, the larger ULBs exhibited positive relationships between financial performances and urban service delivery. Therefore, this article argues for higher fund allocation for basic services and concerted development of smaller cities, through financial empowerment and institutional strengthening, as the key strategies for ensuring sustainable urbanisation.

JEL Classification: H41, R53
Relationship Between Coping Strategies, Religious Attitude, and Optimism of Mothers of Children With Cancer
Authors: Bozkurt Gülçin , İnal Sevil , Yantiri Leman , Alparslan Özgür
Published: December 2018

Introduction: The purpose of this study was to examine the relationship between coping strategies, religious attitude, and optimism of mothers of children with cancer. Method: The sample was 97 mothers of children with cancer. To collect data, the Coping Strategy Questionnaire, Religious Attitude Scale, and Life Orientation were used. Results: There were positive correlations between the total score of Coping Strategy Questionnaire and emotional scores of Religious Attitude Scale ( r = 0.170, p = .04). The correlation relationship between mothers’ coping, religious tendencies, and optimism tendencies was not significant ( p > .05). There were also positive correlations between Coping Strategy Questionnaire Social Support Seeking subscale and the total scores of Religious Attitude Scale ( r = 0.189, p = .03) and Life Orientation Test ( r = 0.183, p = .03). Discussion: Mothers with a higher religious attitude had bettter social support and were more optimistic. These results will contribute to understanding the influence of religion in different cultures.
Using Photo-Elicitation to Explore Families’ Experiences of Burn Camp
Authors: Armstrong-James Laura , Cadogan Julia , Williamson Heidi , Rumsey Nichola , Harcourt Diana
Published: December 2018

A qualitative study using photo-elicitation was conducted to investigate the experiences of family members attending a residential burn camp. Six families were provided with cameras and asked to take photographs of their time at camp. They were subsequently interviewed about their experiences of camp, using their photographs as prompts. Thematic analysis of interview transcripts identified three main themes: benefits for the family as a whole (new activities and experiences and lasting impacts), benefits for the child (having fun without feeling different), and benefits for the parent/carer (support from those who understand). This is the first study to specifically investigate the experience of the whole family at a burn camp and suggests that attendance may offer a number of benefits for parents/carers and children. Photo-elicitation was an effective method for encouraging participants to recall and discuss their time at camp, and should be considered in future burns research.
Creature of Habit or Embracer of Change? Contrasting Consumer Daily Food Behavior with the Tourism Scenario
Authors: Wang Saerom , Lehto Xinran , Cai Liping
Published: December 2018

This research investigates tourist food consumption patterns and food choice motives while on trips, in comparison to their food behavior in the everyday life scenario. The results suggest that consumers’ food choice motives and behaviors during travel are inconsistent with their food regimens followed at home. In addition, gender is found to be a significant variable in explaining such inconsistencies. Implications pertaining to these findings are discussed in the context of tourism experience satisfaction and the role travel destinations can play in consumer wellness management.
Relapsing remitting multiple sclerosis in progressive external ophthalmoplegia: A report of two cases
Authors: Patel Kevin R , Karaa Amel , Mateen Farrah J
Published: December 2018

Evidence from genetic and pathologic studies suggests that mitochondrial dysfunction occurs in multiple sclerosis (MS). Furthermore, cases of MS have been reported in patients with mitochondrial disease. The phenotypic range of mitochondrial illness associating with MS is not yet well defined. In this report, we highlight two cases of patients with confirmed genetic mutations responsible for progressive external ophthalmoplegia who independently meet McDonald criteria for MS. Better characterization of the range of mitochondrial disease associated with MS may improve our understanding of MS disease pathophysiology.
A model-based and experimental approach for the determination of suitable variable valve timings for cold start in partial load operation of a passenger car single-cylinder diesel engine
Authors: Maniatis P , Wagner U , Koch T
Published: December 2018

A manipulation of the charge exchange allows controlling the amount of residual gas during engine warm-up. The residual gas during the warm-up phase leads to an increase of the exhaust gas temperature and supports to reach the exhaust after-treatment system operating temperature faster. In addition, the warm residual gas increases the combustion chamber temperature, which reduces the HC and CO emissions. However, fuel consumption increases. For that reason, such heating measures should be the best compromise of both, exhaust gas temperature increase and engine efficiency, in order to provide efficient heating strategies for passenger car diesel engines. Therefore, simulative and experimental investigations are carried out at the Institute of Internal Combustion Engines of the Karlsruhe Institute of Technology to establish a reliable cam design methodology. For the experimental investigations, a modern research single-cylinder diesel engine was set up on a test bench. In addition, a one-dimensional simulation model of the experimental setup was created in order to simulate characteristics of valve lift curves and to investigate their effects on the exhaust gas temperature and the exhaust gas enthalpy flow. These simulations were based on design of experiments (DoE), so that all characteristics can be used sustainably for modeling and explaining their influences on the engine operation. This methodology allows numerically investigating promising configurations and deriving cam contours which are manufactured for testing. To assess the potential of these individual configurations, the results obtained were compared with each other as well as with the series configuration. Results show that the combination of DoE and one-dimensional simulation for the design of camshaft contours is well suited which was also validated with experimental results. Furthermore, the potential of residual gas retention by favorable configurations with a second event already revealed in various publications could be confirmed with respect to exhaust gas temperature increase and engine efficiency.
The classification of gasoline/diesel dual-fuel combustion based on the heat release rate shapes and its application in a light-duty single-cylinder engine
Authors: Lee Jeongwoo , Chu Sanghyun , Kang Jaegu , Min Kyoungdoug , Jung Hyunsung , Kim Hyounghyoun , Chi Yohan
Published: December 2018

In this research, there are two major sections for analysis: the characteristics of gasoline and diesel dual-fuel combustion and their application to operating load extension with high thermal efficiency and low emissions. All the experiments were completed using a single-cylinder compression ignition engine with 395 cc displacement. In the first section, the dual-fuel combustion modes were classified into three cases by their heat release rate shapes. Staying at 1500 r/min with a total value of 580 J of low heat for each cycle condition, the diesel injection timing was varied from before top dead center with a 6–46 °crank angle with 70% of gasoline fraction based on the low heating value. Among the modes were two suitable dual-fuel combustion modes for a premixed compression ignition. The first suitable mode shows multiple peaks in the heat release rate (mode 2) and the second suitable mode shows a single peak with a “bell-shaped” heat release rate (mode 3). These two dual-fuel combustion types showed a high gross indicated thermal efficiency of up to 46%. Based on the results in the first section, the practical application of dual-fuel premixed compression ignition combustion was investigated considering a high thermal efficiency and a high-load condition. At a 1500 r/min/gross indicated mean effective pressure of 6.5 bar, 48% of the gross indicated thermal efficiency was obtained by using dual-fuel premixed compression ignition combustion mode 3. This mode was typical of a “reactivity controlled compression ignition,” while the nitrogen oxides and the particulate matter emissions satisfied the EURO-6 regulation (0.21 g/kW h and 2.8 mg/m3, respectively). In addition, a high thermal efficiency (45%) with low maximum pressure rise rate, NOx (nitrogen oxides), and particulate matter emissions was obtained at 2000 r/min/gross indicated mean effective pressure 14 bar condition by the adjustment of dual-fuel premixed compression ignition combustion mode 2. As a result, this research contributes to the understanding and practical application of dual-fuel combustion for a light-duty compression ignition engine.
Prospective associations between cardiac stress, glucose dysregulation and executive cognitive function in Black men: The Sympathetic activity and Ambulatory Blood Pressure in Africans study
Authors: Jansen van Vuren Esmé , Malan Leoné , von Känel Roland , Magnusson Martin , Lammertyn Leandi , Malan Nicolaas T
Published: December 2018

Objective:

Glucose dysregulation is an independent risk factor for cardiovascular and neurodegenerative disease development through synaptic dysfunction resulting in cognitive decline. The aim of this study was to study the interplay between impaired glycaemic metabolism (hyperglycaemia and insulin resistance), cardiac stress (cardiac troponin T and N-terminal brain natriuretic peptide) and executive cognitive function prospectively, in a bi-ethnic sex cohort.

Methods:

Black and White teachers (N = 338, aged 20–63 years) from the Sympathetic activity and Ambulatory Blood Pressure in Africans study were monitored over a 3-year period. Fasting blood samples were obtained for cardiac troponin T, N-terminal brain natriuretic peptide, glycated haemoglobin and the homeostatic model assessment-insulin resistance for insulin resistance. The Stroop colour-word conflict test was applied to assess executive cognitive function at baseline.

Results:

Over the 3-year period, Black men revealed constant high levels of cardiac troponin T (⩾4.2 ng/L), pre-diabetes (glycated haemoglobin > 5.7%) and insulin resistance (homeostatic model assessment-insulin resistance >3). %Δ Glycated haemoglobin was associated with %Δ insulin resistance (p < 0.001) and increases in %ΔN-terminal brain natriuretic peptide (p = 0.02) in Black men only. In the latter, baseline Stroop colour-word conflict test was inversely associated with %Δ cardiac troponin T (p = 0.001) and %Δ insulin resistance levels (p = 0.01).

Conclusion:

Progressive myocyte stretch and chronic myocyte injury, coupled with glucose dysregulation, may interfere with processes related to interference control in Black men.
Inter-day test–retest reliability and feasibility of isokinetic, isometric, and isotonic measurements to assess quadriceps endurance in people with chronic obstructive pulmonary disease: A multicenter study
Authors: Frykholm Erik , Géphine Sarah , Saey Didier , van Hees Hieronymus , Lemson Arthur , Klijn Peter , Maltais François , Nyberg André
Published: December 2018

The aims were to determine reliability and feasibility of measurements to assess quadriceps endurance in people with chronic obstructive pulmonary disease. Sixty participants (forced expiratory volume in one second (mean ± standard deviation) 55 ± 18% of predicted, age 67 ± 8 years) were tested in an inter-day, test–retest design. Isokinetic, isometric, and isotonic protocols were performed using a computerized dynamometer. Test–retest relative and absolute reliability was determined via intraclass correlation coefficient (ICC), coefficient of variation (CV%), and limits of agreement (LoA%). Isokinetic total work demonstrated very high relative reliability (ICC: [95% confidence interval] = 0.98 [0.94–0.99]) and the best absolute reliability (CV% (LoA%) = 6.5% (18.0%)). Isokinetic fatigue index, isometric, and isotonic measures demonstrated low-to-high relative reliability (ICC = 0.64 [0.46–0.77], 0.88 [0.76–0.94], 0.91 [0.85–0.94]), and measures of absolute reliability (CV% (LoA%)) were 20.3% (56.4%), 14.9% (40.8%), and 15.8% (43.1%). For isokinetic total work and isometric measurements, participants performed better on retest (4.8% and 10.0%, respectively). The feasibility was similar across protocols with an average time consumption of less than 7.5 minutes. In conclusion, isokinetic, isometric, and isotonic measurements of quadriceps endurance were feasible to a similar extent and presented low-to-very high relative reliability. Absolute reliability seems to favor isokinetic total work measurements.
The Peculiar Preferences of Sports Fans: Toward a Preference-Based Motivation for the Uncertainty of Outcome Hypothesis
Authors: Humphreys Brad R. , Miceli Thomas J.
Published: December 2018

The uncertainty of outcome hypothesis (UOH) informs economic models of fan attendance decisions, team revenue generation, and league outcomes. Despite this importance, little attention has been paid to the role of consumer preferences in motivating the UOH. We develop consumer choice models that generate predictions consistent with the UOH. These models contain utility functions with diminishing marginal utility in team success, or Leontief preferences for success, and assume that league decisions are based on maximization of aggregate welfare. The most general specification shows that when the population contains both partisan and nonpartisan fans, perfect uncertainty of outcome is optimal.
Role of Topical Biological Therapies and Dressings in Healing Ischemic Wounds
Authors: Orrapin Saritphat , Rekasem Kittipan
Published: December 2018

Ischemic wounds are the most severe expression of critical limb ischemia (CLI), and they have been defined clinically as an end stage of peripheral arterial disease. Urgent revascularization is a fundamental part for limb salvage in patients with CLI. However, the risk of revascularization should be weighed against the likelihood of success given a patient’s life-threatening comorbidities. Once the condition of arterial insufficiency is revascularized, wound care is an important aspect to promote the wound healing process and infection control. MOIST concept for wound care is a modern systematic treatment for enhanced wound healing process. Currently, advanced biological therapies are emerging in ischemic wound therapies to restore the wound healing process and involve active biological agents to support the wound healing process. We studied and summarized the different types of available topical biological therapies and their mechanisms on the healing process including platelet-derived growth factor, epidermal growth factor, fibroblast growth factor, and vascular endothelial growth factor, platelet-rich plasma, and honey for local wound care of patient with CLI. Our review suggests that topical platelet-derived growth factor, epidermal growth factor, platelet-rich plasma, and honey are available as well as considered in the ischemic wound healing process enhancement through the MOIST concept. In conclusion, biologic wound dressing or topical agent therapy may improve the wound healing process, increase limb salvage, is inexpensive, and provides potential safety with nontoxic low-risk therapy in patients with an ischemic wound. Thus, local wound care by biological dressing should be added in adjuvant treatment for ischemic wound patients. However, further randomized studies are needed to support efficacy and long-term outcomes of these biological dressing in patients with ischemic wound.
Maggot Therapy in Angiopathic Leg Ulcers: A Systematic Review and Meta-Analysis
Authors: Siribumrungwong Boonying , Wilasrusmee Chumpon , Rerkasem Kittipan
Published: December 2018

Maggot therapy (MT) is a biological debridement tool using blowfly larvae to digest necrotic tissue as its food. In addition, maggot secretion contains several peptides that has antibacterial effect and healing stimulants that might enhance wound healing. Clinical outcomes from previous meta-analyses demonstrated benefit of MT, but results were highly heterogeneous. We have conducted an updated systematic review and meta-analysis with clearly defined clinical outcomes according to mechanism of MT including successful debridement, healing rate, and time to heal. Furthermore, our study was the first meta-analysis that reported wound-related pain between MT and conventional therapy. MEDLINE and Scopus were searched for comparative studies of MT and conventional therapy. Ten studies were eligible, of which 5 studies were angiopathic (venous or mixed arteriovenous ulcers) and the other 5 were diabetic foot ulcer. The MT had significant higher rate of successful debridement with risk ratio of 2.3 (95% confidence interval = 1.7-3.0) with low heterogeneity. Time to heal was about 3.1 weeks (95% confidence interval = 1.2-5.0), significantly shorter in MT but with high heterogeneity. Healing rate and pain were not significantly different between groups with high heterogeneity. In conclusion, MT was an effective debridement tool compared with conventional therapy. More studies should be done to confirm other findings because of high heterogeneity.
Role of immune responses for extracellular matrix remodeling in the ischemic brain
Authors: Dzyubenko Egor , Manrique-Castano Daniel , Kleinschnitz Christoph , Faissner Andreas , Hermann Dirk M.
Published: December 2018

Neuroinflammation is one of the key components contributing to the devastating outcome of ischemic stroke. Starting with stroke onset, inflammatory processes contribute both to cell damage and tissue remodeling. The early release of alarmins triggers the upregulation of multiple proinflammatory cytokines, resulting in the compromised integrity of the blood–brain barrier. From this moment on, the infiltration of peripheral immune cells, reactive gliosis and extracellular matrix (ECM) alterations become intricately intertwined and act as one unit during the tissue remodeling. While the mechanisms of leukocyte and glia activation are amply reviewed, the field of ECM modification remains as yet under explored. In this review, we focus on the interplay between neuroinflammatory cascades and ECM in the ischemic brain. By summarizing the currently available evidence obtained by in vitro research, animal experimentation and human studies, we aim to propose a new direction for the future investigation of stroke recovery.
Diabetes Care and Management Using Electronic Medical Records: A Systematic Review
Authors: Lessing Stephanie E. , Hayman Laura L.
Published: December 2018

Background:

Diabetes treatment and management provide a unique opportunity for examination of the effectiveness of electronic health records (EHRs) on patient health outcomes, continuity of care, and areas for further development. This systematic literature review was designed to identify the strengths and limitations of EHR and opportunities for improvement proposed in original research and recent rigorous systematic reviews.

Methods:

This review utilized methodology adapted from PRISMA. Inclusion criteria for original research were published between March 2003 and November 2017; included randomized controlled trial design with participants ≥18 years of age with diabetes diagnosis ≥1 year; measured outcomes included HbA1c, blood pressure, and LDL cholesterol levels. Criteria for systematic reviews included research focused on EHR outcomes, improvement of care for patients with diabetes, prevention of adverse outcomes, web-based communication, and limitations of EHR regarding chronic disease management. Thirteen articles qualified for inclusion.

Results:

Meta-synthesis of articles suggests that chronic disease patients benefit most by decision support tools that alert physicians of drug interactions, communication tools that keep them informed and engaged in their treatment regimens and detailed reporting and tracking designed to inform progress. Collective results suggest that EHR technology is advancing rapidly; however, patient outcomes documented via EHR systems remain largely unknown.

Conclusion:

A fertile area for inquiry designed to enhance patient outcomes in diabetes and chronic disease management is determining how EHR systems can be utilized for new drug and treatment options in addition to enhancing the quality, cost-effectiveness, and continuity of care.
Alpine Skiing Injuries
Authors: Davey Annabelle , Endres Nathan K. , Johnson Robert J. , Shealy Jasper E.
Published: December 2018

Context:

Alpine skiing is a popular sport worldwide but has significant risk for injury. The epidemiology of skiing-related injuries has been described, which has led to the identification of risk factors for specific types of injuries.

Evidence Acquisition:

Pertinent literature from peer-reviewed publications was reviewed.

Study Design:

Clinical review.

Level of Evidence:

Level 5.

Results:

The adoption of international standards for ski-boot-binding systems has changed the profile of skiing-related injuries over time, as has the widespread use of helmets. An understanding of mechanisms of injury, risk factors, and preventative measures may decrease the incidence of skiing-related injuries.

Conclusion:

Advances in standards for skiing equipment have been effective at decreasing both the frequency and severity of skiing-related injuries, but additional efforts are required to improve the safety of the sport.
“I didn’t say, ‘Macbeth,’ it was my Google Doc!”: A secondary English case study of redefining learning in the 21st Century
Authors: Marlatt Rick
Published: December 2018

The substitution, augmentation, modification, redefinition (SAMR) model offers a framework by which schools and teachers can implement digital tools through curricular design that encourages participatory learning. 21st Century students should be producing content and making meaning in educational settings with high levels of engagement and by the same literacy methods they use in social contexts. This case study examines the digital pedagogy of one English teacher at a Western United States high school. Using the SAMR model as a theoretical framework, this article first reviews relevant literature on creating participatory cultures in schools with Google Docs. Then, through observations, interviews, and artifacts, the analysis attempts to pinpoint specific phases of the teacher’s instruction where the potential to enhance academic opportunities is transformed by creativity and collaboration and leads to a redefinition of the learning environment. This article considers both the teacher’s pedagogy in her Macbeth unit as well as the school’s technology procedures in measuring its progress within the SAMR model.
The use of information and communication technologies by arthritis health professionals to disseminate a self-management program to patients: a pilot randomized controlled trial protocol
Authors: De Angelis Gino , Brosseau Lucie , Davies Barbara , King Judy , Wells George A.
Published: December 2018

Design and objective: This paper describes the protocol for a three-arm, single-blind, parallel design randomized controlled trial (RCT) to investigate the perceived usability of Facebook to share information from an evidence-based arthritis self-management program with patients compared with email or an educational website after two weeks.

Study population

Three-hundred and twenty-seven arthritis health professionals (i.e., nurses or physical/occupational therapists) registered with their regulatory body in Canada, currently practicing clinically defined as spending a minimum of 50% of their time (working week) in direct arthritis patient care.

Interventions

The proposed RCT will include three information and communication technology (ICT) intervention groups: Facebook, email, and an educational website.

Outcome measures

The primary outcome will be perceived usefulness by health professionals of using the ICT intervention to share information with their patients according to the technology acceptance model 2 (TAM2) questionnaire at two weeks post-intervention. Secondary outcomes will include other usability domains of the TAM2 questionnaire (i.e., perceived ease of use, result demonstrability, output quality, job relevance, image, voluntariness, subjective norm, and intention to use) at two weeks, three months, and six months post-intervention. Analysis: An analysis of variance will be conducted to compare TAM2 questionnaire scores of the Facebook group with the email and educational website groups.
Autoimmune Ataxia During Maintenance Therapy for Acute Lymphoblastic Leukemia
Authors: Voeller Julie , Ikonomidou Chrysanthy , Brucker Justin , Diamond Carol , Frierdich Sharon , Patel Neha
Published: December 2018

Neurologic dysfunction during acute lymphoblastic leukemia treatment is commonly associated with chemotherapy. Nonchemotherapy contributions should be considered for persistent atypical symptoms. We describe a boy with acute lymphoblastic leukemia who developed recurrent fevers, diarrhea, progressive ataxia, and neuropsychiatric impairment during maintenance chemotherapy. He was found to have cytomegalovirus in his serum and colon, but not in his cerebrospinal fluid. Instead, his cerebrospinal fluid revealed oligoclonal bands not present in the serum, suggesting an autoimmune process. Prompt treatment with ganciclovir and immunotherapy resulted in marked clinical improvement. Early recognition and treatment of an autoimmune encephalitis is paramount for optimal clinical outcome.
Development and Application of an Annotation Procedure to Assess the Impact of Hearing Aid Amplification on Interpersonal Communication Behavior
Authors: Meis Markus , Krueger Melanie , Gablenz Petra v. , Holube Inga , Gebhard Maria , Latzel Matthias , Paluch Richard
Published: December 2018

Hearing impairment is associated with a decrease in speech intelligibility and health-related quality of life, such as social isolation and participation restriction. However, little is known about the extent to which hearing impairment and hearing aid fittings change behavior in acute communication situations as well as interrelated behavior patterns. Based on a pilot study, in which the basis for annotating communication behavior was laid, group discussions in noise were initiated with 10 participants using three different hearing-aid brands. The proposed offline annotation scheme revealed that different hearing aids were associated with changes in behavior patterns. These behavioral changes were congruent with speech recognition threshold results and also with subjective assessments. Some of the results were interpreted in terms of participation restriction and activity limitation following the framework of the International Classification of Functioning, Disability and Health. In addition to the offline annotation scheme, a procedure for instantaneous coding of eight behavior patterns was iteratively developed and used for the quick examination of lab studies with good to excellent interrater reliability values.
Patients’ and Family Members’ Subjective Experiences of a Diagnostic Evaluation of Mild Cognitive Impairment
Authors: Morris Jonna L , Hu Lu , Hunsaker Amanda , Liptak Amy , Seaman Jennifer Burgher , Lingler Jennifer H
Published: December 2018

Background:

People with a diagnosis of mild cognitive impairment (MCI) often struggle with uncertainty and fear when learning of and coping with their diagnosis. However, little is known about their experiences and perspectives, and those of their care partners, when seeking out and undergoing a diagnostic evaluation for their cognitive symptoms.

Method:

This study is a secondary analysis of a focus group discussion that was initially conducted to learn the perspectives and experiences of participants and their care partners during a mock disclosure session of brain scan results. Participant’s broader views on their experience of completing a cognitive evaluation resulting in an MCI diagnosis were evaluated in this study. Analysis used qualitative content methodology and line-by-line coding which generated categories and themes.

Results:

The (1) “presence of a threat” and (2) attempts to “minimize the threat” emerged as overarching themes driving the process of seeking out a diagnostic evaluation for cognitive symptoms. Subthemes that highlight the complexity of the presence of a threat included the “fear of stigma,” and the “emotional reactions” related to an MCI diagnosis. Three additional subthemes represented approaches that participants and their care partners used to minimize threat of MCI: “use of language” to minimize the threat; “information sharing and withholding”; and the “use of social support to legitimize personal experiences.”

Conclusion:

These findings add to the literature by elucidating the uncertainty, fears, and coping strategies that accompany a diagnostic evaluation of MCI.
Experimental study on the influence of preliminary desiccation on the swelling pressure and hydraulic conductivity of compacted bentonite
Authors: Lang Lin Zhi , Baille Wiebke , Tripathy Snehasis , Schanz Tom
Published: December 2018

In deep geological repositories, compacted bentonites have been proposed for use as barrier materials for isolating nuclear waste. The prevailing thermo-hydro-mechanical boundary conditions in the repositories may affect the swelling capacity and permeability of the compacted bentonites. In this study, the effect of preliminary desiccation on the subsequent hydro-mechanical behaviour (swelling pressure and hydraulic conductivity) of compacted Calcigel bentonite was investigated experimentally at 22°C and 80°C. In the first stage of the test, the compacted specimens were subjected to suction-controlled desiccation at 22°C and 80°C using the vapour-equilibrium technique. After the water content reached equilibrium at a given suction, the axial, radial and volumetric shrinkage strains were measured. Afterwards, constant-volume swelling-pressure tests were performed on the desiccated specimens (second test stage) by saturating the dried specimens with deionized water at 22°C and 80°C. At the end of the swelling-pressure test, the hydraulic conductivities of four saturated specimens were measured at each temperature. The volumetric shrinkage strain of the compacted bentonite during desiccation is controlled by suction instead of temperature. In addition, the preliminary desiccation increases both the swelling pressure and hydraulic conductivity of compacted bentonite, particularly if compacted bentonite undergoes extreme desiccation at an applied suction of >700 MPa.
Liraglutide ameliorates beta-cell function, alleviates oxidative stress and inhibits low grade inflammation in young patients with new-onset type 2 diabetes
Authors: Zhang Wen-qiang , Tian Yuan , Chen Xiao-min , Wang Li-fen , Chen Chan-chan , Qiu Chuan-mei
Published: December 2018

Background

The prevalence of type 2 diabetes in youth is escalating rapidly. We aimed to evaluate the effects of liraglutide on beta-cell function, metabolic productions of oxidative stress, low grade inflammation compared with metformin in young patients with recent onset type 2 diabetes mellitus.

Methods

Sixty patients were randomly assigned to receive 8-week liraglutide or metformin treatment. Beta-cell function was assessed by modified beta cell function index (MBCI), early phase of insulin secretion index (ΔI30/ΔG30), proinsuin to insulin ratio (P/I) and the insulin area under the curve (AUCins). The expression of 8-OH-dG and 8-iso-PGF2α and hs-C-reactive protein (hs-CRP) were measured as indications of oxidative stress and low grade inflammation.

Results

After 8 weeks liraglutide treatment, MBCI, ΔI30/ΔG30, AUCins significantly increased, 8-OH-dG, 8-iso-PGF2α, P/I and hs-CRP remarkably reduced. The differences before and after 8-week liraglutide treatment in ΔMBCI (11.1 [2.81, 43.08] vs 0.00 [− 8.16, 10.47], P = 0.017), ΔLNΔI30/ΔG30 (0.44 [0.04, 0.85] vs − 0.09 [− 0.33, 0.36], P = 0.049), ΔAUCins (117 [− 8, 376] vs − 21 [− 314, 109] mIU/L, P = 0.013), ΔP/I (− 0.05 [− 0.09, − 0.03] vs − 0.02 [− 0.04, 0.01], P = 0.026)were remarkably enhanced compared to those of the metformin therapy. The expression of 8-OH-dG, 8-iso-PGF2α and hs-CRP also decreased after 8-week metformin treatment.

Conclusions

These data demonstrated that liraglutide administration was more effective on ameliorating beta-cell function than metformin treatment in young patients with new-onset type 2 diabetes mellitus. Both liraglutide and metformin could alleviate the level of oxidative stress and attenuate low grade inflammatory, we speculate this effect may not the main mechanism of beta-cell function improvement by liraglutide in diabetic patients.

Trial registration Chinese Clinical Trials registry, chiCTR1800018008, Registered 27 August 2018—retrospectively registered.
Critical psychiatry: a brief overview
Authors: Middleton Hugh , Moncrieff Joanna
Published: December 2018

Critical psychiatry has often been confused with what is widely known as ‘anti-psychiatry’. In this article the distinction is clarified and the particular contribution critical psychiatry makes is outlined. That contribution is constructive criticism: of the relationship between medicine and mental health practice, of the way drug and psychotherapeutic treatments for mental health difficulties might be better understood. These have implications for everyday clinical practice and there is much to be gained by openly embracing the controversies critical psychiatry highlights.

LEARNING OBJECTIVES

•

Understand the origins of critical psychiatry and recognise some of the difficulties that arise from identifying psychiatry with medicine

•

Appreciate the differences between disease-centred and drug-centred approaches to prescribing psychiatric medication

•

Become aware of implications that arise from psychotherapeutic outcomes research

DECLARATION OF INTERESTS

H. M. and J. M. are co-chairs of the UK Critical Psychiatry Network.
Critical psychiatry is becoming Luddite
Authors: Tyrer Peter
Published: December 2018

The critical psychiatry movement has a part to play in correcting some of the exaggerated claims sometimes made by inveterate optimists in our profession. But it has gone too far in creating increasingly destructive commentaries that add little to knowledge and only serve as a brake on progress.

DECLARATION OF INTEREST

None.
T-Cell–Inflamed Gene-Expression Profile, Programmed Death Ligand 1 Expression, and Tumor Mutational Burden Predict Efficacy in Patients Treated With Pembrolizumab Across 20 Cancers: KEYNOTE-028
Authors: Ott Patrick A. , Bang Yung-Jue , Piha-Paul Sarina A. , Razak Albiruni R. Abdul , Bennouna Jaafar , Soria Jean-Charles , Rugo Hope S. , Cohen Roger B. , O’Neil Bert H. , Mehnert Janice M. , Lopez Juanita , Doi Toshihiko , van Brummelen Emilie M.J. , Cristescu Razvan , Yang Ping , Emancipator Kenneth , Stein Karen , Ayers Mark , Joe Andrew K. , Lunceford Jared K.
Published: December 2018

PURPOSE

Biomarkers that can predict response to anti–programmed cell death 1 (PD-1) therapy across multiple tumor types include a T-cell–inflamed gene-expression profile (GEP), programmed death ligand 1 (PD-L1) expression, and tumor mutational burden (TMB). Associations between these biomarkers and the clinical efficacy of pembrolizumab were evaluated in a clinical trial that encompassed 20 cohorts of patients with advanced solid tumors.

METHODS

KEYNOTE-028 ( ClinicalTrials.gov identifier: NCT02054806) is a nonrandomized, phase Ib trial that enrolled 475 patients with PD-L1–positive advanced solid tumors who were treated with pembrolizumab 10 mg/kg every 2 weeks for 2 years or until confirmed disease progression or unacceptable toxicity occurred. The primary end point was objective response rate (ORR; by RECIST v1.1, investigator review). Secondary end points included safety, progression-free survival (PFS), and overall survival (OS). Relationships between T-cell–inflamed GEP, PD-L1 expression, and TMB and antitumor activity were exploratory end points.

RESULTS

ORRs (with 95% CIs) ranged from 0% (0.0% to 14.2%) in pancreatic cancer to 33% (15.6% to 55.3%) in small-cell lung cancer. Across cohorts, median (95% CI) PFS ranged from 1.7 months (1.5 to 2.9 months) to 6.8 months (1.9 to 14.1 months) in pancreatic and thyroid cancers, respectively, and median OS from 3.9 months (2.8 to 5.5 months) to 21.1 months (9.1 to 22.4 months) in vulvar and carcinoid tumors, respectively. Higher response rates and longer PFS were demonstrated in tumors with higher T-cell–inflamed GEP, PD-L1 expression, and/or TMB. Correlations of TMB with GEP and PD-L1 were low. Response patterns indicate that patients with tumors that had high levels of both TMB and inflammatory markers (GEP or PD-L1) represent a population with the highest likelihood of response. Safety was similar and consistent with prior pembrolizumab reports.

CONCLUSION

A T-cell–-inflamed GEP, PD-L1 expression, and TMB predicted response to pembrolizumab in multiple tumor types. These biomarkers (alone/in combination) may help identify patients who have a higher likelihood of response to anti–PD-1 therapies across a broad spectrum of cancers.
Matrix stiffness mechanically conditions EMT and migratory behavior of oral squamous cell carcinoma
Authors: Matte Bibiana F. , Kumar Aditya , Placone Jesse K. , Zanella Virgílio G. , Martins Manoela D. , Engler Adam J. , Lamers Marcelo L.
Published: December 2018

Tumors are composed of heterogeneous phenotypes, each having different sensitivities to the microenvironment. One microenvironment characteristic–matrix stiffness–helps regulate malignant transformation and invasion in mammary tumors, but its influence on oral squamous cell carcinoma (OSCC) is unclear. We observed that on stiff matrices, a highly invasive OSCC line with low E-cad/N-cad ratio (InvH/E:NL; SCC25) had increased migration velocity and decreased adhesion strength compared to a poorly invasive OSCC line with high E-cad/N-cad ratio (InvL/E:NH; Cal27). However, InvL/E:NH cells acquire a mesenchymal signature and begin to migrate faster when exposed to prolonged time on a stiff niche, suggesting that cells could be mechanically conditioned. InvL/E:NH cells migrated faster due to increased focal adhesion assembly, which could be reduced when increasing integrin affinity with high divalent cation concentrations. Mirroring these data in human patients, we observed that collagen organization, an indicator of matrix stiffness, was increased with advanced disease and correlated with early recurrence. Consistent with epithelial tumors, our data suggests that OSCC cells are mechanically sensitive and that their contribution to tumor progression is mediated in part by this sensitivity.
Dynamics of pleasure-displeasure at the limit of exercise tolerance: conceptualizing the sense of exertional physical fatigue as an affective response
Authors: Hartman Mark E. , Ekkekakis Panteleimon , Dicks Nathan D. , Pettitt Robert W.
Published: December 2018

The search for variables involved in the regulation and termination of exercise performance has led to integrative models that attribute a central role to the brain and utilize an array of psychological terms (e.g., sensation, perception, discomfort, tolerance). We propose that theorizing about exercise regulation would benefit by establishing crossdisciplinary bridges to research fields, such as affective psychology and neuroscience, in which changes along the dimension of pleasure-displeasure are considered the main channel via which homeostatic perturbations enter consciousness and dictate corrective action (slowing down or stopping). We hypothesized that ratings of pleasure-displeasure would respond to the severity of homeostatic perturbation and would be related to time-to-exhaustion during exercise performed at an unsustainable intensity. In a within-subjects experiment (N=15, 13 men and 2 women, age 23.4±2.2 y; peak oxygen uptake 46.0±8.0 ml·kg−1·min−1), we compared the slope of ratings of pleasure-displeasure (acquired every one min) during cycling exercise at a power output 10% above critical power until volitional termination under glycogen-loaded and glycogen-depleted conditions. As hypothesized, ratings of pleasure-displeasure declined more steeply under glycogen depletion (p=0.009, d=0.70) and correlated closely with time-to-exhaustion under both glycogen-loaded (r=0.85; p<.001) and glycogen-depleted conditions (r=0.83; p<.001). We conclude that in exercise, as in other domains, changes in pleasure-displeasure may be the main channel via which homeostatic perturbations enter consciousness. This proposal may have important implications for conceptualizing and identifying the neurobiological mechanisms of the sense of exertional physical fatigue.
Agonistic behaviour and energy metabolism of bold and shy swimming crab Portunus trituberculatus
Authors: Su Xianpeng , Sun Yunfei , Liu Dapeng , Wang Fang , Liu Jingjing , Zhu Boshan
Published: December 2018

The metabolism and behaviour of crustaceans are highly flexible, and the inter-individual variation in these traits is evolutionarily and ecologically significant. In the present study, we analysed the relationships among personality traits (boldness, activity and hesitancy), agonistic behaviour and energy status (glycogen, glucose and lactate) in the swimming crab Portunus trituberculatus. The main results were as follows: (1) Boldness was significantly correlated with activity and hesitancy. Bold crabs were more likely to initiate and win a fight. In bold individuals, the frequencies of “move to”, “cheliped display”, “grasp” and “contact” were significantly higher than those of shy individuals, whereas the frequency of “move away” was significantly lower than that of shy individuals. (2) Before fighting, the glucose concentrations in the haemolymph of bold individuals were significantly lower than those of shy individuals, whereas the concentrations of lactate showed the opposite trend. There were no significant differences in glycogen and lactate concentrations in the claw muscle between bold and shy individuals. (3) After fighting, the glucose and lactate concentrations in the haemolymph of both bold and shy individuals were significantly higher than those before fighting. The glucose concentrations in the haemolymph were significantly higher in bold individuals than shy individuals. In addition, bold individuals, compared with shy individuals, showed a larger increase in glucose in the haemolymph but a smaller increase in lactate. (4) After fighting, the glycogen concentrations in the claw muscle were significantly lower than those before fighting, however, there were no significant differences in the concentrations of lactate in the claw muscle. These results indicated that the agonistic behaviour of the swimming crab is related to its behavioural type. Energy reserves may be one of the factors affecting the personality traits and agonistic behaviour in crabs. These results should lay a foundation for in-depth understanding of the relationships among crustacean personality, agonistic behaviour and metabolic physiology.