bluuebunny/crossref_metadata_2025 huggingface dataset:
On Aquinas's Theological Reliabilism
Authors: Di Ceglie Roberto
Published: December 2014

In an essay titled Aquinas on the Foundations of Knowledge, Eleonore Stump rejects the idea that Aquinas's epistemology is foundationalist. I agree with Stump, and share in her conviction that the Angelic doctor developed instead what can be seen as a kind of theological reliabilism. In this article, I intend to take her position a step further. First, I would like to show that Thomistic reliabilism falls into a vicious circle if seen as based on a merely rational theism. Second, I am going to argue that for Aquinas such reliabilism depends instead on Christian faith, construed as the act of believing the revealed truth by virtue of the love relationship that God allows human beings to have with him.
Factors associated with clinical characteristics and symptoms in a case series of oral lichen planus
Authors: Barbosa Natália G. , Silveira Éricka J. D. , Lima Emeline N. de A. , Oliveira Patrícia T. , Soares Maria Sueli M. , de Medeiros Ana Miryam C.
Published: December 2014

Background

Oral lichen planus (OLP) is a relatively common chronic inflammatory disease whose etiopathogenesis is not completely understood. Several factors have been proposed in an attempt to explain the variety of clinical manifestations and periods of exacerbation and remission of symptoms of these lesions. The objective of this study was to associate local factors, systemic diseases, and level of anxiety with clinical characteristics of OLP.

Methods

The following factors were analyzed in 37 patients with OLP: presence of smoking, alcohol consumption, diabetes mellitus, hypertension, and hepatitis C virus infection. Anxiety was measured by the Spielberger State‐Trait Anxiety Inventory. These variables were associated with clinical form and symptoms (chi‐squared/Fisher's exact test).

Results

The erosive form was the most prevalent presentation (57.1%). Symptoms were reported by 45.7% of the patients. Most patients were non‐smokers (97.3%), and none of them was an alcoholic. Diabetes and hypertension were present in 10.8% and 16.2% of the patients, respectively. Only one patient was hepatitis C virus seropositive, and 78.4% presented moderate levels of anxiety. No significant association was observed between the variables studied and clinical form or symptoms.

Conclusions

In this study, no association was observed between local and systemic factors or level of anxiety and clinical characteristics of OLP.
Stroke physician versus stroke neurologist: can anyone thrombolyse?
Authors: Lee A. , Gaekwad A. , Bronca M. , Cheruvu L. , Davies O. , Whitehead C. , Agzarian M. , Chen C.
Published: December 2014

Background/Aim

The aim of this study is to compare the outcomes of thrombolysis under standard clinical settings between subjects treated by a stroke neurologist versus those treated by a non‐neurologist stroke physician.

Methods

Single‐centre, observational cohort study of subjects thrombolysed in a calendar year, stratified according to the physician type authorising thrombolysis. Endpoints measured include proportion of subjects with symptomatic intracranial haemorrhage, door‐to‐needle time, change in National Institute of Health Stroke Scale and discharge destination.

Results

Forty‐nine subjects with a mean age 76 ± 16 years underwent thrombolysis, 21 were under the care of a stroke neurologist and 28 by a non‐neurologist stroke physician. No symptomatic intracranial haemorrhages were observed. There was no difference in terms of door‐to‐needle time, proportion of individuals with haemorrhagic transformation, mortality or discharge destination between the two groups.

Conclusion

Due to the single‐centre, observational nature of this study, the equivalent outcomes between those thrombolysed by a stroke neurologist versus those thrombolysed by a stroke physician must be interpreted with caution pending further studies. Nevertheless, in the current setting, no signal for harm has been detected. This study is unique as it is the first to our knowledge comparing outcomes between a neurologist and non‐neurologist following thrombolysis.
Dynamic Social Security after the crisis: Towards a new welfare state?
Authors: Diamond Patrick , Lodge Guy
Published: December 2014

The conservative bias in social attitudes to the welfare state is manifested in entrenched support among the public for traditional welfare and social security benefits, chiefly higher pension payments and public expenditure on health care. This pattern has been reinforced by the 2008 financial crisis and the Great Recession as public support for social protection strategies geared towards “new” social risks – structural changes in labour markets, adverse demography, gender inequality, and family instability – has remained relatively weak. This pattern of resistance to change may hardly be surprising given that reforms are more often viewed by the public as a form of retrenchment with clear losers and few obvious beneficiaries. This underlines that political courage is rarely enough to achieve structural reforms of the welfare state. There will need to be clearly defined short‐term and long‐term objectives underpinned by a coherent rationale capable of persuading publics and citizens of the case for change if a more “Dynamic” system of social security is to be enacted in the industrialized countries over the next 20 years.
Understanding the Brazilian social policy model: Myths, milestones and Dynamic Social Security
Authors: Matijascic Milko , Kay Stephen J.
Published: December 2014

Since Brazil's re‐democratization in 1985, the country's system of social protection has become more focused on the neediest population groups while at the same time emphasizing universal access. In a context of severe inequality, the sub‐national units of government have played a greater role in reaching the broader population. Yet Brazil's social protection model favours cash transfers over social services, and reduces inequalities in the context of a highly unequal labour market. Strategies based on cash transfers appear to have reached their limits, because they are not the most effective way to promote equality and generate opportunities, when compared to the outcomes obtained by social service provision. Furthermore, while much progress toward reducing inequality has been achieved, benefits and services continue to fall short of what might be considered as typifying a welfare state or “Dynamic Social Security”.
Temporary employment protection and productivity growth in EU economies
Authors: DAMIANI Mirella , POMPEI Fabrizio , RICCI Andrea
Published: December 2014

This article examines national and industry‐level differences in total factor productivity (TFP), or efficiency, for 14 European countries and ten industries for the period 1995–2007. The main aim is to ascertain the extent to which employment protection legislation (EPL) for workers with temporary contracts affects TFP, based on difference‐in‐difference estimations. The results show that the deregulation of temporary employment negatively affects TFP growth in European economies and that, at industry level, this liberalization affects industries with a higher propensity to use temporary workers. Furthermore, the authors find that the deregulation of temporary employment discourages training and the acquisition of firm‐specific skills.
Aesthetics, Authenticity and the Spectacle of the Real: How Do We Educate the Visual World We Live in Today?
Authors: Adkins Kirsten
Published: December 2014

In his analysis of the twentieth century, the philosopher Alain Badiou defined a ‘passion for the real’ in terms of spectacle, in its extreme violence, disseminated through art or cultural media, that would shake us out of a complacency we might call reality. But how do we teach Badiou's ‘real’ in the technological world we live in today? We now have continual access to the ‘spectacle’ of the real uploaded within moments of it happening. Photography, video and consumer journalism become a dominating force in our visual experience of the world. In the face of this, how might we consider our relationship with the image, its aesthetic and authenticity? What role does art education play in promoting a critical dialogue with representations of today's real?
Doubting Learning Outcomes in Higher Education Contexts: from Performativity towards Emergence and Negotiation
Authors: Addison Nicholas
Published: December 2014

Learning Outcomes models, particularly constructive alignment, are the default ‘theoretical’ tool underpinning HE curriculum design in the UK despite continuing doubts as to their efficacy. With reference to the literature, this article summarises the history of the Learning Outcomes movement and charts the perceived benefits and deficits of Learning Outcomes/Assessment as it pertains to art and design. It proceeds with an examination of the theoretical assumptions that underpin its principles specifically in relation to inclusivity and creative practice. Drawing on cultural historical activity theory, a case is made for a less prescriptive model, one that recognises socially constructed, situated meaning‐making, and the impossibility of second‐guessing the affect‐laden motivations that generate specific learning needs.
Study protocol for ‘we DECide’: implementation of advance care planning for nursing home residents with dementia
Authors: Ampe Sophie , Sevenants Aline , Coppens Evelien , Spruytte Nele , Smets Tinne , Declercq Anja , van Audenhove Chantal
Published: December 2014

Aim

To evaluate the effects of ‘we DECide’, an educational intervention for nursing home staff on shared decision‐making in the context of advance care planning for residents with dementia.

Background

Advance care planning (preparing care choices for when persons no longer have decision‐making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision‐making (the involvement of persons and their families in care and treatment decisions).

Design

This quasi‐experimental pre‐test–post‐test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff.

Methods

‘We DECide’ focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The ‘ACP‐audit’ assesses participants’ views on the organization of advance care planning (organizational level), the ‘OPTION scale’ evaluates the degree of shared decision‐making in individual conversations (clinical level) and the ‘IFC‐SDM Questionnaire’ assesses participants’ views on Importance, Frequency and Competence of realizing shared decision‐making (clinical level). (Project funded: July 2010).

Discussion

The study hypothesis is that ‘we DECide’ results in a higher realization of shared decision‐making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end‐of‐life care and more person‐centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy‐makers.
Potential stagnation in the splanchnic hemodynamics demonstrated by the dynamic microbubbles in chronic liver disease
Authors: Sekimoto Tadashi , Maruyama Hitoshi , Kondo Takayuki , Shimada Taro , Kiyono Soichiro , Yokosuka Osamu
Published: December 2014

Background and Aim

Impaired splanchnic hemodynamics are well‐documented phenomena in cirrhosis. However, comprehensive hemodynamic features from the superior mesenteric artery (SMA) to the superior mesenteric vein (SMV) via intestinal capillaries have not been studied. The aim was to examine splanchnic hemodynamics and their relationship with clinical presentations.

Methods

Contrast‐enhanced ultrasound was performed for both the SMA and SMV under fasting conditions and postprandially following ingestion of a liquid diet. The microbubble traveling time (MTT) was determined as the difference between the contrast onset in the SMA and SMV, indicating the time required for microbubble transit through the splanchnic circulation.

Results

There were 192 subjects for fasting conditions (81 cirrhosis, 72 chronic hepatitis, 39 healthy controls), and 74/192 for postprandial conditions (44 cirrhosis, 11 chronic hepatitis, 19 healthy controls). The MTT (fasting; postprandial) was significantly longer in cirrhosis (7.7 ± 2.9 s; 7.0 ± 0.3 s) than in controls (5.4 ± 2.3 s, P < 0.001; 3.9 ± 0.9 s, P < 0.001) and chronic hepatitis (6.3 ± 2.5 s, P = 0.007; 5.1 ± 1.4 s, P = 0.013). The MTT ratio (postprandial/fasting) showed disease‐related changes: 0.75 ± 0.20 in controls, 0.78 ± 0.15 in chronic hepatitis, and 1.00 ± 0.28 in cirrhosis (P = 0.003, vs controls; P = 0.036, vs chronic hepatitis).

Conclusions

The real‐time observation of traveling microbubble on the sonogram revealed a prolonged transit with a weak postprandial response in the intestinal circulation, suggesting better understanding of underlying pathophysiology of splanchnic hemodynamics in chronic liver disease.
Honoring Choices Minnesota: Preliminary Data from a Community‐Wide Advance Care Planning Model
Authors: Wilson Kent S. , Kottke Thomas E. , Schettle Sue
Published: December 2014

Advance care planning (ACP) increases the likelihood that individuals who are dying receive the care that they prefer. It also reduces depression and anxiety in family members and increases family satisfaction with the process of care. Honoring Choices Minnesota is an ACP program based on the Respecting Choices model of La Crosse, Wisconsin. The objective of this report is to describe the process, which began in 2008, of implementing Honoring Choices Minnesota in a large, diverse metropolitan area. All eight large healthcare systems in the metropolitan area agreed to participate in the project, and as of April 30, 2013, the proportion of hospitalized individuals 65 and older with advance care directives in the electronic medical record was 12.1% to 65.6%. The proportion of outpatients aged 65 and older was 11.6% to 31.7%. Organizations that had sponsored recruitment initiatives had the highest proportions of records containing healthcare directives. It was concluded that it is possible to reduce redundancy by recruiting all healthcare systems in a metropolitan area to endorse the same ACP model, although significantly increasing the proportion of individuals with a healthcare directive in their medical record requires a campaign with recruitment of organizations and individuals.
Adiposity Estimated Using Dual Energy X‐Ray Absorptiometry and Body Mass Index and Its Association with Cognition in Elderly Adults
Authors: Smith Evelyn , Bailey Phoebe E. , Crawford John , Samaras Katherine , Baune Bernhard T. , Campbell Lesley , Kochan Nicole , Menant Jasmine , Sturnieks Daina L. , Brodaty Henry , Sachdev Perminder , Trollor Julian N.
Published: December 2014

Objectives

To determine whether obesity, estimated according to body mass index (BMI), waist circumference, and body fat and abdominal fat assessed using dual‐energy X‐ray absorptiometry (DEXA), was associated with cognitive performance.

Design

Cross‐sectional.

Setting

Community based.

Participants

Individuals aged 74–94 (N = 406).

Measurements

BMI, waist circumference, body fat, and abdominal fat were assessed using DEXA. Cognitive performance was assessed using a comprehensive neuropsychological battery.

Results

When categorized using BMI, overweight individuals had higher global cognitive function and executive function scores than normal‐weight individuals. This relationship did not differ according to sex. When categorized according to DEXA, there were no relationships between body fat and cognitive function in the whole group, but women in the middle and highest tertiles of DEXA body fat had better executive function than those in the lowest tertile. Men in the middle tertile of DEXA body fat had significantly better executive function and memory than those in the lowest tertile. BMI had greater power to predict executive function than DEXA body fat. No significant associations were found between cognition and estimates of abdominal adiposity.

Conclusion

This study found an association between being overweight and better executive function in elderly adults; this association was stronger for the simpler BMI than the more‐elaborate DEXA measures.
A descriptive model of the offence chain for imprisoned adult male firesetters (descriptive model of adult male firesetting)
Authors: Barnoux Magali , Gannon Theresa A. , Ó Ciardha Caoilte
Published: December 2014

Purpose

Firesetting has devastating consequences. Although some theoretical efforts have been made to explain firesetting (i.e., a small number of multi‐ and single‐factor theories), little effort has been devoted to understand how deliberate firesetting unfolds across time (i.e., micro or offence chain theories). This research aimed to produce the first descriptive offence chain theory for incarcerated adult male firesetters.

Methods

Thirty‐eight adult male firesetters – recruited from prison establishments in England and Wales – were interviewed about the events, thoughts, and feelings leading up to, surrounding, and immediately following a deliberate incident of firesetting.

Results

Using grounded theory analysis, the descriptive model of adult male firesetting (DMAF) was developed documenting the cognitive, behavioural, affective, and contextual factors leading to a single incident of deliberate firesetting.

Conclusions

New information generated from the DMAF is presented and its contributions to the current evidence base are highlighted. Clinical implications, limitations, and future research directions are also discussed.
Postharvesting population dynamics of the South American sea lion (Otaria byronia) in the southwestern Atlantic
Authors: Franco‐Trecu Valentina , Drago Massimiliano , Baladán Claudia , García‐Olazábal Mateo D. , Crespo Enrique A. , Cardona Luis , Inchausti Pablo
Published: December 2014

Many pinniped populations precipitously declined during the 19th and 20th centuries due to overharvesting. In Uruguay, the South American sea lion (SASL) was harvested until 1986. Birth rates in two nearby breeding colonies have had opposite trends for at least 20 yr. We assessed different mechanisms that could explain opposite trends in birth rates in the two SASL colonies. We compared feeding habits (δ15N and δ13C) of breeding females, birth mass, individual growth rate and early survival of pups and the social structure between colonies. Breeding females from the two colonies did not differ in their feeding habits. However, male and female pups grew faster but had a lower survival in the second month in the smallest colony. We found differences in the social structures, with a higher proportion of males in the smallest colony. The latter is important because peripheral SASL males may abduct and kill pups, which may explain the lower survival of pups in smaller colonies. We believe that the cumulative effects of population extractions have lowered the local SASL population size and disrupted its social structure to the point where Allee‐like effects could become important and hamper the recovery of the Uruguayan SASL population.
Papal Diplomacy and The Great War
Authors: Pollard John
Published: December 2014

The election of Giacomo Della Chiesa as Pope Benedict XV coincided with the outbreak of the First World War. His pacifism led to vigorous attempts to halt the war, which failed because of the Vatican's isolation and poor diplomatic prestige. The most notable attempt was Benedict Peace Note of 1917 that set out seven proposals for negotiating peace. Despite Benedict's failure to alter the course of the war, his diplomatic efforts were matched by humanitarian action on behalf of prisoners of war and famished children. Benedict's legacy has been greater diplomatic resources for the Vatican and an energetic search for peace.
The Unbearable Humanum: Reflecting Back, Working Forwards
Authors: Kirwan Michael
Published: December 2014

This article, “reflects back and works forwards”, by thinking together the three “sorrowful mysteries” of the last one hundred years; three marked and irrevocable steps of escalation and complexity in the history of international conflict. Along with so many others in this centenary year, we commemorate: its causes, and the lessons to be learned. What are the continuities between the Great War, 1914–18, and the second “sorrowful mystery”, the advent of nuclear weapons? This brings us to the specific challenges that face us in the present: globalized violence in the name of religion, the reactive “war on terror” and the development of “smart” technology, remind us that our context too is unprecedented and uniquely dangerous. Explanatory avenues opened up include discussion of the moral and political implications of unmanned weapons, or drones. Here is an example of the crisis of sacrifice associated with René Girard, while Girard's own recasting of Clausewitz's notion of the “escalation to extremes”, and the humanism in Edward Schillebeeckx are also examined.
The Church, War and the European Union
Authors: Wicker Brian
Published: December 2014

The concept of ‘just war’ has long been embedded in the structure of a world divided into sovereign nation-states. And groups like UKIP want to perpetuate this structure. But sovereign states are in melt down under the impact of globalisation. So just war needs to be rethought in order to reflect a truly catholic outlook, and the church needs to understand this.
The effectiveness of an oral health care program for preventing ventilator‐associated pneumonia
Authors: Liao Yu‐Mei , Tsai Jung‐Rung , Chou Fan‐Hao
Published: December 2014

Aims and objectives

To determine the effectiveness of an oral health care program for preventing ventilator‐associated pneumonia (VAP).

Background

Research has shown a significant correlation between oral bacteria and VAP, indicating that an oral health care program plays a very important role in VAP prevention.

Design and methods

A quasi‐experimental study was used and conducted in the intensive care unit in a medical centre. A total of 199 mechanically ventilated patients were enrolled and divided into two groups: the experimental group (n = 99) and control group (n = 100). The experimental group was cared for using an evidence‐based oral health care program, and the control group was cared for using routine nursing care procedures. Each group received the assigned treatment for four consecutive days.

Results

The incidence of VAP in the experimental group (4%, 4/95) was significantly lower than that in the control group (21%, 18/82). The oral assessment guide (OAG) mean score (9.16 ± 2·07) of the experimental group was significantly different (P < 0·05) from that of the control group (10·07 ± 1·79). The general estimated equation further showed that there was a significant difference between groups (P < 0·01) for the third post‐test data and no significant difference for the pre‐test or the first and second post‐test data between groups, indicating that an increased duration of intervention resulted in significant decreases in the OAG scores in the experimental group compared with the control group.

Conclusions

The evidence‐based oral health care program effectively improved oral mucosal health and statistically reduced the incidence of VAP in this study.

Relevance to clinical practice

The study findings may be useful as an empirical reference for health care professionals performing an oral health care program in the future. Additionally, it may serve as a reference for long‐term care policies aimed at reducing the ventilation duration, days of hospitalization and mortality rate to enhance patient safety and the quality of medical care.
Modelling the effects of secondary spherical aberration on refractive error, image quality and depth of focus
Authors: Xu Renfeng , Bradley Arthur , López Gil Norberto , Thibos Larry N.
Published: December 2014

Purpose

To examine the role of Zernike secondary spherical aberration and its component terms on refraction, image quality and depth of focus.

Methods

Computational methods were used to define wavefronts with controlled levels of r6, r4 and r2 terms, and image quality associated with these terms for a range of target vergences. Target vergences that generated maximum image quality were used as an objective measures of refractive error.

Results

Unlike primary Zernike spherical aberration, which generates peak image quality with a near paraxial focus, in the absence of other higher order aberrations, peak image quality with secondary spherical aberration is achieved with a near marginal focus. When alone, positive primary and secondary spherical aberration induce small hyperopic shifts in refraction, but in the presence of other higher order aberrations, secondary spherical aberration can induce significant myopic shifts in refractive error, as predicted by the combined lower order r4 & r2 component of . The predicted expansion in depth of focus associated with increased primary or secondary spherical aberration is mostly absent if a strict image quality criterion is applied. The expansion of depth of focus observed with a low image quality criterion when opposite sign and are combined is primarily due to the elevated r4 term.

Conclusions

Secondary Zernike spherical aberration can have a significant impact on refractive error, image quality and depth of focus, but mostly due to the lower order components within this polynomial. Our analysis shows that the r6 term that defines secondary spherical aberration actually narrows rather than expands depth of focus, when in the presence of the r4 term within . Therefore, a multifocal lens generated with exclusively primary spherical aberration is likely to be more effective than one that includes opposite sign of primary and secondary spherical aberration.
Reverse Atrial Remodeling Following Pulmonary Vein Isolation: The Importance of the Body Mass Index
Authors: ARANA‐RUEDA EDUARDO , PEDROTE ALONSO , GARCÍA‐RIESCO LORENA , ARCE‐LEÓN ALVARO , GÓMEZ‐PULIDO FEDERICO , DURÁN‐GUERRERO JUAN‐MANUEL , FERNÁNDEZ‐CISNAL AGUSTÍN , FRUTOS‐LÓPEZ MANUEL , SÁNCHEZ‐BROTONS JUAN‐ANTONIO
Published: December 2014

Background

Pulmonary vein isolation (PVI) causes a reduction in left atrium size that is attributable to reverse atrial remodeling (RAR). The objective of this study was to identify predictors of RAR and determine its association with other parameters of improvement in cardiac function.

Methods

It is a prospective study with 74 patients (52 ± 9 years old, 81% male), and 51% of patients had paroxysmal atrial fibrillation. Patients were serially assessed with transthoracic echocardiography; plasma N‐terminal B‐type natriuretic peptide (NT‐proBNP); and high‐sensitivity C‐reactive protein levels at baseline and 3, 6, and 12 months following the PVI. RAR was defined as a reduction in the left atrial volume index (LAV‐index) >10% from baseline at the end of follow‐up. A multivariate analysis was conducted to identify predictors of RAR.

Results

The LAV‐index decreased significantly during follow‐up in the entire population (P = 0.0005). RAR (experienced by 63.5% of the patients) was more frequent (76% vs. 42%; P = 0.004) and pronounced (reduction 16.65 ± 14% vs. 8 ± 14%; P = 0.015) in patients with a successful ablation (46 of 74 patients, 62.2%). Only patients with RAR showed significant improvement in NT‐proBNP levels (P = 0.0001), systolic function (P = 0.035), and diastolic function (P = 0.005). Multivariable analysis revealed that a successful ablation (odds ratio [OR] = 4.6; 95% confidence interval [CI] 1.46–14.68; P = 0.009), LAV‐index (OR = 1.15; 95% CI 1.03–1.2; P = 0.021), and patient's body mass index (OR = 0.84; 95% CI 0.74–0.96; P = 0.012) were independent predictors of RAR.

Conclusions

Successful PVI ablation is the main predictor of RAR that is associated with other parameters of improvement in cardiac function. The patient's body mass index may have a negative effect on RAR.
The use of an acetoacetyl‐CoA synthase in place of a β‐ketothiolase enhances poly‐3‐hydroxybutyrate production in sugarcane mesophyll cells
Authors: McQualter Richard B. , Petrasovits Lars A. , Gebbie Leigh K. , Schweitzer Dirk , Blackman Deborah M. , Chrysanthopoulos Panagiotis , Hodson Mark P. , Plan Manuel R. , Riches James D. , Snell Kristi D. , Brumbley Stevens M. , Nielsen Lars K.
Published: December 2014

Engineering the production of polyhydroxyalkanoates (PHAs) into high biomass bioenergy crops has the potential to provide a sustainable supply of bioplastics and energy from a single plant feedstock. One of the major challenges in engineering C4 plants for the production of poly[(R)‐3‐hydroxybutyrate] (PHB) is the significantly lower level of polymer produced in the chloroplasts of mesophyll (M) cells compared to bundle sheath (BS) cells, thereby limiting the full PHB yield‐potential of the plant. In this study, we provide evidence that the access to substrate for PHB synthesis may limit polymer production in M chloroplasts. Production of PHB in M cells of sugarcane is significantly increased by replacing β‐ketothiolase, the first enzyme in the bacterial PHA pathway, with acetoacetyl‐CoA synthase. This novel pathway enabled the production of PHB reaching an average of 6.3% of the dry weight of total leaf biomass, with levels ranging from 3.6 to 11.8% of the dry weight (DW) of individual leaves. These yields are more than twice the level reported in PHB‐producing sugarcane containing the β‐ketothiolase and illustrate the importance of producing polymer in mesophyll plastids to maximize yield. The molecular weight of the polymer produced was greater than 2 × 106 Da. These results are a major step forward in engineering a high biomass C4 grass for the commercial production of PHB.
Correlation between umbilical cord hemoglobin and rate of jaundice requiring phototherapy in healthy newborns
Authors: Nakagawa Machiko , Ishida Yasushi , Nagaoki Yuko , Ohta Hidenobu , Shimabukuro Rinshu , Hirata Michio , Yamanaka Michiko , Kusakawa Isao
Published: December 2014

Background

Delay of umbilical cord clamping by at least 1 min is recommended for newborns not requiring resuscitation in the International Liaison Committee On Resuscitation–Consensus on Science with Treatment Recommendations (ILCOR‐CoSTR) 2010 guidelines. The delay in clamping improves iron status through early infancy but may increase the likelihood of jaundice requiring phototherapy. The present study investigated the relationship between umbilical cord hemoglobin and the rate of jaundice requiring phototherapy in healthy Japanese newborns.

Methods

Cord hemoglobin was measured in healthy newborns and the rate of infants receiving phototherapy for jaundice and other data were obtained from medical records.

Results

Jaundice requiring phototherapy mostly occurred in association with high cord blood hemoglobin, which is increased by delayed cord clamping.

Conclusions

Higher cord hemoglobin may increase neonatal jaundice in newborns in Japan, therefore the present results support the Japan Resuscitation Council guideline 2010, which does not recommend delay of umbilical cord clamping by at least 1 min, in contrast to the ILCOR guidelines.
Effect of an Integrated Health Management Program Based on Successful Aging in Korean Women
Authors: Ahn Okhee , Cha Hye Gyeong , Chang Soo Jung , Cho Hyun‐Choul , Kim Hee Sun
Published: December 2014

Objectives

This study evaluates the efficacy of an integrated health management program (IHMP) based on successful aging in older women.

Design and Sample

A single group pretest and posttest research design was employed, with a sample of 33 older Korean women over 60 years registered in a public health center. The intervention, including exercise, health education, and social activities, was performed 3 hr per week for 12 weeks.

Measures

Demographic characteristics, body composition, physical fitness, biomarkers, depression, and social support were measured. Data were analyzed with a Wilcoxon signed‐rank test, statistical significance levels were set at p < .05.

Results

After the intervention, body mass index was significantly decreased (p = .003) and skeletal muscle mass was significantly increased (p = .002). Chair stand (p = .023) and straight walking test (p < .001) were significantly improved. Systolic blood pressure (p < .003), diastolic blood pressure (p = .030), and blood cholesterol (p = .011) were significantly decreased. Depression (p = .043) was significantly decreased, and social support (p < .001) was significantly increased.

Conclusions

Adopting and maintaining an IHMP can be useful to promote physical, psychological, and social functioning that lead to successful aging in older Korean women.
Memories of falling in elderly patients with dementia: response concordance rate and reproducibility
Authors: Otaki Masayo , Moriguchi Kyoko , Lebowitz Adam , Asada Takashi
Published: December 2014

Background

Although demented elderly patients have impaired memory, memories of falling are not uncommon. We aim to clarify reliability of memories of falling in such patients.

Methods

Subjects included 62 patients (18 men, 44 women) diagnosed with dementia who resided in long‐term care facilities. Mean age was 82.9 ± 7.8 years, mean Mini‐Mental State Examination score was 16.4 ± 4.7 points, and mean Functional Independence Measure score was 67.9 ± 18.4 points. Subjects were asked a closed question about whether they were aware of having fallen (i.e. memories of falling) over the past year. Fear of falling was quantified using the visual analogue scale and FACES Pain Rating Scale. Scores were re‐measured during retest approximately 10 days later to examine reproducibility of memories and fear of falling. Subjects whom staff had witnessed suffering a fall between baseline and retest session were excluded.

Results

Fall memory concordance rate was 0.84, visual analogue scale reproducibility (correlation coefficient) was 0.98, and FACES Pain Rating Scale was 0.86. No differences in Mini‐Mental State Examination scores were noted between groups for whom memories of falling were or were not reproducible. No correlation was observed among Mini‐Mental State Examination, Functional Independence Measure scores, and intensity of fear of falling.

Conclusions

There was a high concordance rate for patients' memories of falling, which suggests that falls were retained as memories. No relationship was observed between memories of falling and degree of cognitive impairment, and severe dementia did not necessarily imply memories of falling were unreliable. The reproducibility of fear of falling suggested the intensity of fear of falling was not easily altered. It was possible memories of falling and fear of falling mutually interacted to reinforce and fixate with each other, leading to the observed phenomenon. Therefore, it appeared memories of falling were retained by patients; this fact can be used in fall prevention and vital function maintenance.
Comparisons of clinical symptoms in biomarker‐confirmed Alzheimer's disease, dementia with Lewy bodies, and frontotemporal dementia patients in a local memory clinic
Authors: Shea Yat Fung , Ha Joyce , Chu Leung‐Wing
Published: December 2014

Background

There has been no previous Chinese study that differentiated the clinical symptoms among biomarker‐confirmed Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD). The objective of this study was to compare the cognitive, behavioural, and neuropsychiatric symptoms in biomarker‐confirmed AD, DLB, and FTD patients.

Methods

We recruited 30 patients (14 AD, 7 DLB, 9 FTD) who presented to the memory clinic at Queen Mary Hospital from 1 January 2007 to 31 December 2013. AD was diagnosed according to the National Institution of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria with cerebrospinal fluid biomarkers (tau, phosphorylated tau, and amyloid β‐42) fulfilling locally determined cut‐off values for AD. DLB was diagnosed based on the McKeith diagnostic criteria. The behavioural variant of FTD was diagnosed based on the revised diagnostic criteria proposed by the International bvFTD Criteria Consortium, and language variant FTD was diagnosed based on the latest published criteria. In addition, patients with DLB and FTD had typical imaging features on single‐photon emission computed tomography or 18fludeoxyglucose‐positron emission tomography, either with or without Pittsburgh Compound B imaging, which supported their diagnoses. Data on patient characteristics including demographics, presenting clinical features, Mini‐Mental State Examination, clinical dementia ratings, and neuropsychiatry inventory scores were collected.

Results

There were no differences in age, education level, dementia severity, and duration of symptoms before presentation among the three subgroups of patients. All patients had amnesia symptoms, which were not statistically significant. Apraxia was most common in AD. While 83% of the patients were affected by behavioural and neuropsychiatric symptoms of dementia, behavioural disinhibition and decline in executive function were most common in FTD patients. Recurrent hallucinations, fluctuation of consciousness, parkinsonism, and rapid eye movement sleep behaviour disorder were most common in DLB.

Conclusion

Memory impairment and apathy are not useful discriminative symptoms in diagnosing AD, DLB, and FTD. Apraxia favours AD. Hallucinations, particularly well‐formed visual hallucinations, favour DLB. Overall, behavioural and neuropsychiatric symptoms of dementia symptoms are common among the three groups of dementia patients.
Effects of a startle stimulus on response speed and inhibition in a go/no‐go task
Authors: Washington Jessica R. , Blumenthal Terry D.
Published: December 2014

Two studies examined the interaction of an acoustic startle stimulus and visual go/no‐go task stimuli on startle reactivity and task performance. In the first study, an acoustic stimulus (50 ms, 100 dB noise) was presented alone or with a green (go) or red (no‐go) circle; in the second study, a prepulse (50 ms, 75 dB noise) was presented alone or 120 ms before the startle stimulus or circle. The startle stimulus speeded responses to the go stimuli and increased the covert false alarm rate in the no‐go condition (measured by EMG activity in the hand), although very few overt errors were made in the no‐go condition. Startle response magnitude was increased by a circle but decreased by a prepulse. The speeding of go responses caused by a startle stimulus was attenuated by the occurrence of a startle response, suggesting that an intense accessory stimulus can facilitate responding to an imperative stimulus, and that the startle response to that intense stimulus can interfere with that facilitation.
Acquired Capability for Suicide, Pain Tolerance, and Fearlessness of Pain—Validation of the Pain Tolerance Scale of the German Capability for Suicide Questionnaire
Authors: Wachtel Sarah , Siegmann Paula , Ocklenburg Cäcilia , Hebermehl Lisa , Willutzki Ulrike , Teismann Tobias
Published: December 2014

The interpersonal theory of suicide (Joiner, 2005) postulates that for a serious suicide attempt, one has to possess the acquired capability to commit suicide. Acquired capability includes higher pain tolerance, which is further assumed to comprise both an elevated physical pain tolerance and fearlessness of pain. Recently, the German Capability for Suicide Questionnaire (GCSQ) was validated. The aim of this study is further validation of the GCSQ's Pain Tolerance scale by investigating the scale's association with objective pain tolerance and fearlessness of pain in two undergraduate samples (N = 81; N = 76). Both associations were found indicating a strong criterion validity of the Pain Tolerance scale.
Insights into the pathogenesis of GvHD: what mice can teach us about man
Authors: Hülsdünker J. , Zeiser R.
Published: December 2014

Acute graft‐vs‐host disease (GvHD) is a life‐threatening complication of allogeneic hematopoietic cell transplantation (allo‐HCT). Most of the knowledge about the biology of GvHD is derived from mouse models of this disease and therefore a critical analysis of potential advantages and disadvantages of the murine GvHD models is important to classify and understand the findings made in these models. The central events leading up to GvHD were characterized in three phases which includes the tissue damage‐phase, the T cell priming‐phase and the effector‐phase, when the disease becomes clinically overt. The role of individual cytokines, chemokines, transcription factor or receptors was studied in these models by using gene deficient or transgenic mice in the donor or recipient compartments. Besides, numerous studies have been performed in these models to prevent or treat GvHD. Several recent clinical trials were all based on previously reported findings from the mouse model of GvHD such as the trials on CCR5‐blockade, donor statin treatment, vorinostat treatment or adoptive transfer of regulatory T cells for GvHD prevention. The different mouse models for GvHD and graft‐vs‐leukemia effects are critically reviewed and their impact on current clinical practice is discussed.
Hemolysis in patients with antibody deficiencies on immunoglobulin replacement treatment
Authors: Quinti Isabella , Pulvirenti Federica , Milito Cinzia , Granata Guido , Giovannetti Gianluca , La Marra Fabiola , Pesce Anna M. , Farrugia Albert , Coluzzi Serelina , Girelli Gabriella
Published: December 2014

Background

Immunoglobulin (Ig)G replacement with intravenous or subcutaneous immunoglobulins is a lifelong substitutive therapy in patients with primary antibody deficiencies (PADs). Hemolysis after immunoglobulin therapy was described in patients receiving high immunoglobulin dosages. The issue of hemolysis after immunoglobulin administration at replacement doses has been considered of little clinical significance.

Study Design and Methods

This was a single‐center observational study over a 2‐year period on immunoglobulin‐induced hemolysis in a cohort of 162 patients with PADs treated with immunoglobulin administered at replacement dosages.

Results

Six patients had signs and symptoms of immunoglobulin‐induced hemolysis. Two additional asymptomatic patients were identified by a short‐term study run on 16 randomly selected asymptomatic patients. Alloantibodies eluted from patients' red blood cells (RBCs) had anti‐A and Rh specificities (anti‐D and anti‐C). The immunoglobulins contained alloantibodies with the same specificities of the antibodies eluted from patients' RBCs.

Conclusion

Hemolysis occurred in patients receiving immunoglobulin at replacement dosages. Polyvalent immunoglobulin preparations contained multiple clinically significant antibodies that could have unexpected hemolytic consequences, as anti‐C whose research and titration are not required by the European Pharmacopoeia. The issue of hemolysis in long‐term recipients of immunoglobulin treatment administered at replacement dosages should be more widely recognized.
Off-Design Performance of a Single Stage Transonic Turbine
Authors: Woinowsky-Krieger M. , Lavoie J.-P. , Vlasic E. P. , Moustapha S. H.
Published: December 2014

This paper presents results of rig testing of a transonic, single stage turbine at off-design conditions. Mapping of the 3.4 pressure ratio, 1.9 stage loading turbine ranged from 70% through 120% of design speed and 75% to 125% of design pressure ratio. Results show expansion efficiency dropping over 4% from 100% to 80% of design speed at design pressure ratio, while remaining within half a percent from 90% to 110% of design pressure ratio at design speed. Efficiency lapse rate from equivalent sea-level to cruise altitude Reynolds numbers at the design point was measured and found to be worth over 1.5%. Analyses of test results using a viscous 3D solver showed very good agreement for the efficiency change with speed.
Distributed Flight Control and Propulsion Control Implementation Issues and Lessons Learned
Authors: Schley William R.
Published: December 2014

This paper addresses the motivations for using a distributed control system architecture, technical challenges, typical functions which are off-loaded to remote terminals, sensor/effector interface issues, data bus selection, technology insertion issues, lessons learned, and objectives for future distributed control implementations. Typical design requirements, constraints, environmental conditions, and operational challenges will be described. Examples of various distributed control system implementations will be discussed, including both propulsion control and flight control examples.
Investigation of Periodic Boundary Conditions in Multi-Passage Cascade Flows Using Overset Grids
Authors: Tuncer Ismail H. , Weber Stefan , Sanz Wolfgang
Published: December 2014

A Navier-Stokes solution method with overset grids is applied to unsteady multi-passage cascade flows, and the unsteady blade loadings are compared against the single passage solutions with the direct store interblade boundary condition. In the overset grid solutions, the multi-passage domain is discretized with O-type grids around each blade and a rectangular background grid. Blade grids are allowed to move in time relative to the background grid as prescribed by the oscillatory plunging motion. The overset grid method uses a simple, robust numerical algorithm to localize moving intergrid boundary points and to interpolate solution variables across grids. Computational results are presented for two and four passage, subsonic and transonic flows through a turbine and a compressor cascade. The overset grid solutions over the multi-passage periodic domains agree well with the single passage solutions and the experimental data. It is concluded that the time linearization error introduced by the direct store approach is negligible in the range of flow conditions studied.
Distributed Control System for Turbine Engines
Authors: Shaffer Phillip L.
Published: December 2014

A Distributed Control System (DCS) for a turbine engine has been demonstrated and tested, consisting of prototype Electronic Interface Units (EIUs) connected to data and power busses. In the DCS, a central control computer communicated with smart sensors and smart actuators via a 2.5 megabit/sec digital data bus, using the Fieldbus protocol. Power was distributed to the smart devices as 100-kHz 100V peak AC, allowing light, simple power converters at each smart device. All smart sensors, smart actuators and cables were dual-redundant. The smart actuators received position demand from the central control computer, exchanged data between channels to provide local redundancy management, closed the position loop locally, and reported actuator position to the central controller. Smart sensors converted sensed signals to digital values in engineering units, and performed local built-in tests. Testing of the DCS was done in a closed-loop simulation with an engine model. Frequency response of the DCS was almost identical with the conventional system.
Semi Closed Gas Turbine Cycle and Humid Air Turbine: Thermoeconomic Evaluation of Cycle Performance and of the Water Recovery Process
Authors: Corti Andrea , Facchini Bruno , Manfrida Giampaolo , Desideri Umberto
Published: December 2014

A comparison between power plants built according to the HAT (Humid Air Turbine) and SCGT/CC (Semi-Closed Gas Turbine/Combined Cycle) concepts is presented, ranging from thermodynamic performance (efficiency and specific power output) to projected data for plant construction and operating costs. Both options appear to be of potential interest to electric utilities considering advanced gas turbine power plants, with significant differences form the point of view of plant size, water consumption, and adaptability to advanced developments for the limitation of environmental impact (CO2 emissions).