bluuebunny/crossref_metadata_2025 huggingface dataset:
Victim hierarchies in the domestic violence disclosure scheme
Authors: Duggan Marian
Published: January 2018

Since its national implementation in March 2014, the UK Domestic Violence Disclosure Scheme (also known as ‘Clare’s Law’) has enabled thousands of people in England and Wales to seek information from the police about whether their partner has a history of domestically abusive behaviours. Politicians have hailed the policy on the basis that it empowers people to make informed choices about their safety, thus representing a vital part of wider domestic violence reduction strategies. This, of course, is all dependent upon people knowing the policy exists; being able to apply to it; meeting the relevant criteria; there being information to disclose; and this being relayed to the applicant accordingly. Drawing on empirical research into the policy’s operation in one policing area, this paper highlights several discrepancies with respect to how the scheme is functioning. The analysis suggests that the hierarchical, two-tier approach to implementation is impacting on displaced responsibility and potential risk enhancement, while the symbolic mobilisation of domestic violence victims for contemporary political gain is also explored. The paper concludes with suggestions for reform to boost the ability of the policy to prevent domestic violence and abuse.
Stroke After Minor Head Trauma in Infants and Young Children With Basal Ganglia Calcification: A Lenticulostriate Vasculopathy?
Authors: Goraya Jatinder Singh , Berry Shivankshi , Saggar Kavita , Ahluwalia Archana
Published: January 2018

The authors retrospectively reviewed charts of the children with basal ganglia stroke who either had preceding minor head injury or showed basal ganglia calcification on computed tomography (CT) scan. Twenty children, 14 boys and 6 girls were identified. Eighteen were aged between 7 months to 17 months. Presentation was with hemiparesis in 17 and seizures in 3. Preceding minor head trauma was noted in 18. Family history was positive in 1 case. Bilateral basal ganglia calcification on CT scan was noted in 18. Brain magnetic resonance imaging done in 18 infants showed acute or chronic infarcts in basal ganglia. Results of other laboratory and radiological investigations were normal. Four infants were lost to follow-up, 9 achieved complete or nearly completely recovery, and 7 had persistent neurological deficits. Basal ganglia calcification likely represents mineralized lenticulostriate arteries, a marker of lenticulostriate vasculopathy. Abnormal lenticulostriate vessels are vulnerable to injury and thrombosis after minor head trauma resulting in stroke.
Reverberation time improvement of lecture auditorium: A case study
Authors: Yadav Saurabh , Sharma Gaurav , Nag Sarthak , Gupta Arpan
Published: January 2018

In this study, reverberation time of a lecture auditorium has been analyzed experimentally and analytically. It is well-known fact that reverberation time affects the speech intelligibility and hence should be within the range of possible optimum values. Experiments were performed to calculate the reverberation time of a lecture auditorium constructed at Indian Institute of Technology Mandi (IIT Mandi), for different internal conditions such as furniture and curtains. Experimental results were compared with the theoretically calculated values of reverberation time. It is found that acoustic performance of the lecture auditorium has significantly improved using curtains on the windows and furniture. For further improvement, it has also been suggested to use the carpet on the floor of the auditorium. The theoretical value of reverberation time is also calculated to show the improvement which can be achieved using carpet. The effect of audience on reverberation time has also been studied theoretically.
Computational fluid dynamics investigation into flow behavior and acoustic mechanisms at the trailing edge of an airfoil
Authors: Jackson Beren R , Dakka Sam M
Published: January 2018

Airfoil self-noise or trailing edge noise and shear noise were investigated computationally for a NACA 0012 airfoil section, focusing on noise mechanisms at the trailing edge to identify and understand sources of noise production using ANSYS Fluent. A two-dimensional computational fluid dynamics simulation has been performed for 0°, 8°, and 16° airfoil angles of attack capturing surface pressure contours, contours of turbulent intensity, contours of surface acoustic power level, vorticity magnitude levels across the airfoil profile, and x- and y-directional self-noise and shear noise sources across the airfoil profile. The results indicate that pressure gradients at the upper surface do increase as the angle of attack increases, which is a measure of vortices near the surface of the trailing edge associated with turbulence cease as the boundary layer begins to separate. Comparison of the turbulent intensity contours with surface acoustic power level contours demonstrated direct correlation between the energy contributed by turbulent structures (i.e. vortices) and the level of noise measured at the surface and within the boundary layer of the airfoil. As angle of attack is increased, both x and y sources have the same trends; however, y sources (perpendicular to the free-stream flow) appear to have a bigger impact as angle of attack is increased. Furthermore, as the angle of attack increased, shear noise contributes less and less energy further downstream of the airfoil and becomes dominated by noise energy from vortical structures within turbulence. The two-dimensional computational fluid dynamics simulation revealed that pressure, turbulent intensity, and surface acoustic power contours further corroborated the previously tested noise observations phenomena at the trailing edge of the airfoil.
Semi-supervised identification of cancer subgroups using survival outcomes and overlapping grouping information
Authors: Wei Wei , Sun Zequn , da Silveira Willian A , Yu Zhenning , Lawson Andrew , Hardiman Gary , Kelemen Linda E , Chung Dongjun
Published: January 2018

Identification of cancer patient subgroups using high throughput genomic data is of critical importance to clinicians and scientists because it can offer opportunities for more personalized treatment and overlapping treatments of cancers. In spite of tremendous efforts, this problem still remains challenging because of low reproducibility and instability of identified cancer subgroups and molecular features. In order to address this challenge, we developed Integrative Genomics Robust iDentification of cancer subgroups (InGRiD), a statistical approach that integrates information from biological pathway databases with high-throughput genomic data to improve the robustness for identification and interpretation of molecularly-defined subgroups of cancer patients. We applied InGRiD to the gene expression data of high-grade serous ovarian cancer from The Cancer Genome Atlas and the Australian Ovarian Cancer Study. The results indicate clear benefits of the pathway-level approaches over the gene-level approaches. In addition, using the proposed InGRiD framework, we also investigate and address the issue of gene sharing among pathways, which often occurs in practice, to further facilitate biological interpretation of key molecular features associated with cancer progression. The R package “InGRiD” implementing the proposed approach is currently available in our research group GitHub webpage ( https://dongjunchung.github.io/INGRID/ ).
Relationship between nurses’ moral sensitivity and the quality of care
Authors: Amiri Elham , Ebrahimi Hossein , Vahidi Maryam , Asghari Jafarabadi Mohamad , Namdar Areshtanab Hossein
Published: January 2018

Background:

To provide care with high quality, nurses face a number of moral issues requiring them to have moral abilities in professional performance. Moral sensitivity is the first step in moral performance. However, its relation to the quality of care patients receive is controversial.

Research objective:

This study aims to determine the relationship between the moral sensitivity of nurses and the quality of care received by patients in the medical wards.

Research design:

A descriptive correlational study using validated tools, including Moral Sensitivity Questionnaire and the Quality Patient Quality Scale.

Participants and research context:

In total, 198 nurses and 198 patients in 17 medical wards of hospitals affiliated with Tabriz University of Medical Sciences, Iran.

Ethical considerations:

The study was reviewed and approved by the Ethics Committee of Tabriz University of Medical Sciences.

Findings:

The mean values of nurses’ moral sensitivity and nurses’ quality care were 136.47 ± 13.30 and 196.36 ± 44.10, respectively. There was no significant relationship between the patient care quality and nurses’ moral sensitivity ( r = −.14, p = .5). However, there was a significant inverse relationship between the dimension of “Experiencing moral conflicts” and the overall score of quality care ( r = −.50, p = .04), the dimensions of “psychosocial ( r = −.50, p = .04)” and “physical ( r = −.50, p = .03).”

Conclusion:

Considering the significant inverse relationship between the score of patient quality care and the dimension of moral conflict experience, it seems when nurses make moral decisions, they experience a conflict between personal and professional values in their careers and thus experience moral tension. If this tension is not resolved properly, it can provide a way for them to distance themselves from patients, thereby making nurses indifferent to moral care.
Book Review: Priti Darooka (Ed.), Road to Rights: Women, Social Security and Protection in India
Authors: Abraham Dimple Tresa
Published: January 2018

Priti Darooka (Ed.), Road to Rights: Women, Social Security and Protection in India. PWESCR, SAGE & Yoda Press, 2016, 228 pages, ₹750. ISBN 978-93-515-0914-1.
Book Review: Gargi Chakravartty and Supriya Chotani, Charting a New Path: Early Years of National Federation of Indian Women
Authors: Katju Vasudha
Published: January 2018

Gargi Chakravartty and Supriya Chotani, Charting a New Path: Early Years of National Federation of Indian Women. New Delhi: People’s Publishing House, 2015, xix, 360 pages, ₹300. ISBN 978-81-7007-254-6.
Comparative Study of Intramedullary Hammertoe Fixation
Authors: Obrador Caterina , Losa-Iglesias Marta , Becerro-de-Bengoa-Vallejo Ricardo , Kabbash Christina A.
Published: January 2018

Background:

Temporary Kirschner wire fixation (K-wire) is a widely used, low-cost fixation method for the correction of hammertoe deformity. Reported complications associated with K-wires prompted the development of new implants over the past decade. However, there is a lack of literature on comparative studies analyzing functional outcomes using validated questionnaires. The purpose of this study was to analyze functional outcomes in patients who had undergone proximal interphalangeal joint fusion using 2 types of intramedullary implant, the Smart Toe and the TenFuse, and to compare them with the outcomes in patients treated with standard K-wire fixation.

Methods:

A retrospective review of operative hammertoe correction by a single surgeon was performed in 96 patients followed for more than 12 months. Functional outcome was assessed using the Foot Function Index (FFI), the Short Form 36 (SF-36), and the 10-point visual analog scale (VAS) validated questionnaires. Complications and fusion rates were also evaluated. Several patients in the study underwent corrections in different toes; thus, a total of 186 toes were included in the study. From these, 65 toes (34.9%) were treated with K-wire fixation, 94 (50.5%) with Smart Toe titanium implant, and 27 (14.5%) with TenFuse allograft implant.

Results:

No statistically significant differences in functional outcome and incidence of complications were observed among the 3 fixation groups, although the 2 intramedullary implants were associated with greater fusion rates and patient satisfaction. Breakage of the Smart Toe implant was significantly higher than that of the other fixations, with 10.6% of implants breaking within the first year postoperatively. SF-36 and VAS scores decreased 12 months after surgery for the 3 types of fixation, with no statistically significant differences observed.

Conclusion:

The use of Smart Toe and TenFuse implants provided operative outcomes comparable to those obtained using a K-wire fixation and slightly better patient satisfaction. Our results suggest that utilization of these implants for hammertoe correction was a reasonable choice that provided good alignment, pain reduction, and improved function at final follow-up. However, they are more expensive than K-wires. For this reason, in-depth cost-benefit studies would be required to justify their use as a standard treatment.

Level of Evidence:

Level III, comparative series.
A composite material with inextensible-membrane-type interface
Authors: Castro LP , Pesetskaya E
Published: January 2018

We consider a model of a composite material with “inextensible membrane type” interface conditions. An analytic solution of a stationary heat conduction problem in an unbounded doubly periodic two-dimensional composite whose matrix and inclusions consist of isotropic temperature-dependent materials is given. In the case where the conductive properties of the inclusions are proportional to those of the matrix, the problem is transformed into a fully linear boundary value problem for doubly periodic analytic functions. The solution makes it possible to calculate the average properties over the unit cell and discuss the effective conductivity of the composite. We present numerical examples to indicate some peculiarities of the solution.
The Role the Type of Vascular Access Plays in the Transmission of Hepatitis C Virus in a High Prevalence Hemodialysis Unit
Authors: Saxena A.K. , Panhotra B.R. , Sundaram D.S.
Published: January 2018

Background

The necessity of having a vascular access site as well as extracorporeal blood circulation, may add to the risk for patients being dialyzed in units with high HCV prevalence of acquiring hepatitis C virus (HCV) infection. This study endeavors to determine the role the type of vascular access plays in the transmission of HCV infection in the hemodialysis (HD) unit of a Middle Eastern country.

Methods

The records of 198 patients with end-stage renal disease (ESRD) enrolled on maintenance HD from November 1995 to November 2000 at this tertiary care center, were retrospectively reviewed to match the HCV prevalence and seroconversion rates among patients groups being dialyzed through various types of vascular accesses. Factors such as, number of units of blood transfused and dialytic age (time-span since the initiation of the HD treatment), implicated in transmission of HCV infection in HD units, were also recorded, and compared among these cohorts.

Results

The overall, high HCV seroprevalence of 43.4% (86/198) and annual seroconversion rate of 8.6% per year were recorded. Patients with arteriovenous fistula (AVF) documented peak anti-HCV prevalence [61.7% (63/102)] and annual seroconversion rates (12.3%) as compared to lowest prevalence of 12.9% (4/34) and seroconversion rate of 2.5%, observed among patients with permanent Catheters (PC). Patients dialyzed through polytetrafluoroethylene (PTFE) grafts recorded the next highest HCV prevalence of 47.8% (11/23) with seroconversion rate of 9.5% but temporary catheter (TC) group had HCV prevalence of 19% (8/42) and seroconversion rate of 3.8% [Odd Ratio (OR)-1.58, 95% Confidence Interval (CI) (0.37–7.12), p-NS].

Conclusions

Considerably higher annual seroconversion rates in AVF [OR-10.90, 95% CI (3.2–40.0), p<0.0001] and PTFE [OR-5.71, 95% CI (1.31–26.79), p<0.016)] groups, appear to suggest that the patients being dialyzed through AVF and PTFE, carried significantly higher risk of acquisition of HCV infection compared to those dialyzed through TC and PC (reference group). This could possibly be attributed to likely accessibility of HCV to blood circulation due to possible breakdown of standard infection control precautions during repeated punctures and cannulations of AVF and PTFE to perform a HD, in a unit with high baseline HCV prevalence.
Stretch Expanded Polytetrafluoroethylene Graft with Intrawall Radial Support System: An Advance in Vascular access Graft Design
Authors: Davidson I.J.A. , Cava Bartsch C. , Bravo K. , Gable D. , Munschauer C.
Published: January 2018

Vascular access expanded polytetrafluoroethylene (ePTFE) grafts with external support systems consisting of parallel rings or in a spiral configuration are designed to resist kinking and compression at the apex of loop grafts or when crossing a joint. However, during the implantation procedure, the rings or spiral must be removed from the portion of the graft that is cut to allow the graft to be divided at the desired angle and suture the anastomosis. A new ePTFE graft (Intering) with an intrawall radial support system and a smooth lumen permits easy division of the support segments at the chosen angle. Moreover, minimal resistance is encountered during suturing of the graft. The results of early experience with Intering grafts crossing the elbow joint, in short-segment revisions, and in primary forearm loop configurations are encouraging.
Percutaneous treatment of thrombosed arteriovenous fistulae using the Gelbfish-Endovac aspiration thrombectomy device
Authors: Falk A. , Gelbfish G.A.
Published: January 2018

Purpose

To study the efficacy and safety of percutaneous treatment of thrombosed hemodialysis arteriovenous fistulae (AVF) using the Gelbfish-Endovac aspiration thrombectomy device (Gelbfish-Endovac).

Methods

From September 2003 to May 2004, twenty-nine percutaneous thrombectomy procedures were performed in 27 patients (median age of 67 years, 14 females) with thrombosed hemodialysis AVF using the Gelbfish-Endovac. Prior interventions, procedure time, anticoagulation, use of additional devices/thrombolytic agents, technical success, clinical success, complication rates, and patency at 30, 60 and 90 days were evaluated.

Results

Sixteen upper arm and 13 forearm AVF were declotted. Seventeen AVF had prior percutaneous interventions. Three AVF had not matured. Median AVF age was 9 months. Heparin was used in 14 procedures. Sixteen arterial lesions and 25 venous lesions were uncovered and treated. Two AVF required the additional use of the Arrow-Trerotola percutaneous thrombectomy device. One AVF underwent side branch ligation. No thrombolytic agents were used. Median procedure time was 70 minutes. Initial technical success was achieved in 24 AVF and clinical success was achieved in 22 AVF. Eleven complications occurred. Ten AVF remained open at 30 days, 10 at 60 days and 8 at 90 days without further interventions. With additional percutaneous interventions, 16 AVF remained open at 30 days, 16 at 60 days and 15 at 90 days.

Conclusion

The Gelbfish-Endovac aspiration thrombectomy device is safe and efficacious for percutaneous de-clotting of AVF.
Complications and management of long-term central venous access catheters and ports
Authors: Yildizeli B. , Laçin T. , Batirel H.F. , Yüksel M.
Published: January 2018

Purpose

Although prolonged venous access devices (PVADs) are used in case prolonged intravenous therapy is required, implantation and use of these devices is associated with complications. The purpose of this study was to evaluate perioperative and long-term complications associated with PVADs and the management of these complications.

Methods

A retrospective review was undertaken of 225 PVADs implanted in 217 patients from February 1993 to June 2004. This included 144 single-lumen port infusion systems, 49 single-lumen Hickman® catheters and 32 double-lumen Groshong® catheters. The PVADs were inserted using either the percutaneous Seldinger method (n=183) or cutdown access to the subclavian vein (n=42). Indications for placement were as follows: chemotherapy in 66.2% of patients, drug-infusion treatment in 31.6% of patients and total parenteral nutrition in 2.2% of patients.

Results

Perioperative complications occurred in 13 patients (5.7%): catheter malposition in seven patients (3.1%), pneumothorax in three patients (1.3%), hemorrhage in two patients (0.9%) and catheter embolization in one patient (0.4%). Long-term complications appeared in 15 patients (6.6%): infection in five patients (2.2%), thrombosis in three patients (1.3%), extravasation in three patients (1.3%), and catheter fracture in four patients (1.8%). The fractured fragments were removed by the Amplatz® snare device. In 10 patients (4.4%) only were PVADs removed prior to completion of the intended therapy. Indications for removal were catheter infection in five patients (2.2%) and catheter fracture in five patients (2.2%).

Conclusions

PVAD implantation is associated with some risk of serious perioperative and long-term complications. Care of the catheter and the patient should be maintained with the proper and immediate evaluation of the perioperative and long-term complications.
Saphenous Vein Eversion: A Novel Technique for Hickman® Catheter Insertion
Authors: Zamora O. , Merhav H.J.
Published: January 2018

Saphenous eversion Hickman® catheter insertion can provide an alternative technique for venous access in patients in whom upper body access is not feasible. The technique is simple and obviates many of the complications of upper body permanent venous access catheter insertion. Further experience is required to assess whether this technique can become one of the standard Hickman® insertion techniques.
Efficacy and Safety of a Retrograde Tunneled Hemodialysis Catheter: 6-Month Clinical Experience with the Cannon Catheter™ Chronic Hemodialysis Catheter
Authors: Davanzo W.J.
Published: January 2018

Purpose

Tunneled catheters play an important role in the delivery of hemodialysis, for both temporary and long-term vascular access. Proper catheter tip positioning is critical for optimal blood flow and performance. The modular Cannon Catheter™ II Chronic Hemodialysis Catheter is placed tip first, then tunneled back to the exit site, in a simple technique (retrograde tunneling) that provides precise tip placement within the right atrium. This retrospective study evaluated 6-month efficacy and safety of the Cannon catheter in 38 patients.

Methods

Monthly mean flow, pressure, Kt/V, and URR were determined. Safety parameters included early and late device-related complications, device removals, and device survival.

Results

87% of subjects had history of vascular access failure. Cannon catheters were inserted via an internal jugular vein with retrograde tunneling in all patients without insertional complication. Mean flow ranged from 369.0 to 404.8 ml/min, with a trend for increasing flow over time. High flow allowed delivery of correspondingly high clearance. Mean URR remained ≥71%; mean weekly Kt/V ranged between 1.55 and 1.60, above current K/DOQI adequacy guidelines. There were no device-related hospitalizations or deaths. Catheter-related bacteremia occurred in 3 patients over the 6 months (0.62 bacteremias/1,000 patient-days), resolving through outpatient treatment. The Cannon catheter provided extended high flow vascular access (≥6 months or until hemodialysis catheter-based access was no longer needed) in 95% of patients.

Conclusion

Retrograde tunneling of the Cannon Catheter™ II Chronic Hemodialysis Catheter allowed optimal tip placement and high flow rates, as well as safe, reliable, extended use.
Influence of Autologous Arteriovenous Fistula on the Blood Supply to the Hand in Very Elderly Hemodialyzed Patients
Authors: Kusztal M. , Weyde W. , Letachowicz W. , Porazko T. , Krajewska M. , Penar J. , Klinger M.
Published: January 2018

Introduction

Arteriovenous fistula (AVF) creation for hemodialysis (HD) could predispose to local arterial insufficiency of the hand (steal syndrome). Patients with diabetes mellitus, peripheral arterial disease and elderly patients tend to have a higher risk of hand ischemia.

Purpose and methods

To estimate the influence of AVF on the blood supply to the hands in the elderly population and to identify steal syndrome cases by non-invasive diagnostics (finger photoplethysmography (PPG), pulse volume recording (PVR), Doppler analysis and pulseoxymetry). The evaluation was carried out in 25 random patients (10 females, 15 males) >75 yrs of age (79.6 ± 3.87 yrs), whose functioning autologous AVFs had been placed at least 1 month previously.

Results

Mean PPG and PVR amplitudes did not differ in statistical analysis (p > 0.05) between hands with and without an AVF. One patient (4%) with end-to-side anastomosis was diagnosed with steal syndrome (typical manifestation confirmed in PPG, Doppler and pulseoxymetry). Two other patients with high brachiocephalic anastomosis presented subclinical steal syndrome (only low PPG and PVR).

Conclusions

Even in the very elderly, AVF creation should be considered due to a lesser influence on the blood supply to the hands. Non-invasive diagnostics used by us seemed to be useful in identifying steal syndrome after AVF creation.
The management of hemodialysis arteriovenous fistulas in well functioning renal transplanted patients: Many doubts, few certainties
Authors: Manca O. , Pisano G.L. , Carta P. , Manca E.M. , Piredda G.B. , Pili G. , Logias F. , Jacono F. LO , Barracca A.
Published: January 2018

Vascular access (VA) for hemodialysis (HD) is one of the most important clinical problems in end-stage renal disease (ESRD) patients because it can limit a life support system and can influence long-term dialysis patient survival. Nevertheless, VA becomes useless after a successful renal transplant. Therefore, we wanted to evaluate the natural history of arteriovenous fistulas (AVF) in renal transplanted patients and the possibility of maintaining the fistula as patent or not.

Methods

A retrospective study was conducted to evaluate kidney transplant patients in our unit from April 1994 to April 2004. We studied 542 patients.

Results

There were 365 patients with a well functioning kidney. Eighty-six patients died. Ninety-one patients were put back on dialysis: 89 patients on HD and two patients on CAPD. Of the 365 patients with functioning kidney transplants, 198 patients demonstrated a patent fistula, while 167 patients had a closed fistula. One hundred and twenty-five patients had a spontaneous closure and 42 patients had a surgical closure. Of the 89 patients put back on dialysis, 49 patients used the previous AVF, while it was necessary to create a new VA in 40 patients.

Conclusions

As demonstrated by the results of our study, after renal transplantation the possibility of spontaneous AVF closure caused by a thrombosis is not a rare event. The dilemma is whether to preserve a fistula that could be useful in case of restarting HD or to perform a systematic fistula closure because of cardiac output and cardiac failure risks. Concerning this question there is no consensus between different authors in the literature. In reviewing the literature and analyzing our data, we conclude that the definite indications for AVF closure in well functioning renal transplanted patients are heart failure, high flow fistula, VA complications and important aesthetic reasons. Routine AVF closure is not indicated until prospective and randomized studies can demonstrate the ability of this procedure to reduce the high incidence of cardiac morbidity and mortality that is present, even after renal transplantation.
Intra-operative central vein angioplasty during arteriovenous access creation
Authors: Shemesh D. , Olsha O. , Berelowitz D. , Zaghal I. , Goldin I. , Zigelman C.
Published: January 2018

Central vein stenosis or occlusion due to prior use of central vein hemodialysis catheters may lead to disabling extremity edema or cause early failure after arteriovenous access construction. Our integrated program for arteriovenous access management enables us to identify these stenoses pre-operatively. We carried out intra-operative angiography and angioplasty during arteriovenous access creation in 3 patients with good immediate and long-term results. Intra-operative endovascular therapy is a new application of peripheral vascular surgery techniques for patients with significant central vein stenosis undergoing access surgery, which exploits the high postoperative flow state to maintain patency after angioplasty. It may also be applicable in situations such as proximal arterial stenosis with anticipated steal syndrome and other conditions that may compromise access patency.
Catheter lock solutions: it's time for a change
Authors: Mandolfo S. , Borlandelli S. , Elli A.
Published: January 2018

In recent years, the number of patients on hemodialysis (HD) with central vascular catheters (CVCs) has grown. However, CVC use is often associated with an important risk for catheter related bloodstream infections (CRBI) and inadequate dialysis due to flow problems. In this study, we reviewed alternative solutions to heparin for locking HD CVCs. Several experiences have demonstrated that trisodium citrate (TSC) (30–47%), citrate (4%) and taurolidine (1.35%) solutions are effective and safe for the prevention of CRBI, while heparin stimulates biofilm formation. High citrate (47%) concentrations can also provide significant advantages in reducing catheter clotting, but controlled studies with larger populations are necessary to confirm and to extend the use of such solutions in clinical practice. Side effects with high sodium citrate concentrations have been reported only immediately after locking, the symptoms are probably caused by a temporary drop in ionized calcium and magnesium, but it is evident that these solutions should only be used by skilled and authorized personnel, with a rigorous protocol.
Measurement of automobile N2O from bag and continuous stream by quantum cascade laser spectroscopy
Authors: Rahman Montajir , Rooney Richard , Hara Kenji , Nakatani Shigeru
Published: January 2018

N2O emission from automobile has been regulated by the United States Environment Protection Agency due to its higher global warming potential compared to CO2. Responding to this, an instrument for fast sensing of ultra-low concentration of N2O from automobile has become an urgent need. In this study, an instrument based on the quantum cascade laser spectroscopy has been developed and applied for certification testing of ultra-low N2O in automobile exhaust. The pulsed quantum cascade laser can emit coherent lights in the mid-infrared region where N2O shows strong absorption and better control of wavelength. Therefore, a very low detection limit can be achieved and interference of co-existing gases can be avoided using a super fine resolution of the mid-infrared spectrum. The US Code of Federal Regulations Parts 1065/1066 allows measuring N2O from sample storage bags, from a continuous dilute stream or a raw exhaust stream. Typically, batch (bag) sampling has better accuracy and repeatability, but continuous sampling is more efficient in terms of test cell running time and provides test-mode emissions. In this study, the quantum cascade laser analyzer has been applied to investigate correlations between bag sampling and continuous dilute exhaust sampling using a fleet of vehicles with a wide range of N2O emission levels all meeting United States Environment Protection Agency emission standards. Very good correlation between these two sampling methods was observed for the majority of tests conducted and in best case the difference was less than ±1%. The direct injection gasoline vehicle emits higher N2O than conventional port injection gasoline vehicles. The quantum cascade laser analyzer has been successfully applied for United States Environment Protection Agency N2O certification test.
Does personal experience of dementia change attitudes? The Bristol and South Gloucestershire survey of dementia attitudes
Authors: Cheston Richard , Hancock Jude , White Paul
Published: January 2018

Background

It is unclear how attitudes towards people with dementia are formed and whether, for instance, increased contact with people with dementia, either through work or personal experience alters attitudes. This study used a validated questionnaire (the Approaches to Dementia Questionnaire) to examine whether having experience of dementia (either as a result of work, or by being affected by dementia) is associated with differences in attitudes towards dementia.

Methods

A modified version of the Approaches to Dementia Questionnaire was completed by 2201 participants, either online or in written form. Participants also recorded their age, gender and ethnicity as well as whether they worked with people with dementia or had been personally affected by dementia.

Results

Increased contact with people with dementia was associated with increases in both total Approaches to Dementia Questionnaire scores and across both sub-scales reflecting more positive person-centred attitudes toward dementia. The highest levels of increase were found amongst non-white participants.

Conclusions

This study is, we believe, the first attempt to look systematically at whether greater contact with people with dementia is associated with changes in attitudes. The results strongly support the contention that increased contact with people with dementia leads to more person-centred attitudes, and by inference, less stigmatising views.
Does Stroke Rehabilitation Really Matter? Part B: An Algorithm for Prescribing an Effective Intensity of Rehabilitation
Authors: Jeffers Matthew Strider , Karthikeyan Sudhir , Gomez-Smith Mariana , Gasinzigwa Sarah , Achenbach Jannis , Feiten Astrid , Corbett Dale
Published: January 2018

Background. The proportional recovery rule suggests that current rehabilitation practices may have limited ability to influence stroke recovery. However, the appropriate intensity of rehabilitation needed to achieve recovery remains unknown. Similarities between rodent and human recovery biomarkers may allow determination of rehabilitation thresholds necessary to activate endogenous biological recovery processes. Objective. We determined the relative influence that clinically relevant biomarkers of stroke recovery exert on functional outcome. These biomarkers were then used to generate an algorithm that prescribes individualized intensities of rehabilitation necessary for recovery of function. Methods. A retrospective cohort of 593 male Sprague-Dawley rats was used to identify biomarkers that best predicted poststroke change in pellet retrieval in the Montoya staircase-reaching task using multiple linear regression. Prospective manipulation of these factors using endothelin-1-induced stroke (n = 49) was used to validate the model. Results. Rehabilitation was necessary to reliably predict recovery across the continuum of stroke severity. As infarct volume and initial impairment increased, more intensive rehabilitation was required to engage recovery. In this model, we prescribed the specific dose of daily rehabilitation required for rats to achieve significant motor recovery using the biomarkers of initial poststroke impairment and infarct volume. Conclusions. Our algorithm demonstrates an individualized approach to stroke rehabilitation, wherein imaging and functional performance measures can be used to develop an optimized rehabilitation paradigm for rats, particularly those with severe impairments. Exploring this approach in human patients could lead to an increase in the proportion of individuals experiencing recovery of lost motor function poststroke.
An optimization model for the operations of a pallet pool with both radio-frequency identification–tagged pallets and non-tagged pallets
Authors: Ren Jianwei , Chen Chunhua , Xu Hao , Zhao Qingqing
Published: January 2018

In a pallet pool, pallets would be delivered through a supply chain. The operation procedure that consists of at least five operation processes as distribution, reposition, recycling, purchase (or rent), and maintenance is quite complex. These pallets are likely to be damaged, lost, destroyed, and so on. So, it is necessary to monitor the pallets using radio-frequency identification technology. However, there is no literature on the management of a pallet pool with both radio-frequency identification–tagged pallets and non-tagged pallets being put into consideration. In our research, an optimization model is presented to manage such a pallet pool. The objective of the optimization model is to minimize the total operation cost of a pallet pool including distribution cost, reposition cost, recycling cost, purchase or rent cost, loss cost, maintenance cost, loading and unloading cost, storage cost, and punishment cost. A particle swarm optimization algorithm is developed in Microsoft Visual Basic. Our numerical example shows that the optimization model and particle swarm optimization algorithm are effective. It is proved that the model and algorithm also can be used to measure whether the investment of a radio-frequency identification system is valuable or not. We proposed some suggestions for the pallet pools management.
Type synthesis of uncoupled translational parallel manipulators based on actuation wrench screw theory
Authors: Zhang Yanbin , Zhao Yifu , Jing Xianling , Li Xiangpan
Published: January 2018

In this article, a new methodology for type synthesis of uncoupled translational parallel manipulators with 3-degrees of freedom is proposed based on actuation wrench screw theory. Mapping matrix between outputs of the moving platform and the inputs of the actuators for uncoupled translational parallel manipulators is derived. The forms of both the actuated twist screws and the actuation wrench screws of the limbs are determined by means of the condition that the Jacobian is a diagonal matrix with full rank. The steps used to confirm the non-actuated screws of the limbs are also established. Then, procedures for structure synthesis of the limbs are set up and all possible basic structure limbs are enumerated. Some new uncoupled translational parallel manipulators are synthesized by selecting three limbs connecting the platform to the base and two examples are given. The approach proposed is applicable to the type synthesis of uncoupled parallel manipulators with rotational mobility as well.
Discordant Results Obtained for Different Methods of HER-2/Neu Testing in Breast Cancer – A Question of Standardization, Automation and Timing
Authors: Lüftner D. , Henschke P. , Kafka A. , Anagnostopoulos I. , Wiechen K. , Geppert R. , Stein H. , Wernecke K.D. , Kreienberg R. , Possinger K.
Published: January 2018

Background

HER-2/neu positivity is required for the selection of stage IV breast cancer patients for trastuzumab therapy. We compared the results of the recommended immunohistochemistry (IHC) evaluation with the automated ACIS™ IHC system and with fluorescence in situ hybridization (FISH). These HER-2/neu tissue results were correlated with the serum HER-2/neu (sHER-2/neu) levels at the time of metastatic spread.

Patients and Methods

A total of 61 IHC slides from 30 patients were stained using the HercepTest™. HER-2/neu gene amplification was determined using the Ventana™ FISH assay. sHER-2/neu levels were measured with the Oncogene Science” ELISA kit. The concordance of HER-2/neu results was determined using the concordance index Kappa (κ).

Results

The best concordance between any IHC and FISH was found for the automated ACIS system (88.5%, κ=0.68, category “good”). The comparison between the manual interpretations and the automated IHC was categorized as “very good” (95.1%, κ=0.85). The median sHER-2/neu level of FISH positive patients was significantly higher (67 ng/mL) than that of FISH negative patients (17 ng/mL, p=0.018). The increase in HER-2/neu positivity comparing tissue to stage IV serum was statistically significant (p=0.001).

Conclusions

The concordance between conventional IHC and computerized analysis was very good. The number of patients with stage IV breast cancer with an elevated sHER-2/neu level was much higher than HER-2/neu positivity in tissue. This discrepancy is only partially explained by the influence of tumor load. Patients with an elevated sHER-2/neu level and no tissue overexpression should be considered for retesting of tissue or a new biopsy.
K562 Cell Sensitization to 5-Fluorouracil- or Interferon-Alpha-Induced Apoptosis Via Cordycepin (3′-Deoxyadenosine): Fine Control of Cell Apoptosis Via Poly(A) Polymerase Upregulation
Authors: Lallas G.C. , Courtis N. , Havredaki M.
Published: January 2018

K562 cells represent a classical model for the study of drug resistance. Induction of apoptosis is accompanied by concomitant distinct modulations of poly(A) polymerase (PAP) and other proteins involved in mRNA maturation. Recent data suggest the involvement of mRNA stability in the induction of specific apoptosis pathways. In this study we used a specific polyadenylation inhibitor, cordycepin (3-deoxyadenosine), to investigate the involvement of polyadenylation in K562 cell apoptosis and drug resistance. The combination of cordycepin with either 5-fluorouracil or interferon-alpha sensitized chemoresistant K562 cells to apoptosis. This sensitization was followed by distinct PAP modulations before and after the appearance of characteristic apoptosis pointers (DNA laddering, DAPI staining, mitochondrial transmembrane potential). PAP modulations appeared essential for K562 sensitization. mRNA polyadenylation therefore seemed to be involved not only in apoptosis but also in drug resistance. Polyadenylation inhibition by cordycepin under certain conditions sensitized chemoresistant K562 cells to apoptosis and thus polyadenylation could prove to be a fine target for overcoming drug resistance.
Predictors of Random Sextant Biopsy Outcome in Screened Men with PSA >4 ng/mL and a negative Sextant Biopsy at Previous Screening. Experience in a Population-Based Screening Program in Florence
Authors: Ciatto S. , Lombardi C. , Rubeca T. , Zappa M.
Published: January 2018

The aim of this study was to evaluate possible pedictors of the outcome of repeat random sextant biopsy of the prostate prompted by a rise in prostate-specific antigen (PSA). Random biopsies performed for PSA elevation (>4 ng/mL) in the course of a randomized study of screening efficacy were reviewed, and 87 consecutive biopsies (carcinoma=13, highgrade prostatic intraepithelial neoplasia=6, negative=68) performed in subjects with a negative random biopsy at the previous screening round were considered. Findings at digital rectal examination or transrectal ultrasonography and total PSA value were not useful predictors of repeat biopsy outcome, whereas PSA velocity was significantly associated with biopsy outcome. The positive predictive value for a cancer biopsy was 2.7% (1/36), 28.5% (2/7), and 22.7% (10/44) for PSA velocity values of <0.1, 0.1–0.19, and >0.19 ng/mL/yr, respectively. A cutoff of 0.1 ng/mL/yr for PSA velocity would have allowed to avoid approximately half (35/74=47.2%) of the benign biopsies while decreasing the sensitivity by 7.6% (1/13), and is thus suggested as a possible criterion for the indication of repeat random biopsy for persistent PSA elevation.
ADVIA Centaur® Her-2/Neu Shows Value in Monitoring Patients with Metastatic Breast Cancer
Authors: Lüftner D. , Cheli C. , Mickelson K. , Sampson E. , Possinger K.
Published: January 2018

Introduction

The proteolytic breakdown product corresponding to the extracellular domain (ECD) of the HER-2/neu oncoprotein p185 is found in the circulation of healthy individuals and patients having cancers of epithelial origin. For the current evaluation we sought to determine the analytical performance as well as the clinical utility of the newly developed ADVIA Centaur® HER-2/neu assay (Bayer HealthCare LLC, Diagnostics Division, Tarrytown, NY, USA) in monitoring patients with metastatic breast cancer during the course of disease and treatment and to compare the obtained results with those of CA 15–3.

Methods

The analytical performance (including precision, normal range, interfering substances, minimum detectable concentration, dilution recovery, spiking recovery and high-dose hook effect) were determined. HER-2/neu and CA 15–3 values were measured in retrospective samples obtained from 59 patients with metastatic breast cancer undergoing treatment over a 6–12 month period. Serial changes in serum HER-2/neu and CA 15–3 were correlated with changes in clinical status on a visit-to-visit basis. For each pair of serial measurements, changes of equal to or greater than, or less than 15% for HER-2/neu and 21% for CA 15–3 were considered to indicate progression or lack of progression, respectively.

Results

The ADVIA Centaur HER-2/neu assay demonstrated within-run imprecision and total imprecision ranging from 3.0–5.6% and from 3.2–5.7%, respectively. The upper limit of normal was 15.2 ng/mL (90% CI: 14.2–17.0 ng/mL). No significant interference (<5%) was seen with bilirubins, hemoglobin, triglycerides and cholesterol or therapeutic drugs commonly present in the sera of breast cancer patients. The minimum detectable concentration (analytical sensitivity) was found to be 0.5 ng/mL. The patient population in the clinical study included breast cancer patients who responded to therapy (stable, partial or complete response) or had disease progression. HER-2/neu levels showed a concordance of 78.1% (82/105 restaging time points) with the clinical course of disease, whereas CA 15–3 levels showed a concordance of 76.2% (80/105 restaging time points). The concordance with clinical status increased to 85.7% (90/105 restaging time points) when both results were used in combination as a series test.

Conclusions

The ADVIA Centaur HER-2/neu assay provides excellent analytical performance for serial testing of serum HER-2/neu levels. The clinical data demonstrate the usefulness of serum HER-2/neu in monitoring metastatic breast cancer patients during treatment. Furthermore, the results indicate that serum HER-2/neu and CA 15–3 may be useful in identifying disease progression or therapeutic response in different subgroups of women with metastatic breast cancer.
Transforming Growth Factor Beta 1 Serum Levels in Patients with Preinvasive and Invasive Lesions of the Breast
Authors: Lebrecht A. , Grimm C. , Euller G. , Ludwig E. , Ulbrich E. , Lantzsch T. , Hefler L. , Koelbl H.
Published: January 2018

Transforming growth factor beta (TGF-β)1 is thought to be involved in breast carcinogenesis. TGF-β1 acts in an antiproliferative manner in the early stages of breast carcinogenesis, but promotes tumor progression and metastases in the advanced stages of the disease. No data have been published on serum TGF-β1 in breast cancer. We investigated TGF-β1 serum levels in patients with breast cancer (n=135), ductal carcinoma in situ (DCIS) I to III (n=67) or fibroadenoma (n=35), and in healthy women (n=40) to determine its value as a differentiation marker between malignant, pre-invasive and benign diseases and as a predictive marker for metastatic spread. Median (range) TGF-β1 serum levels in patients with breast cancer, DCIS I-III or benign breast lesions and in healthy women were 48.8 (18–82.4) pg/mL, 45.3 (26.9–58.3) pg/mL, 47.2 (17.2–80.5) pg/mL and 51.6 (30.9–65.1) pg/mL, respectively (p=0.2). In breast cancer patients TGF-β1 serum levels showed no statistically significant correlation with tumor stage, lymph node involvement, histological grade, estrogen receptor status and progesterone receptor status. Our data fail to indicate any correlation between serum TGF-β1 levels and clinicopathological parameters of breast diseases. Serum TGF-β1 levels do not provide clinical information in addition to established tumor markers.