bluuebunny/crossref_metadata_2025 huggingface dataset:
Migration to the Downtown Eastside neighbourhood of Vancouver and changes in service use in a cohort of mentally ill homeless adults: a 10-year retrospective study
Authors: Somers Julian M , Moniruzzaman Akm , Rezansoff Stefanie N
Published: January 2016

Objectives

Little research has investigated the role of migration as a potential contributor to the spatial concentration of homeless people with complex health and social needs. In addition, little is known concerning the relationship between possible migration and changes in levels of service use over time. We hypothesised that homeless, mentally ill individuals living in a concentrated urban setting had migrated from elsewhere over a 10-year period, in association with significant increases in the use of public services.

Setting

Recruitment was concentrated in the Downtown Eastside neighbourhood of Vancouver, Canada.

Participants

Participants (n=433) met criteria for chronic homelessness and serious mental illness, and provided consent to access administrative data.

Methods

Linked administrative data were used to retrospectively examine geographic relocation as well as rates of health, justice, and social welfare service utilisation in each of the 10 years prior to recruitment. Generalised estimating equations were used to estimate the effect of migration on service use.

Results

Over a 10-year period there was significant movement into Vancouver's Downtown Eastside neighbourhood (from 17% to 52% of the cohort). During the same period, there were significant annual increases in community medical services (adjusted rate ratio (ARR) per year=1.08; 95% CI 1.06 to 1.10), hospital admissions (ARR=1.08; 95% CI 1.04 to 1.11), criminal convictions (ARR=1.08; 95% CI 1.03 to 1.13), and financial assistance payments (ARR=1.04; 95% CI 1.03 to 1.06). Migration was significantly associated with financial assistance, but not with other types of services.

Conclusions

Significant increases in service use over a 10-year period coincided with significant migration into an urban area where relevant services were concentrated. These results highlight opportunities for early intervention in spatially diverse neighbourhoods to interrupt trajectories marked by worsening health and extremely high service involvement. Further research is urgently needed to investigate the causal relationships between physical migration, health and social welfare, and escalating use of public services.

Trial registration numbers

ISRCTN57595077 andISRCTN66721740; Post-results.
Understanding influences and decisions of households with children with asthma regarding temperature and humidity in the home in winter: a qualitative study
Authors: Tod Angela Mary , Nelson Peter , Cronin de Chavez Anna , Homer Catherine , Powell-Hoyland Vanessa , Stocks Amanda
Published: January 2016

Objectives

This study aimed to understand the influences and decisions of households with children with asthma regarding keeping warm and well at home in winter.

Setting

Community settings in Rotherham and Doncaster, South Yorkshire, UK.

Participants

Individuals from 35 families and 25 health, education and social care staff underwent interview. 5 group interviews were held, 1 with parents (n=20) and 4 with staff (n=25).

Outcome measures

This qualitative study incorporated in-depth, semistructured individual and group interviews, framework analysis and social marketing segmentation techniques.

Results

The research identifies a range of psychological and contextual influences on parents that may inadvertently place a child with asthma at risk of cold, damp and worsening health in a home. Parents have to balance a range of factors to manage fluctuating temperatures, damp conditions and mould. Participants were constantly assessing their family's needs against the resources available to them. Influences, barriers and needs interacted in ways that meant they made ‘trade-offs’ that drove their behaviour regarding the temperature and humidity of the home, including partial self-disconnection from their energy supply. Evidence was also seen of parents lacking knowledge and understanding while working their way through conflicting and confusing information or advice from a range of professionals including health, social care and housing. Pressure on parents was increased when they had to provide help and support for extended family and friends.

Conclusions

The findings illustrate how and why a child with asthma may be at risk of a cold home. A ‘trade-off model’ has been developed as an output of the research to explain the competing demands on families. Messages emerge about the importance of tailored advice and information to families vulnerable to cold-related harm.
Leisure time physical activity and subsequent physical and mental health functioning among midlife Finnish, British and Japanese employees: a follow-up study in three occupational cohorts
Authors: Lahti Jouni , Sabia Séverine , Singh-Manoux Archana , Kivimäki Mika , Tatsuse Takashi , Yamada Masaaki , Sekine Michikazu , Lallukka Tea
Published: January 2016

Objectives

The aim of this study was to examine whether leisure time physical activity contributes to subsequent physical and mental health functioning among midlife employees. The associations were tested in three occupational cohorts from Finland, Britain and Japan.

Design

Cohort study.

Setting

Finland, Britain and Japan.

Participants

Prospective employee cohorts from the Finnish Helsinki Health Study (2000–2002 and 2007, n=5958), British Whitehall II study (1997–1999 and 2003–2004, n=4142) and Japanese Civil Servants Study (1998–1999 and 2003, n=1768) were used. Leisure time physical activity was classified into three groups: inactive, moderately active and vigorously active.

Primary outcome measure

Mean scores of physical and mental health functioning (SF-36) at follow-up were examined.

Results

Physical activity was associated with better subsequent physical health functioning in all three cohorts, however, with varying magnitude and some gender differences. Differences were the clearest among Finnish women (inactive: 46.0, vigorously active: 49.5) and men (inactive: 47.8, active vigorous: 51.1) and British women (inactive: 47.3, active vigorous: 50.4). In mental health functioning, the differences were generally smaller and not that clearly related to the intensity of physical activity. Emerging differences in health functioning were relatively small.

Conclusions

Vigorous physical activity was associated with better subsequent physical health functioning in all three cohorts with varying magnitude. For mental health functioning, the intensity of physical activity was less important. Promoting leisure time physical activity may prove useful for the maintenance of health functioning among midlife employees.
Preovulatory uterine flushing with saline as a treatment for unexplained infertility: a randomised controlled trial protocol
Authors: Maheux-Lacroix Sarah , Dodin Sylvie , Moore Lynne , Bujold Emmanuel , Lefebvre Jessica , Bergeron Marie-Ève
Published: January 2016

Introduction

In vitro fertilisation (IVF) is the treatment of choice for unexplained infertility. Preovulatory uterine flushing could reduce intrauterine debris and inflammatory factors preventing pregnancy and constitute an alternative to IVF. Our objective is to assess the efficacy of preovulatory uterine flushing with physiological saline for the treatment of unexplained infertility.

Methods and analysis

We will perform a randomised controlled trial based on consecutive women aged between 18 and 37 years consulting for unexplained infertility for at least 1 year. On the day of their luteinising hormone surge, 192 participants will be randomised in two equal groups to either receive 20 mL of physiological saline by an intrauterine catheter or 10 mL of saline intravaginally. We will assess relative risk of live birth (primary outcome), as well as pregnancy (secondary outcome) over one cycle of treatment. We will report the side effects, complications and acceptability of the intervention.

Ethics and dissemination

This project was approved by the Ethics committee of theCentre Hospitatlier Universitaire de Quebec(no 2015–1146). Uterine flushing is usually well tolerated by women and would constitute a simple, affordable and minimally invasive treatment for unexplained infertility. We plan to communicate the results of the review by presenting research abstracts at conferences and by publishing the results in a peer-reviewed journal.

Trial registration number

NCT02539290; Pre-results.
Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities
Authors: Pannick Samuel , Sevdalis Nick , Athanasiou Thanos
Published: January 2016

Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a universal challenge; moreover, there is evidence that managers—particularly middle managers—also have a role to play in quality improvement. Yet managerial participation in quality improvement interventions is often assumed, rather than proven. We identify specific factors that influence the coordination of front-line staff and managers in quality improvement, and integrate these factors into a novel model: the model of alignment. We use this model to explore the implementation of an interdisciplinary intervention in a recent trial, describing different participation incentives and barriers for different staff groups. The extent to which clinical and managerial interests align may be an important determinant of the ultimate success of quality improvement interventions.
Predictors of inhospital mortality following out-of-hospital cardiac arrest: Insights from a single-centre consecutive case series
Authors: Whittaker Andrew , Lehal Manpreet , Calver Alison L , Corbett Simon , Deakin Charles D , Gray Huon , Simpson Iain , Wilkinson James R , Curzen Nicholas
Published: January 2016

Purpose of the study

Out-of-hospital cardiac arrest (OHCA) has a poor prognosis despite bystander resuscitation and rapid transfer to hospital. Optimal management of patients after arrival to hospital continues to be contentious, especially the timing of emergency coronary angiography±revascularisation. Robust predictors of inhospital outcome would be of clinical value for initial decision-making.

Study design

A retrospective analysis of consecutive patients who presented to a university hospital following OHCA over a 70-month period (2008–2013). Patients were identified from the emergency department electronic patient registration and coding system. For those patients who underwent emergency percutaneous coronary intervention, details were crosschecked with national databases.

Results

We identified 350 consecutive patients who were brought to our hospital following OHCA. Return of spontaneous circulation (ROSC) for >20 min was achieved either before arrival or inhospital in 196 individuals. From the 350 subjects, 114 (32.6%) survived to hospital discharge. When sustained ROSC was achieved, either before or inhospital, survival to discharge was 58.2% (114 of 196). Non-shockable rhythm, absence of bystander cardiopulmonary resuscitation, ‘downtime’ >15 min and initial pH ≤7.11 were predictors of inhospital death. 12% patients who underwent angiography in the presence of ST elevation had no acute coronary occlusion. 21% patients with acute coronary occlusion at angiography did not have ST elevation.

Conclusions

In our cohort of patients with OHCA, those who achieve ROSC had a survival-to-discharge rate of 58.2%. We identified four predictors of inhospital death, which are readily available at the time of patient presentation. Reliance on ST elevation to decide about coronary angiography and revascularisation may be flawed. More data are required.
Risk factors and effect of selective removal on retroviral infections prevalence in Belgian stray cats
Authors: Garigliany M. , Jolly S. , Dive M. , Bayrou C. , Berthemin S. , Robin P. , Godenir R. , Petry J. , Dahout S. , Cassart D. , Thiry E. , Desmecht D. , Saegerman C.
Published: January 2016

The aim of this study was to evaluate the effect of several risk/protective factors and predictors on the prevalence of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infections in 302 stray cats captured during a trap‐neuter‐release programme in a mixed urban‐rural area from Belgium, from 2010 to 2012. The impact of selective removal of FIV‐positive cats on the apparent prevalence in the remaining population over this three‐year period was also assessed. The seroprevalences over three years were 18.8 per cent for FIV and 0.7 per cent for FeLV. For FIV, the seroprevalence decreased significantly from the first year of the programme (2010; 30.5 per cent) to the last (2012; 13.1 per cent). Sex (male) and age (adult and old cats) were risk factors, while the year of sampling (years 2011 and 2012) was a protective factor. Age, sex and location were the most relevant predictors of FIV status. The data presented in this study revealed a very high FIV seroprevalence in Belgian stray cats, while FeLV was almost absent. The selective removal of positive cats had a drastic effect on the FIV seroprevalence in the remaining cat population.
Low-cost bidirectional selector based on Ti/TiO2/HfO2/TiO2/Ti stack for bipolar RRAM arrays
Authors: Li Yingtao , Li Rongrong , Yuan Peng , Gao Xiaoping , Chen Enzi
Published: January 2016

In this paper, a low-cost Ti/TiO2/HfO2/TiO2/Ti stack structure is proposed as a selector for bipolar resistive random access memory (RRAM) cross-bar array applications. We demonstrate reproducible resistive switching characteristics with significant nonlinearity and good uniformity in the one selector and one resistor (1S1R) structure device that integrate the bidirectional selector with a bipolar Pt/Ti/HfO2/Pt RRAM device. These results provide a good point of reference for evaluating the potential low-cost applications in bipolar RRAM cross-bar array.
Effects of S/Ce-codoping on electronic structures and optical properties of anatase TiO2from density functional theory calculations
Authors: Zhou Shi Wen , Liu Jian , Peng Ping , Chen Wen Qin
Published: January 2016

The electronic and optical properties of S- and/or Ce-(co)doped anatase titanium dioxide (TiO2) are investigated using density functional theory plus U (DFT[Formula: see text]U) calculations. The optimized total energy suggests that TiO2codoping by Ce and S favours the configuration of one substitutional Ce atom occupied on a Ti site with one substitutional S atom either on its nearest neighboring O or Ti site. The calculated results show that all doping configurations exhibit remarkable red-shift and excellent photocatalytic properties compared with pure TiO2. These reinforced features can mainly be ascribed to the appearance of S [Formula: see text] states in the top of valence band (VB) and Ce [Formula: see text] states in the bottom of conduction band (CB) as well as the contribution from the increasing octahedral dipole moments. The synergetic effects of cationic Ce and anionic S can extend optical absorption edge, which results in higher absorption coefficient in the visible light region than that of the anionic S monodoping and cationic Ce monodoping case; in the same time, decreasing the codoping concentration leads to reduced optical absorption. Additionally, Ce and S as cations incorporating into TiO2lattices can induce stronger redox potential with a lower defect formation energy under O-rich condition compared with other doping systems.
Integrated Determination of Objective Criteria Weights in MCDM
Authors: Zavadskas Edmundas Kazimieras , Podvezko Valentinas
Published: January 2016

In multiple criteria evaluation, criteria weights are of great importance. In practice, subjective criteria weights determined by specialists/experts are commonly used. The types of elements of a decision matrix also play an important role in the evaluation of alternatives. The objective weights help to estimate the structure of data. The entropy method is widely used for determining the weights (significances) of criteria. A new method of the criterion impact loss, CILOS, is used for determining a relative impact loss experienced by the criterion of an alternative, when another criterion is chosen to be the best. The authors of the paper have combined the best features of the entropy method and the CILOS approach to obtain a new method – Integrated Determination of Objective CRIteria Weights, or (IDOCRIW).
Review of chrono-, litho- and biostratigraphy across the global Hangenberg Crisis and Devonian–Carboniferous Boundary
Authors: Becker Ralph Thomas , Kaiser Sandra Isabella , Aretz Markus
Published: January 2016

Chrono-, litho- and biostratigraphy across the Devonian–Carboniferous transition are reviewed to provide a precise time framework for the global Hangenberg Crisis and for the current search for a revised basal Carboniferous Global Stratotype Section and Point (GSSP). The outer shelf deposits of the Rhenish Massif (Germany) form a lithological standard. Pre- (main Wocklum Limestone), lower (top Wocklum Limestone/Drewer Sandstone to Hangenberg Black Shale), middle (Hangenberg Shale/Sandstone), upper (Stockum Limestone), and post-crisis (Hangenberg Limestone) deposits are defined. Combined with the conodont, ammonoid and miospore zonations and eustatic trends, this succession can be correlated internationally. The contemporaneous successions of the Ardennes serve as a reference for shallow shelf settings. The positive and negative aspects of five options for a redefined Devonian–Carboniferous boundary level are discussed: (1) base of the black shale (main extinction level, base of
Bispathodus costatus–Protognathodus kockeli
Interregnum and LN Zone), (2) sequence boundary (widespread unconformities) or glacial and regressive peak (base of Hangenberg Sandstone), (3) base of the
kockeli
Zone and of initial postglacial transgression (base of lower Stockum Limestone), (4) entry of
Siphonodella
(
Eosiphonodella
)
sulcata
(base of upper Stockum Limestone), and (5) base of post-crisis interval (base of Hangenberg Limestone), at approximately the poorly correlated current GSSP level. Due to homonymy,
Siphonodella
(
Siphonodella
)
hassi
Ji, 1985 is renamed as
Siphonodella
(
Siphonodella
)
jii
nom. nov. Consequently, the mid-lower Tournaisian
S.
(
S
.)
hassi
Zone (previous Upper
S.
(
S.
)
duplicata
Zone) becomes the
S.
(
S.
)
jii
Zone.
Did Pyrenean glaciers dance to the beat of global climatic events? Evidence from the Würmian sequence stratigraphy of an ice-dammed palaeolake depocentre in Andorra
Authors: Turu Valentí , Calvet Marc , Bordonau Jaume , Gunnell Yanni , Delmas Magali , Manuel Vilaplana Joan , Jalut Guy
Published: January 2016

The ice-marginal depositional sequence of La Massana provides a chronostratigraphic benchmark for reconstructing the Würmian glacial evolution of the Valira catchment in Andorra, SE Pyrenees. The sedimentary record of Andorra confirms the asynchronous chronology of glacier fluctuations in different parts of the Pyrenean mountain range. A major ice recession occurred at the end of Marine Isotope Stage (MIS) 4. High magnitude valley-glacier fluctuations during MIS 3 constitute another important finding. Major readvances occurred toward the end of MIS 3, whereas MIS 2 (in particular, the global Last Glacial Maximum, or LGM) featured sharp contrasts in ice recession rates between Pyrenean valleys. Substantial distances separated MIS 4 glacier fronts (the Würmian maximum ice extent, or MIE) from those reached during the global LGM, in contrast to situations in the eastern Pyrenees, where Würmian MIE and global LGM ice fronts nearly coincided. Overall, the Valira glaciers reveal patterns that are more similar to those recorded elsewhere in the western and central Pyrenees than in the eastern Pyrenees. The rapid fluctuations recorded by Andorran glaciers during the second half of the Würm also suggest a response to global forcing events such as Heinrich events in the North Atlantic.
A Filtering Mechanism to Reduce Network Bandwidth Utilization of Transaction Execution
Authors: Zhao Lihang , Chen Lizhong , Choi Woojin , Draper Jeffrey
Published: January 2016

Hardware Transactional Memory (HTM) relies heavily on the on-chip network for intertransaction communication. However, the network bandwidth utilization of transactions has been largely neglected in HTM designs. In this work, we propose a cost model to analyze network bandwidth in transaction execution. The cost model identifies a set of key factors that can be optimized through system design to reduce the communication cost of HTM. Based on the model and network traffic characterization of a representative HTM design, we identify a huge source of superfluous traffic due to failed requests in transaction conflicts. As observed in a spectrum of workloads, 39% of the transactional requests fail due to conflicts, which renders 58% of the transactional network traffic futile. To combat this pathology, a novel in-network filtering mechanism is proposed. The on-chip router is augmented to predict conflicts among transactions and proactively filter out those requests that have a high probability to fail. Experimental results show the proposed mechanism reduces total network traffic by 24% on average for a set of high-contention TM applications, thereby reducing energy consumption by an average of 24%. Meanwhile, the contention in the coherence directory is reduced by 68%, on average. These improvements are achieved with only 5% area added to a conventional on-chip router design.
Citadel
Authors: Nair Prashant J. , Roberts David A. , Qureshi Moinuddin K.
Published: January 2016

Stacked memory modules are likely to be tightly integrated with the processor. It is vital that these memory modules operate reliably, as memory failure can require the replacement of the entire socket. To make matters worse, stacked memory designs are susceptible to newer failure modes (e.g., due to faulty through-silicon vias, or TSVs) that can cause large portions of memory, such as a bank, to become faulty. To avoid data loss from large-granularity failures, the memory system may use symbol-based codes that stripe the data for a cache line across several banks (or channels). Unfortunately, such data-striping reduces memory-level parallelism, causing significant slowdown and higher power consumption.

This article proposes
Citadel
, a robust memory architecture that allows the memory system to retain each cache line within one bank. By retaining cache lines within banks, Citadel enables a high-performance and low-power memory system and also efficiently protects the stacked memory system from large-granularity failures. Citadel consists of three components;
TSV-Swap
, which can tolerate both faulty data-TSVs and faulty address-TSVs; Tri-Dimensional Parity (3DP), which can tolerate column failures, row failures, and bank failures; and
Dynamic Dual-Granularity Sparing (DDS)
, which can mitigate permanent faults by dynamically sparing faulty memory regions either at a row granularity or at a bank granularity. Our evaluations with real-world data for DRAM failures show that Citadel provides performance and power similar to maintaining the entire cache line in the same bank, and yet provides 700 × higher reliability than ChipKill-like ECC codes.
JavaScript Parallelizing Compiler for Exploiting Parallelism from Data-Parallel HTML5 Applications
Authors: Na Yeoul , Kim Seon Wook , Han Youngsun
Published: January 2016

With the advent of the HTML5 standard, JavaScript is increasingly processing computationally intensive, data-parallel workloads. Thus, the enhancement of JavaScript performance has been emphasized because the performance gap between JavaScript and native applications is still substantial. Despite this urgency, conventional JavaScript compilers do not exploit much of parallelism even from data-parallel JavaScript applications, despite contemporary mobile devices being equipped with expensive parallel hardware platforms, such as multicore processors and GPGPUs.

In this article, we propose an automatically parallelizing JavaScript compiler that targets emerging, data-parallel HTML5 applications by leveraging the mature affine loop analysis of conventional static compilers. We identify that the most critical issues when parallelizing JavaScript with a conventional static analysis are ensuring correct parallelization, minimizing compilation overhead, and conducting low-cost recovery when there is a speculation failure during parallel execution. We propose a mechanism for safely handling the failure at a low cost, based on compiler techniques and the property of idempotence. Our experiment shows that the proposed JavaScript parallelizing compiler detects most affine parallel loops. Also, we achieved a maximum speedup of 3.22 times on a quad-core system, while incurring negligible compilation and recovery overheads with various sets of data-parallel HTML5 applications.
DASH
Authors: Usui Hiroyuki , Subramanian Lavanya , Chang Kevin Kai-Wei , Mutlu Onur
Published: January 2016

Modern SoCs integrate multiple CPU cores and hardware accelerators (HWAs) that share the same main memory system, causing interference among memory requests from different agents. The result of this interference, if it is not controlled well, is missed deadlines for HWAs and low CPU performance. Few previous works have tackled this problem. State-of-the-art mechanisms designed for CPU-GPU systems strive to meet a target frame rate for GPUs by prioritizing the GPU close to the time when it has to complete a frame. We observe two major problems when such an approach is adapted to a heterogeneous CPU-HWA system. First, HWAs miss deadlines because they are prioritized
only when
close to their deadlines. Second, such an approach does
not
consider the diverse memory access characteristics of different applications running on CPUs and HWAs, leading to low performance for latency-sensitive CPU applications and deadline misses for some HWAs, including GPUs.

In this article, we propose a Deadline-Aware memory Scheduler for Heterogeneous systems (DASH), which overcomes these problems using three key ideas, with the goal of meeting HWAs’ deadlines while providing high CPU performance. First, DASH prioritizes an HWA when it is not on track to meet its deadline
any time
during a deadline period, instead of prioritizing it only when close to a deadline. Second, DASH prioritizes HWAs over memory-intensive CPU applications based on the observation that memory-intensive applications’ performance is not sensitive to memory latency. Third, DASH treats short-deadline HWAs differently as they are more likely to miss their deadlines and schedules their requests based on worst-case memory access time estimates.

Extensive evaluations across a wide variety of different workloads and systems show that DASH achieves significantly better CPU performance than the best previous scheduler while always meeting the deadlines for all HWAs, including GPUs, thereby largely improving frame rates.
Perceptions of incompetence in the ICT workplace
Authors: Al-Saggaf Yeslam , Burmeister Oliver K. , Weckert John
Published: January 2016

The aim of this study is to examine incompetence in the Australian ICT workplace from the perspective of Australian ICT professionals. The data collection for this project included conducting a quantitative survey, conducting qualitative interviews and conducting focus group discussions with key informants. Of the 2,315 respondents who participated in the survey, the MRF analysis revealed that incompetence was ranked fifth from the top of a list of the 57 most common ethical problems experienced by ICT professionals (N=750, 35.9%). An inspection of the results of the cross tabulations revealed that 34.8% described their occupational category as manager and 29.1% indicated they were consultants. The GLM has found a significant relationship between the choice of incompetence and occupation (Deviance = 23.15, Df = 6, P=0.0007) suggesting occupation, among other things, does predict the choice of incompetence. The findings from the qualitative interviews are consistent with the above findings. A cross referencing of the interviewees responses that addressed the issue of incompetence during the interviews against their occupation has revealed that consultants had more to say on the topic than any other occupation (20.8% or 10 of the 48 references). This is followed by managers who accounted for 14.6% (7 of the 48 references). These findings indicate that the experienced professionals have a greater concern about incompetence than others; an observation that the findings from the focus group interviews have also confirmed. Obtaining such findings would not have been possible had only one method been used.
The significance of ICT in the generation of code of conduct
Authors: Yanagihara Sachiko , Koga Hiroshi
Published: January 2016

The purpose of this study is considering the creation of the Code of Conduct by using ICT. In particular, we consider the ethics of ICT by a case study of Japanese NPO which does a support project of "hikikomori." On a global scale, social withdrawal and reclusion are real problems and in the information society of today, these problems are often associated with modern lifestyle and use of technology. However, in this paper, it is not to discuss the therapeutic point of view of withdrawal. Rather, it is discussed online communication in withdrawal support groups. It is the object of this paper to clarify the process of the Code of Conduct through online communication is formed.
First dose is always freemium
Authors: Kimppa Kai K. , Heimo Olli I. , Harviainen J. Tuomas
Published: January 2016

In this paper we look at three different groups of games. The traditional payment methods for games, although they do have their problems, are typically less problematic from ethical perspective than their more modern counterparts. Payment methods such as lure-to-pay use psychological tricks to lock the player to the game. Whereas pay to pass boring parts or pay to win just use game-external mechanics to make the play easier, and thus intent to, and have consequences other than at least many of the players would want to. This paper is a first stab at the topic from a Moorean just-consequentialist perspective, and in future papers we intend to compare a wider range of philosophical methods, payment methods as well as look into empirical data on players views on the topic.
Ethical, legal and social concerns relating to exoskeletons
Authors: Greenbaum Dov
Published: January 2016

Exoskeletons, i.e., wearable robotics, are designed and built to amplify human strength and agility. In many cases, their purpose is to replace diminished or lost limb functionality, helping people regain some ambulatory freedom. As such, exoskeletons are particularly suited to help those with restricted mobility due to paralysis or weakened limbs. For all their promise, exoskeletons and other wearable robotics raise a number of ethical and social concerns that will need to be confronted by ethicists, the industry, and society as a whole. General social concerns relate to the personal and psychological impact on disabled individuals and their families. And as a society, we may need to reconsider ableness, in light of these and other technological opportunities for overcoming our limitations. But that's only for those who can afford these machines: with exoskeletons costing as much as a luxury car, there are social justice concerns relating to access to this cost-prohibitive technology, as well as the eventual dependencies on such an expensive device. Ought insurers be required to purchase these for paralyzed individuals to significantly improve their quality of life; or are there competing interests and ideals that might support an insurer's refusal to invest in this technology? Some exoskeleton manufacturers, in conjunction with defense contractors, are reportedly pursuing military grade as well as industrial grade exoskeleton solutions. These solution enable soldiers and workers to perform longer and harder. In upgrading humans into quasi-machines, however, we run the risk of treating them more like machines than humans. In the workplace this may result in the overworking of an employee, in the military this could further dehumanize warfare and its very human actors. The prospect of augmenting otherwise healthy individuals (as distinct from treatment focused on achieving, sustaining or restoring health) raises further ethical concerns relating to human enhancement, an area fraught with slippery slopes. These issues are not only limited to our regular daily interactions, but also arise in sports, as the disabled (and now disgraced) Olympian, Oscar Pistorius, has shown us. There are no simple solutions for any of these issues, although many solutions may arise organically; for example, costs and access issues may be lessened as the technology becomes more widespread and cheaper. Other issues can be dealt with through well thought out regulatory solutions. But, for society at large, exoskeletons and other future human enhancements technologies raise much more longstanding and complex questions that will force us to redefine how we perceive humanity and self.
False friends and false coinage
Authors: Elder Alexis
Published: January 2016

In this paper, an analogy that Aristotle drew between false friends and false coinage is leveraged to identify ethically important features of cases involving so-called sociable robots. The use of such robots to care for the elderly and disabled poses both benefits and costs. Although a uniform verdict on the ethical use of these robots is unlikely to be forthcoming, owing to the importance of context and wide array of variables that can influence assessment of a situation, progress can be made by using analogies from other domains. Such analogies can help identify relevant features of a given situation, in order to better evaluate the costs and benefits to patients, caregivers, and designers, thereby facilitating appropriately context-sensitive judgments.
Animating the ethical demand
Authors: Vistisen Peter , Jensen Thessa , Poulsen Søren Bolvig
Published: January 2016

This paper addresses the challenge of attaining ethical user stances during the design process of products and services and proposes animation-based sketching as a design method, which supports elaborating and examining different ethical stances towards the user. The discussion is qualified by an empirical study of Responsible Research and Innovation (RRI) in a Triple Helix constellation. Using a three-week long innovation workshop, UCrAc, involving 16 Danish companies and organisations and 142 students as empirical data, we discuss how animation-based sketching can explore not yet existing user dispositions, as well as create an incentive for ethical conduct in development and innovation processes. The ethical fulcrum evolves around Løgstrup's Ethical Demand and his notion of spontaneous life manifestations. From this, three ethical stances are developed; apathy, sympathy and empathy. By exploring both apathetic and sympathetic views, the ethical reflections are more nuanced as a result of actually seeing the user experience simulated through different user dispositions. Exploring the three ethical stances by visualising real use cases with the technologies simulated as already being implemented makes the life manifestations of the users in context visible. We present and discuss how animation-based sketching can support the elaboration and examination of different ethical stances towards the user in the product and service development process. Finally we present a framework for creating narrative representations of emerging technology use cases, which invite to reflection upon the ethics of the user experience.
Nuclear Receptors as Therapeutic Targets in Liver Disease: Are We There Yet?
Authors: Rudraiah Swetha , Zhang Xi , Wang Li
Published: January 2016

Nuclear receptors (NR) are ligand-modulated transcription factors that play diverse roles in cell differentiation, development, proliferation, and metabolism and are associated with numerous liver pathologies such as cancer, steatosis, inflammation, fibrosis, cholestasis, and xenobiotic/drug-induced liver injury. The network of target proteins associated with NRs is extremely complex, comprising coregulators, small noncoding microRNAs, and long noncoding RNAs. The importance of NRs as targets of liver disease is exemplified by the number of NR ligands that are currently used in the clinics or in clinical trials with promising results. Understanding the regulation by NR during pathophysiological conditions, and identifying ligands for orphan NR, points to a potential therapeutic approach for patients with liver diseases. An overview of complex NR metabolic networks and their pharmacological implications in liver disease is presented here.
Triclosan: A Widespread Environmental Toxicant with Many Biological Effects
Authors: Yueh Mei-Fei , Tukey Robert H.
Published: January 2016

Triclosan (TCS) is a broad-spectrum antimicrobial agent that has been added to personal care products, including hand soaps and cosmetics, and impregnated in numerous different materials ranging from athletic clothing to food packaging. The constant disposal of TCS into the sewage system is creating a major environmental and public health hazard. Owing to its chemical properties of bioaccumulation and resistance to degradation, TCS is widely detected in various environmental compartments in concentrations ranging from nanograms to micrograms per liter. Epidemiology studies indicate that significant levels of TCS are detected in body fluids in all human age groups. We document here the emerging evidence—from in vitro and in vivo animal studies and environmental toxicology studies—demonstrating that TCS exerts adverse effects on different biological systems through various modes of action. Considering the fact that humans are simultaneously exposed to TCS and many TCS-like chemicals, we speculate that TCS-induced adverse effects may be relevant to human health.
Altered expression of uncoupling protein 2 in GLP-1-producing cells after chronic high glucose exposure: implications for the pathogenesis of diabetes mellitus
Authors: Urbano Francesca , Filippello Agnese , Di Pino Antonino , Barbagallo Davide , Di Mauro Stefania , Pappalardo Alessandro , Rabuazzo Agata Maria , Purrello Michele , Purrello Francesco , Piro Salvatore
Published: January 2016

Glucagon-like peptide-1 (GLP-1) is a gut L-cell hormone that enhances glucose-stimulated insulin secretion. Several approaches that prevent GLP-1 degradation or activate the GLP-1 receptor are being used to treat type 2 diabetes mellitus (T2DM) patients. In T2DM, GLP-1 secretion has been suggested to be impaired, and this defect appears to be a consequence rather than a cause of impaired glucose homeostasis. However, although defective GLP-1 secretion has been correlated with insulin resistance, little is known about the direct effects of chronic high glucose concentrations, which are typical in diabetes patients, on GLP-1-secreting cell function. In the present study, we demonstrate that glucotoxicity directly affects GLP-1 secretion in GLUTag cells chronically exposed to high glucose. Our results indicate that this abnormality is associated with a decrease in ATP production due to the elevated expression of mitochondrial uncoupling protein 2 (UCP2). Furthermore, UCP2 inhibition using small interfering RNA (siRNA) and the application of glibenclamide, an ATP-sensitive potassium (KATP+) channel blocker, reverse the GLP-1 secretion defect induced by chronic high-glucose treatment. These results show that glucotoxicity diminishes the secretory responsiveness of GLP-1-secreting cells to acute glucose stimulation. We conclude that the loss of the incretin effect, as observed in T2DM patients, could at least partially depend on hyperglycemia, which is typical in diabetes patients. Such an understanding may not only provide new insight into diabetes complications but also ultimately contribute to the identification of novel molecular targets within intestinal L-cells for controlling and improving endogenous GLP-1 secretion.
Intermittent hypoxia induces NF-κB-dependent endothelial activation via adipocyte-derived mediators
Authors: Lee Mary Y. K. , Wang Yan , Mak Judith C. W. , Ip Mary S. M.
Published: January 2016

Aberrant release of adipocytokines from adipose tissues dysregulates cardiometabolic functions. The present study hypothesizes that chronic intermittent hypoxia (IH) present in obstructive sleep apnea leads to adipose tissue dysfunction, which in turn contributes to vascular pathogenesis. The effect of IH was evaluated in adipose depots and aortic tissues in lean rats in vivo. Furthermore, the cellular and molecular mechanisms underlying pathophysiological interactions between adipocytes and endothelial cells were investigated in vitro. The in vivo results showed that IH induced upregulation of IL-6 and monocyte chemoattractant protein-1 (MCP-1) in subcutaneous and periaortic adipose tissues and downregulated phosphorylation of endothelial nitric oxide synthase [eNOS (ser1177)] in the aorta with activation of Erk and p38 MAPK. In support, cultured adipocytes demonstrated IH-induced elevations of NADPH oxidase 4, phosphorylation of Erk, NF-κBp65, and inducible NOS (iNOS) and increased expression of IL-6 and MCP-1. Likewise, endothelial EA.hy926 (EA) cells exposed to IH showed eNOS (ser1177) and intracellular cGMP reduction, whereas MCP-1 and iNOS expression were upregulated. Treatment of EA cells with conditioned media derived from IH-exposed cultured adipocytes caused nuclear translocation of NF-κBp65 and elevation of MCP-1, which were prevented by addition of neutralizing IL-6 antibodies to the conditioned media. Recombinant IL-6 in addition to IH induced further MCP-1 release and iNOS protein expression in EA cells, which were prevented by pharmacological inhibition of Erk, p38, and NF-κB. These findings suggest that IH could induce adipose tissue inflammation, which may cross talk with endothelial cells via adipocyte-derived mediators such as IL-6, and promote NF-κB-dependent endothelial dysfunction.
Urocortins and CRF receptor type 2 variants in the male rat colon: gene expression and regulation by endotoxin and anti-inflammatory effect
Authors: Yuan Pu-Qing , Wu S. Vincent , Pothoulakis Charalabos , Taché Yvette
Published: January 2016

Urocortins (Ucns) 1, 2, and 3 and corticotropin-releasing factor receptor 2 (CRF2) mRNA are prominently expressed in various layers of the upper gut. We tested whether Ucns and CRF2 variants are also expressed in the different layers of the rat colon, regulated by LPS (100 μg/kg ip) and play a modulatory role in the colonic immune response to LPS. Transcripts of Ucns and CRF2b, the most common isoform in the periphery, were detected in all laser microdissected layers, including myenteric neurons. LPS increased the mRNA level of Ucn 1, Ucn 2, and Ucn 3 and decreased that of CRF2b in both the colonic mucosa and submucosa + muscle (S+M) layers at 2, 6, and 9 h after injection with a return to basal at 24 h. In addition, CRF2a, another variant more prominent in the brain, and a novel truncated splice variant CRF2a-3 mRNA were detected in all segments of the large intestine. LPS reciprocally regulated the colonic expression of these CRF2 variants by decreasing both CRF2a and CRF2b, while increasing CRF2a-3 in the mucosa and S+M. The CRF2 antagonist astressin2-B further enhanced LPS-induced increase of mRNA level of interleukin (IL)-1β, TNF-α, and inducible nitric oxide synthase in S+M layers and IL-1β in the mucosa and evoked TNF-α expression in the mucosa. These data indicate that Ucns/CRF2 variants are widely expressed in all colonic layers and reciprocally regulated by LPS. CRF2 signaling dampens the CD14/TLR4-mediated acute inflammatory response to Gram-negative bacteria in the colon.
TGF-β signaling in the kidney: profibrotic and protective effects
Authors: Sureshbabu Angara , Muhsin Saif A. , Choi Mary E.
Published: January 2016

Transforming growth factor-β (TGF-β) is generally considered as a central mediator of fibrotic diseases. Indeed, much focus has been placed on inhibiting TGF-β and its downstream targets as ideal therapeutic strategies. However, pharmacological blockade of TGF-β has not yet translated into successful therapy for humans, which may be due to pleiotropic effects of TGF-β signaling. Equally, TGF-β signaling as a protective response in kidney injury has been relatively underexplored. An emerging body of evidence from experimental kidney disease models indicates multifunctionality of TGF-β capable of inducing profibrotic and protective effects. This review discusses recent advances highlighting the diverse roles of TGF-β in promoting not only renal fibrosis but also protective responses of TGF-β signaling. We review, in particular, growing evidence that supports protective effects of TGF-β by mechanisms which include inhibiting inflammation and induction of autophagy. Additional detailed studies are required to fully understand the diverse mechanisms of TGF-β actions in renal fibrosis and inflammation that will likely direct toward effective antifibrotic therapies.
When a Little Knowledge Can Be Dangerous: False-Positive Diagnosis of Behavioral Variant Frontotemporal Dementia among Community Clinicians
Authors: Shinagawa Shunichiro , Catindig Joseree Ann , Block Nikolas R. , Miller Bruce L. , Rankin Katherine P.
Published: January 2016

Background: Accurate diagnosis of behavioral variant frontotemporal dementia (bvFTD) is important as patients' behavioral symptoms have profound implications for their families and communities. Since the diagnosis of bvFTD derives from behavioral features, accurate identification of patients can be difficult for non-specialists. Concrete rates of diagnostic accuracy among non-specialists are unavailable. Methods: To examine the accuracy of community clinicians' diagnoses of bvFTD and to identify patient characteristics leading to misdiagnosis, we reviewed the charts and referral letters of 3,578 patients who were seen at our specialized center. Referral diagnosis and reasons, manifesting symptoms, demographic data, Mini-Mental State Examination score, Clinical Dementia Rating score and Neuropsychiatric Inventory score were extracted. Results: 60% of patients assigned a single diagnosis of bvFTD by community clinicians did not have bvFTD according to specialists. Compared to specialist-confirmed bvFTD patients, false bvFTD patients were more likely to be depressed and to be non-Caucasian, showed less euphoria, apathy, disinhibition and abnormal eating behaviors, had milder disease severity and better overall cognition. bvFTD was mentioned by referring clinicians in 86% of specialist-confirmed bvFTD cases, but missed cases were called Alzheimer's, Parkinson's or Huntington's disease, or progressive aphasia. Conclusion: These results revealed a widespread lack of familiarity with core diagnostic symptoms among non-specialists and suggest that community clinicians require specialized diagnostic support before providing a definitive diagnosis of bvFTD.