bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling the response of light-activated shape memory polymers
Authors: Yuan Zhi , Muliana Anastasia , Rajagopal Kumbakonam Ramamani
Published: January 2016

The aim of this paper is to model the macroscopic response of light-activated shape memory polymers (LASMPs) subject to mechanical loadings and exposure to light at certain wavelengths and frequencies. When exposed to external stimuli of mechanical, thermal, photochemical and other origins, polymers undergo microstructural changes, e.g., scission, cross-linking, crystallization, etc. These microstructural changes affect the macroscopic performance of the polymers. In this study, in order to incorporate the effect of microstructural changes on the macroscopic response of light-activated shape memory polymers, we formulate constitutive models based on the notion that the natural configuration of the body under consideration evolves during its response. The theoretical framework appeals to a multinetwork approach consisting of two microstructural networks, which are the original network and the new network formed owing to a light activation. An important distinction between the approach considered here and the usual multinetwork approaches is that there is no conversion of one network to another; instead, what we have is the formation of a second network owing to the linking of photosensitive particles that get linked due to light irradiation. Furthermore, two different constitutive models are considered. The first model assumes the two networks are isotropic. The second model takes into account the directional preference of the second network that is formed. Both these models build on the work of Sodhi and Rao, which is based on the framework developed by Rajagopal and Srinivasa. Several classical boundary value problems involving homogeneous and inhomogeneous deformations are studied. We also investigate two nonlinear constitutive relations and different loading modes. The results highlight the differences in the responses when isotropic and anisotropic models are considered.
A Practical Approach to Managing Transcatheter Aortic Valve Replacement With Sedation
Authors: Neuburger Peter J. , Saric Muhamed , Huang Conan , Williams Mathew Russell
Published: January 2016

Transcatheter aortic valve replacement is increasingly performed as a minimally invasive treatment option for aortic valve disease. The typical anesthetic management for this procedure was traditionally similar to surgical aortic valve replacement and involved general anesthesia and transesophageal echocardiography. In this review, we discuss the technological advances in transcatheter valve systems that have improved outcomes and allow for use of sedation instead of general anesthesia. We describe an anesthetic protocol that avoids general anesthesia and utilizes transthoracic echocardiography for procedural guidance.
Perspective on a Modified Developmental and Reproductive Toxicity Testing Strategy for Cancer Immunotherapy
Authors: Prell Rodney A. , Halpern Wendy G. , Rao Gautham K.
Published: January 2016

The intent of cancer immunotherapy (CIT) is to generate and enhance T-cell responses against tumors. The tumor microenvironment establishes several inhibitory pathways that lead to suppression of the local immune response, which is permissive for tumor growth. The efficacy of different CITs, alone and in combination, stems from reinvigorating the tumor immune response via several mechanisms, including costimulatory agonists, checkpoint inhibitors, and vaccines. However, immune responses to other antigens (self and foreign) may also be enhanced, resulting in potentially undesired effects. In outbred mammalian pregnancies, the fetus expresses paternally derived alloantigens that are recognized as foreign by the maternal immune system. If unchecked or enhanced, maternal immunity to these alloantigens represents a developmental and reproductive risk and thus is a general liability for cancer immunotherapeutic molecules. We propose a tiered approach to confirm this mechanistic reproductive liability for CIT molecules. A rodent allopregnancy model is based on breeding 2 different strains of mice so that paternally derived alloantigens are expressed by the fetus. When tested with a cross-reactive biotherapeutic, small molecule drug, or surrogate molecule, this model should reveal on-target reproductive liabilities if the pathway is involved in maintaining pregnancy. Alternatively, allopregnancy models with genetically modified mice can be interrogated for exquisitely specific biotherapeutics with restricted species reactivity. The allopregnancy model represents a relatively straightforward approach to confirm an expected on-target reproductive risk for CIT molecules. For biotherapeutics, it could potentially replace more complex developmental and reproductive toxicity testing in nonhuman primates when a pregnancy hazard is confirmed or expected.
Using self-reported and objective measures of self-control to predict exercise and academic behaviors among first-year university students
Authors: Stork Matthew J , Graham Jeffrey D , Bray Steven R , Martin Ginis Kathleen A
Published: January 2016

Thirty students (mean age = 18 ± 0.5 years) completed self-report (Self-Control Scale) and objective (isometric handgrip squeeze performance) measures of self-control, provided their exercise and academic (study/schoolwork) plans for the next month, and then logged these behaviors over the subsequent 4-week period. Trait self-control predicted exercise and academic behavior. Handgrip squeeze performance predicted academic behavior and adherence to academic plans. Further, regression analysis revealed that trait self-control and handgrip performance explained significant variance in academic behavior. These findings provide a new understanding of how different self-control measures can be used to predict first-year students’ participation in, and adherence to, exercise and academic behaviors concurrently.
Dietary carbohydrate quantity and quality in relation to obesity: A pooled analysis of three Finnish population-based studies
Authors: Kaartinen Niina E. , Knekt Paul , Kanerva Noora , Valsta Liisa M. , Eriksson Johan G. , Rissanen Harri , Jääskeläinen Tuija , Männistö Satu
Published: January 2016

Background: The relationship between carbohydrate intake, dietary glycaemic index (GI) and load (GL), and obesity remains unsolved. Sugar intake and obesity represent a timely topic, but studies on sugar subcategories are scarce. We aimed to study whether total carbohydrate, sucrose, lactose, fibre, dietary GI, and GL are associated with obesity in 25–79-year-old Finns. Methods: Our pooled analysis included three cross-sectional population-based studies: the DILGOM Study ( n = 4842), the Helsinki Birth Cohort Study ( n =1979), and the Health 2000 Survey ( n = 5521). Diet was assessed by a validated food-frequency questionnaire, and anthropometric measurements were collected by standardised protocols. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression analysis. Results: In the model, which included sex, age, education, smoking, physical activity, and energy intake, the likelihood of being obese (body mass index ⩾ 30 kg/m2) appeared lower in the highest quartiles of total carbohydrate (OR 0.65; 95% CI 0.57–0.74; P for trend < 0.0001), sucrose (OR 0.53; 95% CI 0.47–0.61; P < 0.0001), and dietary GL (OR 0.64; 95% CI 0.56–0.73; P < 0.0001) compared to the lowest quartiles. In contrast, dietary GI did not associate with obesity. Fibre intake associated inversely with abdominal obesity (OR 0.80; 95% CI 0.71–0.90; P < 0.001). The inverse sucrose–obesity relationship appeared stronger in high fruit consumers compared to low fruit consumers ( P for interaction 0.02). Conclusions: Although most of the studied carbohydrate exposures were associated with a diminished likelihood of being obese, prospective studies are needed to assess temporal relations to support causal inference.
A case of partial aortic balloon occlusion in an unstable multi-trauma patient
Authors: Hörer Tal M , Cajander Per , Jans Anders , Nilsson Kristofer F
Published: January 2016

The usage of aortic balloon occlusion or resuscitative endovascular balloon occlusion of the aorta in trauma management for bleeding control is increasing rapidly as an alternative to thoracotomy and aortic clamping. Little is known about the effects of partial occlusion of the aorta as a bridge to definitive treatment, but one of its advantages may be limited visceral organ ischemia. We describe the first known case of partial aortic balloon occlusion in trauma for reaching a targeted systolic blood pressure, which was used as an adjunctive tool in trauma management and as a bridge to definitive treatment.
‘Don’t make it a doctrine’: Material religion, transcendence, critique
Authors: Reinhardt Bruno
Published: January 2016

Once a matter of beliefs, symbols, values and worldviews, religion has progressively appeared in recent anthropological works as material religion, a highly concrete phenomenon based on affects, senses, substances, places, artifacts, and technologies. But what happened to transcendence, the dimension of religious worldmaking that remains beyond – hidden, untouched, unseen, unheard or unfulfilled? Is it necessarily the ‘other’ of material religion, a residual category that carries no ethnographic value? Retaining an emic concern with authority and a reflexive awareness about processes of boundary-making, in this article I approach material religion as a field of problematization inhabited by anthropologists and religious subjects alike. I examine some of the protocols whereby Pentecostal Christians in Ghana engage critically with the problem of materiality in their own religion, and argue that this operation lends ethnographic access to the role of transcendence in material religion’s everyday.
The science grapevine: Influence of blog information on the online media coverage of the 2010 arsenic-based life study
Authors: Vestergaard Gunver Lystbaek
Published: January 2016

Informal chatter has always been part of the scientific community, but with the emergence of online blogs these casual debates have become public. Here, I present a case study of how blog information influenced the online news frames during the December 2010 coverage of the arsenic-based life study. The results show how media frames were homogeneous and transformed abruptly from a positive ‘Gee Whiz’ frame towards a critical frame and lastly to a meta media frame over the course of a few days. From beginning to end, the blogosphere heavily influenced the news content, use of sources and spread of information between news outlets. Such rapid and uncontrollable influence of blogosphere information on online news coverage can be explained theoretically as an example of science grapevine communication.
An evaluation of Cognitive Stimulation Therapy sessions for people with dementia and a concomitant support group for their carers
Authors: Bailey Jan , Kingston Paul , Alford Simon , Taylor Louise , Tolhurst Edward
Published: January 2016

This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile.
Participatory visual methods in the ‘Psychology loves Porta Capuana’ project
Authors: Arcidiacono Caterina , Grimaldi Daria , Di Martino Salvatore , Procentese Fortuna
Published: January 2016

This article describes the use of participatory visual and multimedia methods as part of a participatory action research carried out in a highly degraded urban area of a metropolis. The project was developed by the ‘I love Portacapuana’ committee in collaboration with community psychology lab and 180 undergraduate psychology students of the University of Naples Federico II. The joint use of visual tools such as photographs and videos with Internet-based collaborative work groups – through social networks such as Facebook – has proved effective in interpreting the needs of local citizens. This process has also involved a thorough analysis in terms of strengths and weaknesses as well as opportunities and threats in the local context. Indeed, the integration of visual tools into the broader framework of community diagnosis has fostered an interactive dialogue between the local community, researchers and local authorities. This, in turn, has lead to the outlining of a series of intervention strategies for local urban regeneration.
Experimental study on uniaxial tensile and welding performance of a new coated fabric for airship envelopes
Authors: Wang Fengxin , Chen Yonglin , Xu Wen , Song Zhensen , Fu Gongyi
Published: January 2016

This paper investigated the mechanical properties of GQ-6 subjected to a tremendous amount of uniaxial tests. Such material is a new kind of ultra high molecular weight polyethylene fiber and aimed to be adopted in stratospheric airship. To begin with, mono-uniaxial tensile tests were conducted. The cycling-uniaxial tensile experiments were then carried out on the basis of the mono-uniaxial tensile tests data. Finally, performances of welding seams were thoroughly investigated with forty welding specimens. Results of mono-uniaxial tensile tests revealed that such woven fabric possesses high tensile strength and low elongation ratio at break. Meanwhile, the stress–strain behaviors were fitted by the Ogden model and a good agreement between such model and experimental data was obtained. Influences of the uniaxial loading cycle on such woven stiffness were discussed and the elastic moduli were defined with a standard hysteresis loop. For the welding tests, four types of overlapping welding failures were discovered. Compared with intact specimens, an appropriate welding width of 60 mm and an approximate 15% discount of the ultimate tensile stress on the intact textile were obtained.
Using HRD to Support Repatriates
Authors: Greer Tomika W. , Stiles Alexandra C.
Published: January 2016

A systematic review of repatriation literature in human resource development (HRD) journals reveals common themes of low motivation to repatriate among expatriates and high rates of repatriation failure in organizations. In addition, there is a gap in the published research regarding organization development (OD), suggesting that there is a need to look more closely at managing the changes for individuals, teams, and organizations associated with repatriation. In this article, we addressed this literature gap by proposing a framework for creating an OD strategy for repatriation. This framework is useful for HRD instructors, trainers, and other practitioners who are tasked with creating and instructing others on how to create an OD strategy for repatriation. Such a strategy could help improve repatriation motivation and decrease repatriation failure, ultimately improving organizational performance. The proposed framework was adapted from a positive model of planned change and focuses on discovering, examining, and capitalizing on previous organizational successes to positively impact the repatriation process.
Anti-inflammatory nutritional intervention in patients with relapsing-remitting and primary-progressive multiple sclerosis: A pilot study
Authors: Riccio Paolo , Rossano Rocco , Larocca Marilena , Trotta Vincenzo , Mennella Ilario , Vitaglione Paola , Ettorre Michele , Graverini Antonio , De Santis Alessandro , Di Monte Elisabetta , Coniglio Maria Gabriella
Published: January 2016

The aim of this work was to assess the influence of nutritional intervention on inflammatory status and wellness in people with multiple sclerosis. To this end, in a seven-month pilot study we investigated the effects of a calorie-restricted, semi-vegetarian diet and administration of vitamin D and other dietary supplements (fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, resveratrol and multivitamin complex) in 33 patients with relapsing-remitting multiple sclerosis and 10 patients with primary-progressive multiple sclerosis. At 0/3/6 months, patients had neurological examination, filled questionnaires and underwent anthropometric measurements and biochemical analyses. Serum fatty acids and vitamin D levels were measured as markers of dietary compliance and nutritional efficacy of treatment, whereas serum gelatinase levels were analyzed as markers of inflammatory status. All patients had insufficient levels of vitamin D at baseline, but their values did not ameliorate following a weekly administration of 5000  IU, and rather decreased over time. Conversely, omega-3 polyunsaturated fatty acids increased already after three months, even under dietary restriction only. Co-treatment with interferon-beta in relapsing-remitting multiple sclerosis was irrelevant to vitamin D levels. After six months nutritional treatment, no significant changes in neurological signs were observed in any group. However, serum levels of the activated isoforms of gelatinase matrix metalloproteinase-9 decreased by 59% in primary-progressive multiple sclerosis and by 51% in relapsing-remitting multiple sclerosis patients under nutritional intervention, including dietary supplements. This study indicates that a healthy nutritional intervention is well accepted by people with multiple sclerosis and may ameliorate their physical and inflammatory status.
Contemporary Approaches to Prescribing Exercise in Coronary Artery Disease Patients
Authors: Brubaker Peter H. , Ross James H. , Joo Kee Chan
Published: January 2016

Health care professionals engaged in the management of coronary artery disease (CAD) patients, both in primary and secondary prevention settings, should possess the knowledge to develop and modify both aerobic exercise as well as musculoskeletal resistance exercise training programs. The traditional exercise prescription (ExRx) for aerobic-type exercise describes the intensity, frequency, duration, and mode of exercise, as well as the rate of progression. The more contemporary ExRx focuses on the energy expenditure associated with all physical activity not just structured exercise bouts. The total “volume or dose” of physical activity is associated with important health outcomes, including the potential to prevent and potentially reverse CAD lesions. Also, emerging evidence supporting the use of high-intensity interval training in CAD patients will also be provided. Furthermore, this review will also address the issue of generating an appropriate ExRx in the absence of maximal exercise “stress” test data, a common occurrence in the primary care setting and in this era of health care cost containment. Prescribing resistance exercise for CAD patients requires careful consideration and will be discussed in this review. Finally, this review will conclude with a section that describes the special considerations and/or modifications for some common comorbidities seen in CAD patients
The clinical applicability of an automated plethysmographic determination of the ankle-brachial index after vascular surgery
Authors: van der Slegt Jasper , Verbogt Nathalie PA , Mulder Paul GH , Steunenberg Stijn L , Steunenberg Bastiaan E , van der Laan Lijckle
Published: January 2016

An automated ankle-brachial index device could lead to potential time savings and more accuracy in ankle-brachial index-determination after vascular surgery. This prospective cross-sectional study compared postprocedural ankle-brachial indices measured by a manual method with ankle-brachial indices of an automated plethysmographic method. Forty-two patients were included. No significant difference in time performing a measurement was observed (1.1 min, 95% CI: −0.2 to +2.4; P = 0.095). Mean ankle-brachial index with the automated method was 0.105 higher (95% CI: 0.017 to 0.193; P = 0.020) than with the manual method, with limits of agreement of −0.376 and +0.587. Total variance amounted to 0.0759 and the correlation between both methods was 0.60. Reliability expressed as maximum absolute difference (95% level) between duplicate ankle-brachial index-measurements under identical conditions was 0.350 (manual) and 0.152 (automated), although not significant ( p = 0.053). Finally, the automated method had 34% points higher failure rate than the manual method. In conclusion based on this study, the automated ankle-brachial index-method seems not to be clinically applicable for measuring ankle-brachial index postoperatively in patients with vascular disease.
Frequency of abdominal aortic expansion after thoracic endovascular repair of type B aortic dissection
Authors: Weber Tim F , Böckler Dittmar , Müller-Eschner Matthias , Bischoff Moritz , Kronlage Moritz , von Tengg-Kobligk Hendrik , Kauczor Hans-Ulrich , Hyhlik-Dürr Alexander
Published: January 2016

Purpose

To determine abdominal aortic expansion after thoracic endovascular aortic repair (TEVAR) in patients with aortic dissection type B and 36 months minimum follow-up.

Methods

Retrospective study of 18 TEVAR patients with follow-up >36 months. Abdominal aortic diameters at celiac trunk (location B) and infrarenal aorta (location C) were recorded on the first and last imaging after TEVAR. False lumen thrombosis was determined at level of endograft (A) and at B and C. Aortic expansion was defined as diameter increase of 5 mm or 15%. Correlation analyses were performed to investigate potential determinants of expansion.

Results

Median follow-up was 75.2 months. Sixteen of 18 patients (88.9%) demonstrated abdominal expansion. Mean expansion was 9.9 ± 6.1 mm at B and 11.7 ± 6.5 mm at C, without a difference between acute and chronic dissections. Critical diameters of 55 mm were reached in two patients treated for chronic dissection (11.1%). Annual diameter increase was significantly greater at locations with baseline diameters >30 mm (2.1 ± 1.1 mm vs. 1.0 ± 0.6 mm, p = 0.009). Baseline diameters were greater in patients with chronic dissections.

Conclusion

Abdominal aortic expansion can be frequently recognized after TEVAR for aortic dissection type B and occurs independently from thoracic false lumen thrombosis. Clinical significant abdominal aortic expansion may occur more frequently in patients treated with TEVAR for chronic dissection.
Moving people and minds: Dance as a vehicle of democratic education
Authors: Catalano Theresa , Leonard Alison E
Published: January 2016

Engaging today’s youth in civil discussions of contentious issues remains both a crucial element in democratically oriented education and extremely challenging to facilitate. The purpose of this article, which documents and presents pilot study findings from a dance workshop that engaged practicing teachers surrounding the issue of immigration, is to understand how dance can be integrated into the curriculum to prepare students to engage in democratic deliberation. Data collection consisted of pre- and post-workshop interviews with participants and was analyzed based on common principles of democracy and democratic education found in the literature. Findings point to the important role that dance could have in developing the trust, empathy, and reflectiveness necessary to engage in civil dialogue that is the essential foundation of a democratic society.
In vitro pressure manifolding distribution evaluation of ABThera™ Active Abdominal Therapy System, V.A.C.® Abdominal Dressing System, and Barker’s vacuum packing technique conducted under dynamic conditions
Authors: Delgado Angel , Sammons Alexander
Published: January 2016

Objectives:

Temporary abdominal closure methods allow for management of open abdomens where immediate primary closure is not possible and/or where repeat abdominal entries are necessary. We assessed pressure mapping and fluid extraction efficiency of three open abdomen dressing systems: ABThera™ Active Abdominal Therapy System, V.A.C.® Abdominal Dressing System, and Barker’s vacuum packing technique.

Methods:

An in vitro test model was designed to simulate physical conditions present in an open abdomen. The model consisted of a rigid rest platform with elevated central region and a flexible outer layer with centrally located incision. Constant −125 mmHg negative pressure was applied according to the type of system, under simulated dynamic conditions, using albumin-based solution with a viscosity of 14 cP. Data were collected by pressure sensors located circumferentially into three concentric zones: Zone 1 (closest to negative pressure source), Zone 2 (immediately outside of manifolding material edge), and Zone 3 (area most distal from negative pressure source). Each value was the result of approximately 100 pressure readings/zone/experiment with a total of three experiments for each system.

Results:

Pressure distribution of ABThera Therapy was significantly (p < 0.05) superior to Barker’s vacuum packing technique in all three evaluated zones. Similarly, V.A.C. Abdominal Dressing System pressure distribution was significantly (p < 0.05) improved compared to Barker’s vacuum packing technique in all zones. There were no pressure distribution differences in Zone 1 between ABThera Therapy and V.A.C. Abdominal Dressing System; however, in Zones 2 and 3, ABThera Therapy was significantly (p < 0.05) superior to V.A.C. Abdominal Dressing System.

Conclusions:

These data suggest that all approaches to negative pressure therapy for open abdomen treatment are not equal. Additional research should be conducted to elucidate clinical implications of data demonstrated here.
Endoscopic balloon dilatation of Crohn’s‐associated intestinal strictures: High patient satisfaction and long‐term efficacy
Authors: Rueda Guzmán Anna , Wehkamp Jan , Kirschniak Andreas , Naumann Aline , Malek Nisar P. , Goetz Martin
Published: January 2016

Introduction

Stricture formation is a common long‐term complication of Crohn’s disease. Endoscopic balloon dilatation offers a bowel‐sparing treatment option, but long‐term outcome and its association with patient‐, stricture‐, and procedure‐related factors is only poorly understood. Patient satisfaction with endoscopic balloon dilatation is largely unknown.

Methods

We performed a retrospective review of all endoscopic balloon dilatation for Crohn’s disease‐related strictures between January 2005 and January 2013. Long‐term outcome, complication rates and predictive factors were evaluated. Patient satisfaction was assessed using a questionnaire and telephone interviews.

Results

A total of 118 balloon dilatations were performed for 69 strictures in 46 patients. One patient was excluded from further analysis due to malignancy. Median time from diagnosis of Crohn’s disease to symptomatic stricture formation was 19 years. Technical success, defined as passage of the endoscope after dilatation, was reportedly obtained in 95 of 106 procedures (89.6%). Two perforations occurred, one of which could be managed conservatively. No episodes of severe bleeding were recorded (procedure‐related complication rate: 2/118; 1.7%). During a median follow‐up of 4.8 years (range 0.4–8.7), 55.6% (25/45) of patients were able to avoid surgery. Of the patients, 35.6% (16/45) did not need any further intervention, 40.0% (18/45) underwent more than one dilatation, and 24.4% (11/45) were operated after the first dilatation. The percentage of patients who were satisfied with the procedure and would again opt for balloon dilation as first line therapy was 83.3% (35/42). None of the risk factors examined in this study correlated with the necessity for subsequent surgery.

Discussion

Endoscopic balloon dilatation is a safe and effective first line therapy for Crohn’s disease‐related strictures. No technical, stenosis‐, or patient‐related factor reliably predicted sustained dilatation success. Patient satisfaction was high.
Impact of Electroacupuncture Treatment on Quality of Life and Heart Rate Variability in Fibromyalgia Patients
Authors: Díaz-Toral Livia G. , Banderas-Dorantes Tania R. , Rivas-Vilchis José F.
Published: January 2016

This study examines the effects of electroacupuncture treatment on health-related quality of life and heart rate variability in women with fibromyalgia. Twenty women with fibromyalgia received a 10-week treatment with electroacupuncture. Primary outcome measures were the Fibromyalgia Impact Questionnaire, the Short Form 36 Health Survey Questionnaire, and heart rate variability. Compared with pretreatment, there was a significant improvement in health-related quality of life; electroacupuncture significantly increases low frequency, low frequency/high frequency, and decreases high frequency, all indicating rise in sympathetic tone. Fibromyalgia patients showed a significant ( P < .05) improvement in pain, fatigue, morning tiredness, stiffness, anxiety, and depression on the Fibromyalgia Impact Questionnaire scores; and physical function, physical role, body pain, general health, and vitality scores on the Short Form 36 Health Survey Questionnaire. These changes mainly in mental status scores could be related to a new autonomic balance with sympathetic predominance at the horary of the study.
Medical and Pharmacy Costs for New Hire Nurses Following a Physical Strength Evaluation Screening in a Large Health System
Authors: Terpeluk Paul , Rogen Bruce , Gilliam Thomas
Published: January 2016

Nurses often encounter situations that require lifting patients, often using awkward body positions. Hiring nurses with strength suitable for these jobs decreases nurses’ risk for illness and injury and would be expected to result in more appropriate and lower health care, pharmacy, and disability costs. The physical strength of new hire nurse applicants was assessed using a defensible isokinetic evaluation in the years 2011 and 2012. Health care and pharmacy costs were monitored for the first 12 months following date of hire and compared with costs for nurses hired without screening during the prior 2 years (2009 and 2010). The strength assessment group had significantly ( p < .05) lower health care and pharmacy costs per member per month (PMPM) compared with the comparison group. The study suggests that use of physical capability strength assessment is effective in hiring nurses with appropriate strength capability, resulting in significant health care and pharmacy cost avoidance.
Constructing Organizational Identity on Internal Social Media
Authors: Madsen Vibeke Thøis
Published: January 2016

This study explored how coworkers use internal social media (ISM) to contribute to the construction of organizational identity. The study analyzed 3 months of interactions among coworkers at a large Danish bank on ISM. In addition, 17 coworkers were interviewed to provide additional understanding about the online interactions. The study found that these coworkers constructed organizational identity when they challenge, negotiate, and discuss organizational issues on ISM. They use phrases from vision and mission statements to support their arguments and to push the understanding of organizational identity so that it is in line with their perceptions of what the bank really is or should be. Some of these discussions on ISM develop into organizational stories, which are shared and discussed in informal, in-person conversations among coworkers. The stories become narratives, which contribute to the organizational identity, help coworkers make sense of the organization, and help them identify with the organization.
What’s Age Got to Do With It? A Comparison of Bariatric Surgical Outcomes Among Young, Midlife, Older and Oldest Adults
Authors: Marihart Cindy L. , Brunt Ardith R. , Marihart Samuel A. , Geraci Angela A.
Published: January 2016

Bariatric surgery has become an accepted method to treat obesity and its related diseases in adults; nevertheless, few bariatric surgery follow-up studies compare changes in body mass index (BMI), disease outcomes, and side effects among age groups. This study compares bariatric surgery outcomes across four adult age groups by comparing changes in milestone BMIs such as highest and lowest BMI, perceived existing disease outcomes, and symptoms related to those diseases. Data were obtained using a 40-item questionnaire that was mailed to 2,520 patients of a Midwestern weight management center who were at least 18 months post-bariatric surgical procedure. The 534 respondents were divided into four age groups in years: 18 to 49 ( n = 171), 50-59 ( n = 148), 60-69 ( n = 138), and ≥ 70 ( n = 77). There were no differences among the age groups for lowest ( p = .93) and current BMI ( p = .51). Significant improvement in eight chronic diseases occurred across all age groups. There were no differences between age groups in reported occurrence of incontinence ( p = .65), diarrhea ( p = .22), flatulence ( p = .46), heartburn ( p = .73), and indigestion ( p = .22). Constipation rarely occurred among the oldest adults ( p < .001). Bariatric surgery should be considered an option for weight loss and disease management for older adults as much as it is for younger adults.
The Impact of Obesity on Health Care Utilization and Expenditures in a Medicare Supplement Population
Authors: Musich Shirley , MacLeod Stephanie , Bhattarai Gandhi R. , Wang Shaohung S. , Hawkins Kevin , Bottone Frank G. , Yeh Charlotte S.
Published: January 2016

Objective: Obesity is a contributor to increased chronic conditions resulting in higher utilization of medical services among broad populations of older adults. The objective of this study was to evaluate the magnitude of the impact of weight on health care use patterns among Medicare Supplement insureds. Method: We estimated the impact of weight as a function of body mass index (BMI) on health care utilization and expenditures using propensity weighted multivariate regression models. The outcomes were controlled initially for demographics and socioeconomics and then additionally for chronic conditions and health status. Results: Among the 9,484 survey respondents, 22.9% were obese. Those categorized as obese were significantly more likely to incur inpatient admissions and orthopedic procedures. Annualized health care expenditures were US$1,496 higher for obese compared with normal weight. The excess utilization and expenditures associated with obesity were explained by chronic conditions and poor health status. Conclusion: Obesity-related expenditures associated with medical management are largely preventable and may benefit from interventions that target lifestyle behaviors and weight management among older adults.
Association of Co-Existing Impairments in Cognition and Self-Rated Vision and Hearing With Health Outcomes in Older Adults
Authors: Liu Phillip L. , Cohen Harvey Jay , Fillenbaum Gerda G. , Burchett Bruce M. , Whitson Heather E.
Published: January 2016

Objective: The objective of this study was to assess the relationship of disability (activities of daily living [ADL] and instrumental ADL [IADL]), self-rated health (SRH), and 6-year mortality with co-existing impairments in vision (self-rated), hearing (self-rated), and/or cognition (Short Portable Mental Status Questionnaire) in older adults. Method: The study sample comprised of 3,871 participants from the North Carolina Established Populations for Epidemiologic Studies of the Elderly study (NC EPESE). Results: Persons with all three impairments had increased odds of ADL/IADL disability and low SRH. Participants with combined visual and cognitive impairments had increased odds of mortality. Whereas sensory impairments were associated with poor SRH, cognitive impairment was not unless both sensory impairments were present. Conclusion: Co-existent sensory and cognitive impairments were associated with higher risk of impaired functional status. Self-rated auditory impairment alone was not associated with higher odds of death, but mortality was linked to visual and, particularly, cognitive impairment, alone or combined.
Aging in Saudi Arabia
Authors: Karlin Nancy J. , Weil Joyce , Felmban Wejdan
Published: January 2016

Objective: This exploratory study sought to measure current self-reported experiences of older Saudi adults. Method: Self-reported aging perceptions and demographic data from semistructured questions were obtained from 52 community-dwelling older Saudi adults aged 50 or older. A thematic content analysis was completed around issues of family life/social support, daily/weekly activities, health and health programs, and older adults’ own thoughts about aging and the experience and future of personal aging. Results: Several key themes emerged from the interviews. The majority of respondents in this preliminary study acknowledge a preference for family care. Formal programs in Saudi Arabia are attended with relative infrequency while older adults recognize family support as the preferred method of support. Older Saudi interviewees hold a positive view of aging, but physical functioning, varying financial resources, and other daily obligations are a concern for those in this study. Discussion: Data suggest as the Saudi population ages, more research is needed on the aging experience with particiular emphasis on issues relevant to older adults . Future research must work to clarify the aging experience as cultural context changes.
Hematopoietic stem/progenitor cell commitment to the megakaryocyte lineage
Authors: Woolthuis Carolien M. , Park Christopher Y.
Published: January 2016

The classical model of hematopoiesis has long held that hematopoietic stem cells (HSCs) sit at the apex of a developmental hierarchy in which HSCs undergo long-term self-renewal while giving rise to cells of all the blood lineages. In this model, self-renewing HSCs progressively lose the capacity for self-renewal as they transit into short-term self-renewing and multipotent progenitor states, with the first major lineage commitment occurring in multipotent progenitors, thus giving rise to progenitors that initiate the myeloid and lymphoid branches of hematopoiesis. Subsequently, within the myeloid lineage, bipotent megakaryocyte-erythrocyte and granulocyte-macrophage progenitors give rise to unipotent progenitors that ultimately give rise to all mature progeny. However, over the past several years, this developmental scheme has been challenged, with the origin of megakaryocyte precursors being one of the most debated subjects. Recent studies have suggested that megakaryocytes can be generated from multiple pathways and that some differentiation pathways do not require transit through a requisite multipotent or bipotent megakaryocyte-erythrocyte progenitor stage. Indeed, some investigators have argued that HSCs contain a subset of cells with biased megakaryocyte potential, with megakaryocytes directly arising from HSCs under steady-state and stress conditions. In this review, we discuss the evidence supporting these nonclassical megakaryocytic differentiation pathways and consider their relative strengths and weaknesses as well as the technical limitations and potential pitfalls in interpreting these studies. Ultimately, such pitfalls will need to be overcome to provide a comprehensive and definitive understanding of megakaryopoiesis.
Informative gene selection and the direct classification of tumors based on relative simplicity
Authors: Chen Yuan , Wang Lifeng , Li Lanzhi , Zhang Hongyan , Yuan Zheming
Published: January 2016

Background

Selecting a parsimonious set of informative genes to build highly generalized performance classifier is the most important task for the analysis of tumor microarray expression data. Many existing gene pair evaluation methods cannot highlight diverse patterns of gene pairs only used one strategy of vertical comparison and horizontal comparison, while individual-gene-ranking method ignores redundancy and synergy among genes.

Results

Here we proposed a novel score measure named relative simplicity (RS). We evaluated gene pairs according to integrating vertical comparison with horizontal comparison, finally built RS-based direct classifier (RS-based DC) based on a set of informative genes capable of binary discrimination with a paired votes strategy. Nine multi-class gene expression datasets involving human cancers were used to validate the performance of new method. Compared with the nine reference models, RS-based DC received the highest average independent test accuracy (91.40 %), the best generalization performance and the smallest informative average gene number (20.56). Compared with the four reference feature selection methods, RS also received the highest average test accuracy in three classifiers (Naïve Bayes, k-Nearest Neighbor and Support Vector Machine), and only RS can improve the performance of SVM.

Conclusions

Diverse patterns of gene pairs could be highlighted more fully while integrating vertical comparison with horizontal comparison strategy. DC core classifier can effectively control over-fitting. RS-based feature selection method combined with DC classifier can lead to more robust selection of informative genes and classification accuracy.
Approach to Hyponatremia in Congestive Heart Failure: A Survey of Canadian Specialist Physicians and Trainees
Authors: Miller Amanda , Kuehl Bonnie , Tennankore Karthik , Soroka Steven
Published: January 2016

Background:

Hyponatremia is a recognized complication of congestive heart failure (CHF) and is associated with reduced survival. Therefore, early identification and appropriate management of hyponatremia is important. The aim of this study was to determine the general approach amongst Canadian healthcare practitioners and trainees to the identification and management of hyponatremia complicating CHF.

Methods:

Respondents completed 15 multiple-choice style questions in 3 case scenarios regarding the approach to management of hyponatremia complicating CHF using an online survey on UKidney.com between November 2012 and May 2013. Results were presented as a proportion of averaged correct/incorrect responses amongst Canadian nephrologists, cardiologists, internists and trainees in each of two domains; pathophysiology and management. Management was further subdivided into correct and incorrect use of diuretic therapy, hypertonic saline, oral urea tablets, vasopressin receptor antagonists (vaptans) and rate of sodium correction. Correct responses were determined by an expert panel of Canadian nephrologists and cardiologists based on review of evidence informed guidelines and current recommendations.

Results:

There were 1757 responses to our online survey amongst 455 Canadian respondents, 1139 of which were from cardiologists, nephrologists, general internists, or trainees. Overall, the pathophysiology governing hyponatremia in CHF was correctly identified 68.7 % of the time ( n = 380 responses, averaged over 4 questions). Hyponatremia was managed inappropriately 43.6 % of the time, with trainees scoring best overall with correct responses 60.3 % of the time ( n = 759 responses, over 11 questions). Importantly, an incorrect rate for sodium correction was selected 61.1 % of the time overall, ( n = 211 responses, averaged over 3 questions).

Conclusions:

This study identified that there are differences in the understanding of pathophysiology and management strategies for hyponatremia in the context of CHF amongst Canadian specialist physicians and trainees. A more consistent approach to hyponatremia is required and might best be achieved through formal knowledge translation.
Inferring the Effects of Cancer Treatment: Divergent Results From Early Breast Cancer Trialists’ Collaborative Group Meta-Analyses of Randomized Trials and Observational Data From SEER Registries
Authors: Henson Katherine E. , Jagsi Reshma , Cutter David , McGale Paul , Taylor Carolyn , Darby Sarah C.
Published: January 2016

Purpose

To compare the effect of breast cancer radiotherapy as estimated from observational data with findings from randomized trials.

Materials and Methods

Rate ratios were obtained for selected end points among 13,932 women randomly assigned to receive radiotherapy or not in trials contributing to recent meta-analyses by the Early Breast Cancer Trialists’ Collaborative Group. Estimates of the same quantities were derived for 393,840 women registered with breast cancer in the US SEER registries between 1973 and 2008.

Results

In the randomized trials, radiotherapy after breast-conserving surgery reduced mortality from both breast cancer (rate ratio, 0.82; 95% CI, 0.75 to 0.90) and all causes (rate ratio, 0.92; 95% CI, 0.86 to 0.99). Reductions of similar magnitude were seen in the trials of radiotherapy after mastectomy in node-positive disease (rate ratios, breast cancer 0.84; 95% CI, 0.76 to 0.94; all causes, 0.89; 95% CI, 0.81 to 0.97). In the observational data, radiotherapy after breast-conserving surgery was associated with much larger mortality reductions (rate ratios, breast cancer, 0.64; 95% CI, 0.62 to 0.66; all causes, 0.63; 95% CI, 0.62 to 0.65), whereas radiotherapy after mastectomy in node-positive disease was associated with substantial increases in mortality (rate ratios, breast cancer, 1.34; 95% CI, 1.31 to 1.37; all causes, 1.23; 95% CI, 1.22 to 1.25). Detailed adjustment of the observational data for potential confounders did not reduce the divergence from the randomized data.

Conclusion

This study of mortality after radiotherapy for breast cancer found strikingly divergent results between the Early Breast Cancer Trialists’ Collaborative Group meta-analyses of randomized data and the SEER observational data, even when efforts had been made to remove confounding and selection biases. Nonrandomized comparisons are liable to provide misleading estimates of treatment effects. Therefore, they need careful justification every time they are used.