bluuebunny/crossref_metadata_2025 huggingface dataset:
Working Together to Promote Diabetes Control: A Practical Guide for Diabetes Health Care Providers in Establishing a Working Alliance to Achieve Self-Management Support
Authors: Jones Allan , Vallis Michael , Cooke Debbie , Pouwer François
Published: November 2015

The quality of the “patient-carer” relationship is the foundation of self-management support and has been shown to influence treatment outcome in relation to psychological and somatic illness, including diabetes. It has long been accepted within applied psychology that the quality of the client-therapist relationship—termed theworking alliance—is of central importance to treatment outcome and may account for a significant degree of the overall treatment effect. Diabetes healthcare providers have recently expressed a need for further training in communication techniques and in the psychological aspects of diabetes. Could we take a page from the psychological treatment manual onworking alliancein therapy to guide the diabetes healthcare provider in their role of supporting the person with diabetes achieve and maintain better metabolic control? This paper examines the role of the working alliance in diabetes care and offers a practical guide to the diabetes healthcare provider in establishing a working alliance with the person with diabetes in managing diabetes.
Metabolic Control and Illness Perceptions in Adolescents with Type 1 Diabetes
Authors: Wisting Line , Bang Lasse , Natvig Henrik , Skrivarhaug Torild , Dahl-Jørgensen Knut , Lask Bryan , Rø Øyvind
Published: November 2015

Background. Disturbed eating behavior and psychosocial variables have been found to influence metabolic control, but little is known about how these variables interact or how they influence metabolic control, separately and combined.Objective. To explore associations between metabolic control (measured by HbA1c) and eating disorder psychopathology, coping strategies, illness perceptions, and insulin beliefs in adolescents with type 1 diabetes.Methods. A total of 105 patients (41.9% males) with type 1 diabetes (12–20 years) were interviewed with the Child Eating Disorder Examination. In addition, self-report psychosocial questionnaires were completed. Clinical data, including HbA1c, was obtained from the Norwegian Childhood Diabetes Registry.Results. Significant gender differences were demonstrated. Among females, HbA1c correlated significantly with eating restriction (.29,p< .05), the illness perception dimensionsconsequences, personal control, coherence,andconcern(ranging from .33 to .48), and the coping strategyventilating negative feelings(−.26,p< .05). Illness perceptionpersonal controlcontributed significantly to HbA1c in a regression model, explaining 23% of the variance among females (β.48,p< .001). None of the variables were significantly associated with HbA1c among males.Conclusions. Illness perceptions appear to be important contributors to metabolic control in females, but not males, with type 1 diabetes.
Dexmedetomidine Pretreatment Attenuates Kidney Injury and Oxidative Stress during Orthotopic Autologous Liver Transplantation in Rats
Authors: Yu Xiaofang , Chi Xinjin , Wu Shan , Jin Yi , Yao Hui , Wang Yiheng , Xia Zhengyuan , Cai Jun
Published: November 2015

This paper aims to explore whether pretreatment with dexmedetomidine (Dex) has antioxidative and renal protective effects during orthotopic autologous liver transplantation (OALT) and its impact on nuclear factor erythroid 2‐related factor 2 (Nrf2) activation. Sprague‐Dawley rats were randomized into groups that include sham‐operated (group S), model (group M), low dose Dex (group D1),
high dose Dex (group D2), atipamezole (a nonspecific α2 receptor blocker) + high dose Dex (group B1), ARC239 (a specific α2B/c receptor blocker) + high dose Dex (group B2), and BRL‐44408 (a specific α2A receptor blocker) + high dose Dex (group B3). Then histopathologic examination of the kidneys and measurement of renal function, the renal Nrf2 protein expression, and oxidants and antioxidants were performed 8 hours after OALT. We found that pretreatment with Dex activated Nrf2 in glomerular cells and upregulated antioxidants but reduced oxidants (all P < 0.01, group D2 versus group M). Atipamezole and BRL‐44408, but not ARC239, reversed these protective effects. In conclusion, pretreatment with Dex activates Nrf2 through α2A receptor, increases the antioxidant levels, and attenuates renal injury during OALT.
Equine Metabolic Syndrome Affects Viability, Senescence, and Stress Factors of Equine Adipose‐Derived Mesenchymal Stromal Stem Cells: New Insight into EqASCs Isolated from EMS Horses in the Context of Their Aging
Authors: Marycz Krzysztof , Kornicka Katarzyna , Basinska Katarzyna , Czyrek Aleksandra
Published: November 2015

Currently, equine metabolic syndrome (EMS), an endocrine disease linked to insulin resistance, affects an increasing number of horses. However, little is known about the effect of EMS on mesenchymal stem cells that reside in adipose tissue (ASC). Thus it is crucial to evaluate the viability and growth kinetics of these cells, particularly in terms of their application in regenerative medicine. In this study, we investigated the proliferative capacity, morphological features, and accumulation of oxidative stress factors in mesenchymal stem cells isolated from healthy animals (ASCN) and horses suffering from EMS (ASCEMS). ASCEMS displayed senescent phenotype associated with β‐galactosidase accumulation, enlarged cell bodies and nuclei, increased apoptosis, and reduced heterochromatin architecture. Moreover, we observed increased amounts of nitric oxide (NO) and reactive oxygen species (ROS) in these cells, accompanied by reduced superoxide dismutase (SOD) activity. We also found in ASCEMS an elevated number of impaired mitochondria, characterized by membrane raptures, disarrayed cristae, and vacuole formation. Our results suggest that the toxic compounds, accumulating in the mitochondria under oxidative stress, lead to alternations in their morphology and may be partially responsible for the senescent phenotype and decreased proliferation potential of ASCEMS.
Reviews on Mechanisms of In Vitro Antioxidant Activity of Polysaccharides
Authors: Wang Junqiao , Hu Shuzhen , Nie Shaoping , Yu Qiang , Xie Mingyong
Published: November 2015

It is widely acknowledged that the excessive reactive oxygen species (ROS) or reactive nitrogen species (RNS) induced oxidative stress will cause significant damage to cell structure and biomolecular function, directly or indirectly leading to a number of diseases. The overproduction of ROS/RNS will be balanced by nonenzymatic antioxidants and antioxidant enzymes. Polysaccharide or glycoconjugates derived from natural products are of considerable interest from the viewpoint of potent in vivo and in vitro antioxidant activities recently. Particularly, with regard to the in vitro antioxidant systems, polysaccharides are considered as effective free radical scavenger, reducing agent, and ferrous chelator in most of the reports. However, the underlying mechanisms of these antioxidant actions have not been illustrated systematically and sometimes controversial results appeared among various literatures. To address this issue, we summarized the latest discoveries and advancements in the study of antioxidative polysaccharides and gave a detailed description of the possible mechanisms.
Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes
Authors: D’Souza Melba Sheila , Venkatesaperumal Ramesh , Ruppert Susan D. , Karkada Subrahmanya Nairy , Jacob Devakirubai
Published: November 2015

The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.
Calibration of a Stereo Radiation Detection Camera Using Planar Homography
Authors: Baek Seung-Hae , Rathnayaka Pathum , Park Soon-Yong
Published: November 2015

This paper proposes a calibration technique of a stereo gamma detection camera. Calibration of the internal and external parameters of a stereo vision camera is a well-known research problem in the computer vision society. However, few or no stereo calibration has been investigated in the radiation measurement research. Since no visual information can be obtained from a stereo radiation camera, it is impossible to use a general stereo calibration algorithm directly. In this paper, we develop a hybrid-type stereo system which is equipped with both radiation and vision cameras. To calibrate the stereo radiation cameras, stereo images of a calibration pattern captured from the vision cameras are transformed in the view of the radiation cameras. The homography transformation is calibrated based on the geometric relationship between visual and radiation camera coordinates. The accuracy of the stereo parameters of the radiation camera is analyzed by distance measurements to both visual light and gamma sources. The experimental results show that the measurement error is about 3%.
Use of Palliative Endocrine Therapy in Patients with Hormone Receptor-Positive Distant Metastatic Breast Cancer: How Often, How Effective, How Long?
Authors: Güth Uwe , Huang Dorothy Jane , Schötzau Andreas , Schmid Seraina Margaretha
Published: November 2015

Background: This study provides real-world clinical evidence regarding palliative endocrine therapy (ET) in breast cancer (BC). The main questions to be answered were: how often and how long did patients receive ET? A particular aspect was the analysis of compliance and persistence with ET. Methods: An analysis of a nonselected/consecutive cohort of women with distant metastatic hormone receptor-positive BC (n = 205) was conducted. Results: In all, 165 patients (80.5%) received ET during the palliative disease course. The noncompliance rate was 1.5%. Sixty-seven patients (40.6%) had ET as the only antineoplastic therapy. The median number of therapy lines was 2, and the median duration was 18 months. The median metastatic disease survival (MDS) was 34 months. In patients who had an MDS of ≥9 months (n = 145; 87.9%), during 70.6% of the MDS time only ET had been administered. Patients who were naïve to ET more often had a good response to and a longer duration of palliative ET than those who were not. The nonpersistence rate was 4.3%. Conclusions: Excluding the few patients who had a rapidly progressive course, the disease was controlled for about 70% of the entire palliative disease course with ET alone. Only very few patients were nonpersistent with ET and consciously stopped a still effective, ongoing ET.
No Change in Executive Performance in ALS Patients: A Longitudinal Neuropsychological Study
Authors: Kasper Elisabeth , Zydatiss Kolja , Schuster Christina , Machts Judith , Bittner Daniel , Kaufmann Jörn , Benecke Reiner , Vielhaber Stefan , Teipel Stefan , Prudlo Johannes
Published: November 2015

Background/Aims: A substantial proportion of amyotrophic lateral sclerosis (ALS) patients develop cognitive impairments. Longitudinal investigations of cognition in ALS have shown mixed results. While some authors report that cognitive performance remains stable as the disease progresses, others have found evidence for deterioration in various domains. Our objective was to investigate cognitive performance in ALS longitudinally, using the example of executive functions. Methods: 93 ALS patients and 73 age-, sex- and education-matched healthy controls underwent up to four neuropsychological evaluations, separated by 3- to 6-month intervals. We examined whether performance declined longitudinally on seven tests assessing various sub-components of executive functioning. Furthermore, we assigned an executive-performance-based ‘cognitive status' to each participant for every evaluation, examining whether cognitive deterioration (if present) was modulated by their baseline cognitive status and whether cognitive status changed over time. Results: Regardless of their cognitive status at baseline, ALS patients showed no significant decline in the sub-components of executive functioning. Conclusion: Our findings imply that the executive deficits which develop in some ALS patients emerge before motor symptoms and remain stable after an initial decline. The discrepancy between this trajectory and the progressive decline in motor functions may result from a differential vulnerability of motor and non-motor prefrontal neurons to the pathomechanism of ALS.
T-Cell Responses to Tyrosinase-Derived Self-Peptides in Patients with Leukoderma Induced by Rhododendrol: Implications for Immunotherapy Targeting Melanoma
Authors: Takagi Rie , Kawano Masaaki , Nakamura Koichiro , Tsuchida Tetsuya , Matsushita Sho
Published: November 2015

Background: Rhododendrol, a phenolic compound contained in lightening/whitening cosmetics, can bind and inhibit tyrosinase and was reported to induce leukoderma in Japan. Only 2% of the cosmetics users are affected, and tacrolimus is effective in treatment of the condition. Objective: To test the hypothesis that the disease is an autoimmune disorder. Methods: Short-term T-cell lines were established using peripheral blood mononuclear cells from 8 patients with human melanoma-associated and tyrosinase-derived synthetic peptides. The effects of rhododendrol on melanoma immunization were also examined. Results: Seven out of 8 patients were positive for HLA-DR4. Both class I- and class II-restricted and tyrosinase peptide-specific T-cell responses were observed. Immunization of mice with rhododendrol-treated and irradiated B16 melanoma cells successfully delayed the growth of melanoma cells in vivo. Conclusion: Rhododendrol-induced leukoderma is an autoimmune disorder, with rhododendrol as an environmental factor and HLA-DR4 as a genetic factor. Rhododendrol might be effective in treating melanomas.
Efficient Identification of Null-Allele Single Nucleotide Polymorphism Markers
Authors: Özbek Umut , Feingold Eleanor , Weeks Daniel E.
Published: November 2015

Objectives: At the beginning of a genome-wide association study, many markers are discarded because they fail to meet standard quality control criteria. Some of these markers are out of Hardy-Weinberg equilibrium (HWE) because they have ‘null alleles' (which may be deletions or third alleles that do not hybridize to standard probes). It may be useful to identify null-allele markers so that they can be analyzed under different models or in order to explore regions of copy number variation. Methods: We present a model for the chip-based genotype data that are produced when a null-allele single nucleotide polymorphism (SNP) is genotyped under standard (2-allele) assumptions. We show that this model can be combined with the standard HWE model to develop classification procedures based on the supervised learning algorithms Support Vector Machines (SVM), Classification and Regression Trees (CART) or Random Forests for identifying null-allele SNPs. Results: We report a list of null-allele SNPs we identified on the Illumina 660W-Quad chip and provide suggestions for applying our CART model to other SNP sets. Conclusions: Properly identified null-allele SNPs can be used to test for genotype-phenotype associations or to identify regions which may contain copy number variants.
Analysis of Pediatric Pancreatitis (APPLE Trial): Pre-Study Protocol of a Multinational Prospective Clinical Trial
Authors: Párniczky Andrea , Mosztbacher Dóra , Zsoldos Fanni , Tóth Anna , Lásztity Natália , Hegyi Péter ,   on behalf of the Hungarian Pancreatic Study Group and the International Association of Pancreatology
Published: November 2015

Background: Single-centered studies show increased number of acute pancreatitis (AP) in children. Here, the Pediatric Section of the Hungarian Pancreatic Study Group introduces an international observational clinical trial (APPLE) to collect a critical mass of clinical data and biomedical research samples in a uniform prospective manner. Summary: The APPLE-R is for patients under 18 years of age with a history of pancreatitis. The study primarily provides information on possible genetic variants behind the disease and their impact on the prognosis. The APPLE-P is for patients under 18 years of age with a diagnosis of AP. Children with AP diagnosed based on the fulfillment of ‘2 out of 3' of the Atlanta criteria will be selected. This subtrial requests detailed information from the medical history, etiology, complains and symptoms, physical examinations, laboratory parameters, imaging, immediate therapy at admission and complications of the disease. The APPLE trial has been registered at the ISRCTN registry and has received the relevant ethical approval. The study is open for all pediatric centers throughout the world. Key Message: This is the first worldwide study tracking earlier (APPLE-R) and ongoing episodes (APPLE-P) of pancreatitis.
Left Subclavian Artery Revascularization in Preparation for Coronary Artery Bypass Grafting
Authors: Rahimi Saum A. , Shah Noor , Labinskyy Volodymyr , Lee Leonard Y.
Published: November 2015

Coronary subclavian steal syndrome is a rare but important condition that occurs after a left internal mammary artery (LIMA) to coronary artery bypass in the setting of a stenotic left subclavian artery. The lack of blood flow through the subclavian artery causes the reversal of flow in the LIMA so that it essentially steals blood from the myocardium. In order to avoid this complication, many surgeons now opt to either revascularize the stenotic subclavian artery prior to coronary artery bypass grafting or to use an alternate vessel as the bypass graft. Here, we present the case of an asymptomatic patient with poor exercise tolerance who was recently diagnosed with both triple-vessel coronary disease and peripheral arterial disease, which was most notably characterized by occlusion of the left subclavian artery. This case demonstrates the surgical management of this complex clinical entity.
Combining the Rowland Universal Dementia Assessment Scale and the Informant Questionnaire on Cognitive Decline in the Elderly to Improve Detection of Dementia in an Arabic-Speaking Population
Authors: Nielsen T. Rune , Phung Thien Kieu Thi , Chaaya Monique , Mackinnon Andrew , Waldemar Gunhild
Published: November 2015

Background/Aims: The aim of this study was to assess whether combining the Rowland Universal Dementia Assessment Scale (RUDAS) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) could improve diagnostic accuracy when screening for dementia in an Arabic-speaking population with low levels of literacy. Methods: Based on data from 225 elderly participant and informant dyads, the screening performances of the two instruments were compared and three methods for combining them - ‘or', ‘and' and ‘weighted sum' rules - were assessed. Results: The ‘weighted sum' method had a significantly better area under the curve value compared to the RUDAS used alone. The ‘weighted sum' method and the ‘and' rule had the highest specificity, while the ‘or' rule had the best sensitivity. Conclusion: Harnessing the RUDAS and IQCODE increased diagnostic accuracy when screening for dementia in this study population.
Grapevine Downy Mildew Plasmopara viticola Infection Elicits the Expression of Allergenic Pathogenesis-Related Proteins
Authors: Rossin Giacomo , Villalta Danilo , Martelli Paola , Cecconi Daniela , Polverari Annalisa , Zoccatelli Gianni
Published: November 2015

Background: Downy mildews are a group of microorganisms belonging to the Chromista kingdom that can infect specific plants. When growing on plant tissues these microbes can elicit the expression of pathogenesis-related proteins (PRs), a group of stress-induced proteins frequently described as allergens in many plant species. Our aim was to verify by a proteomic approach whether the allergic reactions experienced by a farmer working in a vineyard infected by Plasmopara viticola (Pv), the etiological agent of downy mildew, are elicited by PRs expressed by the grapevine upon infection or by allergens present in Pv. Methods: A skin prick test and prick-to-prick test with infected field grapevine leaves and control leaves were carried out. Field leaves and ad hoc Pv-inoculated leaves were compared by SDS-PAGE and IgE-immunoblotting with extracts from control leaves and Pv sporangia. IgE-binding proteins were further separated by two-dimensional electrophoresis and the positive spots analyzed by nanoHPLC-Chip and tandem mass spectrometry (MS/MS) for identification. Results: Only infected leaves showed IgE-binding protein bands at 42 and 36 kDa. This agreed with the positive skin prick test experienced by the patient only with the infected leaves extract. Two-dimensional electrophoresis followed by MS/MS analysis led to the identification of PR-2 (β-1,3-glucanase) and harpin-binding protein 1 as putative allergens, the latter having never been reported before. Conclusion: The results indicate that Pv infection might represent a new source of plant allergens.
Prostatic Urethral Lift: A New Minimally Invasive Treatment for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia
Authors: Bozkurt Aliseydi , Karabakan Mehmet , Keskin Ercument , Hirik Erkan , Balci M.B. Can , Nuhoglu Baris
Published: November 2015

Introduction: Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTSs) secondary to benign prostatic hyperplasia (BPH). The PUL procedure involves the placement of implants that retract the obstructing prostate lobes. This procedure achieves quantifiable improvements in functional outcomes and quality of life (QoL), while preserving erectile and ejaculatory functions. Methods: Seventeen patients diagnosed with BPH who had undergone the UroLift® procedure between March 2011 and June 2015 were retrospectively evaluated. The parameters evaluated in the pre-operative, intra-operative and 1-year post-operative period were demographic data, and pre-operative, intra-operative and 1-year post-operative results were obtained from the International Prostate Symptom Score (IPSS), Uroflowmetry QoL index, International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) for ejaculatory function (MSHQ-EjD). Results: The average improvements from baseline to 12 months after intervention were significant for the total IPSS 9.6. There was a 4.2-point increase in Qmax, a 0.9-point improvement in QoL and a 32% decrease in PVR. No statistically significant difference was found in the IIEF and MSHQ-EjD scores when the pre-operative and post-operative 3rd and 12th month scores were evaluated (p > 0.05). Conclusions: PUL offers rapid improvement in voiding and storage symptoms, QoL and flow rate that is durable to 12 months after intervention. PUL is a minimally invasive procedure that has the moderate effect in treating troublesome LUTS secondary to benign prostatic obstruction and preserving total sexual function.
Neuron Types in the Presumptive Primary Somatosensory Cortex of the Florida Manatee (Trichechus manatus latirostris)
Authors: Reyes Laura D. , Stimpson Cheryl D. , Gupta Kanika , Raghanti Mary Ann , Hof Patrick R. , Reep Roger L. , Sherwood Chet C.
Published: November 2015

Within afrotherians, sirenians are unusual due to their aquatic lifestyle, large body size and relatively large lissencephalic brain. However, little is known about the neuron type distributions of the cerebral cortex in sirenians within the context of other afrotherians and aquatic mammals. The present study investigated two cortical regions, dorsolateral cortex area 1 (DL1) and cluster cortex area 2 (CL2), in the presumptive primary somatosensory cortex (S1) in Florida manatees (Trichechus manatus latirostris) to characterize cyto- and chemoarchitecture. The mean neuron density for both cortical regions was 35,617 neurons/mm3 and fell within the 95% prediction intervals relative to brain mass based on a reference group of afrotherians and xenarthrans. Densities of inhibitory interneuron subtypes labeled against calcium-binding proteins and neuropeptide Y were relatively low compared to afrotherians and xenarthrans and also formed a small percentage of the overall population of inhibitory interneurons as revealed by GAD67 immunoreactivity. Nonphosphorylated neurofilament protein-immunoreactive (NPNFP-ir) neurons comprised a mean of 60% of neurons in layer V across DL1 and CL2. DL1 contained a higher percentage of NPNFP-ir neurons than CL2, although CL2 had a higher variety of morphological types. The mean percentage of NPNFP-ir neurons in the two regions of the presumptive S1 were low compared to other afrotherians and xenarthrans but were within the 95% prediction intervals relative to brain mass, and their morphologies were comparable to those found in other afrotherians and xenarthrans. Although this specific pattern of neuron types and densities sets the manatee apart from other afrotherians and xenarthrans, the manatee isocortex does not appear to be explicitly adapted for an aquatic habitat. Many of the features that are shared between manatees and cetaceans are also shared with a diverse array of terrestrial mammals and likely represent highly conserved neural features. A comparative study across manatees and dugongs is necessary to determine whether these traits are specific to one or more of the manatee species, or can be generalized to all sirenians.
Biodegradable Airway Stents - Bench to Bedside: A Comprehensive Review
Authors: Dutau Hervé , Musani Ali Imran , Laroumagne Sophie , Darwiche Kaid , Freitag Lutz , Astoul Philippe
Published: November 2015

Airway stents are indicated to treat symptomatic narrowing or to close fistulas of the central airways. They are generally divided into two types: the silicone stents and the metallic stents. Unlike in malignancies, removability is a major objective of temporary stenting in benign conditions, which poses the challenge of a new rigid bronchoscopic procedure under general anesthesia and stent removal with all its attendant risks and costs. The concept of a biodegradable (BD) stent that could maintain the patency of an airway for a predetermined duration of time is very appealing. These BD stents would gradually degrade and eventually vanish from the airway once they are no longer needed. Such stents are currently an area of intense research. Another very promising concept of drug delivery with such stents is also a very exciting area of current research. The aim of this comprehensive review is to discuss all pertinent available literature on the use of BD materials in various clinical applications and to extensively review all animal and humans trials involving BD airway stents.
Parkinson's Disease in the Gulf Countries: An Updated Review
Authors: Alamri Yassar , MacAskill Michael , Anderson Tim , Benamer Hani
Published: November 2015

Background: The Arabian Gulf region is a rapidly developing part of the world. With the increase in average life-expectancy, idiopathic Parkinson's disease (PD), is also expected to increase in prevalence. Furthermore, the high rate of consanguinity among Arabs probably makes familial cases of PD more likely to be encountered than other areas in the world. This review provides an update on the published literature on sporadic and familial PD in Gulf Arabs. Summary: Although the Arab population of this region shares religious beliefs and demographic characteristics with other Arabs, their environmental exposures and genetic makeup may be different. This could account for the relatively low prevalence of PD reported in the Al-Thugba study (27 per 100,000) compared with prevalence rates by most other studies on Arab (mainly North African) populations (31.4-557.4 per 100,000). Key Messages: Gulf countries are considered rich countries, which makes conducting nation-wide or even international studies logistically easier than it is in many other countries. Such multinational research can be organized by the existing Gulf Cooperation Council, or through a collaboration of the Ministries of Health. This would, hopefully, culminate in the introduction of more research centers, as well as the implementation of better health care policies and practices for the ageing community.
Is Green Better than Blue? The Danish jha Opt-out and the Unilateral Attempt to Attract Highly Skilled Labour
Authors: Wind Marlene , Adamo Silvia
Published: November 2015

In 20–30 years Denmark will, just like the rest of the eu, be in need of an increasing number of highly skilled workers from outside the eu to sustain its welfare society. While the eu has adopted a common Blue Card aiming at making it possible for foreign workers to live and work in most of the eu, Denmark has, due to its opt-out in Justice and Home Affairs, chosen its own Green Card Scheme. This article looks into this choice and compares the recent Danish attempt to attract high skilled workers with the Blue Card directive. It analyses the differences and similarities between the two schemes and investigates why initiatives to attract highly skilled workers have not been successful at either the Danish nor the European level.
Three new species of Cypella (Iridaceae) from South America, and taxonomic delimitation of C. suffusa Ravenna
Authors: Paz Deble Leonardo , Alves Fabiano da Silva , González Andrés , Deble Anabela Silveira de Oliveira
Published: November 2015

Three new species of Cypella are described and illustrated for the complex of grasslands ecosystems of Rio de La Plata: C. aurinegra, C. guttata and C. ravenniana. The former is endemic to the region of the Taquari river, southern Cerro Largo Department, Uruguay, and is closely related to Cypella fucata and C. luteogibbosa, but can be distinguished from these species by its yellow flowers stained with dark-purple, narrower outer tepals, smaller inner tepals, shorter adaxial crests of style branches, slender filaments, and seeds with smooth testa. Cypella guttata occurs in Artigas and Rivera Departments, northern Uruguay, and in Santana do Livramento Municipality, southwestern Rio Grande do Sul State, Brazil. This species resembles C. herbertii and C. lapidosa, and can be distinguished by its flowers with central depression showing red spots, filaments narrower and tape-shaped, style branches with shorter adaxial crests, and small transverse stigmatic surface of the abaxial crest. The range of geographic distribution of C. ravenniana includes southern Misiones, and northeast Corrientes Provinces, Argentina, and west and northwest Rio Grande do Sul State, Brazil. This species can be recognized by its one-flowered spathes, borne on short peduncles. Cypella ravenniana was firstly misidentified as C. suffusa; however, having as base the type and topotypical collections of the latter species, C. suffusa is recognized by its two-flowered spathes borne on long peduncles, and perigone golden-yellow with deep central concavity. Data about phenology, geographic distribution, conservation and dichotomous keys to segregate these three new species from its related species are supplied.
High-Grade Neuroendocrine Carcinoma of the Larynx
Authors: Deep Nicholas L. , Ekbom Dale C. , Hinni Michael L. , Zarka Matthew A. , Patel Samir H.
Published: November 2015

Objective:

To report a single institutional series of high-grade neuroendocrine carcinoma of the larynx (NCL), a very rare yet aggressive tumor. To review the management of NCL, including discussion of clinical behavior, treatment outcome, and prognosis.

Method:

A retrospective chart review of high-grade laryngeal neuroendocrine carcinomas at a single institution, including small- and large-cell neuroendocrine carcinomas. A total of 8 patients with high-grade NCL treated at our institution from 1992 to 2014 were identified.

Results:

The median age at diagnosis was 65.5 years (range, 43-80). Five patients were male. Two patients had a known smoking history. Primary tumor location was supraglottic in 7 patients and glottic in 1 patient. Primary treatment consisted of surgery alone (3 patients), radiotherapy alone (1 patient), combination of chemotherapy and radiotherapy (1 patient), and surgery followed by postoperative chemoradiotherapy (3 patients). Locoregional recurrence followed by distant metastasis occurred in 6 patients. Median overall survival was 44.0 months (95% CI, 3-62.0).

Conclusion:

High-grade NCL is a rare diagnosis. Compared to well- and moderately differentiated NCL, high-grade NCL has a far more aggressive clinical course and associated with a worse prognosis. To our knowledge, this is the largest series of patients with high-grade NCL treated at a single institution. Prompt diagnosis and multimodality therapy including elective neck dissection may improve survival.
The Impact of Ignoring the Level of Nesting Structure in Nonparametric Multilevel Latent Class Models
Authors: Park Jungkyu , Yu Hsiu-Ting
Published: November 2015

The multilevel latent class model (MLCM) is a multilevel extension of a latent class model (LCM) that is used to analyze nested structure data structure. The nonparametric version of an MLCM assumes a discrete latent variable at a higher-level nesting structure to account for the dependency among observations nested within a higher-level unit. In the present study, a simulation study was conducted to investigate the impact of ignoring the higher-level nesting structure. Three criteria—the model selection accuracy, the classification quality, and the parameter estimation accuracy—were used to evaluate the impact of ignoring the nested data structure. The results of the simulation study showed that ignoring higher-level nesting structure in an MLCM resulted in the poor performance of the Bayesian information criterion to recover the true latent structure, the inaccurate classification of individuals into latent classes, and the inflation of standard errors for parameter estimates, while the parameter estimates were not biased. This article concludes with remarks on ignoring the nested structure in nonparametric MLCMs, as well as recommendations for applied researchers when LCM is used for data collected from a multilevel nested structure.
The Effects of Including Observed Means or Latent Means as Covariates in Multilevel Models for Cluster Randomized Trials
Authors: Aydin Burak , Leite Walter L. , Algina James
Published: November 2015

We investigated methods of including covariates in two-level models for cluster randomized trials to increase power to detect the treatment effect. We compared multilevel models that included either an observed cluster mean or a latent cluster mean as a covariate, as well as the effect of including Level 1 deviation scores in the model. A Monte Carlo simulation study was performed manipulating effect sizes, cluster sizes, number of clusters, intraclass correlation of the outcome, patterns of missing data, and the squared correlations between Level 1 and Level 2 covariates and the outcome. We found no substantial difference between models with observed means or latent means with respect to convergence, Type I error rates, coverage, and bias. However, coverage could fall outside of acceptable limits if a latent mean is included as a covariate when cluster sizes are small. In terms of statistical power, models with observed means performed similarly to models with latent means, but better when cluster sizes were small. A demonstration is provided using data from a study of the Tools for Getting Along intervention.
Effect of carbon fabric type on properties of 2D carbon–carbon composites processed by liquid pitch impregnation–pyrolysis
Authors: Jana Biswanath , Rajulapati KV , Prasad N Eswara , Jain RK , Rao K Bhanu Sankara
Published: November 2015

The present study reports on the microstructural, physical, thermal and mechanical properties of two types (A and B) of carbon–carbon composites processed by an economical route. Skeleton composites were first made by pyrolysing laminated carbon fibre-reinforced phenolic composites and subsequently densified by liquid pitch impregnation–pyrolysis process. Both types of composite employed polyacrylonitrile-based 8-harness satin woven carbon fabrics, Type A being woven with tows of continuous fibres, whereas Type B used yarns of discontinuous fibres. Experimental results indicated that the Type A composite had better flexural and tensile modulus and strength values. However, the Type B composite had better interlaminar shear strength and through-thickness thermal conductivity, despite being less dense. These results are discussed and explained from microstructural and fractographic analysis using optical and scanning electron microscopes. Finally, the results were compared with those intended for similar applications.
Laparoscopic gastrojejunostomy for superior mesenteric artery syndrome in a patient with Parkinson’s disease
Authors: Chung A , Smith LI , McMurran AEL , Ali A
Published: November 2015

Introduction

Superior mesenteric artery syndrome is rare cause of intestinal obstruction. We report an unusual case of a patient with Parkinson’s disease who developed superior mesenteric artery syndrome and discuss her management including laparoscopic gastrojejunostomy and Roux-en-Y anastomosis.

Case presentation

A 78-year-old patient with advanced Parkinson’s disease presented with significant malnutrition, vomiting and post-prandial abdominal pain. Computed tomography confirmed duodenal compression by the superior mesenteric artery. We hypothesised this was likely triggered by extreme weight loss associated with advanced Parkinson’s disease. As the patient failed to improve with conservative measures, laparoscopic gastrojejunostomy and Roux-en-Y anastomosis was successfully performed without complications and the patient discharged on day 7.

Conclusion

Successful treatment was achieved due to early recognition of the consequences of chronic illness and addressing malnutrition. From this experience, we propose that laparoscopic gastric bypass is a safe and minimally invasive effective treatment option for superior mesenteric artery syndrome.
The manufacture of blood plasma products in Scotland: a brief history
Authors: Foster Peter R
Published: November 2015

A number of essential clinical products are derived from human blood plasma, including immunoglobulin products for the treatment of infections and disorders of immunity; albumin for protein and fluid replacement and coagulation factors for the treatment of haemophilia and other disorders of haemostasis. For many years, these protein pharmaceuticals were manufactured by the Scottish National Blood Transfusion Service (SNBTS) at its Scottish Protein Fractionation Centre (PFC) in Edinburgh, a contribution which ended with the closure of the PFC in 2008. The origins and development of plasma fractionation in Scotland are summarised in this article, as well as issues which contributed to the closure of the PFC.
A clinical evaluation of efficacy and safety of cefepime monotherapy versus piperacillin-tazobactam in patients of paediatric age group with febrile neutropenia in a tertiary care centre of north India
Authors: Aamir Mohammad , Abrol Pankaj , Sharma Deepak , Punia Harish
Published: November 2015

Objective

To evaluate clinically the efficacy and safety in northern India of cefepime monotherapy versus piperacillin-tazobactam in patients of paediatric age group with febrile neutropenia.

Material and Methods

Children aged ≤18 years admitted febrile with chemotherapy-induced neutropenia were randomised into two groups comprising 20 cases in each group viz. CEF (receiving cefepime only) and PIP-TAZO (receiving piperacillin-tazobactam). Based on clinical and laboratory tests, patients were classified into: microbiologically documented infections (MDI); clinically documented infections (CDI); and unexplained fever (UF). They were assessed for clinical signs and symptoms as well as laboratory parameters at the time of enrolment and subsequently on days 3 and 7.

Results

Incidence of MDI, CDI and UF were 22.5%, 47.5% and 30%, respectively. The mean duration of neutropenia (in days) was 5.45 ± 2.1 in the PIP-TAZO group and 5.5 ± 1.5 in the CEF group ( P = 0.305). The success rate defined as clearing infection effectively and improvement of neutropenia was comparable ( P = 0.705). There was a mortality rate of 20% in the PIP-TAZO group as compared to 10% in the CEF group.

Conclusion

We conclude that cefepime monotherapy and piperacillin-tazobactam are equally efficacious and safe in treating patients with febrile neutropenia. Empirical monotherapy with cefepime would prevent an unnecessary extra economic burden as well as avoiding the serious adverse or toxic effects of multi-drug regimes, especially in low- and middle-income countries.
Dedicated to Their Degrees
Authors: Allen Taryn Ozuna , Zhang Yi (Leaf)
Published: November 2015

Objective: Increasing degree completion in science, technology, engineering, and mathematics (STEM) fields, particularly engineering, is a national priority. With an aspiration to increase the number of STEM graduates by one million in the next 10 years, more research is needed to understand the role of community colleges in achieving this national goal. This qualitative study examined the motivations and learning experiences of adult learners who transferred from a community college to pursue an engineering degree at a 4-year university. Method: Using Knowles, Holton, and Swanson’s theory for adult learning, or andragogy, we interviewed 18 adult students who transferred from a community college to engineering programs at a 4-year research institution. Each participant was interviewed twice using a one-on-one, semi-structured format. Results: We found students were motivated to pursue engineering programs because of the perceived prestige associated with becoming an engineer and because of their personal curiosity in solving problems and understanding how things work. The participants further demonstrated their motivation for learning through their high post-baccalaureate aspirations, which included pursuing graduate school. To achieve academic and vocational success, students strategically developed peer relationships and selectively participated in engagement opportunities with the greatest professional or academic benefits. Contributions: Recommendations for campus policies and practices include restructuring campus involvement opportunities to allow adult learners to access information through self-paced activities. Furthermore, our findings suggest institutions should communicate the academic and professional benefits of campus involvement and consider strategies to facilitate interactions between older adult students and their younger peers.
Cognitive Dissonance or Credibility? A Comparison of Two Theoretical Explanations for Selective Exposure to Partisan News
Authors: Metzger Miriam J. , Hartsell Ethan H. , Flanagin Andrew J.
Published: November 2015

Selective exposure research indicates that news consumers tend to seek out attitude-consistent information and avoid attitude-challenging information. This study examines online news credibility and cognitive dissonance as theoretical explanations for partisan selective exposure behavior. After viewing an attitudinally consistent, challenging, or politically balanced online news source, cognitive dissonance, credibility perceptions, and likelihood of selective exposure were measured. Results showed that people judge attitude-consistent and neutral news sources as more credible than attitude-challenging news sources, and although people experience slightly more cognitive dissonance when exposed to attitude-challenging news sources, overall dissonance levels were quite low. These results refute the cognitive dissonance explanation for selective exposure and suggest a new explanation that is based on credibility perceptions rather than psychological discomfort with attitude-challenging information.
Silencing Political Opinions: An Assessment of the Influence of Geopolitical Contexts in Colombia
Authors: Abril Eulàlia Puig , Rojas Hernando
Published: November 2015

One of the most understudied aspects of the spiral of silence theory is the influence on opinion expression of different social structures anchored in geopolitical units, such as cities or states. This study evaluates political opinion expression after an election by relying on national survey data collected in Colombia (Latin America) and using multilevel analytic techniques to assess geopolitical and individual contexts of influence. Results provide evidence that a disagreeable national context—an election outcome contrary to one’s preference—matters in explaining citizens’ political expression. In addition, individual-level variables in the form of self-censorship were studied. Rather than an individual’s level of self-censorship contributing to expression inhibition, it appears that aggregate city levels of self-censorship affect the likelihood of an individual expressing his or her opinion after a presidential election.
Estimating language skills in Samoan- and Tongan-speaking children growing up in New Zealand
Authors: Reese Elaine , Ballard Elaine , Taumoepeau Mele , Taumoefolau Melenaite , Morton Susan B. , Grant Cameron , Atatoa-Carr Polly , McNaughton Stuart , Schmidt Johanna , Mohal Jatender , Perese Lana
Published: November 2015

The MacArthur–Bates Communicative Development Inventory (short form) was adapted for Samoan and Tongan speakers in New Zealand. The adaptation process drew upon language samples from Samoan and Tongan parent–child dyads with 20- and 26-month-old children and adult informants. The resulting 100-word language inventories in Samoan and Tongan, plus a single question about word combinations, were then administered to over 600 mothers of 2-year-olds in the Growing Up in New Zealand pre-birth longitudinal cohort study who identified their children as understanding Samoan or Tongan. Most mothers were able to complete the inventories without the help of an interpreter or interviewer. Important demographic correlates of children’s vocabulary and grammar were mothers’ country of birth, education, and deprivation level, and children’s birth order. Mothers’ birthplace was the single best predictor of children’s vocabulary development in Samoan and Tongan, with children of mothers who were born outside New Zealand having higher Samoan and Tongan vocabularies. Clinical implications are discussed, along with future analyses of the language development of these children from the Growing Up cohort.