bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum 25-Hydroxyvitamin D3 Levels Are Associated with Carotid Intima-Media Thickness and Carotid Atherosclerotic Plaque in Type 2 Diabetic Patients
Authors: Wang Yurong , Zhang Huijuan
Published: March 2017

Objective.To investigate the relationship between serum 25-hydroxyvitamin D3 [25(OH)D3] levels and carotid intima-media thickness (IMT) as well as carotid atherosclerotic plaque in patients with type 2 diabetes mellitus (T2DM).Methods.314 patients with T2DM were enrolled in this study. The clinical data and laboratory examinations of subjects were recorded, such as serum 25(OH)D3, hemoglobin A1c (HbA1c), serum lipids, fasting blood glucose (FBG), and other biochemical parameters. Color Doppler ultrasound was used to measure carotid IMT and carotid atherosclerotic plaques. Patients were divided into four quartile groups according to the serum 25(OH)D3 levels from low to high: group Q1~group Q4.Results.From group Q1 to group Q4, carotid IMT and the incidence of plaque were gradually reduced. Serum 25(OH)D3 levels were lower in the plaque group compared with the nonplaque group (P<0.01). Serum 25(OH)D3 levels were negatively correlated with the carotid IMT (r=−0.4,P<0.01). Multiple linear stepwise regression analysis showed that serum 25(OH)D3 was independently associated with carotid IMT (β=−0.009,P<0.01). Logistic regression analysis showed that serum 25(OH)D3 levels were independently associated with the presence of carotid plaque in T2DM (OR = 0.95; 95%CI: 0.92~0.98,P=0.004).Conclusions.Low vitamin D status may contribute to the incidence of carotid atherosclerosis in type 2 diabetic patients.
A Queue-Based Monte Carlo Analysis to Support Decision Making for Implementation of an Emergency Department Fast Track
Authors: Fitzgerald Kristin , Pelletier Lori , Reznek Martin A.
Published: March 2017

Emergency departments (EDs) are seeking ways to utilize existing resources more efficiently as they face rising numbers of patient visits. This study explored the impact on patient wait times and nursing resource demand from the addition of a fast track, or separate unit for low-acuity patients, in the ED using a queue-based Monte Carlo simulation in MATLAB. The model integrated principles of queueing theory and expanded the discrete event simulation to account for time-based arrival rates. Additionally, the ED occupancy and nursing resource demand were modeled and analyzed using the Emergency Severity Index (ESI) levels of patients, rather than the number of beds in the department. Simulation results indicated that the addition of a separate fast track with an additional nurse reduced overall median wait times by 35.8 ± 2.2 percent and reduced average nursing resource demand in the main ED during hours of operation. This novel modeling approach may be easily disseminated and informs hospital decision-makers of the impact of implementing a fast track or similar system on both patient wait times and acuity-based nursing resource demand.
Intravenous Lidocaine: Old-School Drug, New Purpose—Reduction of Intractable Pain in Patients with Chemotherapy Induced Peripheral Neuropathy
Authors: Heuvel Sandra A. S. van den , Wal Selina E. I. van der , Smedes Lotte A. , Radema Sandra A. , Alfen Nens van , Vissers Kris C. P. , Steegers Monique A. H.
Published: March 2017

Background. Treatment of intractable pain due to chemotherapy induced peripheral neuropathy (CIPN) is a challenge. Intravenous (iv) lidocaine has shown to be a treatment option for neuropathic pain of different etiologies. Methods. Lidocaine (1.5 mg/kg in 10 minutes followed by 1.5 mg/kg/h over 5 hours) was administered in nine patients with CIPN, and analgesic effect was evaluated during infusion and after discharge. The immediate effect of lidocaine on pressure pain thresholds (PPT) and the extent of the stocking and glove distribution of sensory abnormalities (cold and pinprick) were assessed. Results. Lidocaine had a significant direct analgesic effect in 8 out of 9 patients (P=0.01) with a pain intensity difference of >30%. Pain reduction persisted in 5 patients for an average of 23 days. Lidocaine did not influence mean PPT, but there was a tendency that the extent of sensory abnormalities decreased after lidocaine. Conclusion. Iv lidocaine has direct analgesic effect in CIPN with a moderate long-term effect and seems to influence the area of cold and pinprick perception. Additional research is needed, using a control group and larger sample sizes to confirm these results.
Vibration Analysis and Models of Adjacent Structures Controlled by Magnetorheological Dampers
Authors: Basili Michela , De Angelis Maurizio
Published: March 2017

This paper deals with the vibration analysis of adjacent structures controlled by a magnetorheological (MR) damper and with the discussion of a numerical procedure for identification and definition of a reliable finite element model. The paper describes an extensive experimental campaign investigating the dynamic response, through shaking table tests, of a tridimensional four-story structure and a two-story structure connected by an MR device. Several base excitations and intensity levels are considered. The structures were tested in nonconnected and connected configuration, with the MR damper operating in passive or semiactive mode. Moreover, the paper illustrates a procedure for the structural identification and the definition of a reliable numerical model valid for adjacent structures connected by MR dampers. The procedure is applied in the original nonconnected configuration, which represents a linear system, and then in the connected configuration, which represents a nonlinear system due to the MR damper. In the end, the updated finite element model is reliable and suitable for all the considered configurations and the mass, damping, and stiffness matrices are derived. The experimental and numerical responses are compared and the results confirm the effectiveness of the identification procedure and the validation of the finite element model.
Sonographic Markers in the Prediction of Fetal Complex Gastroschisis
Authors: Andrade Walkyria S. , Brizot Maria L. , Rodrigues Agatha S. , Tannuri Ana C. , Krebs Vera L. , Nishie Estela N. , Francisco Rossana P.V. , Zugaib Marcelo
Published: March 2017

Objective: To investigate the ultrasound (US) markers predictive of complex gastroschisis (CG), mortality, and morbidity in fetuses with gastroschisis. Materials and Methods: This was a retrospective cohort study of 186 pregnancies with isolated fetal gastroschisis. Eight US markers were analyzed. The predictions and associations of US markers with CG, mortality, and morbidity were assessed. Combinations of US markers predictive of CG were investigated. Results: Extra-abdominal bowel dilatation (EABD), intra-abdominal bowel dilatation (IABD), and polyhydramnios were predictive of CG. EABD between 25 and 28 weeks had a sensitivity of 64%, a specificity of 89%, a positive predictive value (PPV) of 56.2%, and negative predictive value (NPV) of 91.8%. The predictions of IABD were sensitivity = 26.7%, specificity = 96.7%, PPV = 61.5%, and NPV = 86.8%. The odds ratios for CG in the presence of 1 and 2 US markers, compared with the absence of a US marker, were 18.3 (95% CI, 3.83-87.64) and 73.3 (95% CI, 6.14-876), respectively. Conclusion: US markers predictive of CG were established. The combination of these markers increases the probability of CG.
Clinical and Dermoscopic Features of the Scalp in 31 Patients with Dermatomyositis
Authors: Jasso-Olivares Julio C. , Tosti Antonella , Miteva Mariya , Domínguez-Cherit Judith , Díaz-González José M.
Published: March 2017

Background: Scalp involvement is not directly evaluated in patients with dermatomyositis (DM). Therefore, the exact frequency of scalp dermatomyositis (SDM) and its clinical and trichoscopic characteristics have been poorly described. Objective: The aim of this study was to determine the frequency and clinical and dermoscopic features of SDM in patients diagnosed with DM. Methods: We performed a descriptive prospective, cross-sectional observational study that included all patients diagnosed with DM at a Mexican academic institute over the course of a year. Results: Twenty-four out of 31 patients with DM had scalp involvement at clinical examination, with a prevalence of 77.4%. SDM was clinically characterized by erythema in all cases, scales in 20 (83.3%) patients, nonscarring alopecia in 21 (87.5%) patients, pruritus in 17 (70.8%) patients, and poikiloderma of the scalp in 16 (51.6%) patients. Twenty-eight patients were evaluated by trichoscopy. The most consistent finding was the presence of enlarged capillaries, found in 20 (71.4%) cases, followed by peripilar casts (57.1%) and tufting and interfollicular scales in 14 (50%) cases. Twenty-two patients also had positive nail fold capillaroscopic features similar to those observed by trichoscopy. Limitations: The simple size was limited. Conclusions: Scalp involvement and alopecia are common in patients with DM, and trichoscopy shows features similar to those found at capillaroscopy. Trichoscopy is a very important tool for diagnosis of scalp involvement in patients with DM.
Impaired Hydrogen Sulfide–Mediated Vasodilation Contributes to Microvascular Endothelial Dysfunction in Hypertensive Adults
Authors: Greaney Jody L. , Kutz Jessica L. , Shank Sean W. , Jandu Sandeep , Santhanam Lakshmi , Alexander Lacy M.
Published: March 2017

Reductions in hydrogen sulfide (H
2
S) production have been implicated in the pathogenesis of vascular dysfunction in animal models of hypertension; however, no studies have examined a functional role for H
2
S in contributing to microvascular dysfunction in hypertensive (HTN) adults. We hypothesized that endogenous production of H
2
S would be reduced, impaired endothelium-dependent vasodilation would be mediated by reductions in H
2
S-dependent vasodilation, and vascular responsiveness to exogenous H
2
S (sodium sulfide) would be attenuated in HTN compared to normotensive adults. Fifteen normotensive (51±2 years; blood pressure, 116±3/76±3 mm Hg) and 14 HTN adults (57±2 years; blood pressure 140±3/89±2 mm Hg) participated. H
2
S biosynthetic enzyme expression (Western blot) and substrate-dependent H
2
S production (amperometric probe) were measured in cutaneous tissue homogenates. Red cell flux (laser Doppler flowmetry) was measured during graded perfusions of acetylcholine (ACh; 10
–6
–10
–1
mol/L) and sodium sulfide (10
–5
–10
1
mol/L) using intradermal microdialysis; the functional role of H
2
S was determined using pharmacological inhibition with aminooxyacetic acid (0.5 mmol/L). H
2
S biosynthetic enzyme expression and substrate-dependent H
2
S production were reduced in HTN adults (all
P
<0.05). ACh-induced endothelium-dependent vasodilation was blunted in HTN adults (
P
=0.012). Aminooxyacetic acid attenuated ACh-induced vasodilation in normotensive adults (ACh, 1.31±0.13 versus ACh+aminooxyacetic acid, 1.07±0.09 flux/mm Hg;
P
=0.025) but had no effect on vasodilation in HTN adults (ACh, 1.16±0.10 versus ACh+aminooxyacetic acid, 1.37±0.11 flux/mm Hg;
P
=0.47). Sodium sulfide–induced vasodilation was not different between groups. Collectively, these findings indicate that while the microvasculature maintains the ability to vasodilate in response to exogenous H
2
S, reductions in endogenous synthesis and H
2
S-dependent vasodilation contribute to endothelial dysfunction in human hypertension.
Asymmetric Modulation of El Niño and La Niña and the Linkage to Tropical Pacific Decadal Variability
Authors: Okumura Yuko M. , Sun Tianyi , Wu Xian
Published: March 2017

El Niño–Southern Oscillation (ENSO) in a 1300-yr preindustrial control simulation of the Community Climate System Model, version 4 (CCSM4), exhibits distinct modulation in association with tropical Pacific decadal variability (TPDV). The frequency and duration of El Niño events modulate with changes in the interbasin sea surface temperature (SST) gradient related to the leading mode of TPDV, which resembles the interdecadal Pacific oscillation (IPO). La Niña shows similar changes with the IPO but is also controlled by changes in El Niño that often precedes La Niña, and these effects tend to cancel each other. The amplitude of ENSO, on the other hand, is closely related to the second leading mode of TPDV that affects the zonal and meridional contrast of tropical Pacific climate. Significant changes in the pattern and seasonal evolution related to this TPDV mode are found mainly for El Niño because of the nonlinear relation between the atmospheric deep convection and SSTs. The resultant changes in the amplitude of El Niño, in turn, affect the amplitude and duration of the following La Niña, as well as the asymmetry in their patterns and duration. The decadal ENSO modulation associated with both TPDV modes is not symmetrical between El Niño and La Niña and thus is not likely to occur solely as a result of random variability. The patterns of TPDV in CCSM4 have resemblance to those simulated by its atmospheric component coupled to a slab ocean model, suggesting that TPDV induced by stochastic atmospheric variability interacts with the ENSO dynamics.
Book Review: Bob Adamson, Jon Nixon and Feng Su, The Reorientation of Higher Education: Challenging the East–West Dichotomy
Authors: Kamalakar G.
Published: March 2017

Bob Adamson, Jon Nixon and Feng Su, The Reorientation of Higher Education: Challenging the East–West Dichotomy. China: Comparative Education Research Centre, The University of Hong Kong/Springer, 2012, 314 pp., HKD250/USD38/ ₹1,896.
The Impact of Culture and Identity on Emotional Reactions to Insults
Authors: Maitner Angela T. , Mackie Diane M. , Pauketat Janet V. T. , Smith Eliot R.
Published: March 2017

People from honor cultures show heightened emotional responses to insults to their social image. The current research investigates whether people from honor cultures also show heightened protection of social identities. We find that honor concerns may be embedded in some social identities but not others, and that those identities associated with honor concerns are defended more than identities not associated with honor. Three experiments investigated participants’ emotional responses to insults to their ethnic or student identity. Results showed that compared with dignity culture (British) participants, participants from an honor culture (Arab) reported stronger anger responses both across and within cultures when their Arab identity, an identity explicitly linked to honor concerns, was insulted. In contrast, responses did not differ between dignity (American) and honor (Arab) cultures when participants received an insult to their student identity, a non-honor-oriented identity. These findings suggest that overarching cultural values are not applied to all identities, and therefore, that cultural variables influence psychological outcomes differently for different identities.
Stenotic lesion level did not affect outcomes of carotid endarterectomy
Authors: Suhara Masamitsu , Hoshina Katsuyuki , Akai Atsushi , Isaji Toshihiko , Akagi Daisuke , Yamamoto Kota , Miyahara Takuya , Watanabe Toshiaki
Published: March 2017

Background

Carotid endarterectomy is the established treatment for carotid artery stenosis, and remains the primary surgical option due to its superior outcomes compared to carotid arterial stenting. However, Japanese patients are known to have unfavorable anatomical conditions for carotid endarterectomy, with a relatively higher level of the carotid artery bifurcation than in the Western population. We investigated the outcomes of carotid endarterectomy in our institute and evaluated the procedural quality by comparing patients based on higher or lower lesion levels.

Methods

The clinical data of 65 patients who underwent carotid endarterectomy were collected retrospectively. The outcomes reviewed included stroke-free survival and stroke-free rate. The patients were divided into a higher group ( n = 25) and a lower group ( n = 40), based on lesion location in respect of the 2nd cervical vertebral level.

Results

There was no perioperative death and only one case of stroke in the higher group within 30 days after carotid endarterectomy. At 5 years after carotid endarterectomy, the stroke-free survival rates were 83.4% in the higher group and 87.8% in the lower group, while the stroke-free rates were 96.0% and 94.0%, respectively; there were no significant differences between groups.

Conclusions

Stenotic lesion level did not affect the outcome or procedural quality of carotid endarterectomy.
Domesticating the ‘troubled family’: Racialised sexuality and the postcolonial governance of family life in the UK
Authors: Turner Joe
Published: March 2017

This article examines how the UK’s Troubled Families Programme works as a strategy of domestication which produces and delimits certain forms of ‘family life’. Drawing upon critical geographies of home and empire, the article explores how the Troubled Families Programme works to manage the troubled family as part of a longer history of regulating unruly households in the name of national health and civilisation. Viewing the Troubled Families Programme as part of the production of heteronormative order highlights how the policy remobilises and reconfigures older forms of colonial rule which work to demarcate between civility/savagery, the developable/undevelopable. In examining the postcolonial dimension of neoliberal social policy, the article stresses how the Troubled Families Programme relies on racialising and sexualised logics of socio-biological control borrowed from imperial eugenics. Reading the Troubled Families Programme in this way contributes to our understanding of neoliberal rule. That the troubled family can be either domesticated or destroyed (through benefit sanctions and eviction) equally reveals the extent to which domesticity works as a key site for the production of both ‘worthy’ and ‘surplus’ life.
Exploring market failures in open innovation
Authors: Hewitt-Dundas Nola , Roper Stephen
Published: March 2017

There is now considerable empirical evidence demonstrating the innovation and performance benefits that accrue to firms engaging in open innovation (OI). Here, we use novel data on micro-businesses to show that the average level of engagement in OI falls well below the optimal level, a finding that reflects that of other empirical studies. We identify and examine three market failures which may help to explain this result. These relate to a lack of understanding of the potential benefits of OI by firms, a lack of information about the capabilities of potential partners and a lack of information about the trustworthiness of potential partners. Our findings provide evidence that policy initiatives designed to offset these information failures are likely to increase the range of partners with which firms engage with significant benefits for innovation.
How Transformational Leadership Supports Intrinsic Motivation and Public Service Motivation: The Mediating Role of Basic Need Satisfaction
Authors: Jensen Ulrich Thy , Bro Louise Ladegaard
Published: March 2017

Motivating public service employees to greater effort is a key issue for managers and scholars. Transformational leadership concerns behaviors to develop, share, and sustain a vision for the organization and has been suggested as an important lever in this respect. However, we know little about the processes by which transformational leadership may stimulate work motivation. Integrating transformational leadership, public service motivation (PSM), and self-determination theory, this article sheds light on the psychological mechanisms underlying the motivational effects of transformational leadership. According to structural equation modeling, the relationships between transformational leadership and two types of autonomous work motivation—intrinsic motivation and PSM—are mediated by the satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Our findings support the claim that the motivational effects of transformational leadership are mediated by need satisfaction, but also that satisfaction of individual needs is not equally important for intrinsic motivation and PSM, respectively.
Effective dose in low-dose CT compared with radiography for templating of total hip arthroplasty
Authors: Geijer Mats , Rundgren Gustav , Weber Lars , Flivik Gunnar
Published: March 2017

Background

Recently, total hip arthroplasty (THA) has come to focus on restoration of individual anatomy including femoral neck anteversion and global offset (femoral and acetabular offset). Three-dimensional (3D) computed tomography (CT) data could provide a better basis for preoperative templating. The use of CT has been hampered by high radiation dose.

Purpose

To evaluate the effective dose used in pelvis and hip CT for THA templating.

Material and Methods

CT data from two clinical trials of THA were evaluated for CT scan length and volume CT dose index (CTDIvol). The effective doses from hip-knee-ankle CT and pelvis and hip radiography were compared. Conversion factors for effective dose for radiography were calculated using the PCXMC software.

Results

A reduced dose CT protocol for pelvis imaging gave a substantial dose reduction compared with standard CT, while maintaining sufficient image quality. Between the two clinical trials there was a significant reduction in effective CT dose corresponding to changes in the CT protocol ( P < 0.01). The CT dose for the latter group was similar to, but nevertheless significantly higher than for, radiography ( P < 0.01). However, in the latter group the theoretical minimum dose for CT, using the minimum scan length required by the templating software, was equal to the dose from radiography.

Conclusion

Although the CT dose remained higher than for radiography, potential reductions in scan length could reduce the dose further so that CT would have a comparable level of risk to radiography with the added benefit of 3D templating.
Influence of Background Noise Produced in University Facilities on the Brain Waves Associated With Attention of Students and Employees
Authors: Trista´n-Hernández E. , Pav´on-García I. , Campos-Cantón I. , Ontaño´n-García L. J. , Kolosovas-Machuca E. S.
Published: March 2017

As a consequence of noise exposure, lack of attention badly affects directly the academic and work performance. The study of the brain and the waves that it produces is the most objective way to evaluate this process. Attentional improvement is associated with increases of the amplitude in both beta and theta bands. The objective of this work is to study the influence of background noise produced inside university facilities on changes in the cerebral waves related to attention processes (beta 13–30 Hz and theta 4–7 Hz). Volunteers were asked to perform a specific task in which attention was involved. This task was performed in both silent and noisy conditions. To evaluate the cerebral activity of volunteers during the development of the test, measurement of spontaneous activity (electroencephalogram) was developed. The results show significant decreases in both beta and theta frequency bands under background noise exposure. Since attentional improvement is related to an increment on amplitude of both beta and theta bands, it is suggested that decreases on amplitude of these frequency bands could directly be related to a lack of attention caused by the exposure to background noise.
Epidemiology and Outcomes of Lisfranc Injuries Identified at the National Football League Scouting Combine
Authors: McHale Kevin J. , Vopat Bryan G. , Beaulieu-Jones Brendin R. , Sanchez George , Whalen James M. , McDonald Lucas S. , DiGiovanni Christopher W. , Theodore George H. , Provencher Matthew T.
Published: March 2017

Background:

Lisfranc injuries are challenging to treat and may have a detrimental effect on athletic performance.

Purpose:

(1) Determine the epidemiological characteristics of Lisfranc injuries at the annual National Football League (NFL) Scouting Combine, (2) define player positions at risk for these injuries, and (3) evaluate the impact that these injuries and radiographic findings have on NFL draft position and performance.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All players who sustained a Lisfranc injury prior to Combine evaluation between 2009 and 2015 were evaluated. The epidemiological characteristics, player positions affected, treatment methods, and number of missed collegiate games were recorded. Radiographic outcomes were analyzed via Combine radiograph findings, while NFL performance outcomes were assessed for all Lisfranc injuries (2009-2013) compared with matched controls in the first 2 years of play.

Results:

A total of 41 of 2162 (1.8%) Combine participants were identified with Lisfranc injuries, of whom 26 of 41 (63.4%) were managed operatively. Players who underwent surgery were more likely to go undrafted compared with players managed nonoperatively (38.5% vs 13.3%, operative vs nonoperative management, respectively; P = .04) and featured a worse NFL draft pick position (155.6 vs 109; P = .03). Lisfranc-injured players when compared with controls were noted to have worse outcomes in terms of NFL draft position (142 vs 111.3, Lisfranc-injured players vs controls, respectively; P = .04), NFL career length 2 years or longer (62.5% vs 69.6%; P = .23), and number of games played (16.9 vs 23.3; P = .001) and started (6.8 vs 10.5; P = .08) within the first 2 years of their NFL career. Radiographs demonstrated that 17 of 41 (41.5%) athletes had residual Lisfranc joint displacement greater than 2 mm compared with the contralateral foot. Lisfranc-injured athletes with greater than 2 mm residual displacement, when compared with matched controls, had worse draft position (156.9 vs 111.2 for Lisfranc-injured players vs controls, respectively; P = .009) and fewer games played (14.4 vs 23.3; P = .001) and started (3.1 vs 10.5; P = .03). Moreover, athletes with greater than 2 mm residual displacement featured worse outcomes across all assessed NFL variables versus athletes with residual displacement of 2 mm or less.

Conclusion:

Lisfranc injuries identified at the NFL Combine have an adverse effect on an NFL athlete’s draft status, draft position, and overall play during initial NFL seasons. In particular, residual displacement of the Lisfranc joint has a detrimental effect on the first 2 seasons of NFL play and may lead to long-lasting negative effects on the athlete’s career.
Providing Health Care in the Shadow of Violence: Does Emotion Regulation Vary Among Hospital Workers From Different Professions?
Authors: Goldblatt Hadass , Freund Anat , Drach-Zahavy Anat , Enosh Guy , Peterfreund Ilana , Edlis Neomi
Published: March 2017

Research into violence against health care staff by patients and their families within the health care services shows a rising frequency of incidents. The potentially damaging effects on health care staff are extensive, including diverse negative psychological and physical symptoms. The aim of this qualitative study was to examine how hospital workers from different professions reacted to patients’ and visitors’ violence against them or their colleagues, and how they regulated their emotional reactions during those incidents. The research question was as follows: How do different types of hospital workers regulate the range of their emotional reactions during and after violent events? Participants were 34 hospital workers, representing several professional sectors. Data were collected through in-depth semistructured interviews, which were later transcribed and thematically content analyzed. Five themes were revealed, demonstrating several tactics that hospital workers used to regulate their emotions during incidents of violent outbursts by patients or visitors: (1) Inability to Manage Emotion Regulation, (2) Emotion Regulation by Distancing and Disengagement Tactics, (3) Emotion Regulation Using Rationalization and Splitting Tactics, (4) Emotion Regulation via the Use of Organizational Resources, and (5) Controlling Emotions by Suppression. Hospital workers who experienced dissonance between their professional expectations and their emotional reactions to patients’ violence reported using various emotion regulation tactics, consequently managing to fulfill their duty competently. Workers who did not experience such dissonance felt in full control of their emotions and did not manifest responses of emotion regulation. Others, however, experienced intense emotional flooding and failed to regulate their emotions. We recommend developing health care staff’s awareness of possible emotional implications of violent incidents, for themselves as people and for their intact functioning at work. In addition, we recommend further development of health care staff training programs for coping with violent patients and enhancement of formal and informal organizational support.
Humility, Love and Radical Discipleship: Steps toward an Ontology of the Sainted Self
Authors: McLeod-Harrison Mark S.
Published: March 2017

My goal is to explicate the ontological framework of the human self that is required for radical discipleship. I do this through two notions: Christian love (agape) and Christian humility. To that end I explore the other- and the self-regarding aspects of humility and love, posing a problem for love and humility rooted in our typical notions of self-interest and phronesis. I then propose a way of rethinking humility and love in the context of a sketch of solidarity and an alternative ontology of the self.
Multi-objective optimization of double suction centrifugal pump
Authors: Tao Ran , Xiao Ruofu , Zhu Di , Wang Fujun
Published: March 2017

Double suction centrifugal pumps are widely used for water supplying system. In this study, the original design of a double centrifugal pump lacked sufficient head at the design flow rate condition. Therefore, the most important objective was to optimize the design to improve the head. A strategy inspired by “liquid–gas cavitation process” is innovatively used for intelligent global search of better pump designs with both higher head and wider-higher efficiency. This strategy has advantages including flexibility, parallelism, and feasibility on overstepping the local-best. The computational fluid dynamics and artificial neural network are used. It helps this optimization to find unknown points in the non-linear and multi-dimensional searching space, and accelerate the optimization process. Candidates were found after search, and the best one was chosen using Pareto principle. Experimental and numerical studies verify that the optimized impeller meets the requirement of head. The efficiency is also significantly improved with higher best efficiency and wider high efficiency range than original design. The critical cavitation is also improved at design condition. This study provides an effective strategy and a good solution for multi-objective optimization of double suction centrifugal pumps. Moreover, this study provides references for the combination of optimizations with artificial intelligence especially in the pump’s design.
A comparative convergence and accuracy study of composite guided-ultrasonic wave solution methods: Comparing the unified analytic method, SAFE method and DISPERSE
Authors: Barazanchy Darun , Giurgiutiu Victor
Published: March 2017

Multiple approaches and programs are available to the public to predict ultrasonic guided-wave propagation dispersion curves in a material. Each approach and program will have its own advantage and disadvantage making it suitable for a specific end use and less suitable for others. This manuscript aims to compare three different guided-ultrasonic wave dispersion curves retrieval methods for multiple cases. First a single layer of isotropic, unidirectional, orthotropic and monoclinic material is examined, followed by a multi-layer case (consisting of 10 layers of the aforementioned materials) and finally four different laminates and one sandwich laminate are evaluated. The goal of this manuscript is to give a concise overview of the advantages and limitations of each approach to assist the end user in choosing the right program to use.
Chemoresistance is associated with overexpression of HAX-1, inhibition of which resensitizes drug-resistant breast cancer cells to chemotherapy
Authors: Yang Ji , Wu Yue , Wang Xiao , Xu Liqian , Zhao Xiaohong , Yang Yunmei
Published: March 2017

Acquired resistance to standard chemotherapy is the common and critical limitation for cancer therapy. Hematopoietic cell-specific protein 1-associated protein X-1 (HAX-1) has been reported to be upregulated in numerous cancers. However, the role of HAX-1 in oncotherapy remains unclear. In this study, we established MDA-MB-231 cell lines which were resistant to cisplatin (MDA-MB-231/CR) or doxorubicin (MDA-MB-231/DR) to study the chemoresistance in breast cancer. As a result, the HAX-1 which is an apoptosis-associated protein was observed to be overexpressed in both MDA-MB-231/CR and MDA-MB-231/DR compared with the routine MDA-MB-231 cells. Moreover, knockdown of HAX-1 via RNA interference decreased IC50 level of cisplatin by 70.91% in MDA-MB-231/CR cells, and the IC50 level of doxorubicin was decreased by 76.46% in MDA-MB-231/DR cells when the HAX-1 was downregulated. Additionally, we found that the knockdown of HAX-1 induced the release of cytochrome C from mitochondria, resulting in the activation of caspases. Taken together, our study indicates that the overexpression of HAX-1 is essential in the development of chemoresistance in breast cancer. Furthermore, we identify that HAX-1 may become the target for cancer therapy.
Feedback regulation of methyl methanesulfonate and ultraviolet-sensitive gene clone 81 via ATM/Chk2 pathway contributes to the resistance of MCF-7 breast cancer cells to cisplatin
Authors: Lv Juan , Qian Ying , Ni Xiaoyan , Xu Xiuping , Dong Xuejun
Published: March 2017

The methyl methanesulfonate and ultraviolet-sensitive gene clone 81 protein is a structure-specific nuclease that plays important roles in DNA replication and repair. Knockdown of methyl methanesulfonate and ultraviolet-sensitive gene clone 81 has been found to sensitize cancer cells to chemotherapy. However, the underlying molecular mechanism is not well understood. We found that methyl methanesulfonate and ultraviolet-sensitive gene clone 81 was upregulated and the ATM/Chk2 pathway was activated at the same time when MCF-7 cells were treated with cisplatin. By using lentivirus targeting methyl methanesulfonate and ultraviolet-sensitive gene clone 81 gene, we showed that knockdown of methyl methanesulfonate and ultraviolet-sensitive gene clone 81 enhanced cell apoptosis and inhibited cell proliferation in MCF-7 cells under cisplatin treatment. Abrogation of ATM/Chk2 pathway inhibited cell viability in MCF-7 cells in response to cisplatin. Importantly, we revealed that ATM/Chk2 was required for the upregulation of methyl methanesulfonate and ultraviolet-sensitive gene clone 81, and knockdown of methyl methanesulfonate and ultraviolet-sensitive gene clone 81 resulted in inactivation of ATM/Chk2 pathway in response to cisplatin. Meanwhile, knockdown of methyl methanesulfonate and ultraviolet-sensitive gene clone 81 activated the p53/Bcl-2 pathway in response to cisplatin. These data suggest that the ATM/Chk2 may promote the repair of DNA damage caused by cisplatin by sustaining methyl methanesulfonate and ultraviolet-sensitive gene clone 81, and the double-strand breaks generated by methyl methanesulfonate and ultraviolet-sensitive gene clone 81 may activate the ATM/Chk2 pathway in turn, which provide a novel mechanism of how methyl methanesulfonate and ultraviolet-sensitive gene clone 81 modulates DNA damage response and repair.
Clinical, cellular, and bioinformatic analyses reveal involvement of WRAP53 overexpression in carcinogenesis of lung adenocarcinoma
Authors: Yuan Xiao-Shuai , Cao Long-Xiang , Hu Ye-Ji , Bao Fei-Chao , Wang Zhi-Tian , Cao Jin-Lin , Yuan Ping , Lv Wang , Hu Jian
Published: March 2017

Lung cancer, of which non-small cell lung cancer accounts for 80%, remains a leading cause of cancer-related mortality and morbidity worldwide. Our study revealed that the expression of WD repeat containing antisense to P53 (WRAP53) is higher in lung-adenocarcinoma specimens than in specimens from adjacent non-tumor tissues. The prevalence of WRAP53 overexpression was significantly higher in patients with tumor larger than 3.0 cm than in patients with tumor smaller than 3.0 cm. The depletion of WRAP53 inhibits the proliferation of lung-adenocarcinoma A549 and SPC-A-1 cells via G1/S cell-cycle arrest. Several proteins interacting with WRAP53 were identified through co-immunoprecipitation and liquid chromatography/mass spectrometry. These key proteins indicated previously undiscovered functions of WRAP53. These observations strongly suggested that WRAP53 should be considered a promising target in the prevention or treatment of lung adenocarcinoma.
Crocodile choline fromCrocodylus siamensisinduces apoptosis of human gastric cancer
Authors: Mao Xiao-Mei , Fu Qi-Rui , Li Hua-Liang , Zheng Ya-Hui , Chen Shu-Ming , Hu Xin-Yi , Chen Qing-Xi , Chen Qiong-Hua
Published: March 2017

Crocodile choline, an active compound isolated from Crocodylus siamensis, was found to exert potent anti-cancer activities against human gastric cancer cells in vitro and in vivo. Our study revealed that crocodile choline led to cell cycle arrest at the G2/M phase through attenuating the expressions of cyclins, Cyclin B1, and CDK-1. Furthermore, crocodile choline accelerated apoptosis through the mitochondrial apoptotic pathway with the decrease in mitochondrial membrane potential, the increase in reactive oxygen species production and Bax/Bcl-2 ratio, and the activation of caspase-3 along with the release of cytochrome c. In addition, this study, for the first time, shows that Notch pathway is remarkably deregulated by crocodile choline. The combination of crocodile choline and Notch1 short interfering RNA led to dramatically increased cytotoxicity than observed with either agent alone. Notch1 short interfering RNA sensitized and potentiated the capability of crocodile choline to suppress the cell progression and invasion of gastric cancer. Taken together, these data suggested that crocodile choline was a potent progression inhibitor of gastric cancer cells, which was correlated with mitochondrial apoptotic pathway and Notch pathway. Combining Notch1 inhibitors with crocodile choline might represent a novel approach for gastric cancer.
Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
Authors: Ballesio Laura , Gigli Silvia , Di Pastena Francesca , Giraldi Guglielmo , Manganaro Lucia , Anastasi Emanuela , Catalano Carlo
Published: March 2017

The objective of this study is to analyze magnetic resonance imaging shrinkage pattern of tumor regression after neoadjuvant chemotherapy and to evaluate its relationship with biological subtypes and pathological response.

We reviewed the magnetic resonance imaging studies of 51 patients with single mass-enhancing lesions (performed at time 0 and at the II and last cycles of neoadjuvant chemotherapy). Tumors were classified as Luminal A, Luminal B, HER2+, and Triple Negative based on biological and immunohistochemical analysis after core needle biopsy. We classified shrinkage pattern, based on tumor regression morphology on magnetic resonance imaging at the II cycle, as concentric, nodular, and mixed. We assigned a numeric score (0: none; 1: low; 2: medium; 3: high) to the enhancement intensity decrease. Pathological response on the surgical specimen was classified as complete (grade 5), partial (grades 4–3), and non-response (grades 1–2) according to Miller and Payne system. Fisher test was used to relate shrinkage pattern with biological subtypes and final pathological response.

Seventeen patients achieved complete response, 25 partial response, and 9 non-response. A total of 13 lesions showed nodular pattern, 20 concentric, and 18 mixed. We found an association between concentric pattern and HER2+ (p < 0.001) and mixed pattern and Luminal A lesions (p < 0.001). We observed a statistical significant correlation between concentric pattern and complete response (p < 0.001) and between mixed pattern and non-response (p = 0.005). Enhancement intensity decrease 3 was associated with complete response (p < 0.001).

Shrinkage pattern and enhancement intensity decrease may serve as early response indicators after neoadjuvant chemotherapy. Shrinkage pattern correlates with tumor biological subtypes.
Apoptosis mediated chemosensitization of tumor cells to 5-fluorouracil on supplementation of fish oil in experimental colon carcinoma
Authors: Rani Isha , Sharma Bhoomika , Kumar Sandeep , Kaur Satinder , Agnihotri Navneet
Published: March 2017

5-Fluorouracil has been considered as a cornerstone therapy for colorectal cancer; however, it suffers from low therapeutic response rate and severe side effects. Therefore, there is an urgent need to increase the clinical efficacy of 5-fluorouracil. Recently, fish oil rich in n-3 polyunsaturated fatty acids has been reported to chemosensitize tumor cells to anti-cancer drugs. This study is designed to understand the underlying mechanisms of synergistic effect of fish oil and 5-fluorouracil by evaluation of tumor cell–associated markers such as apoptosis and DNA damage. The colon cancer was developed by administration of N,N-dimethylhydrazine dihydrochloride and dextran sulfate sodium salt. Further these animals were treated with 5-fluorouracil, fish oil, or a combination of both. In carcinogen-treated animals, a decrease in DNA damage and apoptotic index was observed. There was also a decrease in the expression of Fas, FasL, caspase 8, and Bax, and an increase in Bcl-2. In contrast, administration of 5-fluorouracil and fish oil as an adjuvant increased both DNA damage and apoptotic index by activation of both extrinsic and intrinsic apoptotic pathways as compared to the other groups. The increased pro-apoptotic effect by synergism of 5-fluorouracil and fish oil may be attributed to the incorporation of n-3 polyunsaturated fatty acids in membrane, which alters membrane fluidity in cancer cells. In conclusion, this study highlights that the induction of apoptotic pathway by fish oil may increase the susceptibility of tumors to chemotherapeutic regimens.
Upregulation of long noncoding RNA zinc finger antisense 1 enhances epithelial–mesenchymal transition in vitro and predicts poor prognosis in glioma
Authors: Lv Qiao-Li , Chen Shu-Hui , Zhang Xue , Sun Bao , Hu Lei , Qu Qiang , Huang Yuan-Tao , Wang Gui-Hua , Liu Yan-Ling , Zhang Ying-Ying , Zhou Hong-Hao
Published: March 2017

Increasing evidence indicates that long noncoding RNAs play important roles in development and progression of various cancers. Zinc finger antisense 1 is a novel long noncoding RNA whose clinical significance, biological function, and underlying mechanism are still undetermined in glioma. In this study, we reported that zinc finger antisense 1 expression was markedly upregulated in glioma and tightly correlated with clinical stage. Moreover, patients with high zinc finger antisense 1 expression had shorter survival. Multivariate Cox regression analysis provided a clue that, probably, zinc finger antisense 1 level could serve as an independent prognostic factor for glioma. Functionally, zinc finger antisense 1 acted as an oncogene in glioma because its knockdown could promote apoptosis and significantly inhibit cell proliferation, migration, and invasion. Furthermore, zinc finger antisense 1 silencing could result in cell cycle arrest at the G0/G1 phase and correspondingly decrease the percentage of S phase cells in both U87 and U251 cell lines. Moreover, it was found that silenced zinc finger antisense 1 could impair migration and invasion by inhibiting the epithelial–mesenchymal transition through reducing the expression of MMP2, MMP9, N-cadherin, Integrin β1, ZEB1, Twist, and Snail as well as increasing E-cadherin level in glioma. Taken together, our data identified that zinc finger antisense 1 might act as a valuable prognostic biomarker and potential therapeutic target for glioma.
Ganoderic acid targeting nuclear factor erythroid 2–related factor 2 in lung cancer
Authors: Gill Balraj Singh , Kumar Sanjeev , Navgeet
Published: March 2017

Lung cancer causes huge mortality worldwide, and targeting new pathway may provide an alternative in modulating signaling in cancer. Nuclear factor erythroid 2–related factor 2 is the major regulator of endogenous and exogenous stress by activating numerous antioxidant genes critical in cancer, Alzheimer’s, Parkinson’s, and inflammatory bowel diseases. Ganoderic acid is a triterpene from basiodiomycetes fungus Ganoderma lucidum with numerous therapeutic effects. In this study, ganoderic acid and its 50 isomers and natural activators were docked by receptor-based molecular docking using Maestro 9.6 (Schrödinger Inc.) in the Kelch-like ECH-associated protein 1-nuclear factor erythroid 2–related factor 2 signaling pathway. The receptor-based molecular docking reveals the best binding interaction of nuclear factor erythroid 2–related factor 2 and ganoderic acid A with GScore (−9.69) (kcal/mol), Lipophilic EvdW (−1.83), Electro (−0.72), Glide emodel (−73.369), H bond (−1.1), molecular mechanics/generalized Born surface area (−75.541) with Leu 718, Asp 800, Cys 797 residues involved in hydrogen bonding. The calculated docking energy highlights the lipophilic, hydrogen bonding, pi–pi stacking interactions, and non-covalent bonding. Analysis showed the involvement of cysteine and serine residues which were crucial in the activation and translocation from cytoplasm to the nucleus in the nuclear factor erythroid 2–related factor 2 signaling process. The molecular docking tool QikProp analyzed the absorption, distribution, metabolism, excretion, and toxicity but needs some modifications in their structure to satisfy Lipinski’s rule. Ganoderic acid A is a best docked isoform which inhibits the cell proliferation, viability, migration, and reactive oxygen species and messenger RNA expression of nuclear factor erythroid 2–related factor 2 in H460 cells.
Prospective Risk Factors for Intense Grief in Family Members of Veterans Who Died of Terminal Illness
Authors: Burke Laurie A. , Neimeyer Robert A. , Bottomley Jamison S. , Smigelsky Melissa A.
Published: March 2017

Many bereavement researchers focus on predicting and preventing complicated grief, a psychologically crippling, sometimes life-threatening response to loss that persists for lengthy periods, often with serious health consequences. Reviews of studies have identified specific risk factors (e.g., low social support, insecure attachment style) that predict high levels of complicated grief symptomatology. However, studies rarely investigate multiple risk factors in combination, and still more rarely trace factors observable during the end-of-life period and their predictive power for identifying intense grief in family members following the death. We therefore investigated several pre-loss risk factors for post-loss bereavement distress in 35 family members of Veterans who died of a terminal illness after receiving palliative care. Results revealed that being female, Caucasian, losing a spouse, and experiencing high anticipatory grief prior to the death, all predicted high levels of grief 6 to 10 weeks following the death. Moreover, psychosocial factors such as being highly dependent upon the Veteran, displaying high neuroticism, reporting low levels of social support, and being unable to make sense of the prognosis or death predicted more intense post-loss grief reactions.