bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential identification of a claudicant group vulnerable to acute kidney injury
Authors: Jaffer Usman , Singh Prashant , Aslam Mohammed , IITam Frederick Wai Keung , Standfield Nigel J
Published: March 2016

This observational study aimed to investigate the relationship between renal injury, endothelial function and oxidative stress in claudicants undergoing maximal treadmill exercise. Twenty patients with claudication were identified in whom the urinary N-acetyl-β-D-glucosaminidase (β-NAG)/creatinine ratio, plasma oxidative state and endothelial function were tested pre- and post-maximal treadmill walking exercise. Of the 20 participants in this study, the urinary NAG/creatinine (Cr) rose from a pre-exercise level of 8.9, 6.7 to 14.3 (μmol/L/mmol Cr; median, IQR) to 12.9, 9.1 to 17.7 post exercise (p = 0.0003, Mann Whitney U test). Of the 20 participants, eight participants had a rise of the NAG/Cr ratio post exercise whereas 12 did not. Participants with a rise in the NAG/Cr ratio post exercise had a greater ability to increase endothelial reactivity (%; median, IQR; 2.56, 0.1 to 3.7) cf. (0.1, −4.8 to 0.9, p = 0.03); they also walked further (metres; median, IQR; 415, 208 to 908) cf. (170, 100 to 315, p = 0.04), had a lower pre-exercise H2O2 (median, IQR; 1.9, 1.4 to 2.3 cf. 2.7, 2.1 to 3.3; p = 0.04) and a greater rise in H2O2 post exercise (18.8, −1.5 to 129.7 cf., −7.7, −13.9 to −2.0, p = 0.04). The mechanism by which the phenotypically distinct sub-group of patients with intermittent claudication who experience a NAG/Cr rise involves complex interactions between systemic oxidative stress and endothelial function. Implications on cardiovascular risk in this group requires further investigation.
Effect of course length and corridor width on the 2-minute walk test performance in geriatric patients
Authors: Lindemann Ulrich , Beck Luisa , Becker Clemens
Published: March 2016

Objective:

To evaluate the effect of course length and corridor width on 2-minute walk test results in older adults.

Design:

Cross-sectional and experimental study with different test conditions.

Setting:

Geriatric rehabilitation clinic.

Subjects:

A total of 21 patients (median age 81 years).

Main measures:

Patients walked two minutes on a 20 m and 40 m course with a 2 m or 1 m corridor width and on a continuous course without any turning in a corridor of 2 m width, five walks in total. The distance traveled within the 2 minutes was recorded.

Results:

Compared with the 20 m course length, median walking distances measured by the 2-minute walk test in a walk way 2 m broad were better on the continuous corridor without any turn (136.9 m vs. 129.3 m, p = 0.002) and on the 40 m course (131.8 m vs. 129.3 m, p = 0.003). Walking distance on a 20 m course length was longer in a corridor of 2 m width compared with the 1 m corridor width (129.3 m vs. 119.2 m, p = 0.005). The walking distance was not affected by corridor width on the 40 m course length.

Conclusions:

Performance of elderly patients on the 2-minute walk test is influenced by the width of the corridor and the length of the course used.
Retrospective evaluation of palliative care and hospice utilization in hospitalized patients with metastatic breast cancer
Authors: Shin Jennifer A , Parkes Amanda , El-Jawahri Areej , Traeger Lara , Knight Helen , Gallagher Emily R , Temel Jennifer S
Published: March 2016

Background:

Hospitalizations in patients with metastatic cancer occur commonly at the end of life but have not been well-described in individuals with metastatic breast cancer.

Aim:

To describe the reasons for admission and frequency of palliative care and hospice utilization in hospitalized patients with metastatic breast cancer.

Design:

This was a retrospective chart review of patients who had their first hospitalization with a diagnosis of metastatic breast cancer between 1 January 2009 and 31 December 2010. To standardize follow-up time, we collected data for 3 years post the index hospitalization.

Setting/participants:

We identified 123 consecutive patients who were hospitalized for the first time with a diagnosis of metastatic breast cancer at a single, tertiary care center.

Results:

Uncontrolled symptoms accounted for half (50%, 62/123) of index admissions. The majority of patients died during the follow-up period (76%, 94/123), and the median time from index admission to death was 6 months (range: 0–34 months). Approximately half (53%, 50/94) died in the hospital or within 14 days of last hospital discharge, and less than one-third (29%, 27/94) were referred to hospice after their last hospitalization. The inpatient palliative care team evaluated 57% (54/94) of those who died at least once during an admission, but only 17% (16/94) of patients attended an outpatient palliative care appointment.

Conclusions:

Hospitalized patients with metastatic breast cancer are commonly admitted for uncontrolled symptoms and have a poor prognosis. However, only a minority receive outpatient palliative care or are referred to hospice during their last hospitalization prior to death.
Metabolic network expression in parkinsonism: Clinical and dopaminergic correlations
Authors: Ko Ji Hyun , Lee Chong Sik , Eidelberg David
Published: March 2016

Little is known of the precise relationship between the expression of disease-related metabolic patterns and nigrostriatal dopaminergic dysfunction in parkinsonism. We studied 51 subjects with Parkinson's disease (PD) (18 non-demented, 24 demented, and 9 dementia with Lewy bodies) and 127 with atypical parkinsonian syndromes (47 multiple system atrophy (MSA), 38 progressive supranuclear palsy (PSP), and 42 corticobasal syndrome (CBS)) with 18F-fluorodeoxyglucose PET to quantify the expression of previously validated disease-related patterns for PD, MSA, PSP, and CBS and 18F-fluoropropyl-β-CIT PET to quantify caudate and putamen dopamine transporter (DAT) binding. The patients in each group exhibited significant elevations in the expression of the corresponding disease-related pattern ( p < 0.001), relative to 16 healthy subjects. With the exception of cerebellar MSA (MSA-C), all groups displayed significant reductions in putamen DAT binding relative to healthy subjects ( p < 0.05). Correlations between the dopaminergic and metabolic measures were significant in PD and CBS but not in MSA and PSP. In all patient groups with the exception of MSA-C and CBS, pattern expression values and DAT binding correlated with disease duration and severity measures. The findings suggest that in these parkinsonian disorders, metabolic network expression and DAT binding provide complementary information regarding the underlying disease process.
Searching for a truly “iso-metabolic” gas challenge in physiological MRI
Authors: Peng Shin-Lei , Ravi Harshan , Sheng Min , Thomas Binu P , Lu Hanzhang
Published: March 2016

Hypercapnia challenge (e.g. inhalation of CO2) has been used in calibrated fMRI as well as in the mapping of vascular reactivity in cerebrovascular diseases. An important assumption underlying these measurements is that CO2 is a pure vascular challenge but does not alter neural activity. However, recent reports have suggested that CO2 inhalation may suppress neural activity and brain metabolic rate. Therefore, the goal of this study is to propose and test a gas challenge that is truly “iso-metabolic,” by adding a hypoxic component to the hypercapnic challenge, since hypoxia has been shown to enhance cerebral metabolic rate of oxygen (CMRO2). Measurement of global CMRO2 under various gas challenge conditions revealed that, while hypercapnia (P = 0.002) and hypoxia (P = 0.002) individually altered CMRO2 (by −7.6 ± 1.7% and 16.7 ± 4.1%, respectively), inhalation of hypercapnic-hypoxia gas (5% CO2/13% O2) did not change brain metabolism (CMRO2 change: 1.5 ± 3.9%, P = 0.92). Moreover, cerebral blood flow response to the hypercapnic-hypoxia challenge (in terms of % change per mmHg CO2 change) was even greater than that to hypercapnia alone (P = 0.007). Findings in this study suggest that hypercapnic-hypoxia gas challenge may be a useful maneuver in physiological MRI as it preserves vasodilatory response yet does not alter brain metabolism.
The Impact of Depth of Aesthetic Processing and Visual-Feature Transformations on Recognition Memory for Artworks and Constructed Design Patterns
Authors: Wang Tingting , Cant Jonathan S. , Cupchik Gerald
Published: March 2016

We conducted a study to examine how people perceptually encode and then recognize real artworks and constructed design patterns. We first manipulated depth of processing during an incidental perceptual encoding task (Phase 1) wherein participants made both affective/aesthetic and cognitive judgments. For painting stimuli, the contrast was between liking (yes/no) and a search for food in the paintings (present/absent). For design stimuli, the comparison was between liking and relative similarity of figure and ground in terms of color or texture. In Phase 2, we examined the effects of transforming visual features (i.e., color and texture) of the original stimuli on performance in a surprise recognition-memory task. Consistent with a depth-of-processing hypothesis, affective (i.e., liking) processing led to deeper perceptual encoding but, counter to our predictions, did not lead to better performance in the recognition-memory task. This benefit of aesthetic processing in the encoding phase was only observed with artworks but not with constructed design patterns that lacked salient semantic content. Moreover, texture transformations were discerned more accurately than color transformations across the different stimulus sets and tasks. This underscores the primacy of bottom-up processing of elementary stimulus features over top-down instructions to make affective judgments or search for semantic content.
Debt amnesia: Homeowners’ discourses on the financial costs and gains of homebuying
Authors: Soaita Adriana M , Searle Beverley A
Published: March 2016

In Anglo-Saxon societies, homeowners expect to create synergies between the owned house seen as a space of shelter, a place of home, a store of wealth and increasingly, an investment vehicle (and an object of debt). Drawing on interviews with owner-occupiers and on historic house value and mortgage data in Great Britain, we examine the way in which homes’ meanings are negotiated through the subjective calculation of the financial costs and gains of homebuying. We explore homebuyers’ miscalculation of gains, their disregard of inflation and more generally, the inconspicuousness of debt in relation to gains within their accounts, which we term ‘debt amnesia’. We show that the phenomenon of debt amnesia is socially constructed by congruent socio-linguistic, cultural, institutional and ideological devices besides being supported by historic growth in house values. Informed by the ideas of ‘tacit knowledge’ and ‘metaphoric understanding’, we reflect on how the occurrence of the unspoken and the partiality of metaphor reinforce the internalisation of homeownership.
Intimate Worlds
Authors: O’Brien Karen
Published: March 2016

This study investigates wills, inventories, and probate records and identifies high numbers of women reinforcing kinship relations, demonstrating commitment, signifying resilience, and arranging emotional investment in female-centered families. As well as allotting property and possessions, the will also acts as a statement of female emotional strength and declares a woman’s most cherished desires, offering an insight into an important awareness of the way they thought about their personal relationships as well as into the facts and statistics about their life cycles. This definition challenges heteronormative classifications of the structure of the family and intimate relationships and attains a closer understanding of intimacy in early modern families.
Effect of equi-biaxially fabric prestressing on the tensile performance of woven E-glass/polyester reinforced composites
Authors: Mostafa Nawras H , Ismarrubie ZN , Sapuan SM , Sultan MTH
Published: March 2016

The tensile properties of prestressed fabric-reinforced composites have been investigated. A method of applying an equi-biaxially fabric prestressing prior to and during the curing process of a plain-weave fabric composite was performed. A novel fibre prestressing equipment was built to apply and measure the tension load in the principal yarn directions of a fabric. The equi-biaxial fabric prestressing level, ranged from zero to 100 MPa, was used. Tensile tests were performed for the batches with different fabric prestressing levels to estimate the optimum level that gives the maximum tensile performance. The samples were also tested at different orientation angles, precisely from warp to bias direction. Prestressing the fabric enhanced the tensile performance such as elastic modulus and critical stress to first fracture of the composite by 10–20%. Most tensile properties, for instance tensile modulus and critical stress, reached their ultimate values at 50 MPa of prestressing level; however, the tensile-limited toughness was maximum at a level of fabric prestressing of ∼75 MPa.
From Monocultural to Multicultural
Authors: Arbabi Khatereh , Yeh Christine Jean , Mahmud Zuria , Salleh Amla
Published: March 2016

Migration to a new country can be very difficult for adolescents as they are also experiencing a critical transition into adulthood. The current study investigates cross-cultural transition issues facing Iranian immigrant adolescents living in Malaysia. Data were gathered from individual interviews with 100 Iranian adolescents (ages 14-18 years), who have lived in Malaysia for between 2 months and 5 years. Descriptive phenomenology qualitative research was used to explore the impact of the migration process on Iranian adolescents. Analysis revealed five major themes regarding participants’ life experiences in Malaysia: (a) initial expectations; (b) differences in ethnicity, religion, and beliefs; (c) communication barriers; (d) differences in personal evaluations; and (e) psychological issues. The results of this study clearly show that migration for Iranian adolescents in Malaysia is a time of unexpected challenges that may not be experienced by other migrant adolescents in other countries. Our findings contribute to the literature on the unique experiences of Iranian adolescents living in Malaysia and also build on the current research on adolescents who have recently immigrated. In addition, our results further uncover the process of immigration for individuals who are moving from a monocultural society (such as Iran) to a multicultural context (such as Malaysia).
Collagen–carboxymethyl cellulose–tricalcium phosphate multi-lamellar cryogels for tissue engineering applications: Production and characterization
Authors: Odabas Sedat
Published: March 2016

Collagen–carboxymethyl cellulose–tricalcium phosphate cryogels were prepared for diverse biomedical applications. Further chemical and structural characterizations were performed by Fourier transform infrared spectra, thermogravimetric analysis, X-ray crystallography, and scanning electron microscopy. The mechanical properties were tested by unconfined compression test. Moreover, hemocompatibility of the cryogels was also evaluated by basic biochemical blood testing. Chemical and structural analysis results demonstrate the achievement of the cross-linking without any major alteration in collagen and carboxymethyl cellulose with a thermally and structurally stable blend formation. Scanning electron micrographs demonstrate the multi-lamellar formation with macro- and micro-pore compositions which can correlate with water uptake results of the cryogels. Hemocompatibility evaluations exhibited that the cryogels are non-toxic and blood-compatible. The overall results including mechanical testing of these tricalcium phosphate–consisting collagen/carboxymethyl cellulose cryogels may have potential use as a material for hard tissue regeneration.
Synthesis and characterization of crystalline poly(N-(2-hydroxyethyl)aniline) microspheres
Authors: Abd El-Salam HM , Askalany HG
Published: March 2016

Poly( N-(2-hydroxyethyl)aniline) microsphere was prepared in aqueous hydrochloric acid (HCl) in one step, using ammonium persulphate as an oxidant. The effect of monomer, oxidant, HCl concentrations and temperature on polymerization rates was investigated. The data show that polymerization rate increases with increasing reactant concentrations. In addition, the initial rate increases with raising the temperature. The apparent activation energy found was 57.4319 kJ/mole. Also, Δ H* and Δ S* found were 55.0691 kJ/mole and 78.3662 J/mole K respectively. Infrared and proton nuclear magnetic resonance spectroscopies, thermogravimetric analysis, X-ray diffraction, scanning electron microscopy and elemental analysis characterize the obtained polymer sample to confirm the suggested structure. The mechanism of the polymerization reaction are discussed.
Unilateral contact condition enhanced with squeeze film modelling in automotive differentials
Authors: Virlez Geoffrey , Brüls Olivier , Duysinx Pierre , Géradin Michel , Cardona Alberto
Published: March 2016

The dynamic behaviour of automotive drivetrains is significantly influenced by contacts occurring between the various parts. In this paper, a three-dimensional formulation is proposed to model unilateral and frictional contact conditions between two rigid planar rings. The magnitude of the contact force is determined by a penalty method. In a second step, a simple squeeze film model is developed to account for the damping effect produced by the lubricating oil filling the gap between the two contacting bodies. The relevance and the accuracy of these models are illustrated through the global multibody modelling of a TORSEN differential.
Target classification layer design via vehicle-to-vehicle communication
Authors: Kim Changseb , Park Jongwon , Huh Kunsoo
Published: March 2016

Recently, an active safety system based on vehicle-to-vehicle communication was introduced to minimize the threat of car accidents on the road and to overcome the limitations of the current sensor-based advanced driver assist system. In order to implement the system based on vehicle-to-vehicle communication, target classification is the key layer to be developed. In this study, based on the transmitted path history of the remote vehicles, the road geometry around the host vehicle is reconstructed without in-vehicle sensors such as vision cameras. A tracking algorithm for the remote vehicle is formulated in order to predict its position continuously by using an extended Kalman filter. A local map is obtained with an outlier filter, and the target classification algorithm is designed from vehicle-to-vehicle communication data. The proposed algorithms are validated by simulations and experiments carried out using test vehicles.
Factors associated with thrombosis in pediatric patients with systemic lupus erythematosus
Authors: Driest K D , Sturm M S , O’Brien S H , Spencer C H , Stanek J R , Ardoin S P ,   for the CARRA Registry Investigators
Published: March 2016

Objective

The risk of thrombosis is increased in patients with systemic lupus erythematosus (SLE). Few studies have assessed factors associated with thrombosis within the pediatric SLE (pSLE) population. We sought to better characterize these associated factors in pSLE patients using the Childhood Arthritis & Rheumatology Research Alliance (CARRA) registry.

Methods

Within the CARRA registry, patients with a history of thrombosis were compared to those without. Univariate logistic regression was used to calculate odds ratios. A multivariable logistic regression model was conducted that included variables from the univariate analysis that had a p value < 0.10 and other variables identified as clinically significant from published literature.

Results

Among the 979 pSLE patients in the CARRA registry, 24 (2.5%) patients had a history of arterial thrombosis and 35 (3.6%) of venous thrombosis. In the univariate analysis, the odds ratio of having a thrombotic event were found to be significantly higher in patients with a history of vasculitis, avascular necrosis (AVN), or antiphospholipid antibody (aPL). Similar results were found for vasculitis, AVN, and aPL in the multivariable analysis.

Conclusion

Our study of pSLE patients suggests that vasculitis, positive APL, and AVN are associated with thrombotic events in this population.
Deconstructing Corruption
Authors: Borooah Vani K.
Published: March 2016

This article employs a unique set of data to paint a quantitative picture of the nature of corruption in rural India by computing the proportion of approaches to various officials that resulted in a bribe, thus providing a ranking of officials by ‘corruption rate’; examining the size of the bribe associated with the different reasons for approaching officials; showing that in the case of officials who received approaches for a variety of purposes, the same official could charge a different bribe depending on the nature of the work to be done; testing whether corruption in India has increased over time and finally, by using the method of inequality decomposition, analyzing the extent to which observed inequality in the bribes paid by different households could be due to the facts that (i) different households paid differently for the same purpose and (ii) different purposes required bribes of different amounts, with each household paying the same amount for a particular purpose. The article shows that of the occasions on which households approached officials for getting their work done, 18 per cent resulted in a bribe, averaging `147, being paid. Not only that, every area of interaction between citizens and officials to get some work done resulted in someone, somewhere having to pay a bribe. Even the provision of basic facilities, such as drinking water and sanitation, was not exempted. Compounding this, we find systematic evidence that corruption in India has increased in the past 15 years. The existence of corruption is overlaid with a degree of inequality: The size of the bribe varied depending upon the official approached and the purpose of the approach.
Validation and Cross-Cultural Adaptation of a Chinese Version of the Emotional and Social Dysfunction Questionnaire in Stroke Patients
Authors: Huang Hui-Chuan , Shyu Meei-Ling , Lin Mei-Feng , Hu Chaur-Jong , Chang Chien-Hung , Lee Hsin-Chien , Chi Nai-Fang , Chang Hsiu-Ju
Published: March 2016

The objectives of this study were to develop a cross-cultural Chinese version of the Emotional and Social Dysfunction Questionnaire (ESDQ-C) and test its validity and reliability among Chinese-speaking stroke patients. Various methods were used to develop the ESDQ-C. A cross-sectional study was used to examine the validity and reliability of the developed questionnaire, which consists of 28 items belonging to six factors, anger, helplessness, emotional dyscontrol, indifference, inertia and fatigue, and euphoria. Satisfactory convergence and known-group validities were confirmed by significant correlations of the ESDQ-C with the Profile of Mood States–Short Form ( p < .05) and with the Hospital Anxiety and Depression Scale ( p < .05). The internal consistency was represented by Cronbach’s alpha, which was .96 and .79 to .92 for the entire scale and subscales, respectively. Appropriate application of the ESDQ-C will be helpful to identify critical adjustment-related types of distress and patients who experience difficulty coping with such distress.
A symplectic Brezis–Ekeland–Nayroles principle
Authors: Buliga Marius , de Saxcé Géry
Published: March 2016

We propose a modification of the Hamiltonian formalism which can be used for dissipative systems. This work continues a previous work on Hamiltonian inclusions and advances by the introduction of a symplectic version of the Brezis–Ekeland–Nayroles principle. As an application we show how standard plasticity can be treated in our formalism.
Nonlinear elasticity with limiting small strain for cracks subject to non-penetration
Authors: Itou Hiromichi , Kovtunenko Victor A , Rajagopal Kumbakonam R
Published: March 2016

A major drawback of the study of cracks within the context of the linearized theory of elasticity is the inconsistency that one obtains with regard to the strain at a crack tip, namely it becoming infinite. In this paper we consider the problem within the context of an elastic body that exhibits limiting small strain wherein we are not faced with such an inconsistency. We introduce the concept of a non-smooth viscosity solution which is described by generalized variational inequalities and coincides with the weak solution in the smooth case. The well-posedness is proved by the construction of an approximation problem using elliptic regularization and penalization techniques.
Effective properties of thermoperistatic random structure composites: Some background principles
Authors: Buryachenko Valeriy A
Published: March 2016

The basic feature of the peridynamic model considered here is a continuum description of a material’s behavior as the integrated nonlocal force interactions between infinitesimal particles. In contrast to classical local and nonlocal theories, the peridynamic equation of motion introduced by Silling ( J Mech Phys Solids 2000; 48: 175–209) is free of any spatial derivatives of displacement. A theory of thermoelastic composite materials (CMs) with nonlocal thermoperistatic properties of multiphase constituents of arbitrary geometry is analyzed for statistically homogeneous CMs subjected to homogeneous loading. A generalization of the Hill’s equality to peristatic composites is proved. The classical representations of effective elastic moduli through the mechanical influence functions for elastic CMs are generalized to the case of peristatics, and the energetic definition of effective elastic moduli is proposed. The general results establishing the links between the effective properties (effective elastic moduli, effective thermal expansion) and the corresponding mechanical and transformation influence functions are obtained by the use of the decomposition of local fields into load and residual fields. Effective properties of thermoperistatic CM are expressed through the introduced local stress polarization tensor averaged over the extended inclusion phase. A detected similarity of results for both the peristatic and locally elastic composites is explained fundamentally, as the methods used for obtaining the results widely exploit the Hill’s condition and the self-adjointness of the stress operator. However, the representation of effective properties for composites with both the local thermoelastic and nonlocal thermoperistatic properties do not always coincide. Therefore, the representation of effective eigenfields through mechanical influence functions generalizing Levin’s representation does not in general hold for thermoperistatic CMs; this is demonstrated for a one-dimensional numerical example.
Simultaneous early-onset immune thrombocytopenia and autoimmune thyroid disease following alemtuzumab treatment in relapsing-remitting multiple sclerosis
Authors: Obermann Mark , Ruck Tobias , Pfeuffer Steffen , Baum Julia , Wiendl Heinz , Meuth Sven G
Published: March 2016

Objective:

We report two cases of patients with relapsing-remitting multiple sclerosis with early-onset thrombocytopenia and autoimmune thyroid disease after the first treatment course with 60-mg alemtuzumab.

Methods:

Case series and review of the literature.

Results:

Both patients showed severe thrombocytopenia with platelet counts of 2 × 109 and 11 × 109/L, respectively, as well as increased thyroid antibodies within only a few months after initiating alemtuzumab treatment (11 and 9 months). Both patients responded considerably well to medical therapy including corticosteroids and intravenous immunoglobulins with slow platelet recovery over several weeks. Interestingly, both patients were previously treated with fingolimod and showed a marked lymphocytopenia that led to discontinuation.

Conclusion:

These cases emphasize the necessity of careful clinical surveillance and proper education of patients treated with alemtuzumab as proposed by the safety-monitoring program. Previous severe lymphocytopenia under therapy with other disease-modifying therapies may be a risk factor for the development of immune thrombocytopenia.
The early historical construction of journalism’s gatekeeping role
Authors: Vos Tim P , Finneman Teri
Published: March 2016

This study analyzes journalistic discourse about journalism’s gatekeeping role in the late 19th and early 20th centuries. The intent is to understand how the notions of newsworthiness, news selection, and news judgment came to be expressed in normative terms in the journalistic field. The study finds discursive strategies that explained news judgment in terms of a special skill that journalists possessed, that downplayed judgment while shifting focus to the external qualities of events, and that explained news judgment in terms of the social and economic values of the information provided. The findings demonstrate how journalistic capital is formed in the context of professionalization efforts.
Hydrogen Proton Magnetic Resonance Spectroscopy in Multidomain Amnestic Mild Cognitive Impairment and Vascular Cognitive Impairment Without Dementia
Authors: Chen Shuang-Qing , Cai Qing , Shen Yu-Ying , Xu Chuan-Xiao , Zhou Hua , Zhao Zhong
Published: March 2016

To investigate the value of hydrogen proton magnet resonance spectroscopy (1H-MRS) in the differential diagnosis of multiple-domain amnestic mild cognitive impairment (M-aMCI) and vascular cognitive impairment with no dementia (VCIND); 1H-MRS was performed in patients with M-aMCI and VCIND. The level was determined for N-acetylaspartate (NAA), glutamate (Glu), inositol (mI), choline (Cho), and creatine (Cr). Compared with the normal control group, the NAA–Cr ratio in all regions studied was significantly lower in the M-aMCI and VCIND groups. The Glu–Cr ratio in the posterior cingulate gyrus of the M-aMCI group was significantly lower than in the VCIND. The mI–Cr ratio in the frontal white matter of the VCIND was significantly higher than in the M-aMCI group. In the white matter adjacent to the lateral ventricles, the Cho–Cr ratio was significantly higher in the VCIND than the M-aMCI. Our results suggested 1H-MRS is an effective method in the differential diagnosis of M-aMCI and VCIND.
Factors Affecting Long-Term Results of Above-Knee Femoropopliteal Bypass
Authors: De Santis Francesco , Pattaro Cristian , Mani Gabriele , Pramstaller Peter Paul , Loreni Giorgio , Martini Guido
Published: March 2016

Introduction:

The aim of this study was to assess whether individual patients’ or bypass characteristics may influence long-term results of prosthetic above-knee femoropopliteal bypasses in patients with claudication in today’s endovascular era.

Methods:

Seventy-one consecutivee Expanded Polytetrafluoroethylene (e-PTFE) bypasses were considered. All patients presented a debilitating claudication. Patency of grafts was achieved by Kaplan-Meier method. The association between individual patients’ or graft characteristics and primary patency (PP) or secondary patency (SP) was assessed via Cox regression models.

Results:

An immediate technical success was achieved in all cases. No patient was lost during follow-up (8-90 months, median = 34 months). The median PP was 48 months. Occlusion occurred in 32 bypasses (45%). Eight (25%) of these were treated conservatively. Fifty-two bypasses (73%) were still patent at the end of follow-up, and 13 (25%) of these had been submitted to one or more surgical revisions. There were 2 graft infections. Of 17 (25%) patients with occluded graft at the end of follow-up, 2 (2.8%) had significant aggravation followed by limb loss. The PP was directly influenced by undetected minor distal anastomosis technical defects (hazard ratio [HR] = 5.89, P value = .000002), popliteal artery size (HR = 0.62, P value = 0.007), and distal anastomosis angle ≥40° (HR = 5.55, P value = .003). The SP was associated strictly to technical defects (HR = 11.08, P value = .000007). Multivariable analyses confirmed the influence of technical defects (HR = 6.42, P value = .000003) and anastomosis angle (HR = 1.05, P value = .009) on PP and that of technical defects on SP (HR = 10.84, P value = .00003). A significantly shorter SP was also observed after a previous failed endovascular treatment on the superficial femoral artery (HR = 3.73, P value = .02).

Conclusion:

An adequate arterial size, an ideal anastomotic angle, and the absence of minor, technical defects have a major role in prosthetic above-knee femoropopliteal bypass long-term outcome. A previous, failed endovascular procedure on the superficial femoral artery could markedly alter the natural history of patients with claudication because this approach seems to have a detrimental effect on long-term outcome of grafts needing surgical revisions
Dyslipidemia Part 1—Review of Lipid Metabolism and Vascular Cell Physiology
Authors: Helkin Alex , Stein Jeffery J. , Lin Stacey , Siddiqui Sufyan , Maier Kristopher G. , Gahtan Vivian
Published: March 2016

Dyslipidemia, more specifically, high-serum low-density lipoproteins and low-serum high-density lipoproteins, are known risk factors for cardiovascular disease. The current clinical treatment of dyslipidemia represents the outcome of a large body of fundamental basic science research on lipids, lipid metabolism, and the effects of different lipids on cellular components of the artery, inflammatory cells, and platelets. In general, lower density lipids activate intracellular pathways to increase local and systemic inflammation, monocyte adhesion, endothelial cell dysfunction and apoptosis, and smooth muscle cell proliferation, resulting in foam cell formation and genesis of atherosclerotic plaque. In contrast, higher density lipids prevent or attenuate atherosclerosis. This article is part 1 of a 2-part review, with part 1 focusing on lipid metabolism and the downstream effects of lipids on the development of atherosclerosis, and part 2 on the clinical treatment of dyslipidemia and the role of these drugs for patients with arterial disease exclusive of the coronary arteries.
Robotic-Assisted Endovascular Pulmonary Artery Foreign Body Retrieval
Authors: Wolujewicz Michael
Published: March 2016

As intravascular robotics technology continues to evolve, so do the potential applications. The present case describes the use of the Magellan Robotic System within the pulmonary artery. A 61-year-old female was referred for retrieval of a transected port catheter, which had embolized into the pulmonary artery. After a failed attempt using a conventional technique, retrieval was ultimately successful with assistance of the Magellan system. The unique navigational capabilities and stability of the system may make it a valuable tool in pulmonary artery interventions.
Collaboration and Negotiation
Authors: Frates Elizabeth Pegg , Bonnet Jonathan
Published: March 2016

Counseling patients on behavior change is an important skill that traditional medical training does not emphasize. Most practitioners are trained in the expert approach to handle problems, which is useful in the acute care setting. However, in the case of chronic disease, a coach approach is more effective. This approach allows the patient to reflect on his or her own motivators for change as well as obstacles hindering the change. Changing from the expert approach to the coach approach is contingent on the lifestyle medicine practitioner sharing information when the patient is ready to receive it, listening mindfully, asking open-ended questions, treating problems as opportunities to learn and grow, and encouraging patients to take responsibility for their actions. By collaborating with the patient, the practitioner can guide patients to find solutions to the problems they are facing and foster an environment that leads patients to self-discovery, accepting responsibility for their behaviors, and ultimately, achieving goals that result in healthier daily habits. As a framework and a guide, lifestyle medicine practitioners can use a 5-step cycle of collaboration and a ladder of behavior change when working with patients on behavior change.
Mongersen, an oral Smad7 antisense oligonucleotide, in patients with active Crohn’s disease
Authors: Ardizzone Sandro , Bevivino Gerolamo , Monteleone Giovanni
Published: March 2016

In Crohn’s disease (CD), the tissue-damaging inflammation is sustained by defects of counter-regulatory mechanisms, which normally inhibit immune-inflammatory signals and promote repair of mucosal injury. In particular, in inflamed gut of CD patients there are elevated levels of Smad7, an intracellular protein that inhibits the function of transforming growth factor (TGF)-β1. Knockdown of Smad7 with a specific antisense oligonucleotide, named mongersen, restores TGF-β1 activity thus leading to suppression of inflammatory pathways and resolution of colitis in mice. Consistently, oral administration of mongersen to patients with active CD induces clinical remission.

In this article, we review the available data supporting the pathogenic role of Smad7 in CD and discuss the results of recent phase I and II trials assessing the efficacy and safety of mongersen in CD patients.
Managing Use of Over-the-Counter Medications in the School Setting
Authors: Wallace Anne C.
Published: March 2016

The use of over-the-counter (OTC) medications in our unique school setting has proven to be a cost-effective and valuable tool in keeping students in the classroom and prepared to learn. Disruptions in educational time due to minor complaints become frustrating for students and teachers. Utilizing the assessment skills of the school nurse and treatment options available through the use of OTC medications decreases those disruptions and protects the educational time. The opportunity to increase student understanding and health literacy regarding the correct use of OTC medications is a valuable way to protect the health of students. Lessons learned in the residential setting may have application to other school settings.
Making Global Health Rotations a Two-Way Street
Authors: Pitt Michael B. , Gladding Sophia P. , Majinge Charles R. , Butteris Sabrina M.
Published: March 2016

As US residency programs are increasingly offering global health electives for their trainees, there is a growing call for these opportunities to include bidirectional exchanges—where residents from both the US and international partner institutions rotate at the other’s site. Curricular, logistical, and funding challenges of hosting residents from an international site may be barriers to developing these programs. In this report, the authors describe an 8-year experience of a US institution hosting residents from a resource-limited international partner and provide a framework for others institutions to develop bidirectional exchanges. They also report the visiting international residents’ perceptions of the impact of the exchange on their clinical practice, teaching, career paths, and their home institution.
Reconstruction of an Ordovician seafloor volcanohydrothermal system: a case study from the Copper Coast, southeastern Ireland using field, geochemical and fluid inclusion data
Authors: Breheny C. , Moore K. R. , Costanzo A. , Feely M.
Published: March 2016

Volcanic rocks in south County Waterford include flow-top hyaloclastite, pillow lavas and peperite, which are formed typically by sub-aqueous eruption or intrusion into unconsolidated sediment. Element mobility in wet sediment during emplacement of volcanic intrusions was reconstructed on a variety of spatial scales using bulk-rock and mineral analysis. Magma-sediment and magma-water interactions enhanced hydrothermal alteration. The chemistry of chlorite was a function of mixing between an Fe-rich magmatic fluid and a Mg-rich meteoric fluid. Chlorite geothermometry yields temperatures of formation between 230 and 388°C compatible with other metamorphic indicators. Fluid inclusion microthermometric data from genetically-related mineralized quartz veins reveal a hydrothermal vein mineralization event that occurred at lower temperatures during the end stage of volcanic activity. A convection driven mixing trend reflects the trapping of co-existing brine with entrained seawater concomitant with, the late stages of emplacement of the Bunmahon Volcano intrusions.
Ferrostalderite, CuFe2TlAs2S6, a new mineral from Lengenbach, Switzerland: occurrence, crystal structure, and emphasis on the role of iron in sulfosalts
Authors: Biagioni Cristian , Bindi Luca , Nestola Fabrizio , Cannon Ralph , Roth Philippe , Raber Thomas
Published: March 2016

The new mineral species ferrostalderite, CuFe2TlAs2S6, was discovered in the Lengenbach quarry, Binn Valley, Wallis, Switzerland. It occurs as minute, metallic, black, equant to prismatic crystals, up to 50 mu;m, associated with dolomite, realgar, baumhauerite (?) and pyrite. Minimum and maximum reflectance data for COM wavelengths in air are [λ (nm): R (%)]: 471.1: 24.2/25.4; 548.3: 23.7/24.7; 586.6: 22.9/23.8; 652.3: 21.0/22.0. Electron microprobe analyses give (wt.%): Cu 6.24(25), Ag 4.18(9), Fe 9.95(83), Zn 4.46(91), Hg 1.22(26), Tl 26.86(62), As 19.05(18), Sb 0.63(6),S 25.39(47), total 97.98(72). On the basis of 12 atoms per formula unit, the chemical formula of ferrostalderite is Cu0.75(2)Ag0.30(1)Fe1.36(10)Zn0.52(11)Hg0.05(1)Tl1.00(1)[As1.94(4)Sb0.04(1)]∑1.98(4)S6.04(4). The new mineral is tetragonal, space group I4̄2 m, with a = 9.8786(5), c = 10.8489(8) Å, V = 1058.71(11) Å3, Z = 4. The main diffraction lines of the calculated powder diagram are [d (in Å), intensity, hkl]: 4.092, 70, 211; 3.493, 23, 220; 3.396, 35, 103; 3.124, 17, 310; 2.937, 100, 222; 2.656, 19, 321; 2.470, 19, 400; 2.435, 33, 303. The crystal structure of ferrostalderite has been refined by Xray single-crystal data to a final R1= 0.050, on the basis of 1169 reflections with F0 > 4σ(F0). It shows a three dimensional framework of (Cu,Fe)-centred tetrahedra (1M1 + 2 M2), with channels parallel to [001] hosting disymmetric TlS6and (As,Sb)S3 polyhedra. Ferrostalderite is derived from its isotype stalderiteM1CuM2Zn2TlAs2S6through the homovalent substitution M2Zn2+ → M2Fe2+. The ideal crystal-chemical formula of ferrostalderite isM1CuM2Fe2TlAs2S6.
Geology and mineralogy of Li mineralization in the Central Iberian Zone (Spain and Portugal)
Authors: Roda-Robles E. , Pesquera A. , Gil-Crespo P. P. , Vieira R. , Lima A. , Garate-Olave I. , Martins T. , Torres-Ruiz J.
Published: March 2016

Lithium mineralization is common in the Central Iberian Zone and, to a lesser extent, in the Galizia-Trás-OsMontes Zone of Spain and Portugal, occurring along a ∼500 km-long NNW-SSE striking belt. There are different styles of Li mineralization along this belt; they are mainly associated with aplite-pegmatite bodies and, to a much lesser extent, with veins of quartz and phosphate. Lithium mineralization in the Central Iberian Zone may be classified into four types: aplite-pegmatite dykes occurring in pegmatitic fields, Li mineralization associated with leucogranitic cupolas, beryl-phosphate pegmatites and quartz-montebrasite veins. The main Li minerals of these bodies include Li-mica, spodumene and/or petalite in the pegmatitic fields and leucogranitic cupolas; triphylite–lithiophilite in the beryl-phosphate pegmatites, and amblygonite–montebrasite in the quartz-montebrasite veins. The origin of these different styles of mineralization is considered to be related to differentiation of peraluminous melts, which were generated by partial melting of metasedimentary rocks during the Variscan orogeny. On the basis of paragenesis and chemical composition, the pegmatitic fields and Li mineralization associated with granitic cupolas record the highest fractionation levels, whereas the beryl-phosphate pegmatites and quartz-montebrasite veins show lower degrees of fractionation. There are a number of textural and mineralogical indicators for Li exploration in the Central Iberian Zone and in the Galizia-Trás-Os-Montes Zone, with the highest economic potential for Li being in the pegmatite fields.
Comprehensive mutational profiling of core binding factor acute myeloid leukemia
Authors: Duployez Nicolas , Marceau-Renaut Alice , Boissel Nicolas , Petit Arnaud , Bucci Maxime , Geffroy Sandrine , Lapillonne Hélène , Renneville Aline , Ragu Christine , Figeac Martin , Celli-Lebras Karine , Lacombe Catherine , Micol Jean-Baptiste , Abdel-Wahab Omar , Cornillet Pascale , Ifrah Norbert , Dombret Hervé , Leverger Guy , Jourdan Eric , Preudhomme Claude
Published: March 2016

Key Points

Recurrent mutations in chromatin modifiers and cohesin were observed in t(8;21) AML, but not inv(16) AML. t(8;21) AML patients with mutations in kinase signaling plus chromatin modifiers or cohesin members had the highest risk of relapse.
A Human Variant of Glucose-Regulated Protein 94 That Inefficiently Supports IGF Production
Authors: Marzec Michal , Hawkes Colin P. , Eletto Davide , Boyle Sarah , Rosenfeld Ron , Hwa Vivian , Wit Jan M. , van Duyvenvoorde Hermine A. , Oostdijk Wilma , Losekoot Monique , Pedersen Oluf , Yeap Bu Beng , Flicker Leon , Barzilai Nir , Atzmon Gil , Grimberg Adda , Argon Yair
Published: March 2016

IGFs are critical for normal intrauterine and childhood growth and sustaining health throughout life. We showed previously that the production of IGF-1 and IGF-2 requires interaction with the chaperone glucose-regulated protein 94 (GRP94) and that the amount of secreted IGFs is proportional to the GRP94 activity. Therefore, we tested the hypothesis that functional polymorphisms of human GRP94 affect IGF production and thereby human health. We describe a hypomorphic variant of human GRP94, P300L, whose heterozygous carriers have 9% lower circulating IGF-1 concentration. P300L was found first in a child with primary IGF deficiency and was later shown to be a noncommon single-nucleotide polymorphism with frequencies of 1%–4% in various populations. When tested in the grp94−/− cell-based complementation assay, P300L supported only approximately 58% of IGF secretion relative to wild-type GRP94. Furthermore, recombinant P300L showed impaired nucleotide binding activity. These in vitro data strongly support a causal relationship between the GRP94 variant and the decreased concentration of circulating IGF-1, as observed in human carriers of P300L. Thus, mutations in GRP94 that affect its IGF chaperone activity represent a novel causal genetic mechanism that limits IGF biosynthesis, quite a distinct mechanism from the known genes in the GH/IGF signaling network.