bluuebunny/crossref_metadata_2025 huggingface dataset:
Promoting oral health practice among patients with diabetes attending primary health care clinics
Authors: Aljaber Abeer , Al-Surimi Khaled
Published: June 2016

The oral public health program for patients with diabetes was initiated by Saudi Arabia Ministry of Health (MoH) based on international quality standard to control the severity of oral disease in patients with diabetes through improving the accessibility of patients to dental clinics in primary health care centers (PHCC). This program intends to deliver oral health care (OHC) for each patient with diabetes at least one visit every six months. However, we found that more than 90% of patients with diabetes that visited prince Mohammed bin Saud PHCC in Riyadh do not get their regular dental check up every six months. We developed a quality improvement project (QIP) using the quality improvement model to activate MoH oral health program for patients with diabetes visiting prince Mohamed bin Saud PHCC.

The aim of our QIP was to increase number of patients with diabetes receiving their regular oral health check up during the PHC visit. The quality team tested two simple improvement ideas. The first idea was having the dentist signature on appointment request. The testing of the first idea led to the second idea, that both physician and dentist should sign the referral form. After running several PDSA cycles to test these interventions ideas, we found the number of patients with diabetes seen in dental clinic had increased dramatically compared with the baseline assessment. We conclude that the idea of signing the referral form by both physician and dentist is a practical and simple strategy to be executed and has a direct impact on the patient clinical flow between clinics.
Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia: a developing country perspective
Authors: Conner J Michael , Aviles-Robles Martha J , Asdahl Peter H , Zhang Fang Fang , Ojha Rohit P
Published: June 2016

Objectives

The prevalence of malnourishment among paediatric cancer patients undergoing chemotherapy in developing countries is poorly documented despite greater potential for malnourishment in such settings. We aimed to estimate the prevalence of malnourishment among paediatric cancer patients in Mexico City, and assess the association between malnourishment and length of hospital stay.

Methods

Individuals eligible for this study were paediatric cancer patients (aged <18 years) admitted to Hospital Infantil de Mexico Federico Gomez (Mexico City) with febrile neutropaenia. Our exposure of interest, malnourishment, was defined as an age-adjusted and sex-adjusted z-score<−2 (ie, 2 SDs below the expected mean of the WHO reference population). We estimated time ratios (TRs) and 95% confidence limits (CLs) for the association between malnourishment and length of hospital stay.

Results

Our study population comprised 111 paediatric cancer patients with febrile neutropaenia, of whom 71% were aged <10 years and 52% were males. The prevalence of malnourishment was 14%, equal to a 530% (standardised morbidity ratio=6.3; 95% CL 3.7, 10) excess of malnourishment compared with the world reference population. The median length of hospital stay for malnourished patients was 15 days, which corresponded with a 50% (TR=1.5, 95% CL 1.0, 2.3) relative increase in length of stay compared with patients who were not malnourished. Patients with body mass indices equal to the mean of the world reference population had the shortest length of stay.

Conclusions

Future studies should explore potential interventions for malnourishment to reduce the length of hospital stay or other established adverse consequences of malnourishment.
Systematic review and meta-analysis of optimal P2Y12blockade in dual antiplatelet therapy for patients with diabetes with acute coronary syndrome
Authors: Rossington Jennifer A , Brown Oliver I , Hoye Angela
Published: June 2016

Background

Patients with diabetes are at increased risk of acute coronary syndromes (ACS) and their mortality and morbidity outcomes are significantly worse following ACS events, independent of other comorbidities. This systematic review sought to establish the optimum management strategy with focus on P2Y12blockade in patients with diabetes with ACS.

Methods

MEDLINE (1946 to present) and EMBASE (1974 to present) databases, abstracts from major cardiology conferences and previously published systematic reviews were searched to June 2014. Relevant randomised control trials with clinical outcomes for P2Y12inhibitors in adult patients with diabetes with ACS were scrutinised independently by 2 authors with applicable data was extracted for primary composite end point of cardiovascular death, myocardial infarction (MI) and stroke; enabling calculation of relative risks with 95% CI with subsequent direct and indirect comparison.

Results

Four studies studied clopidogrel in patients with diabetes, with two (3122 patients) having primary outcome data showing superiority of clopidogrel against placebo with RR0.84 (95% CI 0.72–0.99). Irrespective of management strategy, the newer agents prasugrel (2 studies) and ticagrelor (1 study) had a lower primary event rate compared with clopidogrel; RR 0.80 (95% CI 0.66 to 0.97) and RR 0.89 (95% CI 0.77 to 1.02), respectively. When ticagrelor was indirectly compared with prasugrel, there was a trend to an improved primary outcome with prasugrel (RR 1.11 (95% CI 0.94 to 1.31)) particularly in those managed with percutaneous coronary intervention (PCI) (RR 1.23 (95% CI 0.95 to 1.59)). Prasugrel demonstrated a statistical superiority with prevention of further MI with RR 1.48 (95% CI 1.11 to 1.97). This was not at the expense of increased major thrombolysis in MI (TIMI) bleeding rates RR 0.94 (95% CI 0.59 to 1.51).

Conclusions

This meta-analysis shows the addition of a P2Y12inhibitor is superior to placebo, with a trend favouring the use of prasugrel in patients with diabetes with ACS, particularly those undergoing PCI.
A prognostic scoring system for arm exercise stress testing
Authors: Xie Yan , Xian Hong , Chandiramani Pooja , Bainter Emily , Wan Leping , Martin Wade H
Published: June 2016

Objective

Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals.

Methods

In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64.1 (11.1) years. (mean (SD)) between 1997 and 2002. From multivariate Cox models, arm exercise scores were developed for prediction of 5-year and 12-year all-cause and cardiovascular mortality and 5-year cardiovascular mortality or myocardial infarction (MI).

Results

Arm exercise capacity in resting metabolic equivalents (METs), 1 min heart rate recovery (HRR) and ST segment depression ≥1 mm were the stress test variables independently associated with all-cause and cardiovascular mortality by step-wise Cox analysis (all p<0.01). A score based on the relation HRR (bpm)+7.3×METs−10.5×ST depression (0=no; 1=yes) prognosticated 5-year cardiovascular mortality with a C-statistic of 0.81 before and 0.88 after adjustment for significant demographic and clinical covariates. Arm exercise scores for the other outcome end points yielded C-statistic values of 0.77–0.79 before and 0.82–0.86 after adjustment for significant covariates versus 0.64–0.72 for best fit pharmacological myocardial perfusion imaging models in a cohort of 1730 veterans who were evaluated over the same time period.

Conclusions

Arm exercise scores, analogous to the Duke Treadmill Score, have good power for prediction of mortality or MI in patients who cannot perform leg exercise.
Cardiovascular MR T2-STIR imaging does not discriminate between intramyocardial haemorrhage and microvascular obstruction during the subacute phase of a reperfused myocardial infarction
Authors: Hansen Esben Søvsø Szocska , Pedersen Steen Fjord , Pedersen Steen Bønløkke , Kjærgaard Uffe , Schmidt Nikolaj Hjort , Bøtker Hans Erik , Kim Won Yong
Published: June 2016

Objective

Microvascular obstruction (MVO) and intramyocardial haemorrhage (IMH) are known complications of myocardial ischaemia-reperfusion injury. Whereas MVO is an established marker for a poor clinical outcome, the clinical significance of IMH remains less well defined. Cardiovascular MR (CMR) and T2 weighted short tau inversion recovery (T2-STIR) imaging have been used to detect IMH and to explore its clinical importance. IMH is typically identified within the area-at-risk as a hypointense signal core on T2-STIR images. Because MVO will also appear as a hypointense signal core, T2-STIR imaging may not be an optimal method for assessing IMH. In this study, we sought to investigate the ability of T2-STIR to discriminate between MVO with IMH in a porcine myocardial ischaemia-reperfusion model that expressed MVO with and without IMH.

Method

MVO with and without IMH (defined from both macroscopic evaluation and T1 weighted CMR) was produced in 13 pigs by a 65-min balloon occlusion of the mid left anterior descending artery, followed by reperfusion. Eight days after injury, all pigs underwent CMR imaging and subsequently the hearts were assessed by gross pathology.

Results

CMR identified MVO in all hearts. CMR and pathology showed that IMH was present in 6 of 13 (46%) infarcts. The sensitivity and specificity of T2-STIR hypointense signal core for identification of IMH was 100% and 29%, respectively. T2-values between hypointense signal core in the pigs with and without IMH were similar (60.4±3 ms vs 63.0±4 ms).

Conclusions

T2-STIR did not allow identification of IMH in areas with MVO in a porcine model of myocardial ischaemic/reperfusion injury in the subacute phase of a reperfused myocardial infarction.
Cutaneous vitiligo associated with hypovitaminosis D in Malayan flying foxes (Pteropus vampyrus) and Island flying foxes (Pteropus hypomelanus)
Authors: Stringer Elizabeth , Han Sushan , Larsen R Scott
Published: June 2016

Eight Malayan flying foxes (Pteropus vampyrus) and three Island flying foxes (Pteropus hypomelanus) presented for varying degrees of skin depigmentation of the wing membranes, face and feet. Lesions were observed six months after bats were placed in a newly constructed indoor‐only exhibit. Serum 25‐hydroxyvitamin D (25‐OH‐D) concentrations were low relative to concentrations from bats at another zoological institution. Skin biopsies indicated segmental loss of melanin pigment within the epidermis; skin scrapes and culture results were negative for infectious agents. A diagnosis of cutaneous vitiligo was made. All bats were removed from the exhibit and housed in an off‐exhibit holding area that contained UV‐B lights. Bats were regularly seen basking and slow repigmentation was noted over several months. Four months after initial presentation, serum 25‐OH‐D concentrations were significantly higher than original concentrations. Based on these results, these two species of diurnal bat should have access to UV‐B light.
Out Subword-Free Languages and Its Subclasses
Authors: Tian Jing , Shao Yong , Zhao Xianzhong
Published: June 2016

Let [Formula: see text] be a finite alphabet and [Formula: see text] the set of all words over [Formula: see text]. A subword-free language (also known as a hypercode) is an independent subset of [Formula: see text] with respect to the embedding order (denoted by [Formula: see text]) on [Formula: see text]. In this paper we introduce three subsets of the partial order [Formula: see text], and study three subclasses of languages defined by these subsets. They are out subword-free languages, left subword-free languages and right subword-free languages. The properties of these languages are established for determining their combinatorial and algebraic structures. By equipping them with two binary operations, respectively, all these classes of languages form semilattice-ordered semigroups. It is shown that they are freely generated by [Formula: see text] in three subvarieties of semilattice-ordered semigroups, respectively. It is also shown that the word problems for these free algebras are solvable.
Some Properties of Extractable Codes and Insertable Codes
Authors: Kunimochi Yoshiyuki
Published: June 2016

This paper deals with insertability and mainly extractablity of codes. A code C is called insertable (or extractable) if the free submonoid C* generated by C satisfies if z, [Formula: see text] implies [Formula: see text] (or z, [Formula: see text] implies [Formula: see text]). We show that a finite insertable code is a full uniform code. On the other hand there are many finite extractable codes which are not full uniform codes. We cannot still characterize the structures of infinite extractable codes. Here we give some results on the class of infix extractable codes. First, we consider a necessary and sufficient condition whether a given infix code C is extractable or not by using the syntactic graph of the code. Secondly, we investigate the extractability for the families of other related bifix codes. We newly define the bifix codes, called e(m)-codes and [Formula: see text]-codes, and refer to the extractability of them.
One-Way Jumping Finite Automata
Authors: Chigahara Hiroyuki , Fazekas Szilárd Zsolt , Yamamura Akihiro
Published: June 2016

We propose the one-way jumping finite automaton model, restricting the jumping relation of the recently introduced jumping finite automaton so that the machine can only jump over symbols it cannot process in its current state. The reading head of a one-way jumping finite automaton moves deterministically in one direction within the input word, whereas movement of the reading head of jumping finite automaton is non-deterministic. The class of languages accepted by one-way jumping finite automata is different from that of jumping finite automata, in particular, it includes all regular languages, as opposed to the latter. We study one-way jumping finite automata and obtain closure properties, a pumping lemma, and separation results with respect to the classical language classes of the Chomsky hierarchy.
ESTIMATION OF COGNITIVE WORKLOAD BY APPROXIMATE ENTROPY OF EEG
Authors: LI XIAOLING , JIANG YING , HONG JUN , DONG YUANZHE , YAO LEI
Published: June 2016

The traditional cockpit display-control system usually has great many instruments and much complex information, which leads to the pilots to take a long time to be familiar with the cockpit interface and often cause accidents when emergencies happen. Thus it is necessary to evaluate the cognitive workload of the pilots under multitask conditions. A simplified evaluation method of cognitive workload by approximate entropy (ApEn) of electroencephalography (EEG) is proposed in this paper. We design a series of experiments about the flight instruments, which have different instrument number, pointer speed, and operation difficulty, and collect the EEG, interval time (IT), and misjudgment rate (MR), then classify and analyze these data with ApEn algorithm, traceability, and dualistic linear regression method. It can be found that ApEn is increased with increasing experiment difficulty, which shows that ApEn can be used as the evaluation criteria of cognitive workload. As the ApEn and the number of dipoles have a positive correlation relationship, the cognitive workload and ApEn are both changed with increasing the number of brain dipoles. Taking MR and IT as the independent variables, and ApEn as the dependent variable, we obtain an empirical formula to simplify the assessment process of the cognitive workload. This study concludes that ApEn can be used as the evaluation criteria of cognitive workload, which could be applied in the ergonomics estimation of human-interface interaction field.
Implementation, Test Pattern Generation, and Comparative Analysis of Different Adder Circuits
Authors: Saini Vikas K. , Akhter Shamim , Chauhan Tanuj
Published: June 2016

Addition usually affects the overall performance of digital systems and an arithmetic function. Adders are most widely used in applications like multipliers, DSP (i.e., FFT, FIR, and IIR). In digital adders, the speed of addition is constrained by the time required to propagate a carry through the adder. Various techniques have been proposed to design fast adders. We have derived architectures for carry-select adder (CSA), Common Boolean Logic (CBL) based adders, ripple carry adder (RCA), and Carry Look-Ahead Adder (CLA) for 8-, 16-, 32-, and 64-bit length. In this work we have done comparative analysis of different types of adders in Synopsis Design Compiler using different standard cell libraries at 32/28 nm. Also, the designs are analyzed for the stuck at faults (s-a-0, s-a-1) using Synopsis TetraMAX.
Supraglottic Kaposi’s Sarcoma in HIV-Negative Patients: Case Report and Literature Review
Authors: Server Ela A. , Durna Yusuf M. , Yigit Ozgur , Bozkurt Erol R.
Published: June 2016

This paper presents a case report of an HIV-negative, supraglottic Kaposi’s sarcoma patient. The 80-year-old male patient was admitted with complaints of hoarseness, difficulty in swallowing, and a stinging sensation in his throat for approximately six months. The endoscopic larynx examination revealed a lesion which had completely infiltrated the epiglottis, reached right aryepiglottic fold, was vegetating, pink and purple in color, multilobular, fragile, and shaped like a bunch of grapes, and partially blocked the bleeding airway passage. The case was discussed by the hospital’s head-neck cancer committee and a surgery decision was made. A tracheotomy was performed under local anesthesia before the operation due to respiratory distress and endotracheal intubation difficulty. Direct laryngoscopy showed that the mass was limited in the supraglottic area, had invaded the entire left aryepiglottic fold and one-third of the front right aryepiglottic fold, and completely covered epiglottis. It should be remembered that although rare, Kaposi’s sarcoma may be encountered in larynx malignancy cases. Disease-free survival may be achieved through local excision and postoperative radiotherapy.
Selective Sensing of Tyrosine Phosphorylation in Peptides Using Terbium(III) Complexes
Authors: Sumaoka Jun , Akiba Hiroki , Komiyama Makoto
Published: June 2016

Phosphorylation of tyrosine residues in proteins, as well as their dephosphorylation, is closely related to various diseases. However, this phosphorylation is usually accompanied by more abundant phosphorylation of serine and threonine residues in the proteins and covers only 0.05% of the total phosphorylation. Accordingly, highly selective detection of phosphorylated tyrosine in proteins is an urgent subject. In this review, recent developments in this field are described. Monomeric and binuclearTbIIIcomplexes, which emit notable luminescence only in the presence of phosphotyrosine (pTyr), have been developed. There, the benzene ring of pTyr functions as an antenna and transfers its photoexcitation energy to theTbIIIion as the emission center. Even in the coexistence of phosphoserine (pSer) and phosphothreonine (pThr), pTyr can be efficintly detected with high selectivity. Simply by adding theseTbIIIcomplexes to the solutions, phosphorylation of tyrosine in peptides by protein tyrosine kinases and dephosphorylation by protein tyrosine phosphatases can be successfully visualized in a real-time fashion. Furthermore, the activities of various inhibitors on these enzymes are quantitatively evaluated, indicating a strong potential of the method for efficient screening of eminent inhibitors from a number of candidates.
Molecular and Growth-Based Drug Susceptibility Testing ofMycobacterium tuberculosisComplex for Ethambutol Resistance in the United States
Authors: Yakrus Mitchell A. , Driscoll Jeffrey , McAlister Allison , Sikes David , Hartline Denise , Metchock Beverly , Starks Angela M.
Published: June 2016

Ethambutol (EMB) is used as a part of drug regimens for treatment of tuberculosis (TB). Susceptibility ofMycobacterium tuberculosiscomplex (MTBC) isolates to EMB can be discerned by DNA sequencing to detect mutations in theembBgene associated with resistance. US Public Health Laboratories (PHL) primarily use growth-based drug susceptibility test (DST) methods to determine EMB resistance. The Centers for Disease Control and Prevention (CDC) provides a service for molecular detection of drug resistance (MDDR) by DNA sequencing and concurrent growth-based DST using agar proportion. PHL and CDC test results were compared for 211 MTBC samples submitted to CDC from September 2009 through February 2011. Concordance between growth-based DST results from PHL and CDC was 88.2%. A growth-based comparison of 39 samples, where anembBmutation associated with EMB resistance was detected, revealed a higher percentage of EMB resistance by CDC (84.6%) than by PHL (59.0%) which was significant (Pvalue = 0.002). Discordance between all growth-based test results from PHL and CDC was also significant (Pvalue = 0.003). Most discordance was linked to false susceptibility using the BACTEC™MGIT™960 (MGIT) growth-based system. Our analysis supports coalescing growth-based and molecular results for an informed interpretation of potential EMB resistance.
Ultrasonic Nonlinearity Evaluation of the Cracked Interface
Authors: Qiu Yanjun , Zhang Yilin , Su Yewang , Cao Peng , Zhao Youxuan
Published: June 2016

This paper derives a novel analytical solution for acoustic nonlinearity evaluation of the cracked interface. When microcracks exist at the interface, the tensile and compressive effective moduli of the cracked interface are considered to be different. It is clearly shown that the tension and compression elastic asymmetry can result in acoustic nonlinearity. In addition, numerical simulations using the finite element method are conducted to validate the theoretical solution. It is shown that numerical results agree well with the analytical solution. Finally, two factors affecting acoustic nonlinearity are studied based on the analytical solution. One is the tension and compression elastic asymmetry and another is the frequency of incident wave. Different from acoustic nonlinearity parameter of the general second harmonics, it is found that acoustic nonlinearity parameter is a function of two factors.
Molecular Background of miRNA Role in Asthma and COPD: An Updated Insight
Authors: Szymczak Izabela , Wieczfinska Joanna , Pawliczak Rafal
Published: June 2016

Inflammatory airway diseases are a significant health problems requiring new approaches to the existing therapies and addressing fundamental issues. Difficulties in developing effective therapeutic strategies might be caused by lack of understanding of their exact molecular mechanism. MicroRNAs (miRNAs) are a class of regulators that already revolutionized the view of gene expression regulation. A cumulating number of investigations show a pivotal role of miRNAs in the pathogenesis of asthma, chronic obstructive pulmonary disease (COPD), or airway remodeling through the regulation of many pathways involved in their pathogenesis. Expression changes of several miRNAs have also been found to play a role in the development and/or improvement in asthma or COPD. Still, relatively little is known about the role of miRNAs in inflammatory disorders. The microRNA profiles may differ depending on the cell type or antigen-presenting cell. Based on the newest literature, this review discusses the current knowledge concerning miRNA contribution and influence on lung inflammation and chosen inflammatory airway diseases: asthma and COPD.
Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants
Authors: Janaillac Marie , Labarinas Sonia , Pfister Riccardo E. , Karam Oliver
Published: June 2016

Background.In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2).Methods.Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2and transcutaneous values and the accuracy between the trends of blood pCO2and TcpCO2in all consecutive premature infants born at <33 weeks’ gestational age.Results.248 infants were included (median gestational age: 29 + 5 weeks and median birth weight: 1250 g), providing 1365 pairs of TcpCO2and blood pCO2values. Pearson’sRcorrelation between these values was 0.58. The mean bias was −0.93 kPa with a 95% confidence limit of agreement of −4.05 to +2.16 kPa. Correlation between the trends of TcpCO2and blood pCO2values was good in only 39.6%.Conclusions.In premature infants, TcpCO2was poorly correlated to blood pCO2, with a wide limit of agreement. Furthermore, concordance between trends was equally low. We warn about clinical decision-making on TcpCO2alone when used as continuous monitoring.
A Comparative Study of Land Cover Classification by Using Multispectral and Texture Data
Authors: Qadri Salman , Khan Dost Muhammad , Ahmad Farooq , Qadri Syed Furqan , Babar Masroor Ellahi , Shahid Muhammad , Ul-Rehman Muzammil , Razzaq Abdul , Shah Muhammad Syed , Fahad Muhammad , Ahmad Sarfraz , Pervez Muhammad Tariq , Naveed Nasir , Aslam Naeem , Jamil Mutiullah , Rehmani Ejaz Ahmad , Ahmad Nazir , Akhtar Khan Naeem
Published: June 2016

The main objective of this study is to find out the importance of machine vision approach for the classification of five types of land cover data such as bare land, desert rangeland, green pasture, fertile cultivated land, and Sutlej river land. A novel spectra-statistical framework is designed to classify the subjective land cover data types accurately. Multispectral data of these land covers were acquired by using a handheld device named multispectral radiometer in the form of five spectral bands (blue, green, red, near infrared, and shortwave infrared) while texture data were acquired with a digital camera by the transformation of acquired images into 229 texture features for each image. The most discriminant 30 features of each image were obtained by integrating the three statistical features selection techniques such as Fisher, Probability of Error plus Average Correlation, and Mutual Information (F+ PA + MI). Selected texture data clustering was verified by nonlinear discriminant analysis while linear discriminant analysis approach was applied for multispectral data. For classification, the texture and multispectral data were deployed to artificial neural network (ANN:n-class). By implementing a cross validation method (80-20), we received an accuracy of 91.332% for texture data and 96.40% for multispectral data, respectively.
A Time-DependentΛandGCosmological Model Consistent with Cosmological Constraints
Authors: Kantha L.
Published: June 2016

The prevailing constantΛ-Gcosmological model agrees with observational evidence including the observed red shift, Big Bang Nucleosynthesis (BBN), and the current rate of acceleration. It assumes that matter contributes 27% to the current density of the universe, with the rest (73%) coming from dark energy represented by the Einstein cosmological parameterΛin the governing Friedmann-Robertson-Walker equations, derived from Einstein’s equations of general relativity. However, the principal problem is the extremely small value of the cosmological parameter (~10−52 m2). Moreover, the dark energy density represented byΛis presumed to have remained unchanged as the universe expanded by 26 orders of magnitude. Attempts to overcome this deficiency often invoke a variableΛ-Gmodel. Cosmic constraints from action principles require that either bothGandΛremain time-invariant or both vary in time. Here, we propose a variableΛ-Gcosmological model consistent with the latest red shift data, the current acceleration rate, and BBN, provided the split between matter and dark energy is 18% and 82%.Λdecreases (Λ~τ-2, whereτis the normalized cosmic time) andGincreases (G~τn) with cosmic time. The model results depend only on the chosen value ofΛat present and in the far future and not directly onG.
CD44 Expression Level and Isoform Contributes to Pancreatic Cancer Cell Plasticity, Invasiveness, and Response to Therapy
Authors: Zhao Shujie , Chen Chen , Chang Katherine , Karnad Anand , Jagirdar Jaishree , Kumar Addanki P. , Freeman James W.
Published: June 2016

Purpose: A subpopulation of pancreatic ductal adenocarcinoma (PDAC) cells is thought to be inherently resistant to chemotherapy or to give rise to tumor cells that become resistant during treatment. Here we determined the role of CD44 expression and its isoforms as a marker and potential target for tumor cells that give rise to invasive and gemcitabine-resistant tumors.

Experimental Design: RT-PCR, Western blotting, and DNA sequencing was used to determine CD44 isoform and expression levels. Flow cytometry was used to sort cells on the basis of their CD44 expression level. CD44 expression was knocked down using shRNA. Tumorigenic properties were determined by clonogenic and Matrigel assays, IHC, tumor growth in vivo using luciferase imaging and by tumor weight.

Results: We identified an invasive cell population that gives rise to gemcitabine-resistant tumors. These cancer cells express a high level of CD44 standard isoform and have an EMT phenotype (CD44s/EMT). In vivo, CD44s/EMT engraft and expand rapidly and give rise to tumors that express high levels of CD44 isoforms that contain multiple exon variants. CD44low-expressing cells show continued sensitivity to gemcitabine in vivo and knockdown of CD44 in CD44s/EMT cells increases sensitivity to gemcitabine and decreases invasiveness.

Conclusions: PDAC cells expressing high levels of CD44s with a mesenchymal-like phenotype were highly invasive and developed gemcitabine resistance in vivo. Thus, initial targeting CD44 or reversing the CD44high phenotype may improve therapeutic response. Clin Cancer Res; 22(22); 5592–604. ©2016 AACR.
A Randomized Double-Blind Placebo-Controlled Phase IIB Trial of Curcumin in Oral Leukoplakia
Authors: Kuriakose Moni Abraham , Ramdas Kunnambath , Dey Bindu , Iyer Subramanya , Rajan Gunaseelan , Elango Kalavathy K. , Suresh Amritha , Ravindran Divya , Kumar Rajneesh R. , R Prathiba , Ramachandran Surya , Kumar Nisha Asok , Thomas Gigi , Somanathan Thara , Ravindran Hiran K. , Ranganathan Kannan , Katakam Sudhakar Babu , Parashuram Shivashankar , Jayaprakash Vijayvel , Pillai M. Radhakrishna
Published: June 2016

Oral leukoplakia is a potentially malignant lesion of the oral cavity, for which no effective treatment is available. We investigated the effectiveness of curcumin, a potent inhibitor of NF-κB/COX-2, molecules perturbed in oral carcinogenesis, to treat leukoplakia. Subjects with oral leukoplakia (n = 223) were randomized (1:1 ratio) to receive orally, either 3.6 g/day of curcumin (n = 111) or placebo (n = 112), for 6 months. The primary endpoint was clinical response obtained by bi-dimensional measurement of leukoplakia size at recruitment and 6 months. Histologic response, combined clinical and histologic response, durability and effect of long-term therapy for an additional six months in partial responders, safety and compliance were the secondary endpoints. Clinical response was observed in 75 (67.5%) subjects [95% confidence interval (CI), 58.4–75.6] in the curcumin and 62 (55.3%; 95% CI, 46.1–64.2) in placebo arm (P = 0.03). This response was durable, with 16 of the 18 (88.9%; 95% CI, 67.2–96.9) subjects with complete response in curcumin and 7 of 8 subjects (87.5%) in placebo arm, demonstrating no relapse after 6 months follow-up. Difference in histologic response between curcumin and placebo was not significant (HR, 0.88, 95% CI, 0.45–1.71; P = 0.71). Combined clinical and histologic response assessment indicated a significantly better response with curcumin (HR, 0.50; 95% CI, 0.27–0.92; P = 0.02). Continued therapy, in subjects with partial response at 6 months, did not yield additional benefit. The treatment did not raise any safety concerns. Treatment of oral leukoplakia with curcumin (3.6 g for six months), thus was well tolerated and demonstrated significant and durable clinical response for 6 months. Cancer Prev Res; 9(8); 683–91. ©2016 AACR.
House Dust Mite-Specific Sublingual Immunotherapy Prevents the Development of Allergic Inflammation in a Mouse Model of Experimental Asthma
Authors: Hagner Stefanie , Rask Carola , Brimnes Jens , Andersen Peter Sejer , Raifer Hartmann , Renz Harald , Garn Holger
Published: June 2016

Background: Evidence regarding sublingual immunotherapy (SLIT) efficacy and its good safety profile has been demonstrated with pollen and house dust mite (HDM) allergens in the treatment of airway allergies. In addition, the use of grass pollen presents a SLIT disease-modifying treatment for respiratory allergies. Objectives: The aim of this study was to demonstrate the efficacy of HDM-based SLIT in mouse models of allergic airway inflammation and to gain insights into the involved local immunological mechanisms. Methods: Balb/c mice were sensitized/challenged with Dermatophagoides farinae (Der f) extract and underwent Der f-SLIT in prophylactic and therapeutic settings. The SLIT efficacy was assessed using lung function measurements, analysis of local inflammatory responses by bronchoalveolar lavage cell differentiation and lung histology. Humoral and cellular responses were monitored by ELISA, cytokine bead array and flow cytometry analyses. Results: In a prophylactic setting, Der f-SLIT with 12 development units per dose reduced the eosinophil-dominated inflammatory response in the lung paralleled by a marked reduction in airway hyperresponsiveness. Local Th2 responses were prevented as demonstrated by significantly lower levels of IL-5 and IL-13. Additionally, SLIT-treated mice revealed a lower proportion of CD4-CD8- γδ cells and a higher frequency of CD8+CD25+IFNγ+ T cells in the lungs compared to sham-treated mice. In a therapeutic setting, Der f-SLIT also resulted in reduced inflammatory responses in the lung. Conclusion: The efficacy of Der f-SLIT was demonstrated in prophylactic and therapeutic conditions using experimental mouse models of HDM-induced airway inflammation. A potential role of a so far underestimated lymphocyte subpopulation was also indicated.
Description of the Characteristics of Multiple Sclerosis Patients in the Region of Valencia (Spain) Who Requested Treatment with Disease-Modifying Drugs during the 2005-2014 Decade
Authors: Ribes García Sara , Gómez-Pajares Fernando , Albelda Puig Carmen , García Herrera José Luis , Casanova Estruch Bonaventura
Published: June 2016

Background: More than 3,000 multiple sclerosis (MS) patients were treated with disease-modifying drugs (DMDs) in the Region of Valencia during 2005-2014. We aimed at describing the demographic and clinical characteristics of MS patients who requested treatment with DMDs, variations in their use, and the factors associated with change to second-line therapies during this decade. Methods: A retrospective cohort study with information from Subcomité Especializado de Medicamentos de Alto Impacto Sanitario y/o Económico registers. A statistical analysis was run in 2 phases: descriptive analysis of the sample using classical statistical methods, and of DMD trend by a chi-square test for linear trends; analytic analysis to examine the factors associated with change to second-line treatment (logistic regression model). Results: We selected 2,205 patients (mean age 32.12, SD 9.64; 70% females, and 86.6% remising-remitting MS (RRMS)); 1,012 patients were attended to in highly specialized MS units (45.8%); 525 in monographic units (23.8%); and 668 in general units (30.2%). DMD prescriptions increased, and glatiramer acetate was more widespread at the end of the period (35.4%). Conclusion: Variability in access to different treatments was slight. The younger the patient, the higher the risk of first-line RRMS treatment failing in female gender and first treatment with interferon.
Predicting Heart Failure With Preserved and Reduced Ejection Fraction
Authors: Ho Jennifer E. , Enserro Danielle , Brouwers Frank P. , Kizer Jorge R. , Shah Sanjiv J. , Psaty Bruce M. , Bartz Traci M. , Santhanakrishnan Rajalakshmi , Lee Douglas S. , Chan Cheeling , Liu Kiang , Blaha Michael J. , Hillege Hans L. , van der Harst Pim , van Gilst Wiek H. , Kop Willem J. , Gansevoort Ron T. , Vasan Ramachandran S. , Gardin Julius M. , Levy Daniel , Gottdiener John S. , de Boer Rudolf A. , Larson Martin G.
Published: June 2016

Background—

Heart failure (HF) is a prevalent and deadly disease, and preventive strategies focused on at-risk individuals are needed. Current HF prediction models have not examined HF subtypes. We sought to develop and validate risk prediction models for HF with preserved and reduced ejection fraction (HFpEF, HFrEF).

Methods and Results—

Of 28,820 participants from 4 community-based cohorts, 982 developed incident HFpEF and 909 HFrEF during a median follow-up of 12 years. Three cohorts were combined, and a 2:1 random split was used for derivation and internal validation, with the fourth cohort as external validation. Models accounted for multiple competing risks (death, other HF subtype, and unclassified HF). The HFpEF-specific model included age, sex, systolic blood pressure, body mass index, antihypertensive treatment, and previous myocardial infarction; it had good discrimination in derivation (c-statistic 0.80; 95% confidence interval [CI], 0.78–0.82) and validation samples (internal: 0.79; 95% CI, 0.77–0.82 and external: 0.76; 95% CI: 0.71–0.80). The HFrEF-specific model additionally included smoking, left ventricular hypertrophy, left bundle branch block, and diabetes mellitus; it had good discrimination in derivation (c-statistic 0.82; 95% CI, 0.80–0.84) and validation samples (internal: 0.80; 95% CI, 0.78–0.83 and external: 0.76; 95% CI, 0.71–0.80). Age was more strongly associated with HFpEF, and male sex, left ventricular hypertrophy, bundle branch block, previous myocardial infarction, and smoking with HFrEF (
P
value for each comparison ≤0.02).

Conclusions—

We describe and validate risk prediction models for HF subtypes and show good discrimination in a large sample. Some risk factors differed between HFpEF and HFrEF, supporting the notion of pathogenetic differences among HF subtypes.
The Puzzle of False Judgement in the Theaetetus
Authors: Stein Nathanael
Published: June 2016

A puzzle about false judgement is raised in the Theaetetus (187d-200c), but not successfully answered there. On the proposed account, the confusion that explicitly vitiates Theaetetus’ final attempt to define knowledge is already at work implicitly in this puzzle. Theaetetus shares popular assumptions about knowledge (epistēmē), but also accepts that there are cognitive constraints on judgement (doxa): the puzzle arises because he fails to distinguish the one cognitive condition from the other.
Regional Cooperation in the North Sea under Part ix of the Law of the Sea Convention
Authors: Whomersley Chris
Published: June 2016

The importance of the North Sea is emphasised by the recent House of Lords report on maritime cooperation there. This prompts a consideration of the international legal principles underpinning such cooperation, as well as a description of the means by which the North Sea States have given practical effect to this cooperation, particularly in relation to living resources and the marine environment.
Norse against Old English: 20-0
Authors: Holmberg Anders
Published: June 2016

The conclusion seems inescapable, if the facts in Emonds & Faarlund are more or less right: Middle English would be the outcome of a shift from West Germanic grammar to an eccentric form of North Germanic grammar.
The Viking Hypothesis from a Dialectologist’s Perspective
Authors: Kortmann Bernd
Published: June 2016

The Viking Hypothesis neglects (i) the significant degree of stability from Old to Middle (and even Modern) English grammar and (ii) parallel, but independent, developments not induced by North Germanic in the grammars of continental West Germanic dialects.
Norsified English or Anglicized Norse?
Authors: Trudgill Peter
Published: June 2016

Emonds & Faarlund have brilliantly demonstrated that the syntax of English owes a great deal to the syntax of Old Norse, and more than has generally been thought. This is genuinely significant. But, from a variationist perspective, the difference of nomenclature—“North Germanic” rather than “West Germanic”—is not.
Legal Treatment of Honour Crimes: Comparison Between Iraqi National and the Kurdistan Region’s Laws
Authors: Begikhani Nazand , Faraj Najat M
Published: June 2016

The article discusses the legal treatment of honour crimes in Iraq and the Iraqi Kurdistan Region. It examines the judicial context in Kurdistan Region, focussing on the criminal justice system and law implementation mechanisms in relation to honour-based violence in general and honour killings in particular.

The article draws on several years’ research into honour crimes in the Iraqi Kurdistan Region, including an investigation into honour-based violence led by the University of Bristol between 2008–2010. The research involved 131 semi-structured interviews with stakeholders addressing honour crimes, including legal professionals, MPs, prosecutors, police officers, victims, women’s rights activists, government officials and members of national and international agencies, including unami and undp.

The article will look at different sets of legal remedies for honour crimes along with the attempts and the challenges involved in establishing justice for women in the region torn by years of war, internal conflicts and the rise of radical ideologies in the form of political Islam.
A new combination in the genus Liparis (Orchidaceae) for the Italian flora
Authors: BARTOLUCCI FABRIZIO , GALASSO GABRIELE
Published: June 2016

The genus Liparis Richard (1817: 21) comprises about 320 species, broadly distributed worldwide but mainly in tropical and subtropical areas (Pridgeon et al. 2005). In Europe only the circumboreal L. loeselii (Linnaeus 1753: 947) Richard (1817: 38) occurs (Hultén & Fries 1986). Recently the new taxon L. loeselii (L.) Rich. subsp. nemoralis Perazza et al. (2012: 489) was described from northeastern Italy. It is endemic to Friuli Venezia Giulia, Veneto and Trentino-Alto Adige (Perazza & Lorenz 2013, Peruzzi et al. 2014).
Primula calderiana subsp. bawaii (Primulaceae): a new subspecies from Arunachal Pradesh, India
Authors: BAWRI AMAL , GAJUREL PADMA RAJ , KHAN MOHAMMED LATIF
Published: June 2016

A new subspecies Primula calderiana subsp. bawaii, from Arunachal Pradesh is described and illustrated. The complete description with illustrations and colour plate is provided for easy identification. Its conservation status is assessed as Critically Endangered as per IUCN.
A new species of Zwicknia Murányi (Plecoptera, Capniidae) from the French and Swiss Jura Mountains, the French Massif Central, and the French Middle Rhône Region
Authors: REDING JEAN-PAUL G. , LAUNAY BERTRAND , RUFFONI ALEXANDRE , VINÇON GILLES , BOUMANS LOUIS
Published: June 2016

A new species of Zwicknia Murányi, Z. ledoarei sp. n., from the Jura Mountains of France and Switzerland, the French Massif Central, and the French Middle Rhône Region, is described on the basis of morphology and molecular methods. Information on the distribution and the ecological preferences of this new species is also provided.
Contribution to the taxonomy of the genus Coeleumenes van der Vecht, 1963 (Hymenoptera: Vespidae: Eumeninae) from Vietnam, with description of a new species
Authors: NGUYEN LIEN THI PHUONG
Published: June 2016

Coeleumenes flavus sp. nov is described and illustrated from Vietnam (Son La), C. burmanicus van der Vecht, 1963 is redescribed. A key to both species from Vietnam is given.
Calorimetry-Derived Composition Vectors to Resolve Component Raman Spectra in Phospholipid Phase Transitions
Authors: Kitt Jay P. , Bryce David A. , Harris Joel M.
Published: June 2016

Multidimensional least squares analysis is a well-established technique for resolving component vibrational spectra from mixed samples or systems. Component resolution of temperature-dependent vibrational spectra is challenging, however, due to the lack of a suitable model for the variation in sample composition with temperature. In this work, analysis of temperature-dependent Raman spectra of lipid membranes is accomplished by using “concentration” vectors independently derived from enthalpy changes determined by differential scanning calorimetry. Specifically, the lipid–bilayer phase transitions of DMPC (1,2-dipalmitoyl-sn-glycero-3-phosphocholine) are investigated through Raman spectra acquired from individual, optically trapped vesicles in suspension as a function of temperature. Heat capacity profiles of the same vesicle suspension are measured using differential scanning calorimetry and numerically integrated to generate enthalpy change curves of each phase transition, which are in turn used to construct composition vectors. Multidimensional least squares analysis optimized for a fit to these composition vectors allows resolution of the component spectra corresponding to gel, ripple, and liquid–crystalline phases of the DMPC. The quality of fit of the calorimetry-derived results is confirmed by unstructured residual differences between the data and the model, and a composition variation predicted by the resolved spectra that matches the calorimetry results. This approach to analysis of temperature-dependent spectral data could be readily applied in other areas of materials characterization, where one is seeking to learn about structural changes that occur through temperature-dependent phase transitions.
Determination of Water Vapor Pressure Over Corrosive Chemicals Versus Temperature Using Raman Spectroscopy as Exemplified with 85.5% Phosphoric Acid
Authors: Rodier Marion , Li Qingfeng , Berg Rolf Willestofte , Bjerrum Niels Janniksen
Published: June 2016

A method to determine the water vapor pressure over a corrosive substance was developed and tested with 85.5 ± 0.4% phosphoric acid. The water vapor pressure was obtained at a range of temperatures from ∼25 ℃ to ∼200 ℃ using Raman spectrometry. The acid was placed in an ampoule and sealed with a reference gas (either hydrogen or methane) at a known pressure (typically ∼0.5 bar). By comparing the Raman signals from the water vapor and the references, the water pressure was determined as a function of temperature. A considerable amount of data on the vapor pressure of phosphoric acid are available in the literature, to which our results could successfully be compared. A record value of the vapor pressure, 3.40 bar, was determined at 210 ℃. The method required a determination of the precise Raman scattering ratios between the substance, water, and the used reference gas, hydrogen or methane. In our case the scattering ratios between water and reference ν1 Q-branches were found to be 1.20 ± 0.03 and 0.40 ± 0.02 for H2 and CH4, respectively.
Slipping into functional stupidity: The bifocality of organizational compliance
Authors: Paulsen Roland
Published: June 2016

Drawing on ethnographical work at the Swedish Public Employment Service, this article contextualizes functional stupidity in relation to other types of organizational compliance. Rather than seeing stupidity as a personality trait, I argue that it should be regarded as a transient unreflective mode of compliance one may yield to for a number of reasons but also reflect on in hindsight. Based on the empirical material, I distinguish 10 ‘stupidity rationales’ emanating from reflective types of compliance with which employees can motivate the practice of functional stupidity. Functional stupidity can be seen as the modus operandi of ego-dystonic compliance we enter in order to endure long hours of imposed work assignments we would rather not perform.