bluuebunny/crossref_metadata_2025 huggingface dataset:
Dopamine Transporter (DaT) Scan Utilization in a Movement Disorder Center
Authors: Oravivattanakul Srivadee , Benchaya Lucas , Wu Guiyun , Ahmed Anwar , Itin Ilia , Cooper Scott , Gostkowski Michal , Rudolph Joseph , Appleby Kristin , Sweeney Patrick , Fernandez Hubert H.
Published: October 2015

Background

The aim of this work was to describe utilization patterns of dopamine transporter (DaT) scan and its influence on patient management at a single movement disorders center. DaT scan helps differentiate between neurodegenerative from non‐neurodegenerative parkinsonism and essential tremor (ET). It has been recently approved in the United States in 2011.

Methods

We conducted a retrospective review of all patients, observed by movement disorders neurologists, who received a DaT scan. Demographic data, medication use, and prescan diagnosis were collected.

Results

A total of 216 DaT scans were performed at our center from 1 June 2011 to 31 October 2012. A total of 175 scans were included for analysis. Rates of DaT scan utilization varied from 5 to 33 per 100 new patients observed. When our specialists suspected neurodegenerative parkinsonism before the scan (N = 70), the scan was abnormal in 57%. When non‐neurodegenerative parkinsonism was prescan diagnosis (N = 46), the scan was normal in 65%. When essential/dystonic tremor was suspected (N = 14), the scan was normal in 79%. When psychogenic disorder was the prescan diagnosis (N = 15), the scan was normal in only 47%. Only 4% of patients with abnormal scan remained off anti‐PD medications, whereas 24% of patients with negative scan were still on anti‐PD medications.

Conclusions

DaT scan utilization among specialists varied greatly. Scan results correlated most when prescan diagnosis was ET than when working diagnosis was neurodegenerative parkinsonism or other non‐neurodegenerative parkinsonism. Scan result was least consistent when prescan diagnosis was psychogenic disorder. Finally, DaT scans influenced medical treatment more when it was abnormal, compared to when it was normal.
Velocity‐selective‐inversion prepared arterial spin labeling
Authors: Qin Qin , van Zijl Peter C.M.
Published: October 2015

Purpose

To develop a Fourier‐transform based velocity‐selective inversion (FT‐VSI) pulse train for velocity‐selective arterial spin labeling (VSASL).

Methods

This new pulse contains paired and phase cycled refocusing pulses. Its sensitivities to B0/B1 inhomogeneity and gradient imperfections such as eddy currents were evaluated through simulation and phantom studies. Cerebral blood flow (CBF) quantification using FT‐VSI prepared VSASL was compared with conventional VSASL and pseudocontinuous ASL (PCASL) at 3 Tesla.

Results

Simulation and phantom results of the proposed FT‐VSI pulse train demonstrated excellent robustness to B0/B1 field inhomogeneity and eddy currents. The estimated CBF of gray matter and white matter for the FT‐VSI prepared VSASL, averaged among eight healthy volunteers, were 49.5 ± 7.5 mL/100 g/min and 14.8 ± 2.4 mL/100 g/min, respectively. Excellent correlation and agreement between the FT‐VSI method and conventional VSASL and PCASL were found. The averaged signal‐to‐noise ratio (SNR) value in gray matter of the FT‐VSI method was 39% higher than VSASL using conventional double refocused hyperbolic tangent pulses and 9% lower than PCASL.

Conclusion

A novel FT‐VSI pulse train was demonstrated to be a suitable labeling module for VSASL with robustness of velocity‐selective profile to B0/B1 field inhomogeneity and gradient imperfections. Compared with conventional VSASL, FT‐VSI prepared VSASL produced consistent CBF maps with higher SNR values. Magn Reson Med 76:1136–1148, 2016. © 2015 Wiley Periodicals, Inc.
High‐resolution 1H‐MRSI of the brain using SPICE: Data acquisition and image reconstruction
Authors: Lam Fan , Ma Chao , Clifford Bryan , Johnson Curtis L. , Liang Zhi‐Pei
Published: October 2015

Purpose

To develop data acquisition and image reconstruction methods to enable high‐resolution 1H MR spectroscopic imaging (MRSI) of the brain, using the recently proposed subspace‐based spectroscopic imaging framework called SPICE (SPectroscopic Imaging by exploiting spatiospectral CorrElation).

Theory and Methods

SPICE is characterized by the use of a subspace model for both data acquisition and image reconstruction. For data acquisition, we propose a novel spatiospectral encoding scheme that provides hybrid data sets for determining the subspace structure and for image reconstruction using the subspace model. More specifically, we use a hybrid chemical shift imaging /echo‐planar spectroscopic imaging sequence for two‐dimensional (2D) MRSI and a dual‐density, dual‐speed echo‐planar spectroscopic imaging sequence for three‐dimensional (3D) MRSI. For image reconstruction, we propose a method that can determine the subspace structure and the high‐resolution spatiospectral reconstruction from the hybrid data sets generated by the proposed sequences, incorporating field inhomogeneity correction and edge‐preserving regularization.

Results

Phantom and in vivo brain experiments were performed to evaluate the performance of the proposed method. For 2D MRSI experiments, SPICE is able to produce high‐SNR spatiospectral distributions with an approximately 3 mm nominal in‐plane resolution from a 10‐min acquisition. For 3D MRSI experiments, SPICE is able to achieve an approximately 3 mm in‐plane and 4 mm through‐plane resolution in about 25 min.

Conclusion

Special data acquisition and reconstruction methods have been developed for high‐resolution 1H‐MRSI of the brain using SPICE. Using these methods, SPICE is able to produce spatiospectral distributions of 1H metabolites in the brain with high spatial resolution, while maintaining a good SNR. These capabilities should prove useful for practical applications of SPICE. Magn Reson Med 76:1059–1070, 2016. © 2015 Wiley Periodicals, Inc.
Rapid inner‐volume imaging in the steady‐state with 3D selective excitation and small‐tip fast recovery imaging
Authors: Sun Hao , Fessler Jeffrey A. , Noll Douglas C. , Nielsen Jon‐Fredrik
Published: October 2015

Purpose

Develop a method for rapid three‐dimensional inner‐volume (IV), or reduced field‐of‐view, steady‐state imaging. Methods: Tailored radiofrequency pulses for exciting a three‐dimensional IV were designed using a recently proposed algorithm and used in three different sequences: spoiled gradient echo, balanced steady‐state free precession, and “small‐tip fast recovery” (STFR) which uses a “tip‐up” RF pulse after the readout to fast recover spins to the longitudinal axis. The inner‐ and outer‐volume (OV) steady‐state signals were analyzed. To demonstrate the potential utility of the proposed method, segmented stack‐of‐spirals reduced field‐of‐view images in a volunteer were acquired.

Results

For a given three‐dimensional IV excitation pulse, STFR can achieve higher IV/OV signal ratio compared with spoiled gradient echo and balanced steady‐state free precession. For spoiled gradient echo and balanced steady‐state free precession, this ratio is significantly lower than that produced by a single IV excitation. For STFR, this ratio exceeds that produced by a single IV excitation, due to partial OV saturation produced by the nonspatially selective tip‐up pulse. Reduced FOV STFR stack‐of‐spirals imaging with 2‐fold under‐sampling in both x‐y and z is demonstrated.

Conclusion

STFR provides an effective mechanism for OV suppression in steady‐state IV imaging. The recently proposed joint pulse design method can be used in the STFR sequence to achieve fast reduced field‐of‐view imaging. Magn Reson Med 76:1217–1223, 2016. © 2015 Wiley Periodicals, Inc.
Post optimization for accurate and efficient reliability‐based design optimization using second‐order reliability method based on importance sampling and its stochastic sensitivity analysis
Authors: Lim Jongmin , Lee Byungchai , Lee Ikjin
Published: October 2015

In this study, a post optimization technique for a correction of inaccurate optimum obtained using first‐order reliability method (FORM) is proposed for accurate reliability‐based design optimization (RBDO). In the proposed method, RBDO using FORM is first performed, and then the proposed second‐order reliability method (SORM) is performed at the optimum obtained using FORM for more accurate reliability assessment and its sensitivity analysis. In the proposed SORM, the Hessian of a performance function is approximated by reusing derivatives information accumulated during previous RBDO iterations using FORM, indicating that additional functional evaluations are not required in the proposed SORM. The proposed SORM calculates a probability of failure and its first‐order and second‐order stochastic sensitivity by applying the importance sampling to a complete second‐order Taylor series of the performance function. The proposed post optimization constructs a second‐order Taylor expansion of the probability of failure using results of the proposed SORM. Because the constructed Taylor expansion is based on the reliability method more accurate than FORM, the corrected optimum using this Taylor expansion can satisfy the target reliability more accurately. In this way, the proposed method simultaneously achieves both efficiency of FORM and accuracy of SORM. Copyright © 2015 John Wiley & Sons, Ltd.
Mechanical performance of woven carbon fabric reinforced pCBT composites with nanosilica particles
Authors: Liang Wenyan , Duan Zhiwei , Yue Jin , Wang Zhenqing , Osei Bonsu Alex
Published: October 2015

The effect of nanosilica content (0, 0.5, and 2 wt%) on mechanical performance of carbon fabric woven cloth reinforced polymerized poly(butylene terephthalate) resin composites (CF/pCBT) is investigated. The catalyst and nanosilica particles are added on the prepreg surface, and hot‐press processing is adopted in order to manufacture CF/pCBT composites. The experimental results reveal that nanosilica could enhance the mechanical performance of CF/pCBT composites. After adding nanosilica in the composites, elastic modulus enhances 23.96%, and Mode‐II fracture toughness increases 380.43%. Scanning electron microscope observation shows that dispersity of nanoparticles in composites plays an important role on the overall mechanical performance of the obtained composites. Furthermore, failure mechanism has been analyzed according to the damage morphology. POLYM. COMPOS., 38:2528–2535, 2017. © 2015 Society of Plastics Engineers
Nuchal translucency distributions for different chromosomal anomalies in a large unselected population cohort
Authors: Christiansen Marianne , Ekelund Charlotte K. , Petersen Olav Bjørn , Hyett Jon , Eastwood Nathan , Ball Susan , Tabor Ann , Vogel Ida
Published: October 2015

What's already known about this topic?

The distributions of the fetal nuchal translucency thickness (NT) for trisomy 21, trisomy 18, trisomy 13, monosomy X and unbalanced translocations are shifted towards larger values.

What does this study add?

We present visually the distributions of the fetal nuchal translucency thickness (NT) for different chromosomal anomalies obtained from a large, unselected cohort with postnatal follow‐up. The NTs of the common autosomal trisomies, monosomy X and unbalanced translocations were shifted towards larger values, while the distributions for the balanced translocations, the uncommon autosomal trisomies and the triploidies more closely resembled that of the normal/no karyotype population.
Application of risk score analysis to low‐coverage whole genome sequencing data for the noninvasive detection of trisomy 21, trisomy 18, and trisomy 13
Authors: Tynan J. A. , Kim S. K. , Mazloom A. R. , Zhao C. , McLennan G. , Tim R. , Liu L. , Hannum G. , Hull A. , Bombard A. T. , Oeth P. , Burcham T. , van den Boom D. , Ehrich M.
Published: October 2015

Objectives

Clinical performance of a low coverage, low cost, massively parallel sequencing (MPS)‐based assay to stratify risk of trisomy 21, 18, and 13 pregnancies was determined.

Methods

The study included 1100 samples with birth outcome or karyotype results, comprising low‐risk patients (84.2%) negative for risk indications from maternal age, serum screening, ultrasound, or family history, and high‐risk patients (15.8%) with at least one of the aforementioned indications. Cell free DNA (cfDNA) was extracted from maternal plasma. Library preparation incorporated 96 index barcodes to enable sequencing on a HiSeq 2000 or 2500. Risk scores were calculated using chromosomal representation, fetal fraction, and maternal age at the estimated date of delivery. A risk score greater than or equal to 1 in 100 was used to stratify samples as high risk for trisomy 21, trisomy 18, or trisomy 13.

Results

Sensitivity and specificity were calculated based on risk group stratification. Trisomy 21, trisomy 18, and trisomy 13 were detected with greater than 99% sensitivity and 99.9% specificity. Fetal sex classification accuracy was 99.3%.

Conclusions

We conclude that simplified MPS can be used to stratify the risk of pregnancies for trisomy 21, trisomy 18, and trisomy 13 and accurately determine fetal sex. © 2015 John Wiley & Sons, Ltd.
Gender Differences in Implicit Processing of Sexual Stimuli
Authors: Dewitte Marieke
Published: October 2015

The present studies investigated whether men and women differ in cognitive–motivational processing of sexual stimuli in order to better understand the commonly observed gender differences in sexual outcome variables. Because these processes often operate without conscious control, we focused specifically on automatic stimulus processing. Using a series of implicit tasks, we measured inhibition, attentional orientation, appraisal and approach–avoidance motivation regarding sexually explicit stimuli in male and female students. Results showed that men were more strongly motivated to approach sexual stimuli than women and were better able to inhibit sexual information as to prevent activation of the sexual response. With regard to attentional orientation, men were more easily drawn by sexual cues than women, yet only when the cues were presented long enough to allow more elaborative processing. No gender differences were found in the implicit evaluation of sexual information, although men and women did differ at the level of self–reported sexual evaluations. Our results indicate the importance of incorporating information–processing mechanisms and emotion regulation strategies into the conceptualization of the sexual response and promote further research on the specificity, robustness, predictive validity and malleability of the cognitive–motivational processes underlying sexual arousal. Copyright © 2015 European Association of Personality Psychology
Effects of a combined physical and psychosocial intervention program for childhood cancer patients on quality of life and psychosocial functioning: results of the QLIM randomized clinical trial
Authors: van Dijk‐Lokkart Elisabeth M. , Braam Katja I. , van Dulmen‐den Broeder Eline , Kaspers Gertjan J. L. , Takken Tim , Grootenhuis Martha A. , Streng Isabelle C. , Bierings Marc , Merks Johannes H. , van den Heuvel‐Eibrink Marry M. , Veening Margreet A. , Huisman Jaap
Published: October 2015

Objective

Although survival rates in childhood cancer have improved, prevention and reduction of late effects remain important. This study evaluates the effects of a combined physical exercise and psychosocial intervention on health‐related quality of life (HrQoL) and psychosocial functioning in childhood cancer patients.

Methods

In this multicenter randomized controlled trial, cancer patients (aged 8–18 years) and their parents filled in questionnaires on HrQoL, depressive symptoms, behavioral problems, and self‐esteem. Measurements were conducted at baseline, shortly after the 12‐week intervention period and 12 months after baseline. Generalized estimating equations analyses were performed to assess short‐term and long‐term psychosocial effects.

Results

Of the 174 eligible patients, 68 (39.1%) participated. The intervention group consisted of 30 participants at baseline [mean age 13.0 (SD 3.0) years; 53% male], 26 at short‐term and 22 at long‐term follow‐up. The ‘care as usual’ control group consisted of 38 participants at baseline [mean age 12.6 (SD 3.1) years; 53% male], 33 at short‐term and 31 at long‐term follow‐up. Overall, the intervention did not improve psychosocial functioning and HrQoL. According to parent‐proxy reports, the intervention leads to a greater improvement on pain‐related HrQoL on both the short (β = 13.4; 95% CI: 3.0; 23.8) and long term (β = 13.0; 95% CI: 1.6; 24.4) and to greater improvement on procedural anxiety immediately after the intervention (β = 12.6; 95% CI: 1.9; 23.3).

Conclusion

A combined physical and psychosocial training for children with cancer did not have effects on HrQoL or psychosocial functioning, with exception of modest positive effects on parent‐reported pain and procedural anxiety Copyright © 2015 John Wiley & Sons, Ltd.
Rhamnolipids induce oxidative stress responses in cherry tomato fruit to Alternaria alternata
Authors: Yan Fujie , Hu Hao , Lu Laifeng , Zheng Xiaodong
Published: October 2015

BACKGROUND

Rhamnolipids showed an antimicrobial activity applicable to a variety of pathogenic microorganisms, but mechanisms were mostly focused on their direct inhibitory effect.

RESULTS

This study showed that disease incidence obviously decreased when cherry tomatoes were treated with rhamnolipids, whether before or after Alternaria alternata inoculation. The activities of antioxidant enzymes, including superoxide dismutase and catalase, were increased in rhamnolipid‐pretreated cherry tomato inoculated with A. alternata within 12 h, while contents of reactive oxygen species decreased. Moreover, resistant response of cherry tomato treated with rhamnolipids and A. alternata was also attributed to activity stimulation of ascorbate peroxidase and glutathione reductase, accompanied with an increase in reduced glutathione, which is beneficial for scavenging excessive H2O2.

CONCLUSION

Results indicated that rhamnolipids could effectively reduce fungal disease of harvested cherry tomato by inducing fruit resistance and mechanisms involved in elicitation of antioxidative reactions such as the ability to scavenge excess reactive oxygen species. © 2015 Society of Chemical Industry
Eco‐driving in urban traffic networks using traffic signals information
Authors: De Nunzio Giovanni , de Wit Carlos Canudas , Moulin Philippe , Di Domenico Domenico
Published: October 2015

The problem of eco‐driving is analyzed for an urban traffic network in presence of signalized intersections. It is assumed that the traffic light timings are known and available to the vehicles via infrastructure‐to‐vehicle communication. This work provides a solution to the energy consumption minimization while traveling through a sequence of signalized intersections and always catching a green light. The optimal‐ control problem is non‐convex because of the constraints coming from the traffic lights; therefore, a sub‐optimal strategy to restore the convexity and solve the problem is proposed. Firstly, a pruning algorithm aims at reducing the optimization domain by considering only the portions of the traffic light's green phases that allow to drive in compliance with the city speed limits. Then, a graph is created in the feasible region in order to approximate the energy consumption associated with each available path in the driving horizon. Lastly, after the problem convexity is recovered, a simple optimization problem is solved on the selected path to calculate the optimal crossing times at each intersection. The optimal speeds are then suggested to the driver. The proposed sub‐optimal strategy is compared with the optimal solution provided by dynamic programming for validation purposes. It is also shown that the low computational load of the presented approach enables robustness properties and results very appealing for online use. Copyright © 2015 John Wiley & Sons, Ltd.
Clitoral Pain Following Retropubic Midurethral Sling Placement
Authors: Christofferson Melanie , Barnard Jami , Montoya T. Ignacio
Published: October 2015

Introduction

Although uncommon, postprocedural pain with associated sexual dysfunction may be seen in patients after retropubic midurethral sling placement for treatment of stress urinary incontinence.

Aims

To describe a report of a woman who developed localized severe, persistent periclitoral pain after placement of a retropubic midurethral sling.

Methods

A healthy 41-year-old underwent an uncomplicated retropubic midurethral sling procedure. She developed persistent postoperative clitoral pain with worsening associated with arousal, impairing sexual function. Symptoms resolved with time and a course of steroid medication.

Main Outcome Measures

To report a case of clitoral pain following midurethral sling surgery, and to provide a discussion about clitoral innervation, possible pain etiologies, and management options.

Results

We report a case of clitoral pain associated with sexual dysfunction and provide a review of clitoral innervation as well as potential mechanisms of nerve injury associated with a retropubic sling procedure.

Conclusion

Clitoral pain symptoms following placement of a retropubic midurethral sling should be evaluated and promptly addressed, given the potential negative impact on the patient's sexual function.
Generalized Multifactor Dimensionality Reduction (GMDR) Analysis of Drug‐Metabolizing Enzyme‐Encoding Gene Polymorphisms may Predict Treatment Outcomes in Indian Breast Cancer Patients
Authors: Agarwal Gaurav , Tulsyan Sonam , Lal Punita , Mittal Balraj
Published: October 2015

Background

Prediction of response and toxicity of chemotherapy can help personalize the treatment and choose effective yet non‐toxic treatment regimen for a breast cancer patient. Interplay of variations in various drug‐metabolizing enzyme (DME)‐encoding genes results in variable response and toxicity of chemotherapeutic drugs. Generalized multi‐analytical (GMDR) approach was used to determine the influence of the combination of variants of genes encoding phase 0 (SLC22A16); phase I (CYP450, NQO1); phase II (GSTs, MTHFR, UGT2B15); and phase III (ABCB1) DMEs along with confounding factors on the response and toxicity of chemotherapeutic drugs in breast cancer patients.

Methods

In an Indian breast cancer patient cohort (n = 234), response to neo‐adjuvant chemotherapy (n = 111) and grade 2–4 toxicity to chemotherapy were recorded. Patients were genotyped for 19 polymorphisms selected in four phases of DMEs by PCR or PCR–RFLP or Taqman allelic discrimination assay. Binary logistic regression and GMDR analysis was performed. Bonferroni test for multiple comparisons was applied, and p value was considered to be significant at <0.025.

Results

For ABCB1 1236C>T polymorphism, CT genotype was found to be significantly associated with response to NACT in uni‐variate and multi‐variate analysis (p = 0.018; p = 0.013). The TT genotype of NQO1 609C>T had a significant association with (absence of) grade 2–4 toxicity in uni‐variate analysis (p = 0.021), but a non‐significant correlation in multi‐variate analysis. In GMDR analysis, interaction of CYP3A5*3, NQO1 609C>T, and ABCB1 1236C>T polymorphisms yielded the highest testing accuracy for response to NACT (CVT = 0.62). However, for grade 2–4 toxicity, CYP2C19*2 and ABCB1 3435C>T polymorphisms yielded the best interaction model (CVT = 0.57).

Conclusion

This pharmacogenetic study suggests a role of higher order gene–gene interaction of DME‐encoding genes, along with confounding factors, in determination of treatment outcomes and toxicity in breast cancer patients. This can be used as a potential objective tool for individualizing breast cancer chemotherapy with high efficacy and low toxicity.
Emancipating Sexuality: Breakthroughs into a Bulwark of Tradition
Authors: Alexander Amy C. , Inglehart Ronald , Welzel Christian
Published: October 2015

This article presents evidence for a rising emancipatory spirit, across generations and around the world, in a life domain in which religion hitherto blocked emancipatory gains: sexual freedoms. We propose an explanation of rising emancipative values that integrates several approaches into a single idea—the utility ladder of freedoms. Specifically, we suggest thatobjectivelyimproving living conditions—from rising life expectancies to broader education—transform the nature of life from a source of threats into a source of opportunities. As life begins to hold more promise for increasing population segments, societies climb the utility ladder of freedoms: practicing and respecting universal freedoms becomes increasingly vital to take advantage of rising life opportunities. This trend has begun to spill over into a life domain in which religious norms have until recently been able to resist emancipatory gains: sexual freedoms. We present (1) crossnational, (2) longitudinal, (3) generational and (4) multilevel evidence on an unprecedentedly broad basis in support of this theory.
Patriarchy, Power, and Pay: The Transformation of American Families, 1800–2015
Authors: Ruggles Steven
Published: October 2015

This article proposes explanations for the transformation of American families over the past two centuries. I describe the impact on families of the rise of male wage labor beginning in the nineteenth century and the rise of female wage labor in the twentieth century. I then examine the effects of decline in wage labor opportunities for young men and women during the past four decades. I present new estimates of a precipitous decline in the relative income of young men and assess its implications for the decline for marriage. Finally, I discuss explanations for the deterioration of economic opportunity and speculate on the impact of technological change on the future of work and families.
How to measure time preferences in children: a comparison of two methods
Authors: Angerer Silvia , Lergetporer Philipp , Glätzle-Rützler Daniela , Sutter Matthias
Published: October 2015

We measure time preferences in a sample of 561 children aged 7–11 years. Using a within-subject design, we compare the behavior of our subjects using two distinct experimental measures of time preferences: a standard choice list with multiple decisions and a single choice time-investment-exercise requiring one decision only. We find that both measures yield very similar aggregate results, correlate significantly within subjects and can be explained by basically the same explanatory variables. Advantages and disadvantages of both measures are discussed. Our findings are relevant for the design of experiments to measure time preferences.
Objective Assessment of Activity in Inpatients with Traumatic Brain Injury: Initial Findings
Authors: Driver Simon , Rachal Lauren , Swank Chad , Dubiel Randi
Published: October 2015

Purpose:Use accelerometers to examine the physical activity behaviours of individuals following TBI undergoing inpatient rehabilitation.

Method:Twenty-one individuals with Traumatic brain injury (TBI) undergoing inpatient rehabilitation (9 females, 12 males;Mage = 43.8 ± 14.7 years;MGCS = 9.1 ± 4.3;Mtime since injury = 40.8 ± 22.1 days;Mlength of stay (LOS) = 30 ± 14 days) wore accelerometers for an average of 8.4 ± 2.0 consecutive days (1440 minutes/day). Activity counts (AC) were collected at 1 minute epochs and descriptive statistics were calculated to assess intensity of activity and time spent being active and sedentary.

Results:During scheduled therapy, time individuals completed an average of 161.4 ± 65.5 AC/minute, which decreased to 114.5 ± 51.3 during non-therapy time and 22.2 ± 10 when sleeping. Using population level cut points, individuals were on average considered inactive during therapy, inactive or sedentary during non-therapy time, and only one participant spent >1 minute in moderate intensity activity. The mean length of active and sedentary bouts was 9 minutes.

Discussion:Findings indicate that the amount and intensity of activity completed is low amongst individuals completing inpatient rehabilitation after TBI, with the majority considered sedentary or inactive. While the sample is small, it is important to develop and implement safe and effective strategies to increase activity levels during rehabilitation.
Rho-associated kinase signalling and the cancer microenvironment: novel biological implications and therapeutic opportunities
Authors: Chin Venessa T. , Nagrial Adnan M. , Chou Angela , Biankin Andrew V. , Gill Anthony J. , Timpson Paul , Pajic Marina
Published: October 2015

The Rho/ROCK pathway is involved in numerous pivotal cellular processes that have made it an area of intense study in cancer medicine, however, Rho-associated coiled-coil containing protein kinase (ROCK) inhibitors are yet to make an appearance in the clinical cancer setting. Their performance as an anti-cancer therapy has been varied in pre-clinical studies, however, they have been shown to be effective vasodilators in the treatment of hypertension and post-ischaemic stroke vasospasm. This review addresses the various roles the Rho/ROCK pathway plays in angiogenesis, tumour vascular tone and reciprocal feedback from the tumour microenvironment and explores the potential utility of ROCK inhibitors as effective vascular normalising agents. ROCK inhibitors may potentially enhance the delivery and efficacy of chemotherapy agents and improve the effectiveness of radiotherapy. As such, repurposing of these agents as adjuncts to standard treatments may significantly improve outcomes for patients with cancer. A deeper understanding of the controlled and dynamic regulation of the key components of the Rho pathway may lead to effective use of the Rho/ROCK inhibitors in the clinical management of cancer.
The origins and implications of late prehistoric plant husbandry in northern Japan
Authors: Crawford Gary W. , Takamiya Hiroto
Published: October 2015

Introduction

Processes of acculturation and assimilation in contact situations have been the subject of considerable interest to North American and Japanese prehistorians alike. In the latter case, research has emphasized the transition, beginning about 1000 BC, to the wet-rice-focussed Yayoi (Akazawa 1981, 1986) (see TABLE1 for plant nomenclature used in this paper). The spread of agriculture to northeastern Japan is usually viewed as a northeastward progression of a frmtier that reached northern Tohoku by the Middle Yayoi (FIGURES 1 & 2). However, the situation is more complex than this, in our view, and involves a spatial and cultural dichotomy between Hokkaido and northern Tohoku on the one hand and southern Tohokusouthwestern Japan on the other. Furthermore, we interpret Ainu culture (as distinct from the Ainu biological population) of Hokkaido and Sakhalin to be an outcome of a long period of social interaction along this boundary.
A NOTE ON -JORDAN DERIVATIONS OF RINGS AND BANACH ALGEBRAS
Authors: KOSI-ULBL IRENA , VUKMAN JOSO
Published: October 2015

In this paper we prove the following result: let$m,n\geq 1$be distinct integers, let$R$be an$mn(m+n)|m-n|$-torsion free semiprime ring and let$D:R\rightarrow R$be an$(m,n)$-Jordan derivation, that is an additive mapping satisfying the relation$(m+n)D(x^{2})=2mD(x)x+2nxD(x)$for$x\in R$. Then$D$is a derivation which maps$R$into its centre.
A Theory of Entrepreneurship
Authors: Evans George Herberton
Published: October 2015

While definitions of terms must vary with the purposes of their use, several studies of American entrepreneurship might be started with the word entrepreneur confined to those business executives who are associated with (a) the organization of new business units, (b) substantial expansions of established units, and (c) strenuous efforts to adapt established units to a changing environment. Such a conception, which uses terms that would obviously have to be made more precise as a study progressed, excludes from the term entrepreneur those business executives who carry on more or less routine operations, and it directs attention to the dynamic activities of businessmen. It is a little broader than a strict interpretation of the term innovator and fits fairly well the idea implicit in many definitions of the term entrepreneur, namely, that the entrepreneur is the businessman who introduces new ideas and changes the rate at which the wheels of enterprise go ‘round. Moreover, it utilizes three types of business activity concerning which there are data available for studies of the policy-determining executive. I should perhaps add that those who attempt to organize, expand, or adapt business units should be called entrepreneurs as well as those who achieve these goals. Attempts often reveal new ideas that successors are able to put into operation.
Constitutional Identity
Authors: Jacobsohn Gary Jeffrey
Published: October 2015

Constitutional theorists have had relatively little to say about the identity of what they study. This article addresses this inattention with a philosophical and comparative exploration of the concept of constitutional identity. Without such attention, a major preoccupation of theorists—constitutional change—will continue to be inadequately considered. The argument is advanced that there are attributes of a constitution that allow us to identify it as such, and that there is a dialogical process of identity formation that enables us to determine the specific identity of any given constitution. Representing a mix of aspirations and commitments expressive of a nation's past, constitutional identity also evolves in ongoing political and interpretive activities occurring in courts, legislatures, and other public and private domains. Conceptual possibilities of constitutional identity are, herein, pursued in two constitutional settings—India and Ireland—that highlight its distinctive features.
The Byzantine conquest of Cilicia and the Hamdanids of Aleppo, 959–965
Authors: Garrood William
Published: October 2015

Between 959 and 965, Byzantine forces, directed and most often led by Nikephoros Phokas, launched a series of successful campaigns of conquest, particularly in the east. Although little studied, these conquests are significant. The subject of this article, the conquest of the Cilician plain in 965, represents the culmination of a century of Byzantine pressure on the Arab border states, of which Tarsos was the last. Simultaneously, the elimination of the Hamdanid emirate of Aleppo as a threat to the Empire helped to lay the groundwork for further successes in Syria after 965. It is the contention of this article that these objectives were intertwined and that Nikephoros Phokas followed a concerted and structured strategy through this period, aimed primarily at the conquest of Cilicia. Other objectives, though dramatic, should thus be seen as subordinate to this underlying objective.
VII—Further Investigations into the Periodic Lamé Functions
Authors: Ince E. L.
Published: October 2015

Hitherto the Lamé functions of u, of real periods 2K and 4K, and the Lamé polynomials in particular, have been expressed as series of integral powers of sn u (multiplied, in appropriate cases, by cn u, dn u, or cn u dn u). The necessity to use these, or the corresponding Weierstrassian forms, is a serious handicap to research, because the terms of the expression are not mutually orthogonal. In particular, results that can be deduced from the orthogonal properties of the Fourier series in which periodic Mathieu functions are developed, find no analogues in the Lamé functions as expressed in the customary forms. For instance, the integral equations that generate the Mathieu functions have proved to be valuable sources of information, but those for the Lamé functions cannot be much more than scientific curiosities until the development of Lamé functions as series of orthogonal functions enables them to be put to use.
Systematic review of brucellosis in the Middle East: disease frequency in ruminants and humans and risk factors for human infection
Authors: MUSALLAM I. I. , ABO-SHEHADA M. N. , HEGAZY Y. M. , HOLT H. R. , GUITIAN F. J.
Published: October 2015

A systematic review of studies providing frequency estimates of brucellosis in humans and ruminants and risk factors forBrucellaspp. seropositivity in humans in the Middle East was conducted to collate current knowledge of brucellosis in this region. Eight databases were searched for peer-reviewed original Arabic, English, French and Persian journal articles; the search was conducted on June 2014. Two reviewers evaluated articles for inclusion based on pre-defined criteria. Of 451 research articles, only 87 articles passed the screening process and provided bacteriological and serological evidence for brucellosis in all Middle Eastern countries.Brucella melitensisandB. abortushave been identified in most countries in the Middle East, supporting the notion of widespread presence ofBrucellaspp. especiallyB. melitensisacross the region. Of the 87 articles, 49 were used to provide evidence of the presence ofBrucellaspp. but only 11 provided new knowledge on the frequency of brucellosis in humans and ruminants or on human risk factors for seropositivity and were deemed of sufficient quality. Small ruminant populations in the region show seroprevalence values that are among the highest worldwide. Human cases are likely to arise from subpopulations occupationally exposed to ruminants or from the consumption of unpasteurized dairy products. The Middle East is in need of well-designed observational studies that could generate reliable frequency estimates needed to assess the burden of disease and to inform disease control policies.
A 74-year-old unoperated univentricular heart: the oldest reported survival
Authors: Gesuete Valentina , Fabi Marianna , Bonvicini Marco
Published: October 2015

Univentricular heart is a rare congenital heart malformation. Nowadays prognosis is considered to be strictly linked to surgical intervention, and survival into late adulthood is unusual.

In some patients native haemodynamic circulation balances pulmonary and systemic blood flow, allowing long-term survival without the need for surgery.

We report the case of a 74-year-old man with a univentricular heart in natural history, and we discuss the factors that might contribute to his extraordinary long-term survival.
Transient Modeling in Simulation of Hospital Operations for Emergency Response
Authors: Paul Jomon Aliyas , George Santhosh K. , Yi Pengfei , Lin Li
Published: October 2015

Rapid estimates of hospital capacity after an event that may cause a disaster can assist disaster-relief efforts. Due to the dynamics of hospitals, following such an event, it is necessary to accurately model the behavior of the system. A transient modeling approach using simulation and exponential functions is presented, along with its applications in an earthquake situation. The parameters of the exponential model are regressed using outputs from designed simulation experiments. The developed model is capable of representing transient, patient waiting times during a disaster. Most importantly, the modeling approach allows real-time capacity estimation of hospitals of various sizes and capabilities. Further, this research is an analysis of the effects of priority-based routing of patients within the hospital and the effects on patient waiting times determined using various patient mixes. The model guides the patients based on the severity of injuries and queues the patients requiring critical care depending on their remaining survivability time. The model also accounts the impact of prehospital transport time on patient waiting time.
Characteristics of Fatal Ambulance Crashes During Emergency and Non-emergency Operation
Authors: Pirrallo Ronald G. , Swor Robert A.
Published: October 2015

Objective:

To analyze the characteristics of fatal ambulance crashes to assist emergency medical services (EMS) directors in objectively developing their EMS system's policy governing ambulance operations.

Hypothesis:

No difference exists between the characteristics of fatal ambulance crashes during emergency and nonemergency use.

Design:

Retrospective, cross-sectional, comparative analysis of ambulance crashes resulting in fatalities reported to the Fatal Accident Reporting System (FARS) from 1987 to 1990.

Methods:

Twenty variables, representing characteristics of fatal ambulance crashes, were selected from the National Highway Traffic Administration FARS Codebook and were evaluated using tests of significance for categorical data grouped by emergency use and nonemergency use. Crash variable categories examined included demographics, accident configuration, accident severity, vehicle description, and ambulance operator action.

Results:

During the four-year study period, 109 fatal ambulance crashes occurred producing 126 deaths. Four states, New York, Michigan, California, and North Carolina, accounted for 37.5% of all fatal crashes. Seventy-five fatal crashes (69%) occurred during emergency use (EU) and 34 fatal crashes (31%) occurred during nonemergency use (NEU). The total number of fatal crashes varied in a downward trend (1987:32; 1988:24; 1989:28; 1990:25). The number of fatal EU crashes also varied in a downward trend (1987:28; 1988:16; 1989:19; 1990:12), while the number of fatal NEU crashes increased each year [1987:4; 1988:8; 1989:9; 1990:13](p = .016). Most EU fatal crashes occurred between 1200 h and 1800 h (p = .009). Most NEU fatal crashes occurred during times when light conditions were poor (p = .003). When a violation was charged to the ambulance driver (17 cited), the vehicle was more likely to be in EU (p = .056). No statistically significant differences between EU and NEU were identified by: 1) day of week; 2) season; 3) atmospheric conditions; 4) roadway surface type; 5) roadway surface condition; 6) speed limit; 7) roadway alignment; 8) relationship to junction; 9) manner of collision; 10) year manufactured; 11) vehicle role; 12) vehicle maneuver; 13) manner leaving scene; 14) extent of deformation; 15) violations charged; or 16) number of persons killed in accident.

Conclusion:

Few characteristics differentiate between fatal ambulance crashes during EU and NEU. The difference between EU and NEU were statistically significant in only three out of the 20 variables examined: 1) year occurred; 2) time of day; and 3) light condition. These data provide few objective measures that may be used to develop ambulance operation policies to decrease fatal ambulance crashes.
Effect of First Aid Education on First Aid Knowledge and Skills of Commercial Drivers in South West Nigeria
Authors: Olumide Adesola O. , Asuzu Michael C. , Kale Oladele O.
Published: October 2015

Background

Prompt prehospital care is essential for improving outcomes of road crash victims; however, this service is sub-optimal in developing countries because Emergency Medical Services (EMS) are not readily available. Training of lay responders in first aid has been suggested as a means of filling this gap in settings with inadequate EMS. This study was conducted to determine the effect of first aid training on the first aid knowledge and skills of commercial drivers.

Methods

A before-and-after study was conducted among 128 commercial drivers (62 intervention and 66 controls) selected by multi-stage sampling. Drivers’ first aid knowledge and skills were assessed at baseline, immediate, and three months post-intervention. The intervention involved a 2-day training session in first aid. Repeated measures ANOVA was used to test for differences in respondents’ pre- and post-intervention scores over the three assessment points.

Results

Mean first aid knowledge scores for intervention drivers were 48.9% (SD=12.0), 57.8% (SD=11.2), and 59.2% (SD=9.0) at baseline, immediate, and three months post-intervention. Corresponding scores for the controls were 48.3% (SD=12.8), 39.2% (SD=15.3), and 46.8% (SD=15.3). Mean first aid skill scores for intervention drivers were 17.5% (SD=3.8), 80.7% (SD=8.3), and 72.3% (SD=16.8). Scores for control drivers were 16.5% (SD=4.5), 16.3% (SD=4.7), and 20.4% (SD=9.1), respectively. Repeated measures ANOVA showed significant differences in first aid knowledge and skills scores over the three phases. Independent t-test revealed significant differences in scores between the intervention and control groups post-intervention.

Conclusion

The training led to significant improvement in first aid knowledge and skills of intervention drivers. This confirms that lay responders can be trained in provision of first aid. The slight drop in skills scores, which occurred three months post-intervention, highlights the need for periodic refresher trainings to be conducted for the drivers in order to maintain the knowledge and skills acquired.

OlumideAO, AsuzuMC, KaleOO. Effect of first aid education on first aid knowledge and skills of commercial drivers in South West Nigeria. Prehosp Disaster Med. 2015;30(6):579–585.
Potential Exposure to Ebola Virus from Body Fluids due to Ambulance Compartment Permeability in Sierra Leone
Authors: Casey Megan L. , Nguyen Duong T. , Idriss Barrie , Bennett Sarah , Dunn Angela , Martin Stephen
Published: October 2015

Introduction

Prehospital care, including patient transport, is integral in the patient care process during the Ebola response. Transporting ill persons from the community to Ebola care facilities can stop community spread. Vehicles used for patient transport in infectious disease outbreaks should be evaluated for adequate infection prevention and control.

Problem

An ambulance driver in Sierra Leone attributed his Ebola infection to exposure to body fluids that leaked from the patient compartment to the driver cabin of the ambulance.

Methods

A convenience sample of 14 vehicles used to transport patients with suspected or confirmed Ebola in Sierra Leone were assessed. The walls separating the patient compartment and driver cabin in these vehicles were evaluated for structural integrity and potential pathways for body fluid leakage. Ambulance drivers and other staff were asked to describe their cleaning and decontamination practices. Ambulance construction and design standards from the National Fire Protection Association, US General Services Administration, and European Committee on Standardization (CEN) were reviewed.

Results

Many vehicles used by ambulance staff in Sierra Leone were not traditional ambulances, but were pick-up trucks or sport-utility vehicles that had been assembled or modified for patient transport. The wall separating the patient compartment and driver cabin in many vehicles did not have a waterproof seal around the edges. Staff responsible for cleaning and disinfection did not thoroughly clean bulk body fluids with disposable towels before disinfection of the patient compartment. Pressure from chlorine sprayers used in the decontamination process may have pushed body fluids from the patient compartment into the driver cabin through gaps around the wall. Ambulance design standards do not require a waterproof seal between the patient compartment and driver cabin. Sealing the wall by tightening or replacing existing bolts is recommended, followed by caulking of all seams with a sealant.

Conclusion

Waterproof separation between the patient compartment and driver cabin may be essential for patient transport vehicles in infectious disease outbreaks, especially when chlorine sprayers are used for decontamination or in resource-limited settings where cleaning supplies may be limited.

CaseyML, NguyenDT, IdrissB, BennettS, DunnA, MartinS. Potential exposure to Ebola virus from body fluids due to ambulance compartment permeability in Sierra Leone. Prehosp Disaster Med. 2015;30(6):625–627.