bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between insurance and 30‐day readmission rates in patients 65 years and older discharged from an acute care hospital with hospice services
Authors: Whitney Patricia , Chuang Elizabeth J.
Published: May 2016

BACKGROUND

Patients who are dual eligible for both Medicare and Medicaid have previously been shown to have increased healthcare utilization and cost. However, this relationship has not been examined for patients at the end of life. Dual eligible patients enrolled in hospice may receive more comprehensive care in the community, reducing readmissions in the final weeks or months of life.

OBJECTIVE

Determine whether patients who have dual coverage with Medicare and Medicaid and are discharged with referral to hospice services after palliative care consult during their hospitalization differ in their 30‐day readmission rate compared with similar patients with other types of insurance.

DESIGN

Retrospective cohort study.

SETTING

Three acute care hospitals affiliated with Montefiore Medical Center in the Bronx, New York.

PATIENTS

In total, 2755 inpatients who received palliative care consultation and were discharged with hospice services.

PREDICTOR

Dual eligible for Medicare and Medicaid compared with other insurance status. MEASUREMENTS: Readmission to Montefiore Medical Center for any reason within 30 days of the index admission.

RESULTS

Overall, 9.24% of patients with dual Medicare and Medicaid coverage were readmitted within 30 days compared with 13.12% of others (adjusted odds ratio: 0.77; 95% confidence interval: 0.59‐0.98; P = 0.041).

CONCLUSIONS

Dual eligibility for Medicare and Medicaid is associated with lower 30‐day readmission rates in patients enrolled in a hospice program. Insurance coverage that increases access to custodial care (home attendant hours and residential care) may help decrease burdensome hospital readmissions near the end of life. Journal of Hospital Medicine 2016;11:688–693. © 2016 Society of Hospital Medicine
Urban effects on summertime air temperature in Germany under climate change
Authors: Grossman‐Clarke Susanne , Schubert Sebastian , Fenner Daniel
Published: May 2016

ABSTRACT

The impact of global climate change on urban relative to rural summertime air temperatures is investigated for nine major cities in Germany, under the Representative Concentration Pathway trajectory 8.5. The analysis is based on simulations of representative summers with a regional climate model (RCM) in conjunction with a multilayer urban parametrization when driven by three global circulation models (GCMs). The GCMs are selected because they project different warming rates for Germany. Specifically, each GCM provides boundary conditions for the RCM for two past and two future summers that resemble average conditions for Germany with respect to 2‐m air temperature statistics during a historical (1976–2005) and a future (2031–2060) period. Thus, one emphasis of our study is on the effects of the different driving GCMs on urban–rural air temperature differences (ΔTu−r). The simulations show climate change signals (CCSs) in summer‐mean ΔTu−r of the city ensemble of up to 0.15 K. Across all driving GCMs, the largest changes are projected for the city of Berlin. Characteristics of the diurnal courses of ΔTu−r, the magnitude of the CCS and its physical reasons are GCM specific. Specifically, CCSs are caused either by positive or negative changes in the Bowen ratio of the rural boundary with little change in the urban surface fluxes, or vice versa. The study emphasizes the importance of the driving GCM in RCM simulations when investigating urban effects on air temperature under global climate change.
A new classification algorithm for daughter cyclone formation with respect to the parent's frontal system – application for the Mediterranean Basin
Authors: Saaroni Hadas , Harpaz Tzvi , Ziv Baruch
Published: May 2016

This article presents a semi‐objective methodology to classify formation scenarios of a new ‘daughter’ cyclone (DC), based on the thermal field characteristics of the parent cyclone (PC). An automated algorithm assigns a DC to one of seven formation types, according to the following considerations: Whether the DC is formed on a front belonging to the parent's frontal system or to a different frontal system, and whether this frontal system is cold, warm or quasi‐stationary. An additional type contains DCs formed within the warm sector of the parent. The algorithm uses measures derived from wind and temperature fields at 850‐hPa: the temperature gradient, the temperature advection and the temperature Laplacian, each computed at the formation location of the DC, and also the temperature difference between the DC and the PC. The classification method was applied to 4303 Mediterranean DCs which were observed during 33 winters. Totally 85% of the DCs were identified as belonging to one of the seven predefined types, implying that the formation of the remaining 15% was not related to baroclinic or thermal factors. Among the successfully classified DCs, over half were formed on the frontal system of the parent, a third of the DCs on a separate frontal system and only 13% were formed within the warm sector. Most of the ‘cold front’ cyclones were formed at the major Mountain Lee locations, whereas those formed on warm fronts were generated mostly over the Adriatic, Ligurian and Aegean Seas. Inspection of composite maps of distinct formation types in various regions revealed unique formation scenarios, like DCs forming over western Morocco but belonging to third generation Genoa Lows. Other reflects discontinuous movement of cyclones, resulting from encounter with topographical obstacles, found mostly on PCs' warm fronts, or from the attraction of cyclogenetic areas left behind, mostly on PCs' cold fronts.
Incorporating a 3‐dimensional printer into the management of early‐stage cervical cancer
Authors: Baek Min‐Hyun , Kim Dae‐Yeon , Kim Namkug , Rhim Chae Chun , Kim Jong‐Hyeok , Nam Joo‐Hyun
Published: May 2016

We used a 3‐dimensional (3D) printer to create anatomical replicas of real lesions and tested its application in cervical cancer. Our study patient decided to undergo radical hysterectomy after seeing her 3D model which was then used to plan and simulate this surgery. Using 3D printers to create patient‐specific 3D tumor models may aid cervical cancer patients make treatment decisions. This technology will lead to better surgical and oncological outcomes for cervical cancer patients. J. Surg. Oncol. 2016;114:150–152. © 2016 Wiley Periodicals, Inc.
Systemic inflammatory markers as prognostic factors in stage IIA colorectal cancer
Authors: Park Byung Kwan , Park Ji Won , Han Eon Chul , Ryoo Seung‐Bum , Han Sae‐Won , Kim Tae‐You , Chie Eui Kyu , Jeong Seung‐Yong , Park Kyu Joo
Published: May 2016

Background

The aim of this study was to evaluate systemic inflammatory markers as prognostic factors in patients with stage IIA colorectal cancer.

Methods

Among the patients who underwent curative resection for colorectal cancer at Seoul National University Hospital between 2002 and 2010, 1,035 who were classified as postoperative pathologic stage IIA (T3N0M0) were included. Systemic inflammatory markers, such as the neutrophil‐to‐lymphocyte ratio (NLR), derived neutrophil‐to‐lymphocyte ratio (dNLR), platelet‐to‐lymphocyte ratio (PLR), prognostic nutritional index (PNI), and serum fibrinogen level, were retrospectively reviewed. The patients were divided into two groups according to the cut‐off values of the systemic inflammatory markers after receiver operating characteristic (ROC) curve analysis. Survival analysis was performed to identify factors associated with disease‐free survival (DFS) and overall survival (OS).

Results

Age, American Society of Anesthesiologists (ASA) score, tumor location, number of harvested lymph nodes, venous invasion, perineural invasion, adjuvant treatment and PNI (HR = 1.534, 95%CI: 1.065–2.211, P = 0.022; HR = 1.915, 95%CI: 1.286–2.852, P = 0.001 for DFS and OS, respectively) were independent significant prognostic factors for both DFS and OS.

Conclusions

PNI can be a prognostic marker in stage IIA colorectal cancer. J. Surg. Oncol. 2016;114:216–221. © 2016 Wiley Periodicals, Inc.
Clinicopathological features of colloid adenocarcinoma of the lung: A report of six cases
Authors: Masai Kyohei , Sakurai Hiroyuki , Suzuki Shigeki , Asakura Keisuke , Nakagawa Kazuo , Watanabe Shun‐Ichi
Published: May 2016

Objectives

Colloid adenocarcinoma of the lung (CA) is a rare neoplasm that is associated with abundant mucin, which destroys alveoli. We evaluated the clinicopathological features of CA.

Methods

A total of 4,648 patients underwent surgical resection of primary lung cancer at our institution from 2002 to 2014. We analyzed the clinicopathological features of CA in six (0.13%) of these patients.

Results

All patients were asymptomatic. The median age was 60.5 years. The median tumor size was 2.4 cm. All tumors appeared as solitary solid nodules on computed tomography (CT). Four of the six showed intense 18F‐fluorodeoxyglucose positron emission tomography (18F‐FDG–PET) accumulation, and the remaining two showed weak 18F‐FDG accumulation. All patients underwent lobectomy with systematic lymph node dissection. Histologically, CAs presented with various degrees of a non‐mucinous component in addition to abundant mucin. Only one patient with pN2 had recurrence.

Conclusions

On CT, CA appears a solitary solid nodule. Further, FDG–PET findings present various 18F‐FDG accumulations. Lobectomy with systematic lymph node dissection is an appropriate procedure in view of lymph node metastasis. Since the definitive diagnosis of CA of the lung is difficult, further immunohistochemical and genetic analyses are needed. J. Surg. Oncol. 2016;114:211–215. © 2016 Wiley Periodicals, Inc.
Long‐term follow‐up of amitriptyline treatment for idiopathic cough
Authors: Ryan Marisa A. , Cohen Seth M.
Published: May 2016

Objectives/Hypothesis

To evaluate short‐ and long‐term treatment outcomes of amitriptyline for idiopathic cough.

Study Design

Retrospective chart review and anonymous survey of a patient cohort.

Methods

We evaluated a cohort of adults treated for cough at the Duke Voice Care Center with amitriptyline over a 2‐ to 3‐year period. We characterized demographics, symptoms, treatment variability, and treatment effects from chart review and survey responses. We performed univariate analysis comparing cough improvement to age, gender, symptoms of throat irritation, cough duration, concurrent speech therapy, and dosage.

Results

Eighty‐nine percent were taking the medication at the first clinical follow‐up at a mean 2.6 months, and overall, 67% reported ≥50% improvement. No statistically significant predictors of cough improvement with medication were identified. At follow‐up 2 to 3 years later, overall, 53% reported ≥50% improvement, with only 34% of patients still taking amitriptyline. After 2 to 3 years, 65% of patients had titrated the medication to effect, and 33% restarted the medication. Occurrence of side effects was the most frequent reason for stopping the medication.

Conclusions

Amitriptyline can be an effective and well‐tolerated part of short‐ and long‐term management of idiopathic cough in adults. Titrating the dose and restarting are often necessary. Larger studies and randomized control trials are needed to better understand the outcomes of using amitriptyline to treat idiopathic cough.

Level of Evidence

4 Laryngoscope, 126:2758–2763, 2016
Evaluation of type II thyroplasty on phonatory physiology in an excised canine larynx model
Authors: Devine Erin E. , Hoffman Matthew R. , McCulloch Timothy M. , Jiang Jack J.
Published: May 2016

Objectives/Hypothesis

Type II thyroplasty is an alternative treatment for spasmodic dysphonia, addressing hyperadduction by incising and lateralizing the thyroid cartilage. We quantified the effect of lateralization width on phonatory physiology using excised canine larynges.

Methods

Normal closure, hyperadduction, and type II thyroplasty (lateralized up to 5 mm at 1‐mm increments with hyperadducted arytenoids) were simulated in excised larynges (N = 7). Aerodynamic, acoustic, and videokymographic data were recorded at three subglottal pressures relative to phonation threshold pressure (PTP). One‐way repeated measures analysis of variance assessed effect of condition on aerodynamic parameters. Random intercepts linear mixed effects models assessed effects of condition and subglottal pressure on acoustic and videokymographic parameters.

Results

PTP differed across conditions (P < .001). Condition affected percent shimmer (P < .005) but not percent jitter. Both pressure (P < .03) and condition (P < .001) affected fundamental frequency. Pressure affected vibratory amplitude (P < .05) and intrafold phase difference (P < .05). Condition affected phase difference between the vocal folds (P < .001).

Conclusions

Hyperadduction increased PTP and worsened perturbation compared to normal, with near normal physiology restored with 1‐mm lateralization. Further lateralization deteriorated voice quality and increased PTP. Acoustic and videokymographic results indicate that normal physiologic relationships between subglottal pressure and vibration are preserved at optimal lateralization width, but then degrade with further lateralization. The 1‐mm optimal width observed here is due to the small canine larynx size. Future human trials would likely demonstrate a greater optimal width, with patient‐specific value potentially determined based on larynx size and symptom severity.

Level of Evidence

NA Laryngoscope, 2016 127:396–404, 2017
Factors that impact health‐related quality of life over time for individuals with head and neck cancer
Authors: Reeve Bryce B. , Cai Jianwen , Zhang Hongtao , Weissler Mark C. , Wisniewski Kathy , Gross Heather , Olshan Andrew F.
Published: May 2016

Objectives/Hypothesis

To identify sociodemographic, behavioral, and clinical factors associated with health‐related quality of life (HRQOL) for head and neck cancer (HNC) patients over time.

Study Design

A population‐based longitudinal cohort study.

Methods

Newly diagnosed HNC patients (N = 587) were administered the Functional Assessment of Cancer Therapy–Head and Neck questionnaire at baseline (median 3 months postdiagnosis) and two follow‐up assessments (median 22 and 42 months). Linear mixed‐effect models were used with backward variable selection to identify factors associated with HRQOL over time (P < .05). Adjusted means reported at 2 years postdiagnosis.

Results

African Americans reported better Functional Well‐Being than whites (mean of 20.01 vs. 18.53) and fewer HNC symptoms over time. Older patients (75+ years) reported better HRQOL than younger patients (< 50 years). Current tobacco use compared to no tobacco use had worse Physical (20.20 vs. 21.50), Emotional (17.55 vs. 19.06), Social (21.28 vs. 22.88), and Functional (17.32 vs. 19.29) Well‐Being and more HNC symptoms (21.50 vs. 23.71). Radiation therapy was associated with worse Physical and Functional Well‐Being and more head and neck symptoms over time, but HRQOL was similar to those who were not irradiated by 2 to 4 years postdiagnosis.

Conclusion

This study identified key factors for individuals at risk for poorer HRQOL that may help clinicians and caregivers find solutions to address these decrements. Smoking cessation programs can be encouraged for survivors who use tobacco. Psychological and social support and medications may help for dealing with emotional distress and dealing with the physical symptoms from treatment.

Level of Evidence

4. Laryngoscope, 126:2718–2725, 2016
Evaluation of Sediment Deposition in a Mediterranean Reservoir: Comparison of Long Term Bathymetric Measurements and SWAT Estimations
Authors: Licciardello Feliciana , Toscano Attilio , Cirelli Giuseppe L. , Consoli Simona , Barbagallo Salvatore
Published: May 2016

This study aims to demonstrate that the SWAT model can be used to predict discharge and sediment yield values in reservoir contributing catchments helping also to define the main factors that determine sedimentation rates in semi‐arid Mediterranean environments. This aim was achieved by comparing SWAT simulation results with water flows (over 29 years) and sediment deposition (over 47 years) volumes collected (by a campaign of bathymetric surveys) in a Sicilian reservoir. The mean monthly runoff coefficient calculated for the period 1980–2008 was 0·17. The mean sedimentation volume in the reservoir during the period 1963–2009 was 51,000 m3 year−1. Field surveys and collection of spatially distributed databases of soil, topography and climate were carried out in order to characterize the contributing catchment. The SWAT model was applied to simulate sediment volumes cumulated over group of years as well as water flow volumes reaching annual and monthly the reservoir. The performance of the hydrological and erosion components of the model was evaluated by a combination of both summary and difference statistical measures after a sensitivity analysis and a calibration/validation process. The model was able to simulate observed runoff volumes at both annual and monthly scale. The mean sedimentation volume simulated by SWAT during the whole period was 8·1% lower than the value obtained by the bathymetric measurements (equal to 72·103 Mg) with very good values of the efficiency coefficient (equal to 0·91). Copyright © 2016 John Wiley & Sons, Ltd.
Solvent Effect on Electrochemical Properties of a Co(II)‐Based Metallo‐Supramolecular Polymer Film
Authors: Hsu Chih‐Yu , Zhang Jian , Moriyama Satoshi , Higuchi Masayoshi
Published: May 2016

The influence of solvents on the electrochemical properties of a Co(II)‐bisterpyridine‐based metallo‐supramolecular polymer (polyCo) thin films are studied. A redox couple of the polyCo film on GC electrode is observed in the reduction domain due to the redox reaction between Co(II) and Co(I) which belongs to a Nernstian reversible process in aqueous electrolyte solution. While a significant difference on the electrochemical stability of polyCo film is found in the electrolyte solution of organic solvent. A shrinking behaviour of the film is observed after redox switching in acetonitrile solution. The formation of the mixed‐ligand of cobalt ion with water molecules as well as the hydrophilic property of the anion enable a stable redox switching of polyCo film in aqueous electrolytes.
Physico‐Chemical and Rheological Properties of Gellan in Aqueous‐Salt Solutions and Oilfield Saline Water
Authors: Kudaibergenov Sarkyt E. , Tatykhanova Gulnur S. , Sigitov Vladimir B. , Nurakhmetova Zhanar A. , Blagikh Eugene V. , Gussenov Iskander Sh. , Seilkhanov Tulegen M.
Published: May 2016

The physico‐chemical and rheological properties of low acyl gellan (LAG) were investigated in aqueous solutions of various salts. 1H NMR spectroscopic study of LAG was conducted in salt‐free solutions at different temperatures. FTIR spectra revealed that the characteristic bands of both asymmetric and symmetric carboxylate groups are shifted to higher frequency regions as a result of effective surrounding of glucuronate residuesby mono‐ and divalent cations of salts. According to viscometricresults the effectiveness of salts to enhance gelation of gellan changes in the following order: BaCl2 > CaCl2 ≈ MgCl2 > KCl > NaCl. The behavior of LAG in model aqueous‐salt solutions and real oilfield saline water was evaluated by means of rheological measurements.The shear rate (and effective viscosity) of 0.5 wt.% gellan solution versus shear stress increases (and decreases) in the sequence of CaCl2 > MgCl2 > KCl > NaCl demonstrating the pseudo plastic character. The sol‐gel and liquid‐solid phase transitions of gellan solutionswere observed upon addition of oilfield water containing 73 g · L−1 of alkaline and alkaline earth metal ions. The effectiveness of salts to induce the separation of liquid and solid phases changes in the sequence: NaCl > KCl > MgCl2 ≈ CaCl2 ≈ BaCl2. The mechanical properties of gellan gels under compression were studied and the Young modules and breaking stresses were found. Sol‐gel transition of gellan solution inside of sand pack model was demonstrated. The hydrodynamic behavior of 0.5 wt.% gellan solution injected into the sand pack model with high (20 d) and low (2 d) permeability is useful to model the oil reservoirs in the process of enhanced oil recovery. The influence of clay minerals – bentonite on the rheological characteristics of gellan solution was evaluated for simulation of drilling mud ability to carry up the drilled rock particles from the bottomhole of the well to the surface.
Resolving phase ambiguity in dual‐echo dixon imaging using a projected power method
Authors: Zhang Tao , Chen Yuxin , Bao Shanshan , Alley Marcus T. , Pauly John M. , Hargreaves Brian A. , Vasanawala Shreyas S.
Published: May 2016

Purpose

To develop a fast and robust method to resolve phase ambiguity in dual‐echo Dixon imaging.

Methods

A major challenge in dual‐echo Dixon imaging is to estimate the phase error resulting from field inhomogeneity. In this work, a binary quadratic optimization program was formulated to resolve the phase ambiguity. A projected power method was developed to efficiently solve the optimization problem. Both the 1‐peak fat model and 6‐peak fat model were applied to three‐dimensional (3D) datasets. Additionally, the proposed method was extended to dynamic magnetic resonance imaging (MRI) applications using the 6‐peak fat model. With institutional review board (IRB) approval and patient consent/assent, the proposed method was evaluated and compared with region growing on 29 consecutive 3D high‐resolution patient datasets.

Results

Fast and robust water/fat separation was achieved by the proposed method in different representative 3D datasets and dynamic 3D datasets. Superior water/fat separation was achieved using the 6‐peak fat model compared with the 1‐peak fat model. Compared to region growing, the proposed method reduced water/fat swaps from 76 to 7% of the patient cohort.

Conclusion

The proposed method can achieve fast and robust phase error estimation in dual‐echo Dixon imaging. Magn Reson Med 77:2066–2076, 2017. © 2016 International Society for Magnetic Resonance in Medicine
P2Y2 purinergic receptors are highly expressed in cardiac and diaphragm muscles of mdx mice, and their expression is decreased by suramin
Authors: De Oliveira Moreira Drielen , Santo Neto Humberto , Marques Maria Julia
Published: May 2016

Introduction: In Duchenne muscular dystrophy (DMD) and in the mdx mouse model of DMD, the lack of dystrophin leads to increased calcium influx and muscle necrosis. Patients suffer progressive muscle loss, and cardiomyopathy is an important determinant of morbidity. P2 purinergic receptors participate in the increased calcium levels in dystrophic skeletal muscles. Methods: In this study, we evaluated whether P2 receptors are involved in cardiomyopathy in mdx mice at later stages of the disease. Results: Western blotting revealed that P2Y2 receptor levels were upregulated (54%) in dystrophic heart compared with a normal heart. Suramin reduced the levels of P2Y2 to almost normal values. Suramin also decreased heart necrosis (reduced CK‐MB) and the expression of the stretch‐activated calcium channel TRPC1. Conclusions: This study suggests that P2Y2 may participate in cardiomyopathy in mdx mice. P2‐selective drugs with specific actions in the dystrophic heart may ameliorate cardiomyopathy in dystrophinopathies. Muscle Nerve 55: 116–121, 2017
A linearized high‐order difference scheme for the fractional Ginzburg–Landau equation
Authors: Hao Zhao‐peng , Sun Zhi‐zhong
Published: May 2016

The numerical solution for the one‐dimensional complex fractional Ginzburg–Landau equation is considered and a linearized high‐order accurate difference scheme is derived. The fractional centered difference formula, combining the compact technique, is applied to discretize fractional Laplacian, while Crank–Nicolson/leap‐frog scheme is used to deal with the temporal discretization. A rigorous analysis of the difference scheme is carried out by the discrete energy method. It is proved that the difference scheme is uniquely solvable and unconditionally convergent, in discrete maximum norm, with the convergence order of two in time and four in space, respectively. Numerical simulations are given to show the efficiency and accuracy of the scheme. © 2016 Wiley Periodicals, Inc. Numer Methods Partial Differential Eq 33: 105–124, 2017
Osteopontin affects macrophage polarization promoting endocytic but not inflammatory properties
Authors: Schuch Karina , Wanko Bettina , Ambroz Katharina , Castelo‐Rosa Alexandra , Moreno‐Viedma Verónica , Grün Nicole G. , Leitner Lukas , Staffler Günther , Zeyda Maximilian , Stulnig Thomas M.
Published: May 2016

Objective

Macrophages are the main drivers of obesity‐induced adipose tissue (AT) inflammation that causes insulin resistance. Macrophages polarize toward different inflammatory (M1) or protective (M2) phenotypes. Osteopontin (OPN) is an inflammatory cytokine highly expressed in AT in obesity and known to be involved in chronic inflammatory processes. It was hypothesized that OPN polarizes macrophages into a proinflammatory phenotype.

Methods

AT macrophages (ATMs) of OPN‐deficient (Spp1−/−) and wild‐type C57BL/6 (WT) mice with obesity and bone marrow‐derived macrophages (BMDMs) of Spp1−/− and WT mice as well as human monocyte‐derived macrophages (MDMs) polarized in the presence of OPN were investigated.

Results

While ATM infiltration was lower in Spp1−/− upon high‐fat diet, Spp1−/− ATMs expressed more M1 and less M2 markers but less tumor necrosis factor‐α compared with WT. There was no effect of OPN deficiency on BMDM polarization. In human MDMs, the presence of OPN during polarization ambiguously altered M1/M2‐related marker expression and diminished LPS‐induced inflammatory cytokine production. Strikingly, phagocytic activity was elevated by the presence of OPN during polarization in both human MDMs and murine BMDMs.

Conclusions

In contradiction to our hypothesis, data indicated that OPN does not induce inflammatory macrophages but was a signal to induce phagocytosis, which may be required due to increased adipocyte death in obesity.
Endothelial function following glucose ingestion in adults with prediabetes: Role of exercise intensity
Authors: Malin Steven K. , Rynders Corey A. , Weltman Judy Y. , Jackson Roberts L. , Barrett Eugene J. , Weltman Arthur
Published: May 2016

Objective

To determine whether high intensity exercise (HIE) would improve endothelial function more than an isocaloric bout of moderate intensity exercise (MIE) following glucose ingestion in adults with prediabetes.

Methods

Twelve subjects with prediabetes completed all three conditions: time‐course matched control and isocaloric exercise (∼200 kcal) at moderate (MIE; at lactate threshold) and high intensity (HIE; 75% of difference between lactate threshold and VO2peak). Brachial artery flow‐mediated dilation (FMD) was measured before exercise (baseline), within 30 min postexercise, and 1 and 2 hr following a 75 g oral glucose tolerance test (OGTT). Plasma F2‐isoprostanes were also assessed during the protocol (i.e., baseline to 2 hr OGTT) as a biomarker of oxidative stress.

Results

MIE reduced postexercise F2‐isoprostanesAUC compared with time‐course matched control and HIE. Although exercise had no statistical effect on FMD postexercise or during the OGTT, elevations in FMDAUC after MIE and HIE were associated with reduced postexercise F2‐isoprostanesAUC.

Conclusions

Exercise at either intensity had no effect on FMD immediately postexercise following glucose administration. However, individuals with reduced oxidative stress responses to exercise had greater exercise‐induced improvement in FMD. Further work is required to identify the mechanism by which exercise alters oxidative stress to enhance endothelial function.
Efficacy of an orlistat‐resveratrol combination for weight loss in subjects with obesity: A randomized controlled trial
Authors: Arzola‐Paniagua María Angélica , García‐Salgado López Enrique Raúl , Calvo‐Vargas Cesar G. , Guevara‐Cruz Martha
Published: May 2016

Objective

To evaluate the efficacy of an orlistat‐resveratrol (O‐R) combination in subjects with obesity over a 6‐month period.

Methods

This study was a double‐blind, parallel, randomized controlled clinical trial. Patients fulfilling the selection criteria (age from 20 to 60 years and body mass index (BMI) ≥30 and ≤39.9 kg/m2) consumed an energy‐reduced diet with 500 fewer calories than their usual diet for 2 weeks. Then the participants were randomly assigned to four groups, placebo, resveratrol, orlistat, or O‐R, and they consumed the energy‐reduced diet for 6 months. The study consisted of seven visits. During each visit, a 24‐h recall was performed, along with measurements of anthropometric and serum biochemical parameters.

Results

A total of 161 participants were selected. Of these, 84 participants completed the study. A significant weight loss of −6.82 kg (95% CI −8.37 to −5.26) was observed in the O‐R group compared with −3.50 kg (−5.05 to −1.95, P = 0.021) in the placebo group. In contrast, the −6.02 kg (−7.68 to −4.36) orlistat and −4.68 kg (−6.64 to −2.71) resveratrol monotherapy losses did not significantly differ from the placebo. Significant decreases in BMI, waist circumference, fat mass, triglycerides, leptin, and leptin/adiponectin ratio were observed with the O‐R combination.

Conclusions

The O‐R combination was the most effective weight loss treatment.
Theoretical investigation of curved π‐conjugated fullerene flakes: open‐shell character, aromaticity, and third‐order nonlinear optical property
Authors: Fukuda Kotaro , Fujiyoshi Jun‐ya , Minamida Yuka , Nagami Takanori , Matsui Hiroshi , Ito Soichi , Kishi Ryohei , Kitagawa Yasutaka , Champagne Benoît , Nakano Masayoshi
Published: May 2016

Open‐shell singlet nature, aromaticity, and second hyperpolarizabilities of two kinds of curved π‐conjugated fragments of C60 fullerene, called C60 flakes, together with their corresponding planar analogues are theoretically investigated. It is found that one curved system, A-1, exhibits intermediate open‐shell singlet nature, while the other structure, B-1, and the two corresponding planar systems possess a closed‐shell ground state. The variation of the open‐shell singlet nature is explained by the number of Clar's sextets in the resonance structures, which is associated with the local aromaticity, as quantified by the NICS0 values. The calculated orientationally averaged second hyperpolarizabilities show that the intermediate open‐shell singlet system A‐1 exhibits the best performance, and that the other curved system B‐1 is the worst among the four C60 flakes, whereas all systems exhibit better performance than the original spherical C60 system. This tendency suggests that a lower dimensionality in the π‐conjugated structure is beneficial to the construction of efficient nonlinear optical molecules. The present results not only show that the open‐shell singlet system A‐1 is a performant nonlinear optical molecule, but they also contribute to a deeper understanding of the electronic structure of curved π‐conjugated molecules. Copyright © 2016 John Wiley & Sons, Ltd.
Halogen bonding in biological context: a computational study of D2 dopamine receptor
Authors: Luchi Adriano M. , Angelina Emilio L. , Andujar Sebastián A. , Enriz Ricardo D. , Peruchena Nélida M.
Published: May 2016

In this work, Halogen Bond (X‐bond) interactions formed by halogenated ligands (LX) at the Dopamine Receptor D2 (DRD2) binding pocket were studied by Molecular Dynamics (MD) and charge density analysis. The X‐bonds were contrasted with the Hydrogen Bond (H‐bond) interactions established by hydroxylated analogs (LOH, where X was replaced by OH). The ligands for this study were extracted from a dataset of compounds deposited in ZINC database that were active in binding assays to DRD2. This dataset was subjected to the filtering rules by employing cheminformatics tools to find the LX/LOH pairs that were then submitted to MD simulations. A homology model of DRD2 was employed for the simulations because no crystal structure is yet available for the receptor. To mimic the positive cap (σ‐hole) on the halogen atom, a massless, positive charged extra‐point was introduced in the force field. An analysis of the charge density (QTAIM) was performed on reduced models of simulated complexes to explain their binding differences. Results show that the halogen atom tends to form X‐bond with protein backbone oxygen atom. Two out of the four halogenated ligands studied form a specific X‐bond with the carbonyl oxygen of Ser193. This specific X‐bond decreases the inherent propensity of transmembrane 5 to unfolding. These results suggest a possible role of the X‐bond as a protein secondary structure modulator because of the ability of the halogen to interact with the protein backbone. Copyright © 2016 John Wiley & Sons, Ltd.
Temperature memory effect and its stability revealed via differential scanning calorimetry in ethylene‐vinyl acetate within glass transition range
Authors: Xi Wang Tao , Min Huang Wei , Chen Hongmei , Xiao Rui , Bo Lu Hai , Feng Kang Shu
Published: May 2016

In this article, we reveal the temperature memory effect (TME) in a commercial thermoplastic polymer, namely ethylene‐vinyl acetate (EVA), within its glass transition range via a series of differential scanning calorimeter (DSC) tests. In addition, we investigate the influence of heating holding time and also compare the observed TME in current study with that of shape memory alloys (SMAs). It is concluded that the TME via DSC (without any macroscopic shape change) is achievable within the glass transition range of a polymer. Conversely, although the observed TME shares the many similar features as those in SMAs, due to the nature of micro‐Brownian motion in the glass transition of polymers, the resulted TME is strongly affected by the heating holding time. © 2016 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2016, 54, 1731–1737
Strain stiffening and negative normal stress in alginate hydrogels
Authors: Hashemnejad Seyed Meysam , Kundu Santanu
Published: May 2016

Alginate hydrogels are polysaccharide biopolymer networks widely useful in biomedical and food applications. Here, we report nonlinear mechanical responses of ionically crosslinked alginate hydrogels captured using large amplitude oscillatory shear experiments. Gelation was performedin situin a rheometer and the rheological investigations on these samples captured the strain‐stiffening behavior for these gels as a function of oscillatory strain. In addition, negative normal stress was observed, which has not been reported earlier for any polysaccharide networks. The magnitude of negative normal stress increases with the applied strain amplitude and can exceed that of the shear stress at large‐strain. Fitting a constitutive relationship to the stress‐strain curves reveals that the mode of deformation involves stretching of the alginate chains and bending of both the chains and the junction zones. The contribution of bending increases near saturation ofGblocks as Ca2+concentration was increased. The results presented here provide an improved understanding of the deformation behavior of alginate hydrogels and such understanding can be extended to other crosslinked polysaccharide networks. © 2016 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys.2016,54, 1767–1775
Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria
Authors: Adedimeji Adebola A. , Lounsbury David , Popoola Oluwafemi , Asuzu Chioma , Lawal Akinmayowa , Oladoyin V. , Crifase Cassandra , Agalliu Ilir , Shankar Viswanathan , Adebiyi Akindele
Published: May 2016

Background

Cancers constitute a significant public health problem in Nigeria. Breast, cervix and prostate cancers are leading causes of cancer‐related deaths. Changing diets, lifestyles, HIV/AIDS and macro‐structural factors contribute to cancer morbidity and mortality. Poor health information linking cancer risk to individual behaviors, environmental pollutants and structural barriers undermine prevention/control efforts. Studies suggest increasing health literacy and empowering individuals to take preventive action will improve outcomes and mitigate impact on a weak health system.

Methods

We obtained qualitative data from 80 men, women, and young adults in 11 focus groups to assess beliefs, risk‐perceptions, preventive behaviors and perceptions of barriers and facilitators to cancer control in Ibadan, Nigeria and conducted thematic analysis.

Results

Participants demonstrated awareness of cancers and mentioned several risk factors related to individual behaviors and the environment. Nonetheless, myths and misconceptions as well as micro, meso and macro level barriers impede prevention and control efforts.

Conclusion

Developing and implementing comprehensive context‐relevant health literacy interventions in community settings are urgently needed.Copyright © 2016 John Wiley & Sons, Ltd.
Educational differences in likelihood of attributing breast symptoms to cancer: a vignette‐based study
Authors: Marcu Afrodita , Lyratzopoulos Georgios , Black Georgia , Vedsted Peter , Whitaker Katriina L.
Published: May 2016

Background

Stage at diagnosis of breast cancer varies by socio‐economic status (SES), with lower SES associated with poorer survival. We investigated associations between SES (indexed by education), and the likelihood of attributing breast symptoms to breast cancer.

Method

We conducted an online survey with 961 women (47–92 years) with variable educational levels. Two vignettes depicted familiar and unfamiliar breast changes (axillary lump and nipple rash). Without making breast cancer explicit, women were asked ‘What do you think this […..] could be?’ After the attribution question, women were asked to indicate their level of agreement with a cancer avoidance statement (‘I would not want to know if I have breast cancer’).

Results

Women were more likely to mention cancer as a possible cause of an axillary lump (64%) compared with nipple rash (30%). In multivariable analysis, low and mid education were independently associated with being less likely to attribute a nipple rash to cancer (OR 0.51, 0.36–0.73 and OR 0.55, 0.40–0.77, respectively). For axillary lump, low education was associated with lower likelihood of mentioning cancer as a possible cause (OR 0.58, 0.41–0.83). Although cancer avoidance was also associated with lower education, the association between education and lower likelihood of making a cancer attribution was independent.

Conclusion

Lower education was associated with lower likelihood of making cancer attributions for both symptoms, also after adjustment for cancer avoidance. Lower likelihood of considering cancer may delay symptomatic presentation and contribute to educational differences in stage at diagnosis. Copyright © 2016 John Wiley & Sons, Ltd.
Design strategies to address the effect of hydrophobic epitope on stability and in vitro assembly of modular virus‐like particle
Authors: Tekewe Alemu , Connors Natalie K. , Middelberg Anton P. J. , Lua Linda H. L.
Published: May 2016

Virus‐like particles (VLPs) and capsomere subunits have shown promising potential as safe and effective vaccine candidates. They can serve as platforms for the display of foreign epitopes on their surfaces in a modular architecture. Depending on the physicochemical properties of the antigenic modules, modularization may affect the expression, solubility and stability of capsomeres, and VLP assembly. In this study, three module designs of a rotavirus hydrophobic peptide (RV10) were synthesized using synthetic biology. Among the three synthetic modules, modularization of the murine polyomavirus VP1 with a single copy of RV10 flanked by long linkers and charged residues resulted in the expression of stable modular capsomeres. Further employing the approach of module titration of RV10 modules on each capsomere via Escherichia coli co‐expression of unmodified VP1 and modular VP1‐RV10 successfully translated purified modular capomeres into modular VLPs when assembled in vitro. Our results demonstrate that tailoring the physicochemical properties of modules to enhance modular capsomeres stability is achievable through synthetic biology designs. Combined with module titration strategy to avoid steric hindrance to intercapsomere interactions, this allows bioprocessing of bacterially produced in vitro assembled modular VLPs.
Influencing Parameter Study on Primary Breakup of Free Falling Steel Melt Jets Using Volume of Fluid Simulation
Authors: Neumann Sebastian , Dubberstein Tobias , Chaves Humberto , Kirmse Clemens , Schwarze Rüdiger
Published: May 2016

The free falling liquid steel jet behavior is numerically investigated using implicit large eddy simulations (ILES) and the volume of fluid (VOF) approach. The research is focused on primary breakup phenomena near the nozzle using the standard open‐source computational fluid dynamics library OpenFOAM. To quantify the influence of process and constructional parameters exclusively for the structure of a free falling liquid steel jet, several central conditions are explored. The calculations concentrate on disturbances at the nozzle inlet due to adverse inflow conditions. The jet behavior is caused by an asymmetrical lift of the stopper rod and a liquid steel rotation in the tundish based on the magnetic heating process, which is transported into the nozzle due to the conservation of angular momentum. The calculations with adjusted rotation show distinct influences with developing structures like helix or hollow‐cone‐shaped jets. Differences are observed based on the nozzle type. In particular, a tube nozzle (constant diameter) and an industrial nozzle setup (divergent–convergent shape) are investigated. The inflow conditions have a large influence on the tube nozzle, where the outflow is delayed and the jet disintegrates. However, the industrial nozzle type shows less impact, but the jet surface is in general more corrugated and disturbed.
Diagnosis and management of priapism
Authors: Muneer Asif , Zacharakis Evangelos , Ralph David J.
Published: May 2016

Priapism, a prolonged penile erection, is a rare urological emergency which can pose a significant management challenge. In this article the authors describe the pathophysiology and management of the condition.
Short‐term outcome of periviable small‐for‐gestational‐age babies: is our counseling up to date?
Authors: Lawin‐O'Brien A. R. , Dall'Asta A. , Knight C. , Sankaran S. , Scala C. , Khalil A. , Bhide A. , Heggarty S. , Rakow A. , Pasupathy D. , Papageorghiou A. T. , Lees C. C.
Published: May 2016

Objective

There are limited data for counseling on and management of periviable small‐for‐gestational‐age (SGA) fetuses. We therefore aimed to investigate the short‐term outcome of periviable SGA fetuses in relation to the likely underlying cause.

Methods

This was a retrospective study of data from three London tertiary fetal medicine centers obtained between 2000 and 2015. We included viable singleton pregnancies with a severely small fetus, defined as those with an abdominal circumference ≤ 3rd percentile, identified between 22 + 0 and 25 + 6 weeks' gestation. Data obtained included fetal biometry, presence of placental anomalies, uterine and fetal Doppler and neonatal outcome. We excluded cases with structural abnormalities, proven or suspected abnormal karyotype or genetic syndromes. Cases were classified according to the suspected underlying cause of the small fetal size into one of the following categories: uteroplacental insufficiency, evidence of placental damage with normal uterine artery Doppler, viral infection, or unclassied.

Results

There were 245 cases included in the study. Of these, at diagnosis of SGA, 201 (82%) were categorized as uteroplacental cause, 13 (5%) as suspected placental cause, one (0.4%) as suspected viral cause and 30 (12%) could not be assigned to any of these categories. Overall, 101 (41%) cases survived the neonatal period; 89 (36%) underwent in-utero fetal demise, 22 (9%) died neonatally and 33 (14%) pregnancies were terminated. The diagnosis‐to‐delivery interval was 8.1 weeks in those that survived and 4.5 weeks in those that died neonatally.

Conclusions

Almost 90% of periviable SGA cases are associated with uteroplacental insufficiency or intraplacental damage. Survival is related to gestational age at delivery, with outcomes better than might be assumed at diagnosis and some pregnancies reaching term. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Three dimensional (Z‐dependence), collective and individual semi‐empirical formulae for L X‐ray production and ionization cross section by protons impact within corrected ECPSSR theory and updated experimental data: a review
Authors: Deghfel B. , Kahoul A. , Derradj I. , Bendjedi A. , Khalfallah F. , Sahnoune Y. , Bentabet A. , Nekkab M.
Published: May 2016

In this paper we propose a new three dimensional semi‐empirical formulae for the deduction of L X‐ray production and ionization cross sections by introducing the dependence on the atomic number of the target, noted as ‘Z‐dependence’. The data are also fitted collectively and separately (for each element) by analytical functions to calculate semi‐empirical cross sections. For this purpose, the corrected ECPSSR model (noted as eCPSSR) and the published experimental data of Lα, Lβ and Lγ X‐ray production and L1, L2 and L3 ionization cross sections in the period (1950–2014) are combined to calculate the semi‐empirical ones for a wide range of elements by proton impact. The semi‐empirical cross sections (for the three x‐rays lines Lα, Lβ, Lγ and the three sub‐shells L1, L2, L3) are then deduced by fitting the available experimental data normalized to their corresponding theoretical values (using the eCPSSR model) giving a better representation of the experimental data for the individual interpolation. At last, a comparison is made between the three semi‐empirical formulae reported in this work. Copyright © 2016 John Wiley & Sons, Ltd.
Preoperative Nutritional Assessment by Controlling Nutritional Status (CONUT) is Useful to estimate Postoperative Morbidity After Esophagectomy for Esophageal Cancer
Authors: Yoshida Naoya , Baba Yoshifumi , Shigaki Hironobu , Harada Kazuto , Iwatsuki Masaaki , Kurashige Junji , Sakamoto Yasuo , Miyamoto Yuji , Ishimoto Takatsugu , Kosumi Keisuke , Tokunaga Ryuma , Imamura Yu , Ida Satoshi , Hiyoshi Yukiharu , Watanabe Masayuki , Baba Hideo
Published: May 2016

Background

A nutritional indicator suitable for predicting complications after esophagectomy has not been confirmed. The nutritional screening tool CONUT is a potential candidate.

Methods

We retrospectively analyzed 352 patients who underwent elective esophagectomy with lymphadenectomy for esophageal cancer between April 2005 and December 2014. Patients were divided into three groups according to the malnutrition degree in controlling nutritional status (CONUT): normal, light malnutrition, moderate or severe malnutrition.

Results

The numbers of patients assigned to the normal, light malnutrition, and moderate or severe malnutrition groups were 205, 126, and 21, respectively. One hundred forty‐seven (41.8 %) patients were considered malnourished. Patients with moderate or severe malnutrition had a significantly high incidence of any morbidity, severe morbidities, and surgical site infection. Hospital stay in patients with moderate or severe malnutrition was significantly longer. Logistic regression analysis suggested that moderate or severe malnutrition was an independent risk factor for any morbidity [hazard ratio (HR) 2.75, 95 % confidence interval (CI) 1.081–7.020; p = 0.034] and severe morbidities (HR 3.07, 95 % CI 1.002–9.432; p = 0.049).

Conclusions

CONUT was a convenient and useful tool to assess nutritional status before esophagectomy. Patients with moderate or severe malnutrition according to CONUT are at high risk for postoperative complications.