bluuebunny/crossref_metadata_2025 huggingface dataset:
EMBARAZO ADOLESCENTE EN EL CONTEXTO FAMILIA, SAN JUAN DEL ORO, SANDIA-PUNO
Authors: JOVER QUIMPER HERNAN ALBERTO
Published: July 2015

La investigación, tuvo el objetivo de analizar, el embarazo de los adolescentes en el contexto familia, San Juan del Oro; Sandia-Puno: 2011. Los materiales de estudio, fueron: la observación, la entrevista y el documental. La muestra fue de 160 madres adolescentes, de un universo de 398. El método de análisis, fue el hipotético-deductivo. Resultados, los factores individuales y el índice de maternidad-embarazo precoz, se aproxima a -1(.820). La correlación estuvo fuerte e inversamente asociadas con la adolescencia temprana y media, en la relación sexual, embarazos, grado de instrucción secundaria y primaria, autoestima baja y normal. Los factores sociodemográficos y el índice de embarazo-maternidad precoz, se aproxima a -1(.967). La correlación estuvo fuerte e inversamente asociadas, con poco control paternal y tipo de familia. Los factores socioeconómicos y el índice de maternidad-precoz de los adolescentes,se aproxima a -1(.867). La correlación estuvo fuerte e inversamente asociados, con la ocupación de los padres trabajo informal y formal, el nivel de ingreso bajo y medio, la inserción al trabajo en la adolescencia intermedia. Los factores socioculturales y el índice de embarazo-maternidad precoz, se aproxima a -1(.962). La correlación estuvo fuerte e inversamente asociados, con las normas de conducta familiares, educación sexual y capacitaciones.Discusión, los factores individuales, sociodemográficos, socioeconómicos y culturales, están asociados al índice de embarazo y maternidad precoz. Con afecciones a la salud, alteraciones de peso, anemias, hemorragias y abortos. Las normas de conductas inculcadas en el hogar, no siempre se acataron. Interrumpen, el desarrollo biológico y el aprendizaje de los códigos de valores éticos modernos. Escolaridad de alta repetición, deserción estudiantil y frustración en la autorrealización personal.    

 

Palabras clave: adolescente, sociodemográfico, socioeconómico, sociocultural y embarazo.
REFORMAS PENALES O REFORMAS SOCIALES: EN TORNO A LA LUCHA CONTRA LA INSEGURIDAD CIUDADANA EN PERÚ
Authors: ARAUJO FRIAS JAIME
Published: July 2015

Resumen
El presente artículo tiene por objeto reflexionar sobre las respuestas por parte de los políticos peruanos a uno de los problemas más acuciantes desatado en la última década en nuestro país, la inseguridad ciudadana. Se ha dicho que el aumento de la delincuencia es producto del desarrollo económico sostenido que ha venido experimentando el país y que es el precio que se tiene que pagar por ello. Es tal sentido, la medida que se ha tomado para enfrentar tal fenómeno ha sido las reformas legales penales.

En nuestra opinión dichas ideas respecto de la relación entre desarrollo económico y aumento de la inseguridad ciudadana son insostenibles, y de otro lado las reformas penales como única alternativa para enfrentar la ola de delitos es un absurdo. Pues las investigaciones sociales sugieren que la mejor alternativa son las reformas sociales antes que las reformas penales.

PALABRAS CLAVE: * inseguridad ciudadana * ciudadanía * democracia * derecho penal
ABSTRACT
CRIMINAL OR SOCIAL REFORMS: EXAMINING THE FIGHT AGAINST INSECURITY IN PERU

This article aims to reflect on the responses from Peruvian politicians to one of the most pressing problems unleashed in our country in the last decade, political insecurity. It has been said that the increase in crime is the result of sustained economic growth that the country has been experiencing and that’s the price you have to pay for it. In this vein, the measure taken up to address this phenomenon has been criminal law reform.

In our opinion these ideas about the relationship between economic development and increased insecurity are unsustainable and secondly penal reforms as the only way to address the crime wave is absurd. Social research suggests that the best solution involves social rather then penal reforms.

KEY WORDS: * insecurity * citizenship * democracy * criminal law
INCIDENCIA DE LOS CONFLICTOS SOCIALES EN LA REGIÓN PUNO
Authors: CHAMBI APAZA EMILIO , ESCOBAR MAMANI FORTUNATO
Published: July 2015

En todas las sociedades existen pugnas entre los actores sociales, tanto individuales o colectivos, unos por imponer sus intereses y otros por intentar conquistar sus derechos frustrados, cuando sus ansiedades y expectativas no son satisfechas. La investigación describe las controversias catalogadas como «conflicto». La metodología del trabajo fue la recolección de testimonios de actores sociales, tanto de quechuas, aimaras e hispanohablantes de la Región Puno, durante el año de 2013 a mayo del 2014. La primera fuente de recopilación, fue las grabaciones de declaraciones de protagonistas que denunciaron a través de la prensa hablada y escrita. Y por otro lado se realizó encuestas al azar a los implicados en el conflicto. Estos datos fueron corroborados con entrevistas individuales y en profundidad por medio de grupos focales relacionados al campo de la actividad económica, social, política y ambiental. Los resultados indican, que de un total de 192 familias del medio rural de Puno, el 29 % de los conflictos surgen por problemas del terreno (dentro de lo ambiental) y por herencia de padres a hijos, seguido por 14% de problemas que son conyugales y un 10% por daños a los cultivos, la delincuencia y el maltrato físico de las personas involucradas. Los hechos señalados indican que el mayor problema está relacionado con la propiedad de la tierra y la cuestión ambiental como recursos indispensables de subsistencia; es decir, el conflicto está en torno al control de los recursos naturales destinados al cultivo y pastoreo. Procesos, sobre las cuales deben adoptarse políticas públicas tanto para prevención y resolución de los conflictos sociales en Puno y el País.

PALABRAS CLAVE: * Conflictos sociales * violencia * acción colectiva * política * cultura * tierra * territorio
EL ANÁLISIS DE POLÍTICAS EN LA SOCIOLOGÍA DE LA ACCIÓN PÚBLICA
Authors: Fontaine Guillaume
Published: July 2015

La sociología de la acción pública encuentra su origen en el análisis de las políticas públicas, un campo de estudio que se estructuró y evolucionó al ritmo de la creación y la consolidación del Estado de Bienestar social hasta mediados de los años 1970, luego de la crisis de este modelo hasta el momento. El análisis de las políticas públicas está atravesado por dos tipos de problemas: los que nacen de la contraposición de las políticas públicas con la política y lo político; y aquellos que contraponen el análisis de las políticas con el análisis para las políticas. Su institucionalización en tanto disciplina académica fue determinada por ambos factores y tomó una orientación positivista, cuyos límites aparecieron pronto. 
ANÁLISIS DE ESTABILIDAD DE LA PRESA HUACOTO MEDIANTE INTERACCIÓN DE LOS MÉTODOS DE ELEMENTOS FINITOS Y EQUILIBRIO LÍMITE
Authors: CARNERO CARNERO ERASMO , CARNERO GUZMAN GONZALO
Published: July 2015

En nuestro entorno se observa que muchas obras civiles no son monitoreadas durante y después de la ejecución de las mismas, este hecho puede producir prejuicios financieros, sociales y políticos. Por otro lado las herramientas de cálculo empleadas para el diseño muchas veces son inadecuadas o los principios fundamentales de ingeniería no son aplicados coherentemente al usar programas de computación. Un ejemplo de estos problemas es el caso de la presa Huacoto ubicada en el distrito de Orurillo, provincia de Melgar donde filtraciones de agua erosionaron el talud aguas abajo a solo tres años de ser puesta en funcionamiento. El presente estudio se basa en la experiencia obtenida evaluando este problema geotécnico, las investigaciones se iniciaron en junio del 2012 con inspecciones en el lugar y con la obtención de muestras. La evaluación constó de tres fases, primero el análisis del flujo interno mediante elementos finitos, segundo el análisis de estabilidad del talud aguas abajo y finalmente el diseño de medidas correctivas, estas dos últimas fases empleando métodos de equilibrio límite (Bishop y Janbu Simplificado). Las tres fases se realizaron usando el software SLIDE 6.0. El estudio mostró que la inestabilidad de la presa era fruto de diversos factores como baja calidad del suelo de cantera, insipiente compactación, carencia de elementos de control de flujo interno (núcleo y filtros) y carencia de monitoreo pos constructivo; la combinación de estos factores se tradujo en el retiro de la presa en vista del peligro que representaba.
Produção de mudas de cultivares de alface utilizando duas espumas fenólicas em Altamira, Pará
Authors: Couto Alzirio Lino , Moreira Djair Alves , Araujo Junior Pedro Vitoriano de
Published: July 2015

O sucesso de qualquer produção comercial de hortaliças inicia-se com a produção de mudas. A espuma fenólica tem se mostrado um interessante e prático substrato para este processo. A utilização deste produto depende de uma lavagem precedente para reduzir a acidez. Porém, já é possível encontrar à venda espumas fenólicas com pH próximo. Por isso o objetivo deste trabalho foi avaliar a produção de mudas de cultivares de alface utilizando duas espumas fenólicas em Altamira, Pará. O delineamento constou de um esquema fatorial 2 (substratos) x 6 (cultivares). Os dois substratos foram as espumas fenólicas Green Up®, com pH 6.0 (± 0.5)., e a outra com pH 2.6 (± 0.5). As cultivares avaliadas foram: Alcione, Amanda, Lucy Brown, Caipira, Multiblond 3 e Solaris. Foi avaliada porcentagem de germinação, índice de velocidade de emergência, altura da planta e número de folhas. Houve diferença significativa para altura da planta em função dos substratos testados. A porcentagem de germinação mais elevada foi obtida com a espuma fenólica sem tratamento. A cultivar Caipira foi a que teve o menor desempenho na germinação. Para todas as variáveis analisadas, a cultivar Lucy Brown apresentou os melhores resultados em ambos os substratos.
Effects of Groundwater Exploitation on Embankment for High-speed Railway Lines
Authors: Huang Luwei , Xiao Hong , Yang Song , Han Yugang
Published: July 2015

Groundwater exploitation will cause significant subsidence to the ground, then influence the deformation of
embankment for high-speed railway lines, which may threaten the safety of train operation. To study the law of
embankment deformation aroused by groundwater exploitation near high-speed railway lines, a 3D fluid-solid coupling
model is established based on infiltrating solidification theory and using finite element software ABAQUS, and
embankment deformations caused by different pumping rates and pumping distance are analyzed. The results show that
pumping rate and pumping distance are both of great influence on the deformations of embankment for high-speed
railway lines. Therefore, in order to control the effects of groundwater exploitation on embankment, it should be forbidden
to add new pumping well near the railway lines and groundwater exploitation should be strictly limited within the
influence scope.
Study on Landscape Features of Traditional Villages in Low Hilly Areas in Sichuan During Urbanization in China
Authors: Yuanyuan Jia
Published: July 2015

The rapid urbanization is giving changes to China’s appearance. Urban areas, for their own sake, are encroaching
on lands and villages. The traditional villages are open to exploitation for the development of tourism. They are severely
destroyed and the buildings significantly altered for more economic benefits. The traditional culture has been lost;
instead, modern villages are constructed. People have no idea about that the preservation of traditional villages can actually
bring more benefits. The villages can be found in the specific environment and space, and traditional culture in these
villages. The well preserved landscape of the villages lays foundation and is the prerequisite for their development.
Among the 4,000 ancient towns in Sichuan Province in China, more than 1,000 of them are historically important and deserve
preservation. This paper will study Shangli Town, a traditional one in the low hilly western areas in Sichuan, focus
on the relation between its physical form and its traditional culture, and try to understand the deep structure which forms
the featured landscape of the traditional village, so as to preserve the landscape features of the traditional villages and revitalize
them in a real sense.
Coagulation disturbances in paediatric patients with hepatic veno-occlusive disease after stem cells transplantation
Authors: Jevtic Dragana , Vujic Dragana , Zecevic Zeljko , Veljkovic Dobrila , Gazikalovic Slobodan , Elezovic Ivo
Published: July 2015

Introduction. Hepatic veno-occlusive disease (VOD) is a life threatening
complication after stem cells transplantation (SCT). Its prediction, precise
diagnosis and treatment remain unclear. Objective. Our goals were to
determine the incidence, outcome and changes in haemostatic parameters in
patients with VOD. Also, we tried to determine coagulation disturbances and
their practical significance in early diagnosis of such patients. Methods. We
prospectively evaluated all consecutive VOD patients after SCT, aged 3 months
to 17 years, from February 2004 to July 2008 treated at the Mother and Child
Health Institute of Serbia ?Dr Vukan Cupic? (IMD). All patients were
diagnosed according to the Seattle criteria. The values of PT, aPTT,
fibrinogen, FVIII, AT and vWF were measured on the day prior to the
initiation of conditioning regiment and on the days 1, 7 and 14 from the
moment of VOD diagnosis. Laboratory testing was performed in the IMD
haemostasis laboratory and results were statistically evaluated. Results.
During the study period 74 SCT were performed at IMD. VOD developed 11
patients; 10 of 46 were autologous and 1 of 28 allogeneic SCT patients. In
our group of patients the incidence of VOD was 14.8%. VOD was classified as
mild in 7, moderate in 1 and severe in 3 patients. At the moment of
establishing the diagnosis all patients had a significantly increased
activity of vWF, FVIII and fibrinogen, and decreased AT. All of them were
dependent on platelet transfusions. Conclusion. Platelet transfusion
dependence suggests coagulation activation with great significance and
indicates a possible development of VOD. Our results also suggest that
monitoring coagulation parameters levels in the first five days from the
establishment of diagnosis may have a significant predictive value for VOD
outcome.
Clinical and experimental evidences on the prothrombotic properties of neutrophils
Authors: Maugeri Norma , Manfredi Angelo , Maseri Attilio
Published: July 2015

Epidemiologic studies have shown that the neutrophil count correlates with
the risk of myocardial infarction and stroke and identify patients more
susceptible to reinfarction and in-hospital death. In particular, neutrophils
action was initially associated to blood rheological changes, or to the
effect of neutrophil-derived eicosanoids or proteases. Animal models indicate
that platelet-leukocyte P-selectin dependent cross-talk contributes to fibrin
deposition during in vivo thrombus formation. In fact, platelet P-selectin,
through its leukocyte counter-receptor PSGL-1, determines the activation of
leukocyte ?2 integrins, the binding of fibrinogen and the expression of
tissue factor on leukocyte surface. Monocytes stimulated in vitro with LPS,
PMA and P-selectin synthesize and express tissue factor. fMLP, P-selectin,
TNFalpha and C5a are effective stimuli that trigger the synthesis and
expression of biologically active tissue factor in neutrophils. The
experimental evidence well agrees with clinical observations: patients with
acute coronary syndromes, acute respiratory distress syndrome,
antiphospholipid syndromes, giant cell arteritis and myeloproliferative
syndromes have increased the expression of tissue factor on leukocyte
surface. Moreover circulating neutrophils express mRNA codifying for
fulllength and/or alternatively spliced tissue factor, suggesting a new
important link between thrombosis and inflammation. All together, clinical
and experimental evidence suggest that the leukocyte thrombogenic profile is
a relevant player in patients with a high risk of thromboembolic events and
possibly represents a suitable target for molecular intervention.
Detection of disseminated intravascular coagulation with the help of the conception of constant intravascular microcoagulation
Authors: Bokarev Igor , Popova Ludmila
Published: July 2015

The possibility of intravascular blood coagulation existence in the
microvascular vessels and capillaries without the presence of a large
thrombus in the arteries and veins has been known from the middle of 19th
century. It is impossible to know exactly about the prevalence of this
pathology, because there is a jumble in terminology that does not help
statistics to be exact. One of the reasons of so high mortality from
disseminated intravascular coagulation (DIC) is due to the impossibility to
always make exact diagnosis, and as ?. Levi thinks it is provoked in the
absence of generally accepted idea of DIC syndrome. We investigated these
markers and the intensity of intravascular blood coagulation in a number of
patients. Our understanding of the problems of DIC was formulated on the
grounds of a thirty-year study of the problem involving over 1,500 patients.
Thereby, the conception of constant intravascular microcoagulation (CIMC) was
developed with the following aims: to report the existing material and bring
to researchers and doctors in practice information about the presence of the
phenomenon of CIMC and to resolve debatable questions of definitions and
practical usage of up-to-date information about DIC with the help of CIMC
conception.
Platelet function tests and resistance to antiplatelet therapy
Authors: Stegnar Mojca
Published: July 2015

The clinical efficacy of antiplatelet therapy (aspirin, P2Y12 and
glycoprotein IIb/IIIa receptor antagonists) to prevent occlusive arterial
events in patients with atherothrombotic disease is well established. Despite
the proven benefits of antiplatelet therapy, many patients continue to
experience arterial events. Many factors may influence the response of
platelets to antiplatelet therapy and some patients with adequate compliance
to the treatment may exhibit failure of platelet inhibition as determined by
ex vivo laboratory tests, a phenomenon termed ?resistance?to antiplatelet
therapy. Platelet function can be measured by numerous platelet function
tests, with which various parameters of platelet activation, secretion,
adhesion and aggregation can be determined. These tests include light
transmission (optical) and whole blood aggregometry, point-of-care devices,
such as platelet function analyzers PFA-100?, and VerifyNow?, flow cytometry,
serum thromboxane B2 and urinary levels of the thromboxane B2 metabolite
11-dehyro-thromboxane B2. Other tests, such as whole blood platelet
aggregation measured by platelet counting, thrombelastography and devices
such as the cone and plate(let) analyzer, Plateletworks and thrombotic status
analyzer have also been used to determine platelet inhibition by antiplatelet
drugs, but their use is not widespread and therefore experience is limited.
Further studies need to be carried out to answer basic questions on the
clinical utility and cost-effectiveness of laboratory monitoring of
antiplatelet therapy before it can be recommended in clinical practice.
Small Audit Firm Membership in Associations, Networks, and Alliances: Implications for Audit Quality and Audit Fees
Authors: Bills Kenneth L. , Cunningham Lauren M. , Myers Linda A.
Published: July 2015

In this study, we examine the benefits of membership in an accounting firm association, network, or alliance (collectively referred to as “an association”). Associations provide member accounting firms with numerous benefits, including access to the expertise of professionals from other independent member firms, joint conferences and technical trainings, assistance in dealing with staffing and geographic limitations, and the ability to use the association name in marketing materials. We expect these benefits to result in higher-quality audits and higher audit fees (or audit fee premiums). Using hand-collected data on association membership, we find that association member firms conduct higher-quality audits than nonmember firms, where audit quality is proxied for by fewer Public Company Accounting Oversight Board (PCAOB) inspection deficiencies and fewer financial statement misstatements, as well as less extreme absolute discretionary accruals and lower positive discretionary accruals. We also find that audit fees are higher for clients of member firms than for clients of nonmember firms, suggesting that clients are willing to pay an audit fee premium to engage association member audit firms. Finally, we find that member firm audits are of similar quality to a size-matched sample of Big 4 audits, but member firm clients pay lower fee premiums than do Big 4 clients. Our inferences are robust to the use of company size-matched control samples, audit firm size-matched control samples, propensity score matching, two-stage least squares regression, and to analyses that consider changes in association membership. Our findings should be of interest to regulators because they suggest that association membership assists small audit firms in overcoming barriers to auditing larger audit clients. In addition, our findings should be informative to audit committees when making auditor selection decisions, and to investors and accounting researchers interested in the relation between audit firm type and audit quality.
SEC Comment Letters and Insider Sales
Authors: Dechow Patricia M. , Lawrence Alastair , Ryans James P.
Published: July 2015

We document that insider trading is significantly higher than normal levels prior to the public disclosure of SEC comment letters relating to revenue recognition. Furthermore, insider trading is triple its normal level for firms with high short positions. We find a small negative return at the comment letter release date and a negative drift in returns of 1 to 5 percent over the next 50 days following the release. We also find that greater pre-disclosure sales are associated with a stronger negative drift. This evidence suggests that insiders appear to benefit from trading prior to revenue recognition comment letters. We investigate whether the delayed price reaction to comment letter releases is due to investor inattention. Consistent with this explanation, we document that comment letters are downloaded infrequently from EDGAR in the days following their public disclosure.

JEL Classifications: M41; M48; K42
Interventions That Restore Awareness of Hypoglycemia in Adults With Type 1 Diabetes: A Systematic Review and Meta-analysis
Authors: Yeoh Ester , Choudhary Pratik , Nwokolo Munachiso , Ayis Salma , Amiel Stephanie A.
Published: July 2015

OBJECTIVE

Impaired awareness of hypoglycemia (IAH) increases the risk of severe hypoglycemia (SH) sixfold and affects 30% of adults with type 1 diabetes (T1D). This systematic review and meta-analysis looks at the educational, technological, and pharmacological interventions aimed at restoring hypoglycemia awareness (HA) in adults with T1D.

RESEARCH DESIGN AND METHODS

We searched The Cochrane Library, MEDLINE, Embase, Science Citation Index Expanded, Social Sciences Citation Index, PsycINFO, and CINAHL from inception until 1 October 2014. Included studies described HA status at baseline. Outcome measures were SH rates, change in HA, counterregulatory hormone responses, and glycemic control.

RESULTS

Forty-three studies (18 randomized controlled trials, 25 before-and-after studies) met the inclusion criteria, comprising 27 educational, 11 technological, and 5 pharmacological interventions. Educational interventions included structured diabetes education on flexible insulin therapy, including psychotherapeutic and behavioral techniques. These were able to reduce SH and improve glycemic control, with greater benefit from the latter two techniques in improving IAH. Technological interventions (insulin pump therapy, continuous glucose monitoring, and sensor-augmented pump) reduced SH, improved glycemic control, and restored awareness when used in combination with structured education and frequent contact. Pharmacological studies included four insulin studies and one noninsulin study, but with low background SH prevalence rates.

CONCLUSIONS

This review provides evidence for the effectiveness of a stepped-care approach in the management of patients with IAH, initially with structured diabetes education in flexible insulin therapy, which may incorporate psychotherapeutic and behavioral therapies, progressing to diabetes technology, incorporating sensors and insulin pumps, in those with persisting need.
Relationship of Urologic Complications With Health-Related Quality of Life and Perceived Value of Health in Men and Women With Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Interventions and Complications (DCCT/EDIC) Cohort
Authors: Jacobson Alan M. , Braffett Barbara H. , Cleary Patricia A. , Dunn Rodney L. , Larkin Mary E. , Wessells Hunter , Sarma Aruna V. ,   the DCCT/EDIC Research Group
Published: July 2015

OBJECTIVE

Limited information exists about the influence of urologic complications on health-related quality of life (HRQOL) in patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS

We studied 664 men and 580 women from the Diabetes Control and Complications Trial/Epidemiology of Interventions and Complications Study: mean ages were 51.6 ± 6.6 and 50.6 ± 7.2 years and duration of diabetes was 29.5 ± 4.8 and 29.8 ± 5.1 years, respectively. We assessed associations of sexual dysfunction, lower urinary tract symptoms (LUTS), and, in women, urinary incontinence (UI) with general quality of life (SF-36), perceived value of health (EuroQol-5), diabetes-related quality of life (Diabetes Quality of Life Scale [DQOL]), and psychiatric symptoms (Symptom Checklist 90-R).

RESULTS

In both men and women, urologic complications adversely affected HRQOL and psychiatric symptoms, even after accounting for history of depression leading to treatment. Multivariable analyses accounting for the presence of diabetic retinopathy, neuropathy, and nephropathy also revealed substantial independent effects. In men, for example, the odds (95% CI) of a low DQOL score (≤25th percentile) were 3.01 (1.90–4.75) times greater with erectile dysfunction and 2.65 (1.68–4.18) times greater with LUTS and in women, 2.04 (1.25–3.35) times greater with sexual dysfunction and 2.71 (1.72–4.27) times greater with UI/LUTS combined compared with men and women without such complications. Similar effects were observed for the other measures.

CONCLUSIONS

Sexual dysfunction and urinary complications with type 1 diabetes are associated with decreased quality of life and perceived value of health and with higher levels of psychiatric symptoms, even after accounting for other diabetes complications and depression treatment.
Trends in Health Care Expenditure in U.S. Adults With Diabetes: 2002–2011
Authors: Ozieh Mukoso N. , Bishu Kinfe G. , Dismuke Clara E. , Egede Leonard E.
Published: July 2015

OBJECTIVE

Direct medical cost of diabetes in the U.S. has been estimated to be 2.3 times higher relative to individuals without diabetes. This study examines trends in health care expenditures by expenditure category in U.S. adults with diabetes between 2002 and 2011.

RESEARCH DESIGN AND METHODS

We analyzed 10 years of data representing a weighted population of 189,013,514 U.S. adults aged ≥18 years from the Medical Expenditure Panel Survey. We used a novel two-part model to estimate adjusted mean and incremental medical expenditures by diabetes status, while adjusting for demographics, comorbidities, and time.

RESULTS

Relative to individuals without diabetes ($5,058 [95% CI 4,949–5,166]), individuals with diabetes ($12,180 [11,775–12,586]) had more than double the unadjusted mean direct expenditures over the 10-year period. After adjustment for confounders, individuals with diabetes had $2,558 (2,266–2,849) significantly higher direct incremental expenditures compared with those without diabetes. For individuals with diabetes, inpatient expenditures rose initially from $4,014 in 2002/2003 to $4,183 in 2004/2005 and then decreased continuously to $3,443 in 2010/2011, while rising steadily for individuals without diabetes. The estimated unadjusted total direct expenditures for individuals with diabetes were $218.6 billion/year and adjusted total incremental expenditures were approximately $46 billion/year.

CONCLUSIONS

Our findings show that compared with individuals without diabetes, individuals with diabetes had significantly higher health expenditures from 2002 to 2011 and the bulk of the expenditures came from hospital inpatient and prescription expenditures.
Diabetes, Lower-Extremity Amputation, and Death
Authors: Hoffstad Ole , Mitra Nandita , Walsh Jonathan , Margolis David J.
Published: July 2015

OBJECTIVE

The goal of the study was to determine whether complications of diabetes well-known to be associated with death such as cardiovascular disease and renal failure fully explain the higher rate of death in those who have undergone a lower-extremity amputation (LEA).

RESEARCH DESIGN AND METHODS

This was a longitudinal cohort study of patients cared for in the Health Improvement Network. Our primary exposure was LEA and outcome was all-cause death. Our “risk factor variables” included a history of cardiovascular disease (a history of myocardial infarctions, cerebrovascular accident, and peripheral vascular disease/arterial insufficiency), Charlson index, and a history of chronic kidney disease. We estimated the effect of LEA on death using Cox proportional hazards models.

RESULTS

The hazard ratio (HR) for death after an LEA was 3.02 (95% CI 2.90, 3.14). The fully adjusted (all risk factor variables) LEA HR was diminished only by ∼22% to 2.37 (2.27, 2.48). Furthermore, LEA had an area under the receiver operating curve (AUC) of 0.51, which is poorly predictive, and the fully adjusted model had an AUC of 0.77, which is better but not strongly predictive. Sensitivity analysis revealed that it is unlikely that there exists an unmeasured confounder that can fully explain the association of LEA with death.

CONCLUSIONS

Individuals with diabetes and an LEA are more likely to die at any given point in time than those who have diabetes but no LEA. While some of this variation can be explained by known complications of diabetes, there remains a large amount of unexplained variation.
Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program
Authors: Erondu Ngozi , Desai Mehul , Ways Kirk , Meininger Gary
Published: July 2015

OBJECTIVE

This study assessed the incidence of serious adverse events of diabetic ketoacidosis (DKA) among patients with type 2 diabetes treated with canagliflozin.

RESEARCH DESIGN AND METHODS

All serious adverse events of DKA and related events (ketoacidosis, metabolic acidosis, and acidosis) from 17,596 patients from randomized studies of canagliflozin through 11 May 2015 were analyzed.

RESULTS

Serious adverse events of DKA and related events were reported in 12 patients (0.07%), including 4 (0.07%), 6 (0.11%), and 2 (0.03%) treated with canagliflozin 100 and 300 mg and comparator, respectively; corresponding incidence rates were 0.522, 0.763, and 0.238 per 1,000 patient-years, respectively. Most patients with DKA and related events had a blood glucose >300 mg/dL (16.7 mmol/L) at presentation of DKA, were on insulin, and had DKA-precipitating factors, including some with type 1 diabetes/latent autoimmune diabetes of adulthood.

CONCLUSIONS

DKA and related events occurred at a low frequency in the canagliflozin type 2 diabetes program, with an incidence consistent with limited existing observational data in the general population with type 2 diabetes.
Investigation of Centroid Connector Placement for Advanced Traffic Assignment Models with Added Network Detail
Authors: Jafari Ehsan , Gemar Mason D. , Juri Natalia Ruiz , Duthie Jennifer
Published: July 2015

Advanced traffic assignment models, such as simulation-based dynamic traffic assignment, typically incorporate more detailed network representations than do traditional planning models. In this context, the placement of centroid connectors may have a significant effect on model performance, and attention must be paid to their number and location to avoid unrealistic congestion or low utilization of minor roadways by local traffic. Given that the manual inspection of centroid connector placement may be too time-consuming in large regional networks, this paper proposes two simple automatic centroid connector placement strategies for dynamic traffic assignment applications. The first approach radially distributes the connectors to the nearest nodes and is intended to exemplify some limitations of the most common techniques in practice. The second strategy involves dividing the centroid and subsequent demand into two parts, distributing the demand across one sub-centroid linked to nearby nodes and one linked to the periphery, and thus effectively establishing a bilevel distribution. A modification of this strategy involves eliminating nodes at signalized intersections as viable candidates for connection. As part of the evaluation of the methods, a new metric, the locality factor, has been introduced to describe the use of minor streets by local traffic. The numerical experiments, conducted on two real-world networks, exemplify the effects of the incorporation of local streets and the placement of centroid connectors on model results. Sensitivity testing and limited field data comparisons suggest that the bilevel centroid connector placement strategy achieves more realistic results.
Using Lagrangian Relaxation to Solve Ready Mixed Concrete Dispatching Problems
Authors: Narayanan Pavan Kumar , Rey David , Maghrebi Mojtaba , Waller S. Travis
Published: July 2015

The logistics and planning problem of delivering ready mixed concrete (RMC) to a set of demand customers from multiple depots is addressed. The RMC dispatching problem (RMCDP) is closely related to the vehicle routing problem, with the difference that a truck may visit demand nodes in the RMCDP more than once. This class of routing problems can be represented by using mixed-integer programming (MIP) and is known to be NP-hard. Solving RMC delivery problems is often achieved through heuristics and metaheuristic-based methods as exact solution approaches are often unable to find optimal solutions efficiently, in particular when multiple depots are represented in the model. Although a variety of methods are available to solve MIP models, in this paper an attempt is made to solve the RMCDP by using a Lagrangian relaxation technique. Namely, a solution algorithm based on Lagrangian relaxation is derived to reduce the complexity of the initial MIP model and show that the proposed relaxation is able to provide promising computation results on a realistic data set representative of an active RMCDP in the region of Adelaide, Australia.
Mycotoxins: Producing Fungi and Mechanisms of Phytotoxicity
Authors: Ismaiel Ahmed , Papenbrock Jutta
Published: July 2015

Mycotoxins are secondary fungal metabolites, toxic to humans, animals and plants. Among the hundreds of known mycotoxins, aflatoxins, citrinin, patulin, penicillic acid, tenuazonic acid, ochratoxin A, cytochalasins, deoxynivalenol, fumonisins, fusarin C, fusaric acid, and zearalenone are considered the types that most contaminate cereal grain. The majority of the mycotoxins in these groups are produced by three fungal genera: Aspergillus, Penicillium and Fusarium. These metabolites primarily affect the seed quality, germination, viability, seedling vigour, growth of root and cleoptile. Additionally, since the fungi responsible for the production of these mycotoxins are often endophytes that infect and colonize living plant tissues, accumulation of mycotoxins in the plant tissues may at times be associated with development of plant disease symptoms. The presence of mycotoxins, even in the absence of disease symptoms, may still have subtle biological effects on the physiology of plants. Several studies highlight the toxic effects of mycotoxins on animals and cell lines but little is known about the mode of action of most of these metabolites on plant cells. The most important mycotoxins with phytotoxic effects and their producers in addition to their discovery are briefly outlined below and will be addressed in this article.
Preliminary Evaluation of Enteric Viruses in Bottled Mineral Water Commercialized in Brazil
Authors: Rodrigues dos Santos Vivian , Rigotto Caroline , Staggemeier Rodrigo , Vecchia Andréia , Henzel Andréia , Spilki Fernando
Published: July 2015

In Brazil, mineral water is widely consumed and as of yet there have been no studies done in the country that aim to detect enteric viruses in this water source. The aim of this study was to analyze the presence of the human adenovirus (HAdV), the human rotavirus genogroup A (GARV) and the human enterovirus (hEV) in mineral water samples from six different brands that are commercialized in southern Brazil, using molecular techniques and comparing the results with bacterial indicators. Samples of 1.5 L and 500 mL were analyzed for viruses through PCR and total and thermotolerant coliforms. Additionally, heterotrophic bacteria were assayed using a commercial kit. The most prevalent virus was adenovirus (32.5%) followed by rotavirus (25%) and enterovirus (17.5%). Total and thermotolerant coliforms were absent in all samples and only three samples out of the 60 analyzed presented heterotrophic bacteria contamination. We conclude that, following the example taken into consideration regarding the public supply of drinking water, stricter measures for microbiological control should also be applied to mineral water so that this actually becomes a safer alternative.
SPR Biosensor Probing the Interactions between TIMP-3 and Heparin/GAGs
Authors: Zhang Fuming , Lee Kyung , Linhardt Robert
Published: July 2015

Tissue inhibitor of metalloproteinases-3 (TIMP-3) belongs to a family of proteins that regulate the activity of matrix metalloproteinases (MMPs), which can process various bioactive molecules such as cell surface receptors, chemokines, and cytokines. Glycosaminoglycans (GAGs) interact with a number of proteins, thereby playing an essential role in the regulation of many physiological/patho-physiological processes. Both GAGs and TIMP/MMPs play a major role in many cell biological processes, including cell proliferation, migration, differentiation, angiogenesis, apoptosis, and host defense. In this report, a heparin biosensor was used to map the interaction between TIMP-3 and heparin and other GAGs by surface plasmon resonance spectroscopy. These studies show that TIMP-3 is a heparin-binding protein with an affinity of ~59 nM. Competition surface plasmon resonance analysis indicates that the interaction between TIMP-3 and heparin is chain-length dependent, and N-sulfo and 6-O-sulfo groups (rather than the 2-O-sulfo groups) in heparin are important in the interaction of heparin with TIMP-3. Other GAGs (including chondroitin sulfate (CS) type E (CS-E)and CS type B (CS-B)demonstrated strong binding to TIMP-3, while heparan sulfate (HS), CS type A (CSA), CS type C (CSC), and CS type D (CSD) displayed only weak binding affinity.
Menahydroquinone-4 Prodrug: A Promising Candidate Anti-Hepatocellular Carcinoma Agent
Authors: Enjoji Munechika , Watase Daisuke , Matsunaga Kazuhisa , Kusuda Mariko , Nagata-Akaho Nami , Karube Yoshiharu , Takata Jiro
Published: July 2015

Recently, new therapeutics have been developed for hepatocellular carcinoma (HCC). However, the overall survival rate of HCC patients is still unsatisfactory; one of the reasons for this is the high frequency of recurrence after radical treatment. Consequently, to improve prognosis, it will be important to develop a novel anti-tumor agent that is especially effective against HCC recurrence. For clinical application, long-term safety, together with high anti-tumor efficacy, is desirable. Recent studies have proposed menahydroquinone-4 1,4-bis-N,N-dimethylglycinate hydrochloride (MKH-DMG), a prodrug of menahydroquinone-4 (MKH), as a promising candidate for HCC treatment including the inhibition of recurrence; MKH-DMG has been shown to achieve good selective accumulation of MKH in tumor cells, resulting in satisfactory inhibition of cell proliferation in des-γ-carboxyl prothrombin (DCP)-positive and DCP-negative HCC cell lines. In a spleen-liver metastasis mouse model, MKH-DMG has been demonstrated to have anti-proliferation and anti-metastatic effects in vivo. The characteristics of MKH-DMG as a novel anti-HCC agent are presented in this review article.
Setting Diverging Colors for a Large-Scale Hypsometric Lunar Map Based on Entropy
Authors: Zeng Xingguo , Mu Lingli , Liu Jianjun , Yang Yiman
Published: July 2015

A hypsometric map is a type of map used to represent topographic characteristics by filling different map areas with diverging colors. The setting of appropriate diverging colors is essential for the map to reveal topographic details. When lunar real environmental exploration programs are performed, large-scale hypsometric maps with a high resolution and greater topographic detail are helpful. Compared to the situation on Earth, fewer lunar exploration objects are available, and the topographic waviness is smaller at a large scale, indicating that presenting the topographic details using traditional hypsometric map-making methods may be difficult. To solve this problem, we employed the Chang’E2 (CE2) topographic and imagery data with a resolution of 7 m and developed a new hypsometric map-making method by setting the diverging colors based on information entropy. The resulting map showed that this method is suitable for presenting the topographic details and might be useful for developing a better understanding of the environment of the lunar surface.
Review on Physically Flexible Nonvolatile Memory for Internet of Everything Electronics
Authors: Ghoneim Mohamed , Hussain Muhammad
Published: July 2015

Solid-state memory is an essential component of the digital age. With advancements in healthcare technology and the Internet of Things (IoT), the demand for ultra-dense, ultra-low-power memory is increasing. In this review, we present a comprehensive perspective on the most notable approaches to the fabrication of physically flexible memory devices. With the future goal of replacing traditional mechanical hard disks with solid-state storage devices, a fully flexible electronic system will need two basic devices: transistors and nonvolatile memory. Transistors are used for logic operations and gating memory arrays, while nonvolatile memory (NVM) devices are required for storing information in the main memory and cache storage. Since the highest density of transistors and storage structures is manifested in memories, the focus of this review is flexible NVM. Flexible NVM components are discussed in terms of their functionality, performance metrics, and reliability aspects, all of which are critical components for NVM technology to be part of mainstream consumer electronics, IoT, and advanced healthcare devices. Finally, flexible NVMs are benchmarked and future prospects are provided.
Study on Pyroelectric Harvesters Integrating Solar Radiation with Wind Power
Authors: Hsiao Chun-Ching , Jhang Jia-Wai , Siao An-Shen
Published: July 2015

Pyroelectric harvesters use temperature fluctuations to generate electrical outputs. Solar radiation and waste heat are rich energy sources that can be harvested. Pyroelectric energy converters offer a novel and direct energy-conversion technology by transforming time-dependent temperatures directly into electricity. Moreover, the great challenge for pyroelectric energy harvesting lies in finding promising temperature variations or an alternating thermal loading in real situations. Hence, in this article, a novel pyroelectric harvester integrating solar radiation with wind power by the pyroelectric effect is proposed. Solar radiation is a thermal source, and wind is a dynamic potential. A disk generator is used for harvesting wind power. A mechanism is considered to convert the rotary energy of the disk generator to drive a shutter for generating temperature variations in pyroelectric cells using a planetary gear system. The optimal period of the pyroelectric cells is 35 s to harvest the stored energy, about 70 μJ, while the rotary velocity of the disk generator is about 31 RPM and the wind speed is about 1 m/s. In this state, the stored energy acquired from the pyroelectric harvester is about 75% more than that from the disk generator. Although the generated energy of the proposed pyroelectric harvester is less than that of the disk generator, the pyroelectric harvester plays a complementary role when the disk generator is inactive in situations of low wind speed.
Screening and Evaluation of Some Green Algal Strains (Chlorophyceae) Isolated from Freshwater and Soda Lakes for Biofuel Production
Authors: Selvarajan Ramganesh , Felföldi Tamás , Tauber Tamás , Sanniyasi Elumalai , Sibanda Timothy , Tekere Memory
Published: July 2015

Microalgae are photosynthetic microorganisms that can produce lipids, proteins and carbohydrates in large amounts and within short periods of time and these can be processed into both biofuels and other useful commercial products. Due to this reason microalgae are considered as a potential source of renewable energy; and one of the most important decisions in obtaining oil from microalgae is the choice of species. In this study, the potential of Chlorophyceae species isolated from freshwater and soda lakes in Hungary and Romania (Central Europe) were characterized and evaluated by determining their biomass accumulation, lipid productivity, fatty acid profiles, and biodiesel properties besides protein and carbohydrate productivity. Out of nine strains tested, three accumulated more than 40% dry weight of protein, four accumulated more than 30% dry weight of carbohydrate and the strain Chlorella vulgaris LC8 accumulated high lipid content (42.1% ± 2.6%) with a favorable C16-C18 fatty acid profile (77.4%) as well as suitable biodiesel properties of high cetane number (57.3), low viscosity (4.7 mm2/s), lower iodine number (75.18 g I2/100 g), relative cloud point (8.8 °C) and negative cold filter plugging point (−6.5 °C). Hence the new strain, Chlorella vulgaris LC8 has potential as a feedstock for the production of excellent quality biodiesel.
Complete Genomic Characterization of Porcine Reproductive and Respiratory Syndrome Virus Strain HB-XL
Authors: Zuo Yi , Yuan Wanzhe , Sun Jiguo
Published: July 2015

Porcine reproductive and respiratory syndrome virus (PRRSV) is the causal agent of a serious disease of swine. Here, we report the genome sequence of PRRSV strain HB-XL isolated from a pig farm with a clinical outbreak of porcine reproductive and respiratory syndrome. The genome is 15,323 bp long and has nine open reading frames (GenBank: KP162169). Comparative and phylogenetic analysis showed that HB-XL belongs to the highly pathogenic PRRSV (HP-PRRSV) subfamily in the family PRRSV. The viral nonstructural protein 2 (Nsp2) of the HB-XL strain contained 30 discontinuous amino acid (AA) deletions relative to that of the Nsp2 of the VR2332 strain. The AA substitutions R13 and R151 suggested high virulence of the HB-XL strain. The unique mutations in glycoprotein 5 (GP5) and Nsp2 revealed that HB-XL might be a novel variant PRRSV strain recombined with vaccine strains. However, the low morbidity and mortality in the pig herd from which HB-XL was isolated indicate that the virulence of the virus was weak, so it has potential as a future vaccine strain.