bluuebunny/crossref_metadata_2025 huggingface dataset:
A Cost Effective Desalination Plant Using a Solar Chimney with Recycled Aluminum Can Collector
Authors: Rajesh Singuru , Choudary Ravipati Bapaiah
Published: June 2016

The main objective of the work was to use solar energy for desalination of water. A solar chimney desalination system, which includes the solar chimney, solar collector, evaporation system, and passive condenser, was designed and built. The air enters into collector and gets heated and released at the bottom of chimney. Due to draught effect dry air goes upward. The air is humidified by spraying salt water into the hot air stream using a mistifier at the middle of chimney. Then, the partial vapours contained in the air are condensed to give desalinated water. The performance of the integrated system including power and potable water production was estimated and the results were discussed. With a 3.4 m height setup, experimental test rig was capable of evaporating 3.77 L water daily condensing 2.3 L water. It is compact in nature as it is easy to assemble and dissemble. It can be used for purifying rain water in summer under rain water harvesting. Because of using country wood, recycled Al cans, and GI sheet in fabrication, it is lower in cost.
Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes
Authors: Yu Lingling , Tian Jianmei , Zhao Xingli , Cheng Ping , Chen Xiaoqian , Yu Yun , Ding Xiaochun , Zhu Xueping , Xiao Zhihui
Published: June 2016

We aim to determine risk factors and clinical outcomes for bowel perforation in premature infants with NEC. We analyzed clinical data of 57 cases of premature infants with NEC at our NICU between January 2010 and December 2012. Based on the presence of bowel perforation, we divided these infants into two groups: perforated NEC group (n=10) and nonperforated NEC group (n=47). We compared general information, clinical characteristics, and laboratory findings between groups. The perforated NEC group, compared to the nonperforated NEC group, had significantly lesser gestational age, lower birth weight, higher prevalence of apnea, mechanical ventilation, sepsis and shock, lower blood pH, higher levels of blood glucose, abnormal WBC count and thrombocytopenia, and elevated CRP (allP<0.05). Moreover, the perforated NEC group had significantly longer durations of fasting and TPN usage, higher incidences of EUGR and cholestasis, longer duration of antibiotics, higher frequency of advanced antibiotics use, and poorer prognosis than the nonperforated NEC group (allP<0.05). Bowel perforation in premature infants with NEC was associated with multiple risk factors. Early identification of some of these risk factors in premature infants with NEC may help implement early intervention to reduce the incidence of bowel perforation and thereby improve the prognosis.
Metastatic Malignant Ovarian Steroid Cell Tumor: A Case Report and Review of the Literature
Authors: Lee Jessica , John Veena S. , Liang Sharon X. , D’Agostino Catherine A. , Menzin Andrew W.
Published: June 2016

We report a case of malignant ovarian steroid cell tumor not otherwise specified (NOS) in a 47-year-old female who presented with hirsutism, virilization, and amenorrhea. At the time of laparotomy, the tumor had already spread to the pelvic cul-de-sac. She underwent a total hysterectomy, bilateral salpingo-oophorectomy, and tumor resection with no residual disease. She received three cycles of bleomycin, etoposide, and cisplatin (BEP) and is now free of disease 24 months after surgery. Literature review of ovarian steroid cell tumors NOS including clinicopathological features and clinical management was performed.
Public Awareness and Identification of Counterfeit Drugs in Tanzania: A View on Antimalarial Drugs
Authors: Mhando Linus , Jande Mary B. , Liwa Anthony , Mwita Stanley , Marwa Karol J.
Published: June 2016

Background. The illicit trade in counterfeit antimalarial drugs is a major setback to the fight against malaria. Information on public awareness and ability to identify counterfeit drugs is scanty.Aim. Therefore, the present study aimed at assessing public awareness and the ability to identify counterfeit antimalarial drugs based on simple observations such as appearance of the drugs, packaging, labelling, and leaflets.Methodology. A cross-sectional study was conducted using interviewer administered structured questionnaire and a checklist. Respondents were required to spot the difference between genuine and counterfeit antimalarial drugs given to them. Data was analysed using SPSS version 20.Results. The majority of respondents, 163 (55.6%), were able to distinguish between genuine and counterfeit antimalarial drugs. Respondents with knowledge on health effects of counterfeit drugs were more likely to identify genuine and counterfeit drugs than their counterparts (P=0.003; OR = 2.95; 95% CI: 1.47–5.65). The majority of respondents, 190 (64.8%), perceived the presence of counterfeit drugs to be a big problem to the community.Conclusions. A substantial proportion of respondents were able to distinguish between genuine and counterfeit antimalarial drugs. Public empowerment in identifying counterfeit drugs by simple observations is a major step towards discouraging the market of counterfeit drugs.
Labeling Adipose‐Derived Stem Cells with Hoechst 33342: Usability and Effects on Differentiation Potential and DNA Damage
Authors: Schendzielorz P. , Froelich K. , Rak K. , Gehrke T. , Scherzad A. , Hagen R. , Radeloff A.
Published: June 2016

Adipose‐derived stem cells (ASCs) have been extensively studied in the field of stem cell research and possess numerous clinical applications. Cell labeling is an essential component of various experimental protocols and Hoechst 33342 (H33342) represents a cost‐effective and easy methodology for live staining. The purpose of this study was to evaluate the labeling of rat ASCs with two different concentrations of H33342 (0.5 μg/mL and 5 μg/mL), with particular regard to usability, interference with cell properties, and potential DNA damage. Hoechst 33342 used at a low concentration of 0.5 μg/mL did not significantly affect cell proliferation, viability, or differentiation potential of the ASCs, nor did it cause any significant DNA damage as measured by the olive tail moment. High concentrations of 5 μg/mL H33342, however, impaired the proliferation and viability of the ASCs, and considerable DNA damage was observed. Undesirable colabeling of unlabeled cocultivated cells was seen in particular with higher concentrations of H33342, independent of varying washing procedures. Hence, H33342 labeling with lower concentrations represents a usable method, which does not affect the tested cell properties. However, the colabeling of adjacent cells is a drawback of the technique.
Identification and Discrimination of Brands of Fuels by Gas Chromatography and Neural Networks Algorithm in Forensic Research
Authors: Ugena L. , Moncayo S. , Manzoor S. , Rosales D. , Cáceres J. O.
Published: June 2016

The detection of adulteration of fuels and its use in criminal scenes like arson has a high interest in forensic investigations. In this work, a method based on gas chromatography (GC) and neural networks (NN) has been developed and applied to the identification and discrimination of brands of fuels such as gasoline and diesel without the necessity to determine the composition of the samples. The study included five main brands of fuels from Spain, collected from fifteen different local petrol stations. The methodology allowed the identification of the gasoline and diesel brands with a high accuracy close to 100%, without any false positives or false negatives. A success rate of three blind samples was obtained as 73.3%, 80%, and 100%, respectively. The results obtained demonstrate the potential of this methodology to help in resolving criminal situations.
Sleep in Chronic Obstructive Pulmonary Disease: Evidence Gaps and Challenges
Authors: Jen Rachel , Li Yanru , Owens Robert L. , Malhotra Atul
Published: June 2016

Chronic obstructive pulmonary disease (COPD) prevalence is rising to epidemic proportions due to historical smoking trends, the aging of the population, and air pollution. Although blaming the victims has been common in COPD, the majority of COPD worldwide is now thought to be nonsmoking related, that is, caused by air pollution and cookstove exposure. It is increasingly appreciated that subjective and objective sleep disturbances are common in COPD, although strong epidemiological data are lacking. People with obstructive sleep apnea (OSA) plus COPD (the so-called overlap syndrome) have a high risk of cardiovascular death, although again mechanisms are unknown and untested. This review aims to draw attention to the problem of sleep in COPD, to encourage clinicians to ask their patients about symptoms, and to stimulate further research in this area given the large burden of the disease.
Reliable and Energy Efficient Protocol for MANET Multicasting
Authors: AlQarni Bander H. , AlMogren Ahmad S.
Published: June 2016

A mobilead hocnetwork (MANET) consists of a self-configured set of portable mobile nodes without any central infrastructure to regulate traffic in the network. These networks present problems such as lack of congestion control, reliability, and energy consumption. In this paper, we present a new model for MANET multicasting called Reliable and Energy Efficient Protocol Depending on Distance and Remaining Energy (REEDDRE). Our proposal is based on a tone system to provide more efficiency and better performance, and it combines solutions over the Medium Access Control (MAC) layer. The protocol consists of a new construction method for mobile nodes using a clustering approach that depends on distance and remaining energy to provide more stability and to reduce energy consumption. In addition, we propose an adjustment to the typical multicast flow by adding unicast links between clusters. We further present in our model a technique to provide more reliability based on a busy tone system (RMBTM) to reduce excessive control overhead caused by control packets in error recovery. We simulate our proposal using OPNET, and the results show enhancement in terms of reliability, packet delivery ratio (PDR), energy consumption, and throughput.
Reconfigurable and Tunable Filtenna for Cognitive LTE Femtocell Base Stations
Authors: Nachouane Hamza , Najid Abdellah , Tribak Abdelwahed , Riouch Fatima
Published: June 2016

A single-port uniplanar antenna with a built-in tunable filter is presented for operation in multiple LTE bands for cognitive femtocell applications. The antenna is based on a monopole microstrip patch fed by coplanar waveguide. The frequency reconfigurability is achieved by using two PIN diodes to couple or decouple a ring slot resonator filter from the antenna feed line. By switching the PIN diodes, the proposed design can operate in either wideband or narrowband modes. When the antenna operates in the narrowband state, two varactor diodes are used to continuously tune the narrowband frequency from 2.55 to 3.2 GHz, while the wideband state is obtained over the 1.35–6.2 GHz band. The diodes and their biasing networks have nearly no severe effect on the antenna characteristics. Prototypes of the proposed structure using ideal and real switches, with and without varactors, are fabricated and tested. Measured and simulated results are in good agreement, thus verifying the good performance of the proposed design. The obtained results show that the proposed antenna is very suitable for cognitive radio applications, in which the wideband mode is used for spectrum sensing and the narrowband mode for transmission at different frequency bands.
Recurrent Mutations in the MTOR Regulator RRAGC in Follicular Lymphoma
Authors: Ying Zhang Xiao , Jin Meiyan , Peterson Luke F. , Bernard Denzil , Saiya-Cork Kamlai , Yildiz Mehmet , Wang Shaomeng , Kaminski Mark S. , Chang Alfred E. , Klionsky Daniel J. , Malek Sami N.
Published: June 2016

Purpose: This study was performed to further our understanding of the biological and genetic basis of follicular lymphoma and to identify potential novel therapy targets.

Experimental Design: We analyzed previously generated whole exome sequencing data of 23 follicular lymphoma cases and one transformed follicular lymphoma case and expanded findings to a combined total of 125 follicular lymphoma/3 transformed follicular lymphoma. We modeled the three-dimensional location of RRAGC-associated hotspot mutations. We performed functional studies on novel RRAGC mutants in stable retrovirally transduced HEK293T cells, stable lentivirally transduced lymphoma cell lines, and in Saccharomyces cerevisiae.

Results: We report recurrent mutations, including multiple amino acid hotspots, in the small G-protein RRAGC, which is part of a protein complex that signals intracellular amino acid concentrations to MTOR, in 9.4% of follicular lymphoma cases. Mutations in RRAGC distinctly clustered on one protein surface area surrounding the GTP/GDP–binding sites. Mutated RRAGC proteins demonstrated increased binding to RPTOR (raptor) and substantially decreased interactions with the product of the tumor suppressor gene FLCN (folliculin). In stable retrovirally transfected 293T cells, cultured in the presence or absence of leucine, multiple RRAGC mutations demonstrated elevated MTOR activation as evidenced by increased RPS6KB/S6-kinase phosphorylation. Similar activation phenotypes were uncovered in yeast engineered to express mutations in the RRAGC homolog Gtr2 and in multiple lymphoma cell lines expressing HA-tagged RRAGC-mutant proteins.

Conclusions: Our discovery of activating mutations in RRAGC in approximately 10% of follicular lymphoma provides the mechanistic rationale to study mutational MTOR activation and MTOR inhibition as a potential novel actionable therapeutic target in follicular lymphoma. Clin Cancer Res; 22(21); 5383–93. ©2016 AACR.
CD103 and Intratumoral Immune Response in Breast Cancer
Authors: Wang Zhi-Qiang , Milne Katy , Derocher Heather , Webb John R. , Nelson Brad H. , Watson Peter H.
Published: June 2016

Purpose: CD103 is expressed in several immune cell types but in the context of the intratumoral immune response may be most important as a marker of antigen-activated CD8 T cells.

Methods: We have examined the prognostic significance of CD103 TILs in breast cancer by IHC in a cohort of 424 breast cancer patients.

Results: CD103 TILs were present in all subtypes but were more abundant in ER-negative tumors where CD103 TILs were preferentially localized to the intraepithelial compartment. CD103 was associated with tumor size, tumor grade, and ER/PR status (P < 0.05). CD103 TIL density and the epithelial to stromal ratio was highest in the basal-like tumors. Intraepithelial CD103 but not intrastromal CD103 was associated with better relapse-free and overall survival in basal-like subtype tumors [HR = 0.28; 95% confidence interval (CI), 0.17–0.72; P = 0.0047 and HR = 0.25; 95% CI, 0.17–0.66; P = 0.0017, respectively). CD8 status showed similar but less significant associations, but the combination of dual CD103+CD8+ TIL status was the most strongly prognostic combination for relapse-free and overall survival (HR = 0.10; 95% CI, 0.07–0.62; P = 0.006 and HR = 0.09; 95% CI, 0.07–0.57; P = 0.003, respectively).

Conclusions: CD103 TILs are indicative of a good prognosis specifically within the basal-like subtype of breast cancer. Clin Cancer Res; 22(24); 6290–7. ©2016 AACR.
Effects of Black Raspberry Extract and Protocatechuic Acid on Carcinogen-DNA Adducts and Mutagenesis, and Oxidative Stress in Rat and Human Oral Cells
Authors: Guttenplan Joseph B. , Chen Kun-Ming , Sun Yuan-Wan , Kosinska Wieslawa , Zhou Ying , Kim Seungjin (Agatha) , Sung Youngjae , Gowda Krishne , Amin Shantu , Stoner Gary D. , El-Bayoumy Karam
Published: June 2016

Effects of black raspberry (BRB) extract and protocatechuic acid (PCA) on DNA adduct formation and mutagenesis induced by metabolites of dibenzo[a,l]pyrene (DBP) were investigated in rat oral fibroblasts. The DBP metabolites, (±)-anti-11,12-dihydroxy-11,12,-dihydrodibenzo[a,l]pyrene (DBP-diol) and 11,12-dihydroxy-13,14-epoxy-11,12,13,14-tetrahydrodibenzo[a,l]pyrene (DBPDE) induced dose-dependent DNA adducts and mutations. DBPDE was considerably more potent, whereas the parent compound had no significant effect. Treatment with BRB extract (BRBE) and PCA resulted in reduced DBP-derived DNA adduct levels and reduced mutagenesis induced by DBP-diol, but only BRBE was similarly effective against (DBPDE). BRBE did not directly inactivate DBPDE, but rather induced a cellular response—enhanced DNA repair. When BRBE was added to cells 1 day after the DBP-diol, the BRBE greatly enhanced removal of DBP-derived DNA adducts. As oxidative stress can contribute to several stages of carcinogenesis, BRBE and PCA were investigated for their abilities to reduce oxidative stress in a human leukoplakia cell line by monitoring the redox indicator, 2′,7′-dichlorodihydrofluorescein diacetate (H2DCF) in cellular and acellular systems. BRBE effectively inhibited the oxidation, but PCA was only minimally effective against H2DCF. These results taken together provide evidence that BRBE and PCA can inhibit initiation of carcinogenesis by polycyclic aromatic hydrocarbons; and in addition, BRBE reduces oxidative stress. Cancer Prev Res; 9(8); 704–12. ©2016 AACR.
STAT3 as a Chemoprevention Target in Carcinogen-Induced Head and Neck Squamous Cell Carcinoma
Authors: Peyser Noah D. , Wang Lin , Zeng Yan , Acquafondata Marie , Freilino Maria , Li Hua , Sen Malabika , Gooding William E. , Satake Masanobu , Wang Zhenghe , Johnson Daniel E. , Grandis Jennifer R.
Published: June 2016

Head and neck squamous cell carcinoma (HNSCC) is a frequently fatal disease due, in large part, to a high rate of second primary tumor (SPT) formation. The 4-nitroquinoline 1-oxide (4-NQO) mouse model of oral carcinogenesis provides a robust system in which to study chemopreventive agents in the context of chemically induced HNSCC tumors. STAT3 is a potent oncogene that is hyperactivated by tyrosine phosphorylation early in HNSCC carcinogenesis and is a rational therapeutic target. We recently reported that loss-of-function of the STAT3 phosphatase PTPRT promotes STAT3 activation in HNSCC tumors and preclinical models and may serve as a predictive biomarker of response to STAT3 inhibitors, including the small-molecule Stattic. We therefore investigated the hypothesis that Ptprt-knockout (KO) mice would be more susceptible to 4-NQO–induced oral carcinogenesis and more sensitive to Stattic-mediated chemoprevention compared with wild-type (WT) mice. Herein, we demonstrate that Ptprt WT and KO mice develop similar spectra of HNSCC disease severity upon 12 weeks of 4-NQO administration, with no apparent effect of Ptprt genotype on carcinogenesis or treatment outcome. Targeting of STAT3 with Stattic resulted in a chemopreventive effect against 4-NQO–induced oral cancer (P = 0.0402). While these results do not support a central role for PTPRT in 4-NQO–induced HNSCC carcinogenesis, further investigation of STAT3 as a chemoprevention target in this cancer is warranted. Cancer Prev Res; 9(8); 657–63. ©2016 AACR.
Cross-talk between 4-1BB and TLR1–TLR2 Signaling in CD8+ T Cells Regulates TLR2′s Costimulatory Effects
Authors: Joseph Ann Mary , Srivastava Ratika , Zabaleta Jovanny , Davila Eduardo
Published: June 2016

The activation of TLR-MyD88 (Toll-like receptor-myeloid differentiation factor 88) signaling within T cells functions as a potent costimulatory signal that boosts antitumor and antiviral responses. However, the molecular mechanisms underlying the costimulatory processes are poorly understood. We compared microarray gene analysis data between TLR1–TLR2-stimulated and unstimulated T-cell receptor transgenic “pmel” and MyD88−/− pmel CD8+ T cells and identified changes in the expression of several TNF family members. In particular, TLR stimulation increased 4-1BB levels in pmel but not in MyD88−/−pmel T cells. A link between 4-1BB and TLR1–TLR2 signaling in CD8+ T cells was highlighted by the suboptimal responses of 4-1BB−/− T cells to TLR1–TLR2 agonist, but their normal response to CD28 or OX40 costimulation. Blocking 4-1BB signaling with antibodies also hindered the costimulatory effects of the TLR1–TLR2 agonist. The elevated levels of 4-1BB transcripts in TLR1–TLR2-stimulated cells were not due to increased mRNA stability nor increased histone activation, but instead were associated with increased binding of p65 and c-Jun to two distinct 4-1BB promoter sites. Combining TLR1–TLR2 ligand with an agonistic antibody to 4-1BB enhanced the antitumor activity in mice with established melanoma tumors. These studies reveal that the costimulatory effects of TLR1–TLR2 signaling in CD8+ T cells are in part mediated by 4-1BB and are important for mounting an effective antitumor immune response. Cancer Immunol Res; 4(8); 708–16. ©2016 AACR.
The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer
Authors: Khan Aftab A. , Akritidis Georgios , Pring Toby , Alagarathnam Swethan , Roberts Geoffrey , Raymond Regina , Varcada Massimo , Novell Richard
Published: June 2016

Aim: The aim of the study was to investigate the role of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker of rectal cancers. Methods: We undertook a retrospective review of patients with rectal cancer. Pre-treatment NLR was assessed for association and predictive values against clinicopathological staging and post-treatment outcomes. Results: A total of 140/180 cases were included in the final analysis [male:female 2:1; mean age 68 years (interquartile range 58-75)]. The pre-operative mean NLR was 5.4 ± 6.8. There was a strong positive correlation between NLR and C-reactive protein (Spearman's rho 64.3%, p < 0.001). A high NLR was associated with a positive nodal status on MRI (5.2 vs. 3.8, p = 0.03) and histopathological (4.8 vs. 3.8, p = 0.02) assessment. The NLR showed an average value for predicting MRI and pathological nodal status on receiver operating characteristic analysis [area under the curve = 0.72 (95% CI = 0.54-0.91), p = 0.031 and area under the curve = 0.64 (95% CI = 0.52-0.077), p = 0.021, respectively]. On multivariate analysis, the total lymph node retrieved at operation was the best predictor of pathological nodal involvement; NLR did not show any predictive value. Patients with an NLR >4 showed reduced recurrence-free (60 vs. 86 months, p = 0.52) and overall survival (57 vs. 84 months, p = 0.40) without statistical significance. Conclusion: Raised pre-treatment NLR may indicate nodal involvement in patients with rectal cancer.
Comparative Gait Analysis in Progressive Supranuclear Palsy and Parkinson's Disease
Authors: Hatanaka Noriko , Sato Kota , Hishikawa Nozomi , Takemoto Mami , Ohta Yasuyuki , Yamashita Toru , Abe Koji
Published: June 2016

Background: Although changes to gait are an important clinical feature of progressive supranuclear palsy (PSP), systematic analyses have not been well examined, especially in comparison to Parkinson's disease (PD). Methods: The characteristics of gait in 20 PSP patients (14 males and 6 females) were evaluated in comparison to 124 PD patients (64 males and 60 females) and 24 controls, that is, healthy age-matched adults (5 males and 19 females). Gait in patients was recorded in a 10-m walking test at a self-selected speed. During this time, patients felt most comfortable while wearing a new portable triaxial accelerometer rhythmogram device. Gait variables among the 3 groups were compared. Results: Both PSP and PD patients shared the following similar hypokinetic gait characteristics: decreased velocity, step length, cadence and mean acceleration. Step time and variability in step time were mutually related. However, among the 3 groups, PSP patients showed characteristically low vertical displacement and a higher acceleration than PD patients at the same cadence. Conclusion: Although PSP and PD patients showed similar hypokinetic gait, a reduced vertical displacement characterized walking in PSP patients, differing substantially from the characteristics of walking displayed by PD patients.
Use of an Amnioport to Maintain Amniotic Fluid Volume in Fetuses with Oligohydramnios Secondary to Lower Urinary Tract Obstruction or Fetal Renal Anomalies
Authors: Polzin William J. , Lim Foong Y. , Habli Mounira , Van Hook James , Minges Melissa , Jaekle Ronald , Crombleholme Timothy M.
Published: June 2016

Objective: We describe a technique to maintain amniotic fluid in fetuses with severe oligo-/anhydramnios secondary to lower urinary tract obstruction or fetal renal disease when urine production is inadequate to maintain a normal amniotic fluid volume (AFV). Methods: An amnioport was inserted into the amniotic space. The catheter was secured to prevent dislodgment and tunneled to a subcutaneous reservoir. The reservoir was accessed as necessary, infusing normal saline to maintain AFV. Pregnancy continued until term or indicated delivery. Results: Since 2010, 15 patients in this category were considered for an amnioport. Six chose comfort care and one elected percutaneous amnioinfusions. Nine amnioport procedures were performed in eight patients. There were no fetal deaths. All eight had successful restoration and maintenance of amniotic fluid. Delivery ranged from 9 to 96 days after placement (mean 63.7 days). One died due to unrecognized laryngeal web and another one died of pulmonary hypoplasia after preterm premature rupture of membranes. None of the remaining six had pulmonary hypoplasia. Three remain alive. Discussion: Severe oligo-/anhydramnios in the second trimester secondary to fetal anomalies is almost uniformly lethal due to pulmonary hypoplasia without restoration of amniotic fluid. The amnioport procedure may allow pulmonary survival but commits families to postnatal care decisions regarding pulmonary and renal complications.
Incidence of Cardiovascular Events after Nephrectomy - A Single Centre, Matched Pair Analysis between Donor and Tumour Nephrectomy in a Long Term Follow-Up
Authors: Nestler Sebastian , Levien Patrick , Neisius Andreas , Thomas Christian , Kamal Mohammed M. , Hampel Christian , Jones Jon , Thüroff Joachim W. , Roos Frederik C.
Published: June 2016

Introduction: The study aimed to compare the incidence of cardiovascular events (CVEs) after donor nephrectomy (DN) and radical tumor nephrectomy (RN), according to an estimated glomerular filtration rate (eGFR), were evaluated over time. Materials and Methods: Follow-up was collected for DN who underwent surgery from 1998 to 2007 for CVE and renal function. All DN were matched for age to patients treated by RN or adenoma enucleation (control group), who were eligible for DN. eGFR was estimated using the Cockgroft-Gould formula. Patients with preoperative comorbidities were excluded. Results: Thirty DN (median age 48.9 years) were included with a median follow-up of 138.5 months (interquartile range 119-159). No significant differences in patients' characteristics were found preoperatively (p > 0.5). Four out of 30 DN developed a CVE (3 myocardial infarctions (MI), 1 stroke), 2 of 30 patients in the control group (both MI) and 8 of 30 RN patients (6 MI, 2 strokes, p > 0.05). Arterial hypertension developed in 14 DN (46.7%), in 12 (40%) after RN and in 15 controls. The CVE occurred after a median time of 68 months (5-231) and were related to a drop of ∼30% in the eGFR irrespective of the group. Conclusion: Decline of renal function after nephrectomy is the main risk factor for CVE. Close monitoring of renal function and new onset hypertension is warranted.
Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?
Authors: Tuithof Marlous , ten Have Margreet , van den Brink Wim , Vollebergh Wilma , de Graaf Ron
Published: June 2016

Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The Composite International Diagnostic Interview 3.0 assessed AUD and other psychiatric disorders. Results: Of 154 subjects with baseline 12-month DSM-5 AUD, 35.4% used only general treatment (GenTx) for mental problems or alcohol/drugs problems; 10.3% used specialized AUD treatment (AUDTx); and 54.3% used no treatment at all. Of these 3 groups, AUDTx users had the highest severity on AUD characteristics, comorbid psychopathology and mental functioning. Compared to non-treatment (NonTx), GenTx users more often had 12-month emotional disorders at follow-up, but AUD remission rates and functioning were similar. NonTx users functioned similarly at follow-up as people in the general population without lifetime AUD or other psychopathology. Conclusion: Adequate treatment seeking often occurs in the general population: the most severe AUD subjects use AUDTx, and most NonTx users have a mild AUD and a favorable course. Current findings suggest a smaller treatment gap than previously reported, but still one-quarter of the people with AUD do not seek AUDTx but could benefit from this, as they have a persistent AUD.
Identifying Technical Procedures in Pulmonary Medicine That Should Be Integrated in a Simulation-Based Curriculum: A National General Needs Assessment
Authors: Nayahangan Leizl Joy , Clementsen Paul Frost , Paltved Charlotte , Lindorff-Larsen Karen Gilboe , Nielsen Bjørn Ulrik , Konge Lars
Published: June 2016

Background: Simulation training is a revolutionary addition to health care education. However, developing simulation-based training programs is often dictated by those simulators that are commercially available. Curriculum development requires deliberate planning and a standardized approach, including a ‘general needs assessment'. Objectives: The aim of this study was to perform a national general needs assessment to identify technical procedures in pulmonary medicine that should be integrated in a simulation-based curriculum. Methods: A three-round Delphi process was initiated among 62 key opinion leaders. Round 1 was an open-ended question to identify technical procedures pulmonologists should learn. Round 2 was a survey using a newly developed needs assessment formula to explore the frequency of procedures, number of operators, risk or discomfort when performed by an inexperienced doctor, and feasibility of simulation-based training. In round 3, results were reviewed and ranked according to priority. Results: The response rates for the three rounds were 74, 63, and 60%, respectively. The Delphi process reduced the 30 procedures identified in round 1 to 11 prioritized technical procedures in round 3. These were: flexible bronchoscopy, pleurocentesis, endobronchial ultrasound, endoscopic ultrasound-guided fine-needle aspiration, noninvasive ventilation treatment, transthoracic biopsy of pleural or lung tumor, focused ultrasound scanning of the lungs, chest tube insertion, needle biopsy of visible lymph node/tumor of the skin, focused ultrasound scanning of the heart, and thoracoscopy. Conclusion: We performed a Delphi study using a needs assessment formula, which identified 11 technical procedures that are highly suitable for simulation-based training. Medical educators can use this list as a resource in planning simulation-based training programs for trainees in pulmonary medicine.
Amniotic Fluid Embolism: A Rare Complication of Second-Trimester Amniocentesis
Authors: Drukker Lior , Sela Hen Y. , Ioscovich Alexander , Samueloff Arnon , Grisaru-Granovsky Sorina
Published: June 2016

Amniotic fluid embolism occurring following diagnostic amniocentesis is extremely rare. Only 2 cases have been reported in the English literature over the past 55 years, the most recent one approximately 3 decades ago. We present a case of amniocentesis at 24 weeks' gestation that was performed as part of an evaluation of abnormal fetal ultrasound findings. Immediately following amniotic fluid aspiration, maternal hemodynamic collapse occurred, initially diagnosed and treated as anaphylactic shock. Shortly after initial therapy, coagulopathy was noted and amniotic fluid syndrome suspected. Rapid response restored maternal hemodynamic stability; however, the fetus had suffered fatal damage.
Measurement of Muscle Strength in Haemodialysis Patients by Pinch and Hand Grip Strength and Comparison to Lean Body Mass Measured by Multifrequency Bio-Electrical Impedance
Authors: Omichi Yukie , Srivareerat Methavee , Panorchan Kwanpeemai , Greenhall George H.B. , Gupta Sanjana , Davenport Andrew
Published: June 2016

Background: Muscle weakness is a risk factor for mortality in haemodialysis (HD) patients; we wished to determine whether measuring the composition of the arm with bioimpedance was associated with arm muscle strength. Methods: We measured pinch strength (PS) and hand grip strength (HGS) in 250 adult HD patients with corresponding post-dialysis multifrequency bioelectrical assessments with segmental body analysis. Results: Mean age 64.0 ± 15.6, 66% male and 45.6% diabetic. The maximum HGS in the dominant or non-fistula arm was 18.9 ± 9.2 kg and PS 4.09 ± 1.96 kg respectively, with a correlation of r = 0.80, p < 0.001. HGS was associated with body cell mass (β 0.37, p < 0.001) and PS with appendicular muscle mass (β 0.06, p < 0.001). Both HGS and PS were independently associated with the ratio of extracellular water (ECW) to total body water (TBW); β -139.5, p = 0.024, β -44.8, p < 0.001 in the arm. The presence of an arterio-venous fistula increased the ECW/TBW ratio in the arm from 0.383 ± 0.009 to 0.390 ± 0.012, p < 0.05. Conclusion: Muscle strength measured by HGS and PS was associated with both markers of whole body and segmental body composition within the arm, particularly ECW/TBW. Bioimpedance measurements and assessment of muscle strength should be measured in the non-fistula arm.
STRATEGIC DECISION-MAKING SPEED IN NEW TECHNOLOGY BASED FIRMS
Authors: Montiel Campos Héctor , Solé Parellada Francesc , Aguilar Valenzuela Francisco Alfonso , Magos Rubio Alejandro
Published: June 2016

New Technology Based Firms (NTBF) operate in high-velocity environments that make considerable demands about the speed of strategic choices. This study draws upon strategic decision-making and organization theories to propose that strategic decision making speed mediates the relation between personal, organizational and environmental factors and performance. Hypotheses were theoretically developed and tested with data from an empirical investigation of Mexican NTBF. Measures of personal characteristics, organization structure, business environment, strategic decision speed and performance were collected from 103 Technology Founder Managers at the end of 2012. The results confirmed that strategic decision making speed influences the performance of NTBF and mediates the relation of uncertainty, CEO model, dynamism and hostility with firm performance.
ADOÇÃO DO PROCESSO ELETRÔNICO DE CONTROLE EXTERNO (E-TCU) NO TRIBUNAL DE CONTAS DA UNIÃO: A EXPERIÊNCIA DOS GESTORES ENVOLVIDOS
Authors: Deus Lígia Francisco de , Farias Josinavia Silva
Published: June 2016

Este trabalho teve como objetivo geral investigar o processo gerencial de adoção do sistema Processo Eletrônico de Controle Externo (e-TCU) no Tribunal de Contas da União, adotando como perspectiva basilar da discussão, os atributos de inovação considerados na Innovation Diffusion Theory (Rogers, 2003). Para o desenvolvimento da pesquisa, foi feito um estudo de caso descritivo-qualitativo por meio de entrevistas estruturadas com dez gestores que estiveram envolvidos com a adoção do e-TCU na instituição estudada, o Tribunal de Contas da União. Como resultados, obtidos por análise de conteúdo das entrevistas transcritas, teve-se que: a) o e-TCU gerou controvérsias para a instituição, principalmente devido às diferentes visões de diferentes atores e à grande mudança organizacional que significou, mas estas foram resolvidas durante o processo; b) os gestores perceberam o novo sistema como uma evolução natural da organização; que com ele poderia melhor realizar seus serviços e, assim, melhor atender à sociedade - visão que foi politicamente muito defendida; c) os benefícios mais notados pelos gestores foram os diversos controles que o sistema proporcionou à instituição, tais como: controle de tempo, de custos, de informação, de trabalho, de localização, de espaço, de imagem institucional e controle ambiental; e d) os atributos facilitadores de adoção de inovação, propostos por Rogers (2003), a saber: vantagem relativa, compatibilidade, complexidade, testabilidade e observabilidade, estiveram, em sua maioria, presentes e positivamente relacionados com a tecnologia adotada, o que pode ter contribuído para o sucesso do processo, visto que tais atributos tendem a aumentar a taxa de adoção de uma inovação.
INOVAÇÕES EM ORGANIZAÇÕES PÚBLICAS: ESTUDO DOS FATORES QUE INFLUENCIAM UM AMBIENTE INOVADOR NO ESTADO DE MINAS GERAIS
Authors: Ferreira Rodrigo De Araújo , Rocha Elisa Maria Pinto da , Carvalhais Jane Noronha
Published: June 2016

O objetivo deste trabalho é analisar o ambiente de inovação nas organizações públicas do Estado de Minas Gerais, sob a perspectiva dos gestores envolvidos em projetos estratégicos e arranjos institucionais voltados para a inovação. Para tal, analisou-se os fatores que influenciam a inovação no ambiente público, identificando pontos críticos a serem priorizados pela política de inovação do Estado, de forma a aperfeiçoá-la. Verificou-se que o grau de presença destes fatores é, em geral, baixo, embora os gestores tenham atribuído a eles elevada importância. Verificou-se, também, divergência de opiniões entre gestores por nível hierárquico quanto a importância e presença destes fatores.
Combining Diuretic Response and Hemoconcentration to Predict Rehospitalization After Admission for Acute Heart Failure
Authors: ter Maaten Jozine M. , Valente Mattia A.E. , Damman Kevin , Cleland John G. , Givertz Michael M. , Metra Marco , O’Connor Christopher M. , Teerlink John R. , Ponikowski Piotr , Bloomfield Daniel M. , Cotter Gadi , Davison Beth , Subacius Haris , van Veldhuisen Dirk J. , van der Meer Peter , Hillege Hans L. , Gheorghiade Mihai , Voors Adriaan A.
Published: June 2016

Background—

Both diuretic response and hemoconcentration are indicators of decongestion and have individually been found to predict rehospitalization after admission for acute heart failure (HF). This study examines the value of combining diuretic response and hemoconcentration to better predict patients at low risk for rehospitalization after admission for acute HF.

Methods and Results—

Diuretic response (defined as weight change per 40 mg of furosemide on day 4 after admission) and hemoconcentration (change in hemoglobin at discharge or day 7) were tested both individually and combined to predict the risk of HF and cardiovascular rehospitalization 60 days after hospitalization for acute HF. Analyses were performed in 1180 patients enrolled in the Placebo-Controlled Randomized Study of the Selective Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized With Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function (PROTECT) trial and validated in 1776 patients enrolled in the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) trial. Poor diuretic response was associated with low systolic blood pressure, high blood urea nitrogen, and history of coronary revascularization in both data sets (all
P
<0.05). Hemoconcentration was mainly associated with better renal function (
P
<0.05). Patients who displayed both favorable diuretic response and hemoconcentration had a markedly lower risk of rehospitalization for HF in PROTECT (multivariable HR, 0.41; 95% CI, 0.24 to 0.70;
P
<0.001) compared with all other patients. This finding was confirmed in EVEREST (multivariable HR, 0.52; 95% CI, 0.33 to 0.82;
P
=0.004) for patients with favorable diuretic response and hemoconcentration compared with all other patients.

Conclusions—

Combining 2 indicators of decongestion, hemoconcentration and diuretic response improves risk prediction for early rehospitalization after an admission for acute HF and may provide clinicians with an easily accessible tool to identify low-risk patients.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT00354458 and NCT00071331.
Cognitive Machine-Learning Algorithm for Cardiac Imaging
Authors: Sengupta Partho P. , Huang Yen-Min , Bansal Manish , Ashrafi Ali , Fisher Matt , Shameer Khader , Gall Walt , Dudley Joel T.
Published: June 2016

Background—

Associating a patient’s profile with the memories of prototypical patients built through previous repeat clinical experience is a key process in clinical judgment. We hypothesized that a similar process using a cognitive computing tool would be well suited for learning and recalling multidimensional attributes of speckle tracking echocardiography data sets derived from patients with known constrictive pericarditis and restrictive cardiomyopathy.

Methods and Results—

Clinical and echocardiographic data of 50 patients with constrictive pericarditis and 44 with restrictive cardiomyopathy were used for developing an associative memory classifier–based machine-learning algorithm. The speckle tracking echocardiography data were normalized in reference to 47 controls with no structural heart disease, and the diagnostic area under the receiver operating characteristic curve of the associative memory classifier was evaluated for differentiating constrictive pericarditis from restrictive cardiomyopathy. Using only speckle tracking echocardiography variables, associative memory classifier achieved a diagnostic area under the curve of 89.2%, which improved to 96.2% with addition of 4 echocardiographic variables. In comparison, the area under the curve of early diastolic mitral annular velocity and left ventricular longitudinal strain were 82.1% and 63.7%, respectively. Furthermore, the associative memory classifier demonstrated greater accuracy and shorter learning curves than other machine-learning approaches, with accuracy asymptotically approaching 90% after a training fraction of 0.3 and remaining flat at higher training fractions.

Conclusions—

This study demonstrates feasibility of a cognitive machine-learning approach for learning and recalling patterns observed during echocardiographic evaluations. Incorporation of machine-learning algorithms in cardiac imaging may aid standardized assessments and support the quality of interpretations, particularly for novice readers with limited experience.
The Ontology of the Secret Doctrine in Plato’s Theaetetus
Authors: Buckels Christopher
Published: June 2016

The paper offers an interpretation of a disputed portion of Plato’s Theaetetus that is often called the ‘Secret Doctrine’. It argues that the Secret Doctrine is a process ontology which takes two types of process, swift and slow motions, as fundamental building blocks for ordinary material objects. Slow motions are powers which, when realized, generate swift motions, and these in turn are subjectively bundled to compose sensible objects and perceivers.
Aristotle Against Delos: Pleasure in Nicomachean Ethics x
Authors: Aufderheide Joachim
Published: June 2016

Two crucial questions, if unanswered, impede our understanding of Aristotle’s account of pleasure inenx.4-5: (1) What are the activities that pleasure is said to complete? (2) In virtue of what does pleasurealwaysaccompany these activities? The answers fall in place if we read Aristotle as responding to the Delian challenge that the finest, best and most pleasant are not united in one and the same thing (eni.8). I propose an ‘ethical’ reading ofenx.4 according to which the best activities in question are those integral to the exercise of virtue.
Diversity of root-lesion nematodes (Pratylenchus spp.) associated with wheat (Triticum aestivum and T. durum) in Morocco
Authors: Mokrini Fouad , Waeyenberge Lieven , Viaene Nicole , Abbad Andaloussi Fouad , Moens Maurice
Published: June 2016

Root-lesion nematodes (Pratylenchus) have a worldwide distribution and cause severe production constraints on numerous important crops. During a survey of the wheat-growing area of Morocco, 17 populations of root-lesion nematode were collected. They were identified on the basis of their morphological and morphometric characters, and by molecular methods. Microscopic observations of females and males demonstrated the occurrence ofP. penetransin 13 of the 17 samples;P. thorneiandP. pseudocoffeaewere detected in four samples from Zaers and a single sample from Settat, respectively. A duplex PCR primer set was used to confirm the presence ofP. penetranswhile the species-specific forward primer PTHO and the common reverse primer D3B were used forP. thornei. For the remaining populations, the D2-D3 expansion segments of the 28S rRNA gene were amplified and the obtained sequences were compared with those ofPratylenchusspecies in the GenBank database. This comparison confirmed the morphological identifications and revealed a population ofP. pinguicaudatus. The study of the phylogenetic relationship of the MoroccanPratylenchuspopulations showed a high similarity (99-100%) between allP. penetranspopulations. The population dynamics of sixPratylenchuspopulations from Morocco were evaluated on carrot disk cultures at 4, 8 and 12 weeks after inoculation, and at 10, 15, 20 and 25°C. The optimum temperature for reproduction of all populations was 20°C. After 8 weeks at this temperature, nematode numbers increased up to 458-fold, 310-fold and 252-fold for the four populations ofP. penetrans, theP. thorneiand theP. pseudocoffeaepopulation, respectively.
Конструируя Роскошь: Бытовое Пространство Советской Номенклатуры, 1940–1952 годы
Authors: Nikonorova Tatiana N. , Никонорова Татьяна Н.
Published: June 2016

This article is based on previously unpublished sources, mainly the archival materials of the Party Control Commission of the Central Committee of the Communist Party of the Soviet Union (CPSU). I argue that luxury can be seen as a phenomenon constructed by the Soviet social and political hierarchy during the 1940s and 1950s. An examination of everyday practices and patterns of consumption of luxury goods (food, clothing, interior furnishings, etc.) indicates that the Soviet elite (nomenklatura) sought to emulate a notional “middle-class” lifestyle. The distribution of so-called “trophy items” imported from East Germany to the Soviet Union caused friction within the party administration and sowed discontent within Soviet society as a whole. The dual policy of the CPSU on the issue of financial security of its members revealed its uncertainty about the state of “permitted” and “unauthorized” luxury.
Too Good to be True
Authors: McWhorter John
Published: June 2016

The grammatical items are not Norse, speakers never called it Norse, and Germanic speakers almost always learned their conquerees’ language rather than imposing it—Old English is not Norse.
Middle English
Authors: Thomason Sarah G.
Published: June 2016

The Viking hypothesis is fatally flawed, in part because syntax is readily borrowed in intense contact situations, while inflectional morphology usually is not—and Middle English inflectional morphology is overwhelmingly of West Germanic origin. The dismissal of lexical evidence is also misguided: the vast majority of basic vocabulary items come from Old English, not from Norse.