bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Orientations and Innovation in Resource-constrained SMEs of an Emerging Economy
Authors: Batra Safal , Sharma Sunil , Dixit Mukund R. , Vohra Neharika
Published: March 2015

While previous research has explored the linkages of strategic orientations and innovation for large businesses of developed economies, relatively little is known about these linkages for SMEs of emerging economies. To study these linkages, data were collected from owners or senior executives of 162 manufacturing SMEs in the Punjab region of India. Our results show that while customer orientation has been found to enable innovation for large firms, it does not directly facilitate innovation for Indian SMEs. The customer-oriented SMEs create successful innovation through better utilisation of their dynamic resources. Therefore, creation of dynamic resources by SMEs is more critical than that of unique resources for successful innovation. Implications of our findings are discussed for theory as well as practice.
Book Review: Kenneth E. Clow and Donald Baack (Eds), Cases in Marketing Management
Authors: Ganesh P.
Published: March 2015

Kenneth E. Clow and Donald Baack (Eds), Cases in Marketing Management, New Delhi: SAGE-Ivey Publication, 2012, 523 pp.
Book Review: Zoltan J. Acs (Ed.), The Knowledge Spillover Theory of Entrepreneurship
Authors: Cunningham James
Published: March 2015

Zoltan J. Acs (Ed.), The Knowledge Spillover Theory of Entrepreneurship, Cheltenham, UK: Edward Elgar Publishing, 2010, 683 pp.
Relevance of Systems Thinking and Scientific Holism to Social Entrepreneurship
Authors: Trivedi Chitvan , Misra Shalini
Published: March 2015

Social enterprises are said to meet two conditions—they address long-standing social problems, and they develop innovative solutions to do so. However, many social enterprises satisfy these two conditions but are unsuccessful in creating sustained positive social change. This article argues that a necessary condition for social enterprises to create and sustain social change is the ability to cognise the ecology of the social problem—the relationship and interaction between a social problem and its context. This article scrutinises how social enterprises conceptualise and address social problems by applying the principles of scientific holism and systems thinking to social entrepreneurial theory and practice. It presents social problem archetypes and develops key lessons for devising effective strategies for addressing social problems.
Eternity and dust? Cancer and the creative God
Authors: Meadowcroft Tim
Published: March 2015

According to the preacher, God has ‘put a sense of past and future into [our] minds, yet [we] cannot find out what God has done from the beginning and the end’ (Eccl 3:11 NRSV). As human beings we occupy the ground between our time-bound limitations and our God-imaging sense of eternity. And according to the Isaiah scroll, God ‘make[s] weal and create[s] woe’ (Isa 45:7 NRSV). There is a shadow side to the creative process of which modern science is making us increasingly aware. This article suggests that the phenomenon of cancer may be understood in the context of this risky creative process, and that as creatures of dust human beings are caught up in the riskiness of creation. This piece of speculative theology then considers the question, ‘What is God doing when cancer strikes?’ in the light of a God who, while creating, resists the suffering released by God’s own creative process.
Overcoming the gender gap: increasing gender diversity, scientific scholarship and social legitimacy of our profession
Authors: Golding Penny M
Published: March 2015

Objectives:

This article examines a recent college review of the gender distribution on Royal Australian and New Zealand College of Psychiatry (RANZCP) committees. It includes an analysis of the key reasons we should seek to address the gender disparity in our committees and conference speakers and strategies by which to achieve this.

Conclusions:

The gender gap in Royal Australian and New Zealand College of Psychiatry leadership influences the perception, social legitimacy, problem-solving capacity and scientific direction of our field. We could improve equality in our college committees and conference speakers by adopting strategies used by governments and other professional associations.
The Board evaluation: method, findings and recommendations
Authors: O’Connor Nick
Published: March 2015

Objectives:

To describe the background, method, findings and recommendations of the Royal Australian and New Zealand College of Psychiatrists Board evaluation.

Conclusions:

An evaluation of the Board in the first half of its initial term indicates that the Board and the new governance processes are developing well. There appears to be a healthy group dynamic and effective working relationships with the Chief Executive Officer and management. A number of priority areas emerged for the Board’s attention. The nature and low level of response from the wider membership indicate a low level of engagement in governance matters. It also seems that there are low levels of ‘governance literacy’ and that a different approach, perhaps facilitated focus groups, may be a more effective method for eliciting effective feedback on Board performance from the membership.
Costs Versus Benefits of Routine Histopathological Examination in Total Ankle Replacement
Authors: Soukup Dylan S. , O’Malley Martin J. , Ellis Scott J.
Published: March 2015

Background:

Routine histopathological examination has previously been scrutinized as a source of extraneous cost in orthopedic foot and ankle care. As an increasingly prevalent joint replacement operation, total ankle replacement poses a notable cost to the health care market in an era of cost containment. The purpose of this study was to compare the costs and benefits of routine histopathological examination of specimens removed during total ankle replacement. We hypothesized that a new diagnosis would rarely be found and such examination would seldom alter patient care.

Methods:

A retrospective review was conducted of all total ankle replacement operations between 2006 and July 2014 at the investigators’ institution. Medical records for 90 patients, undergoing a total of 95 total ankle replacement operations, were reviewed to determine the clinical and pathological diagnoses for each operation and, subsequently, the rates of discrepancy and discordance. Professional charges were determined using estimated reimbursement rates for the Current Procedural Terminology (CPT) codes billed: 88304 (level III microscopic examination), 88305 (level IV microscopic examination), and 88311 (decalcification).

Results:

Degenerative joint disease was diagnosed by the pathologist in 93.7% of cases (89/95), pseudogout in 4.2% (4/95), and rheumatoid arthritis in 2.1% (2/95). The 4 diagnoses of pseudogout were the only cases of new diagnoses based on pathological review. A total of $16 536.81 was spent for examination of all specimens, for an estimated $4 134.20 spent per discrepant diagnosis. Patient care was unaffected by pathological examination.

Conclusion:

A new diagnosis was rarely found by histopathological examination, and patient care remained unaltered in all cases. The costs of routine histopathological examination of tissue specimens removed during total ankle replacement, therefore, outweigh clinical benefits, and such examination should be left to the discretion of the operating surgeon.

Level of Evidence:

Level IV, retrospective case series.
Forklift-Related Crush Injuries of the Foot and Ankle
Authors: Hong Choon Chiet , Nashi Nazrul , Kuan Win Sen , Teh Jing Wen Daniel , Tan Ken Jin
Published: March 2015

Background:

Forklift-related crush injuries of the foot and ankle are relatively common in cities with shipping and construction industries. There is a paucity of literature on the incidence and sequelae of such injuries. We aimed to describe the incidence, patterns of injuries, sequelae, and morbidity associated with this type of injury.

Methods:

A retrospective review of all patients with forklift-related crush injuries of the foot and ankle for 4 years was conducted. Patients’ demographics, mechanisms and patterns of injury, fracture type, compartment syndrome, number of reconstructive operations, operative details, length of hospital stay, medical leave, repeat evaluation in emergency room, and complications were recorded and analyzed.

Results:

There were 113 (2.17%) patients with forklift-related crush injuries out of 5209 patients seen in our institution for injuries of the foot and ankle. Crush injury from the wheels of the forklift truck was the most common mechanism at 71 (62.8%) patients. The forefoot was the most commonly injured region, followed by the midfoot, hindfoot, and ankle, with almost one-third (28.3%) of the patients having multiple injuries to the foot. Nine (8%) had open fractures, while 5 (4.4%) had compartment syndromes. Forty (35.4%) patients required hospitalization, and 35 (87.5%) of those hospitalized required operative intervention. Those who had surgery were more likely to have complications compared with those who did not require operative intervention (16 [45.7%] of 35 patients vs 7 [9%] of 78 patients; P < .05) and more likely to require longer medical leave (mean, 183 vs 30 days, P < .05).

Conclusion:

Forklift-related crush injuries of the foot and ankle are increasingly common in industrialized cities. The forefoot is commonly affected with involvement of multiple regions. Up to one-third of affected patients required hospitalization and multiple operative interventions resulting in loss of productivity, income, and significant morbidity. The possibility of residual disabilities must be clearly defined to the patients and their employers to manage potential workplace limitations and long-term expectations.

Level of Evidence:

Level IV retrospective case series.
Effect of Intraoperative Three-Dimensional Imaging During the Reduction and Fixation of Displaced Calcaneal Fractures on Articular Congruence and Implant Fixation
Authors: Eckardt Henrik , Lind Marianne
Published: March 2015

Background:

Operative treatment of displaced calcaneal fractures should restore joint congruence, but conventional fluoroscopy is unable to fully visualize the subtalar joint. We questioned whether intraoperative 3-dimensional (3D) imaging would aid in the reduction of calcaneal fractures, resulting in improved articular congruence and implant positioning.

Method:

Sixty-two displaced calcaneal fractures were operated on using standard fluoroscopic views. When the surgeon had achieved a satisfactory reduction, an intraoperative 3D scan was conducted, malreductions or implant imperfections were revised, the calcaneus was rescanned, and this sequence was repeated until the optimal operative result was achieved.

Results:

Five fractures underwent 1 intraoperative scan, 39 fractures underwent 2 scans, 13 fractures underwent 3 scans, and 5 fractures underwent 4 scans. The average number of scans was 2.3. Intraoperative scanning led to re-reduction and improvement of reduction in 13 fractures, change of plate position in 1 patient, optimizing of the screw directions in 5 fractures, and shortening of screws that were intra-articular or protruding medially in 6 fractures. The postoperative articular displacement was 0 mm in 69% of the Sanders type 2 fractures and 57% of the Sanders type 3 fractures. Operation duration averaged 118 minutes, and there were no reoperations due to misplaced screws or plates. The average absorbed radiation dose per patient was 288 mGy·cm.

Conclusion:

Intraoperative 3D imaging improved the articular reduction of the posterior facet and secured optimal implant position in displaced calcaneal fractures. Radiation dose to the patient was less than that of a normal foot computed tomography scan.

Level of Evidence:

Level IV, case series.
Safety of Clinical and Non-Clinical Decision Makers in Telephone Triage: A Narrative Review
Authors: Wheeler Sheila Q , Greenberg Mary E , Mahlmeister Laura , Wolfe Nicole
Published: March 2015

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians’ and non-clinicians’ respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002–2012, we applied Donabedian’s structure-process-outcome model to examine groups’ systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) – (right time, right place with the right person), we measured each groups’ corresponding AR rate percentages (outcomes). We analyzed each group’s respective decision-making process as a safe match to the telephone triage task, based on each group’s system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians’ AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians’ safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard.
A cost-effectiveness analysis of teledietetics in short-, intermediate-, and long-term weight reduction
Authors: Chung LMY , Law QPS , Fong SSM , Chung JWY , Yuen PP
Published: March 2015

Introduction

To evaluate the effectiveness of teledietetics in weight loss for 24 weeks and the cost-effectiveness of weight loss between face-to-face and teledietetics services.

Methods

The study was conducted at a community health center and a community dietetics clinic. The study was a quasiexperimental design. Fifty adults aged 20–50 with a BMI ≥23 participated in the study. The face-to-face (FD) group received 12 dietary counselling sessions and recorded their diet in a log book. The teledietetics (TD) group attended three group nutrition seminars and recorded their diet on a Web-based platform. Changes in variables were compared using an independent t-test. Direct and indirect costs were applied to compute cost-effectiveness ratios.

Results

At week 6, the FD group showed greater reductions in all variables than did the TD group. At week 12, the effects reversed. At week 24, the accumulated reductions in weight and fat in the TD group were significantly higher than those in the FD group (all at p < 0.0001). The observed direct costs for 1% weight loss and 1% fat loss were USD 28.24 and USD17.09, respectively.

Discussion

A dietetic service delivered as a teledietetics model is more cost-effective than the face-to-face dietetics model in weight reduction.
Planning as practice of knowing
Authors: Davoudi Simin
Published: March 2015

It is often suggested that a defining feature of planning is its interventionist nature which requires connecting knowledge to action. With the upsurge of evidence-based planning, much is rehearsed about the utilitarian necessity of making such connection. What is less widely discussed is the epistemological nuances and challenges of knowledge–action relationship. This essay aims to contribute to the latter by conceptualising planning as practice of knowing. This is to shift the focus from knowledge as something that planners have to knowing as something that planners do. I would argue that, rather than thinking about knowledge as having an instrumental place in planning, it is more useful to think about planning as practice of knowing that involves knowing what, knowing how, knowing to what end and doing. Seen in this way, practice of knowing is a dynamic process that is situated and provisional, collective and distributed, purposive and pragmatic, and mediated and contested.
Delinquency and alcohol use among adolescents in Europe: The role of cultural contexts
Authors: Gatti Uberto , Soellner Renate , Bräker Astrid-Britta , Verde Alfredo , Rocca Gabriele
Published: March 2015

This paper presents cross-cultural research using data from the Second International Self-Report Delinquency Study (ISRD-2) to evaluate the strength and characteristics of the relationship between different kinds of juvenile delinquency and alcohol use, and to investigate whether, and how, different drinking cultures may influence this relationship. The setting is a school-based survey with a self-report questionnaire in a sample of 7th, 8th and 9th grade students (comprising 12–16 year olds) from 25 European countries. After recording data on alcohol consumption among young people in different European countries, we assessed the degree to which property offences, violent offences and gang membership were associated with the use of alcohol. In addition, a multilevel analysis (MLA) was carried out to ascertain whether the association between delinquency and alcohol use was influenced by variations in drinking cultures. Different drinking patterns were observed in Mediterranean and non-Mediterranean countries. Alcohol consumption was more closely related to involvement in violent crimes than to property offences, and correlated with the frequency and seriousness of delinquent behaviour everywhere. MLA showed that gang membership increased the probability of alcohol abuse to a greater degree in non-Mediterranean countries, while involvement in delinquency proved to be associated with alcohol abuse to a similar degree in the different cultural contexts considered. With regard to cultural influences on the relationships between juvenile delinquency and alcohol use, we ascertained that cultural attitudes towards alcohol influence the delinquency–alcohol relationship at the group level rather than the individual level.
Awareness, Integration and Interconnectedness
Authors: Beer Laura E. , Rodriguez Katrina , Taylor Christina , Martinez-Jones Naomi , Griffin Jennifer , Smith Tony R. , Lamar Margaret , Anaya Reyna
Published: March 2015

Contemplative practices support transformative learning processes but can be difficult to identify in a higher education environment. Advocates of contemplative approaches to education see this void as a concern. When topics like these are ignored, especially when desired by students, staff, and faculty, the holistic, transformative, and deep learning needs of students are unfulfilled. Attention needs to be brought to the connections between contemplative practices and the pursuit of transformative education. In this qualitative study, 17 higher education professionals were asked how they integrate contemplative practices into their work and personal lives. In analyzing the data, three themes emerged, namely, awareness, integration, and interconnectedness. These themes, with accompanying stories, highlight the value and benefits of incorporating contemplative practices into a higher education setting. Using an inductive approach, suggestions for implementing practices were identified and are offered here.
A study on cyber-security of autonomous and unmanned vehicles
Authors: Yağdereli Eray , Gemci Cemal , Aktaş A Ziya
Published: March 2015

Technological developments towards vehicle automation have been taking place for years. Satellite navigation, cruise control and anti-lock braking systems (ABS) are well-known examples of automation technology used in everyday cars. The trend of automation technology being used in vehicles is expected to move closer to full autonomy through technological advancements in robotics and artificial intelligence. As a result, our daily lives will become more and more dependent on digitally-controlled devices and vehicle systems (partially or highly automated). On the other hand, computing and digital systems also have a tendency to become more fragile and susceptible to faults and failures because of cyber-attacks and software and hardware defects, as well as accidental defects introduced by developers. Therefore, autonomous vehicle systems must be developed to bear such dangers in mind and must be equipped with defensive capabilities and measures such that they can be able to respond automatically and dynamically to both accidental and deliberate defects and attacks. In this study, autonomous and unmanned vehicle systems are examined for their cyber-security vulnerabilities. Threats and attacks exploiting these vulnerabilities are identified and classified. Development guidelines and a mitigation strategy to be used in the development of autonomous and unmanned vehicle systems are proposed and discussed in the final section.
School-Based Blood Drive
Authors: Roberts Diane Cody , Taylor Mary Ellen , Pyle Audrey
Published: March 2015

The nurses at an independent Pre-K through 12 educational institution in Houston, Texas (The Kinkaid School), expanded the blood drive program to include innovative collaboration with high school student leaders, parents, and school faculty. Methods implemented in this endeavor included technology utilization, science education, and an enhanced parent workforce. By focusing on community involvement and an altruistic reason for donating, the Kinkaid school nurses helped their community break school donation records 2 years in a row.
Awareness of Intergroup Help Can Rehumanize the Out-Group
Authors: Saguy Tamar , Szekeres Hanna , Nouri Rikki , Goldenberg Amit , Doron Guy , Dovidio John F. , Yunger Chaim , Halperin Eran
Published: March 2015

Dehumanizing the enemy is one of the most destructive elements of intergroup conflict. Past research demonstrated that awareness of harm that the in-group imposed on a specific out-group can increase out-group dehumanization as means of justifying the harm. In this research, we examined whether the opposite process would occur when people become aware of help given to an adversary. We reasoned that the need to justify a good deed toward a persistent enemy can result in more human-like out-group attributions. In two experiments, Israeli-Jews read about their group either helping Palestinians or not. In Study 1, awareness of help provided by the in-group to the out-group resulted in greater out-group humanization. In Study 2, we further established that when a third party helped the out-group, the rehumanization effect was not obtained, suggesting that the phenomenon is of specific intergroup nature. Theoretical and applied implications for conflict resolution are discussed.
Quantifying the Economic Impact of Provider Volume Through Adverse Events
Authors: Scott Daniel J. , Sherman Seth , Dhawan Aman , Cole Brian J. , Bach Bernard R. , Mather Richard C.
Published: March 2015

Background:

Procedures performed by surgeons with higher provider volumes offer advantages both to the individual patient and the health system, with studies documenting fewer adverse events, shorter surgical times, and decreased reoperation rates. With workforce requirements for surgeons growing, it is increasingly necessary to establish the most efficient structure of this workforce.

Hypothesis:

Substantial economic savings are realized when procedures are performed by high-volume providers as compared with low-volume providers in the areas of readmission, prolonged admission, and subsequent surgery.

Study Design:

Economic and decision analysis; Level of evidence, 2.

Methods:

This study utilized decision modeling to estimate the cost savings to high-volume providers in sports medicine. Simple decision models were constructed for 3 common procedures: anterior cruciate ligament (ACL) reconstruction, rotator cuff repair, and total shoulder arthroplasty. Outcome probabilities for adverse events (readmission, prolonged admission, and subsequent surgery) and costs were taken from the literature. A Monte Carlo simulation reflecting the incidence of these procedures in the United States was performed to estimate the total nationwide cost of these procedures, and the impact of both negative and positive policies on this cost were examined using sensitivity analysis.

Results:

The costs per case attributable to adverse outcomes for ACL reconstruction (in 2010 US$) were $496, $781, and $868 for high-, medium-, and low-volume providers, respectively. For rotator cuff repair, these numbers were $523, $640, and $872, and for total shoulder arthroplasty, $1692, $1876, and $2021, respectively. Sensitivity analysis revealed that a 50% increase in the number of these 3 procedures performed by high-volume surgeons could save the health system $23.1 million. If all procedures were performed by high-volume surgeons, the health system could save $72 million.

Conclusion:

The hypothesis was accepted; higher provider volumes for surgeons do convey substantial societal economic benefits. Policies to incentivize and facilitate a greater portion of procedures being performed by high-volume surgeons may increase the efficiency of resource utilization in health care delivery.
Pedagogical Innovation to Establish Partnerships in Adolescent Health Promotion
Authors: Kyle Richard G. , Angus Neil J. , Smith Joanna , Stewart Ceit , MacLennan Fiona
Published: March 2015

Nurses have an established and expanding role in health promotion in support of public health strategies to reduce health inequalities, refocus health care on prevention, and rebalance responsibility for health toward individuals. However, evidence suggests that nurses may be unclear about the content and lack the skills to conduct health promotion. Education has been identified as an important vehicle to increase nurses’ competence and confidence in health promotion, and health promotion is a required component of undergraduate nurse education in the United Kingdom. This article presents a pedagogical innovation that enabled undergraduate student nurses in Scotland to research and rehearse health promotion to raise adolescents’ awareness of risk-taking behaviors. Student nurses completed a 2-week group-work project to develop a resource (e.g., mobile app, poster, lesson plan) targeted toward an adolescent risk behavior (e.g., self-harm, unsafe sex, alcohol misuse). The project culminated with a public “marketplace” event where students showcased their resource and obtained professional, peer, and public feedback. Opportunities afforded by the national curriculum for high school pupils enabled partnerships in adolescent health promotion to be established through involvement of pupils from a local secondary school with an interest in health care careers. School pupils participated in focus groups where students “pitched” their resource and appraised students’ work at the marketplace. This article shares the design and delivery of this project to enable replication or adaptation by health educators elsewhere and offers reflections on perceived project outcomes from the perspective of student nurses, school pupils, and nursing faculty.
Corrosion characteristics of high entropy alloys
Authors: Qiu Y. , Gibson M. A. , Fraser H. L. , Birbilis N.
Published: March 2015

The present paper reports on the electrochemical properties of a wide range of high entropy alloys (HEAs) in a 0.6 M NaCl solution. A consolidated treatise of the topic has to date been lacking, and the purpose of the work herein is to present a primitive galvanic series for numerous HEAs, along with a broad survey of results typifying their electrochemical characteristics, passivity and comparative electrochemistry. The results are coupled with microstructural characterisation. The range of potentials for HEAs is comparable to or nobler than austenitic stainless steel, with a number of HEAs displaying higher pitting potential ( Epit) values than stainless steels, in spite of possessing heterogeneous microstructures.
Influence of remelting on microstructure, hardness and corrosion behaviour of AlCoCrFeNiTi high entropy alloy
Authors: Soare V. , Mitrica D. , Constantin I. , Badilita V. , Stoiciu F. , Popescu A.-M. J. , Carcea I.
Published: March 2015

High entropy alloys are a newly developed class of alloys, which tend to form a single solid solution or a mixture of solid solutions with simple crystal structures. These alloys possess excellent mechanical properties, thermal stability and corrosion resistance. In the present paper, an AlCoCrFeNiTi high entropy alloy was obtained by induction melting, and the influence of the remelting process on the mechanical and corrosion resistance characteristics of the alloy was investigated. Thus, optical and scanning electron microscopy revealed less phase segregation and a fine dendritic structure for the remelted alloy, while corrosion tests indicated that present alloy, in remelted state, has better corrosion resistance than as cast alloy and stainless steel. The Vickers microhardness measurements demonstrated an improvement of the alloy microhardness by remelting process due to the decrease in phase segregation and the increase in dendrite refinement level.
De novo generation of HSCs from somatic and pluripotent stem cell sources
Authors: Vo Linda T. , Daley George Q.
Published: March 2015

Generating human hematopoietic stem cells (HSCs) from autologous tissues, when coupled with genome editing technologies, is a promising approach for cellular transplantation therapy and for in vitro disease modeling, drug discovery, and toxicology studies. Human pluripotent stem cells (hPSCs) represent a potentially inexhaustible supply of autologous tissue; however, to date, directed differentiation from hPSCs has yielded hematopoietic cells that lack robust and sustained multilineage potential. Cellular reprogramming technologies represent an alternative platform for the de novo generation of HSCs via direct conversion from heterologous cell types. In this review, we discuss the latest advancements in HSC generation by directed differentiation from hPSCs or direct conversion from somatic cells, and highlight their applications in research and prospects for therapy.
Angiogenic gene expression and vascular density are reflected in ultrasonographic features of synovitis in early rheumatoid arthritis: an observational study
Authors: Kelly Stephen , Bombardieri Michele , Humby Frances , Ng Nora , Marrelli Alessandra , Riahi Sudeh , DiCicco Maria , Mahto Arti , Zou Lu , Pyne Debasish , Hands Rebecca E , Pitzalis Costantino
Published: March 2015

Introduction

Neovascularization contributes to the development of sustained synovial inflammation in the early stages of Rheumatoid Arthritis. Ultrasound (US) provides an indirect method of assessing synovial blood flow and has been shown to correlate with clinical disease activity in patients with Rheumatoid Arthritis. This study examines the relationship of US determined synovitis with synovial vascularity, angiogenic / lymphangiogenic factors and cellular mediators of inflammation in a cohort of patients with early Rheumatoid Arthritis (RA) patients prior to therapeutic intervention with disease modifying therapy or corticosteroids.

Methods

An ultrasound guided synovial biopsy of the supra-patella pouch was performed in 12 patients with early RA prior to treatment. Clinical, US and biochemical assessments were undertaken prior to the procedure. Ultrasound images and histological samples were obtained from the supra-patella pouch. Histological samples were stained for Factor VIII and a-SMA (a-smooth muscle actin). Using digital imaging analysis a vascular area score was recorded. QT-PCR (quantitative-PCR) of samples provided quantification of angiogenic and lymphangiogenic gene expression and immunohistochemistry stained tissue was scored for macrophage, T cell and B cell infiltration using an existing semi-quantitative score.

Results

Power Doppler showed a good correlation with histological vascular area (Spearman r - 0.73) and angiogenic factors such as vascular endothelial growth factor- A (VEGF-A), Angiopoietin 2 and Tie-2. In addition, lymphangiogenic factors such as VEGF-C and VEGF-R3 correlated well with US assessment of synovitis. A significant correlation was also found between power Doppler and synovial thickness, pro-inflammatory cytokines and sub-lining macrophage infiltrate. Within the supra-patella pouch there was no significant difference in US findings, gene expression or inflammatory cell infiltrate between any regions of synovium biopsied.

Conclusion

Ultrasound assessment of synovial tissue faithfully reflects synovial vascularity. Both grey scale and power Doppler synovitis in early RA patients correlate with a pro-angiogenic and lymphangiogenic gene expression profile. In early RA both grey scale and power Doppler synovitis are associated with a pro-inflammatory cellular and cytokine profile providing considerable validity in its use as an objective assessment of synovial inflammation in clinical practice.
Subjective and objective levels of physical activity and their association with cardiorespiratory fitness in rheumatoid arthritis patients
Authors: Yu Chen-an , Rouse Peter C , Veldhuijzen Van Zanten Jet JCS , Ntoumanis Nikos , Kitas George D , Duda Joan L , Metsios George S
Published: March 2015

Introduction

The aims of the present study were: (a) to examine the agreement between subjective (assessed via the International Physical Activity Questionnaire; IPAQ) and objective (accelerometry; GT3X) physical activity (PA) levels in patients with rheumatoid arthritis (RA), and (b) to evaluate the associations of RA patients’ subjective and objective PA to their scores on the maximal oxygen uptake test (VO2max).

Methods

The participants wore the GT3X for seven days before completing the IPAQ and VO2max test. The Bland-Altman plot was used to illustrate the agreement between the objective and subjective PA data, and the Wilcoxon test was employed to examine the differences. The association between the PA measurement and VO2max test was examined via the correlations and the magnitude was presented by the Steiger’s Z value.

Results

Sixty-eight RA patients (age = 55 ± 13 years, body mass index: 27.8 ± 5.4 kg/m2, median of disease duration = 5 (2–8) yrs) were recruited. Smaller differences between the subjective and objective measures were found when PA was assessed at the moderate level. Wilcoxon tests revealed that patients reported less time spent engaged in sedentary behaviours (Z = −6.80, P < 0.01) and light PA (Z = −6.89, P < 0.01) and more moderate PA (Z = −6.26, P < 0.01) than was objectively indicated. Significant positive correlations were revealed between VO2max with all PA levels derived from accelerometry (light PA rho = .35, P < .01; moderate PA rho = .34, P = .01; moderate and vigorous PA, (MVPA) rho = .33, P = .01), and a negative association to sedentary time (ST) emerged (rho = −.27, P = .04). IPAQ-reported moderate PA and MVPA positively correlated with maxV02 (rho = .25, P = .01, rho = .27, P = .01, respectively). Differences between the magnitude of correlations between the IPAQ-VO2 max and GT3X-VO2 max were only significant for ST (Z = 3.43, P < .01).

Conclusions

Via responses to the IPAQ, RA patients reported that they were less sedentary and engaged in more higher intensity PA than what was objectively assessed. Accelerometry data correlated with VO2max at all PA levels. Only subjective moderate and MPVA correlated with VO2max. Findings suggest that self-reported PA and ST should be interpreted with caution in people with RA and complemented with accelerometry when possible.

Trial registration

Trial registration: ClinicalTrials.gov ISRCTN04121489. Registered 5 September 2012.
Stem cells labeled with superparamagnetic iron oxide nanoparticles in a preclinical model of cerebral ischemia: a systematic review with meta-analysis
Authors: Nucci Leopoldo P , Silva Helio R , Giampaoli Viviana , Mamani Javier B , Nucci Mariana P , Gamarra Lionel F
Published: March 2015

Introduction

Although there is an increase in clinical trials assessing the efficacy of cell therapy in structural and functional regeneration after stroke, there are not enough data in the literature describing the best cell type to be used, the best route, and also the best nanoparticle to analyze these stem cells in vivo. This review analyzed published data on superparamagnetic iron oxide nanoparticle (SPION)-labeled stem cells used for ischemic stroke therapy.

Method

We performed a systematic review and meta-analysis of data from experiments testing the efficacy of cellular treatment with SPION versus no treatment to improve behavioral or modified neural scale outcomes in animal models of stroke by the Cochrane Collaboration and indexed in EMBASE, PubMed, and Web of Science since 2000. To test the impact of study quality and design characteristics, we used random-effects meta-regression. In addition, trim and fill were used to assess publication bias.

Results

The search retrieved 258 articles. After application of the inclusion criteria, 24 reports published between January 2000 and October 2014 were selected. These 24 articles were analyzed for nanoparticle characteristics, stem cell types, and efficacy in animal models.

Conclusion

This study highlights the therapeutic role of stem cells in stroke and emphasizes nanotechnology as an important tool for monitoring stem cell migration to the affected neurological locus.
Krasnoselskii-Mann method for non-self mappings
Authors: Colao Vittorio , Marino Giuseppe
Published: March 2015

Let H be a Hilbert space and let C be a closed, convex and nonempty subset of H. If $T:C\to H$
T
:
C
→
H
is a non-self and non-expansive mapping, we can define a map $h:C\to\mathbb{R}$
h
:
C
→
R
by $h(x):=\inf\{\lambda\geq 0:\lambda x+(1-\lambda)Tx\in C\}$
h
(
x
)
:
=
inf
{
λ
≥
0
:
λ
x
+
(
1
−
λ
)
T
x
∈
C
}
. Then, for a fixed $x_{0}\in C$

x
0

∈
C
and for $\alpha_{0}:=\max\{1/2, h(x_{0})\}$

α
0

:
=
max
{
1
/
2
,
h
(

x
0

)
}
, we define the Krasnoselskii-Mann algorithm $x_{n+1}=\alpha _{n}x_{n}+(1-\alpha_{n})Tx_{n}$

x

n
+
1

=

α
n

x
n

+
(
1
−

α
n

)
T

x
n

, where $\alpha_{n+1}=\max\{\alpha_{n},h(x_{n+1})\}$

α

n
+
1

=
max
{

α
n

,
h
(

x

n
+
1

)
}
. We will prove both weak and strong convergence results when C is a strictly convex set and T is an inward mapping.
Performance evaluation and modeling of a submerged membrane bioreactor treating combined municipal and industrial wastewater using radial basis function artificial neural networks
Authors: Mirbagheri Seyed Ahmad , Bagheri Majid , Boudaghpour Siamak , Ehteshami Majid , Bagheri Zahra
Published: March 2015

Treatment process models are efficient tools to assure proper operation and better control of wastewater treatment systems. The current research was an effort to evaluate performance of a submerged membrane bioreactor (SMBR) treating combined municipal and industrial wastewater and to simulate effluent quality parameters of the SMBR using a radial basis function artificial neural network (RBFANN). The results showed that the treatment efficiencies increase and hydraulic retention time (HRT) decreases for combined wastewater compared with municipal and industrial wastewaters. The BOD, COD,

$$ {\mathrm{NH}}_4^{+}-\mathrm{N} $$

N
H

4
+

−
N

and total phosphorous (TP) removal efficiencies for combined wastewater at HRT of 7 hours were 96.9%, 96%, 96.7% and 92%, respectively. As desirable criteria for treating wastewater, the TBOD/TP ratio increased, the BOD and COD concentrations decreased to 700 and 1000 mg/L, respectively and the BOD/COD ratio was about 0.5 for combined wastewater. The training procedures of the RBFANN models were successful for all predicted components. The train and test models showed an almost perfect match between the experimental and predicted values of effluent BOD, COD,

$$ {\mathrm{NH}}_4^{+}-\mathrm{N} $$

N
H

4
+

−
N

and TP. The coefficient of determination (R2) values were higher than 0.98 and root mean squared error (RMSE) values did not exceed 7% for train and test models.
Calcitriol Prevents In Vitro Vascular Smooth Muscle Cell Mineralization by Regulating Calcium-Sensing Receptor Expression
Authors: Mary Aurélien , Hénaut Lucie , Boudot Cédric , Six Isabelle , Brazier Michel , Massy Ziad A. , Drüeke Tilman B. , Kamel Saïd , Mentaverri Romuald
Published: March 2015

Vascular calcification (VC) is a degenerative disease that contributes to cardiovascular morbidity and mortality. A negative relationship has been demonstrated between VC and calcium sensing receptor (CaSR) expression in the vasculature. Of interest, vitamin D response elements, which allow responsiveness to 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], are present in the promoters of the CaSR gene. We hypothesized that 1,25(OH)2D3, by modulating CaSR expression in vascular smooth muscle cells (VSMCs), might protect against VC. Human VSMCs were exposed to increasing concentrations of 1,25(OH)2D3 (0.01–10 nmol/L) in noncalcifying (1.8 mmol/L) or procalcifying Ca2+0 condition (5.0 mmol/L). Using quantitative RT-PCR and Western blotting we observed a significant increase in both CaSR mRNA and protein levels after exposure to 1.0 nmol/L 1,25(OH)2D3. This effect was associated with a maximal increase in CaSR expression at the cell surface after 48 hours of 1,25(OH)2D3 treatment, as assessed by flow cytometry. Down-regulation of the vitamin D receptor by small interfering RNA abolished these effects. In the procalcifying condition, 1.0 nmol/L 1,25(OH)2D3 blocked the Ca2+0-induced decrease in total and surface CaSR expression and protected against mineralization. Down-regulation of CaSR expression by CaSR small interfering RNA abolished this protective effect. 1,25(OH)2D3 concentrations of 0.5 and 5.0 nmol/L were also effective, but other (0.01, 0.1, and 10 nmol/L) concentrations did not modify CaSR expression and human VSMC mineralization. In conclusion, these findings suggest that nanomolar concentrations of 1,25(OH)2D3 induce a CaSR-dependent protection against VC. Both lower and higher concentrations are either ineffective or may even promote VC. Whether this also holds true in the clinical setting requires further study.
SIRT1 Relays Nutritional Inputs to the Circadian Clock Through the Sf1 Neurons of the Ventromedial Hypothalamus
Authors: Orozco-Solis Ricardo , Ramadori Giorgio , Coppari Roberto , Sassone-Corsi Paolo
Published: March 2015

Circadian rhythms govern homeostasis and organism physiology. Nutritional cues act as time givers, contributing to the synchronization between central and peripheral clocks. Neuronal food-synchronized clocks are thought to reside in hypothalamic nuclei such as the ventromedial hypothalamus (VMH) and the dorsomedial hypothalamus or extrahypothalamic brain areas such as nucleus accumbens. Interestingly, the metabolic sensor of nicotinamide adenine dinucleotide-dependent deacetylase sirtuin-1 (SIRT1) is highly expressed in the VMH and was shown to contribute to both control of energy balance and clock function. We used mice with targeted ablation of Sirt1 in the steroidogenic factor 1 neurons of the VMH to gain insight on the role played by this deacetylase in the modulation of the central clock by nutritional inputs. By studying circadian behavior and circadian gene expression, we reveal that SIRT1 operates as a metabolic sensor connecting food intake to circadian behavior. Indeed, under food restriction and absence of light, SIRT1 in the VMH contributes to activity behavior and circadian gene expression in the suprachiasmatic nucleus. Thus, under specific physiological conditions, SIRT1 contributes to the modulation of the circadian clock by nutrients.
Adipose VEGF Links the White-to-Brown Fat Switch With Environmental, Genetic, and Pharmacological Stimuli in Male Mice
Authors: During Matthew J. , Liu Xianglan , Huang Wei , Magee Daniel , Slater Andrew , McMurphy Travis , Wang Chuansong , Cao Lei
Published: March 2015

Living in an enriched environment (EE) decreases adiposity, increases energy expenditure, causes resistance to diet induced obesity, and induces brown-like (beige) cells in white fat via activating a hypothalamic-adipocyte axis. Here we report that EE stimulated vascular endothelial growth factor (VEGF) expression in a fat depot-specific manner prior to the emergence of beige cells. The VEGF up-regulation was independent of hypoxia but required intact sympathetic tone to the adipose tissue. Targeted adipose overexpression of VEGF reproduced the browning effect of EE. Adipose-specific VEGF knockout or pharmacological VEGF blockade with antibodies abolished the induction of beige cell by EE. Hypothalamic brain-derived neurotrophic factor stimulated by EE regulated the adipose VEGF expression, and VEGF signaling was essential to the hypothalamic brain-derived neurotrophic factor-induced white adipose tissue browning. Furthermore, VEGF signaling was essential to the beige cells induction by exercise, a β3-adrenergic agonist, and a peroxisome proliferator-activated receptor-γ ligand, suggesting a common downstream pathway integrating diverse upstream mechanisms. Exploiting this pathway may offer potential therapeutic interventions to obesity and metabolic diseases.
Minireview: The Impact of Antenatal Therapeutic Synthetic Glucocorticoids on the Developing Fetal Brain
Authors: Peffer Melanie E. , Zhang Janie Y. , Umfrey Leah , Rudine Anthony C. , Monaghan A. Paula , DeFranco Donald B.
Published: March 2015

The life-threatening, emotional, and economic burdens of premature birth have been greatly alleviated by antenatal glucocorticoid (GC) treatment. Antenatal GCs accelerate tissue development reducing respiratory distress syndrome and intraventricular hemorrhage in premature infants. However, they can also alter developmental processes in the brain and trigger adverse behavioral and metabolic outcomes later in life. This review summarizes animal model and clinical studies that examined the impact of antenatal GCs on the developing brain. In addition, we describe studies that assess glucocorticoid receptor (GR) action in neural stem/progenitor cells (NSPCs) in vivo and in vitro. We highlight recent work from our group on two GR pathways that impact NSPC proliferation, ie, a nongenomic GR pathway that regulates gap junction intercellular communication between coupled NSPCs through site-specific phosphorylation of connexin 43 and a genomic pathway driven by differential promoter recruitment of a specific GR phosphoisoform.
Biocultural Theory and the Study of Literature
Authors: Carroll Joseph C.
Published: March 2015

This essay argues that the sciences most relevant to literary study form an integrated complex summarized by the term “biocultural theory.” Foundational theories accepted currently in literary scholarship are incompatible with a biocultural understanding of the evolved character of the human mind. Psychological and social theories that form part of the amalgam designated “poststructuralism” identify important areas of human concern but can now be replaced with empirically grounded concepts that are more complete, more correct, more nuanced. The most important elements in biocultural theory are the theory of human life history and gene-culture coevolution. Biocultural theorists argue that basic human motives are channeled into cultural norms that are articulated in imaginative form through myths, legends, rituals, images, songs, and stories. Biocultural theory offers an opportunity to develop literary research in company with our developing scientific understanding of human motives, emotions, identity, social interactions, and forms of cognition.