bluuebunny/crossref_metadata_2025 huggingface dataset:
(Re)Grounding grounded theory: a close reading of theory in four schools
Authors: Apramian Tavis , Cristancho Sayra , Watling Chris , Lingard Lorelei
Published: October 2016

The debate over what counts as theory has dominated methodological conversations in grounded theory research for decades. Four of the schools of thought in that debate – Glaserian, Straussian, Charmazian, and Clarkeian – hold different assumptions about what theory is and how it is made. The first two schools understand theory as an abstraction that exactingly accounts for exceptions. The second two schools understand theory as a process of describing voices hidden from public view. While Glaserian and Straussian coding processes focus on coding exceptions, Charmazian and Clarkeian coding processes focus on building a story of the participants or social phenomenon. This article attempts to clarify the goals of the schools in an effort to overcome the debate about which kinds of research count as grounded theory and which do not.
Inhibitory effects of telmisartan on culture and proliferation of and Kv1.3 potassium channel expression in peripheral blood CD4+ T lymphocytes from Xinjiang Kazakh patients with hypertension
Authors: Huang Sha-Sha , Zhang Qiu-Bing , Yuan Qing-Yan , He Si-Li , Zhang Yuan-Ming
Published: October 2016

Introduction:

Activation of T lymphocytes, for which potassium channels are essential, is involved in the development of hypertension. In this study, we explored the inhibitory effects of telmisartan on the culture and proliferation of and Kv1.3 potassium channel expression in peripheral blood CD4+ T lymphocytes derived from Xinjiang Kazakh patients with hypertension.

Methods:

CD4+ T-cell samples from hypertensive Kazakh patients and healthy Kazakh people were divided into healthy control, case control, telmisartan, and 4-aminopytidine groups. Changes in the expression levels of interleukin (IL)-6 and IL-17 in the blood of the healthy control and case control subjects were detected by enzyme-linked immunosorbent assay. Peripheral blood CD4+ T lymphocytes were first activated and proliferated in vitro and then incubated for 0, 24, and 48 h under various treatment conditions. Thereafter, changes in CD4+ T-lymphocytic proliferation were determined using Cell Counting Kit-8 and microscope photography. Changes in messenger RNA (mRNA) and protein expression of the Kv1.3 potassium channel in CD4+ T lymphocytes were detected using real-time quantitative polymerase chain reaction and Western blots, respectively.

Results:

The IL-6 and IL-17 expression levels were significantly higher in the blood of the hypertensive Kazakh patients than in the healthy Kazakh people. Telmisartan inhibited T-lymphocytic proliferation, as well as the mRNA and protein expression of the Kv1.3 potassium channel in CD4+ T lymphocytes, and the inhibitory effects were time-dependent, with the strongest inhibition observed after 48 h and significantly weaker inhibition observed after 24 h of treatment.

Conclusions:

Telmisartan may potentially regulate hypertensive inflammatory responses by inhibiting T-lymphocytic proliferation and Kv1.3 potassium channel expression in CD4+ T lymphocytes.
Assistive technologies at home for people with a memory disorder
Authors: Nauha Laura , Keränen Niina S , Kangas Maarit , Jämsä Timo , Reponen Jarmo
Published: October 2016

The aim of this study was to assess in practice whether assistive technologies support and facilitate the work of a family caregiver or care staff, and whether these technologies support the independence of a person with a memory disorder. A comprehensive set of supportive devices and alarm systems were experimentally tested in the care of five test subjects in an assisted living facility by eight nurses, and in the care of four test subjects in a home environment by three family caregivers and one care team. Questionnaires, diaries and logged data were used to evaluate the benefits of the devices. Simple aids and alarm systems that did not need much adjusting were considered most useful by caregivers and nurses, though multiple false alarms occurred during the test period. Technical connection problems, complex user interface, and inadequate sound quality were the primary factors reducing the utility of the tested devices. Further experimental research is needed to evaluate the utility of assistive technologies in different stages of a memory disorder.
Researching through unfamiliar practices
Authors: Banfield Janet
Published: October 2016

This article draws upon my first experience of processing a bird into meat to suggest that growing geographical interest in practices might benefit from a focus as much on the experiences and accounts of first-time practitioners as those of established practitioners.
Interdisciplinary treatment of diabetic foot wounds in the elderly: Low risk of amputations and mortality and good chance of being mobile with good quality of life
Authors: Hartmann Bettina , Fottner Christian , Herrmann Karin , Limbourg Tobias , Weber Matthias M , Beckh Karlheinz
Published: October 2016

Aims:

A major proportion of patients with diabetic foot syndrome are older than 65 years. Little is known about outcomes of these elderly patients.

Methods:

We analysed 245 treatment cases in an observational single-centre study for comorbidities and outcomes over a 6-month period.

Results:

In all, 122 patients had peripheral arterial disease which was significantly increasing with age ( n = 245, df = 1, χ2 = 23.06, p ⩽ 0.0001). Increasing age correlated positively with decreasing rate of revascularisations ( n = 122, df = 1, χ2 = 4.23, p = 0.039). In total, 23 (9.3%) patients died in the observation period. In-hospital mortality was 2.8%, percentage of major amputations 2.8%. In the invasively treated subgroup, 13 out of 67 patients died within the observation period. Death after revascularisation was independent of age ( n = 67, df = 1, χ2 = 2.05, p = 0.153). Mobility decreased in the whole study group with increasing age. The risk of decrease with age was not influenced by revascularisation status.

Conclusion:

With careful interdisciplinary evaluation, elderly patients with diabetic foot syndrome can be treated with favourable outcome. Mobility before and after treatment deserves more attention as a predictor of treatment success and outcome parameter.
Microscale finite element model of brittle multifilament yarn failure behavior
Authors: Döbrich Oliver , Gereke Thomas , Hengstermann Martin , Cherif Chokri
Published: October 2016

A microscale model of multifilament reinforcement yarns made of technical carbon fibers is established based on the finite element method. The model is used to perform simulations of tensile failure. The failure behavior of dry multifilament carbon yarns is modeled using a maximum stress criterion with statistical distribution of the strength. The maximum stress is assigned to every single element and varied according to a normal distribution found in experimental tests of single filaments. The Weibull distribution is used for calculating the local failure stress. The material parameters are calculated in function of the element size to account for the volume-specific statistical breaking effect. Representative simulations of the tensile failure behavior prove the concept of the introduced assumptions.
Risk of Cognitive Decline Associated With Paroxetine Use in Elderly Nursing Home Patients With Depression
Authors: Bali Vishal , Chatterjee Satabdi , Johnson Michael L. , Chen Hua , Carnahan Ryan M. , Aparasu Rajender R.
Published: October 2016

Objective:

This study evaluated the risk of cognitive decline associated with paroxetine use in elderly nursing home patients with depression.

Methods:

A retrospective cohort study was conducted using the 2007 to 2010 Medicare Part D claims and minimum data set (MDS) data involving new users of paroxetine and other selective serotonin reuptake inhibitors (SSRIs). The primary outcome was MDS Cognition Scale. The repeated-measures mixed model was used to examine the effect of paroxetine on cognition after controlling for other factors.

Results:

The baseline MDS Cognition Scale measures for paroxetine (n = 63) and other SSRI users (n =1018) were 2.02 (±1.85) and 2.50 (±2.39), respectively. The repeated-measures mixed model did not find statistically significant difference in cognition with the use of paroxetine (β = 0.02, 95% CI: −0.16 to 0.21]) when compared to other SSRIs.

Conclusions:

There was no differential effect of paroxetine on cognition when compared to other SSRIs.
Special Education Teachers’ Perceptions of Preparedness to Teach Students With Severe Disabilities
Authors: Ruppar Andrea L. , Neeper Lance S. , Dalsen Jennifer
Published: October 2016

In the current study, special education teachers’ perceptions of preparedness to implement recommended practices for students with severe disabilities were examined. A vignette-style survey was sent to special education teachers assigned to teach students with severe disabilities. Overall, respondents reported higher perceptions of preparedness to manage educational programs than to provide direct services to students with severe disabilities. Teachers with a generalist (i.e., cross-categorical) licensure were significantly less prepared to meet intensive medical, communication, and instructional needs of students with severe disabilities. Teachers with master’s degrees felt more prepared to work with students with severe disabilities in several key areas, although they felt less prepared to address long-term curriculum development. Perceptions of preparedness to teach students with severe disabilities varied among teachers with different types of teaching licenses, different levels of education, and different experience levels.
Research on unmanned combat aerial vehicle robust maneuvering decision under incomplete target information
Authors: Wang Yuan , Huang Changqiang , Tang Chuanlin
Published: October 2016

This article investigates the problem of designing a novel maneuvering decision-making method for the unmanned combat aerial vehicle. The design objective is to promote the real-time ability of decision-making method and solve the problem of uncertainty caused by incomplete target information. On the basis of statistics theory, a robust maneuvering decision method with self-adaptive target intention prediction is proposed. The robustness design is embedded in the membership function of the situation parameters. The reachable set theory and adaptive adjustment mechanism of the target state weight are used in the target intention prediction to promote the real-time ability. Simulations are conducted under the condition that the enemy aircraft perform both non-maneuvering and combat maneuvering. The results verify the good properties of the decision-making method, which can extend the survival time of the unmanned combat aerial vehicle when the enemy aircraft attacks, and short the taking position and attack time of the unmanned combat aerial vehicle when the enemy aircraft evades.
Bond strength between carbon fiber–reinforced plastic tubes and aluminum joints for racing car suspension
Authors: Wang Jianfeng , Gao Haibo , Ding Liang , Hao Yuzhou , Wang Baoming , Sun Tianyao , Liang Yuhan
Published: October 2016

According to previous studies, the bond strength between the carbon fiber–reinforced plastics and metals mainly depends on the bond layer between the carbon fiber–reinforced plastic composites and the metal. This article presents the results of the experiments conducted on the tensile bond strength between the carbon fiber–reinforced plastic tubes and aluminum joints. The parameters examined in these experiments include adhesive type, surface roughness of the bonded area, and thickness and length of the bond layer. The results show that the 3M DP-460NS Off-White adhesive was suitable for our experiment. The bonded surfaces of the specimens were smoothened with a P600 sandpaper to achieve higher bond strengths with the adhesive. For the six bond thicknesses tested, a thickness of 0.2 mm was optimal for the tensile experiments. The ultimate tensile force was approximately directly proportional to the bond length.
Surface integrity and fatigue analysis of shot-peening for 7055 aluminum alloy under different high-speed milling conditions
Authors: Yao ChangFeng , Dou XingTang , Wu Daoxia , Zhou Zheng , Zhang JiYin
Published: October 2016

To study the effect of different milled surfaces on shot peening surface integrity (roughness, residual stress, hardness, and microstructure), research on the change of surface integrity is carried out using the same shot peening process for different milling surfaces of 7055-T77 aluminum alloy. Surface integrity measurements, fatigue fracture analysis, and fatigue life tests are conducted to reveal the effect of surface integrity on crack initiation and fatigue life. The results show that shot peening can reduce the dispersion and instability of surface integrity brought by milling processing, although it increases the surface roughness; the maximum residual compressive stress and depth of residual stress layer increase significantly after shot peening, and the residual stress and hardening distribution are very good; larger surface roughness and irregular surface scratches of milling samples before shot peening easily lead to cracks and gouges produced on shot peening surface.
Research on three-dimensional blade designs in an ultra-highly loaded low-speed axial compressor stage: Design and numerical investigations
Authors: Yu Xianjun , Liu Baojie
Published: October 2016

To realize whether the rules for controlling the blade three-dimensional stacking line in a compressor with conventional loading level could be used for the design of a highly loaded compressor, the effects of three-dimensional bladings in an ultra-highly loaded compressor stage were studied numerically. A low-speed compressor stage (Stage-C) with ultra-high loading coefficient (=0.52) was designed at first. Due to the well-chosen through-flow design parameters accompanied using controlled diffusion airfoil with spikeless leading edge, Stage-C achieved the design goal of loading level with high peak efficiency of about 0.89. However, all the blades in Stage-C were designed with radial stacking lines. And then, Stage-C-three-dimensional was re-designed with non-radial stacking blades based on Stage-C, after which 1-point compressor efficiency profit was achieved. Based on the numerical simulations, the performance change in the two compressors and also the effects of blade three-dimensional stacking were discussed in depth. It was found that the endwall corner separation and secondary flows could be suppressed effectively using endwall bending; however, the blade forward sweep design at the rotor tip failed due to strong rotor–stator coupling effects in the highly loaded compressor stage.
Foodies of Color: Authenticity and Exoticism in Omnivorous Food Culture
Authors: Oleschuk Merin
Published: October 2016

Omnivorous cultural theory highlights the persistence of inequalities within gourmet food culture despite its increasing democratization, arguing that foods remain symbols of distinction through their framing as ‘authentic’ and ‘exotic’. Where these two frames have been shown to encompass problematic racial connotations, questions arise over how racial inequalities manifest in foodie discourse. Drawing from interviews with foodies of color living in Toronto, Canada, this article examines how these inequalities are reproduced, adjusted and resisted by people of color. It asks: how do foodies of color interpret and deploy dominant foodie frames of authenticity and exoticism? Analysis reveals each frame’s potential both to encourage cross-cultural understanding and essentialize or exacerbate ethno-cultural difference. Participants’ ambivalent relationship with foodie discourse (i.e. deploying it alongside critiquing it) highlights how cultural capital works alongside ethno-racial inequalities, and reveals the racial tensions remaining within foodies’ attempts to reconcile democracy and distinction.
Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts
Authors: Burnier M. , Awada T. , Marin Braun F. , Rostoucher P. , Ninou M. , Erhard L.
Published: October 2016

The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal interphalangeal motion was 41°. The mean visual analogue scale score was 1.1. The mean QuickDASH score was 11. The mean pinch strength was 82% of the opposite side. Radiographs revealed one partial graft lysis.

Level of evidence: IV
Tropical ecosystems vulnerability to climate change in southern Ecuador
Authors: Eguiguren-Velepucha Paúl Alexander , Chamba Juan Armando Maita , Aguirre Mendoza Nikolay Arturo , Ojeda-Luna Tatiana Lizbeth , Samaniego-Rojas Natalia Soledad , Furniss Michael J. , Howe Carol , Aguirre Mendoza Zhofre Huberto
Published: October 2016

Tropical ecosystems are among the most vulnerable to climate change. Understanding climate impacts on these ecosystems is a primary challenge for policy makers, ecologists, and conservationists today. We analyzed the vulnerability of ecosystems in a very heterogeneous tropical region in southern Ecuador, selected because of its exceptional biodiversity and its ecosystem services provided to people of southern Ecuador and northern Peru. The vulnerability assessment focused on three components: exposure, sensitivity, and adaptive capacity. For the first two components, we identified stressors or drivers of change that negatively influence ecosystems. For the third component, we identified existing and potential buffers that reduce impacts. This process was developed in workshops and by expert elicitation. Representative Concentration Pathway (RCP) scenarios were used, considering RCP 2.6 and RCP 8.5 for a time horizon to 2050. Under the RCP 2.6 scenario, the components of overall vulnerability in the southern region of Ecuador showed very low to moderate vulnerability for most areas, particularly in semi-deciduous forest ecosystems, Amazon semi-deciduous forest, Amazon rainforest, and mangrove forests. These areas had high vulnerability under the RCP 8.5 scenario. A variety of conservation strategies ( e.g., protected areas) were shown to increase the adaptive capacity of ecosystems and reduce their vulnerability. We therefore recommend improving these conservation initiatives in ecosystems like dry forests, where the greatest vulnerability is evident.
Intersectionality and Press Coverage of Political Campaigns
Authors: Ward Orlanda
Published: October 2016

Internationally, scholars have raised substantial concerns regarding unfavorable news coverage of female political candidates and representatives. However, prior research has scarcely considered the intersectional effects of political actors’ race and gender in this context. I investigate these dynamics through a case study of the U.K. 2010 general election, a breakthrough year for black, Asian, and minority ethnic (BAME) women in British politics. Only three had previously been elected to parliament but a further seven joined their ranks that year. While headlines celebrated the possibility of a “small revolution” resulting in “the most diverse parliament ever,” the press also subjected BAME female candidates to exceptional scrutiny regarding their credentials and ability to “transform politics.” Employing a quantitative content analysis of national newspaper coverage, I find that the apparent newsworthiness of BAME women’s intersectional identity was a double-edged sword. While they arguably enjoyed a visibility advantage compared with white female candidates, their coverage was also exceptionally negative and narrowly focused on their ethnicity and gender. I argue that as national legislatures become increasingly diverse, single axis analyses of the effects of politicians’ race, gender, or other axes of identity are insufficient to capture their combined effects on press coverage of politics.
Response to treatment and adverse events associated with use of recombinant activated factor VII in children: a retrospective cohort study
Authors: Cooper James D. , Ritchey Arthur K.
Published: October 2016

Background:

Recombinant activated factor VII (rFVIIa) is United States (US) Food and Drug Administration (FDA)-approved for patients with hemophilia with inhibitors or congenital factor VII deficiency. Initial reports of off-label use highlighted its efficacy, though newer reports have not repeated these findings. In both types of publication, though, secondary thromboses have been seen in adult patients. The data in children are less clear.

Methods:

This study analyzed all rFVIIa use at a large children’s hospital for characteristics and outcomes. Recipients of rFVIIa were identified retrospectively via the electronic medical record. Data on patient diagnosis, lab data, other treatments, adverse events, and outcomes were collected.

Results:

Over 33 months, 66 patient episodes were treated with a total of 606 doses (median = 2). The most common indication (36.4%) was gastrointestinal bleeding (24/66 patients). Only one patient received a dose for an approved labeled indication. For control of bleeding, 33.3% of courses were unsuccessful (19/57). Bleeding from multiple sites was associated with treatment failure. In 16.7% of patients (11/66), unexpected adverse thromboses developed within 1 week of completing a course of rFVIIa. Thromboses in both intra- and extra-corporeal sites were included if they compromised patient care.

Conclusions:

In the majority of cases reviewed, rFVIIa was successful in stopping or slowing serious bleeding episodes. It was least effective when a patient had diffuse bleeding at the time of administration. The thrombosis rate of 16.7% was higher than expected, though causality cannot be declared. Further investigation is needed to determine the risk–benefit ratio in children.
A Systematic Review of Treatment Strategies for Degenerative Lumbar Spine Fusion Surgery in Patients With Osteoporosis
Authors: Fischer Charla R. , Hanson Gregory , Eller Melinda , Lehman Ronald A.
Published: October 2016

Purpose:

To evaluate the current evidence in the literature on treatment strategies for degenerative lumbar spine fusion in patients with osteoporosis.

Methods:

A systematic review of the literature from 1950 to 2015.

Results:

The review of the literature yielded 15 studies on the effect of treatment options for osteoporosis on lumbar fusion rates. This study evaluated only degenerative lumbar spine conditions and excluded deformity patients. One study demonstrated an association between low bone mass as measured by Hounsfield units and lower fusion rates. Six studies evaluated perioperative medical treatment of osteoporosis and showed higher fusion rates in patients treated with alendronate and teriparatide. The strongest evidence was for perioperative teriparatide. Eight studies evaluated surgical treatment strategies in patients with osteoporosis and showed that cement augmentation of pedicle screws and expandable pedicle screws demonstrated improved fusion rates than traditional pedicle screws. The strongest evidence was for expandable pedicle screws.

Conclusion:

There are 15 articles evaluating osteoporosis in patients undergoing lumbar fusion and the highest level of evidence is for perioperative use of teriparatide.
The Role of Phlebotomy (Fasd) and Wet Cupping (Hijamat) to Manage Dizziness and Vertigo From the Viewpoint of Persian Medicine
Authors: Kordafshari Gholamreza , Ardakani Mohammad Reza Shams , Keshavarz Mansoor , Esfahani Mohammad Mehdi , Nazem Esmaeil , Moghimi Maryam , Zargaran Arman , Kenari Hoorieh Mohammadi
Published: October 2016

Dizziness and vertigo are the most common complaints of patients that has a high economic burden on the health system. In modern medicine, treatment for dizziness and vertigo consists of chemical pharmacological therapy. Although these drugs are useful in controlling the disease, their side effects and inefficiency in full control of the disease require the use of complementary medicine in this field. Persian medicine consists of valuable experiences of Persian medicine scholars based on the theory of humors and temperaments. In Persian medicine, 2 types of disease are presented: dizziness ( sadar) and vertigo ( dovar). Persian medicine physicians expressed a different mechanism of action than modern medicine for these diseases. They believed that accumulation of abnormal humors, reeh (normal bloating) or causative pathologic substances, is the basic cause of sadar and dovar and that the most important treatment is cleansing the body, particularly the head from accumulated substances by bloodletting methods.
Mechanoreceptor Reinnervation of Autografts Versus Allografts After Anterior Cruciate Ligament Reconstruction
Authors: Young Simon W. , Valladares Roberto D. , Loi Florence , Dragoo Jason L.
Published: October 2016

Background:

Loss of proprioceptive function occurs after anterior cruciate ligament (ACL) rupture. Clinical, motor, and proprioceptive function is known to improve after ACL reconstruction but does not return to normal. While histological studies of human ACL allografts have been unable to demonstrate mechanoreceptor reinnervation, animal data suggest that reinnervation may occur when an autograft is used.

Purpose:

To compare the presence or absence of mechanoreceptors between allograft versus autograft after ACL reconstruction in humans.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Ten patients with previous ACL reconstruction presenting for either revision ACL surgery or knee arthroscopy for other reasons were enrolled in a prospective, comparative study. Five patients had a previous autograft ACL and 5 patients had an allograft. Biopsies, either from intact or ruptured grafts, were taken from identical locations as close to the femoral and tibial insertions as possible. Specimens were stained with hematoxylin-eosin (H-E) and monoclonal antibodies against neurofilament protein (NFP), known to be present in mechanoreceptor tissue. Immunohistochemical examination was carried out, and the number of NFP+ neural tissue analogs was counted and compared with that of native ACL tissue.

Results:

The mean time between original graft and biopsy was 6.9 years (range, 0.5-15 years). Histological examination showed significantly less NFP+ neural analogs in allograft and autograft patients than control tissue (mean number of NFP+ analogs per high-power field, 0.7 ± 0.9 [allograft] and 0.5 ± 0.8 [autograft] vs 4.7 ± 0.9 [controls]; P < .0001). There was no significant difference in NFP analogs between autograft and allograft tissue.

Conclusion:

We found a reduced concentration of NFP+ neural analogs in ACL grafts compared with native ACL tissue. This deficit exists irrespective of whether allograft or autograft is used. These findings may explain the continued proprioceptive deficits seen clinically after ACL reconstruction.
Empowerment Gone Bad
Authors: Weidenstedt Linda
Published: October 2016

Empowerment as a positively connoted concept has been studied extensively in applied research in different fields. Yet its unfavorable, paradoxical character has so far not received enough theoretical attention to make it possible to improve empowerment efforts. In this theoretically informed analysis of the processes that lead to the paradox of empowerment, the author argues that it evolves from discrepancies between approaching empowerment from a structural versus a communicative viewpoint: empowerees’ agency might be increased on a structural level but simultaneously decreased on a communicative level, leaving them feeling disempowered.
The prevalence of diagnosed α1-antitrypsin deficiency and its comorbidities: results from a large population-based database
Authors: Greulich Timm , Nell Christoph , Hohmann David , Grebe Marco , Janciauskiene Sabina , Koczulla Andreas Rembert , Vogelmeier Claus Franz
Published: October 2016

α1-Antitrypsin deficiency (AATD) is a genetically determined disorder that is associated with different clinical manifestations. We aimed to assess the prevalence of diagnosed AATD and its comorbidities using a large healthcare database.

In this retrospective longitudinal observational study, we analysed data from 4 million insurants. Using International Classification of Diseases revision 10 (ICD-10) codes, we assessed the prevalence, comorbidities and healthcare utilisation of AATD patients (E88.0 repeatedly coded) relative to non-AATD patients with chronic obstructive pulmonary disease (COPD), emphysema or asthma.

In our study population, we identified 673 AATD patients (590 aged ≥30 years), corresponding to a prevalence of 23.73 per 100 000 in all age groups and 29.36 per 100 000 in those ≥30 years. Based on the number of AATD cases detected in the sample size (673 out of 2 836 585), we extrapolated that there were 19 162 AATD cases in Germany during the years studied. AATD patients had a higher prevalence of arterial hypertension, chronic kidney disease and diabetes relative to non-AATD asthma or emphysema patients. When compared to non-AATD COPD patients, AATD patients had significantly more consultations and more frequent and longer hospitalisations.

Our data strengthen the assumption that AATD is associated with a variety of other diseases. Healthcare utilisation appears to be higher among AATD patients as compared to patients with non-AATD-related obstructive lung diseases.
Effects of continuous positive airway pressure on energy balance regulation: a systematic review
Authors: Shechter Ari
Published: October 2016

Obesity is both a cause and a possible consequence of obstructive sleep apnoea (OSA), as OSA seems to affect parameters involved in energy balance regulation, including food intake, hormonal regulation of hunger/satiety, energy metabolism and physical activity. It is known that weight loss improves OSA, yet it remains unclear why continuous positive airway pressure (CPAP) often results in weight gain.

The goal of this systematic review is to explore if and how CPAP affects the behaviour and/or metabolism involved in regulating energy balance.

CPAP appears to correct for a hormonal profile characterised by abnormally high leptin and ghrelin levels in OSA, by reducing the circulating levels of each. This is expected to reduce excess food intake. However, reliable measures of food intake are lacking, and not yet sufficient to make conclusions. Although studies are limited and inconsistent, CPAP may alter energy metabolism, with reports of reductions in resting metabolic rate or sleeping metabolic rate. CPAP appears to not have an appreciable effect on altering physical activity levels. More work is needed to characterise how CPAP affects energy balance regulation.

It is clear that promoting CPAP in conjunction with other weight loss approaches should be used to encourage optimal outcomes in OSA patients.
Mandatory tuberculosis case notification in high tuberculosis-incidence countries: policy and practice
Authors: Uplekar Mukund , Atre Sachin , Wells William A. , Weil Diana , Lopez Rafael , Migliori Giovanni Battista , Raviglione Mario
Published: October 2016

Mandatory tuberculosis (TB) notification is an important policy under the End TB Strategy, but little is known about its enforcement especially in high TB incidence countries. We undertook a literature search for selected high-incidence countries, followed by a questionnaire-based survey among key informants in countries with high-, intermediate- and low-TB incidence. Published literature on TB notification in high-incidence countries was limited, but it did illustrate some of the current barriers to notification and the importance of electronic systems to facilitate reporting by private providers. Required survey data were successfully gathered from 40 out of 54 countries contacted. TB is notifiable in 11 out of 15 high-incidence countries, all 16 intermediate-incidence countries, and all nine low-incidence countries contacted. TB case notification by public sector facilities is generally systematised, but few high-incidence countries had systems and tools to facilitate notification from private care providers. In the context of the new End TB Strategy aimed at eventual TB elimination, all countries should have TB on their national list of notifiable diseases. Enhancing the ease of notification by private providers is essential for effective implementation. To that effect, investing in strengthening disease surveillance systems and introducing digital tools to simplify notification are logical ways forward.
Omalizumab reduces bronchial mucosal IgE and improves lung function in non-atopic asthma
Authors: Pillai Prathap , Chan Yih-Chih , Wu Shih-Ying , Ohm-Laursen Line , Thomas Clare , Durham Stephen R. , Menzies-Gow Andrew , Rajakulasingam Raj K. , Ying Sun , Gould Hannah J. , Corrigan Chris J.
Published: October 2016

Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE and inflammation and preserves/improves lung function when disease is destabilised by staged withdrawal of therapy.

18 symptomatic, non-atopic asthmatics were randomised (1:1) to receive omalizumab or identical placebo treatment in addition to existing therapy for 20 weeks. Bronchial biopsies were collected before and after 12–14 weeks of treatment, then the patients destabilised by substantial, supervised reduction of their regular therapy. Primary outcome measures were changes in bronchial mucosal IgE+cells at 12–14 weeks, prior to regular therapy reduction, and changes in lung function (forced expiratory volume in 1 s) after destabilisation at 20 weeks. Quality of life was also monitored.

Omalizumab but not placebo therapy significantly reduced median total bronchial mucosal IgE+cells (p<0.01) but did not significantly alter median total mast cells, plasma cells, B lymphocytes, eosinophils and plasmablasts, although the latter were difficult to enumerate, being distributed as disperse clusters. By 20 weeks, lung function declined in the placebo-treated patients but improved in the omalizumab treated patients, with significant differences in absolute (p=0.04) and % predicted forced expiratory volume in 1 s (p=0.015).

Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE+mast cells and improves lung function despite withdrawal of conventional therapy.
Brucella abortus down-regulates MHC class II by the IL-6-dependent inhibition of CIITA through the downmodulation of IFN regulatory factor-1 (IRF-1)
Authors: Velásquez Lis N , Milillo M Ayelén , Delpino M Victoria , Trotta Aldana , Fernández Pablo , Pozner Roberto G , Lang Roland , Balboa Luciana , Giambartolomei Guillermo H , Barrionuevo Paula
Published: October 2016

Brucella abortus is an intracellular pathogen capable of surviving inside of macrophages. The success of B. abortus as a chronic pathogen relies on its ability to orchestrate different strategies to evade the adaptive CD4+ T cell responses that it elicits. Previously, we demonstrated that B. abortus inhibits the IFN-γ-induced surface expression of MHC class II (MHC-II) molecules on human monocytes, and this phenomenon correlated with a reduction in antigen presentation. However, the molecular mechanisms, whereby B. abortus is able to down-regulate the expression of MHC-II, remained to be elucidated. In this study, we demonstrated that B. abortus infection inhibits the IFN-γ-induced transcription of MHC-II, transactivator (CIITA) and MHC-II genes. Accordingly, we observed that the synthesis of MHC-II proteins was also diminished. B. abortus was not only able to reduce the expression of mature MHC-II, but it also inhibited the expression of invariant chain (Ii)-associated immature MHC-II molecules. Outer membrane protein 19 (Omp19), a prototypical B. abortus lipoprotein, diminished the expression of MHC-II and CIITA transcripts to the same extent as B. abortus infection. IL-6 contributes to these down-regulatory phenomena. In addition, B. abortus and its lipoproteins, through IL-6 secretion, induced the transcription of the negative regulators of IFN-γ signaling, suppressor of cytokine signaling (SOCS)-1 and -3, without interfering with STAT1 activation. Yet, B. abortus lipoproteins via IL-6 inhibit the expression of IFN regulatory factor 1 (IRF-1), a critical regulatory transcription factor for CIITA induction. Overall, these results indicate that B. abortus inhibits the expression of MHC-II molecules at very early points in their synthesis and in this way, may prevent recognition by T cells establishing a chronic infection.
Democracy out of Tyranny: Comparative Lessons from a Failed “Experiment”
Authors: Tzortzis Ioannis
Published: October 2016

This essay presents the findings of comparative research on democratic transitions by reforma in Greece, Spain, and Turkey but in a framework not previously used and one rather different from the one established in the now-classical study of democratic transitions set by Guillermo O'Donnell and Laurence Whitehead in the 1980s. The departing point of this comparative approach is a case unknown to many: the ill-fated 1973 Greek attempt at self-transformation, known as “the Markezinis experiment” after Spyros Markezinis, who assumed the task of bringing the country to democracy in the way Adolfo Suárez González would do in Spain four years later. The attempt stalled before it was ended by a coup organized by the regime hard-liners tacitly backed by the military as an institution. The cases compared include Spain and Turkey, which underwent similar transitions, but with very different outcomes: consolidated democracy and “difficult democracy,” respectively. The reasons are sought in the different regime natures and elite and counterelite choices.
Lurbinectedin induces depletion of tumor-associated macrophages (TAM), an essential component of its in vivo synergism with gemcitabine
Authors: Céspedes María Virtudes , Guillén María José , López-Casas Pedro Pablo , Sarno Francesca , Gallardo Alberto , Álamo Patricia , Cuevas Carmen , Hidalgo Manuel , Galmarini Carlos María , Allavena Paola , Avilés Pablo , Mangues Ramón
Published: October 2016

We explored whether the combination of lurbinectedin (PM01183) with the antimetabolite gemcitabine may result in synergistic antitumor effect in pancreatic adenocarcinoma (PDA) models. We also studied the contribution of lurbinectedin to this synergism. This drug presents a dual pharmacological effect that contributes to its in vivo antitumor activity: (i) specific binding to DNA minor groove inhibiting active transcription and DNA repair; and (ii) specific depletion of tumor-associated macrophages (TAMs).

We evaluated the in vivo antitumor activity of lurbinectedin, gemcitabine (as single agents) and its combination in SW-1990 and MIA PaCa-2 cell-line xenografts and in patient-derived PDA models (AVATAR). Lurbinectedin-gemcitabine combination induced a synergistic effect on both, MIA PaCa-2 (CI=0.66) and SW1990 (CI=0.80) tumor xenografts. It also induced complete tumor remissions in 4 of 6 patient-derived PDA xenografts. This synergism was associated with enhanced DNA damage (anti-γ-H2AX), cell cycle blockage, caspase-3 activation and apoptosis. In addition to the enhanced DNA damage, which is a consequence of the interaction of the two drugs with the DNA, lurbinectedin induced TAMs depletion leading to CDA down-regulation in PDA tumors. This effect could, in turn, induce an increase of gemcitabine-mediated DNA damage that was especially relevant in high-density TAMs tumors. These results show that lurbinectedin can be used to develop “molecularly-targeted” combination strategies.
Brain diffusion changes in Eisenmenger syndrome
Authors: Dogan Ferit , Sen Dokumaci Dilek , Yildirim Ali , Bozdogan Erol , Boyaci Fatima N , Koca Bulent , Karakas Ekrem
Published: October 2016

Objective:

This preliminary study aimed to evaluate whether there are changes in the apparent diffusion coefficient (ADC) values of the brain in patients presenting with Eisenmenger syndrome (ES).

Methods:

This cross-sectional study included 10 consecutively recruited patients with ES and 10 healthy control subjects. In the patients and controls, eight distinct neuroanatomical locations were selected for analysis. Quantitative measurements of ADC values of the frontal white matter (FWM), occipital white matter, lentiform nucleus (LN), thalamus, frontal cortex, anterior and posterior limbs of the internal capsule and caudate nucleus were measured. Statistical analysis was performed using SPSS® (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) for Windows v. 20. Data were presented as mean ± standard deviation values. The Kruskal–Wallis test was used to assess differences in the ADC values of each brain location between the ES group and the control group. Statistical significance was accepted at the level of p < 0.05.

Results:

The ADC values of the FWM and LN were significantly higher in the ES group than that in the control group. The mean ADC levels of other brain regions were not significantly different between the groups.

Conclusion:

Chronic hypoxia in patients with ES may lead to diffusion changes in the brain tissue. There is a need for further studies to assess the clinical significance of cerebral ADC values in patients with ES.

Advances in knowledge:

The ratio of extracellular volume to intracellular volume in the FWM and LN can be considered to be increased in patients with ES.
The Probit Choice Model Under Sequential Search with an Application to Online Retailing
Authors: Kim Jun B. , Albuquerque Paulo , Bronnenberg Bart J.
Published: October 2016

We develop a probit choice model under optimal sequential search and apply it to the study of aggregate demand of consumer durable goods. In our joint model of search and choice, we derive an expression for the probability of choice that obeys the full set of restrictions imposed by optimal sequential search. Estimation of our partially analytic model avoids the computation of high-dimensional integrations in the evaluation of choice probabilities, which is of particular benefit when search sets are large. We demonstrate the advantages of our approach in data experiments and apply the model to aggregate search and choice data from the camcorder product category at Amazon.com. We show that the joint use of search and choice data provides better performance in terms of inferences and predictions than using search data alone and leads to realistic estimates of consumer substitution patterns.

Data, as supplemental material, are available at https://doi.org/10.1287/mnsc.2016.2545 .

This paper was accepted by Pradeep Chintagunta, marketing.
50th Anniversary Invited Article—Autonomous Vehicles and Connected Vehicle Systems: Flow and Operations Considerations
Authors: Mahmassani Hani S.
Published: October 2016

The impacts of autonomous vehicles, coupled with greater inter-vehicle and system connectivity, may be far-reaching on several levels. They entail changes to (1) the demand and behavior side, (2) the supply of mobility services, and (3) network and facility operational performance. We focus here on their impact on traffic flow and operations, especially in mixed traffic situations in which autonomous vehicles share the road with regular, human-driven vehicles, along with connected vehicles that may also have some automated functions. These mixed traffic situations correspond to likely deployment scenarios of the technologies, especially in the long transition towards 100% deployment. We explain using elementary traffic science concepts how autonomous vehicles and connected vehicles are expected to increase the throughput of highway facilities, as well as improve the stability of the traffic stream. A microsimulation framework featuring varying behavioral mechanisms for the three classes of vehicles is introduced. The framework is used to examine the throughput and stability questions through a series of experiments under varying market penetration rates of autonomous and/or connected vehicles; at low market shares, the impacts are relatively minor on either throughput or stability. However, as market shares increase, autonomous vehicles exert a greater influence on both dimensions compared to the same shares of connected vehicles. Applications of the framework to examine the effectiveness of selected traffic management approaches are discussed, including dedicated lanes for autonomous vehicles (good only if its use is optional and when the market share of autonomous vehicles is greater than the percentage of nominal capacity represented by that lane), and speed harmonization.
The potential crosstalk between the brain and adipose tissue in Obesity
Authors: Al-Mazeedi Sarah , Zakareia Faten
Published: October 2016

Obesity is a major health problem that is increasing in an alarming rate and is associated with an increased prevalence of cardiovascular morbidity and mortality.  New strategies to combat obesity epidemic are urgently needed, but gaps in understanding of obesity pathogenesis continue to limit progress in this goal. This review  aims at discussing the neural aspects of obesity and the brain potential role in energy balance ,also to contribute in the complex solution of obesity puzzle on neurological basis. The hypothalamic region of the brain is the center that plays an important role in the control of feeding and its related behaviors.  A better understanding of its role and how it is affected by neuroendocrine  and adipokines  signaling might be helpful in developing new pharmacological therapy for obesity. Also, this article highlights different mechanisms by which altered brain signaling and hypothalamic inflammation  predispose to diet –induced obesity.