bluuebunny/crossref_metadata_2025 huggingface dataset:
Increase in the Arterial Velocity Pulse Index of Patients with Peripheral Artery Disease
Authors: Murata Naotaka , Shiina Kazuki , Yamashita Jun , Tanaka Nobuhiro , Chikamori Taishiro , Yamashina Akira , Tomiyama Hirofumi
Published: February 2018

Background: Recently, a simple parameter calculated from the brachial pressure waveform recorded using an oscillometric device (arterial velocity pulse index [AVI]: ratio of the forward/reflected pressure wave amplitudes) has become available to assess the pathophysiological abnormalities associated with vascular damage. Peripheral artery disease (PAD) represents one of the disease entities associated with the advanced stages of atherosclerotic vascular damage. The present study was conducted to examine whether an increase in the AVI might be influenced by the presence of PAD. Methods and Results: The AVI was measured from oscillometric recordings of the brachial pressure waveform, and the ankle-brachial pressure index (ABPI) was determined by an oscillometric method. Study 1: In 341 consecutive patients admitted for the management of cardiovascular disease and/or cardiovascular risk factors, the ABPI and the AVI were measured simultaneously. An ABPI ≤0.90 was observed in 19 subjects, and logistic regression analysis revealed a significant association between AVI and ABPI ≤0.90 (odds ratio = 1.81; 95% confidence interval = 1.15–2.84; p = 0.01). Study 2: In another 19 patients with PAD, percutaneous transluminal angioplasty resulted in a decrease in the AVI from 31 ± 8 to 27 ± 8 (p < 0.01). Conclusion: Possible presence of PAD must be taken into account while applying the AVI for the assessment of vascular damage.
Sigmoid Volvulus in Children: Diagnosis and Therapeutic Challenge
Authors: Carmo Leonor , Amaral Marina , Trindade Eunice , Henriques-Coelho Tiago , Pinho-Sousa José
Published: February 2018

Background: Sigmoid volvulus is a rare condition in children. Early diagnosis increases the success of nonsurgical treatment in the emergency department, but posterior elective surgery is important due to the risk of recurrence. Methods/Conclusions: We present the case of a healthy 16-year-old girl with recurrent volvulus and successful endoscopic treatment followed by elective surgery.
Two for One: B-Cell Lymphomas with Features of Marginal and Follicular Lymphomas
Authors: Glazyrin Alexey , Patel Chirag , Kujtan Lara , Madhusudhana Sheshadri
Published: February 2018

Low-grade follicular lymphomas are genetically characterized by the translocation t(14; 18)(q32;q21) with BCL2 gene rearrangements. Marginal zone lymphomas are often associated with translocations or transcriptional deregulations of the MALT gene. We report 2 cases of lymphomas which harbor both the t(14;18)(q32;q21) translocation and MALT gene upregulation. Patients presented with numerous circulating atypical lymphocytes. Lymph node biopsy in both cases on HE staining demonstrated vague nodularity readily highlighted by CD10, CD23, or BCL6. Staining with CD20 and BCL2 demonstrated monotonous diffuse effacement of normal architecture with tumor cells without obvious follicular structures. Morphologically, tumor cells were consistent with centrocytes. Bone marrow biopsy demonstrated a combined peritrabecular and interstitial distribution of the tumor cells. These cases present substantial difficulties for diagnosis and classification. Clinical and morphological features were mostly consistent with follicular lymphoma, with a few features more often seen in marginal zone lymphomas (leukemic presentation, no CD10 in circulating cells, interstitial location of tumor cells in bone marrow); therefore, these cases were finally classified as follicular lymphoma grade I. Both patients were treated with standard chemotherapy regimens for follicular and nongastric MALT lymphomas with a good response to date.
Serum Levels of Interleukin-2 in Patients with Alopecia Areata: Relationship with Clinical Type and Duration of the Disease
Authors: Kasumagić-Halilovic Emina , Cavaljuga Semra , Ovcina-Kurtovic Nermina , Zecevic Lamija
Published: February 2018

Background: Alopecia areata (AA) is a disease characterized by focally, nonscarring hair loss on the scalp or any hair-bearing surface. The etiology is unknown, although the evidence suggests that AA is an immunologically mediated disease. In the pathogenesis of AA, Th1 immune response is predominant. A special cytokine profile is created by Th1 cells, which disturbs the natural balance of the cytokine networks and leads to inflammatory reaction and follicle damage. Objective: The aim of our study was to evaluate serum concentrations of IL-2 in patients with AA and healthy subjects. We also examined a possible association between serum levels of IL-2, disease severity, and duration of AA. Methods: Sixty patients with AA and 20 healthy controls were enrolled in the study. Serum concentrations of IL-2 were measured using enzyme-linked immunoassay techniques. Results: Comparison of mean values of IL-2 has showed that serum concentrations of this cytokine are significantly higher in serum samples of AA patients in relation to the control group (22.2 ± 1.19 vs. 21.1 ± 2.68 pg/mL, respectively; p = 0.0142). No correlations were found between clinical type, duration of the disease, and serum levels of IL-2. Conclusion: Our findings support the evidence that elevation of serum IL-2 is associated with AA. The exact role of serum IL-2 in AA should be additionally investigated in future studies.
A Pictorial Autobiography by Zeng Jifen (1852-1942) and the Use of the “Exemplary” in China’s Modern Transformation
Authors: Yang Binbin
Published: February 2018

Zeng Jifen (1852-1942), a daughter of the distinguished Qing official Zeng Guofan (1811-72), incorporated rich visual materials into her self-edited nianpu or chronological ­autobiography (1931; 1933) for the purpose of modelling the “ancients’ practice of incorporating pictures and texts concurrently.” The effect was a pictorial autobiography that launched a social critique through an exemplary life story and the art of “praise and blame” inherent in the Chinese biographical and artistic traditions. In highlighting the mechanisms Zeng employed to construct her personal history and engage in conversations on familial and national levels across several decades, this study illuminates her ongoing efforts to capitalize on her family heritage and the Confucian ritual tradition for social and political reform. During the process, what may appear to be her tenacious grip on the ritual restraints on women, as previously interpreted, initiated a sea change in women’s education and expanded the authority of women from the domestic sphere to the nationalist state.
The Problematic Status of the Literary Work of Art in Contemporary Aesthetics
Authors: Deac Ioana-Eliza
Published: February 2018

Developing a system that would reunite all the arts and account for their similarities and differences on the basis of a shared set of criteria was one of the main objectives of the aesthetic discipline, whose roots run deep into romantic philosophy. The diversity of modernist experiments poses a number of challenges to such systematisation and invites theoreticians to start anew. To illustrate some of the main difficulties arising from this situation, particularly in the case of the literary work of art, this article will focus on Gérard Genette’s two volume work L’œuvre de l’art (1994, 1997). Genette’s main purpose is to offer a conceptual framework for the description of the work of art that would find a place in the system for its material mode of existence. His objective is achieved at the expense of the coherence of the model since the structure of what he terms allographic and autographic works proves to be asymmetrical. Thus, the autographic works are presented as having a dual nature: transcendental and immanent (that is, physical), while the allographic works comprise three different levels: transcendence – immanence (understood as ideal) – and (physical) manifestation. After confronting Genette’s premises with the conclusions of several disciplines which study the same object of immanence from a different perspective, this paper will propose a revised and more coherent version of his system.
Seasonal Persistence of Circulation Anomalies in the Southern Hemisphere Stratosphere and Its Implications for the Troposphere
Authors: Byrne Nicholas J. , Shepherd Theodore G.
Published: February 2018

Previous studies have highlighted an important organizing influence of the seasonal Southern Hemisphere stratospheric vortex breakdown on the large-scale stratospheric and tropospheric circulation. The present study extends this work by considering the statistical predictability of the stratospheric vortex breakdown event, using reanalysis data. Perturbations to the winter stratospheric vortex are shown to persist into austral spring and to lead to a shift in the statistics of the breakdown event during austral summer. This is interpreted as evidence for the potential for seasonal predictability of the vortex breakdown event in the stratosphere. Coupled variability between the stratosphere and troposphere is then considered. The semiannual oscillation of the tropospheric midlatitude jet is discussed, and evidence for a connection between this behavior and variations in the stratosphere is presented. Based on this connection, an argument is made for the concomitant potential for seasonal predictability in the troposphere, assuming knowledge of the stratospheric initial state. Combining these various results, a nonstationary, regime-based perspective of large-scale extratropical Southern Hemisphere circulation variability between late winter and summer is proposed. The implications of this perspective for some previous studies involving annular modes of the circulation are discussed. In particular, the long annular mode time scales during austral spring and summer should not be interpreted as an increased persistence of perturbations to some slowly varying seasonal cycle, but instead as a reflection of a phase shift of the seasonal cycle induced by stratospheric variability.
One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes
Authors: Rah Yoon Chan , Han Won Gue , Joo Jae Woo , Nam Kuk Jin , Rhee Jihye , Song Jae Jun , Im Gi Jung , Chae Sung Won , Jung Hak Hyun , Choi June
Published: February 2018

Objectives:

To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix.

Methods:

Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed in association with fistula size. Accuracy of various diagnostic examinations was assessed.

Results:

Immediately postsurgery, the average bone conduction threshold (43.34 dB) did not differ significantly from the preoperative value (36.66 dB, P = .083). There were also minimal changes thereafter (45.63 dB) without recurrent case over an average follow-up time of 38.3 months (range, 17-69 months). More than 10 dB hearing loss was found in 7 patients with a case of intraoperative perilymph leakage (2.3%), although 5 of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss ( P = .027).

Conclusion:

Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.
Differences in depressive symptoms between rural and urban Chinese labor force: The mediating effects of community factors
Authors: Li Wanlian , Sun Fei , Anderson Steven
Published: February 2018

Purpose:

This study aimed to examine differences in depressive symptoms between urban and rural workers in mainland China and to identify community factors that could contribute to such residential differences.

Methods:

This study used nationally representative data from the 2014 China’s Labor Force Dynamic Survey. Data were collected through face-to-face interviews on a sample of 22,073 participants from 29 provinces of China, including 15,098 rural workers (Mage = 44.92, standard deviation ( SD) = 14.85) and 6,975 urban workers (Mage = 43.28, SD = 13.62). Mediators included community cohesion, foreseeable community threat, supportive network size and medical benefit coverage. Mediation analyses were conducted using Hayes’ SPSS Macro Process for multiple mediators.

Results:

Urban participants reported fewer depressive symptoms than their rural counterparts. Lower levels of community cohesion, higher community foreseeable threat and poorer medical coverage were related to fewer depressive symptoms. Rural–urban differences were mediated by community cohesion ( B = −0.12, p < .01), foreseeable community threat ( B = −0.08, p < .01) and medical benefit coverage ( B = 0.25, p < .01).

Conclusion:

This study sheds light on distinctive roles of community factors in explaining rural–urban differences in depressive symptoms. Policies or programs should be designed to promote strengths and address weaknesses in rural communities.
Intermunicipal cooperation: The quest for governance capacity?
Authors: Silva Patricia , Teles Filipe , Ferreira Joanna
Published: February 2018

Intermunicipal cooperation is being increasingly adopted in various countries to cope with the dilemmas of territorial scale and resource rationing. Despite the pressures towards the reshaping of administrative boundaries, little is known about the capacity of intermunicipal associations to function as effective, legitimate and resilient policy actors. This article aims to contribute to this debate by addressing two interrelated dimensions. First, it seeks to present a conceptual definition of governance capacity, unpacking the conceptual framework into dimensions that can be measured systematically. Second, it aims to empirically assess the governance capacity of Portuguese intermunicipal associations, drawing on a unique survey of intermunicipal associations. Overall, results suggest that despite being instrumentally driven, intermunicipal associations have proven to be efficient, with members recognizing the benefits and the spillover effects of trustworthy arrangements. However, the path dependencies affecting Portuguese local governments may impact on the relatively low levels of governance capacity.

Points for practitioners

This article undertakes a conceptual analysis of the governance capacity of intermunicipal associations. This analytical framework can be crucial for leaders, practitioners and professionals working in management and administration especially those working in complex and demanding settings. Given the general trend towards intermunicipal cooperation – strongly encouraged by national and European regulations and reforms – practitioners need to be able to measure the capacity of the cooperative arrangements to be established and to be maintained. This article also strives to enlighten those professionals as to which dimensions mostly need to be strengthened so as to allow intelligent collective choices to be made and to set strategic directions for the allocation of (increasingly) scarce resources.
Do Persian Native Speakers Prosodically Mark Wh-in-situ Questions?
Authors: Shiamizadeh Zohreh , Caspers Johanneke , Schiller Niels O.
Published: February 2018

It has been shown that prosody contributes to the contrast between declarativity and interrogativity, notably in interrogative utterances lacking lexico-syntactic features of interrogativity. Accordingly, it may be proposed that prosody plays a role in marking wh-in-situ questions in which the interrogativity feature (the wh-phrase) does not move to sentence-initial position, as, for example, in Persian. This paper examines whether prosody distinguishes Persian wh-in-situ questions from declaratives in the absence of the interrogativity feature in the sentence-initial position. To answer this question, a production experiment was designed in which wh-questions and declaratives were elicited from Persian native speakers. On the basis of the results of previous studies, we hypothesize that prosodic features mark wh-in-situ questions as opposed to declaratives at both the local (pre- and post-wh part) and global level (complete sentence). The results of the current study confirm our hypothesis that prosodic correlates mark the pre-wh part as well as the complete sentence in wh-in-situ questions. The results support theoretical concepts such as the frequency code, the universal dichotomous association between relaxation and declarativity on the one hand and tension and interrogativity on the other, the relation between prosody and pragmatics, and the relation between prosody and encoding and decoding of sentence type.
Constructing a ‘Representative Claim’ for Action on Climate Change: Evidence from Interviews with Politicians
Authors: Willis Rebecca
Published: February 2018

At the 2015 Paris Summit, global leaders agreed a strategy to tackle climate change. Under the agreement, each country must prepare a national plan. What challenges does this pose for politicians? How do they reconcile their representative role with understandings of climate change and measures required to address it? This article analyses interviews with UK politicians, through the framework of the ‘representative claim’ developed by Michael Saward, seeing representation as a dynamic interaction between politicians and those they claim to represent. Thus, politicians need to construct a ‘representative claim’ to justify action on climate. Four different types of claims are identified: a ‘cosmopolitan’ claim, a ‘local prevention’ claim, a ‘co-benefits’ claim and a ‘surrogate’ claim. The analysis shows that it is not straightforward for a politician to argue that action is in the interests of their electorate and that climate advocates need to support efforts to construct and defend claims.
Destination Extension: A Faster Route to Fame for the Emerging Destination Brands?
Authors: Kim Hany , Stepchenkova Svetlana , Yilmaz Semih
Published: February 2018

Brand extension—marketing of a new product as an extension of an existing one—is a well-known strategy to increase brand value in an efficient way. However, the concept has not been sufficiently addressed in the field of destination branding. This study introduces the concept of destination-to-destination brand extension (or “destination extension”) and empirically tests its practical utility using an experimental design. In this design, two established tourism brands, South Korea and UNESCO World Heritage Site, were positioned as potential parent brands while the newly emerging destination of Jeju, the only island in the world with three UNESCO designations of outstanding value, was positioned as the extended brand. After analyzing how parent brand equity as well as the perceived fit between the parent and extended brands influence the brand equity of Jeju, this study demonstrates the feasibility of “destination extension” as an alternative marketing strategy for tourist destinations.
Hall of Mirrors: Media, Democratization, and the Public Sphere in Maranhão, Brazil
Authors: Herrmann Julián Durazo
Published: February 2018

Freedom of expression and access to diverse sources of information are seen as critical elements of democracy, although their concretization on the ground is subject to strong interference. Recent regime change in Maranhão, one of Brazil’s poorest states, has led to the emergence of new media and some expansion of the public sphere. The traditional oligarchy continues to dominate the media, however, and the opposition media replicate its exclusion of nonelite actors. The Maranhão experience confirms that normative approaches to the media either as automatic contributors to democracy or as instruments of elite manipulation have little value for understanding media dynamics.

Liberdade de expressão, bem como o acesso a diversas fontes de informação, são considerados elementos críticos da democracia, ainda que a concretização desses fatores esteja sujeita a forte interferência. A recente troca de regime no Maranhão, um dos estados mais pobres do Brasil, tem levado ao surgimento de uma nova mídia e a uma certa expansão da esfera pública. Contudo, a oligarquia continua dominando a mídia tradicional e a mídia alternativa imita a prática de exclusão de atores não pertencentes à elite. A experiência do Maranhão confirma que tratamentos normativos que veem a mídia como contribuinte automática do processo democrático, ou como instrumento de manipulação da elite, teem pouco valor para se entender a dinâmica da mídia.
Finnish Firefighters’ Barriers to Volunteering
Authors: Malinen Sanna , Mankkinen Teija
Published: February 2018

Although the need for emergency service volunteers is increasing internationally, it is challenging to attract and retain firefighters, who are highly trained and from whom sustained and potentially heavy time investment is required. To recruit and retain fire service volunteers, it is important to understand the barriers these volunteers face, and how these barriers relate to their attitudes and behavioral intentions. We surveyed 762 volunteer firefighters throughout Finland on these issues. Lack of time, conflict with work/school, and other work-related challenges were the most frequently reported barriers, and they were also rated as some of the most severe barriers. The number and severity of barriers were positively related to the volunteers’ absence and turnover intentions, and conflicts with family commitments. A higher number of reported barriers was also negatively related to volunteer satisfaction. No differences in barriers were found between rural and urban areas, or between gender and age groups. We discuss the findings in regard to relevant literature from other countries and conclude with practical implications.
Preparation of polyaniline hollow microspheres/zinc composite and its application in lithium battery
Authors: Li Zhihua , Shen Yuting , Li Yanbo , Zheng Feng , Liu Lanlan , Liu Xiaqing , Zou Dehua
Published: February 2018

Polyaniline (PANI) hollow microspheres were synthesized by a self-assembly method in aqueous solution of poly (2-acrylamido-2-methylpropane sulfonic acid) (PAMPS), and then microspheric zinc (Zn) was introduced into PANI to prepare PANI hollow microspheres/Zn composite. The structure and morphology of as-synthesized samples were investigated by Fourier transform infrared spectroscopy, ultraviolet–visible spectroscopy, and scanning electron microscopy, respectively. The charge/discharge property, cyclic voltammetry, and alternating current (AC) impedance spectroscopy of as-prepared samples were also examined in detail. The results showed that the electrical conductivity of PANI/Zn composite reached 21.2 ± 0.16 S/cm at 20 wt% of Zn, which was 11.4 S/cm higher than that of PANI. The first discharge capacity of PANI/Zn lithium battery reached 570.8 mAh/g at a current density of 0.2 mA/cm2. After 15 cycles, it remained at 159 mAh/g, which was 107 mAh/g higher than that of PANI lithium battery. Furthermore, the results of AC impedance test showed that the addition of Zn powders significantly reduced the internal resistance of battery. Compared with PANI, PANI/Zn composite showed greater capacity, higher conductivity, and charge/discharge efficiency, which was more suitable for the cathode material of high performance lithium battery.
A multi-switching mode intelligent hybrid control of electro-hydraulic proportional systems
Authors: Kong Xiangzhen , Majumdar Hasan , Zang Faye , Jiang Shouyong , Wu Qingzhen , Zhang Wenjun
Published: February 2018

The electro-hydraulic proportional system is a highly non-linear system owing to the fact that the system is composed of components from different disciplines such as electric, hydraulic and mechanical disciplines. In general, a switching-based controller is suitable to the control of such a system. In this paper, a switching-based controller is proposed, which is called multi-switching mode intelligent hybrid control, for electro-hydraulic proportional systems. The novelty of the multi-switching mode intelligent hybrid control is that it integrates the PID control law, the neural-fuzzy control law, and the expert-based control law. To demonstrate the effectiveness of the proposed multi-switching mode intelligent hybrid control, both experiment and simulation were conducted. It is shown that the experimental result corresponds well with the simulation result. Further, the proposed control system was compared with the traditional ones such as PID and neural-fuzzy controller for a trajectory tracking task with an electro-hydraulic proportional, which shows that the proposed one is far superior to these traditional ones. Overall, there is evidence that the proposed multi-switching mode intelligent hybrid control is very effective. It is noted that though the idea of the switching-based control system to electro-hydraulic proportional systems may not be new, the specific integration of the member control laws along with specific control laws developed in this work to electro-hydraulic proportional systems is not reported in the literature and multi-switching mode intelligent hybrid control is potentially useful to other electro-hydraulic proportional systems.
Palladium nanoparticle effects on endocrine reproductive system of female rats
Authors: Leso V , Fontana L , Marinaccio A , Leopold K , Fanali C , Lucchetti D , Sgambato A , Iavicoli I
Published: February 2018

The widespread industrial application of nanomaterials (NMs) has dramatically increased the likelihood of environmental and occupational exposure of humans to such xenobiotics. This issue, together with the increasing public health interest in understanding the effects of chemicals on endocrine system, encouraged to investigate the disruptive potential of NMs on the endocrine function. Therefore, the aim of this study was to evaluate the effects of palladium nanoparticles (Pd-NPs) on the female reproductive system of Wistar rats, intravenously exposed to different doses (0.12, 1.2, and 12 µg/kg), through the assessment of possible quantitative changes in the serum concentrations of several sex hormones. Our results demonstrated that the highest exposure doses significantly reduced the estradiol and testosterone concentrations, while increased the luteinizing hormone levels in treated animals compared to controls. Such alterations are indicative for an abnormal reproductive axis function. However, further investigations are needed to clarify the role of the different NP physicochemical properties in determining such effects, and possible underlining molecular mechanisms, as well as their relevance for the development of diseases in the female reproductive system. Overall, this may be helpful to define accurate risk assessment and management strategies to protect the health of the general and occupational populations exposed to Pd-NPs.
Multilevel Connection as a Pathway to Healing in a Low-income South African Community
Authors: Benjamin Arlene
Published: February 2018

Combined forces of colonialism, tribalism and apartheid were influential, powerful and controlling legislators behind the continued cycle of violence in South Africa. The capacity for healing in the face of ongoing adversity has received growing attention in contexts of historical trauma and the developing world where an understanding of the cultural and historical past is crucial to healing. Notwithstanding, the parallel significance of multilevel and multidimensional connection as central to the process of healing trauma individually and collectively within the context of ongoing violence requires further exploration. This qualitative narrative study consisted of 18 in-depth individual interviews and two follow-up focus groups with women lay counsellors. Women’s narratives were subjected to narrative analysis. Themes reflect counsellors’ healing journeys in the context of historical and continuous trauma and demonstrate elements of connection which facilitate or hinder the process of healing in this community. Findings suggest that participants viewed the worth of multilevel connection to their internal worlds and the world around them as critical to their healing—without the element of connection, healing does not occur and the cycle of disconnection and violence continues.
A targeted review on large deformations of planar elastic beams: extensibility, distributed loads, buckling and post-buckling
Authors: Spagnuolo Mario , Andreaus Ugo
Published: February 2018

In this paper, we give a targeted review of the state of the art in the study of planar elastic beams in large deformations, also in the presence of geometric nonlinearities. The main scope of this work is to present the different methods of analysis available for describing the possible equilibrium forms and the motions of elastic beams. For the sake of completeness, we start by giving an overview of the nonlinear theories introduced for approaching this argument and then we account for the variational principles and deformation energies introduced for modelling beams undergoing large deformations and displacements. We then consider different kinds of loads treated in the literature and the corresponding induced beam deformations. We conclude by accounting for the available analysis for stability and some considerations about problems where live loads are applied, as well as by describing some relevant numerical methods of use in the applications we have in mind. The selection criterion for the reviewed papers is dictated by the need to study large deformations and the dynamics of pantographic sheets. (Large deformations of planar extensible beams and pantographic lattices: heuristic homogenization, experimental and numerical examples of equilibrium. Proc R Soc A 2016; 472(2185): 20150790), dell’Isola et al. (Designing a light fabric metamaterial being highly macroscopically tough under directional extension: first experimental evidence. Z Angew Math Phys 2015; 66(6): 3473–3498), Turco et al. (Hencky-type discrete model for pantographic structures: numerical comparison with second gradient continuum models. Z Angew Math Phys 2016; 67(4): 1–28)].
Genetic Diversity and Functional Analysis of Sigma Factors in Enterobacter cloacae Complex Resourced From Various Niche
Authors: Nazir Farah , Ibrahim Muhammad , Zaman Ghunva , Hussain Annam , Yar Asma Muhammad , Bo Zhu
Published: February 2018

Sigma factors are bacterial transcription factors that bind the core RNA polymerase and direct transcription initiation at a specific promoter site. These specialized sigma factors bind the promoters of genes appropriate to the environmental conditions and selectively increase the transcription of those genes. Here, we attempt to identify sigma factors in 5 genomes belonging to the Enterobacter cloacae complex (Ecc), a group of gram-negative bacteria that are important nosocomial pathogens. This process includes the identification of orthologous sequences, conserved motifs, domains, families, phylogenetic profiles, and protein-protein associations of these components. Based on the reference genome, genome-wide comparison revealed that the genomes of Enterobacter asburiae JCM6051, Enterobacter nimipressuralis CIP 104980, Enterobacter hormaechei ATCC49162, Enterobacter kobei JCM 8580, and Enterobacter ludwigii EN-119 encode 10 sigma factors that exist in the reference strain Enterobacter cloacae subsp cloacae ATCC13047. Moreover, the sequence similarity, protein domains and families of the sigma factors, protein-protein association, and phylogenetic profile indicate that the sigma factor proteins of these 5 strains may have evolutionary relatedness and functional characteristics important to their various environmental niches. Interestingly, the absence of RpoS in E kobei, which contributes to bacterial survival under environmental stress conditions, indicates that RpoS might have been independently acquired and may play different roles relating to pathogenicity, host range determination, and/or niche adaptation. Future work such as RNA sequencing will be directed towards investigating the roles that these sigma factors play in the biology of the Ecc.
Comorbidity of depressive symptoms among primary care patients with diabetes in a federally qualified health center
Authors: Renn Brenna N , Obetz Vanessa , Feliciano Leilani
Published: February 2018

Depression is frequently comorbid with diabetes; however, less is known about this comorbidity in socially disadvantaged populations. This cross-sectional study examined depressive symptomatology among 424 patients with prediabetes or type 2 diabetes mellitus at a federally qualified health center. Prevalence of clinically significant depressive symptoms was assessed using the World Health Organization Five-Item Well-Being Index. The majority (67.7%) endorsed depressive symptoms, with greater prevalence among middle-aged adults (45–64 years) than younger or older counterparts. More women than men endorsed depressive symptoms. Findings suggest the need for routine depression screening in both prediabetes and type 2 diabetes mellitus, particularly among middle-aged and low-income individuals.
‘I don’t even know how to start that kind of conversation’: HIV communication between mothers and adolescents with perinatally acquired HIV
Authors: Gibbs Caroline , Melvin Diane , Foster Caroline , Evangeli Michael
Published: February 2018

Young people with perinatally acquired HIV are now surviving into late adolescence and adulthood. We explored HIV communication within mother/adolescent dyads following naming of the adolescents’ HIV. Five adolescents with perinatally acquired HIV (14–16 years) and their biological mothers were interviewed separately. HIV communication between mothers and children was rare. Discussion most commonly related to biomedical aspects of HIV. Onward HIV disclosure was discouraged by mothers, which often contrasted with adolescents’ beliefs. Discussing emotional and sexual aspects of HIV was mutually avoided. Culturally sensitive support and guidance should be offered to families about discussing HIV, considering potentially differing perspectives.
Neoliberalism and its impact on Latin American crime control fields
Authors: Iturralde Manuel
Published: February 2018

In recent years, there has been a growing debate on how, and whether, during the past three decades, a neoliberal penal State, with close ties to the new economic order, has emerged in the United States and in other nations of the Global North. This article seeks to analyse, based on the criticisms that the neoliberal penal State theory has been subject to, whether, and to what extent, such a take on neoliberalism and the penal State may contribute to attaining a plausible explanation of Latin American crime control fields.
Donor Body Mass Index as a Risk Factor for Delayed Onset of Graft Function
Authors: Miklušica Juraj , Dedinská Ivana , Palkoci Blažej , Sendrey Alexander , Lajčiaková Mariana , Vojtko Martin , Osinová Denisa , Laca L’udovít
Published: February 2018

Delayed graft function continues to pose a significant challenge to clinicians in the context of kidney transplantation. The objective of this retrospective, 5-year analysis is to identify the parameters of beating heart donors and those of recipients that affect the delayed development of graft function. The monitored group was composed of 152 beating heart donors and 179 recipients. Delayed graft function was identified in 32 (17%) patients. The predictor for development of delayed graft function was the body mass index of the donor (odds ratio: 1.1473; 95% confidence interval [CI]: 1.0017-1.3140; P = .0472), and the independent risk factors were donor body mass index 30 to 34.9 kg/m2 (hazard ratio [HR]: 6.0215; 95% CI: 1.4188-25.556; P = .0149), donor body mass index ≥35 kg/m2 (HR: 13.5484; 95% CI: 1.4575-125.938; P = .0220), and abuse of alcohol in the donor’s history (HR: 1.779; 95% CI: 1.0679-2.964; P = .0270).
Biomarker definitions and their applications
Authors: Califf Robert M
Published: February 2018

Biomarkers are critical to the rational development of medical therapeutics, but significant confusion persists regarding fundamental definitions and concepts involved in their use in research and clinical practice, particularly in the fields of chronic disease and nutrition. Clarification of the definitions of different biomarkers and a better understanding of their appropriate application could result in substantial benefits. This review examines biomarker definitions recently established by the U.S. Food and Drug Administration and the National Institutes of Health as part of their joint Biomarkers, EndpointS, and other Tools (BEST) resource. These definitions are placed in context of their respective uses in patient care, clinical research, or therapeutic development. We explore the distinctions between biomarkers and clinical outcome assessments and discuss the specific definitions and applications of diagnostic, monitoring, pharmacodynamic/response, predictive, prognostic, safety, and susceptibility/risk biomarkers. We also explore the implications of current biomarker development trends, including complex composite biomarkers and digital biomarkers derived from sensors and mobile technologies. Finally, we discuss the challenges and potential benefits of biomarker-driven predictive toxicology and systems pharmacology, the need to ensure quality and reproducibility of the science underlying biomarker development, and the importance of fostering collaboration across the entire ecosystem of medical product development.

Impact statement

Biomarkers are critical to the rational development of medical diagnostics and therapeutics, but significant confusion persists regarding fundamental definitions and concepts involved in their use in research and clinical practice. Clarification of the definitions of different biomarker classes and a better understanding of their appropriate application could yield substantial benefits. Biomarker definitions recently established in a joint FDA-NIH resource place different classes of biomarkers in the context of their respective uses in patient care, clinical research, or therapeutic development. Complex composite biomarkers and digital biomarkers derived from sensors and mobile technologies, together with biomarker-driven predictive toxicology and systems pharmacology, are reshaping development of diagnostic and therapeutic technologies. An approach to biomarker development that prioritizes the quality and reproducibility of the science underlying biomarker development and incorporates collaborative regulatory science involving multiple disciplines will lead to rational, evidence-based biomarker development that keeps pace with scientific and clinical need.
The clinical effectiveness of a cognitive behavioural therapy intervention in a work setting: a 5-year retrospective analysis of outcomes
Authors: Hitt David , Tahir Tayyeb , Davies Lyndon , Delahay Jo , Kelson Mark
Published: February 2018

Background

The National Institute for Health and Clinical Excellence (NICE) guidance recommends Cognitive Behavioural Therapy (CBT) as part of multidisciplinary occupational mental health interventions for people with long-term or recurrent short-term sickness absence from work (NICE, 2009). Despite this, there is a paucity of data for both randomised trials for CBT and literature that supports the transferability of CBT into occupational environments.

Aims

This service evaluation aimed to evaluate the clinical effectiveness of CBT by analysing data from a partnership scheme between a local authority and a local heath board using a routine employee population.

Methods

A clinical cohort of 81 employees referred through the partnership scheme completed CBT over a 5-year period via a CBT nurse therapist. A sample of 76 employees was included in the evaluation who completed pre-/post-measures to establish outcome. Of these, 30 were followed up at a 3-year point, completing the same measures.

Results

Each of the clinical measures yielded significant outcomes at 95% confidence intervals, and large effect sizes using Cohen’s d both at post-test and follow-up. No significant difference was shown between post-treatment and follow-up outcomes. CBT was demonstrated to be clinically effective within an occupational mental health setting.

Conclusions

In conclusion, partnership schemes with a focus on mental health between public sector agencies can have a positive outcome for the funding agency as well as individual employees.
Post-menopausal bleeding – Is transvaginal ultrasound a useful first-line investigation in tamoxifen users?
Authors: Abdaal A , Mushtaq Y , Khasati L , Moneim J , Khan F , Ahmed H , Bolton H
Published: February 2018

Objective

To evaluate the role of transvaginal ultrasound triage in women with a history of tamoxifen treatment who present with post-menopausal bleeding.

Study design

A retrospective review was undertaken of patients who presented with symptoms of post-menopausal bleeding and underwent ultrasound triage. Endometrial thickness and ultrasonographic features were then correlated with hysteroscopic and histopathological outcome data. The findings and outcomes for women with a history of tamoxifen use (tamoxifen group) were compared to those who had not taken tamoxifen (non-tamoxifen group).

Results

A total of 614 women with post-menopausal bleeding underwent transvaginal ultrasound triage, of whom 53 had a history of current or previous tamoxifen treatment. An endometrial thickness of ≥5 mm or the presence of other abnormal features was used to triage women to further investigation by hysteroscopy and biopsy. Endometrial thickness was significantly greater in the tamoxifen group (11 mm vs. 6 mm). Nearly all of the tamoxifen group were triaged to further investigation (98.1%), compared with significantly fewer in the non-tamoxifen group (68.3%) Overall, the incidence of endometrial pathology was also significantly higher in tamoxifen patients (43.4% vs. 31.7%).

Conclusion

For women presenting with post-menopausal bleeding, the use of transvaginal ultrasound as a triage tool is rarely helpful in evaluating women who have a history as tamoxifen use, as most will require further investigation with hysteroscopy and biopsy. A post-menopausal bleeding protocol that omits transvaginal ultrasound for women with a history of tamoxifen use may be an appropriate and effective pathway for managing these patients.
A Multidisciplinary Delphi Consensus-Based Checklist to Define Clinical Documentation Tools for Both Routine and Research Purposes
Authors: Veraar Cecilia , Hasler Paul , Schirmer Michael
Published: February 2018

Background:

To the best of our knowledge, a strategic approach to define the contents of structured clinical documentation tools for both clinical routine patient care and research purposes has not been reported so far, although electronic health record will become more and more structured and detailed in the future.

Objective:

To achieve an interdisciplinary consensus on a checklist to be considered for the preparation of disease- and situation-specific clinical documentation tools.

Methods:

A 2-round Delphi consensus-based process was conducted both with 19 physicians of different disciplines and 14 students from Austria, Switzerland, and Germany. Agreement was defined as 80% or more positive votes of the participants.

Results:

The participants agreed that a working group should be set up for the development of structured disease- or situation-specific documentation tools (97% agreement). The final checklist included 4 recommendations concerning the setup of the working group, 12 content-related recommendations, and 3 general and technical recommendations (mean agreement [standard deviation] = 97.4% [4.0%], ranging from 84.2% to 100.0%).

Discussion and Conclusion:

In the future, disease- and situation-specific structured documentation tools will provide an important bridge between registries and electronic health records. Clinical documentation tools defined according to this Delphi consensus-based checklist will provide data for registries while serving as high-quality data acquisition tools in routine clinical care.
Applicability of cadastral data to support the estimation of water use in private swimming pools
Authors: Llausàs Albert , Hof Angela , Wolf Nils , Saurí David , Siegmund Alexander
Published: February 2018

Studies addressing outdoor water use in residential areas rely on surveying methods, the manual digitization of aerial imagery and remote sensing-based approaches to estimate water consumption by different land uses. Publicly available cadastral data potentially offer a more efficient avenue for researchers to obtain information on land use parameters, but few assessments of their quality and applicability have been conducted. A sample of three local areas, encompassing more than 12,000 plots in low-density residential areas and representative of different socioeconomic profiles, were selected in the metropolitan area of Barcelona and along the Mediterranean coast of Catalonia. The reliability and sufficiency of the Spanish cadastre were assessed for the identification of swimming pools against the ground truth evidence provided by high-resolution aerial imagery and the support of object-based image analysis. Omission and commission errors of the cadastre were measured, the delimitation of digitized pool areas was statistically tested for accuracy, and the condition of the facilities was compared in the three study sites. The results do not support the use of the Spanish cadastre as a source of data for uses requiring a high level of detail and completeness. Plot size, socioeconomic and cultural factors affect pool size, the frequency of empty pools and the installation of pool covers in different communities. The study demonstrates that researchers need to complement cadastral data with qualitative information about the condition of the swimming pools to successfully estimate their cumulative water consumption at larger scales. Implications for water use research and spatial planning are discussed.