bluuebunny/crossref_metadata_2025 huggingface dataset:
A fractional Fourier transform-based method to detect impacts between the bogie and the car body of a railway vehicle: A data-driven approach
Authors: Gutiérrez-Carvajal RE , Betancur German R , Castañeda Leonel F , Zajac G
Published: October 2016

Structural railway transport elements are typically designed to work for at least 30 years without undergoing major maintenance. However, real-life operational conditions present behaviors different to the model predicted during the initial design phase, which affects the lifetime of the elements in question. This is the case of first-generation railway vehicles which operates in the city of Medellín, Colombia, as the bolster beam presented cracks after 12 years of operation, possibly due to undesired impacts between the bogie and the pivot of the bolster beam. Monitoring vibrational signals would give some sort of an insight into impact phenomena; however, herein lies the problem, as they are difficult to identify using only vibration signals, occurring during time events that take place in a speed-varying system. In this article, the authors present a technique that automatically detects impacts using multiple in-between time/frequency representations, ranking them according to their capacity to discriminate between impact events. Our results show that the best representation for this data was the Fractional Cepstrum Transform at order 0.5 (auROC = 0.961), which outperformed the best pure domain descriptor by least 4%.
Using visual analytics to make sense of railway Close Calls
Authors: Figueres-Esteban Miguel , Hughes Peter , van Gulijk Coen
Published: October 2016

In the big data era, large and complex data sets will exceed scientists’ capacity to make sense of them in the traditional way. New approaches in data analysis, supported by computer science, will be necessary to address the problems that emerge with the rise of big data. The analysis of the Close Call database, which is a text-based database for near-miss reporting on the GB railways, provides a test case. The traditional analysis of Close Calls is time consuming and prone to differences in interpretation. This paper investigates the use of visual analytics techniques, based on network text analysis, to conduct data analysis and extract safety knowledge from 500 randomly selected Close Call records relating to worker slips, trips and falls. The results demonstrate a straightforward, yet effective, way to identify hazardous conditions without having to read each report individually. This opens up new ways to perform data analysis in safety science.
Beyond the ‘train-first’/‘work-first’ dichotomy: How welfare states help or hinder maternal employment
Authors: Kowalewska Helen
Published: October 2016

Since the mid-1990s, welfare states have introduced various ‘activation’ policies designed to promote employment. Most typologies distinguish between a Nordic-style ‘train-first’ approach focused on developing jobseekers’ employability and an Anglo-Saxon ‘work-first’ approach that instead emphasises quick job (re-)entry. These typologies tell us what activation means for the unemployed (male) worker. However, by ignoring the family, they overlook what activation means for the (female) parent-worker with childcare responsibilities. To contribute to filling this gap, this article uses fuzzy-set ideal-type analysis to compare 22 countries representing five ‘worlds’ of welfare by how (de-)activating their labour market policies, parental leave provisions, childcare services and the scheduling of primary education are for lone mothers. It reveals that cross-national variations in support for maternal activation are not well captured by the Nordic-style ‘train-first’/Anglo-Saxon ‘work-first’ dichotomy. Hence, despite the greater attention to gender and ‘new social risks’ within comparative social policy scholarship in recent years, the activation literature remains gender-blind.
Is it better to invest in hard or soft skills?
Authors: Balcar Jiří
Published: October 2016

Increasing awareness of the productive potential of soft skills has sparked a discussion of their systematic and purposeful development. However, education systems pay only limited attention to this topic in most countries and remain focused on the development of hard skills. Is this approach rational or inadequate? This article provides new evidence on different aspects of the wage returns to soft skills (as an approximation of their productivity), and thereby contributes significantly to the discussion of the role of educational institutions in their development. It provides evidence that soft skills are as productive as hard skills. Moreover, it suggests that the productivity of hard skills stems from their combination with soft skills. These conclusions do not correspond to the fact that the value of education is intermediated mainly by hard skills, resulting in unequal development of soft and hard skills in schools. While concluding that education systems should pay more attention to soft skills development, the analysis recognises that this attention should be differentiated according to employers’ needs, owing to substantial differences in the value of soft skills across economic sectors. It is also noteworthy that while significant gender differences in returns to hard skills were identified, wage returns to soft skills appear gender neutral.
Unsustainable Wind Turbine Blade Disposal Practices in the United States
Authors: Ramirez-Tejeda Katerin , Turcotte David A. , Pike Sarah
Published: October 2016

Finding ways to manage the waste from the expected high number of wind turbine blades in need of disposal is crucial to harvest wind energy in a truly sustainable manner. Landfilling is the most cost-effective disposal method in the United States, but it imposes significant environmental impacts. Thermal, mechanical, and chemical processes allow for some energy and/or material recovery, but they also carry potential negative externalities. This article explores the main economic and environmental issues with various wind turbine blade disposal methods. We argue for the necessity of policy intervention that encourages industry to develop better technologies to make wind turbine blade disposal sustainable, both environmentally and economically. We present some of the technological initiatives being researched, such as the use of bio-derived resins and thermoplastic composites in the manufacturing process of the blades.
The Effects of Mindfulness Meditation on Hope and Stress
Authors: Munoz Ricky T. , Hoppes Steve , Hellman Chan M. , Brunk Kara L. , Bragg Jedidiah E. , Cummins Carissa
Published: October 2016

Purpose:

To evaluate mindfulness meditation as an antecedent of reductions in stress and increases in hope.

Method:

A quasi-experimental design ( N = 46; meditation group, n = 23; comparison group, n = 23) using a community sample was used to evaluate the impact of mindfulness meditation on stress and hope. A path analysis was also used to model a directional relationship between meditation participation and increases in hope mediated by reductions in stress.

Results:

The data indicated that the meditation group exhibited significantly higher hope and lower stress than the comparison group. The path analysis indicated that reductions in stress fully mediated the relationship between mindfulness meditation and increases in hope.

Discussion:

The data support that meditation can increase hope via stress reduction. The results suggest a need for further research into mindfulness meditation and hope, especially since increasing hope is a fundamental aim of strengths-based practice.
Association of Acetaminophen and Ibuprofen Use With Wheezing in Children With Acute Febrile Illness
Authors: Matok Ilan , Elizur Arnon , Perlman Amichai , Ganor Shani , Levine Hagai , Kozer Eran
Published: October 2016

Background: Many infants and children receive acetaminophen and/or ibuprofen during febrile illness. Previously, some studies have linked acetaminophen and ibuprofen use to wheezing and exacerbation of asthma symptoms in infants and children. Objective: To assess whether acetaminophen or ibuprofen use are associated with wheezing in children presenting to the emergency department (ED) with febrile illness. Methods: This was a cross-sectional study of children who presented with fever to the pediatric ED between 2009 and 2013. The data were collected from questionnaires and from the children’s medical files. Patients with wheezing in the ED were compared with nonwheezing patients. Associations between medication use and wheezing were assessed using univariate and multivariate analyses. The multivariate analysis adjusted for potential confounding variables (ie, age, atopic dermatitis, allergies, smoking, antibiotics use, etc) via propensity scores. Results: During the study period, 534 children admitted to the ED met our inclusion criteria, of whom 347 (65%) were included in the study. The use of acetaminophen was similar in children diagnosed with wheezing compared with those without wheezing (n = 39, 81.3%, vs n = 229, 82.7%, respectively). Ibuprofen use was significantly lower in children diagnosed with wheezing (n = 22, 52.4%, vs n = 168, 69.4%, respectively). In multivariate analysis, acetaminophen was not associated with a higher rate of wheezing during acute febrile illness (adjusted odds ratio [OR] = 0.76, 95% CI = 0.24- 2.39), whereas ibuprofen was associated with a lower risk of wheezing (adjusted OR = 0.36, 95% CI = 0.13-0.96). Conclusions: Our study suggests that acetaminophen and ibuprofen are not associated with increased risk for wheezing during acute febrile illness.
Taking One for the Team
Authors: Moules Nancy J. , Estefan Andrew , McCaffrey Graham , Tapp Dianne M. , Strother Douglas
Published: October 2016

In this Part 2 of a three-part research paper, we further our interpretations from our hermeneutic study examining how having a child who has experienced cancer had an impact on the relationship between the parents. In Part 1, we identified the focus of the study and provided background to the topic. We also described the research question, method, and design before offering an interpretive analysis of couples whose relationships survived, thrived, or demised. In this article, we extend the interpretations under an overarching theme of “taking one for the team.” Here, we discuss issues of changes in focus and roles, and the notions of tag teaming, protection, intimacy, and grieving. We examine the phenomenon of putting relationships on hold, then finding reclamation later. In Part 3, we offer implications of these findings for other parents in similar situations and for health care professionals working with these families.
Challenges for an English-Speaking American Nurse Working in Rwanda
Authors: Smith Carrol A. M.
Published: October 2016

An American, English-speaking nurse discusses language and cultural issues while working for a year in Rwanda, East Africa.
Addressing Problem Behavior at Recess Using Peer Praise Notes
Authors: Teerlink Elise , Caldarella Paul , Anderson Darlene H. , Richardson Michael J. , Guzman E. Geovanni
Published: October 2016

School recess, though beneficial to students in many ways, can be a problematic setting due to inadequate supervision, structure, and safety. A peer praise note (PPN) intervention was implemented on the recess playground to address these concerns at a Title I elementary school. Researchers used a single-subject reversal design across all students to evaluate intervention effectiveness. Results included overall improvements in the level, trend, and variability of office discipline referrals (ODRs), especially from reversal to reinstatement of the intervention, and an effect size (percentage of data points exceeding the median; PEM) suggesting that PPNs effectively decreased ODRs. Results from social validity surveys completed by recess aides and students indicated participants’ perceptions that PPNs helped improve student behavior and peer relations, communicate playground rules, extend supervision responsibilities, and offer structured activity to peer praisers. Limitations, future research, and implications are addressed.
Development and implementation of a hospital-based trauma response system in an urban hospital in San Salvador, El Salvador
Authors: Cioè-Peña EC , Granados JC , Wrightsmith LL , Henriquez-Vigil AL , Moresky RT
Published: October 2016

Background

In El Salvador, over 32% of all deaths are due to trauma. However, El Salvador lacks any established standardized trauma response system to treat the most critical of Salvadoran patients. In an effort to improve trauma response in El Salvador, we assessed the impact of a trauma-specific skills training, which could improve trauma care in a setting where no formal trauma training exists.

Methods

We used a pre- and post-interventional design study to measure the critical actions performed during a trauma event, as well as the case-fatality rate, emergency ward-to-operating room time, and utilization of ultrasound. The intervention was a primary trauma care course taught to all study participants.

Results

Eighteen providers were observed over a six-month period and 194 patient encounters (48 pre- and 146 post-intervention) were recorded. There was no significant difference in observed critical actions during major trauma between the pre-intervention and post-intervention periods. There was a significant improvement in ultrasound usage post-intervention (9.5% to 21.4%; p = 0.04).

Conclusion

The lack of behavior change observed following a two-day trauma training underscores the gap between physician knowledge and applied behavior change. This is a limited single center study, but further examination is necessary to determine the role of two-day training courses in the larger context of behavior change within a health system that has no formal post-graduate training in or defined algorithmic trauma care.
Facial injuries: Triage and applying damage control principles
Authors: Perry Mike
Published: October 2016

Facial trauma varies widely in its severity and is also frequently associated with other injuries which can make prioritisation of injuries difficult. An effective method of triage is important to ensure this. This article describes one such approach and discusses the application of damage control principles to facial injuries. Both these issues commonly impact on the management of multiply injured patients with coexisting facial injuries during the initial stages of resuscitation or soon afterwards. Understanding facial trauma is based in part, on parallels with orthopaedic trauma.
The language of objectivity: Reuters’ internal editorial discussions on terminology in the Arab–Israeli conflict, 1967–1982
Authors: Goodman Giora , Boudana Sandrine
Published: October 2016

Influenced by British journalistic traditions, Reuters is a global news agency embracing impartiality as a corporate norm rather than a professional standard. This impartiality, reflected in a careful choice of vocabulary, is meant to satisfy all of Reuters’ subscribers. However, our study of Reuters’ archives demonstrates that this corporate objectivity is not an absolute principle, but the subject of internal debates and tensions, often provoked by subscribers’ reactions to particular news items. This is especially so in the case of the long-lasting and highly demanding coverage of the Arab–Israeli conflict. Focusing on the 1967–1982 period, when the internal debates at Reuters proved to be particularly tense, our archival research revealed that discussions between the London headquarters and the Middle East offices revolved around four major issues, which are the focus of this article: (1) emotive wording, (2) naming of borders and capitals, (3) use of the term ‘Palestinian’ and (4) the ‘terrorist’ and ‘guerrilla’ labels. Analysis of the real-time recording of editorial difficulties faced by Reuters over the Arab–Israeli conflict in the 1960s and 1970s demonstrates how crucial, yet Quixotic, is Reuters’ ambition to reach consensus on a language of objectivity.
Beyond here, beyond now, beyond human: reflecting on ghostly presences in field research
Authors: Edwards Amanda
Published: October 2016

The research encounter can be understood as an interaction between an individuated researcher positioned inside or outside a community or culture, a more fluid researcher testing and sometimes crossing the permeable boundaries of a shifting community, or a brief, fragile entanglement of dynamic trajectories. Within this last, relational approach, previous work identifies the agency of multiple past and present human social relationships in the co-construction of the research story, however, there has been limited reflection on (bio)physical, geographical, artefactual and other more-than-human entanglements. In this article, I use a creative, non-fiction approach to describe the processes, and challenges, involved in developing a dynamic, relational understanding of research encounters through an exploration of how (bio)physical, geographical, artefactual and other presences interact with ghostly geographies, histories and imaginaries in persons and places to influence the generation and analysis of research data.
Making space along the Kemi River: a fluvial geography in Finnish Lapland
Authors: Krause Franz
Published: October 2016

This article illustrates how the main direction of water flow along the Kemi River has entered into the understanding of space in central Finnish Lapland, evident in expressions used for orientation, as well as in place and family names. The article demonstrates how fluvial space-making resonates with the riverbank inhabitants’ engagement with and stories about the river’s flows, especially in fishing, travel and transport. It also shows how a north–south imaginary corresponds with fluvial space on the Kemi. I propose the term ‘fluvitory’ to shift attention from territory to water flows in understanding space-making and argue that moving water must be acknowledged as an active participant in the stories that make space.
Proactive Response Inhibition and Subcortical Gray Matter Integrity in Traumatic Brain Injury
Authors: Hermans Lize , Beeckmans Kurt , Michiels Karla , Lafosse Christophe , Sunaert Stefan , Coxon James P. , Swinnen Stephan P. , Leunissen Inge
Published: October 2016

Background. Traumatic brain injury (TBI) has been associated with impairments in inhibiting prepotent motor responses triggered by infrequent external signals (ie, reactive inhibition). It is unclear whether proactive preparation to inhibit upcoming responses is also affected (ie, proactive inhibition). Successful inhibition relies on frontosubcortical interactions; therefore, impairments might be linked with gray matter atrophy in subcortical structures. Objective. We investigated reactive and proactive inhibition in TBI and control groups, and their relationship with subcortical gray matter. Methods. Participants performed a response inhibition task in which the probability of stopping was manipulated. Reactive inhibition was measured as the stop-signal reaction time (SSRT) when the probability of stopping was low. Proactive inhibition was measured as the change in SSRT and in go response time with increasing probability of stopping. Subcortical gray matter structures were automatically segmented with FSL-FIRST. Group differences in subregional volume and associations with reactive and proactive inhibition efficiency were investigated using shape analysis. Results. Reactive inhibition was impaired in TBI, as indicated by longer SSRTs. Moreover, the degree of atrophy in subregions of subcortical structures was predictive for SSRT in TBI. In contrast, proactive inhibition was not affected because both groups showed no response time slowing as a function of stopping probability. Proactive inhibition efficiency could be predicted by local volume in the anterior left putamen, bilateral pallidum, and right thalamus in controls but not in TBI. Conclusions. Our results reveal that proactive inhibition seems unaffected in TBI and that volume of subregions of subcortical nuclei is predictive for response inhibition proficiency and of clinical relevance in TBI.
Characterization of Pancreaticojejunal Anastomotic Healing in a Porcine Survival Model
Authors: Khajanchee Yashodhan S. , Johnston W. Cory , Cassera Maria A. , Hansen Paul D. , Hammill Chet W.
Published: October 2016

Introduction: Anastomotic leak after pancreaticoduodenectomy is the most important cause of postoperative morbidity and mortality. Histological studies of bowel anastomoses have provided valuable insights regarding causes of anastomotic failure. However, this crucial information is lacking for pancreatico-enteric anastomoses. Methods: Pancreaticoduodenectomy was performed in a porcine model. Animals were survived up to 10 days and then the pancreatico-enteral anastomosis specimen was resected en bloc. Anastomotic bursting pressure was measured and histological sections of the anastomoses were examined. Results: Six out of 8 animals had excellent healing of the anastomoses. One animal developed a clinically significant leak at the pancreaticoduodenal anastomosis (12.5%) and one animal had a subclinical duodeno-duodenal leak discovered on necropsy (12.5%). Both anastomoses that failed had a collagen-to-tissue ratio less than 40%. In contrast, none of the anastomoses with a ratio greater than 40% showed any evidence of disruption. Conclusion: Our results indicate that quantitative measurement of collagen deposition at the pancreatic anastomosis provides objective assessment of healing of the pancreatic anastomosis. A survival porcine model of pancreaticoduodenectomy results in a similar leak rate to published data on pancreaticoduodenectomy in humans and will be useful for future studies assessing novel pharmacologic or technical interventions aimed at improving outcomes.
Management of Intra-Articular Distal Radius Fractures: Volar or Dorsal Locking Plate—Which Has Fewer Complications?
Authors: Abe Yoshihiro , Tokunaga Susumu , Moriya Takuro
Published: October 2016

Background: The aim of this study was to compare the functional outcomes and complications of volar and dorsal plating for the management of intra-articular distal radius fractures, with special regard to indications for dorsal plating. Furthermore, we examine the rationale for choosing dorsal plating and its frequency of use. Methods: Clinical assessments included range of motion measurements at the wrist; grip strength; the Quick Disabilities of the Arm, Shoulder, and Hand score; and the Gartland and Werley score. Clinical results were compared with those achieved using a volarly placed locking plate system. According to Lutsky’s plate theory, the rationale for choosing dorsal plating was based on 4 types of pathologic fractures. Results: Of 112 patients, 38 patients were treated with open reduction internal fixation via a dorsal approach and 68 patients were treated using a volar approach. Except for wrist flexion, there were no other statistical differences in the clinical results between groups for both subjective and objective parameters. There were no statistically significant differences in the complication rates between the volar and dorsal plated groups. One serious complication occurred after volar plating. The most common reason for choosing dorsal plating was irreducible dorsal die-punch fractures. Conclusions: The treatment of displaced intra-articular distal radius fractures with a dorsally versus a volarly placed interlocking plate system demonstrated similar clinical results. Postoperative complications were not readily observed in the patients treated with a dorsal locking plate. Certain fracture patterns are more appropriately stabilized using a dorsal plate fixation.
Factors Affecting Appropriateness of Interfacility Transfer for Hand Injuries
Authors: Petkovic Djuro , Wongworawat Montri D. , Anderson Scott Richard
Published: October 2016

Background: Transfers of patients with higher acuity injuries to trauma centers have helped improve care since the enactment of Emergency Medical Treatment and Active Labor Act. However, an unintended consequence is the inappropriate transfer of patients who do not truly require handover of care. Methods: We retrospectively reviewed the records of all patients transferred to our level I trauma center for injuries distal to the ulnohumeral joint between April 1, 2013, and March 31, 2014; 213 patients were included. We examined the records for appropriateness of transfer based on whether the patient required the care of the receiving hospital’s attending surgeon (appropriate transfer) or whether junior-level residents treated the patient alone (inappropriate transfer) and calculated odds ratios. We performed logistic regression to identify factors associated with appropriateness of transfer; these factors included specialist evaluation prior to transfer, age, insurance status, race, injury type, sex, shift time, distance traveled, and median income. Results: The risk of inappropriate transfers was 68.5% (146/213). Specialist evaluation at the referring hospital was not associated with a lower risk of inappropriate transfers (odds ratio 1.62 [95% CI: 0.48-5.34], P = .383). Only evening shift (15:01 to 23:00) was associated with inappropriate transfers. Amputations and open fractures were associated with appropriate transfers. Conclusion: Second shift and type of injury (namely, amputations and open fractures) were significant factors to appropriateness of transfer. No significant association was found between specialist evaluation and appropriate transfers. Future studies may focus on finding reasons and aligning incentives to minimize inappropriate transfers and associated systems costs.
Lifestyle Approaches to White Coat Hypertension
Authors: Hubkova Tereza
Published: October 2016

This case presentation illustrates the importance of 24 hour ambulatory blood pressure monitoring in patients with white coat hypertension, as many progress into sustained hypertension over time. Also, it serves as a reminder not to overlook a possible underlying sleep breathing disorder in patients who are not obese or fatigued. Finally, the case provides an opportunity to review the value of non-pharmacological and lifestyle approaches to the treatment of both white coat hypertension and sustained hypertension.
Effects of etomidate in the adrenal and cytokine responses to hemorrhagic shock in rats
Authors: Félix Nuno M , Goy-Thollot Isabelle , Walton Ronald S , Gil Solange A , Mateus Luísa M , Matos Ana S , Niza Maria MRE
Published: October 2016

Hemorrhagic shock (HS) induces a compensatory endocrine and cytokine response which aims to restore homeostasis. This response can be modulated by general anesthetics. To our knowledge, no studies have evaluated if etomidate modulates this response in experimental HS. After being premedicated with buprenorphine (0.05 mg/kg subcutaneously), male Wistar rats were anaesthetized with 5% isoflurane and divided into three groups: G1 (control, n = 16), G2 (n = 13), and G3 (n = 14). G2 and G3 were subjected to HS by collecting 30% of their blood volume and resuscitated 90 min later with the collected blood and normal saline, in a 1:3 ratio, respectively. G3 received etomidate (1 mg/kg IV) before HS. Blood gas analysis, adrenocorticotropic hormone (ACTH), corticosterone, and plasma levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 and of TNF-α, IL-6, and IL-10 mRNA obtained through real-time polymerase chain reaction (RT-PCR) were measured at 0, 90, 150, and 240 min after HS induction. Compared with G2, etomidate-treated animals had significantly lower corticosterone, PO2, PO2/FiO2, base excess and HCO3, and higher TNF-α, IL-6, IL-10, and TNF-α mRNA levels ( P <0.05). Etomidate-treated rats showed impaired adrenal and increased cytokine response to HS and evidence of worse tissue oxygenation and lung dysfunction. Based on these results, and until further studies are performed to confirm if these findings occur in clinical patients, we suggest that etomidate should be used cautiously in HS.
Global stroke statistics
Authors: Thrift Amanda G , Thayabaranathan Tharshanah , Howard George , Howard Virginia J , Rothwell Peter M , Feigin Valery L , Norrving Bo , Donnan Geoffrey A , Cadilhac Dominique A
Published: October 2016

Background

Up to date data on incidence, mortality, and case-fatality for stroke are important for setting the agenda for prevention and healthcare.

Aims and/or hypothesis

We aim to update the most current incidence and mortality data on stroke available by country, and to expand the scope to case-fatality and explore how registry data might be complementary.

Methods

Data were compiled using two approaches: (1) an updated literature review building from our previous review and (2) direct acquisition and analysis of stroke events in the World Health Organization (WHO) mortality database for each country providing these data. To assess new and/or updated data on incidence, we searched multiple databases to identify new original papers and review articles that met ideal criteria for stroke incidence studies and were published between 15 May 2013 and 31 May 2016. For data on case-fatality, we searched between 1980 and 31 May 2016. We further screened reference lists and citation history of papers to identify other studies not obtained from these sources. Mortality codes for ICD-8, ICD-9, and ICD-10 were extracted. Using population denominators provided for each country, we calculated both the crude mortality from stroke and mortality adjusted to the WHO world population. We used only the most recent year reported to the WHO for which both population and mortality data were available.

Results

Fifty-one countries had data on stroke incidence, some with data over many time periods, and some with data in more than one region. Since our last review, there were new incidence studies from 12 countries, with four meeting pre-determined quality criteria. In these four studies, the incidence of stroke, adjusted to the WHO World standard population, ranged from 76 per 100,000 population per year in Australia (2009–10) up to 119 per 100,000 population per year in New Zealand (2011–12), with the latter being in those aged at least 15 years. Only in Martinique (2011–12) was the incidence of stroke greater in women than men. In countries either lacking or with old data on stroke incidence, eight had national clinical registries of hospital based data. Of the 128 countries reporting mortality data to the WHO, crude mortality was greatest in Kazhakstan (in 2003), Bulgaria, and Greece. Crude mortality and crude incidence of stroke were both positively correlated with the proportion of the population aged ≥ 65 years, but not with time. Data on case-fatality were available in 42 studies in 22 countries, with large variations between regions.

Conclusions

In this updated review, we describe the current data on stroke incidence, case-fatality and mortality in different countries, and highlight the growing trend for national clinical registries to provide estimates in lieu of community-based incidence studies.
Breaking up sitting time after stroke (BUST-Stroke)
Authors: Janssen Heidi , Dunstan David W , Bernhardt Julie , Walker Frederick R , Patterson Amanda , Callister Robin , Dunn Ashlee , Spratt Neil J , English Coralie
Published: October 2016

Rationale

Prolonged sitting is associated with an increased risk of cardiovascular and all-cause mortality and morbidity. The metabolic and cardiovascular effects of breaking up sitting time in people with stroke are unknown.

Aims and hypotheses

To determine the (i) metabolic and cardiovascular effects and (ii) safety and feasibility of an experimental protocol to break up uninterrupted sitting in people with stroke. We hypothesize that activity breaks will attenuate the effects of uninterrupted sitting on glucose and insulin metabolism, blood pressure, lipid profiles, and plasma fibrinogen and that it will be both safe and feasible.

Sample size estimate

Based on previous estimates of population variability (SD 1% glucose and 30% insulin), 19 paired observations (i.e. participants) will achieve a power of 0.9 to detect a difference of 0.8% in glucose and 24% in insulin area under the curve (two-tailed testing, α = 0.05).

Methods and design

People with stroke will complete three experimental conditions one week apart in randomized order: (a) uninterrupted sitting, (b) prolonged sitting with intermittent walking, and (c) prolonged sitting with intermittent standing exercises. Serial blood samples will be collected and blood pressure measured at 30 min intervals for 8 h.

Study outcomes

Primary outcome will be postprandial glucose and insulin responses. Secondary outcomes will include fibrinogen concentrations, blood pressure, and adverse events and protocol feasibility.

Discussion

This is the first important step in determining the cardiovascular effects of breaking up sitting time after stroke. Findings will guide future studies testing behavioral strategies to reduce sitting time for the purpose of lowering recurrent stroke risk.
New IL-15 receptor-α splicing variants identified in intestinal epithelial Caco-2 cells
Authors: Escudero-Hernández Celia , Martínez-Abad Beatriz , Ruipérez Violeta , Garrote José A , Arranz Eduardo
Published: October 2016

IL-15 is a pleiotropic cytokine related to IL-2 which acts at a broader level than its counterpart. It is presented through its specific high-affinity receptor, IL-15Rα. Both cytokine and receptor are tightly regulated at multiple levels and are widely distributed. Thus, deregulation of their expression leads to an inflammatory immune response. Variants of splicing of IL-15Rα have been described in immune and barrier cells; however, their presence has not been focused on intestinal epithelial cells. In this study, we describe five new alternative variants of splicing of IL-15Rα in Caco-2 cells. Four of them were expressed into proteins inside Caco-2 cells, but these were unable to bind IL-15 or to follow the secretory pathway. However, the expression of mRNA itself might be relevant to diseases such as celiac disease, inflammatory bowel disease or colorectal cancer.
Management of desmoid tumours: A large national database of familial adenomatous patients shows a link to colectomy modalities and low efficacy of medical treatments
Authors: Walter T , Zhenzhen Wang C , Guillaud O , Cotte E , Pasquer A , Vinet O , Poncet G , Ponchon T , Saurin J‐C
Published: October 2016

Background

Desmoid tumours represent a major complication of familial adenomatous polyposis. Our aims were to study the factors associated with the development of desmoid tumours in familial adenomatous polyposis patients, and to describe presentation and management of desmoid tumours.

Methods and patients

We reviewed all patients with familial adenomatous polyposis followed at our institution between 1965–2013, with either identified adenomatous polyposis coli gene mutation, or a personal and family history suggesting adenomatous polyposis coli‐related polyposis. Response to treatment of desmoid tumours was assessed by Response Evaluation Criteria In Solid Tumor (RECIST) criteria.

Results

A total of 180 patients with familial adenomatous polyposis were included with a median follow‐up of 19 years since diagnosis. Thirty‐one (17%) patients developed 58 desmoid tumours, a median (range) 4.7 (0.8–41.6) years after their diagnosis of familial adenomatous polyposis. The only factor significantly associated with occurrence of desmoid tumours was the type of surgery: 12 (12%) desmoid tumours in 104 patients treated by colectomy, versus 19 (25%) desmoid tumours in 76 patients treated by proctocolectomy, p  = 0.027. The localisation of desmoid tumours was: mesenteric (n  = 25), abdominal wall (n  = 30) or extra‐abdominal (n  = 3). Nineteen patients underwent 36 surgical procedures for desmoid tumours. Recurrence occurred in 26 (72%) cases and the recurrence‐free survival was 2.6 (95% confidence interval (CI), 0.2–5.9) years. Thirteen patients received 27 medical treatments over a median 14 months. Objective response was observed in four (15%) patients and the median progression‐free survival was nine (95% CI, 1.1–16.9) months.

Conclusion

If confirmed, colectomy (versus proctocolectomy) should be performed in adenomatous polyposis coli‐related familial adenomatous polyposis patients to avoid desmoid tumours. We show that there is a high prevalence of post‐surgical recurrence and the low efficacy of available medical treatments for desmoid tumours.
Cross-Sectional Analysis of Alcohol Intake and Serum Antibodies to Oral Microorganisms
Authors: Merchant A.T. , Park Y.M. , Dodhia S. , Shrestha D. , Choi Y.H. , Pitiphat W.
Published: October 2016

The objective of this study was to evaluate the relation between alcohol intake and groups of periodontal antibody titers among individuals with normal glucose tolerance (NGT), prediabetes and diabetes. This was a cross-sectional analysis of the National Health and Nutrition Examination Survey III (NHANES III) 1988–1994 data, among individuals 40 y and older with information on alcohol intake and serum immunoglobulin G (IgG) antibody data against 19 oral microorganisms. Participants were excluded if they did not have teeth, reported that they were taking insulin, or having gestational diabetes. The sample size for this analysis was 3,219. Periodontal antibodies were grouped into four clusters using cluster analysis: Orange-Red, Red-Green, Yellow- Orange, and Orange-Blue. Cluster scores were computed for each individual by summing z-scores of standardized log-transformed IgG titers of antibodies against periodontal microorganisms making up each respective cluster. Each cluster score was modeled as an outcome. Alcohol consumption was assessed in g/day using self-reported number of days of drinking in the past 12 mo and the average number of drinks consumed per day on days when they drank. Overall, alcohol intake was positively associated with periodontal antibodies of the Orange-Red cluster (P. melaninogenica, P. intermedia, P. nigrescens, and P. gingivalis), and inversely associated with the Yellow-Orange cluster (S. intermedius, S. oralis, S. mutans, F. nucleatum, P. micra, C. ochracea) after multivariable adjustment. The association between alcohol intake and the Orange-Red cluster was strongest among individuals with diabetes; this relation was seen among individuals with and without periodontal damage. The Orange-Red cluster was positively associated with periodontal damage among individuals with diabetes. Alcohol intake was not associated with any antibody cluster among individuals with NGT or prediabetes. The effect of alcohol intake on periodontal disease may be greater among individuals with diabetes but this finding needs to be confirmed in prospective studies.

Knowledge Transfer Statement: The results of this study can be used by clinicians when treating patients with periodontal disease and diabetes.
Toward Korean Contextualization: An Evangelical Perspective
Authors: Hong Seung Min
Published: October 2016

A major call for contextualized Christianity was issued in Korea more than three decades ago, yet today there are very few examples of contextualized theology in Korea. I first review how contextualization has been dealt with in Korean Christianity. I then revisit the basic meaning of contextualization and emphasize the theological and reciprocal nature of the concept. Finally, I provide examples of what contextualized theology might look like in Korea, focusing on spiritual entities and ancestors, two topics that are prevalent in the Korean socioreligious context.
The Axial Age, Axiality, and the Missionary Enterprise
Authors: Lindenfeld David
Published: October 2016

This article reviews recent literature on the Axial Age as a phase of world history and seeks to illuminate the role of Christian missionaries as part of this broad perspective. Introduced by Karl Jaspers in 1949, the concept has attracted attention from scholars interested in human development. The cognitive psychologist Merlin Donald views it as the third stage of “brain-culture co-evolution,” which draws on the external memory storage that literacy provides. I argue that missionaries have been central agents in conveying such stored knowledge to non-axial cultures.
MAF protein mediates innate resistance to proteasome inhibition therapy in multiple myeloma
Authors: Qiang Ya-Wei , Ye Shiqiao , Chen Yu , Buros Amy F. , Edmonson Ricky , van Rhee Frits , Barlogie Bart , Epstein Joshua , Morgan Gareth J. , Davies Faith E.
Published: October 2016

Key Points

High expression of MAF protein in myeloma due to t(14;16) translocation confers innate resistance to PIs. PIs prevent GSK3-mediated degradation of MAF protein, which further augments the resistance to PIs in t(14:16) myeloma.
CML cells actively evade host immune surveillance through cytokine-mediated downregulation of MHC-II expression
Authors: Tarafdar Anuradha , Hopcroft Lisa E. M. , Gallipoli Paolo , Pellicano Francesca , Cassels Jennifer , Hair Alan , Korfi Koorosh , Jørgensen Heather G. , Vetrie David , Holyoake Tessa L. , Michie Alison M.
Published: October 2016

Key Points

MHC-II and its master regulator CIITA are downregulated in CML stem/progenitor cells in a BCR-ABL kinase–independent manner. JAK1/2 inhibition increased MHC-II expression, suggesting elevation of CML immunogenicity may provide a way to reduce CML persistence.
Noninvasive ventilation during the weaning process in chronically critically ill patients
Authors: Sancho Jesus , Servera Emilio , Jara-Palomares Luis , Barrot Emilia , Sanchez-Oro-Gómez Raquel , Gómez de Terreros F. Javier , Martín-Vicente M. Jesús , Utrabo Isabel , Núñez M. Belen , Binimelis Alicia , Sala Ernest , Zamora Enrique , Segrelles Gonzalo , Ortega-Gonzalez Angel , Masa Fernando
Published: October 2016

Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process.

We conducted a prospective study that included chronically critically ill patients admitted to Spanish respiratory care units. The weaning method used consisted of progressive periods of spontaneous breathing trials. Patients were transferred to NIV when it proved impossible to increase the duration of spontaneous breathing trials beyond 18 h.

231 chronically critically ill patients were included in the study. 198 (85.71%) patients achieved weaning success (mean weaning time 25.45±16.71 days), of whom 40 (21.4%) needed NIV during the weaning process. The variable which predicted the need for NIV was arterial carbon dioxide tension at respiratory care unit admission (OR 1.08 (95% CI 1.01–1.15), p=0.013), with a cut-off point of 45.5 mmHg (sensitivity 0.76, specificity 0.67, positive predictive value 0.76, negative predictive value 0.97).

NIV is a useful tool during weaning in chronically critically ill patients. Hypercapnia despite mechanical ventilation at respiratory care unit admission is the main predictor of the need for NIV during weaning.
Serum 1,25-Dihydroxyvitamin D as a Biomarker of the Absence of Hypercalciuria in Postsurgical Hypoparathyroidism
Authors: García-Pascual Luis , Barahona María José , Perea Verónica , Simó Rafael
Published: November 2016

Context:

Hypercalciuria is an adverse event of postsurgical hypoparathyroidism treatment that can lead to renal complications. The collection of 24-hour urine to detect hypercalciuria is often considered unreliable.

Objective:

The purpose of this study was to find useful predictive biomarkers of hypercalciuria in patients with permanent postsurgical hypoparathyroidism receiving treatment with oral calcium and calcitriol supplements.

Design and Setting:

The investigation was designed as a prospective cross-sectional study. An outpatient hospital clinic served as the study setting.

Patients:

Fifty-four consecutive observations were made of 34 stable outpatients with postsurgical hypoparathyroidism taking oral calcium and calcitriol supplements, and 17 adult controls without hypoparathyroidism.

Intervention:

There were no interventions.

Main Outcome Measure:

Hypercalciuria was defined as 24-hour urine calcium >300 mg.

Results:

Patients without hypercalciuria (n = 21) vs those with hypercalciuria (n = 33) had lower levels of serum 1,25-dihydroxyvitamin D (33.5 ± 11.9 pg/mL vs 45.8 ± 9.5 pg/mL; P < 0.001), similar albumin-corrected serum calcium (8.3 ± 0.5 vs 8.6 ± 0.5 mg/dL; P = nonsignificant), and serum parathyroid hormone (12.5 ± 5.7 vs 10.7 ± 6.8 pg/mL; P = nonsignificant). Multiple linear regression analysis showed an independent relationship between 1,25-dihydroxyvitamin D and urinary calcium excretion (B = 6.2 ± 1.423; P < 0.001). A cutoff value of 33.5 pg/mL for serum 1,25-dihydroxyvitamin D to predict the absence of hypercalciuria had 100% sensitivity and 63.6% specificity, and the area under the receiver operating characteristic curve was 0.797. No patients with serum 1,25-dihydroxyvitamin D levels of <33.5 pg/mL presented with hypercalciuria, regardless of the level of albumin-corrected serum calcium.

Conclusions:

Routine measurement of serum 1,25-dihydroxyvitamin D may be useful as a biomarker to predict the absence of hypercalciuria in patients with permanent postsurgical hypoparathyroidism who are receiving treatment with oral calcium and calcitriol supplements.
Temperature and evaporative water loss of leaf-sitting frogs: the role of reflection spectra
Authors: Herrerías-Azcué Francisco , Blount Chris , Dickinson Mark
Published: October 2016

The near infrared reflection peak in some frogs has been speculated to be either for enhancing crypticity, or to help them with thermoregulation. The theoretical background for the thermoregulatory processes has been established before, but little consideration has been given to the contribution from the frogs' reflection spectra differences. In this investigation, the reflection spectra from a range of different species of frogs were taken and combined with precise surface area measurements of frogs and an approximation to the mass transfer coefficient of agar frog models. These were then used to simulate the temperature and water evaporation in anurans with and without the near infrared reflective peak. We have shown that the presence of the near infrared reflection peak can contribute significantly to the temperature and evaporative water loss of a frog. The significance of the steady-state temperature differences between frogs with and without the near infrared reflection peak is discussed in a realistic and an extreme scenario. Temperature differences of up to 3.2°C were found, and the rehydration period was increased by up to 16.7%, although this does not reduce the number of rehydration events between dawn and dusk.