bluuebunny/crossref_metadata_2025 huggingface dataset:
Alkaloids Profiling of Fumaria capreolata by Analytical Platforms Based on the Hyphenation of Gas Chromatography and Liquid Chromatography with Quadrupole-Time-of-Flight Mass Spectrometry
Authors: Contreras María del Mar , Bribi Noureddine , Gómez-Caravaca Ana María , Gálvez Julio , Segura-Carretero Antonio
Published: November 2017

Two analytical platforms, gas chromatography (GC) coupled to quadrupole-time-of-flight (QTOF) mass spectrometry (MS) and reversed-phase ultrahigh performance liquid chromatography (UHPLC) coupled to diode array (DAD) and QTOF detection, were applied in order to study the alkaloid profile of Fumaria capreolata. The use of these mass analyzers enabled tentatively identifying the alkaloids by matching their accurate mass signals and suggested molecular formulae with those previously reported in libraries and databases. Moreover, the proposed structures were corroborated by studying their fragmentation pattern obtained by both platforms. In this way, 8 and 26 isoquinoline alkaloids were characterized using GC-QTOF-MS and RP-UHPLC-DAD-QTOF-MS, respectively, and they belonged to the following subclasses: protoberberine, protopine, aporphine, benzophenanthridine, spirobenzylisoquinoline, morphinandienone, and benzylisoquinoline. Moreover, the latter analytical method was selected to determine at 280 nm the concentration of protopine (9.6 ± 0.7 mg/g), a potential active compound of the extract. In conclusion, although GC-MS has been commonly used for the analysis of this type of phytochemicals, RP-UHPLC-DAD-QTOF-MS provided essential complementary information. This analytical method can be applied for the quality control of phytopharmaceuticals containing Fumaria extracts currently found in the market.
Lactonase Activity and Lipoprotein‐Phospholipase A2 as Possible Novel Serum Biomarkers for the Differential Diagnosis of Autism Spectrum Disorders and Rett Syndrome: Results from a Pilot Study
Authors: Hayek Joussef , Cervellati Carlo , Crivellari Ilaria , Pecorelli Alessandra , Valacchi Giuseppe
Published: November 2017

Rett syndrome (RTT) and autism spectrum disorders (ASDs) are not merely expression of brain dysfunction but also reflect the perturbation of physiological/metabolic homeostasis. Accordingly, both disorders appear to be associated with increased vulnerability to toxicants produced by redox imbalance, inflammation, and pollution, and impairment of systemic‐detoxifying agents could play a role in the exacerbation of these detrimental processes. To check this hypothesis, the activities of two mechanistically related blood‐based enzymes, paraoxonase‐1 (arylesterase, paraoxonase, and lactonase), and lipoprotein‐associated phospholipase A2 (Lp‐PLA2) were measured in the serum of 79 ASD and 95 RTT patients, and 77 controls. Lactonase and Lp‐PLA2 showed a similar trend characterized by significantly lower levels of both activities in ASD compared to controls and RTT (p < 0.001 for all pairwise comparisons). Noteworthy, receiving operator curve (ROC) analysis revealed that lactonase and, mostly, Lp‐PLA2 were able to discriminate between ASD and controls (lactonase: area under curve, AUC = 0.660; Lp‐PLA2, AUC = 0.780), and, considering only females, between ASD and RTT (lactonase, AUC = 0.714; Lp‐PLA2, AUC = 0.881). These results suggest that lactonase and, especially, Lp‐PLA2 activities might represent novel candidate biomarkers for ASD.
Calculation of Lead-Iron Double-Layer Thickness for Gamma-Ray Shielding by MATLAB Program
Authors: Lekchaum Sarai , Locharoenrat Kitsakorn
Published: November 2017

This contribution is aimed at designing the optimal thickness of lead-iron double-layer container to store a radioactive waste releasing the photon energy at 1.3325 MeV and initial radiation intensity at 100 mSv/hr using the optimization design by MATLAB software. This design consisted of three parts of calculations to achieve 1000 times the radiation attenuation of container. The first was the logarithmic interpolation for the mass attenuation coefficient. The second was the bilogarithmic interpolation for the exposure buildup factor. The third was the contour-plotting analytical technique for the optimal thickness of radiation container. The values of mass attenuation coefficient and exposure buildup factor were exactly validated as compared with the standard reference database. Furthermore, we have found that the optimal thickness was 3.2 cm for lead (1st layer) and 17.0 cm for iron (2nd layer). Container weight was 994.30 kg, whilst container cost was 167.30 USD. The benefit of our design can quickly and precisely apply for the radiation safety assessment of the occupational radiation workers who always work in the nuclear reactor area.
Confidence in Procedural Skills before and after a Two-Year Master’s Programme in Family Medicine in Gezira State, Sudan
Authors: Mohamed K. G. , Hunskaar S. , Abdelrahman S. H. , Malik E. M.
Published: November 2017

Many postgraduate family medicine training programmes have been developed to meet the worldwide dire need for practicing family physicians. This study was conducted in Gezira state of Sudan in a “before-and-after” design in the period of 2010–2012 with the aim to assess improvements in candidates’ confidence in performing certain clinical skills. A self-evaluation questionnaire was used with a five-grade scale (1–5) to assess candidates’ confidence in performing 46 clinical skills. A group of 108 participants responded for both the “before” and the “after” questionnaire: the response rate was 91% (before) and 90% (after). In general, a positive progress trend was detected. The mean skill value for all skills was 3.23 (before) and 3.93 (after) with a mean increase of 21.7% (P<0.001). Male students scored constantly higher than females both before and after completing the master’s programme, while females showed a higher percentage in progress. Scores in certain medical disciplines were higher than others. However, disciplines with low scores in the beginning, such as psychiatry and ophthalmology, showed the highest progress percentage. The results show a significant increase in confidence in performing procedural skills designed in the curriculum of the GFMP master’s programme.
Impact of Mesoscale Motions on Monin-Obukhov Similarity and Surface Energy Balance over a Homogeneous Surface
Authors: Guo Yang , Zuo Hongchao
Published: November 2017

Mesoscale motions are an important factor influencing the applicability of Monin-Obukhov similar theory (MOST) and the surface energy balance. The heterogeneous surface and the vegetation-covered surface also increase the complexity of these two problems. In order to understand the effect of mesoscale motions on turbulent fluxes more clearly, this study analyzes the impact of mesoscale motions on MOST and surface energy balance using the multiresolution decomposition method and the observational data over a homogeneous bare soil surface. Two conclusions are obtained: (1) When mesoscale motions are excluded, the scatter of similarity relations is evidently reduced; the observed values of the dimensionless velocity gradient and dimensionless temperature gradient in stable conditions become less than the values estimated using the universal functions, and the flux-variance relationship for temperature clearly deviates from the −1/3 power law. (2) When mesoscale motions are excluded, the number of energy balance closure outliers at night is dramatically reduced, and the energy balance ratio (EBR) is increased. However, when turbulent mixing is weak, even if mesoscale motions are excluded, the EBR is still relatively low, which is possibly due to the fact that the energy is mainly transported by mesoscale motions instead of turbulence.
Correlation between Cholesterol, Triglycerides, Calculated, and Measured Lipoproteins: Whether Calculated Small Density Lipoprotein Fraction Predicts Cardiovascular Risks
Authors: Khan Sikandar Hayat , Fazal Nadeem , Gilani Shah Athar Abbas , Manzoor Syed Mohsin , Asif Naveed , Ijaz Aamir , Niazi Najmusaqib Khan , Yasir Muhammad
Published: November 2017

Background. Recent literature in lipidology has identified LDL-fractions to be more atherogenic. In this regard, small density LDL-cholesterol (sdLDLc) has been considered to possess more atherogenicity than other LDL-fractions like large buoyant LDL-cholesterol (lbLDLc). Recently, Srisawasdi et al. have developed a method for calculating sdLDLc and lbLDLc based upon a regression equation. Using that in developing world may provide us with a valuable tool for ASCVD risk prediction. Objective. (1) To correlate directly measured and calculated lipid indices with insulin resistance, UACR, glycated hemoglobin, anthropometric indices, and blood pressure. (2) To evaluate these lipid parameters in subjects with or without metabolic syndrome, nephropathy, and hypertension and among various groups based upon glycated hemoglobin results. Design. Cross-sectional study. Place and Duration of Study. From Jan 2016 to 15 April 2017. Subjects and Methods. Finally enrolled subjects (male: 110, female: 122) were evaluated for differences in various lipid parameters, including measured LDL-cholesterol (mLDLc), HDLc and calculated LDL-cholesterol (cLDLc), non-HDLc, sdLDLC, lbLDLC, and their ratio among subjects with or without metabolic syndrome, nephropathy, glycation index, anthropometric indices, and hypertension. Results. Significant but weak correlation was mainly observed between anthropometric indices, insulin resistance, blood pressure, and nephropathy for non-HDLc, sdLDLc, and sdLDLc/lbLDLc. Generally lipid indices were higher among subjects with metabolic syndrome [{sdLDLc: 0.92 + 0.33 versus 0.70 + 0.29 (p<0.001)}, {sdLDLc/lbLDLc: 0.55 + 0.51 versus 0.40 + 0.38 (p=0.010)}, {non-HDLc: 3,63 + 0.60 versus 3.36 + 0.65 (p=0.002)}]. The fact that the sdLDLc levels provided were insignificant in Kruskall Wallis Test indicated a sharp increase in subjects with HbA1c > 7.0%. Subjects having nephropathy (UACR > 2.4 mg/g) had higher concentration of non-HDLc levels in comparison to sdLDLc [{non-HDLc: 3.68 + 0.59 versus 3.36 + 0.43} (p=0.007), {sdLDLc: 0.83 + 0.27 versus 0.75 + 0.35 (p=NS)}]. Conclusion. Lipid markers including cLDLc and mLDLc are less associated with traditional ASCVD markers than non-HDLc, sdLDLc, and sdLDLc/lbLDLc in predicting metabolic syndrome, nephropathy, glycation status, and hypertension.
Correlation between the Intensity of Helicobacter pylori Colonization and Severity of Gastritis
Authors: Ghasemi Basir Hamid Reza , Ghobakhlou Mehdi , Akbari Parvin , Dehghan Arash , Seif Rabiei Mohamad Ali
Published: November 2017

Background. The most common cause of chronic gastritis is infection with Helicobacter pylori. Identifying the relationship between intensities of colonization and activity of gastritis helps the clinician in more effective treatment and posttreatment follow-ups. Methods. In this cross-sectional study, endoscopic gastric biopsy samples of 544 patients who complained symptoms of dyspepsia for more than three months referring to the laboratory were studied. To determine the colonization rate of H. pylori and other pathological findings, Giemsa and H&E stains were, respectively, used. Results. Among 544 subjects, 47 (8.64%) patients had no gastritis, 203 (37.32%) had mild gastritis, 278 (10.51%) suffered moderate gastritis, and 16 (2.94%) had severe gastritis. In this study, patients with mild H. pylori colonization rates had the highest level of mild activity (33.52%); in contrast, those with severe H. pylori colonization had the highest level of severe activity (43.75%). 93.96% of people with severe H. pylori colonization suffered from moderate and severe chronic gastritis. There is a significant statistical relationship between the intensity of H. pylori colonization and histopathological findings including intestinal metaplasia, atrophy, and lymphoid follicle formation. Conclusions. According to the present study, with increasing intensity of H. pylori colonization, chronicity and activity of gastritis and its complications increase.
Apocynin Prevents Abnormal Megakaryopoiesis and Platelet Activation Induced by Chronic Stress
Authors: Sandrini Leonardo , Ieraci Alessandro , Amadio Patrizia , Popoli Maurizio , Tremoli Elena , Barbieri Silvia S.
Published: November 2017

Environmental chronic stress (ECS) has been identified as a trigger of acute coronary syndromes (ACS). Changes in redox balance, enhanced reactive oxygen species (ROS) production, and platelet hyperreactivity were detected in both ECS and ACS. However, the mechanisms by which ECS predisposes to thrombosis are not fully understood. Here, we investigated the impact of ECS on platelet activation and megakaryopoiesis in mice and the effect of Apocynin in this experimental setting. ECS induced by 4 days of forced swimming stress (FSS) treatment predisposed to arterial thrombosis and increased oxidative stress (e.g., plasma malondialdehyde levels). Interestingly, Apocynin treatment prevented these alterations. In addition, FSS induced abnormal megakaryopoiesis increasing the number and the maturation state of bone marrow megakaryocytes (MKs) and affecting circulating platelets. In particular, a higher number of large and reticulated platelets with marked functional activation were detected after FSS. Apocynin decreased the total MK number and prevented their ability to generate ROS without affecting the percentage of CD42d+ cells, and it reduced the platelet hyperactivation in stressed mice. In conclusion, Apocynin restores the physiological megakaryopoiesis and platelet behavior, preventing the detrimental effect of chronic stress on thrombosis, suggesting its potential use in the occurrence of thrombosis associated with ECS.
Miliary Tuberculosis Presenting with ARDS and Shock: A Case Report and Challenges in Current Management and Diagnosis
Authors: Singh Keevan , Hyatali Saara , Giddings Stanley , Singh Kevin , Bhagwandass Neil
Published: November 2017

Miliary tuberculosis, complicated by ARDS and septic shock, is a rare and lethal presentation of this disease. Here we present a case of such a patient, following which we discuss the management of tuberculosis in the ICU and some of the challenges that may be faced. A young HIV negative female presented to us with an acute history of worsening shortness of breath on a background of weight loss, nonproductive cough, and fever. CXR and CT scan showed bilateral miliary type opacities and the patient was admitted to the hospital. Within forty-eight hours of admission she became hypoxemic and was intubated and transferred to the ICU. There she experienced worsening organ dysfunction and developed circulatory shock. Despite escalating doses of noradrenaline, she continued to decline and died before specific anti-TB treatment could be started. Timely diagnosis and treatment initiation are the keys to improving outcomes in critically ill TB patients. However there are many challenges in doing so, especially in a general ICU located in a country with a low TB incidence.
The Biocontrol Efficacy of Streptomyces pratensis LMM15 on Botrytis cinerea in Tomato
Authors: Lian Qinggui , Zhang Jing , Gan Liang , Ma Qing , Zong Zhaofeng , Wang Yang
Published: November 2017

LMM15, an actinomycete with broad spectrum antifungal activity, was isolated from a diseased tomato leaf using the baiting technique. A phylogenetic tree analysis based on similarity percentage of 16S rDNA sequences showed that the bacterium was 97.0% affiliated with the species Streptomyces pratensis. This strain was therefore coded as S. pratensis LMM15. The ferment filtrate of LMM15 had ability to inhibit mycelia growth of Botrytis cinerea and reduce lesion expansion of gray mold on detached leaves and fruits. In greenhouse experiments, both the fresh and dry weights of tomato seedlings were significantly increased with the increased concentrations of total chlorophyll. The incidence of tomato gray mold decreased by 46.35%; this was associated with the increase of proline content and malondialdehyde (MDA) and the changes in defense-related enzymes on tomato leaves when the strain was sprayed on the tomato leaves 24 h prior to inoculation with pathogens. This study showed that the strain S. pratensis LMM15 could be a potential agent for controlling tomato gray mold.
The Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue Subscale): Validity and Reliability of the Iranian Version
Authors: Meysami Alipasha , Yari Hossein , Haghighat Shahpar , Montazeri Ali
Published: November 2017

Background: The aim of this study was to translate and validate the Functional Assessment of Chronic illnesses Therapy-Fatigue (FACIT-fatigue subscale) in Iran. Methods: The Persian version of the FACIT-fatigue scale was developed using the forward-backward translation method. The questionnaire was then presented to a consecutive sample of breast cancer patients (n = 208) attending the Iranian Center of Breast Cancer (ICBC). The reliability was assessed by internal consistency and test-retest using Cronbach's α and intraclass correlation coefficient (ICC), respectively. Convergent validity was examined by correlation between the FACIT-fatigue scale and the Hospital and Depression Scale (HADS). In addition, discriminant validity was evaluated by the ability of the scale to differentiate between patients who differed in disease stage. Results: The internal consistency of the questionnaire was excellent (Cronbach's α = 0.92). The ICC for the FACIT-fatigue was 0.84. Strong correlations were observed between FACIT-fatigue and depression (r = -0.69) and anxiety (r = -0.72) scores. The FACIT-fatigue discriminated well between subgroups of patients who differed in stage (p < 0.001) and probable caseness of anxiety and depression disease (p < 0.001). Conclusion: The Iranian version of the FACIT-fatigue subscale is a valid and reliable instrument to measure fatigue in cancer patients.
Adjuvant Radiotherapy in High-Risk Squamous Cell Carcinoma of the Vulva: A Two-Institutional Italian Experience
Authors: Laliscia Concetta , Fabrini Maria G. , Cafaro Ines , Barcellini Amelia , Baldaccini Davide , Miniati Mario , Parietti Emanuela , Morganti Riccardo , Paiar Fabiola , Gadducci Angiolo
Published: November 2017

Background: The aim of this study was to assess the treatment benefit and patterns of recurrence for patients with high-risk vulvar squamous cell carcinoma treated with surgery followed by adjuvant radiotherapy (RT). Patients and Methods: From January 1999 to June 2016, 51 patients underwent total or partial deep vulvectomy with inguinofemoral lymphadenectomy followed by adjuvant RT with 45-50 Gy in 25 fractions +/- a 4-10 Gy boost. 17 (33.3%) women received concomitant chemotherapy. Results: Median overall survival was 81 months. The 5-year disease-free survival and overall survival rates were 52 and 63%, respectively. In univariate and multivariate analysis, patients aged ≤ 76 years and those receiving an RT total dose of > 54 Gy had a significantly lower risk of progression (p = 0.044 and 0.045; p = 0.012 and 0.018, respectively) and death (p = 0.015 and 0.011; p = 0.015 and 0.026, respectively). There was a trend towards a lower risk of progression for patients with tumor size ≤ 4 (p = 0.098) and negative lymphovascular space involvement (p = 0.080). Also, there was a trend towards a higher risk of death (p = 0.075) for grade 3 tumors. Concomitant chemotherapy provided no significant benefit. Conclusion: Only age and RT total dose are significant prognostic variables for squamous cell carcinoma of the vulva treated with primary surgery and adjuvant RT to improve local and locoregional control.
Evaluation of the Relationship between the Serum Alkaline Phosphatase Level at Dialysis Initiation and All-Cause Mortality: A Multicenter, Prospective Study
Authors: Owaki Akiko , Inaguma Daijo , Tanaka Akihito , Shinjo Hibiki , Inaba Shinichiro , Kurata Kei
Published: November 2017

Background/Aim: High serum alkaline phosphatase (ALP) levels predict mortality independent of bone metabolism parameters and liver function test results in patients on hemodialysis. The relationship between serum ALP at dialysis initiation and mortality during maintenance dialysis is unknown; therefore, we aimed to identify an association. Methods: This multicenter, prospective cohort study analyzed 1,213 patients registered in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis from October 2011 to September 2013. Patients were divided into 2 groups based on serum ALP levels. All-cause mortality and incidences of cardiovascular events after dialysis initiation were compared using the log-rank test and multivariate Cox proportional hazard regression analysis. We performed stratified analysis based on parathyroid hormone (PTH) levels. Results: During the follow-up, 109 (18.0%) and 86 (14.1%) patients died in the high ALP group (232 ≥IU/L; High ALP group) and low ALP group (232 <IU/L; Low ALP group), respectively. All-cause mortality was significantly higher in the High ALP group than in the Low ALP group (p = 0.014). The serum ALP level was significantly correlated with the all-cause mortality rate (hazard ratio = 1.17 per 100 IU/L increase of ALP, 95% confidence interval: 1.11–1.24, p < 0.001). The all-cause mortality rate was significantly higher in the High ALP group among patients with low (<150 pg/mL) or normal (150–300 pg/mL) PTH levels (p = 0.012 and p = 0.005, respectively) than in the Low ALP group; there was no significant difference among patients with a high (≥300 pg/mL) PTH level (p = 1.000). Conclusion: The serum ALP level at dialysis initiation is associated with all-cause mortality during maintenance dialysis.
Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula
Authors: Carey Ryan M. , Hodnett Benjamin L. , Rassekh Christopher H. , Weinstein Gregory S.
Published: November 2017

Background/Aims: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration. Methods: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. This patient was treated with a novel transoral robotic surgery (TORS)-assisted approach aided by sialendoscopy. Results: TORS allowed for exceptional visualization and access to the plunging ranula and sublingual gland while avoiding critical neurovascular structures. The patient healed well without recurrence or complications. Conclusion: The TORS approach with sialendoscopy for plunging ranulas described in this case report shows promise and should be considered for certain clinical presentations. Additional studies evaluating the effectiveness of TORS for plunging ranulas may be indicated.
Cytogenetic Characterization of a Population of Acanthodactylus lineomaculatus Duméril and Bibron, 1839 (Reptilia, Lacertidae), from Southwestern Morocco and Insights into Sex Chromosome Evolution
Authors: Giovannotti Massimo , Nisi Cerioni Paola , Slimani Tahar , Splendiani Andrea , Paoletti Alessio , Fawzi Adnane , Olmo Ettore , Caputo Barucchi Vincenzo
Published: November 2017

Acanthodactylus lineomaculatus is now regarded as an ecotype of A. erythrurus with which it has been recently synonymized. Despite the wide range of A. erythrurus, karyological data for this species are scarce and limited to classical cytogenetic studies carried out in individuals from only 2 locations (central Spain and Spanish enclave of Melilla on the northwestern Mediterranean Moroccan coast). Here, for the first time, we cytogenetically characterized individuals of A. lineomaculatus from the southwestern Moroccan Atlantic coast with the aim to increase the karyological knowledge of this wide-ranging species and to assess if any chromosomal changes can be found in this ecotype in comparison to other populations of this species. The diploid number of the individuals investigated is 2n = 38 which is typical of most lacertids. Active NORs were located telomerically in a medium-small pair of chromosomes, and no inactive NORs were detected. C-banding revealed an intensely heterochromatic W chromosome composed of AT-rich (centromere and long arm telomeric region) and GC-rich (most of the long arm) regions, with extended interstitial telomeric sequences. These telomere-like repeats occupy the GC-rich heterochromatin of the W. The DNA composition of the W represents a trait distinguishing A. lineomaculatus (southwestern Morocco) from A. erythrurus from Spain that possess a DAPI-positive (AT-rich) W chromosome. In conclusion, these results add further evidence to the remarkable karyotype conservation in lacertid lizards, although differences in NOR location and in W chromosome structure among populations could suggest an incipient speciation mediated by chromosome changes in this wide-ranging lizard species.
User-Oriented Evaluation of a Robotic Rollator That Provides Navigation Assistance in Frail Older Adults with and without Cognitive Impairment
Authors: Werner Christian , Moustris George P. , Tzafestas Costas S. , Hauer Klaus
Published: November 2017

Background: Navigational skills decline with age, and this decline is even more pronounced in cognitively impaired (CI) older adults. Navigation assistance is an emerging functionality of robotic rollators (RRs). The evidence on the effectiveness of RR-integrated navigation systems in potential end-users is, however, scarce. Objective: To determine whether RR-provided navigation assistance improves navigation within a real-life environment in the intended user group of frail older adults with and without cognitive impairment currently using a rollator in daily life. Methods: A randomized, between-subject, 2 × 2 factorial design was conducted to test the effects of navigation assistance and cognitive status on participants' navigation performance. Twenty CI (Mini-Mental State Examination [MMSE] 17-26) and 22 not cognitively impaired (NCI; MMSE >26) older rollator users (age 82.5 ± 8.7 years) were included. Participants were matched for cognitive status (CI vs. NCI) and randomized to one of two conditions: RR (1) with or (2) without activated navigation system. All participants had to complete a two-section navigation path with the RR in an unfamiliar, real-life environment. Participants with RR-assisted navigation were supported in wayfinding by directional audio cues of the RR-integrated navigation system. Participants without RR-assisted navigation had to complete the sections by orienting themselves along conventional signposts. Outcomes were success rate, completion and stopping time, number of stops, walking distance, and gait speed. Results: The navigation assistance condition had no significant effect on the success rate in the CI, NCI, or total group. We found significant interactions between navigation assistance and cognitive status for both sections (p = 0.002-0.040), such that RR-assisted navigation reduced the completion time (both sections), stopping time (section 1), and number of stops (section 2) in the CI (p ≤ 0.001-0.014) but not in the NCI group. On the more complex section 2, RR-assisted navigation led to a reduced stopping time and walking distance in the total group (p = 0.014-0.016). Conclusion: The RR-integrated navigation system was effective for improving navigation within a real-life environment in potential end-users, especially in those with cognitive impairment. This is the first study to provide statistical evidence on the effectiveness of an RR-integrated navigation system in the intended user group.
Return to Work of Cancer Survivors
Authors: Seifart Ulf , Schmielau Jan
Published: November 2017

Due to improving treatment options, the number of so-called long-term cancer survivors is steadily increasing. Current studies assume that more than 60% of adults survive their cancer. These patients have a variety of problems (chemotherapy-induced neuropathy, fatigue, etc.) that require very special care. In addition to somatic and psychological side effects of the cancer or its treatment, these patients also suffer from the financial and social consequences of the disease. Thus, for a long-term survivor of working age, the question of a ‘return to work' represents a significant problem since otherwise the financial existence of the patient, and often the family, may substantially deteriorate. Studies show that cancer patients classify financial worries with regard to the quality of life as more significant than physical or psychological side effects of the cancer or its treatment. Furthermore, there are initial studies showing that the social descent due to the disease may also prove relevant for cancer prognosis. In contrast, it was shown in studies and in a Cochrane analysis that professional assistance and support services are suitable for keeping patients in their professional lives. Therefore, both patients and physicians need to be aware of this problem.
ANÁLISE DO CICLO DE VIDA DOS PALETES: UM ESTUDO DE CASO DEMONSTRANDO A IMPORTÂNCIA DO DESIGN PARA SUSTENTABILIDADE
Authors: Engler Rita De Castro , Lacerda Ana Carolina , Guimarães Letícia Hilário
Published: November 2017

Este artigo tem como objetivo demonstrar a importância do design transdisciplinar voltado para sustentabilidade, relacionando diferentes campos do saber com relevantes questoes e problemas complexos (wicked problems) – consumo e produçao, sustentabilidade, gestao de pessoas e processos, tecnologia, excesso de informaçoes, relaçao homem e objeto, cultura, identidade, entre outros – que permeiam o atual cenário fluido e em constante mutaçao. A resoluçao de problemas complexos e perversos nao deve ser entendida como responsabilidade somente dos atores políticos, novas redes devem ser criadas entre indivíduos, empresas e o poder público, associando a criatividade e o empreendedorismo para geraçao de valores compartilhados e soluçoes potenciais em prol da sustentabilidade. A gestao compartilhada de problemas vai ser discutida através de uma metodologia descritiva de estudo de caso em duas comunidades diferentes, mas com propósitos semelhantes. As comunidades do município de Jeceaba (MG) e bairro Jardim Canadá (Nova Lima, MG), que reaproveitaram resíduos (paletes) descartados para produçao de mobiliários e adornos, com o intuito de minimizar os impactos ambientais, porém uma aplica a metodologia do design no processo criativo e na execuçao das peças enquanto a outra nao adota a metodologia em respeito as limitaçoes locais. A análise desses estudos leva a compreensao da importância do design que produz projetos economicamente eficientes, socialmente justos e ambientalmente sustentáveis.
A INCORPORAÇÃO DE BIM NO ENSINO DO CURSO TÉCNICO EM EDIFICAÇÕES
Authors: Cruz Marcio De Oliveira , Cuperschmid Ana Regina Mizrahy , Ruschel Regina Coeli
Published: November 2017

A necessidade de inserir no mercado técnicos qualificados na produçao de modelos de informaçao da construçao, extraçao de dados, detecçao de interferencias e outras açoes relacionadas ao Building Information Modeling (BIM), fez com que a escola Senai Orlando Laviero Ferraiuolo buscasse meios para incorporá-lo ao ensino. Tendo em vista o objetivo de inserçao da formaçao em BIM a nível básico, iniciou-se uma investigaçao das barreiras para a adoçao deste processo no curso e, paralelamente, adotou-se a utilizaçao de estratégias para a incorporaçao do conteúdo em um conjunto abrangente de disciplinas. Neste artigo busca-se relatar o procedimento de diagnóstico das barreiras para adoçao de BIM realizado e o processo simultâneo de açoes para incorporaçao de BIM. Para apoiar este diagnóstico, foi adotado o método de pesquisa etnográfica. Esta investigaçao foi desenvolvida em dois ciclos: no primeiro, aplicou-se o método de diagnóstico de Checcucci, em formato de entrevista em profundidade juntamente com a observaçao participante; no segundo, adaptou-se o método para o formato de levantamento, por meio de um questionário online. Com esta pesquisa foi possível descrever elementos da organizaçao no contexto da incorporaçao de BIM na formaçao do técnico de edificaçoes. Os elementos caracterizados foram a transformaçao na estrutura curricular e a percepçao do corpo docente sobre as barreiras associadas. As contribuiçoes deste trabalho sao o registro do processo e diagnóstico de implementaçao de BIM no curso Técnico em Edificaçoes, as açoes que possibilitaram o amadurecimento do conhecimento dos professores e a adaptaçao do método de Checcucci para diagnóstico da permeabilidade da inserçao de BIM em estruturas curriculares.
INFORMED DESIGN DECISION-MAKING: FROM DIGITAL ANALYSIS TO URBAN DESIGN
Authors: Pezzica Camilla , Lopes João Ventura , Paio Alexandra Claudia Rebelo
Published: November 2017

Este artigo descreve uma nova abordagem ao desenho do espaço público aberto, baseada numa análise multidimensional orientada para a tomada de decisão e para o desenvolvimento de soluções arquitetônicas assentes em evidências. Apresenta uma visão geral das variáveis mais relevantes de projeto e suas restrições, fornecendo assim informações úteis para o desenvolvimento de um desenho urbano mais sustentável, que considera os valores sociais e culturais locais. Este trabalho propõe fornecer uma ferramenta de orientação holística para o desenvolvimento de melhores propostas de projeto em ambientes urbanos contemporâneos; mais especificamente, visa caracterizar de forma síncrona os espaços urbanos através de análises multiescala e multidimensional, quantitativas e qualitativas, incorporando as contribuições da sintaxe espacial, dos estudos de vida pública, da ciência da construção e da análise ambiental/conforto em espaços públicos abertos. Várias ferramentas digitais avançadas são utilizadas para gerir os dados, gerar e testar iterativamente as diferentes propostas do projeto. A metodologia proposta se baseia em diversos testes e análises executados no processo de desenvolvimento de um novo projeto experimental desenvolvido para o Largo da Graça, uma praça urbana localizada no centro histórico de Lisboa que permitiu o teste de diferentes tipos de propostas. Este experimento gerou uma estrutura processual digital para o desenho urbano da praça, no qual se registaram todas as etapas relativas à resolução de vários problemas de projeto, incluindo os objetivos de eficiência (centralidade, conectividade, compacidade, conforto térmico, segurança, igualdade e interação). O processo abarca uma sequência de propostas testadas e comparadas, bem como as escolhas feitas em relação às informações latentes, subjacentes às condições de mudança no uso do espaço público e à adaptabilidade programática da praça portuguesa. A estratégia de projeto adotada e os exemplos extraídos da estrutura processual digital são usados para ilustrar a abordagem prática da metodologia proposta, pretendendo assim demonstrar como o vínculo entre investigação aplicada e desenho urbano sustentável pode ser o adequado para o planejamento e o desenvolvimento de melhores soluções de espaço público.
Antihypertensive Treatment With β‐Blockade in Patients With Asymptomatic Aortic Stenosis and Association With Cardiovascular Events
Authors: Bang Casper N. , Greve Anders M. , Rossebø Anne B. , Ray Simon , Egstrup Kenneth , Boman Kurt , Nienaber Christoph , Okin Peter M. , Devereux Richard B. , Wachtell Kristian
Published: November 2017

Background

Patients with aortic stenosis (
AS
) often have concomitant hypertension. Antihypertensive treatment with a β‐blocker (Bbl) is frequently avoided because of fear of depression of left ventricular function. However, it remains unclear whether antihypertensive treatment with a Bbl is associated with increased risk of cardiovascular events in patients with asymptomatic mild to moderate
AS
.

Methods and Results

We did a post hoc analysis of 1873 asymptomatic patients with mild to moderate
AS
and preserved left ventricular ejection fraction in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study. Propensity‐matched Cox regression and competing risk analyses were used to assess risk ratios for all‐cause mortality, sudden cardiac death, and cardiovascular death. A total of 932 (50%) patients received Bbl at baseline. During a median follow‐up of 4.3±0.9 years, 545 underwent aortic valve replacement, and 205 died; of those, 101 were cardiovascular deaths, including 40 sudden cardiovascular deaths. In adjusted analyses, Bbl use was associated with lower risk of all‐cause mortality (hazard ratio 0.5, 95% confidence interval 0.3‐0.7,
P
<0.001), cardiovascular death (hazard ratio 0.4, 95% confidence interval 0.2‐0.7,
P
<0.001), and sudden cardiac death (hazard ratio 0.2, 95% confidence interval 0.1‐0.6,
P
=0.004). This was confirmed in competing risk analyses (all
P
<0.004). No interaction was detected with
AS
severity (all
P
>0.1).

Conclusions

In post hoc analyses Bbl therapy did not increase the risk of all‐cause mortality, sudden cardiac death, or cardiovascular death in patients with asymptomatic mild to moderate
AS
. A prospective study may be warranted to determine if Bbl therapy is in fact beneficial.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00092677.
Clinical Outcomes After Ablation of the AV Junction in Patients With Atrial Fibrillation: Impact of Cardiac Resynchronization Therapy
Authors: Mittal Suneet , Musat Dan L. , Hoskins Michael H. , Prillinger Julie B. , Roberts Gregory J. , Nabutovsky Yelena , Merchant Faisal M.
Published: November 2017

Background

Patients with atrial fibrillation (
AF
) often undergo AV junction ablation (
AVJA
) and pacemaker implantation. Right ventricular (
RV
) pacing contributes to increased risk of heart failure (
HF
), which may be mitigated by biventricular pacing. We sought to determine the impact of
AVJA
concurrent with
RV
versus biventricular pacemaker implantation on
AF
and
HF
hospitalizations.

Methods and Results

The MarketScan Commercial and Medicare Supplemental claims database was used to select 18‐ to 100‐year‐old patients with AF with pacemaker implantation. Patients were divided into those with an RV and a biventricular pacemaker and further into those who did (
AVJA
+
) or did not undergo concurrent ablation. Separately, the AVJA
+
group was divided into those receiving
RV
versus biventricular pacemakers.
AF
and
HF
hospitalization rates were compared between groups after matching on demographics, comorbidities, and baseline hospitalization rates. The study included 24 361 patients, with
RV
(n=23 377) or biventricular (n=984) pacemakers; 1611 patients underwent
AVJA
.
AVJA
+
was associated with reduced
AF
hospitalization risk (
RV
hazard ratio [
HR
], 0.31;
P
<0.001; biventricular
HR
, 0.20;
P
=0.003) compared with no AVJA. However,
HF
hospitalization risk was increased for
RV
(
HR
, 1.63;
P
=0.001), but not biventricular (
HR
, 0.98;
P
=0.942), pacemakers. In
AVJA
+
patients, biventricular pacing was associated with reduced risk of
HF
hospitalization versus
RV
pacing (
HR
, 0.62;
P
=0.017).

Conclusions

In a large cohort of patients with AF,
AVJA
+
significantly reduced
AF
hospitalizations, irrespective of whether an RV or a biventricular pacemaker was implanted. However,
AVJA
was associated with a marked
HF
hospitalization increase in patients with an
RV
pacemaker, which was ameliorated with biventricular pacing.
Body Mass Index and Vascular Disease in Men Aged 65 Years and Over: HIMS (Health In Men Study)
Authors: Lacey Ben , Yeap Bu B , Golledge Jonathan , Lewington Sarah , McCaul Kieran A , Norman Paul E , Flicker Leon , Almeida Osvaldo P , Hankey Graeme J
Published: November 2017

Background

Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.

Methods and Results

In this prospective cohort study, 12 203 men (aged ≥65) were recruited in 1996–1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow‐up. During a further 8 (SD3) years of follow‐up, there were 1136 first‐ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at ≈ 22.5 to 25 kg/m
2
. In the higher BMI range (≥25 kg/m
2
), 5 kg/m
2
higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18–1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06–1.46]); 34% higher risk of stroke (1.34 [1.11–1.63]); and 78% higher risk of other vascular death (1.78 [1.32–2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m
2
higher BMI, 0.82 [95% confidence interval, 0.61–1.12]).

Conclusions

In this population of older men, risk of major vascular events was lowest at ≈ 22.5 to 25 kg/m
2
. Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m
2
higher BMI associated with ≈30% higher risk.
Introducing the new Indian mangrove species, Vaginatispora microarmatispora (Lophiostomataceae) based on morphology and multigene phylogenetic analysis
Authors: DEVADATHA B. , SARMA V.V. , WANASINGHE D.N. , HYDE KEVIN D. , JONES E.B.G
Published: November 2017

Vaginatispora microarmatispora sp. nov. (Lophiostomataceae) is a new saprobic marine fungal species found on dead intertidal wood of Aegiceras corniculatum collected from Muthupet mangroves, Tamil Nadu, along the south-east coast of India. This species has characters similar to other species of the genus Vaginatispora, but differs in ascospore dimensions. Phylogeny inferred from a combined LSU, SSU, ITS and TEF1 sequence dataset reveal a close association of the new taxon to species of Vaginatispora, but as a distinct lineage. Hence, in this paper, we introduce the new species with illustrations, descriptions and comparison with related taxa. A synopsis of characters of all Vaginatispora species along with a dichotomous key are also provided.
Bronisław Błocki’s taxa of Salvia (Lamiaceae): clarification of their status and typification of names
Authors: NACHYCHKO VIKTOR O. , HELESH MYROSLAVA B. , SOSNOVSKY YEVHEN V.
Published: November 2017

Nine taxa of Salvia published by Bronisław Błocki (1854–1919), a famous investigator of the flora of Galicia (the territory of western Ukraine and southeastern Poland), are examined and discussed. For four validly published names types are designated, a lectotype for each S. dubia and S. ×andrzejowskii, a neotype for each S. ×kerneri and S. ×skofitzii. The illegitimate name S. dubia together with S. ×andrzejowskii should be treated as heterotypic synonym of the accepted name S. ×sylvestris. The name S. ×kerneri is proposed to be accepted for the hybrid S. dumetorum × S. nutans, with S. ×skofitzii as a heterotypic synonym.
A Streamflow and Water Level Forecasting Model for the Ganges, Brahmaputra, and Meghna Rivers with Requisite Simplicity
Authors: Palash Wahid , Jiang Yudan , Akanda Ali S. , Small David L. , Nozari Amin , Islam Shafiqul
Published: November 2017

A forecasting lead time of 5–10 days is desired to increase the flood response and preparedness for large river basins. Large uncertainty in observed and forecasted rainfall appears to be a key bottleneck in providing reliable flood forecasting. Significant efforts continue to be devoted to developing mechanistic hydrological models and statistical and satellite-driven methods to increase the forecasting lead time without exploring the functional utility of these complicated methods. This paper examines the utility of a data-based modeling framework with requisite simplicity that identifies key variables and processes and develops ways to track their evolution and performance. Findings suggest that models with requisite simplicity—relying on flow persistence, aggregated upstream rainfall, and travel time—can provide reliable flood forecasts comparable to relatively more complicated methods for up to 10 days lead time for the Ganges, Brahmaputra, and upper Meghna (GBM) gauging locations inside Bangladesh. Forecasting accuracy improves further by including weather-model-generated forecasted rainfall into the forecasting scheme. The use of water level in the model provides equally good forecasting accuracy for these rivers. The findings of the study also suggest that large-scale rainfall patterns captured by the satellites or weather models and their “predictive ability” of future rainfall are useful in a data-driven model to obtain skillful flood forecasts up to 10 days for the GBM basins. Ease of operationalization and reliable forecasting accuracy of the proposed framework is of particular importance for large rivers, where access to upstream gauge-measured rainfall and flow data are limited, and detailed modeling approaches are operationally prohibitive and functionally ineffective.
Servant leadership as a driver of employee service performance: Test of a trickle-down model and its boundary conditions
Authors: Wang Zhen , Xu Haoying , Liu Yukun
Published: November 2017

Previous research has demonstrated the role of servant leadership, a leadership style emphasizing serving others, in promoting frontline employees’ service performance. It is unclear, however, how servant leadership by leaders at different organizational levels would exert such an influence. Integrating insights from both social learning theory and the trickle-down paradigm of leadership, we develop a cross-level model in which we argue that servant leadership by high-level managers could cascade downward through the organizational hierarchy to influence frontline employees’ service performance and that this trickle-down effect is contingent on the extent to which subordinates identify their leaders as embodying the organization. Using a matched sample of 92 supervisors and 568 frontline employees across 92 sub-branches of a large banking company, we found that servant leadership by high-level managers could indeed promote employees’ in-role and extra-role service performance through its effect on low-level supervisors’ servant leadership. We also found that this trickle-down effect was stronger when high-level managers and low-level supervisors were perceived by their subordinates as more fully embodying the organization. Implications, limitations and future directions are discussed.
The U.S. Health Care Crisis Continues: A Data Snapshot
Authors: Himmelstein David U. , Woolhandler Steffie , Almberg Mark , Fauke Clare
Published: November 2017

Despite implementation of the Affordable Care Act in 2014, the U.S. health care crisis continues. While coverage has been expanded, 28 million people remain uninsured, and tens of millions who have coverage are unable to afford care because of high cost-sharing requirements. Moreover, many with coverage have a sharply restricted choice of physicians and hospitals, and the corporate takeover of medical care in the United States is proceeding rapidly. This article provides a brief précis of recent data on U.S. health policy.
Life Experience of Bereaved Parents After the 2014 Sewol Ferry Disaster in South Korea
Authors: Lee Dong Hun , Khang Minsoo , Shin Jiyoung , Lee Hwa Jung , Brown Jacqueline A.
Published: November 2017

The aim of this study was to identify the outcomes of parental bereavement and the changes in life experience that follow the traumatic death of a teenage child. The results of the study are aimed to assist counselors and educators who work with themes of grief and loss. From 17 in-depth interviews from parents bereaved by the Sewol ferry disaster of 2014 in South Korea, three main categories were found to capture the reality for parents after the sudden and traumatic death of a teenage child: (a) personal changes, (b) changes in close relationships, and (c) changes in social life. Recommendations for future research and potential implications were discussed.