bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing Treat‐to‐Target Practices for Chronic Pain Through Shared Decision Making: Requisites, Prospects, and Challenges
Authors: Falzer Paul R.
Published: February 2016

Objective

Treat‐to‐target (T2T) includes a target or goal, standard symptom assessment, and a treatment decision. In specialties that threat chronic pain, T2T is expected to be implemented collaboratively. The ability of patients to participate fully has been questioned, but these concerns have not been demonstrated empirically. The current study examined how patient self‐assessed symptom measures and illness beliefs affect their willingness to change their current treatment.

Methods

A total of 157 patients with rheumatoid arthritis completed a standard “disease activity” (DA) battery consisting of current joint pain, recent pain, daily functioning, and generality disability assessments, along with an illness belief questionnaire and a willingness to change measure. Data were collected at 2‐month intervals over a 6‐month period. Single and multiple influences on willingness to change were examined using linear mixed models.

Results

Willingness is strongly and directly associated withDAscores. Beliefs that were significant as single factors became nonsignificant onceDAscores were introduced. The findings established a strong and consistent link betweenDAscores and willingness, and ruled out the prospect that illness beliefs mediate or moderate this relationship. It was also found that willingness to change is directly related to the number of significant self‐reported symptoms.

Conclusion

Concerns about the ability of patients to participate in a collaborative implementation of T2T were not substantiated. Future studies can examine the subtle interplay of goals, assessments, and treatment decisions and clarify outstanding issues about the practice of clinical decision making.
Potato tuber expression of Arabidopsis WRINKLED1 increase triacylglycerol and membrane lipids while affecting central carbohydrate metabolism
Authors: Hofvander Per , Ischebeck Till , Turesson Helle , Kushwaha Sandeep K. , Feussner Ivo , Carlsson Anders S. , Andersson Mariette
Published: February 2016

Tuber and root crops virtually exclusively accumulate storage products in the form of carbohydrates. An exception is yellow nutsedge (Cyperus esculentus) in which tubers have the capacity to store starch and triacylglycerols (TAG) in roughly equal amounts. This suggests that a tuber crop can efficiently handle accumulation of energy dense oil. From a nutritional as well as economic aspect, it would be of interest to utilize the high yield capacity of tuber or root crops for oil accumulation similar to yellow nutsedge. The transcription factor WRINKLED1 from Arabidopsis thaliana, which in seed embryos induce fatty acid synthesis, has been shown to be a major factor for oil accumulation. WRINKLED1 was expressed in potato (Solanum tuberosum) tubers to explore whether this factor could impact tuber metabolism. This study shows that a WRINKLED1 transcription factor could induce triacylglycerol accumulation in tubers of transformed potato plants grown in field (up to 12 nmol TAG/mg dry weight, 1% of dry weight) together with a large increase in polar membrane lipids. The changes in metabolism further affected starch accumulation and composition concomitant with massive increases in sugar content.
Screening for secondary hyperparathyroidism in preterm infants
Authors: Dowa Yuri , Kawai Masahiko , Kanazawa Hoshinori , Iwanaga Kougoro , Matsukura Takashi , Heike Toshio
Published: February 2016

Background

The major cause of osteopathy of prematurity is dietary phosphate deficiency, but secondary hyperparathyroidism caused by calcium deficiency or vitamin D deficiency is also important. Because parathyroid hormone (PTH) mobilizes calcium and phosphate from the bone, hyperparathyroidism worsens osteopathy of prematurity. In order to identify useful markers to screen for and diagnose hyperparathyroidism in preterm infants, we measured serum and urinary biochemical markers.

Methods

Several biomarkers, including serum intact PTH (iPTH), were measured in urine and serum samples obtained from 95 preterm infants, and the relationship between serum iPTH and the other parameters was analyzed.

Results

Mean gestation was 33.2 ± 2.9 weeks, and mean birthweight was 1705 ± 402 g. Samples were collected around postnatal day 17.3 ± 7.4. Fourteen infants (14.7%) had iPTH >65 pg/mL. Cut‐offs for serum alkaline phosphatase (ALP) and percent tubular reabsorption rate of phosphate (%TRP) were fixed at 1300 IU/L and 93%, respectively using receiver operating characteristic curves with iPTH cut‐off of 65 pg/mL. Serum ALP was proven to be a good marker: ALP had a sensitivity of 78.6% and a specificity of 86.4%, while %TRP itself was not: %TRP had a sensitivity of 64.3% and a specificity of 58.0%. Combined measurement of serum ALP (>1300 IU/L) and %TRP (≤93%), however, had a specificity of 93.8% for detecting elevated iPTH.

Conclusion

Measurement of serum ALP (>1300 IU/L) is considered as an effective screening method to detect hyperparathyroidism. In addition, combined assessment of ALP(>1300 IU/L) and %TRP(≤93%) is a good indicator of elevated iPTH in preterm infants.
Practice recommendations for the monitoring of renal function in pediatric non‐renal organ transplant recipients
Authors: Filler Guido , Melk Anette , Marks Stephen D.
Published: February 2016

The management of non‐renal pediatric solid organ transplant recipients has become complex over the last decade with innovations in immunosuppression and surgical techniques. Post‐transplantation follow‐up is essential to ensure that children have functioning allografts for as long as possible. CKD is highly prevalent in these patients, often under recognized, and has a profound impact on patient survival. These practice recommendations focus on the early detection and management of hypertension, proteinuria, and renal dysfunction in non‐renal pediatric solid organ transplant recipients. We present seven practice recommendations. Renal function should be monitored regularly in organ transplant recipients, utilizing assessment of serum creatinine and cystatin C. GFR should be calculated using the new Schwartz formula. Transplant physicians should also monitor blood pressure using automated oscillometric devices and confirm repeated abnormal measures with manual blood pressure readings and ambulatory 24‐h blood pressure monitoring. Proteinuria and microalbuminuria should also be assessed regularly. Referrals to a pediatric nephrologist should be made for non‐renal organ transplant recipients with repeated blood pressures >95th percentile using the Fourth Task Force reference intervals, microalbumin/creatinine ratio >32.5 mg/g (3.7 mg/mmol) creatinine on repeated testing and/or GFR <90 mL/min/1.73 m2.
Patterns and sources of variation in pollen deposition and pollen tube formation in flowers of the endemic monoecious shrub Cnidoscolus souzae (Euphorbiaceae)
Authors: Arceo‐Gómez G. , Alonso C. , Abdala‐Roberts L. , Parra‐Tabla V.
Published: February 2016

Pollen deposition and pollen tube formation are key components of angiosperm reproduction but intraspecific variation in these has rarely been quantified. Documenting and partitioning (populations, plants and flowers) natural variation in these two aspects of plant reproduction can help uncover spatial mosaics of reproductive success and underlying causes. In this study, we assess variation in pollen deposition and pollen tube formation for the endemic monoecious shrub Cnidoscolus souzae throughout its distribution range in Mexico, and determine how this variation is structured among populations, plants and flowers. We also infer the relative importance of pollen quantity and quality in determining pollination success in this species. While we found no evidence suggesting that pollen receipt limits C. souzae reproduction across 19 populations, we did find extensive variation in pollen load size and pollen tube number per flower. Total variation in pollen receipt and pollen tube number was mostly explained by intra‐individual and among‐population variance. Furthermore, pollen load size had a stronger effect on the number of pollen tubes at the base of the style than pollen germination rate, suggesting that pollen quantity may be more important than quality for pollen tube success in C. souzae. Our results suggest that both small within‐plant flower differences and broad‐scale differences in community attributes can play an important role in determining pollination success. We emphasise the need to evaluate patterns and sources of variation in pollen deposition and pollen tube formation as a first step in understanding the causes of variation in pollination success over broad spatial scales.
The Impact of ART on Live Birth Outcomes: Differing Experiences across Three States
Authors: Luke Sabrina , Sappenfield William M. , Kirby Russell S. , McKane Patricia , Bernson Dana , Zhang Yujia , Chuong Farah , Cohen Bruce , Boulet Sheree L. , Kissin Dmitry M.
Published: February 2016

Background

Research has shown an association between assisted reproductive technology (ART) and adverse birth outcomes. We identified whether birth outcomes of ART‐conceived pregnancies vary across states with different maternal characteristics, insurance coverage for ART services, and type of ART services provided.

Methods

CDC's National ART Surveillance System data were linked to Massachusetts, Florida, and Michigan vital records from 2000 through 2006. Maternal characteristics in ART‐ and non‐ART‐conceived live births were compared between states using chi‐square tests. We performed multivariable logistic regression analyses and calculated adjusted odds ratios (aOR) to assess associations between ART use and singleton preterm delivery (<32 weeks, <37 weeks), singleton small for gestational age (SGA) (<5th and <10th percentiles) and multiple birth.

Results

ART use in Massachusetts was associated with significantly lower odds of twins as well as triplets and higher order births compared to Florida and Michigan (aOR 22.6 vs. 30.0 and 26.3, and aOR 37.6 vs. 92.8 and 99.2, respectively; Pinteraction < 0.001). ART use was associated with increased odds of SGA in Michigan only, and with preterm delivery (<32 and <37 weeks) in all states (aOR range: 1.60, 1.87).

Conclusions

ART use was associated with an increased risk of preterm delivery among singletons that showed little variability between states. The number of twins, triplets and higher order gestations per cycle was lower in Massachusetts, which may be due to the availability of insurance coverage for ART in Massachusetts.
Identifying Relevant Cases of Conversion and Drift Using the Comparative Agendas Project
Authors: Shpaizman Ilana
Published: February 2016

One of the most important phases of case‐oriented research is identifying the relevant population of cases. The best practice scheme suggests first identifying the positive and then the negative cases, based on the assumption that the population is small and known. This scheme is inapplicable when the population is unknown, as is the case with many public administration and public policy outcomes, which are often less visible. However, most research either ignores this difficulty or recommends a single case study. This article suggests that when the population is unknown scholars can apply the possibility principle to identify the relevant population of cases. In order to do so, a large dataset is required. In policy studies, the Comparative Agendas Project (CAP) can serve this aim. This article highlights CAP's applicability for case selection based on the possibility principle in two less visible policy outcomes: conversion and drift. In that, it not only addresses an overlooked challenge but also promotes both CAP as a useful tool for qualitative researchers and the expansion of comparative work on conversion and drift.
Shared and distinct oculomotor function deficits in schizophrenia and obsessive compulsive disorder
Authors: Damilou Angeliki , Apostolakis Sotirios , Thrapsanioti Eleftheria , Theleritis Christos , Smyrnis Nikolaos
Published: February 2016

Detailed analysis of oculomotor function phenotypes in antisaccade, smooth eye pursuit, and active fixation tasks was performed in a sample of 44 patients with schizophrenia, 34 patients with obsessive compulsive disorder (OCD), and 45 matched healthy controls. A common pattern of performance deficits in both schizophrenia and OCD emerged including higher antisaccade error rate, increased latency for corrective antisaccades, as well as higher rates of unwanted saccades in smooth eye pursuit compared to healthy controls. This common pattern could be related to the dysfunction of a network of cognitive control that is present in both disorders, including the dorsolateral prefrontal cortex, the posterior parietal cortex, and the anterior cingulate cortex. In contrast, only patients with schizophrenia showed a specific increase for correct antisaccade mean latency and the intrasubject variability of latency for error prosaccades as well as a decrease in the gain for smooth eye pursuit, suggesting a specific deficit in saccadic motor control and the frontal eye field in schizophrenia that is not present in OCD. A specific deficit in fixation stability (increased frequency of unwanted saccades during active fixation) was observed only for OCD patients pointing to a deficit in the frontostriatal network controlling fixation. This deficit was pronounced for OCD patients receiving additional antipsychotic medication. In conclusion, oculomotor function showed shared and distinct patterns of deviance for schizophrenia and OCD pointing toward shared and specific neurobiological substrates for these psychiatric disorders.
Social Drivers of Water Utility Privatization in the United States: An Examination of the Presence of Variegated Neoliberal Strategies in the Water Utility Sector
Authors: Greiner Patrick Trent
Published: February 2016

This study uses a logistic regression analysis to investigate the social drivers of water utility privatization in the United States at the local level. In order to do so I combine data gathered from the Environmental Protection Agency's 2012 Safe Drinking Water Information System database and use it in conjunction with the U.S. census's 2008–12 county‐level demographic estimates. I use a logistic regression analysis in order to examine the relationship between theoretically relevant social factors and the probability of a privately owned or operated water system being located within a community. Key findings suggest that water utility privatization in the United States follows the logic of a variegated neoliberalism and constitutes a form of environmental injustice.
Party, Regional and Linguistic Proportionality Under Majoritarian Rules: Swiss Federal Council Elections
Authors: Stojanović Nenad
Published: February 2016

The elections to the Swiss Federal Council in December 2015 re‐established a system of party‐centred concordance, cherished in consociational theory, consisting of two representatives of the Swiss People's Party, two Radicals, two Social Democrats and one Christian Democrat. At the same time, the government has rarely been as unbalanced in terms of the representation of Switzerland's languages and regions. The article analyses the concept of concordance with regard to both aspects of governmental inclusiveness. It also highlights the crucial role of electoral rules used in governmental elections. It argues that they resemble the Alternative Vote, a majoritarian electoral system that has been criticized in consociational theory but prescribed by the rival, centripetalist approach to power sharing.
Two new species of fossil Corethrella Coquillett from Late Eocene Rovno amber, with a species‐level phylogeny for the family based on morphological traits (Diptera: Corethrellidae)
Authors: BARANOV VIKTOR A. , KVIFTE GUNNAR M. , PERKOVSKY EVGENY E.
Published: February 2016

Species in the genus Corethrella Coquillett, the only genus in the family Corethrellidae, feed on the blood of frogs and toads and are unique among Diptera in locating their hosts by sound. Their fossil record goes back to the Cretaceous and comprises seven previously described species from various amber deposits. Herein, we present the first records of Corethrella from Late Eocene Rovno amber (35 Ma), with the description of two new species: Corethrella sontagae sp.n. based on a single male, and Corethrella rovnoensis sp.n. based on a single female. A revised key to fossil species of Corethrella is given. Phylogenetic relationships within Corethrella are investigated based on Bayesian and parsimony analysis, including the new data. All species groups recognized by Borkent (2008) are recovered as monophyletic, with the exception of the drakensbergensis group, which is found to be a paraphyletic grade. Both of the newly described species can be accommodated within modern species groups: C. sontagae shows affinities with the quadrivittata group and C. rovnoensis with the rotunda group.

This published work has been registered in ZooBank, http://zoobank.org/urn:lsid:zoobank.org:pub:AE394C59‐775F‐42DC‐A5A8‐AF9C91E16464.
Emergence of a superradiation: pselaphine rove beetles in mid‐Cretaceous amber from Myanmar and their evolutionary implications
Authors: PARKER JOSEPH
Published: February 2016

Pselaphinae is an exceptionally species‐rich, globally distributed subfamily of minute rove beetles (Staphylinidae), many of which are inquilines of social insects. Deducing the factors that drove pselaphine diversification and their evolutionary predisposition to inquilinism requires a reliable timescale of pselaphine cladogenesis. Pselaphinae is split into a small and highly plesiomorphic supertribe, Faronitae, and its sister group, the ‘higher Pselaphinae’ – a vast multi‐tribe clade with a more derived morphological ground plan, and which includes all known instances of inquilinism. The higher Pselaphinae is dominated by tribes with a Gondwanan taxonomic bias. However, a minority of tribes are limited to the Nearctic and Palearctic ecozones, implying a potentially older, Pangaean origin of the higher Pselaphinae as a whole. Here, I describe fossils from mid‐Cretaceous (∼99 million years old) Burmese amber that confirm the existence of crown‐group higher pselaphines on the Eurasian supercontinent prior to contact with Gondwanan landmasses. Protrichonyx rafifrons gen. et sp.n. is placed incertae sedis within the higher Pselaphinae. Boreotethys gen.n., erected for B. grimaldii sp.n. and B. arctopteryx sp.n., represents an extinct sister taxon and putative stem group of Bythinini, a Recent tribe with a primarily Holarctic distribution. The Laurasian palaeolocality of the newly described taxa implies that higher pselaphines are indeed probably of Jurassic, Pangaean extraction and that the Laurasian‐Gondwanan tribal dichotomy of this clade may have developed vicariantly following Pangaean rifting. Higher pselaphines probably predate the earliest ants. Their physically protective morphological ground plan may have been a preadaptation for myrmecophily when ants became diverse and ecologically ubiquitous, much later in the Cenozoic.

This published work has been registered in ZooBank, http://zoobank.org/urn:lsid:zoobank.org:pub:36E3FE2A-B947-422D-89CA-0EF43B99C382.
Description of the novel KIR2DL4*035 allele identified using high‐throughput sequencing
Authors: Alicata C. , Bottino C. , Guethlein L. A. , Parham P. , Norman P. J.
Published: February 2016

A newly identified allele of the KIR2DL4 natural killer cell receptor for human leukocyte antigen (HLA) class I.
Growth in HIV‐infected children on long‐term antiretroviral therapy
Authors: Feucht Ute D. , Van Bruwaene Lore , Becker Piet J. , Kruger Mariana
Published: February 2016

Objectives

To describe growth in HIV‐infected children on long‐term antiretroviral therapy (ART) and to assess social, clinical, immunological and virological factors associated with suboptimal growth.

Methods

This observational cohort study included all HIV‐infected children at an urban ART site in South Africa who were younger than 5 years at ART initiation and with more than 5 years of follow‐up. Growth was assessed using weight‐for‐age Z‐scores (WAZ), height‐for‐age Z‐scores (HAZ) and body mass index (BMI)‐for‐age Z‐scores (BAZ). Children were stratified according to pre‐treatment anthropometry and age. Univariate and mixed linear analysis were used to determine associations between independent variables and weight and height outcomes.

Results

The majority of the 159 children presented with advanced clinical disease (90%) and immunosuppression (89%). Before treatment underweight, stunting and wasting were common (WAZ<−2 = 50%, HAZ<−2 = 73%, BAZ<−2 = 19%). Weight and BMI improved during the initial 12 months, while height improved over the entire 5‐year period. Height at study exit was significantly worse for children with growth impairment at ART initiation (P < 0.001), and infants (<1 year) demonstrated superior improvement in terms of BMI (P = 0.04). Tuberculosis was an independent risk factor for suboptimal weight (P = 0.01) and height (P = 0.02) improvement. Weight gain was also hindered by lack of electricity (P = 0.04). Immune reconstitution and virological suppression were not associated with being underweight or stunted at study endpoint.

Conclusions

Malnutrition was a major clinical concern for this cohort of HIV‐infected children. Early ART initiation, tuberculosis co‐infection management and nutritional interventions are crucial to ensure optimal growth in HIV‐infected children.
Buy Local? Governmental Incentives to ‘Inform’ Consumers
Authors: Richardson Martin , Stähler Frank
Published: February 2016

This paper considers governmental incentives to provide information to local consumers about the relative merits of local versus foreign goods. We construct a model in which a local firm in a small, open economy competes in its domestic market with imports. Consumers are willing to pay an idiosyncratic premium for the local product, drawn from some support that the importing country government can affect through a costly information campaign. We examine incentives to undertake such a campaign in autarky and in the case of trade. We show, inter alia, that while a national welfare‐maximising government will always wish to shift this distribution upwards, it may not wish to reduce the variance of valuations, and that the optimal response of a foreign government will be to increase any support it offers to its exporters. Furthermore, falling world prices generally reduce the attractiveness of such a campaign both to a welfare‐maximising government and to one that cares only for domestic profits.
Activity‐based costs of plasma transfusions in medical and surgical inpatients at a US hospital
Authors: Shander A. , Ozawa S. , Hofmann A.
Published: February 2016

Background and objectives

Fresh frozen plasma (FFP) usage has significantly increased over the last decade leading to elevated healthcare costs. Although FFP is used in several clinical settings, it is often inappropriately transfused and evidence for its clinical efficacy is poor. Here, we describe plasma usage and transfusion costs in a real‐world US inpatient setting to determine the cost‐effectiveness of FFP transfusion and for comparison to various patient blood management (PBM) options to treat coagulopathies.

Materials and methods

All activities related to plasma transfusion recorded at a single US hospital over one calendar year were collected in a stepwise manner using an activity‐based costing (ABC) methodology. This model maps all technical, administrative and clinical processes inherent to the cost of plasma.

Results

Of 18 200 inpatients recorded, 849 were charged for blood products. In total, 136 medical and surgical inpatients were charged for 577 units of FFP, receiving a total of 534 units; 43 units were charged but not transfused. The total cost per unit of FFP transfused was $409·62 and $1,608·37 per patient transfused with FFP. Wasted products, in‐hospital processes and overhead costs were found to account for 89·8% of the total cost of FFP transfusions.

Conclusion

This study is the first to use ABC methodology to determine the full cost of plasma transfusion in a US inpatient setting. These data reveal the true cost of plasma, providing a useful reference point to compare with the cost of other PBM options to manage coagulation disorders.
In vitro analysis of volume‐reduced washed platelet concentrates stored in bicarbonated Ringer's solution containing less than 5% residual plasma
Authors: Oikawa S. , Minegishi M. , Endo K. , Kawashima W. , Suzuki K. , Shimizu H.
Published: February 2016

Background and Objectives

Volume‐reduced washed platelet (PLT) concentrates (PCs) can prevent circulatory overload and allergic reactions in patients undergoing PLT transfusions. For these reasons, they are in demand for paediatric settings and for patients at risk of circulatory overload. Here, we evaluated the quality of volume‐reduced washed PCs stored for 5 days in a novel acetate‐free PLT additive solution (PAS) containing glucose and bicarbonate (BRS‐A) with <5% residual plasma protein.

Materials and Methods

PCs from two apheresis donations were mixed and divided equally into control and test units. For the test unit (volume‐reduced washed PCs), PLTs were washed and stored in 90 ml BRS‐A with <5% plasma protein. PLTs in the control unit were stored in 200 ml 100% plasma without any washing manipulations. The in vitro properties of PLTs in both units were compared over a 5‐day storage period.

Results

The procedure for volume‐reduced washed PCs effectively removed >98% plasma protein in 100% plasma PCs and yielded an approximately twofold lower mean volume (91 ml) compared to that observed with the control units. Immediately after washing, the mean PLT concentration of the test units was 20·5 × 1011/l, twofold higher than that of the control units. The pH (37°C) levels in the test unit remained above 7·0 for 5 days. Glucose consumption and lactate production rates of the test units on days 1–3 were higher than those of the control units, leading to glucose exhaustion in the test unit by Day 3. Hypotonic shock responses and CD62P and CD42b expression levels in both units were comparable during 5‐day storage.

Conclusion

Considering the pH buffering capacity of BRS‐A, a 90‐ml volume may be acceptable for maintaining the in vitro quality of washed PLTs for at least 2 days.
Microscopic Evaluation of Peritumoral Lesions of Feline Injection Site Sarcomas Identified by Magnetic Resonance Imaging and Computed Tomography
Authors: Nemanic Sarah , Milovancev Milan , Terry Jesse L. , Stieger‐Vanegas Susanne M. , Löhr Christiane V.
Published: February 2016

Objective

Determine whether dual‐phase computed tomography angiogram (CTA) or magnetic resonance imaging (MRI) detect more peritumoral lesions of feline injection site sarcoma (FISS) and determine whether CTA or MRI imaging characteristics of peritumoral lesions correspond with microscopic findings.

Study Design

Prospective clinical study.

Animals

Ten client‐owned cats with FISS.

Methods

A fiducial marker detectable on CTA and MRI was sutured to the skin over the FISS as a standard reference point. All cats received MRI and CTA of the FISS, immediately followed by wide surgical excision. Targeted microscopic evaluation was performed on tissue with imaging‐identified lesions and on the surgical margins.

Results

A total of 87 imaging‐identified peritumoral lesions were examined microscopically (median 4 per cat, range 3–9) with 17/87 (20%) categorized as neoplastic, 51/87 (59%) as nonneoplastic, and 19/87 (22%) as equivocal. In 25 instances, peritumoral lesions were seen on both imaging modalities at the same location. Unique imaging characteristics were seen in 5/17 neoplastic peritumoral lesions (4 cats; all different lesions; 1 CTA, 4 MRI). The CTA and MRI appearances of the remaining 12/17 neoplastic lesions were nonspecific, being observed across more than 1 microscopic category.

Conclusion

CTA and MRI identified a similar number of peritumoral lesions. The extensive overlap between imaging features of neoplastic and nonneoplastic lesions precludes definitive identification of neoplastic peritumoral FISS lesions using CTA or MRI.
First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes—Chapter 5: recipient monitoring and response plan for preventing disease transmission
Authors: Denner Joachim , Tönjes Ralf R. , Takeuchi Yasu , Fishman Jay , Scobie Linda
Published: February 2016

Xenotransplantation of porcine cells, tissues, and organs may be associated with the transmission of porcine microorganisms to the human recipient. A previous, 2009, version of this consensus statement focused on strategies to prevent transmission of porcine endogenous retroviruses (PERVs). This version addresses potential transmission of all porcine microorganisms including monitoring of the recipient and provides suggested approaches to the monitoring and prevention of disease transmission. Prior analyses assumed that most microorganisms other than the endogenous retroviruses could be eliminated from donor animals under appropriate conditions which have been called “designated pathogen‐free” (DPF) source animal production. PERVs integrated as proviruses in the genome of all pigs cannot be eliminated in that manner and represent a unique risk. Certain microorganisms are by nature difficult to eliminate even under DPF conditions; any such clinically relevant microorganisms should be included in pig screening programs. With the use of porcine islets in clinical trials, special consideration has to be given to the presence of microorganisms in the isolated islet tissue to be used and also to the potential use of encapsulation. It is proposed that microorganisms absent in the donor animals by sensitive microbiological examination do not need to be monitored in the transplant recipient; this will reduce costs and screening requirements. Valid detection assays for donor and manufacturing‐derived microorganisms must be established. Special consideration is needed to preempt potential unknown pathogens which may pose a risk to the recipient. This statement summarizes the main achievements in the field since 2009 and focus on issues and solutions with microorganisms other than PERV.
Resolving Tensions among Creative Departments through Brand Identity Definition: The Case Study of Pininfarina
Authors: Mazzalovo Gérald
Published: February 2016

In 2007, the famous Italian car design firm Pininfarina decided to develop its own mono-branded finished goods business. The jump from exclusively B2B activities to B2C was a major strategic move. The project initiated with the formalization of a possible brand identity as being the necessary preliminary exercise. Through the study of all the design activities over 80 years of history and following a semiotic approach, brand aesthetics and ethics invariants were identified. Four different design teams were involved in the project and 5 main findings were identified in the course of the project: Tensions exist among the various design teams because of the lack of coherence in design and each pretends to interpret the brand in a more consistent way The creative teams feel the need for a well-defined and formalized brand identity, providing some missing common creative guidelines characterizing he brand The design teams participated actively and enthusiastically to the process of brand identity definition The President’s positive attitude towards the project and his direct involvement have been essential in the project success The tensions among the design teams have decreased by the brand identity definition process and results The study had direct academic and operational implications: It proved the validity of the semiotic approach to the formalization of brand identity A diagnostic tool was created to measure the degree of consistency of any designed brand manifestation (car, advertising, architecture, car show installations…) with respect to the defined brand ethics and aesthetics. Finally, Pininfarina presented a special concept car (Sintesi) at the Geneva car show in 2008 that integrated all the elements of the newly defined brand identity.
Cuspidal quintics and surfaces with , and 5-torsion
Authors: Rito Carlos
Published: February 2016

If $S$ is a quintic surface in $\mathbb{P}^{3}$ with singular set 15 3-divisible ordinary cusps, then there is a Galois triple cover ${\it\phi}:X\rightarrow S$ branched only at the cusps such that $p_{g}(X)=4$, $q(X)=0$, $K_{X}^{2}=15$ and ${\it\phi}$ is the canonical map of $X$. We use computer algebra to search for such quintics having a free action of $\mathbb{Z}_{5}$, so that $X/\mathbb{Z}_{5}$ is a smooth minimal surface of general type with $p_{g}=0$ and $K^{2}=3$. We find two different quintics, one of which is the van der Geer–Zagier quintic; the other is new.

We also construct a quintic threefold passing through the 15 singular lines of the Igusa quartic, with 15 cuspidal lines there. By taking tangent hyperplane sections, we compute quintic surfaces with singular sets $17\mathsf{A}_{2}$, $16\mathsf{A}_{2}$, $15\mathsf{A}_{2}+\mathsf{A}_{3}$ and $15\mathsf{A}_{2}+\mathsf{D}_{4}$.
The calcium–frequency response in the rat ventricular myocyte: an experimental and modelling study
Authors: Gattoni Sara , Røe Åsmund Treu , Frisk Michael , Louch William E. , Niederer Steven A. , Smith Nicolas P.
Published: February 2016

Key points

In the majority of species, including humans, increased heart rate increases cardiac contractility. This change is known as the force–frequency response (FFR). The majority of mammals have a positive force–frequency relationship (FFR). In rat the FFR is controversial.

We derive a species‐ and temperature‐specific data‐driven model of the rat ventricular myocyte.

As a measure of the FFR, we test the effects of changes in frequency and extracellular calcium on the calcium–frequency response (CFR) in our model and three altered models.

The results show a biphasic peak calcium–frequency response, due to biphasic behaviour of the ryanodine receptor and the combined effect of the rapid calmodulin buffer and the frequency‐dependent increase in diastolic calcium.

Alterations to the model reveal that inclusion of Ca2+/calmodulin‐dependent protein kinase II (CAMKII)‐mediated L‐type channel and transient outward K+ current activity enhances the positive magnitude calcium–frequency response, and the absence of CAMKII‐mediated increase in activity of the sarco/endoplasmic reticulum Ca2+‐ATPase induces a negative magnitude calcium–frequency response.

An increase in heart rate affects the strength of cardiac contraction by altering the Ca2+ transient as a response to physiological demands. This is described by the force–frequency response (FFR), a change in developed force with pacing frequency. The majority of mammals, including humans, have a positive FFR, and cardiac contraction strength increases with heart rate. However, the rat and mouse are exceptions, with the majority of studies reporting a negative FFR, while others report either a biphasic or a positive FFR. Understanding the differences in the FFR between humans and rats is fundamental to interpreting rat‐based experimental findings in the context of human physiology. We have developed a novel model of rat ventricular electrophysiology and calcium dynamics, derived predominantly from experimental data recorded under physiological conditions. As a measure of FFR, we tested the effects of changes in stimulation frequency and extracellular calcium concentration on the simulated Ca2+ transient characteristics and showed a biphasic peak calcium–frequency relationship, consistent with recent observations of a shift from negative to positive FFR when approaching the rat physiological frequency range. We tested the hypotheses that (1) inhibition of Ca2+/calmodulin‐dependent protein kinase II (CAMKII)‐mediated increase in sarco/endoplasmic reticulum Ca2+‐ATPase (SERCA) activity, (2) CAMKII modulation of SERCA, L‐type channel and transient outward K+ current activity and (3) Na+/K+ pump dynamics play a significant role in the rat FFR. The results reveal a major role for CAMKII modulation of SERCA in the peak Ca2+–frequency response, driven most significantly by the cytosolic calcium buffering system and changes in diastolic Ca2+.
TRICO II Core Inventory Calculation and its Radiological Consequence Analyses
Authors: Muswema J. L. , Ekoko G. B. , Lobo J. K.-K. , Lukanda V. M. , Boafo E. K.
Published: February 2016

Two severe accident scenarios are investigated in this paper as they have never been considered previously in the safety analysis report (SAR) of the Congo TRIGA Mark II research reactor (TRICO II) in Kinshasa, the Democratic Republic of Congo. The source term is derived from the reactor core after two postulated accidents: (1) a large plane crash with total destruction of the reactor building and (2) full damage of one fuel element while the reactor building remains intact. Total effective dose (TED), after core inventory, and dose profiles to human organs are derived to assess the operational safety of the reactor. Results from the study will be used to upgrade the current SAR of the reactor as the reactor safety and licensing concepts are changing over the years; the knowledge and lessons learned from the past experience are being updated accordingly with the available data. TEDs to workers of the facility show that higher values are obtained at areas near the source term at the time of the plane crash accident, which dies out as quickly as the plume is carried away following predominant meteorological conditions at the site. The situation with one fuel element totally damaged poses no threat as far as radiation protection is concerned and reveals a maximum TED of 1.30×10−7  mSv at 100 m from the reactor core. This shows that the operation of this type of research reactor is reliable and safe.
Oxidation Behavior of Austenitic Stainless Steel 316L and 310S in Air and Supercritical Water
Authors: Nezakat Majid , Akhiani Hamed , Penttilä Sami , Szpunar Jerzy
Published: February 2016

In this study, we evaluated the oxidation resistance of austenitic stainless steels 316L and 310S in two different environments: air at 600°C and atmospheric pressure and supercritical water at 600°C and pressure of 25 MPa. Results indicated that both alloys showed good oxidation resistance in air by producing a protective oxide layer on their surface. In addition, alloy 310S exhibited lower weight gain during air oxidation compared to alloy 316L due to its higher content of chromium and nickel. Oxidation of alloy 310S in supercritical water was much lower than that of alloy 316L because of the formation of a protective layer of Mn2CrO4 spinel on the surface. No protective scale was formed on the surface of the alloy 316L, as magnetite (Fe3O4) and iron-chromium spinel (FeCr2O4) were the product of oxidation in supercritical water.
Validity of Power Settings of the Wahoo KICKR Power Trainer
Authors: Zadow Emma K. , Kitic Cecilia M. , Wu Sam S.X. , Smith Stuart T. , Fell James W.
Published: February 2016

Purpose:

To assess the validity of power output settings of the Wahoo KICKR Power Trainer (KICKR) using a dynamic calibration rig (CALRIG) over a range of power outputs and cadences.

Methods:

Using the KICKR to set power outputs, powers of 100–999 W were assessed at cadences (controlled by the CALRIG) of 80, 90, 100, 110, and 120 rpm.

Results:

The KICKR displayed accurate measurements of power of 250–700 W at cadences of 80–120 rpm with a bias of –1.1% (95% limits of agreement [LoA] –3.6% to 1.4%). A larger mean bias in power was observed across the full range of power tested, 100–999 W (4.2%, 95% LoA –20.1% to 28.6%), due to larger biases of 100–200 and 750–999 W (4.5%, 95% LoA –2.3% to 11.3%, and 13.0%, 95% LoA –24.4% to 50.3%), respectively.

Conclusions:

Compared with a CALRIG, the KICKR has acceptable accuracy reporting a small mean bias and narrow LoA in the measurement of power output of 250–700 W at cadences of 80–120 rpm. Caution should be applied by coaches and sports scientists when using the KICKR at power outputs of <200 W and >750 W due to the greater variability in recorded power.
Validity and Reliability of a Digital Inclinometer to Assess Knee Joint-Position Sense in a Closed Kinetic Chain
Authors: Romero-Franco Natalia , Montaño-Munuera Juan Antonio , Jiménez-Reyes Pedro
Published: February 2016

Context: Knee joint-position sense (JPS) is a key parameter for optimum performance in many sports but is frequently negatively affected by injuries and/or fatigue during training sessions. Although evaluation of JPS may provide key information to reduce the risk of injury, it often requires expensive and/or complex tools that make monitoring proprioceptive deterioration difficult. Objective: To analyze the validity and reliability of a digital inclinometer to measure knee JPS in a closed kinetic chain (CKC). Design: The validity and intertester and intratester reliability of a digital inclinometer for measuring knee JPS were assessed. Setting: Biomechanics laboratory. Participants: 10 athletes (5 men and 5 women; 26.2 ± 1.3 y, 71.7 ± 12.4 kg; 1.75 ± 0.09 m; 23.5 ± 3.9 kg/m2). Intervention: Knee JPS was measured in a CKC. Main Outcome Measures: Absolute angular error (AAE) of knee JPS in a CKC. Results: Intraclass correlation coefficient (ICC) and standard error of the mean (SEM) were calculated to determine the validity and reliability of the inclinometer. Data showed that the inclinometer had a high level of validity compared with an isokinetic dynamometer (ICC = 1.0, SEM = 1.39, P < .001), and there was very good intra- and intertester reliability for reading the inclinometer (ICC = 1.0, SEM = 0.85, P < .001). Compared with AutoCAD video analysis, inclinometer validity was very high (ICC = 0.980, SEM = 3.46, P < .001) for measuring AAE during knee JPS in a CKC. In addition, the intertester reliability of the inclinometer for obtaining AAE was very high (ICC = .994, SEM = 1.67, P < .001). Conclusion: The inclinometer provides a valid and reliable method for assessing knee JPS in a CKC. Health and sports professionals could take advantage of this tool to monitor proprioceptive deterioration in athletes.
Lasting Improvement of Patient-Reported Outcomes 6 Months After Patellofemoral Pain Rehabilitation
Authors: Hamstra-Wright Karrie L. , Aydemir Burcu , Earl-Boehm Jennifer , Bolgla Lori , Emery Carolyn , Ferber Reed
Published: February 2016

Background/Objective:

Hip- and knee-muscle-strengthening programs are effective in improving short-term patient-reported and disease-oriented outcomes in individuals with patellofemoral pain (PFP), but few to no data exist on moderate- to long-term postrehabilitative outcomes. The first purpose of the study was to assess differences in pain, function, strength, and core endurance in individuals with PFP before, after, and 6 mo after successful hip- or knee-muscle-strengthening rehabilitation. The second purpose was to prospectively follow these subjects for PFP recurrence at 6, 12, and 24 mo postrehabilitation.

Methods:

For 24 mo postrehabilitation, 157 physically active subjects with PFP who reported treatment success were followed. At 6 mo postrehabilitation, pain, function, hip and knee strength, and core endurance were measured. At 6, 12, 18, and 24 mo, PFP recurrence was measured via electronic surveys.

Results:

Sixty-eight subjects (43%) returned to the laboratory at 6 mo. Regardless of rehabilitation program, subjects experienced significant improvements in pain and function, strength, and core endurance pre- to postrehabilitation and maintained improvements in pain and function 6 mo postrehabilitation (Visual Analog Scale/Pain—pre 5.12 ± 1.33, post 1.28 ± 1.14, 6 mo 1.68 ± 2.16 cm, P < .05; Anterior Knee Pain Scale/Function—pre 76.38 ± 8.42, post 92.77 ± 7.36, 6 mo 90.27 ± 9.46 points, P < .05). Over the 24 mo postrehabilitation, 5.10% of subjects who responded to the surveys reported PFP recurrence.

Conclusions:

The findings support implementing a hip-or knee-muscle-strengthening program for the treatment of PFP. Both programs improve pain, function, strength, and core endurance in the short term with moderate- and long-term benefits of improved pain and function and low PFP recurrence.
Metformin versus placebo in combination with insulin analogues in patients with type 2 diabetes mellitus—the randomised, blinded Copenhagen Insulin and Metformin Therapy (CIMT) trial
Authors: Lundby-Christensen Louise , Tarnow Lise , Boesgaard Trine W , S Lund Søren , Wiinberg Niels , Perrild Hans , Krarup Thure , Snorgaard Ole , Gade-Rasmussen Birthe , Thorsteinsson Birger , Røder Michael , Mathiesen Elisabeth R , Jensen Tonny , Vestergaard Henrik , Hedetoft Christoffer , Breum Leif , Duun Elsebeth , Sneppen Simone B , Pedersen Oluf , Hemmingsen Bianca , Carstensen Bendix , Madsbad Sten , Gluud Christian , Wetterslev Jørn , Vaag Allan , Almdal Thomas P
Published: February 2016

Objective

To assess the effect of metformin versus placebo both in combination with insulin analogue treatment on changes in carotid intima-media thickness (IMT) in patients with type 2 diabetes.

Design and setting

Investigator-initiated, randomised, placebo-controlled trial with a 2×3 factorial design conducted at eight hospitals in Denmark.

Participants and interventions

412 participants with type 2 diabetes (glycated haemoglobin (HbA1c) ≥7.5% (≥58 mmol/mol); body mass index >25 kg/m2) were in addition to open-labelled insulin treatment randomly assigned 1:1 to 18 months blinded metformin (1 g twice daily) versus placebo, aiming at an HbA1c≤7.0% (≤53 mmol/mol).

Outcomes

The primary outcome was change in the mean carotid IMT (a marker of subclinical cardiovascular disease). HbA1c, insulin dose, weight and hypoglycaemic and serious adverse events were other prespecified outcomes.

Results

Change in the mean carotid IMT did not differ significantly between the groups (between-group difference 0.012 mm (95% CI −0.003 to 0.026), p=0.11). HbA1cwas more reduced in the metformin group (between-group difference −0.42% (95% CI −0.62% to −0.23%), p<0.001)), despite the significantly lower insulin dose at end of trial in the metformin group (1.04 IU/kg (95% CI 0.94 to 1.15)) compared with placebo (1.36 IU/kg (95% CI 1.23 to 1.51), p<0.001). The metformin group gained less weight (between-group difference −2.6 kg (95% CI −3.3 to −1.8), p<0.001). The groups did not differ with regard to number of patients with severe or non-severe hypoglycaemic or other serious adverse events, but the metformin group had more non-severe hypoglycaemic episodes (4347 vs 3161, p<0.001).

Conclusions

Metformin in combination with insulin did not reduce carotid IMT despite larger reduction in HbA1c, less weight gain, and smaller insulin dose compared with placebo plus insulin. However, the trial only reached 46% of the planned sample size and lack of power may therefore have affected our results.

Trial registration number

NCT00657943; Results.