bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Hearing-Aid Outcomes
Authors: Lopez-Poveda Enrique A. , Johannesen Peter T. , Pérez-González Patricia , Blanco José L. , Kalluri Sridhar , Edwards Brent
Published: September 2017

Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients’ expectations.
Toward a neurobiologically informed psychiatry
Authors: Strik Werner
Published: September 2017

Schizophrenia is a severe and, at the same time fascinating disorder. It is traditionally defined as a «dissociation» of higher brain functions, which implies a modular organization of the brain up to its highest levels of organization. This short review shows how the study of the disorder is still flawed by fundamentally different definitions of the disorder, and that a consistent naturalistic approach may help to revise the vocabulary of psychiatric disorders, opening the way towards a neurobiologically informed psychiatry. Empirical studies and clinical importance supporting this novel approach are summarized.
Oto-Neuro-Ophthalmology Center
Authors: Straumann Dominik
Published: September 2017

Neuro-otology and neuro-ophthalmology are clinical fields destined to be combined in a single interdisciplinary center that offers state-of-the-art diagnosis and treatment to patients with vertigo, dizziness, imbalance, eye movements disorders and disorders of the afferent visual pathways. This paper describes the organization of the Oto-Neuro-Ophthalmology (ONO) center at University Hospital Zurich, Switzerland. The ONO center combines physicians and other medical personnel from the departments of neurology, otorhinolaryngology, ophthalmology, and psychiatry as well as dedicated physical therapists. Patients, typically referred to the center by general practitioners or medical specialists, are comprehensively assessed and treated by considering all neurological, otological, ophthalmological, psychiatric and physiotherapeutic aspects of their disorders. Based on the referral, the patient is assigned to a triage examination (duration: 30 minutes; no later than 10 days after referral) or a full examination. The latter includes a complete assessment of the medical history, a bedside examination, a laboratory test battery and imaging procedures. Importantly, the ONO center is partnered by an experimental laboratory dedicated to vestibular and ocular motor research and formed by the academically active members of the ONO center. To justify the collaborative efforts that go into establishing and continuously upgrading an ONO center, outcome measures become increasingly important.
Emerging mechanisms of long noncoding RNA function during normal and malignant hematopoiesis
Authors: Alvarez-Dominguez Juan R. , Lodish Harvey F.
Published: September 2017

Long noncoding RNAs (lncRNAs) are increasingly recognized as vital components of gene programs controlling cell differentiation and function. Central to their functions is an ability to act as scaffolds or as decoys that recruit or sequester effector proteins from their DNA, RNA, or protein targets. lncRNA-modulated effectors include regulators of transcription, chromatin organization, RNA processing, and translation, such that lncRNAs can influence gene expression at multiple levels. Here we review the current understanding of how lncRNAs help coordinate gene expression to modulate cell fate in the hematopoietic system. We focus on a growing number of mechanistic studies to synthesize emerging principles of lncRNA function, emphasizing how they facilitate diversification of gene programming during development. We also survey how disrupted lncRNA function can contribute to malignant transformation, highlighting opportunities for therapeutic intervention in specific myeloid and lymphoid cancers. Finally, we discuss challenges and prospects for further elucidation of lncRNA mechanisms.
Chimeric antigen receptor T-cell therapies for multiple myeloma
Authors: Mikkilineni Lekha , Kochenderfer James N.
Published: September 2017

Multiple myeloma (MM) is a nearly always incurable malignancy of plasma cells, so new approaches to treatment are needed. T-cell therapies are a promising approach for treating MM, with a mechanism of action different than those of standard MM treatments. Chimeric antigen receptors (CARs) are fusion proteins incorporating antigen-recognition domains and T-cell signaling domains. T cells genetically engineered to express CARs can specifically recognize antigens. Success of CAR-T cells (CAR-Ts) against leukemia and lymphoma has encouraged development of CAR-T therapies for MM. Target antigens for CARs must be expressed on malignant cells, but expression on normal cells must be absent or limited. B-cell maturation antigen is expressed by normal and malignant plasma cells. CAR-Ts targeting B-cell maturation antigen have demonstrated significant antimyeloma activity in early clinical trials. Toxicities in these trials, including cytokine release syndrome, have been similar to toxicities observed in CAR-T trials for leukemia. Targeting postulated CD19+ myeloma stem cells with anti-CD19 CAR-Ts is a novel approach to MM therapy. MM antigens including CD138, CD38, signaling lymphocyte–activating molecule 7, and κ light chain are under investigation as CAR targets. MM is genetically and phenotypically heterogeneous, so targeting of >1 antigen might often be required for effective treatment of MM with CAR-Ts. Integration of CAR-Ts with other myeloma therapies is an important area of future research. CAR-T therapies for MM are at an early stage of development but have great promise to improve MM treatment.
Effect of Comorbidity on Prostate Cancer–Specific Mortality: A Prospective Observational Study
Authors: Rajan Prabhakar , Sooriakumaran Prasanna , Nyberg Tommy , Akre Olof , Carlsson Stefan , Egevad Lars , Steineck Gunnar , Wiklund N. Peter
Published: September 2017

Purpose

To determine the effect of comorbidity on prostate cancer (PCa)–specific mortality across treatment types.

Patients and Methods

These are the results of a population-based observational study in Sweden from 1998 to 2012 of 118,543 men who were diagnosed with PCa with a median follow-up of 8.3 years (interquartile range, 5.2 to 11.5 years) until death from PCa or other causes. Patients were categorized by patient characteristics (marital status, educational level) and tumor characteristics (serum prostate-specific antigen, tumor grade and clinical stage) and by treatment type (radical prostatectomy, radical radiotherapy, androgen deprivation therapy, and watchful waiting). Data were stratified by Charlson comorbidity index (0, 1, 2, or ≥ 3). Mortality from PCa and other causes and after stabilized inverse probability weighting adjustments for clinical patient and tumor characteristics and treatment type was determined. Kaplan-Meier estimates and Cox proportional hazards regression models were used to calculate hazard ratios.

Results

In the complete unadjusted data set, we observed an effect of increased comorbidity on PCa-specific and other-cause mortality. After adjustments for patient and tumor characteristics, the effect of comorbidity on PCa-specific mortality was lost but maintained for other-cause mortality. After additional adjustment for treatment type, we again failed to observe an effect for comorbidity on PCa-specific mortality, although it was maintained for other-cause mortality.

Conclusion

This large observational study suggests that comorbidity affects other cause–mortality but not PCa-specific– mortality after accounting for patient and tumor characteristics and treatment type. Regardless of radical treatment type (radical prostatectomy or radical radiotherapy), increasing comorbidity does not seem to significantly affect the risk of dying from PCa. Consequently, differences in oncologic outcomes that were observed in population-based comparative effectiveness studies of PCa treatments may not be a result of the varying distribution of comorbidity among treatment groups.
Preventing Mistransfusions: An Evaluation of Institutional Knowledge and a Response
Authors: MacDougall Nickolas , Dong Fanglong , Broussard Latoya , Comunale Mark E.
Published: September 2017

BACKGROUND:

Blood product mistransfusions occur when a process error causes transfusion of incompatible blood products. These events are known sources of negative patient outcomes. One such event demonstrated an institutional knowledge gap and an opportunity to reduce this source of transfusion errors. The focus of this study was to evaluate the application of point of care cognitive aids to bridge potentially lethal knowledge gaps in blood product to patient compatibility.

METHODS:

A patient-donor ABO antigen compatibility grid for red blood cells (RBC) and fresh frozen plasma (FFP) was developed for creation of a cognitive aid and a blood product safety quiz. Participants included 117 registered nurses and postgraduate medical interns who were given 2 minutes to complete the quiz for establishing institutional controls. A separate group of 111 registered nurses and interns were given the same timed quiz twice, without and then with a blood product compatibility cognitive aid. An analysis of covariance was used to evaluate without cognitive aid versus with cognitive aid quiz results while taking the specialty (nurse versus interns) and baseline score into consideration. The blood bank adopted the grid as a forcing function to be completed before release of blood products.

RESULTS:

The correct RBC answer percentage increased from 84.7% to 98.3% without and with cognitive aid (average improvement 13.6%, standard deviation [SD] = 18.3%, 95% confidence interval, 10.1%–17.1%, P < .0001, Figure 3); the correct FFP answer percentage increased from 54.2% to 99.6% without and with cognitive aid (average improvement 45.4%, SD = 20.1%, 95% confidence interval, 41.7%–49.2%, P < .0001). Participants with lower baseline RBC and FFP score showed better improvement in the correct answer percentage for RBC and FFP (P < .001), respectively.

CONCLUSIONS:

The use of a cognitive aid for determining blood product ABO compatibility may improve performance during a time-limited test for matching correct patient and blood product ABO type. The use of the cognitive aid as a “forcing function” before the release of blood from the blood bank and before transfusion at the bedside may reduce transfusion mismatch associated with gaps in ABO compatibility knowledge.
Deep Serratus Plane Catheter for Management of Acute Postthoracotomy Pain After Descending Aortic Aneurysm Repair in a Morbidly Obese Patient: A Case Report
Authors: George Renuka M. , Yared Maria , Wilson Sylvia H.
Published: September 2017

Regional procedures for postthoracotomy pain control have classically focused on paravertebral blocks and thoracic epidurals; however, these techniques may be challenging in an increasingly obese population and contraindicated with numerous anticoagulant and antiplatelet agents. While less studied, truncal blocks allow analgesic intervention for this growing patient cohort. This case report describes placement of a deep serratus anterior plane catheter in an intubated, morbidly obese patient with a lumbar drain who failed extubation secondary to acute postthoracotomy pain. The serratus plane catheter facilitated extubation and adequate analgesia without prohibiting anticoagulant use or interfering with the monitoring of spinal cord function.
Placement of Stimulating Epidural Catheter for a Patient With Large Scapular Sarcoma: A Case Report
Authors: Turner James D. , Dobson Sean W. , Weller Robert S. , Lack Christopher M. , Henshaw Daryl S.
Published: September 2017

We report the use of continuous electrical stimulation to assist with the preoperative placement of a thoracic epidural which was used to provide postoperative analgesia in a patient undergoing excision of a large scapular sarcoma. The size of the sarcoma and the surrounding area required to maintain a sterile surgical field necessitated that the epidural catheter be inserted several vertebral interspaces caudal to the level of desired catheter tip termination. The use of electrical stimulation allowed for sequential intercostal muscle stimulation during threading, which enabled the placement of the catheter tip at the appropriate spinal level to optimize analgesia.
Methylene Blue to Treat Refractory Latex-Induced Anaphylactic Shock: A Case Report
Authors: Da Silva Paulo Sergio , Furtado Paula
Published: September 2017

Anaphylaxis occurs in 1/5000–1/20,000 of anesthesia cases and may evolve with shock and cardiovascular collapse in up to 54% of cases. Mortality varies from 3% to 10%. Latex is the second leading cause of anaphylaxis during the perioperative period. We report a case of latex-induced anaphylactic shock refractory to the usual catecholamine treatment that was reversed with the aid of methylene blue. Exaggerated activation of the nitric oxide–cyclic guanosine monophosphate pathway is observed in refractory shock. Methylene blue selectively inhibits this pathway.
Field swimming behavior in largemouth bass deviates from predictions based on economy and propulsive efficiency
Authors: Han Angela X. , Berlin Caroline , Ellerby David J.
Published: September 2017

Locomotion is energetically expensive. This may create selection pressures that favor economical locomotor strategies, such as the adoption of low-cost speeds and efficient propulsive movements. For swimming fish, the energy expended to travel a unit distance, or cost of transport (COT), has a U-shaped relationship to speed. The relationship between propulsive kinematics and speed, summarized by the Strouhal number (St=fA/U, where f is tail beat frequency, A is tail tip amplitude in m and U is swimming speed in m s−1), allows for maximal propulsive efficiency where 0.2<St<0.4. Largemouth bass adopted field speeds that were generally below the range predicted to minimize their COT. This may reflect speed modulation to meet competing functional demands such as enabling effective prey detection and capture. St exceeded the optimal range for the lowest observed swimming speeds. Mechanical and physiological constraints may prevent adoption of efficient St during low-speed swimming.
Innate colour preference, individual learning and memory retention in the ant Camponotus blandus
Authors: Yilmaz Ayse , Dyer Adrian G. , Rössler Wolfgang , Spaethe Johannes
Published: September 2017

Ants are a well-characterized insect model for the study of visual learning and orientation, but the extent to which colour vision is involved in these tasks remains unknown. We investigated the colour preference, learning and memory retention of Camponotus blandus foragers under controlled laboratory conditions. Our results show that C. blandus foragers exhibit a strong innate preference for ultraviolet (UV, 365 nm) over blue (450 nm) and green (528 nm) wavelengths. The ants can learn to discriminate 365 nm from either 528 nm or 450 nm, independent of intensity changes. However, they fail to discriminate between 450 nm and 528 nm. Modelling of putative colour spaces involving different numbers of photoreceptor types revealed that colour discrimination performance of individual ants is best explained by dichromacy, comprising a short-wavelength (UV) receptor with peak sensitivity at about 360 nm, and a long-wavelength receptor with peak sensitivity between 470 nm and 560 nm. Foragers trained to discriminate blue or green from UV light are able to retain the learned colour information in an early mid-term (e-MTM), late mid-term (l-MTM), early long-term (e-LTM) and late long-term (l-LTM) memory from where it can be retrieved after 1 h, 12 h, 24 h, 3 days and 7 days after training, indicating that colour learning may induce different memory phases in ants. Overall, our results show that ants can use chromatic information in a way that should promote efficient foraging in complex natural environments.
pH control in the midgut of Aedes
aegypti under different nutritional conditions
Authors: Nepomuceno Denise Barguil , Santos Vânia Cristina , Araújo Ricardo Nascimento , Pereira Marcos Horácio , Sant'Anna Maurício Roberto , Moreira Luciano Andrade , Gontijo Nelder Figueiredo
Published: September 2017

Aedes aegypti is one of the most important disease vectors in the world. Because their gut is the first site of interaction with pathogens, it is important to understand A. aegypti gut physiology. In this study, we investigated the mechanisms of pH control in the midgut of A. aegypti females under different nutritional conditions. We found that unfed females have an acidic midgut (pH ∼6). The midgut of unfed insects is actively maintained at pH 6 regardless of the ingestion of either alkaline or acidic buffered solutions. V-ATPases are responsible for acidification after ingestion of alkaline solutions. In blood-fed females, the abdominal midgut becomes alkaline (pH 7.54), and the luminal pH decreases slightly throughout blood digestion. Only ingested proteins were able to trigger this abrupt increase in abdominal pH. The ingestion of amino acids, even at high concentrations, did not induce alkalinisation. During blood digestion, the thoracic midgut remains acidic, becoming a suitable compartment for carbohydrate digestion, which is in accordance with the higher alpha-glucolytic activity detected in this compartment. Ingestion of blood releases alkalising hormones in the haemolymph, which induce alkalinisation in ex vivo preparations. This study shows that adult A. aegypti females have a very similar gut physiology to that previously described for Lutzomyia longipalpis. It is likely that all haematophagous Nematocera exhibit the same type of physiological behaviour.
Solar-powered ventilation of African termite mounds
Authors: Ocko Samuel A. , King Hunter , Andreen David , Bardunias Paul , Turner J. Scott , Soar Rupert , Mahadevan L.
Published: September 2017

How termite mounds function to facilitate climate control is still only partially understood. Recent experimental evidence in the mounds of a single species, the south Asian termite Odontotermes obesus, suggests that the daily oscillations of radiant heating associated with diurnal insolation patterns drive convective flow within them. How general this mechanism is remains unknown. To probe this, we consider the mounds of the African termite Macrotermes michaelseni, which thrives in a very different environment. By directly measuring air velocities and temperatures within the mound, we see that the overall mechanisms and patterns involved are similar to that in the south Asian species. However, there are also some notable differences between the physiology of these mounds associated with the temporal variations in radiant heating patterns and CO2 dynamics. Because of the difference between direct radiant heating driven by the position of the sun in African conditions, and the more shaded south Asian environments, we see changes in the convective flows in the two types of mounds. Furthermore, we also see that the south Asian mounds show a significant overturning of stratified gases, once a day, while the African mounds have a relatively uniform concentration of CO2. Overall, our observations show that despite these differences, termite architectures can harness periodic solar heating to drive ventilation inside them in very different environments, functioning as an external lung, with clear implications for human engineering.
Analytical Study of the Process of Sowing Seeds of Conifers by Pin Sowing Unit
Authors: Казаков Игорь , Kazakov Igor' , Казаков Владимир , Kazakov Vladimir
Published: September 2017

The cultivation of seedlings in forest tree nurseries for reforestation and afforestation is an important task of forestry. For sowing seeds of coniferous species in forest nurseries seeder with coil sowing machines are used, which do not provide the desired uniformity of seeding and damage seeds when sowing. Pin sowing machines allow you to eliminate these drawbacks, so research process is interested for forestry. As a result of the research of the process of sowing seeds of conifers by sowing machines with pin metering apparatus, formulas for determination of its angular velocity and rotational speed of the drive of furrow making roller. Formulas to determine seeding rate are proposed, taking into account constructive parameters of seeding machine and size of pins. It is noted that the increase in height and width of pins and also fill factor and number of rows of pins leads to the increase in standards; and increase in gear ratio of the actuator causes its decrease. Uneven supply of seed increases with increased size of pins, so thickness of pins is recommended to be minimum one, taking into account its sufficient strength. Conducted analytical research of the process of work of pin sowing unit enabled to obtain the necessary expressions for calculating structural and technological parameters of the forest sowing machine for sowing seeds of coniferous species in forest nurseries.
Experimental Study of the Dynamics of Weakening of Retention Force of Movable Wooden Structures in Friction Gripping Devices
Authors: Бабкин Александр , Babkin Aleksandr , Мелехов Владимир , Melekhov Vladimir , Руденко Александр , Rudenko Aleksandr
Published: September 2017

When using friction gripping device with a screw drive to move designs from wood there is relaxation of tightening force of the screw with time due to rheological characteristics of wood. Weakening of tightening leads to a reduction of friction forces, holding the floating structure, which can lead to failure and drop of structure. To ensure reliable holding of wooden construction by gripping device within the specified time, prior increase in torque taking into account dynamics subsequent weakening is required. The article presents description of experimental setup to study the rate of weakening of the torque of the screw clamp and development of elastic deformation of samples of wood and plywood of different thickness with clamps of different hardness. Dependence of elastic strain and associated weakening of tightening force from time which samples stay under load, is revealed. The dependence has general nature for all the samples of wood and derivative materials. Regression analysis of the data and graphs of weakening the tightness of the clamps and development of elastic deformations is performed for each experiment. It is established that approximation to exponential function reflects the dependence of attenuation of torque settings on time in the interval up to 24 hours more accurately, than exponential function. To identify factors influencing the rate of weakening of the torque, regression analysis is made. The dependence of the rate of weakening of the torque by on stiffness of the clamp, thickness of wooden construction in the place of installation of gripping device and of the modulus of elasticity of wood is revealed. With the increase in rigidity of clamp and size of cross section of structure, weakening speed increases. Method of determining the rate of increase in force of pre-tightening of friction gripping device with screw drive to move wooden structures is suggested.
The Influence of Environmental and Operational Properties of Plywood on Its Competitiveness and Consumer Risks
Authors: Анисимов Максим , Anisimov Maksim
Published: September 2017

The paper presents data on the influence of operating parameters of finished plywood (formaldehyde emission, tensile strength) on the performance of consumer risks, and changes in its competitiveness. Modern scientific literature focuses on research and development of methods to reduce business risks, aimed at reducing all kinds of economic costs (production, advertising, transportation, etc.). There is virtually no information on the impact of product quality on consumer risks and competitiveness. However, when considering this question regarding the wood and furniture industry, it is worth significant attention due to the fact that the use of glued laminated materials (plywood to a greater extent) as a construction and design materials, because of their significant advantages is increasing every year. Along with this there is a rapid improvement of production methods and used materials. One of the traditional technologies for the production of plywood is gluing sheets of veneer using urea-formaldehyde resins of various modifications. Using a wide range of sorbents is practiced as a part of the applied adhesive composition, action of which can be sent both for simple regulation of flow rate of adhesive and complex processes of reduction of formaldehyde emissions and increase of plywood in strength. An example of reduction of release of formaldehyde can be scientifically proven use of natural mineral clinoptilolite as sorbent-filler, modified in a variety of electromagnetic fields (superhigh frequency field (UHF EMF) and weak pulsed magnetic field (WPMF)). In this regard, the paper describes the impact of changes in basic performance properties of plywood (emission of free formaldehyde and ultimate strength) on consumer risks and competitiveness of finished plywood.
Incentives and Constraints in the Development of Alternative Energy at the Local Level: International and Russian Experience
Authors: Терешина Мария , Tereshina Mariya , Вальвашов Александр , Val'vashov Aleksandr
Published: September 2017

The purpose of the study was the comparative analysis of Russian and foreign practices of alternative energy development at the local level. The object of this research is the set of administrative influences that act as determinants of the formation of generation based on renewable energy as part of sustainable development of local communities and green economy. The subject of study is mechanisms, tools and practices of development of alternative energy. The main methods of research work are general theoretical research methods: analysis and synthesis, as well as methods of measurement, comparison, grouping and graphics. To assess the "gaps" between the current and target status of "green" energy as a set of controlled subsystems, the authors propose a method of GAP analysis, at this the main subsystems are allocated as the share of clean energy in the total volume of its generation, the average share of domestic equipment and components in the composition of power plants for alternative energy, the average level of depreciation of power plants to alternative energy, the average time to receive a construction permission for installations of renewable energy sources and connection to the central power grid. The article analyzed and systematized to-date mechanisms to stimulate the development of alternative energy in municipalities and regional governments in foreign countries. General constraints in the development of alternative power generation are revealed. The differentiation of regions of Russia according to the share of "green" power generation in its total production is made. Practices for effective implementation of infrastructure projects of "green" energy in municipalities of the Russian Federation are described and incentives for alternative energy development at the local level are defined. On the basis of generalization of experience of infrastructure projects in the field of alternative energy in cities and regions of Russia the most significant "barriers" in the development of renewable energy infrastructure at the local level are selected and classified , which include economic, administrative, institutional, technological and climatic ones. Several recommendations for the development of incentives to overcome constraints are formulated.
The Heat of Combustion of Refined Wood Fuel
Authors: Ермоченков Михаил , Ermochenkov Mihail , Хроменко Андрей , Khromenko Andrey
Published: September 2017

Torrefication is a process of low-temperature pyrolysis of wood, used to improve the properties of wood fuel. Torrefied fuel has several advantages compared to the original. Thermal degradation causes changes in mass and composition of wood with increase in carbon percentage, which leads to an increase of combustion value Q. Thermal destruction can be viewed as a multistage process. The degree of decomposition of the material depends on temperature, time of exposure to heat and kinetic parameters of each stage of the process. The article presents the results of experimental studies of combustion value of torrefied woody biomass and its dependence on the degree of thermal decomposition. For experimental studies experimental setup was designed and manufactured. Experimental checking of the installation was carried out. The test showed that accuracy of determining combustion value is not more than 2 %. For experimental studies of the dependence of combustion value on the degree of thermal degradation, samples of wood were prepared in its unsaturated decomposition. Heat treatment of samples was carried out in inert gas environment of helium. Values of heat combustion of wood fuel with varying degrees of thermal destruction are obtained. Model of the dependence of calorific value from relative mass of wood fuel ω is proposed. The mathematical model allowing to determine the relative mass of wood as a function of temperature and time is represented. Dependence of combustion value on degree of thermal decomposition of wood is obtained in explicit form.
Improving HIV Early Infant Diagnosis Supply Chains in Sub-Saharan Africa: Models and Application to Mozambique
Authors: Jónasson Jónas Oddur , Deo Sarang , Gallien Jérémie
Published: September 2017

Early diagnosis of the human immunodeficiency virus (HIV) among infants born to HIV-infected mothers is critical because roughly 50% of untreated infected infants die before the age of two years. Yet most countries in sub-Saharan Africa experience significant delays in diagnosis because of operational inefficiencies in early infant diagnosis (EID) networks. We develop a two-part modeling framework relying on optimization and simulation to generate operational improvements in the assignment of clinics to laboratories and the allocation of capacity across laboratories, and to evaluate the associated impact on the number of infants initiating treatment. Applying our methodology to EID program data from Mozambique, we validate our simulation model and estimate that optimally reassigning clinics to labs would decrease the average sample turnaround time (TAT) by 11% and increase the number of infected infants starting treatment by about 4% relative to the current system. Furthermore, consolidating all diagnostic capacity in one centralized lab would decrease average TATs by an estimated 22% and increase the number of infected infants initiating treatment by 7%. Our sensitivity analysis suggests that the consolidation of capacity in a single location would remain near optimal across a wide range of laboratory utilization levels in Mozambique. However, this full consolidation solution is dominated by configurations with two or more labs for EID networks with average transportation times larger than those currently observed in Mozambique by at least 15%.

The online appendix is available at https://doi.org/10.1287/opre.2017.1646 .
Editorial
Authors: Franco Peter
Published: September 2017

DOI:10.12957/ek.2017.30456Editorial Vol. 6 n.1
Mejora de la satisfacción corporal en chicas y chicos preadolescentes: Efectos a corto plazo de un programa escolar
Authors: Hinz Arnold
Published: September 2017

Introducción. El objetivo de esta investigación ha sido evaluar el programa de prevención escolar Mi cuerpo y yo. El programa fue desarrollado para que los niños y niñas fueran mejor preparados de cara a los cambios inevitables de la pubertad.Método. Para este estudio se empleó un modelo de grupo experimental y grupo control en colegios de Alemania y Francia; hubo 25 clases experimentales y 17 clases de control (484 niños y 485 niñas; edad media de 10,5 años); se midieron los cambios entre pretest y postest.Resultados: En comparación con las clases de control, las clases experimentales muestran un incremento significativo de conocimiento (tamaño de efecto = 0.89), una reducción en la insatisfacción con su cuerpo (TE = 0.12), y en la preocupación por la forma corporal (TE = 0.11), así como un alejamiento del ideal de un cuerpo delgado (SE = 0.13).Discusión y Conclusiones. Los resultados de esta investigación sugieren que el Programa Mi cuerpo y yo es eficaz para la reducción de la insatisfacción corporal en niños y niñas de cuarto y quinto curso de Educación Primaria.
Maternal Knowledge and Use of Galactagogues in Andean Communities of Cusco, Peru
Authors: Monteban Madalena
Published: September 2017

A commonly reported reason for early breastfeeding cessation is inadequate milk production. In response, women across the globe turn to galactagogues – substances used to increase the milk supply. Andean women have traditional knowledge about the medicinal and nutritional properties of plants and animals that are considered good to eat during breastfeeding. This research explores the maintenance and use of galactagogues, and specifically the use of the Andean flicker bird, within the wider framework of breastfeeding and nutrition policies in Peru. To elicit maternal knowledge and use of galactagogues, semi-structured and free-listing interviews were conducted with 33 mothers. Data analysis calculated the frequency and percentage of women reporting each type of galactagogue. In addition, thematic codes and relevant text passages were used in an iterative analytic process to document emerging themes. Identified galactagogues included five plants and six animals. Several galactagogues included protein-rich foods such as lamb meat and the Andean flicker bird. The use of protein-rich galactagogues as solid food is reinforced by public health messages. However, galactagogues in the research communities are usually consumed as soups or drinks, which are less rich in proteins than solid meals. The potential role of liquid galactagogues in the maintenance of appropriate hydration levels during breastfeeding in an environment where safe drinking water is scarce is a new contribution to the existing literature. The results are relevant to the design of maternal and child health policies that comply with intercultural health premises that value and respect the knowledge and practices of Andean Peoples.
Pirates, Captives, and Conversions: Rereading British Stories of White Slavery in the Early Modern Mediterranean
Authors: Hartner Marcus
Published: September 2017

While captivity narratives have long been recognized as an important field of research in American Studies, the substantial body of autobiographical tales portraying captivity in the Muslim world published in England between the late sixteenth and early eighteenth century has only recently begun to attract the attention of literary scholars. Despite a number of important pioneering works, however, British captivity narratives have not only remained at the margins of early modern studies, but even where they have received attention they have mainly been treated as historical source material. In other words, there has hardly been any interest in the genre of captivity narratives as a textual and literary phenomenon in its own right. As a consequence, most of the published stories in question lack thorough narrative analysis, although the genre is situated at the intriguing intersection of travel literature, religious writing (e. g. tales of martyrdom), and prose fiction, and arguably constitutes one of the forerunners of the early novel. This paper proposes that we need to go beyond the limits of current research by rereading British tales of captivity with a stronger interest in their narrative composition, their discursive and generic contexts, and the pragmatics of publishing. Only in this way it will be possible to both do justice and draw more sustained attention to this highly fascinating and yet still understudied genre of literary texts.
Effects of different dietary n-6:n-3 PUFA ratios on growth performance, blood lipid profiles, fatty acid composition of pork, carcass traits and meat quality in finishing pigs
Authors: Liu Wen Chao , Kim In Ho
Published: September 2017

A total of 72 crossbred pigs [(Landrace × Yorkshire) × Duroc] with an average initial BW of 51.59±1.59 kg were used in this 10-wk feeding trial to investigate the effects of different dietary n-6:n-3 polyunsaturated fatty acids (PUFA) ratios in finishing pigs. Pigs were randomly allotted to 3 dietary treatments (each n=24) with 6 replications and 4 pigs per pen (2 barrows and 2 gilts). Pigs were fed a corn-soybean meal-based diets formulated by replacing soybean oil with linseed oil to achieve n-6:n-3 close to 5:1, 10:1 and 15:1, respectively. The growth performance, carcass traits and meat quality parameters (meat color, sensory evaluation, cooking loss, drip loss, pH, longissimus muscle area and water holding capacity) were not influenced (P>0.10) by various dietary n-6:n-3 ratios. Pigs fed dietary n-6:n-3 PUFA ratios of 5:1 had a lower (P<0.05) serum total cholesterol, LDL cholesterol and triglyceride levels. The concentrations of n-3 PUFA , including C18:3n-3, C22:5n-3 and C22:6n-3 were improved (P<0.05) in the longissimus dorsi muscles of pigs fed dietary n-6:n-3 PUFA ratios of 5:1. Furthermore, pigs fed dietary n-6:n-3 PUFA ratio of 5:1 decreased (P<0.05) the n-6 concentrations (C18:2n-6 and C20:4n-6) of longissimus dorsi muscles. In conclusion, lowering the dietary n-6:n-3 ratios to 5:1 could be beneficial for the blood lipid profiles, and improve the nutritional value of pork, without adverse effect on growth performance and meat quality parameters that are related to the consumer acceptance.
Insulin autoimmune syndrome (Hirata’s disease) in an Italian patient: a case report and review of the literature
Authors: Censi Simona , Albergoni Maria Paola , Gallo Nicoletta , Plebani Mario , Boscaro Marco , Betterle Corrado
Published: September 2017

We describe the case of a 54-year-old Caucasian Italian male experiencing episodes of hypoglycemia, occurring mainly after meals. He had never been exposed to insulin and was taking ramipril, flecainide and acetylsalicylic acid. An oral glucose tolerance test (OGTT) showed high blood glucose levels diagnostic for diabetes mellitus at 120 min and hypoglycemia with inappropriately high insulin levels at 240 min. The 72-h fasting test, abdominal computed tomography (CT) and positron emission tomography-CT were normal. Insulin autoantibodies were positive at high titers, prompting a diagnosis of insulin autoimmune syndrome (IAS). The patient was advised to take frequent, small meals and thus achieved a good control of his hypoglycemic symptoms. After 18 months of this dietary management, his insulin autoantibody levels decreased considerably but remained detectable. During an OGTT, his blood glucose levels at 120 min were now indicative of an impaired glucose tolerance rather than diabetes, and there was improvement in the glucose nadir. The patient had no other clinical or latent autoimmune diseases. Here we discuss the main features of IAS (also known as Hirata’s disease) and review the cases of IAS reported in Italy to date.
A Comparative Analysis of Initiatives and Adaptation Measures To Climate Change Undertaken in Poland and Eastern EU Countries
Authors: Michalak Dorota
Published: September 2017

Climate change is one of the greatest contemporary threats to our planet’s environmental, social and economic condition. It is accompanied by massive changes in life support systems on Earth, where its far‑reaching effects will be felt in the upcoming decades. The development of a national adaptation policy (strategy and/or plan) serves as an instrument that provides the necessary framework for adaptation by coordinating the consideration of climate change across relevant sectors, geographical scales, and levels of decision making. The purpose of this paper is to compare the degree of influence of climate change on the economy of the Eastern European Union and compare national strategies for adaptation to climate change in selected countries of Western Europe and Poland. The study shows that countries bearing the brunt of the negative impacts of climate change are Cyprus, Malta, Bulgaria and Poland. These countries recorded the highest climate change index, the greatest losses in terms of estimated GDP, household welfare, land losses, and lower incomes in the agricultural and tourism sectors. With appropriate adaptation measures, countries such as Lithuania, Latvia and Estonia can take advantage of the future changes in weather conditions. A shift in the productivity of the agricultural sector and tourism from south to north can be noted.
Determinants of The Application of Macro Prudential Instruments
Authors: Zakaria Firano , Fatine Filali A.
Published: September 2017

The use of macro prudential instruments today gives rise to a major debate within the walls of central banks and other authorities in charge of financial stability. Contrary to micro prudential instruments, whose effects remain limited, macro prudential instruments are different in nature and can affect the stability of the financial system. By influencing the financial cycle and the financial structure of financial institutions, the use of such instruments should be conducted with great vigilance as well as macroeconomic and financial expertise. But the experiences of central banks in this area are sketchy, and only some emerging countries have experience using these types of instruments in different ways. This paper presents an analysis of instruments of macro prudential policy and attempts to empirically demonstrate that these instruments should be used only in specific economic and financial situations. Indeed, the results obtained, using modeling bivariate panel, confirm that these instruments are more effective when used to mitigate the euphoria of financial and economic cycles. In this sense, the output gap, describing the economic cycle, and the Z-score are the intermediate variables for the activation of capital instruments. Moreover, the liquidity ratio and changes in bank profitability are the two early warning indicators for activation of liquidity instruments.
Regional Differentiation of The Demographic Potential in Italy and Poland
Authors: Pastuszka Sławomir
Published: September 2017

The aim of this paper is to compare the demographic potential of given Italian and Polish regions. The analysis shows that the demographic situation in Poland, unlike in Italy, is not directly related to the level of development of some regions and their geographical location. In Italy, the unfavorable demographic situation is typical of most of the less-developed southern regions, whereas in Poland it oc­curs in voivodships with different economic potential, situated in different parts of the country. This is probably the result of the current polycentric development of Poland, characteristic of a centralized economy, and the polar development in Italy. Certain demographic similarities, but of different levels, related to the dynamics of the population, the level of fertility, and net migration are observable in the macro-regions of Mezzogiorno and Eastern Poland.
Pilot study: whole body manual subcutaneous adipose tissue (SAT) therapy improved pain and SAT structure in women with lipedema
Authors: Herbst Karen L. , Ussery Christopher , Eekema Alyna
Published: September 2017

Background

Lipedema is a common painful subcutaneous adipose tissue (SAT) disorder in women affecting the limbs. SAT therapy is a manual therapy to improve soft tissue quality.

Objective

Determine if SAT therapy improves pain and structure of lipedema SAT.

Design

Single arm prospective pilot study.

Setting

Academic medical center.

Patients

Seven women, 46 ± 5 years, weight 90 ± 19 kg, with lipedema.

Intervention

Twelve 90-min SAT therapy sessions over 4 weeks.

Outcomes

Dual X-ray absorptiometry (DXA) scans, SAT ultrasound (Vevo 2100), leg volumetrics, skin caliper assessment, tissue exam, weight, resting metabolic rate, pain assessment, lower extremity functional scale (LEFS) and body shape questionnaire (BSQ) at baseline and end of study.

Results

Weight, resting metabolic rate and BSQ did not change significantly. Limb fat over total body fat mass (p = 0.08) and trunk fat over total body mass trended down from baseline (p = 0.08) by DXA. Leg volume and caliper assessments in eight of nine areas (p < 0.007), LEFS (p = 0.002) and average pain (p = 0.007) significantly decreased from baseline. Fibrosis significantly decreased in the nodules, hips and groin. Ultrasound showed improved SAT structure in some subjects. Side effects included pain, bruising, itching, swelling and gastroesophageal reflux disease. All women said they would recommend SAT therapy to other women with lipedema.

Limitations

Small number of subjects.

Conclusion

SAT therapy in 4 weeks improved tissue structure, perceived leg function, and volume although shape was not affected. While side effects of SAT therapy were common, all women felt the therapy was beneficial.
Fischer-Tropsch synthesis: Variation of Co/ ${{\gamma}}$ γ -Al2O3 catalyst performance due to changing dispersion, reducibility, acidity and strong metal-support interaction by Ru, Zr and Ce promoters
Authors: Amin Moradian , Farzad Bahadoran , Laleh Shirazi , Yahya Zamani
Published: September 2017

In this study the effect of (0.1 %Ru, 0–10 % Zr) and (0.1 %Ru, 0–10 % Ce) promoters on dispersion, strong metal-support interaction and reduction behavior of cobalt-supported alumina catalyst in the Fischer-Tropsch synthesis was investigated. The synthesized catalysts were characterized by BET, XRD, ICP, TPR, XPS, and TEM techniques. The results show that addition of Ce to the catalyst leads to the shift of the TPR peaks to lower temperatures which expected that shows higher activity due to higher reducibility, but surprisingly due to SMSI effect results in the lower catalyst activity compared with the unpromoted catalyst. Also, there was a synergistic effect between Ce and Ru in the reduction behavior of Ru-Ce promoted catalyst. The other notable finding of this study was the improvement in the catalyst reducibility in the presence of Zr compared with the unpromoted one that equivalently means the higher catalyst activity. Comparison of the Zr-promoted with the Ce-promoted catalysts show that the former have higher catalyst activity than the latter due to higher acidity and SMSI effect in the presence of the Zr promoter. The C5selectivity of the 0.1Ru10Zr/15Co and 3Ce/15Co catalysts at low pressure have shown more than 50 % improvement compared to the unpromoted one. Based on the activity at atmospheric pressure; the unpromoted, 0.1Ru/15Co, 0.1Ru3Ce/15Co and 0.1Ru10Zr/15Co catalysts were selected for high pressure condition tests, in which the 0.1Ru10Zr/15Co catalyst shows the highest catalyst activity and heavier hydrocarbon selectivity.