bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of dose and diet on the pharmacodynamics of omeprazole in the horse
Authors: Sykes B. W. , Underwood C. , Greer R. , McGowan C. M. , Mills P. C.
Published: August 2016

Background

Conflicting data are presented in the current literature regarding the efficacy of omeprazole for suppressing gastric acidity in the horse.

Objectives

The objective of this study was to investigate the duration of intraday acid suppression achieved with two doses of omeprazole under two different dietary conditions.

Study design

A four‐way crossover design.

Methods

Six adult Thoroughbred horses instrumented with percutaneous gastrotomy tubes were used. Intragastric pH was measured for continuous 23 h periods (08.00–07.00 h) for six consecutive days (Days 0–5). Baseline data was recorded on Day 0 and omeprazole administered on Days 1–5. Two doses (1 mg/kg and 4 mg/kg bwt per os once a day) and two diets (a high grain/low fibre [HG/LF] and ad libitum hay [HAY)] diet) were studied. Data for the percent (%) time pH was above 4 (%tpH>4) and median intraday pH was reported for two measurement locations and analysed using generalised estimating equations.

Results

An effect of both diet and dose was evident with mean %tpH>4 and the mean of the median intraday pHs typically higher at the higher (4 mg/kg bwt) dose and in HG/LF diet. The overall efficacy of omeprazole in raising intragastric pH was good under the HG/LF conditions but relatively poor in the HAY diet. A cumulative effect of dosing, not previously reported in the horse, was observed.

Conclusions

The overall efficacy of omeprazole in raising ventral gastric pH was less than previously reported. Both dose and diet may play a role in the efficacy of omeprazole in the horse. Therefore, the use of singular dosing recommendations that encompass all horse types and management conditions may not be appropriate and dosing recommendations that take into account the diet of the horse may be advantageous.
Massive parallel sequencing of solid tumours – challenges and opportunities for pathologists
Authors: Harris Gavin , O'Toole Sandra , George Peter , Browett Peter , Print Cristin
Published: August 2016

The role of pathologists is to provide diagnostic, prognostic and predictive data to enable clinical colleagues to manage patients optimally. Current histo/anatomical pathology is predominantly morphology‐based, with the addition of biomarkers, applied largely through immunohistochemistry, fluorescence in‐situ hybridization (FISH) and a limited range of polymerase chain reaction (PCR)‐based molecular tests. The desire to apply genomics to the clinical care of patients has been facilitated by the human genome project and subsequently by high‐throughput technologies known collectively as massive parallel sequencing (MPS, also referred to as next‐generation sequencing, NGS). The use of MPS to identify mutations/variants and tissue RNA expression profiles for diagnosis, prognostication and targeted therapy stratification is now a reality in many clinical specialities. If histopathologists are considered experts in solid tumour pathology, MPS potentially falls within their scope; however, it challenges our predominant morphology‐based paradigm. This review summarizes and comments on the current and future state of play of MPS for the practising histopathologist. It will focus on somatic mutations in solid tumours and will challenge histopathologists to take further leadership roles in this area.
Euroguidelines in Central and Eastern Europe (ECEE) conference and the Warsaw Declaration – a comprehensive meeting report
Authors: Kowalska JD , Oprea C , de Witt S , Pozniak A , Gökengin D , Youle M , Lundgren JD , Horban A ,   the ECEE Network Group
Published: August 2016

Objectives

The objective of this paper is to summarize the outcomes of the Euroguidelines in Central and Eastern Europe (ECEE) conference held in Warsaw in February 2016. The main aim of this conference was to facilitate a discussion on European AIDS Clinical Society (EACS) guidelines implementation across the region and neighbouring countries and to present the current obstacles in benchmarking HIV care in Europe.

Methods

During a 2‐day meeting, there were country‐based presentations using a predefined template so as to make the data comparable and focus the discussion. Areas covered were country epidemiology, surveillance, national strategy for treatment and prevention, standards of care, access to care and treatment availability. Each participant filled in a questionnaire investigating HIV guidelines usage per country.

Results

In total, 16 Central and Eastern Europe (CEE) and neighbouring countries were represented at the conference: Albania, Armenia, Belarus, Croatia, Czech Republic, Estonia, Georgia, Hungary, Lithuania, Moldova, Poland, Romania, Russia, Serbia, Slovakia and Turkey. EACS guidelines version 7.1 were used in 14 (87%) countries. In 11 (69%) countries, national guidelines were available, of which eight had been recently updated. Half of the countries declared that they use World Health Organization (WHO) and Department of Health and Human Services (DHHS) guidelines, over one‐third the European Centre for Disease Prevention and Control (ECDC) HIV testing guidelines and one in five the International Antiviral Society−USA (IAS‐USA) Panel guidelines from 2012.

Conclusions

Participants declared their will to promote the widespread use of EACS guidelines for HIV infection in the CEE region and neighbouring countries by signing the Warsaw Declaration. They also emphasized the need to increase publishing of data from national cohorts in that region.
Normalisation of hypoxaemia following successful percutaneous closure of a bidirectional shunting secundum atrial septal defect without pulmonary hypertension in a patient with severe non‐ischaemic cardiomyopathy and refractory ventricular tachycardia
Authors: Anderson R. D. , Wilson W. , Morton J. , Aggarwal A.
Published: August 2016

Atrial septal defects (ASD) are an uncommon cause of dyspnoea. A high index of suspicion is required, and further investigation should be prompted in patients with unexplained hypoxaemia, particularly those with pulmonary hypertension. Hypoxic ASD without pulmonary hypertension are rare, and only a handful of cases have been published. We present a middle‐aged man with progressive dyspnoea with a successfully closed ASD without pulmonary hypertension caused by elevated right ventricular pressures secondary to an idiopathic cardiomyopathy.
Outcomes of patients with non‐melanoma solid tumours receiving self‐funded pembrolizumab at Chris O'Brien Lifehouse
Authors: Lomax A. J. , Beith J. , Bhadri V. , Boyer M. , Grimison P. , Horvath L. G. , Kao S. , Tattersall M. , Thomas D. , McNeil C.
Published: August 2016

Background

Immunotherapy agents show anti‐cancer activity in several solid cancers. Efficacy in non‐melanoma solid tumours for non‐approved indications is unknown.

Aim

To evaluate patient and disease characteristics, rate and duration of response, and toxicity of self‐funded pembrolizumab in patients with non‐melanoma solid cancers.

Method

Retrospective review describing outcomes and toxicity of self‐funded pembrolizumab in patients with non‐melanoma solid cancers treated at Chris O'Brien Lifehouse.

Results

From April 2015 to December 2015, 21 patients received or were planned to receive self‐funded pembrolizumab. The median age was 50 years (16–76), 28 and 10% had an Eastern Cooperative Oncology Group performance status of 2, and 3–4 respectively. Sixty‐two percent received at least two to four lines of prior drug treatment. Median follow‐up was 3.0 months (range, 0.4–9.6). Fourteen (67%) patients requested pembrolizumab. Pembrolizumab was clinician offered for 7 (33%) patients. Patients who requested pembrolizumab had worse outcomes. Three patients died before receiving pembrolizumab. Of the 18 patients that received at least one dose, a partial response was observed in 3 (17%). Progressive disease occurred in 83%. Four patients received only one cycle of pembrolizumab and died after a median of 27 days (range 13–43). Immune‐related adverse events of any grade occurred in 33%. No grade 3–4 events were observed.

Conclusion

Pembrolizumab was well tolerated. Meaningful responses were observed in 17% of treated patients. Response continues after 5–6.5 months follow‐up in 11% and >8 months of follow‐up for the other responding patient. Financial impact to the patient can be substantial. Outcomes for 33% were poor with three patients dying prior to receiving therapy and four dying within weeks of receiving one dose. This highlights issues regarding the careful selection of patients, futility of anti‐cancer therapy at the end‐of‐life and patients' perceived benefit of receiving this therapy.
Cause and Consequence in Maize Planting Dates in Germany
Authors: Parker P. S. , Shonkwiler J. S. , Aurbacher J.
Published: August 2016

An important part of agricultural adaptation is the timing of crop sowing dates, affecting yields and the level of risk incurred during a particular season. Cold stress is especially relevant in maize, Zea mays L., so that the timing of planting in the spring is a tactical response to short‐term weather, but is also subject to strategic planning with regard to longer‐term climate. Both factors compare the potential implications of cold stress to the additional yield obtainable through earlier planting. New cultivars suited to growing conditions in Europe and generally increasing spring temperatures have enabled earlier planting, but it is still dependent on short‐term weather during the planting period. In the context of field‐level decision‐making, a panel regression is used to estimate the relationship between weekly local temperature and precipitation and planting dates at specific sites throughout Germany. Next, localised weather data and planting behaviour are linked to yields at the district (Landkreis) level to show the effects of planting date on yield. Based on these relationships optimal planting dates are explored with some associated costs and benefits. Results show a trend towards earlier planting that follows observed increasing spring temperatures and the availability of more cold‐tolerant cultivars but this advance is buffered by the increasing severity of minimum temperatures during a critical period. Earlier planting potentially increases yield but this is offset by additional management costs and risk. A robust and simple depiction of farmer behaviour in climatic, technological and economic context can help to understand trends in crop management and productivity that effect agricultural landscapes.
The Heterogeneity of Glass Surfaces Revealed by Temperature Programmed Desorption
Authors: Ortiz Rivera Lymaris , Bakaev Victor A. , Pantano Carlo G.
Published: August 2016

Adsorption of butanol and pyridine on E‐glass fibers with three different compositions, as well as on powders of silica and the crushed fibers, was studied by temperature programmed desorption (TPD) with a mass‐sensitive detector. In the case of butanol, there are two types of desorbing molecules: at lower temperatures butanol desorbs, but in the range 450°C–600°C, 1‐butene desorption is also observed. It is shown that 1‐butene desorption is due to thermal decomposition of butanol chemisorbed to OH groups on both the glass and silica surfaces. The binding energy distributions of adsorption sites for butanol and pyridine are similar on all three glass compositions, but they are much more heterogeneous compared to silica; this difference is most evident for pyridine and is attributed to the presence Al and B in the glasses. The decomposition temperature of chemisorbed butanol is highest for silica and depends on glass composition for the fibers and powders. Interestingly, the glass which does not contain boron shows a well‐defined peak for the decomposition of chemisorbed butanol, suggestive of unique adsorption sites on this boron‐free surface; but they are much less temperature stable than the chemisorption sites on silica. In situ exposure to water vapor increased the number of active sites for chemisorption.
Effect of Al Speciation on the Structure of High‐Al Steels Mold Fluxes Containing Fluoride
Authors: Gao Jinxing , Wen Guanghua , Huang Ting , Bai Binwen , Tang Ping , Liu Qiang
Published: August 2016

To design suitable mold fluxes for the casting of high‐Al steels, the structure of mold fluxes based on CaO–SiO2, CaO–SiO2–Al2O3, and CaO–Al2O3 was examined by Raman spectroscopy and magic‐angle spinning nuclear magnetic resonance. The results showed that Si atoms are replaced by Al atoms as the network formers with the increase in Al2O3 in the mold fluxes. This converts the silicate slags (CaO–SiO2 mold fluxes) into aluminosilicates slags (CaO–SiO2–Al2O3 or CaO–Al2O3 mold fluxes). The F− ions in the mold flux containing Al2O3 are classified into three categories, according to function: Bridging F's, Nonbridging F's, and Free‐F's. The Al3+ ion holds three distinct coordination environments: IVAl, VAl, and VIAl. The addition of F affects the coordination environment of Al3+ to form AlO3F and AlO2F2 that accommodate the network structure of slags. The network structure in the CaO–SiO2 mold fluxes is mainly connected through Si–O–Si linkage. However, the network structure of the mold fluxes containing elevated content of Al2O3 is mainly connected through Si–O–Si, Al–O–Al, Al–O–Si, and Al–F–Al linkages. Hence, the structural characteristics of high‐Al steels mold fluxes must be considered during the designing step of the mold fluxes.
Contradictory views of nursing care among students at the end of their nursing education
Authors: Arreciado Marañón Antonia , Isla Pera Mª Pilar
Published: August 2016

Aim

To understand how nursing students at the end of their nursing education view nursing care.

Background

Although care is understood as the essence of nursing, it is often difficult for nurses to provide care, which demonstrates a contradiction between theory and practice. Moreover, it is unknown to what extent this contradiction is transmitted to future nursing professionals or how they view nursing care and its practice.

Design

Qualitative ethnographic research.

Methods

The fieldwork was conducted between December 2010 ‐ May 2012 in a university nursing school in Barcelona and two centres where students carry out most of their practical education. The data collection techniques were participant observation and focus groups. A thematic analysis was used.

Results

The students demonstrated contradictory views of nursing care. On one hand, they voiced a more theoretical, official definition where care is considered the core of the profession. On the other hand, they also expressed a view where the provision of care is not nurses’ principal daily activity, a fact that did not surprise them. Students interpreted caring as an activity that has low value and that can be transferred unproblematically to other professionals.

Conclusion

The contradictory views of care reveal a problem in the transmission of the definition of nursing to new generations of professionals and reflect a problematic professional reality where there is dissonance between how nursing is defined and how it is carried out in practice.
Making Sense of Bereavement in People with Profound Intellectual and Multiple Disabilities: Carer Perspectives
Authors: Young Hannah , Hogg James , Garrard Brenda
Published: August 2016

Background

People with intellectual disabilities are thought to have a reduced capacity for understanding death. Drawing on cognitive theory, researchers have suggested that those with profound intellectual and multiple disabilities mainly perceive loss as a mismatch between past and present experiences. However, very little research has considered how carers conceptualize bereavement in relation to this group.

Method

Semi‐structured interviews obtained responses from seven carers. Transcripts were examined using interpretative phenomenological analysis.

Results

Two superordinate themes emerged: ‘difficulty articulating the experience of loss’ and ‘making sense of bereavement through familiar patterns’.

Conclusions

Carers conceptualize bereavement primarily in cognitive terms, but also take account of relational factors mediating loss. Implications for training and further research are outlined.
Site‐specific treatment outcome in smokers following 12 months of supportive periodontal therapy
Authors: Bunæs Dagmar F. , Lie Stein Atle , Åstrøm Anne Nordrehaug , Mustafa Kamal , Leknes Knut N.
Published: August 2016

Aim

To evaluate the effect of cigarette smoking on periodontal health at patient, tooth, and site levels following supportive therapy.

Materials and Methods

Eighty chronic periodontitis patients, 40 smokers and 40 non‐smokers, were recruited to a single‐arm clinical trial. Periodontal examinations were performed at baseline (T0), 3 months following active periodontal therapy (T1), and 12 months following supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Logistic regression analyses adjusted for clustered observations of patients, teeth, and sites and mixed effects models were employed to analyse the data.

Results

All clinical parameters improved from T0 to T2 (p < 0.001), whereas PD, bleeding index (BI), and plaque index (PI) increased from T1 to T2 in smokers and non‐smokers (p < 0.001). An overall negative effect of smoking was revealed at T2 (OR = 2.78, CI: 1.49, 5.18, p < 0.001), with the most pronounced effect at maxillary single‐rooted teeth (OR = 5.08, CI: 2.01, 12.78, p < 0.001). At the patient level, less variation in treatment outcome was detected within smokers (ICC = 0.137) compared with non‐smokers (ICC = 0.051).

Conclusion

Smoking has a negative effect on periodontal health following 12 months of supportive therapy, in particular at maxillary single‐rooted teeth.
Pathogenesis, Diagnosis, and Treatment of Venous Thromboembolism in Older Adults
Authors: Johnson Stacy A. , Eleazer G. Paul , Rondina Matthew T.
Published: August 2016

Older adults have a significantly greater risk of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, than younger adults. The cause of this greater risk is thought to be multifactorial, including age‐related changes in hemostatic factors and greater comorbid conditions and hospitalizations, but is not completely understood. Moreover, VTE remains underrecognized in older adults and may present atypically. Thus, a low index of clinical suspicion is essential when evaluating older adults with possible VTE. Despite this underrecognition in older adults, the diagnostic approach remains similar for all age groups and includes estimation of pretest probability, measurement of the D‐dimer, and imaging. Antithrombotic agents are the mainstay of VTE treatment and, when used appropriately, substantially reduce VTE recurrence and complications. The approval of novel oral anticoagulants (NOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban, provide clinicians with new therapeutic options. In some individuals, NOACs may offer advantages over warfarin, including fewer drug interactions, more‐predictable anticoagulation, and lower risk of bleeding. Nevertheless, anticoagulation of VTE in older adults should always be performed cautiously, because age is a risk factor for bleeding complications. Identifying modifiable bleeding risk factors and balancing the risks of VTE recurrence with hemorrhage are important considerations when using anticoagulants in older adults.
Comparison of U.S. and Japanese Consumers’ Perceptions of Remanufactured Auto Parts
Authors: Matsumoto Mitsutaka , Chinen Kenichiro , Endo Hideki
Published: August 2016

This study compares U.S. and Japanese consumers’ perceptions of remanufactured auto parts. Remanufactured parts have a long history and enjoy continuing success in the U.S. domestic aftermarket. In contrast, although Japan's domestic aftermarket is growing, it remains comparatively underdeveloped. This research examines whether customers’ perceptions of remanufactured products explain their lower acceptance in Japan. Our Internet survey of 440 U.S. and 300 Japanese respondents examined their knowledge of remanufactured auto parts, perceptions of their benefits and risks, and price consciousness. The results reveal that Japanese consumers know less about remanufactured products, perceiving them as entailing lower benefits and greater risk, especially concerning quality, and are less price conscious. Drawing on its results, this study suggests measures to promote markets for remanufactured auto parts in Japan and in economies in which such markets are in an early stage of development.
Individual Capability and Effort in Retirement Benefit Choice
Authors: Bateman Hazel , Eckert Christine , Iskhakov Fedor , Louviere Jordan , Satchell Stephen , Thorp Susan
Published: August 2016

We investigate the role of individual capability and effort in the management of retirement ruin. In an experimental setting, we analyze how 854 defined contribution (DC) plan members reallocated wealth between a lifetime annuity and a phased withdrawal account when we increased the risk of exhausting the phased withdrawal account before the end of life. We find that more numerate individuals who put effort into understanding product features chose more longevity insurance at higher ruin risks. Financially literate members were more likely to show understanding of the product features, but general financial literacy did not directly improve ruin risk management. Initiatives aiming to help DC members understand income stream products at the time of the decision are warranted.
WHAT HAPPENS WHEN COMPENSATIONFOR WHIPLASH CLAIMS Is MADE MORE GENEROUS?
Authors: Cassidy J. David , Leth‐Petersen Søren , Rotger Gabriel Pons
Published: August 2016

ABSTRACT

We examine the effect of a Danish reform in 2002 that increased compensation for permanent loss of earnings capacity and extended the period when whiplash claimants could get compensation for temporary loss of earnings. The first is subject to extensive state verification by the government while the second is not. Using weekly data about disability, drug purchases, and use of health services during 1996–2007, we find that the reform increased the proportion on temporary disability by about 18 percent without a matching increase in drug purchases or the use of health services. We find no effect of compensation for permanent loss of earnings capacity.
Apoptosis signaling pathways in osteoarthritis and possible protective role of melatonin
Authors: Hosseinzadeh Azam , Kamrava Seyed Kamran , Joghataei Mohammad Taghi , Darabi Radbod , Shakeri‐Zadeh Ali , Shahriari Mansour , Reiter Russel J. , Ghaznavi Habib , Mehrzadi Saeed
Published: August 2016

Osteoarthritis (OA) is a degenerative joint disease characterized by progressive erosion of articular cartilage. As chondrocytes are the only cell type forming the articular cartilage, their gradual loss is the main cause of OA. There is a substantial body of published research that suggests reactive oxygen species (ROS) are major causative factors for chondrocyte damage and OA development. Oxidative stress elicited by ROS is capable of oxidizing and subsequently disrupting cartilage homeostasis, promoting catabolism via induction of cell death and damaging numerous components of the joint. IL‐1β and TNF‐α are crucial inflammatory factors that play pivotal roles in the pathogenesis of OA. In this process, the mitochondria are the major source of ROS production in cells, suggesting a role of mitochondrial dysfunction in this type of arthritis. This may also be promoted by inflammatory cytokines such as IL‐1β and TNF‐α which contribute to chondrocyte death. In patients with OA, the expression of endoplasmic reticulum (ER) stress‐associated molecules is positively correlated with cartilage degeneration. Melatonin and its metabolites are broad‐spectrum antioxidants and free radical scavengers which regulate a variety of molecular pathways such as inflammation, proliferation, apoptosis, and metastasis in different pathophysiological situations. Herein, we review the effects of melatonin on OA, focusing on its ability to regulate apoptotic processes and ER and mitochondrial activity. We also evaluate likely protective effects of melatonin on OA pathogenesis.
Coccomyxa actinabiotis sp. nov. (Trebouxiophyceae, Chlorophyta), a new green microalga living in the spent fuel cooling pool of a nuclear reactor
Authors: Rivasseau Corinne , Farhi Emmanuel , Compagnon Estelle , de Gouvion Saint Cyr Diane , van Lis Robert , Falconet Denis , Kuntz Marcel , Atteia Ariane , Couté Alain
Published: August 2016

Life can thrive in extreme environments where inhospitable conditions prevail. Organisms which resist, for example, acidity, pressure, low or high temperature, have been found in harsh environments. Most of them are bacteria and archaea. The bacterium Deinococcus radiodurans is considered to be a champion among all living organisms, surviving extreme ionizing radiation levels. We have discovered a new extremophile eukaryotic organism that possesses a resistance to ionizing radiations similar to that of D. radiodurans. This microorganism, an autotrophic freshwater green microalga, lives in a peculiar environment, namely the cooling pool of a nuclear reactor containing spent nuclear fuels, where it is continuously submitted to nutritive, metallic, and radiative stress. We investigated its morphology and its ultrastructure by light, fluorescence and electron microscopy as well as its biochemical properties. Its resistance to UV and gamma radiation was assessed. When submitted to different dose rates of the order of some tens of mGy · h−1 to several thousands of Gy · h−1, the microalga revealed to be able to survive intense gamma‐rays irradiation, up to 2,000 times the dose lethal to human. The nuclear genome region spanning the genes for small subunit ribosomal RNA‐Internal Transcribed Spacer (ITS) 1‐5.8S rRNA‐ITS2‐28S rRNA (beginning) was sequenced (4,065 bp). The phylogenetic position of the microalga was inferred from the 18S rRNA gene. All the revealed characteristics make the alga a new species of the genus Coccomyxa in the class Trebouxiophyceae, which we name Coccomyxa actinabiotis sp. nov.
Overcoming Barriers to Sustained Engagement in Mental Health Care: Perspectives of Rural Veterans and Providers
Authors: Fischer Ellen P. , McSweeney Jean C. , Wright Patricia , Cheney Ann , Curran Geoffrey M. , Henderson Kathy , Fortney John C.
Published: August 2016

Purpose

To better understand the attitudes, beliefs, and values that influence use of mental health care among rural veterans.

Methods

In‐depth, semistructured interviews were conducted with 25 rural veterans and 11 rural mental health care providers in 4 states. Experienced qualitative interviewers asked participants about the attitudinal factors they thought most influenced rural veterans’ decisions to seek and sustain mental health care. Verbatim transcriptions were analyzed using content analysis and constant comparison.

Findings

Rural veterans and their mental health care providers reported the same major attitudinal barriers to veterans’ mental health treatment‐seeking. Pre‐eminent among those barriers was the importance rural veterans place on independence and self‐reliance. The centrality of self‐reliance was attributed variously to rural, military, religious, and/or gender‐based belief systems. Stoicism, the stigma associated with mental illness and health care, and a lack of trust in the VA as a caring organization were also frequently mentioned. Perceived need for care and the support of other veterans were critical to overcoming attitudinal barriers to initial treatment‐seeking, whereas critical facilitators of ongoing service use included “warm handoffs” from medical to mental health care providers, perceived respect and caring from providers, as well as provider accessibility and continuity.

Conclusions

Attitudes and values, like self‐reliance, commonly associated with rural culture may play an important role in underutilization of needed mental health services. System support for peer and provider behaviors that generate trust and demonstrate caring may help overcome attitudinal barriers to treatment‐seeking and sustained engagement in mental health care among rural veterans.
Financial Performance of Rural Medicare ACOs
Authors: Nattinger Matthew C. , Mueller Keith , Ullrich Fred , Zhu Xi
Published: August 2016

Purpose

The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence.

Methods

We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan.

Results

Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician‐based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance.

Conclusions

Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted.
Assessment of quality of life in adolescent patients with cancer and adolescent survivors of childhood cancer
Authors: Vlachioti Efrosini , Perdikaris Pantelis , Megapanou Efstathia , Sava Floria , Matziou Vasiliki
Published: August 2016

Purpose

The aim of the study was to assess the quality of life (QoL) of adolescents with cancer and survivors of childhood cancer as well as the effect of various demographic factors upon it.

Design and Methods

The sample of the study included 82 adolescents aged 13–20 years who had been diagnosed with any type of cancer. Twenty‐six of them received treatment and 56 survivors of childhood cancer had successfully completed their treatment. Data collection lasted from July 2010 to December 2012 in Children's Hematology‐Oncology Unit in Athens. For data collection, Minneapolis–Manchester Quality Questionnaire of Life Instrument was used. The assessment of the QoL of adolescents undergoing treatment was performed with three measurements and that of the survivors with one.

Results

The QoL of adolescent patients did not significantly change during treatment and they showed a satisfactory QoL. Boys scored higher than girls (z = –1.78, p = .04 in psychological function and t = 2.27, p = .02 in body image) as far as QoL in social relations is concerned (z = –2.79, p = .002 in first measurement and z = –2.31, p = .01 in second measurement). Scores on the scale for the QoL of survivors of childhood cancer who completed treatment was 3.91. Survivors showed a higher QoL than the adolescent patients.

Conclusions

This research has shown that the studied population scored a sufficient QoL, especially survivors of childhood cancer ones. Moreover, their QoL seemed to be influenced by the stage of treatment, the type of cancer, sex, age, family support, and their level of education.
Multivariate Diallel Cross‐Analyses for Body Weight of Rainbow Trout, Oncorhynchus mykiss, in China
Authors: Hu Guo , Gu Wei , Yang Runqing , Wang Bingqian
Published: August 2016

Crossbreeding is a common technical approach for the development of new commercial fish strains characterized by high performance and a short generation time, for the Chinese market. Here, five strains – Bohai, Denmark, Donaldson, Norway, and California – of rainbow trout were used in a complete diallel cross, along with self‐breeding within each strain, to estimate general combining ability; specific combining ability (SCA); and linebred, maternal, and reciprocal effects. These strains were defined based on their location of origin; the Bohai strain was domesticated and has been maintained since 1959 by the Bohai cold‐water fish experimental station in China. Applying univariate and multivariate genetic analyses for body weight using the data set from this complete diallel cross experiment, we found that the cross combination with the Donaldson strain exhibited the most positive growth performance, whereas the Bohai ♀ × Donaldson ♂ cross was the highest performing cross combination in the experiment. Multiple significance tests showed that 40% (4 of 10) of the significant SCA based on univariate analyses (P < 0.05) were not significant based on multivariate analyses (P > 0.05). These results suggested that multivariate genetic analyses may provide more reliable reference guidelines for decision making by managers of breeding programs.
Money, Mortgages, and the Conquest of America
Authors: Park K-Sue
Published: August 2016

In colonial America, land acquired new liquidity when it became liable for debts. Though English property law maintained a firm distinction between land and chattel for centuries, in the American colonies, the boundary between the categories of real and personal property began to disintegrate. There, the novelty of easy foreclosure and consequent easy alienation of land made it possible for colonists to obtain credit, using land as a security. However, scholars have neglected the first instances in which a newly unconstrained practice of mortgage foreclosure appeared—the transactions through which colonists acquired land from indigenous people in the first place. In this article, I explore these early transactions for land, which took place across fundamental differences between colonists' and native communities' conceptions of money, land, and exchange itself. I describe how difference and dependence propelled the growth of the early American contact economy to make land into real estate, or the fungible commodity on the speculative market that it remains today.
Two light‐activated neuroendocrine circuits arising in the eye trigger physiological and morphological pigmentation
Authors: Bertolesi Gabriel E. , Hehr Carrie L. , Munn Hayden , McFarlane Sarah
Published: August 2016

Two biological processes regulate light‐induced skin colour change. A fast ‘physiological pigmentation change’ (i.e. circadian variations or camouflage) involves alterations in the distribution of pigment containing granules in the cytoplasm of chromatophores, while a slower ‘morphological pigmentation change’ (i.e. seasonal variations) entails changes in the number of pigment cells or pigment type. Although linked processes, the neuroendocrine coordination triggering each response remains largely obscure. By evaluating both events in Xenopus laevis embryos, we show that morphological pigmentation initiates by inhibiting the activity of the classical retinal ganglion cells. Morphological pigmentation is always accompanied by physiological pigmentation, and a melatonin receptor antagonist prevents both responses. Physiological pigmentation also initiates in the eye, but with repression of melanopsin‐expressing retinal ganglion cell activity that leads to secretion of alpha‐melanocyte‐stimulating hormone (α‐MSH). Our findings suggest a model in which eye photoperception links physiological and morphological pigmentation by altering α‐MSH and melatonin production, respectively.
Left ventricular non‐compaction revealed by aortic regurgitation due to Kawasaki disease in a boy with LDB3 mutation
Authors: Hachiya Akira , Motoki Noriko , Akazawa Yohei , Matsuzaki Satoshi , Hirono Keiichi , Hata Yukiko , Nishida Naoki , Ichida Fukiko , Koike Kenichi
Published: August 2016

Kawasaki disease (KD) is an acute febrile illness of childhood characterized by systemic vasculitis, especially coronary arteritis. Aortic valve regurgitation (AVR) is a relatively common complication. There have been no reports to date of heart failure and left ventricular non‐compaction (LVNC) after acute KD, although the precise etiology of this condition remains unclear. A 6‐month‐old boy with KD was admitted to hospital. Despite high‐dose i.v. gammaglobulin for dilation of the coronary artery, moderate AVR appeared, and thereafter he developed heart failure. A rough, dense LV myocardium indicated LVNC. On genetic testing a heterogenous 163G > A substitution changing a valine to isoleucine in LIM domain binding protein 3 (LDB3) was identified. Additional cardiac stress, such as that caused by AVR and/or KD might have triggered cardiac failure in the form of LVNC due to LDB3 mutation.
Is there a role for stool metabolomics in cystic fibrosis?
Authors: Kaakoush Nadeem O , Pickford Russell , Jaffe Adam , Ooi Chee Y
Published: August 2016

A number of studies utilizing metabolomics have focused on the pathophysiology of cystic fibrosis (CF) lung disease. Here, we performed fecal metabolomics on pancreatic insufficient (PI) and sufficient (PS) children with CF and compared them with healthy controls (HC). Fecal metabolomics can differentiate between PS‐CF and PI‐CF. We identified a potential biomarker of disease severity or cystic fibrosis transmembrane conductance regulator function (m/z, 463.247; retention time, 0.570717 min) that discriminates between HC versus PS‐CF versus PI‐CF. We also identified lipoyl‐GMP as a potential novel inflammatory biomarker, and elevation in fecal glycerol 1,2‐didodecanoate 3‐tetradecanoate may provide clues to the pathogenesis of intestinal inflammation. For the first time, we demonstrate the potential applications of fecal metabolomics in CF.
The effect of photosynthetically active radiation and temperature on the photosynthesis of two Vietnamese species of Sargassum, S. mcclurei and S. oligocystum, based on the field and laboratory measurements
Authors: Terada Ryuta , Vo Triet D. , Nishihara Gregory N. , Matsumoto Kazuya , Kokubu Shogo , Watanabe Yuki , Kawaguchi Shigeo
Published: August 2016

SUMMARY

The effects of photosynthetically active radiation (PAR) and temperature on the photosynthesis of two Vietnamese brown algae, Sargassum mcclurei and S. oligocystum (Fucales), were determined by field and laboratory measurements. Dissolved oxygen sensors and pulse‐amplitude modulated (PAM) fluorometry were used for the measurements of photosynthetic efficiency. A Diving‐PAM revealed that underwater measurements of the effective quantum yield (Φ

PSII
) of both species declined with increasing incident PAR, with minimum Φ

PSII
occurring during noon to early afternoon. Φ

PSII
recovered in the evening, indicating photo‐adaptation to excessive PAR. In laboratory experiments, Φ

PSII
also decreased under continuous exposure to 1000 μmol photons m−2 s−1; and full recovery occurred after 12 h of dark acclimatization. The net photosynthesis – PAR experiments of S. mcclurei and S. oligocystum conducted at 28°C revealed that the net photosynthetic rate quickly increased at PAR below the saturation irradiance of 361 and 301 μmol photons m−2 s−1 and nearly saturated to maximum net photosynthetic rates of 385 and 292 μg O2 gww
−
1 min−1 without photoinhibition, respectively. Gross photosynthesis and dark respiration experiments determined over a range of temperatures (12–40°C), revealed that the maximum gross photosynthetic rates of 201 and 147 μg O2 gww
−
1 min−1 occurred at 32.9 and 30.7°C for S. mcclurei and S. oligocystum, respectively. The dark respiration rates increased exponentially over the temperature ranges examined. The estimated maximum value of the maximum quantum yield occurred at 19.3 and 20.0°C and was 0.76 and 0.74, respectively. Similar to the natural habitat of the study site, these two species tolerated the relatively high temperatures and broad range of PAR. The ability of these species to recover from exposure to high PAR is one of the mechanisms that allow them to flourish in the shallow water environment.
Why Don't They Just Change? Contract Farming, Informational Influence, and Barriers to Agricultural Climate Change Mitigation
Authors: Schewe Rebecca L. , Stuart Diana
Published: August 2016

Using a mixed‐methods study of contract seed‐corn farmers in southwest Michigan, we examine the effect of interlocking macro and micro social forces on climate change behavior and apply the theoretical frames of treadmills of production and informational influence. We find that competitive agricultural contracts in the seed‐corn industry impose significant structural barriers to adopting climate change mitigation behaviors. Seed‐corn contracts constrain adoption of those behaviors through competitive rankings based solely on net commodity production and by limiting farmers’ access to information to make judicious management decisions. At the micro level, our findings suggest that informational influence—that is, where farmers turn for trusted information—also affects climate change mitigation behaviors, and that these informational networks are embedded within structural constraints. Our findings suggest that agricultural contracts serve as a significant structural constraint on the adoption of mitigation practices and that climate scholarship and policy must address both macro and micro dimensions simultaneously to encourage adoption of climate change mitigation.
Sensitivity and specificity of normality tests and consequences on reference interval accuracy at small sample size: a computer‐simulation study
Authors: Le Boedec Kevin
Published: August 2016

Background

According to international guidelines, parametric methods must be chosen for RI construction when the sample size is small and the distribution is Gaussian. However, normality tests may not be accurate at small sample size.

Objectives

The purpose of the study was to evaluate normality test performance to properly identify samples extracted from a Gaussian population at small sample sizes, and assess the consequences on RI accuracy of applying parametric methods to samples that falsely identified the parent population as Gaussian.

Methods

Samples of n = 60 and n = 30 values were randomly selected 100 times from simulated Gaussian, lognormal, and asymmetric populations of 10,000 values. The sensitivity and specificity of 4 normality tests were compared. Reference intervals were calculated using 6 different statistical methods from samples that falsely identified the parent population as Gaussian, and their accuracy was compared.

Results

Shapiro–Wilk and D'Agostino–Pearson tests were the best performing normality tests. However, their specificity was poor at sample size n = 30 (specificity for P < .05: .51 and .50, respectively). The best significance levels identified when n = 30 were 0.19 for Shapiro–Wilk test and 0.18 for D'Agostino–Pearson test. Using parametric methods on samples extracted from a lognormal population but falsely identified as Gaussian led to clinically relevant inaccuracies.

Conclusions

At small sample size, normality tests may lead to erroneous use of parametric methods to build RI. Using nonparametric methods (or alternatively Box–Cox transformation) on all samples regardless of their distribution or adjusting, the significance level of normality tests depending on sample size would limit the risk of constructing inaccurate RI.
A Physics-Based Model for Metal Matrix Composites Deformation During Machining: A Modified Constitutive Equation
Authors: Nasr M. N. A. , Ghandehariun A. , Kishawy H. A.
Published: August 2016

One of the main challenges encountered in modeling the behavior of metal matrix composites (MMCs) during machining is the availability of a suitable constitutive equation. Currently, the Johnson–Cook (J–C) constitutive equation is being used, even though it was developed for homogeneous materials. In such a case, an equivalent set of homogeneous parameters is used, which is only suitable for a particular combination of particle size and volume fraction. The current work presents a modified form of the J–C constitutive equation that suits MMCs, and explicitly accounts for the effects of particle size and volume fraction, as controlled parameters. Also, an energy-based force model is presented, which considers particle cracking and debonding based on the principles of fracture mechanics. In order to validate the new approach, cutting forces were predicted and compared to experimental results, where a good agreement was found. In addition, the predicted forces were compared to other analytical models available in the literature.
Heat Transfer Analysis of Slewing Ring Bearing for High Thermal Applications
Authors: Babu S. , Manisekar K. , KalaiSelvi Er. S.
Published: August 2016

The challenge in design and manufacturing tasks includes precise measurement of static friction, stiffness, deformation, raceway relative approach, and heat distribution of slewing ring bearings. These parameters affect the life and performance of the rolling elements bearing at elevated thermal environments. Toward that, sections of a complete bearing called linear model mock-up bearing (LMMB) have been designed and fabricated for the study of heat distribution. The physical significance of the heat distribution on bearing elements was studied using square-guarded hot-plate (SGHP) apparatus. The thermal contact conductance (TCC) experiments were carried out by varying surface roughnesses and interface temperatures under different loading conditions by using the combinations of steel plates and LMMB under dry and lubricated conditions. From this study, it is observed that the TCC values obtained from LMMB were significantly high across the contact surfaces of AISI 42100–AISI 52100–AISI 4140 steel plate's combination. Further, the finite element method (FEM) simulation has been carried out successfully to evaluate the temperature distribution in combination of bearing steel plates and LMMB by solidworks software, and the results are discussed.
Relationship between formation of surface-reaction layers and flux of dissociated species in C4F8/Ar plasma for SiO2 etching using pulsed-microwave plasma
Authors: Matsui Miyako , Usui Tatehito , Yasunami Hisao , Ono Tetsuo
Published: August 2016

The mechanism of highly selective etching of SiO2 using pulsed-microwave electron-cyclotron-resonance plasma was investigated by analyzing the relationship between plasma dissociations and fluorocarbon layers formed on surfaces during etching with a cyclo-C4F8/Ar gas mixture. Dissociated molecules of CxFy and CFx species were measured without fragmentations using ion attachment mass spectrometry, and both thicknesses and atomic concentrations of reaction layers formed on etched surfaces were analyzed using x-ray photoelectron spectroscopy. Thus, the impact of CxFy molecules on the formation of fluorocarbon layers were analyzed using this measurement system. The authors found that the process window of highly selective etching of SiO2 over Si was enlarged by using pulsed-microwave plasma because a thinner fluorocarbon layer was formed by controlling C4F8 dissociation by changing the duty cycle of the pulsed-microwaves. With conventional continuous plasma, an etch stop occurred at low wafer bias conditions because a thicker fluorocarbon layer, which protects the SiO2 surface from the ion bombardment, was formed on the SiO2 surface. The thicker fluorocarbon layer was formed from a large amount of CxFy species, such as C2F2, which were generated in the highly dissociated continuous plasma. On the contrary, with pulsed plasma, a thinner fluorocarbon layer was formed due to the lower flux of CxFy species because the dissociation of C4F8 was controlled by reducing the duty cycle of the pulsed-microwave plasma. As a result, the process window was enlarged to the low wafer bias conditions using the pulsed-microwave plasma.