bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonbiopsy Diagnosis of Cardiac Transthyretin Amyloidosis
Authors: Gillmore Julian D. , Maurer Mathew S. , Falk Rodney H. , Merlini Giampaolo , Damy Thibaud , Dispenzieri Angela , Wechalekar Ashutosh D. , Berk John L. , Quarta Candida C. , Grogan Martha , Lachmann Helen J. , Bokhari Sabahat , Castano Adam , Dorbala Sharmila , Johnson Geoff B. , Glaudemans Andor W.J.M. , Rezk Tamer , Fontana Marianna , Palladini Giovanni , Milani Paolo , Guidalotti Pierluigi L. , Flatman Katarina , Lane Thirusha , Vonberg Frederick W. , Whelan Carol J. , Moon James C. , Ruberg Frederick L. , Miller Edward J. , Hutt David F. , Hazenberg Bouke P. , Rapezzi Claudio , Hawkins Philip N.
Published: April 2016

Background—

Cardiac transthyretin (ATTR) amyloidosis is a progressive and fatal cardiomyopathy for which several promising therapies are in development. The diagnosis is frequently delayed or missed because of the limited specificity of echocardiography and the traditional requirement for histological confirmation. It has long been recognized that technetium-labeled bone scintigraphy tracers can localize to myocardial amyloid deposits, and use of this imaging modality for the diagnosis of cardiac ATTR amyloidosis has lately been revisited. We conducted a multicenter study to ascertain the diagnostic value of bone scintigraphy in this disease.

Methods and Results—

Results of bone scintigraphy and biochemical investigations were analyzed from 1217 patients with suspected cardiac amyloidosis referred for evaluation in specialist centers. Of 857 patients with histologically proven amyloid (374 with endomyocardial biopsies) and 360 patients subsequently confirmed to have nonamyloid cardiomyopathies, myocardial radiotracer uptake on bone scintigraphy was >99% sensitive and 86% specific for cardiac ATTR amyloid, with false positives almost exclusively from uptake in patients with cardiac AL amyloidosis. Importantly, the combined findings of grade 2 or 3 myocardial radiotracer uptake on bone scintigraphy and the absence of a monoclonal protein in serum or urine had a specificity and positive predictive value for cardiac ATTR amyloidosis of 100% (positive predictive value confidence interval, 98.0–100).

Conclusions—

Bone scintigraphy enables the diagnosis of cardiac ATTR amyloidosis to be made reliably without the need for histology in patients who do not have a monoclonal gammopathy. We propose noninvasive diagnostic criteria for cardiac ATTR amyloidosis that are applicable to the majority of patients with this disease.
Inhibition of D
4
Dopamine Receptors on Insulin Receptor Expression and Effect in Renal Proximal Tubule Cells
Authors: Zhang Ye , Ren Hongmei , Lu Xi , He Duofen , Han Yu , Wang Hongyong , Zeng Chunyu , Shi Weibin
Published: April 2016

Background

Ion transport in the renal proximal tubule (
RPT
), which is increased in essential hypertension, is regulated by numerous hormones and humoral factors, including insulin and dopamine. Activation of dopamine receptor inhibits sodium reabsorption, whereas activation of insulin receptor increases sodium reabsorption in
RPT
s, and hyperinsulinemic animals and patients have defective renal dopaminergic system. We presume that there is an inhibition of D
4
receptor on insulin receptor expression and effect, and the regulation is lost in spontaneously hypertensive rats (
SHR
s).

Methods and Results

Insulin receptor expression was determined by immunoblotting, and Na
+
‐K
+
‐
ATP
ase activity was detected in both Wistar‐Kyoto (
WKY
) and
SHR RPT
cells. Stimulation of D
4
receptor with
PD
168077 decreased expression of insulin receptors, which was blocked in the presence of the calcium‐channel blocker, nicardipine (10
−6
 mol/L per 24 hours), in cell culture medium without calcium or in the presence of inositol 1,4,5‐trisphosphate (
IP
3) receptor blocker (2‐aminoethyl diphenylborinate [2‐
ADB]
; 10
−6
 mol/L per 24 hours), indicating that extracellular calcium entry and calcium release from the endoplasmic reticulum were involved in the signal pathway. Stimulation of the insulin receptor stimulated Na
+
‐K
+
‐
ATP
ase activity, whereas pretreatment with
PD
168077 for 24 hours decreased the inhibitory effects of insulin receptor on Na
+
‐K
+
‐
ATP
ase activity in
WKY
cells. However, in
SHR
cells, inhibition of D
4
receptor on insulin receptor expression and effect were lost.

Conclusions

Activation of D
4
receptor inhibits insulin receptor expression in
RPT
cells from
WKY
rats. The aberrant inhibition of D
4
receptor on insulin receptor expression and effect might be involved in the pathogenesis of essential hypertension.
Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China
Authors: Jin Chen , Li Wei , Qiao Shu‐Bin , Yang Jin‐Gang , Wang Yang , He Pei‐Yuan , Tang Xin‐Ran , Dong Qiu‐Ting , Li Xiang‐Dong , Yan Hong‐Bing , Wu Yong‐Jian , Chen Ji‐Lin , Gao Run‐Lin , Yuan Jin‐Qing , Dou Ke‐Fei , Xu Bo , Zhao Wei , Zhang Xue , Xian Ying , Yang Yue‐Jin
Published: April 2016

Background

Transradial percutaneous coronary intervention (
PCI
) has been increasingly adopted in clinical practice, given its potential advantages over transfemoral intervention; however, the impact of different access strategies on costs and clinical outcomes remains poorly defined, especially in the developing world.

Methods and Results

Using data from a consecutive cohort of 5306 patients undergoing
PCI
in China in 2010, we compared total hospital costs and in‐hospital outcomes for transradial intervention (
TRI)
and transfemoral intervention. Patients receiving
TRI
(n=4696, 88.5%) were slightly younger (mean age 57.4 versus 59.5 years), less often women (21.6% versus 33.1%), more likely to undergo
PCI
for single‐vessel disease, and less likely to undergo
PCI
for triple‐vessel or left main diseases. The unadjusted total hospital costs were 57 900 Chinese yuan (¥57 900; equivalent to 9190
US
dollars [$9190]) for
TRI
and ¥67 418 ($10,701) for transfemoral intervention. After adjusting for all observed patient and procedural characteristics using the propensity score inverse probability weighting method,
TRI
was associated with a lower total cost (adjusted difference ¥8081 [$1283]). More than 80% of the cost difference was related to lower
PCI
‐related costs (adjusted difference −¥5162 [−$819]), which were likely driven by exclusive use of vascular closure devices in transfemoral intervention, and lower hospitalization costs (−¥1399 [−$222]). Patients receiving
TRI
had shorter length of stay and were less likely to experience major adverse cardiac events or post‐
PCI
bleeding. These differences were consistent among clinically relevant subgroups with acute myocardial infarction, acute coronary syndrome, and stable angina.

Conclusions

Among patients undergoing
PCI
,
TRI
was associated with lower cost and favorable clinical outcomes compared with transfemoral intervention.
Endothelial Notch1 Is Required for Proper Development of the Semilunar Valves and Cardiac Outflow Tract
Authors: Koenig Sara N. , Bosse Kevin , Majumdar Uddalak , Bonachea Elizabeth M. , Radtke Freddy , Garg Vidu
Published: April 2016

Background

Congenital heart disease is the most common type of birth defect, affecting ≈2% of the population. Malformations involving the cardiac outflow tract and semilunar valves account for >50% of these cases predominantly because of a bicuspid aortic valve, which has an estimated prevalence of 1% in the population. We previously reported that mutations in

NOTCH
1

were a cause of bicuspid aortic valve in nonsyndromic autosomal‐dominant human pedigrees. Subsequently, we described a highly penetrant mouse model of aortic valve disease, consisting of a bicuspid aortic valve with thickened cusps and associated stenosis and regurgitation, in
Notch1
‐haploinsufficient adult mice backcrossed into a
Nos3
‐null background.

Methods and Results

Here, we described the congenital cardiac abnormalities in
Notch1

+/−

;Nos3

−/−

embryos that led to ≈65% lethality by postnatal day 10. Although expected Mendelian ratios of
Notch1

+/−

;Nos3

−/−

embryos were found at embryonic day 18.5, histological examination revealed thickened, malformed semilunar valve leaflets accompanied by additional anomalies of the cardiac outflow tract including ventricular septal defects and overriding aorta. The aortic valve leaflets of
Notch1

+/−

;Nos3

−/−

embryos at embryonic day 15.5 were significantly thicker than controls, consistent with a defect in remodeling of the semilunar valve cushions. In addition, we generated mice haploinsufficient for
Notch1
specifically in endothelial and endothelial‐derived cells in a
Nos3
‐null background and found that
Notch1

fl
/+

;
Tie2‐Cre
+/−
;Nos3

−/−

mice recapitulate the congenital cardiac phenotype of
Notch1

+/−

;Nos3

−/−

embryos.

Conclusions

Our data demonstrate the role of endothelial Notch1 in the proper development of the semilunar valves and cardiac outflow tract.
Tackling Complexity in Business and Society Research: The Methodological and Thematic Potential of Factorial Surveys
Authors: Oll Josua , Hahn Rüdiger , Reimsbach Daniel , Kotzian Peter
Published: April 2016

Factorial surveys (FSs) integrate elements of survey research and classical experiments. Using a large number of respondents in a controlled setting, FSs approximate complex and realistic judgment situations through so-called vignettes—that is, carefully designed descriptions of hypothetical people, social situations, or scenarios. Despite being rooted, and predominantly applied, in sociology, FSs are particularly promising for business and society (B&S) scholars. Given the multiplicity, inherent complexity, and sometimes fuzziness of B&S research objects, conventional research methods inevitably reach their limits. This article, therefore, systematically presents methodological and thematic opportunities for FS studies in B&S research. It is argued that FSs are well suited to dealing with the complex interplay of societal-, organizational-, and individual-level factors in B&S research and to studying the principles underlying human perceptions, attitudes, values, social norms, and (anticipated) behavior. The application of the FS method is illustrated based on a showcase example in the realm of socially responsible investments (SRIs). As the literature on the conceptualization of FSs is limited, methodological challenges are addressed to guide B&S researchers past the common methodological pitfalls.
Where does Canada fit in the US–China strategic competition across the Pacific?
Authors: Kawasaki Tsuyoshi
Published: April 2016

Since the end of the Second World War, the United States has enjoyed twin hegemonies, one in the East Asian littoral and the other in the North America continent. But China is now using assertive measures to undermine US maritime supremacy in East Asia. Beijing is also resorting to espionage and cyber attacks against US domestic targets. In short, the United States and China are engaging in strategic competition encompassing these two theatres. Where does Canada fit in this trans-Pacific political power struggle? What are Canada’s policy options, and which one should Canada choose? The present article answers these important yet under-explored questions. After reviewing the US twin hegemonies being challenged by China, the article assesses Ottawa’s current security policy posture. It then examines four potential policy options for Canada. The article concludes that a more pro-US diplomatic policy is the most viable of the four.
“Is all o’ we one?”: Creolization and ethnic identification in Samuel Selvon’s “Turning Christian”
Authors: Simpson Hyacinth M.
Published: April 2016

Samuel Selvon’s fiction reveals the author’s abiding concern with questions of identity and community and his investment in reconciling the seemingly conflicting subjects of creolization and ethnic identification in Caribbean societies, particularly in his native Trinidad. The pervasive and often violent ethnic conflict between Trinidadians of Indian and African heritage is linked to constructions of the nation in which claims to, as well as exclusion from, Creole identities play an important role. In response, Selvon’s fictional interventions position Indian communities (whether peasant, working- or middle-class) in relation to other ethno-racial groups in ways that construct Trinidadian-ness as an inclusive and dynamic negotiation of self and culture across the various communities represented in the nation. Drawing on Kamau Brathwaite’s seminal concept of creolization as well as the work of other theorists (including Mintz, Bolland, and Munasinghe) of Creole identities and the creolization process, the analysis of “Turning Christian” — a short story excerpted from Selvon’s unfinished novel — provides an account of Selvon’s identity politics in this and his other works of fiction.
Improvement of toughness properties of polypropylene filled with nanobentonite using stearic acid as interface modifier
Authors: Hernandez Yarazett , Lozano Tomas , Morales Ana B , Navarro-Pardo Fabiola , Lafleur Pierre G , Sanchez-Valdes Saul , Martinez-Colunga Guillermo , Morales-Zamudio Luisiana , de Lira-Gomez Patricia
Published: April 2016

The mechanical properties of polypropylene-bentonite nanocomposites were studied in this work. In this study, stearic acid was used as both a new surface modifier of the nano bentonite and a new interface modifier during the compounding of the nanocomposites with a twin-screw extruder. Three different weight concentrations (1.5 wt.%, 2.5 wt.%, and 5.0 wt.%.) were chosen for each type of nanobentonite compounds. Fourier transform infrared spectroscopy allowed us the possibility to discard any chemical interaction between the nanobentonite and stearic acid. Nevertheless, the physical interactions between both components favored the mechanical properties, resulting in around 150% improvement in the elongation of the nanocomposites containing stearic acid as surface and interface modifier. This can be due to the good intercalation of the nanobentonite platelets as found by wide angle X-ray diffraction and this was further confirmed by scanning electron microscopy, where the fracture surface analyses of these nanocomposites showed the best dispersion and wetting of the nanoplatelets by the polymer matrix. Crystallization behavior was also modified by stearic acid incorporation and the nanocomposites with better dispersion exhibited crystallization temperatures similar to pure polypropylene.
Effect of high temperature on structural response of reinforced concrete circular columns strengthened with fiber reinforced polymer composites
Authors: Elsanadedy Hussein , Almusallam Tarek , Al-Salloum Yousef , Iqbal Rizwan
Published: April 2016

This research investigates the effect of elevated temperature on behavior of reinforced concrete (RC) circular columns strengthened with different fiber reinforced polymer (FRP) systems. For this purpose, 32 column specimens were prepared. The test matrix comprised: 14 unstrengthened columns, 14 columns strengthened with a single layer of CFRP sheet, and 4 specimens strengthened with a single layer of GFRP sheet. Out of the 14 CFRP-wrapped specimens, 4 columns were thermally insulated with commercially available fire-protection mortar. In addition to control specimens at room temperature, some other columns were subjected to high temperature regimes of 100℃, 200℃, 300℃, 400℃, 500℃, and 800℃ for a period of 3 h. After cooling down, the columns were tested under axial compression until failure. It was indicated that exposure to elevated temperature adversely affected the residual strength, stiffness, and axial/lateral stress–strain response of unstrengthened columns. FRP composites were found effective in enhancing the axial load capacity of exposed columns provided that the temperature at the FRP level does not exceed the decomposition limit of the epoxy resin. The degradation in strength and stiffness was higher in CFRP-strengthened columns compared with GFRP-strengthened columns when exposed to the same temperature level. The used insulation material was found efficient in preventing heat induced damage to CFRP-strengthened columns up to temperature of 800℃ for 3 h duration. Besides this study, the experimental data of 48 uninsulated FRP-strengthened circular concrete specimens subjected to different heating regimes were collected from the literature. The dataset of 55 uninsulated FRP-strengthened specimens was then employed to evaluate the ACI 440.2R-08 model used for assessing compressive strength of FRP-confined concrete. This model was found non-conservative for 48.6% of the data and thus it was revised by the inclusion of an FRP strength reduction factor due to heating, which can be utilized in the design of FRP-strengthened RC columns exposed to elevated temperature.
Measurement invariance of the Beck Depression Inventory-Second Edition across race with South African university students
Authors: Makhubela Malose S
Published: April 2016

Measurement invariance of the Beck Depression Inventory-Second Edition across race (Blacks and Whites) was examined in a sample of university students, from two universities from diverse geographical areas of South Africa ( N = 870). Multigroup confirmatory factor analysis (i.e., means and covariance structures) was used to test the factorial invariance of the hierarchical four-factor structure, composed of three first-order factors (i.e., Negative Attitude, Performance Difficulty, and Somatic Complaints) and one second-order general factor (Depression) found with South African students. Evidence of measurement invariance was established at the level of configural, metric, and scalar invariance. However, there were some evidence of differential additive response style across race—with two non-invariant intercepts (Item 5 and 14) being identified. Results also revealed significant latent mean differences favoring Black students on the Performance Difficulty and Somatic Complaints factors but not on the Negative Attitude factor. Findings suggest that the Beck Depression Inventory-Second Edition provides an assessment of the severity of depressive symptoms that is equivalent across race in university students.
Voice Effects of Public Sector Unions on Turnover
Authors: Choi Yujin , Chung Il Hwan
Published: April 2016

Based on Hirschman’s exit and voice model, this article examines the impact of voice mechanisms on turnover using the case of teacher unions in New York State. In addition, we intend to identify heterogeneous effects of voice mechanisms on turnover depending on observable teacher characteristics. Our findings reveal that school districts with stronger grievance procedures are associated with low turnover at the individual level. These results shed light on public sector union literature as well as the studies on the relationship between turnover and performance.
Internalized Racial Oppression and Higher Education Values
Authors: Brown Danice L. , Rosnick Christopher B. , Segrist Daniel J.
Published: April 2016

A plethora of research underscores the deleterious effects that racial discrimination can have on the higher education pursuits and experiences of African Americans. The current study investigated the relationship between internalized racial oppression, higher education values, academic locus of control, and gender among a sample of African Americans. Participants were 156 African Americans currently attending college. All participants completed measures of internalized racial oppression, perceived value of higher education, and academic locus of control. Results indicated that greater internalized racial oppression correlated with a lower valuing of higher education and a more external academic locus of control. Subsequent mediational analyses showed that academic locus of control was an intervening variable in the relationship between internalized racial oppression and the value placed on higher education for men, but not women. For African American men, greater experiences of internalized racial oppression predicted a more external locus of control, which subsequently predicted a lower valuing of higher education. Implications for mental health providers and educators were discussed herein.
Output-based command shaping technique for an effective payload sway control of a 3D crane with hoisting
Authors: Abdullahi Auwalu M , Mohamed Z , Zainal Abidin MS , Buyamin S , Bature Amir A
Published: April 2016

This paper presents an output-based command shaping (OCS) technique for an effective payload sway control of a 3D crane with hoisting. A crane is a challenging and time-varying system, as the cable length changes during the operation. The OCS technique is designed based on output signals of an actual system and reference model, does not require the natural frequency and damping ratio of the system, and thus can be utilized to minimize the hoisting effects on the payload sway. The shaper was designed by using the derived non-linear model of a 3D crane. To test the effectiveness of the controller, simulations using a non-linear 3D crane model and experiments on a lab-scale 3D crane were performed and compared with a zero vibration derivative (ZVD) shaper and a ZVD shaper designed using an average travel length (ATL) technique. In both the simulations and the experiments, the OCS technique was shown to be superior in reducing the payload sway with reductions of more than 56% and 33% in both of the transient and residual sways that were achieved when compared with both the ZVD and the ATL shapers, respectively. In addition, the OCS technique provided the fastest time response during the hoisting. It is envisaged that the method can be very useful in reducing the complexity of closed-loop controllers for both tracking and sway control.
Prognostics of lithium-ion batteries based on different dimensional state equations in the particle filtering method
Authors: Su Xiaohong , Wang Shuai , Pecht Michael , Ma Peijun , Zhao Lingling
Published: April 2016

Accurate prediction of the remaining useful life of lithium-ion batteries plays a significant role in various devices and many researchers have focused on lithium-ion battery reliability and prognosis. A particle filter (PF) is an effective filter for estimation and prediction of time series data where model structure is available. The prediction accuracy of a PF depends on two key factors: parameter initialization and the state equation. In this paper, parameters are estimated using a PF and two empirical exponential models, i.e. the exponential model and improved exponential model, are used to track the battery capacity degradation; each model uses a different state equation. Experiments were performed to compare prediction accuracy using the related parameters estimation model with that using the capacity decline model; this paper compares the effects of the different state equations on the lithium-ion battery remaining useful life prediction. The experimental results show the merits of the capacity decline model based on particle filtering. The capacity decline model PF is more suitable for estimating the battery capacity trend in the long term.
Temperament in the classroom
Authors: Bassett Hideko Hamada , Denham Susanne A. , Fettig Nicole B. , Curby Timothy W. , Mohtasham Mandana , Austin Nila
Published: April 2016

Based on the emotion socialization and bioecological models, the present study examined the contributions of teacher emotion socialization (i.e., teacher reactions to child emotions) on children’s social–emotional behaviors, and the moderating effect of child temperamental surgency on these relations in the preschool context. A total of 337 children and 80 teachers from private and public preschools/childcares participated in the study. To account for the nested nature of our data, hierarchical linear modeling (HLM) was utilized. The results indicated that several types of teacher reactions to children’s emotions significantly predicted children’s social–emotional behaviors, after adjusting for prior levels of the behaviors. In addition, significant interactions between child surgency and teacher emotion socialization behaviors on children’s social–emotional behaviors were found. These interactions indicated that children with low surgency were more sensitive to teachers’ positive and negative socialization, compared to children with high surgency. Our results highlight the importance of discrete emotion socialization behaviors by teachers to children’s social–emotional development.
Racial Differences in Program Evaluation of a Lifestyle Physical Activity Randomized Controlled Trial
Authors: Cothran Fawn A. , Paun Olimpia , Farran Carol J. , Barnes Lisa L.
Published: April 2016

The purpose of this study was to compare program evaluation responses between African American and Caucasian caregivers of persons with Alzheimer’s disease and related dementias who completed a lifestyle physical activity randomized controlled trial. The aim was to determine if African Americans evaluated the study differently than Caucasians. Family caregivers ( N = 211) were randomly assigned to a 12-month physical activity intervention or a control condition. Upon intervention completion ( n = 114), caregivers responded to an 11-item questionnaire using Likert-type scale responses and three open-ended questions about the overall intervention quality. Findings indicated that African American caregivers evaluated both conditions more favorably than Caucasian caregivers ( p = .02). Content analysis of the narrative responses revealed five major qualitative themes: support, resources, responsibility, adjusting, and time. These findings suggest the value of both access to resources, and support for African American caregivers who participate in intervention research.
Patient Perceptions of Provider and Hospital Factors Associated With New Medication Communication
Authors: Bartlett Ellis Rebecca J. , Bakoyannis Giorgos , Haase Joan E. , Boyer Kiersten , Carpenter Janet S.
Published: April 2016

This research examined provider and hospital factors associated with patients’ perceptions of how often explanations of new medications were “always” given to them, using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. HCAHPS results were obtained for October 2012 to September 2013, from 3,420 hospitals and combined with a Magnet-designated hospital listing. Multiple regression examined correlates of new medication communication, including health care provider factors (perceptions of nurse and physician communication) and health care system factors (magnet designation, hospital ownership, hospital type, availability of emergency services, and survey numbers). Nurse and physician communication was strongly associated with new medication communication ( r = .819, p < .001; r = .722, p < .001, respectively). Multivariable correlates included nurse communication ( p < .001), physician communication ( p < .001), hospital ownership, availability of emergency services, and survey numbers. There was a significant relationship between patients’ perceptions of nurse and physician communication and the explanations they had received about their new medications during hospitalization.
Distinguishing Features and Similarities Between Descriptive Phenomenological and Qualitative Description Research
Authors: Willis Danny G. , Sullivan-Bolyai Susan , Knafl Kathleen , Cohen Marlene Z.
Published: April 2016

Scholars who research phenomena of concern to the discipline of nursing are challenged with making wise choices about different qualitative research approaches. Ultimately, they want to choose an approach that is best suited to answer their research questions. Such choices are predicated on having made distinctions between qualitative methodology, methods, and analytic frames. In this article, we distinguish two qualitative research approaches widely used for descriptive studies: descriptive phenomenological and qualitative description. Providing a clear basis that highlights the distinguishing features and similarities between descriptive phenomenological and qualitative description research will help students and researchers make more informed choices in deciding upon the most appropriate methodology in qualitative research. We orient the reader to distinguishing features and similarities associated with each approach and the kinds of research questions descriptive phenomenological and qualitative description research address.
One Christ—Many Witnesses: Marking the Completion of the Regnum Edinburgh Centenary Series
Authors: Kim Kirsteen , Ma Wonsuk , Gray Tony , Jørgensen Knud
Published: April 2016

Editorial for ‘One Christ—Many Witnesses: Marking the Completion of the Regnum Edinburgh Centenary Series’, a special issue to celebrate the Regnum Edinburgh Centenary Issue.
ECMO cannulation strategy for pulmonary hypertension: an alternative approach to traditional Veno-Arterial ECMO
Authors: Weinberg Allison , Mongero Linda , Armstrong Bethany
Published: April 2016

Pulmonary arterial hypertension (PAH) is a severe disease characterized by a progressive increase of pulmonary pressure and resistance, leading to right heart failure. PAH is commonly diagnosed at a late stage of the disease and is associated with progressive clinical deterioration and premature death. The treatment of PAH continues to be complicated, especially when considering treatment with extracorporeal membrane oxygenation (ECMO). A case is described that involves a heart failure patient placed on a ventricular assist device as a bridge to heart transplantation with recent onset of PAH. The goal was to rest the entire pulmonary circulation during ECMO while allowing the ventricular assist device to continue to function using a modified veno-arterial (VA) cannulation strategy. This configuration allowed the patient’s right heart to rest and ultimately recover while the left ventricular assist device (LVAD) maintained systemic perfusion, successfully allowing the patient to maintain a United Network for Organ Sharing (UNOS) status 1a listing.
Comparability of [18F]THK5317 and [11C]PIB blood flow proxy images with [18F]FDG positron emission tomography in Alzheimer’s disease
Authors: Rodriguez-Vieitez Elena , Leuzy Antoine , Chiotis Konstantinos , Saint-Aubert Laure , Wall Anders , Nordberg Agneta
Published: April 2016

For amyloid positron emission tomography tracers, the simplified reference tissue model derived ratio of influx rate in target relative to reference region (R1) has been shown to serve as a marker of brain perfusion, and, due to the strong coupling between perfusion and metabolism, as a proxy for glucose metabolism. In the present study, 11 prodromal Alzheimer’s disease and nine Alzheimer’s disease dementia patients underwent [18F]THK5317, carbon-11 Pittsburgh Compound-B ([11C]PIB), and 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography to assess the possible use of early-phase [18F]THK5317 and R1 as proxies for brain perfusion, and thus, for glucose metabolism. Discriminative performance (prodromal vs Alzheimer's disease dementia) of [18F]THK5317 (early-phase SUVr and R1) was compared with that of [11C]PIB (early-phase SUVr and R1) and [18F]FDG. Strong positive correlations were found between [18F]THK5317 (early-phase, R1) and [18F]FDG, particularly in frontal and temporoparietal regions. Differences in correlations between early-phase and R1 ([18F]THK5317 and [11C]PIB) and [18F]FDG, were not statistically significant, nor were differences in area under the curve values in the discriminative analysis. Our findings suggest that early-phase [18F]THK5317 and R1 provide information on brain perfusion, closely related to glucose metabolism. As such, a single positron emission tomography study with [18F]THK5317 may provide information about both tau pathology and brain perfusion in Alzheimer’s disease, with potential clinical applications.
How to Invest in Getting Cost-effective Technologies into Practice? A Framework for Value of Implementation Analysis Applied to Novel Oral Anticoagulants
Authors: Faria Rita , Walker Simon , Whyte Sophie , Dixon Simon , Palmer Stephen , Sculpher Mark
Published: April 2016

Cost-effective interventions are often implemented slowly and suboptimally in clinical practice. In such situations, a range of implementation activities may be considered to increase uptake. A framework is proposed to use cost-effectiveness analysis to inform decisions on how best to invest in implementation activities. This framework addresses 2 key issues: 1) how to account for changes in utilization in the future in the absence of implementation activities; and 2) how to prioritize implementation efforts between subgroups. A case study demonstrates the framework’s application: novel oral anticoagulants (NOACs) for the prevention of stroke in the National Health Service in England and Wales. The results suggest that there is value in additional implementation activities to improve uptake of NOACs, particularly in targeting patients with average or poor warfarin control. At a cost-effectiveness threshold of £20,000 per quality-adjusted life-year (QALY) gained, additional investment in an educational activity that increases the utilization of NOACs by 5% in all patients currently taking warfarin generates an additional 254 QALYs, compared with 973 QALYs in the subgroup with average to poor warfarin control. However, greater value could be achieved with higher uptake of anticoagulation more generally: switching 5% of patients who are potentially eligible for anticoagulation but are currently receiving no treatment or are using aspirin would generate an additional 4990 QALYs. This work can help health services make decisions on investment at different points of the care pathway or across disease areas in a manner consistent with the value assessment of new interventions.
An integrated physical-learning model of physical human-robot interactions with application to pose estimation in bikebot riding
Authors: Chen Kuo , Zhang Yizhai , Yi Jingang , Liu Tao
Published: April 2016

Modeling physical human-robot interactions (pHRI) is important in studying human sensorimotor skills and designing human assistive and rehabilitation systems. One of the main challenges for modeling pHRI is the high dimensionality and complexity of human motion and its interactions with robots and the environment. We present an integrated physical-learning pHRI modeling framework with applications to the bikebot riding example. The modeling framework contains an integrated machine-learning-based model for high-dimensional limb motion with a physical-principle-based dynamic model for the human trunk and an interacted bicycle-like robot (bikebot). A new axial linear embedding algorithm is used to obtain the low-dimensional latent dynamics for highly redundant human limb movement. The integrated physical-learning model is then used to estimate human motion through an extended Kalman filter design without using any sensors attached to the limb segments. Extensive bikebot riding experiments are conducted to validate and demonstrate the integrated pHRI model. Comparison results with other machine-learning-based models are also presented to demonstrate the superior performance of the proposed modeling framework for bikebot riding.
Immunosuppression in Dogs During Mammary Cancer Development
Authors: Mucha J. , Rybicka A. , Dolka I. , Szymańska J. , Manuali E. , Parzeniecka-Jaworska M. , Kluciński W. , Król M.
Published: April 2016

Cancer immunosuppression that facilitates tumor progression and metastasis evolves by development of an immunosuppressive network. The aim of this study was to assess this network in dogs with benign or malignant tumors with or without confirmed metastasis. The authors showed that the number of various T cell subpopulations was constant during tumor development; however the number of regulatory T cells (Tregs) was significantly higher in tumor-bearing dogs than in healthy individuals. The number of myeloid-derived suppressor cells (MDSCs) and their p-STAT3 expression (which is a negative regulator of hematopoiesis and regulates VEGF expression) were higher in cancer patients than in control dogs, however their number increased significantly in late-stage cancer patients. Canine mammary carcinomas with confirmed metastases to either lymph nodes or internal organs had greater MDSCs and Treg infiltration than benign mammary tumors or malignant mammary tumors for which metastases had not been detected. Similarly, expression of p-STAT3 and VEGF-C was the highest in tumors with confirmed metastases. This research shows changes occurring in the blood (n = 30 patients) and tumor tissue of patients (n = 100) during canine mammary tumor development. The findings should be considered preliminary because of the small number of samples. Nonetheless, the findings suggest that a high level of Tregs and MDSCs as well as high expression of p-STAT3 and VEGF-C may significantly contribute to mammary tumor progression and metastasis in dogs.
No Evidence of Herpesvirus Infection in West Highland White Terriers With Canine Idiopathic Pulmonary Fibrosis
Authors: Roels E. , Dourcy M. , Holopainen S. , Rajamäki M. M. , Gillet L. , Ehlers B. , Clercx C.
Published: April 2016

In humans, horses, and rodents, an association between pulmonary fibrotic disorders and gammaherpesvirus infection has been suggested. In dogs, canine idiopathic pulmonary fibrosis (CIPF), a progressive fibrotic lung disease of unknown origin and poorly understood pathophysiology, has been reported to occur in West Highland white terriers (WHWTs). The present study investigated the potential association between CIPF and herpesvirus infection. A PCR assay, using a mixture of degenerate and deoxyinosine-substituted primers targeting highly conserved regions of the DNA polymerase gene (DPOL) of herpesviruses, was applied on both lung and blood samples from WHWTs affected with CIPF and controls. Herpesvirus DPOL sequence could not be amplified from any of 46 lung samples (28 affected WHWTs and 18 control dogs of various breeds) and 38 blood samples (19 CIPF WHWTs and 19 control age-matched WHWTs) included. An association between CIPF and herpesvirus infection is therefore unlikely. Investigation of other causes of the disease is warranted.
Verminous Arteritis Due to Crassicauda sp. in Cuvier’s Beaked Whales (Ziphius Cavirostris)
Authors: Díaz-Delgado J. , Fernández A. , Xuriach A. , Sierra E. , Bernaldo de Quirós Y. , Mompeo B. , Pérez L. , Andrada M. , Marigo J. , Catão-Dias J. L. , Groch K. R. , Edwards J. F. , Arbelo M.
Published: April 2016

The vascular system of Cuvier’s beaked whales (CBW) ( Ziphius cavirostris; family Ziphiidae), an extremely deep, prolonged-diving cetacean, is increasingly receiving anatomic and physiologic study due to possible anthropogenic interactions; however, vascular pathology rarely has been reported in this species. Thirteen CBW stranded in the Canary Islands from June 2008 to June 2014 were autopsied. A careful dissection of the thoracic and abdominal vasculature was performed on these animals. All had moderate to severe and extensive chronic fibrosing arteritis with aneurysms, hemorrhages, and thrombosis primarily involving the mesenteric and gastroepiploic arteries and the thoracic and abdominal aorta. Microscopically, the lesions varied from subacute subintimal hemorrhages and severe neutrophilic, eosinophilic, and histiocytic dissecting arteritis with intralesional nematode larvae to marked, chronic, fibrosing arteritis with thickening and distortion of the vascular wall with calcification and occasional cartilage metaplasia. In addition, adult nematodes in renal arteries and veins, renal parenchyma and/or ureter were identified morphologically as Crassicauda sp. Nucleic acid sequenced from renal nematodes from 2 animals yielded closest nucleotide identity to C. magna. The pathogenesis is proposed to involve a host response to larval migration from the intestine to the kidney through the mesenteric arteries, abdominal aorta, and renal arteries. Severe consequences for such lesions are possible and could vary from reduced vascular compliance to chronic renal disease and predisposition to the development of disseminated intravascular coagulation and multiorgan failure. Severe chronic arteritis in CBW is associated with renal parasitism by Crassicauda spp.
Downregulation of ATM Gene and Protein Expression in Canine Mammary Tumors
Authors: Raposo-Ferreira T. M. M. , Bueno R. C. , Terra E. M. , Avante M. L. , Tinucci-Costa M. , Carvalho M. , Cassali G. D. , Linde S. D. , Rogatto S. R. , Laufer-Amorim R.
Published: April 2016

The ataxia telangiectasia mutated ( ATM) gene encodes a protein associated with DNA damage repair and maintenance of genomic integrity. In women, ATM transcript and protein downregulation have been reported in sporadic breast carcinomas, and the absence of ATM protein expression has been associated with poor prognosis. The aim of this study was to evaluate ATM gene and protein expression in canine mammary tumors and their association with clinical outcome. ATM gene and protein expression was evaluated by reverse transcription-quantitative polymerase chain reaction and immunohistochemistry, respectively, in normal mammary gland samples (n = 10), benign mammary tumors (n = 11), nonmetastatic mammary carcinomas (n = 19), and metastatic mammary carcinomas (n = 11). Lower ATM transcript levels were detected in benign mammary tumors and carcinomas compared with normal mammary glands ( P = .011). Similarly, lower ATM protein expression was observed in benign tumors ( P = .0003), nonmetastatic mammary carcinomas ( P < .0001), and the primary sites of metastatic carcinomas ( P < .0001) compared with normal mammary glands. No significant differences in ATM gene or protein levels were detected among benign tumors and nonmetastatic and metastatic mammary carcinomas ( P > .05). The levels of ATM gene or protein expression were not significantly associated with clinical and pathological features or with survival. Similar to human breast cancer, the data in this study suggest that ATM gene and protein downregulation is involved in canine mammary gland tumorigenesis.
Electrical Injuries in Animals
Authors: Schulze C. , Peters M. , Baumgärtner W. , Wohlsein P.
Published: April 2016

Electrical injuries in animals occur most often accidentally. They comprise contact to various forms of currents, including alternating, rotary, or direct currents. Depending on various parameters of the current (including the type of circuit, voltage, current and duration of exposure) and conditions of the animal (such as wet or dry hair coat and pathway of current through the body), lesions may be absent or may include early or localized development of rigor mortis, signs of acute circulatory failure, or severe thermoelectrical burns. Such burns may present as external current marks, singed hair or feathers, metallization of the skin, or occasionally internal electroporation injury resulting in muscle necrosis, hemolysis, vascular damage with thrombosis, injury to brain and spinal cord, or skeletal fractures. Furthermore, lightning strikes occur regularly in grazing animals, which have greater risk of death from step potentials (ground current) in addition to direct strike and contact injury. Such cases may have no lesions, external signs of linear or punctate burns, keraunographic markings, or exit burns on the soles of the hooves or the coronary bands. Besides detailed information about the circumstances at the location where the animal was found, electrical injuries in animals require a thorough morphological workup, including additional investigations in conjunction with certain knowledge about the possible lesion spectrum.
Effect of a Simple Collagen Type I Sponge for Achilles Tendon Repair in a Rat Model
Authors: Müller Sebastian A. , Dürselen Lutz , Heisterbach Patricia , Evans Chris , Majewski Martin
Published: April 2016

Background:

Several sophisticated approaches to tendon engineering have been investigated as ways to improve tendon healing with the early formation of repair tissue with possibly a high amount of type I collagen. Besides the new formation of collagen type I, there is evidence for the natural integration of surrounding collagen type I from healthy tendon parts into the healing defect. However, the simple application of a type I collagen sponge to the healing site to increase the amount of local collagen type I has not been investigated.

Hypothesis:

Healing of the rat Achilles tendon can be accelerated by an additional supply of collagen type I, resulting in increased tear resistance.

Study Design:

Controlled laboratory study.

Methods:

The right Achilles tendons of 42 rats were transected. In half of the animals, a type I collagen sponge was placed into the gap. Animals were allowed to move freely in their cages to simulate early functional therapy. After 1, 2, and 4 weeks, tendon length, width, maximal load to failure, and stiffness were measured and the healing site studied histologically according to the Bonar score. Inflammation was evaluated by the appearance of macrophages and neutrophilic and eosinophilic granulocytes.

Results:

Defects receiving collagen sponges showed improved healing, with significantly stronger (29.5 vs 5.0 N, respectively, at 1 week; P = .00003), shorter (11.6 vs 14.5 mm, respectively, at 4 weeks; P = .005), thicker (10.0 vs 1.8 mm2, respectively, at 1 week; P = .00002), and less stiff (19.5 vs 30.5 N/mm, respectively, at 4 weeks; P = .02) tendons than control tendons. Overall, the biomechanical properties of the collagen-treated tendons appeared to be significantly closer to those of native, uninjured tendons compared with tendons in the control group. Histologically, no inflammatory reaction due to the collagen sponge was found.

Conclusion:

Tendon healing was accelerated by the type I collagen sponge. Moreover, the mechanical properties of collagen-treated tendons appeared to be significantly closer to those of normal, uninjured tendons compared with control tendons without collagen treatment.

Clinical Relevance:

As a simple type I collagen sponge seems to increase the amount of local collagen type I, the careful use of such sponges might be an option for tendon augmentation during Achilles tendon surgery.
Removal analyses of chip and rod in rotary ultrasonic-assisted drilling of carbon fiber-reinforced plastics using core drill
Authors: Li Zhe , Zhang Deyuan , Qin Wei , Geng Daxi
Published: April 2016

Carbon fiber-reinforced plastics (CFRP) have been widely applied in aerospace industry as structural components due to their excellent mechanical and physical properties. Meanwhile, the drilling process is indispensable for machining the assembly holes of CFRP. However, in the conventional drilling process of CFRP, it is prone to produce the defects including delamination, spalling, fuzzing, and tool wear. In recent years, the rotary ultrasonic-assisted drilling (RUAD) with diamond core drill, as a novel machining method, has been employed to reduce the defects. But this is few reported investigations on chip adhesion of tool surface and machined rod jamming into core drill tool during RUAD of CFRP. Therefore, this paper detailedly reported a study on removal analyses of chip and rod in RUAD of CFRP using core drill under no cooling condition for the first time. To begin with, the principle analysis on RUAD of CFRP was presented to illustrate the removal process of chip and rod. And then, the experiment analysis on RUAD of CFRP was carried out to observe the removal effects of chip and rod. The experimental results indicated that compared with the common drilling of core drill, when the vibration amplitude reached 5.0 and 7.5 µm in RUAD, the cutting ability of core drill tool was greatly enhanced, excellent removal effects of chip and rod were obtained, which obviously reduced the chip adhesion, rod jamming, rod fragmentation, thrust force, cutting temperature, and surface roughness, improved the dimensional accuracy of machined hole and rod diameter, prolonged the tool life, as well as acquired superior surface integrity of machined hole and flat fibers fracture surfaces. Furthermore, the experimental results also validated the accuracy of the principle analysis.