bluuebunny/crossref_metadata_2025 huggingface dataset:
Lean Body Weight and Metformin Are Insufficient to Prevent Endometrial Hyperplasia in Mice Harboring Inactivating Mutations in PTEN
Authors: Iglesias David A. , Zhang Qian , Celestino Joseph , Sun Charlotte C. , Yates Melinda S. , Schmandt Rosemarie E. , Lu Karen H.
Published: December 2016

Objectives: Obesity is a major risk factor for endometrial cancer. We evaluated whether obesity exacerbates progression of endometrial hyperplasia (EH) using the PRCre/+ PTENflox/+ mouse model and examined if the type 2 diabetes drug, metformin, could prevent EH. Methods: Twenty obese (PRCre/+ PTENflox/+) mice were maintained on a high-fat diet, while 20 lean mice ate a matching low-fat diet. Ten mice from each group received metformin (1,000 mg/day) in drinking water. Mice were euthanized at 26 weeks. Uterine tissue was scored for degree of EH. Immunohistochemical staining for Ki67 was used to evaluate cellular proliferation. Markers of PI3K/AKT/mTOR activity were evaluated by immunohistochemistry using activation-specific antibodies. Serum adiponectin was quantified by ELISA. Results: Obesity had no effect on the extent of EH in (PRCre/+ PTENflox/+) mice. While metformin significantly altered circulating adiponectin levels in obese and lean animals, it had no effect on EH. There were no differences in endometrial proliferation as measured by Ki67 staining. Neither obesity nor metformin altered PI3K/AKT/mTOR activity in these animals. Conclusions: Weight and metformin did not affect the severity of EH resulting from PTEN inactivation. Alternative mouse models of early endometrial cancer are required for preclinical cancer prevention studies.
Reocclusion after Self-Expandable Metallic Stent Placement for Relieving Malignant Colorectal Obstruction as a Palliative Treatment
Authors: Nitta Toshikatsu , Fujii Kensuke , Hirata Yoshimasa , Tominaga Tomo , Inoue Yoshihiro , Kawasaki Hiroshi , Kawakami Ken , Ishibashi Takashi
Published: December 2016

Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery. He did not attend any of the scheduled follow-up visits after SEMS placement. However, a year and a half after the SEMS placement, the patient attended the hospital because of difficulty in passing stool. A plain abdominal CT scan showed bowel reobstruction due to the ascending colon cancer after SEMS placement. We performed an emergency operation, ascending colostomy, on the same day. Colorectal stent placement may be a good treatment option for patients who refuse to undergo conventional therapeutic treatments or in those with unresectable colorectal cancer. Patients should be carefully followed up every few months after SEMS placement because of the risk of reocclusion.
Positive Traits in the Bipolar Spectrum: The Space between Madness and Genius
Authors: Greenwood Tiffany A.
Published: December 2016

Bipolar disorder is a severe, lifelong mood disorder for which little is currently understood of the genetic mechanisms underlying risk. By examining related dimensional phenotypes, we may further our understanding of the disorder. Creativity has a historical connection with the bipolar spectrum and is particularly enhanced among unaffected first-degree relatives and those with bipolar spectrum traits. This suggests that some aspects of the bipolar spectrum may confer advantages, while more severe expressions of symptoms negatively influence creative accomplishment. Creativity is a complex, multidimensional construct with both cognitive and affective components, many of which appear to reflect a shared genetic vulnerability with bipolar disorder. It is suggested that a subset of bipolar risk variants confer advantages as positive traits according to an inverted-U-shaped curve with clinically unaffected allele carriers benefitting from the positive traits and serving to maintain the risk alleles in the population. The association of risk genes with creativity in healthy individuals (e.g., NRG1), as well as an overall sharing of common genetic variation between bipolar patients and creative individuals, provides support for this model. Current findings are summarized from a multidisciplinary perspective to demonstrate the feasibility of research in this area to reveal the mechanisms underlying illness.
Ulcerative Colitis
Authors: Sonnenberg Elena , Siegmund Britta
Published: December 2016

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease that is chronically present in patients throughout their lives. Hence, the chronic nature of the disease invariably requires continuous medical treatment. Advances in medical therapy over the last decades and current developments offer increasing options and are closely associated with a better life quality in patients. Summary: Recent developments in understanding the pathogenesis of UC are discussed. The current standard therapeutic regimens are outlined and recent developments and upcoming strategies introduced. Key Points: (1) Environmental factors that are yet to be defined contribute to the pathogenesis of UC. (2) An accelerated step-up therapy represents the current standard in UC. (3) Anti-integrins represent the most recently introduced pharmacological class in the therapy of UC. (4) Novel strategies including Janus kinase inhibitors are in the near future.
Bazex Syndrome in Lung Squamous Cell Carcinoma: High Expression of Epidermal Growth Factor Receptor in Lesional Keratinocytes with Th2 Immune Shift
Authors: Amano Maki , Hanafusa Takaaki , Chikazawa Sakiko , Ueno Makiko , Namiki Takeshi , Igawa Ken , Miura Keiko , Yokozeki Hiroo
Published: December 2016

An 82-year-old Japanese man was referred for detailed examination of hyperkeratotic erythematous plaques on his palms and soles for 6 months. Two weeks before his first visit, he had undergone lung lobectomy for right lung squamous cell carcinoma (SCC). Laboratory findings showed elevations of eosinophil counts, serum IgE, thymus and activation-regulated chemokine, SCC antigen, and soluble interleukin-2 receptor levels. Histological results of a skin biopsy involving the left palm showed psoriasiform dermatitis. Before lung lobectomy, the hyperkeratotic erythematous plaques on the palms and soles and the erythemas on the trunk and extremities were difficult to treat with topical steroids. After lobectomy, the skin symptoms dramatically and rapidly subsided with topical steroids. Therefore, we diagnosed Bazex syndrome (BS), also known as acrokeratosis paraneoplastica, as a paraneoplastic cutaneous disease in lung SCC. The mild eosinophilia subsided and levels of SCC antigen, IgE, and soluble interleukin-2 receptor were reduced. BS is a paraneoplastic cutaneous disease characterized by acral psoriasiform lesions associated with an underlying neoplasm. In a previous report, a shift to the Th2 immune condition was found in patients with non-small cell lung cancer, as shown in our patient. Epidermal growth factor receptor (EGFR) is also known as tumor growth factor-α receptor; it is increased in psoriatic keratinocytes. In our case, EGFR expression increased in lesional keratinocytes 2 weeks after surgery and decreased 4 weeks after surgery. We speculate that a shift to Th2 immune reactions in lung SCC may be the pathogenesis of BS, whereby lesional keratinocytes highly express EGFR in parallel with disease activity.
Debilitating Skin Toxicity Associated with Pembrolizumab Therapy in an 81-Year-Old Female with Malignant Melanoma
Authors: Khokhar Muhammad O. , Kettle Jacob , Palla Amruth R.
Published: December 2016

Frequently described immune-mediated adverse effects of immune therapy include dermatological complications, hepatitis, colitis, pneumonitis, and endocrinopathies. As utilization of pembrolizumab and related agents continues to expand both in the available indications as well as duration of exposure, there remains a significant potential to uncover previously undescribed adverse events. From a dermatological standpoint, 39% of patients receiving pembrolizumab therapy experience some form of skin-related drug toxicity [Naidoo et al.: Ann Oncol 2015;26: 2375–2391]. We describe a case of pembrolizumab-induced disabling autoimmune ectodermal toxicity.
Prognostic Role of HER2 Status and Adjuvant Trastuzumab Treatment in Lymph Node-Negative Breast Cancer Patients - a Retrospective Single Center Analysis
Authors: Fokter Dovnik Nina , Dovnik Andraž , Čas Sikošek Nina , Ravnik Maja , Arko Darja , Takač Iztok
Published: December 2016

Background: The natural course of traditionally prognostically unfavorable human epidermal growth factor receptor 2 (HER2)-positive breast cancer has been changed by anti-HER2 therapy. It is not clear whether the prognosis for HER2-positive patients treated with adjuvant trastuzumab differs from that of HER2-negative patients. Methods: We performed a retrospective study including patients with lymph node-negative invasive breast cancer treated at our institution in the period 2000-2009. Disease-free (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method. The Cox proportional hazards model was applied to control for other clinically important variables. Results: Median follow-up was 90-109 months. The 5-year DFS rates for HER2-negative patients, HER2-positive patients without adjuvant trastuzumab and trastuzumab-treated HER2-positive patients were 88.1% (95% confidence interval (CI) 85.6-90.6%), 73.1% (95% CI 64.3-81.9%) and 90.7% (95% CI 83.1-98.3%), respectively. No significant difference in DFS was observed between trastuzumab-treated HER2-positive patients and HER2-negative patients in multivariate analysis (hazard ratio 1.15; 95% CI 0.53-2.46; p = 0.728). There were no differences in OS among the 3 groups. Conclusion: Based on our results, the negative prognostic effect of HER2 positivity seen before targeted anti-HER2 treatment has completely disappeared in the era of routine trastuzumab administration in the adjuvant setting.
Laterality of Pneumonia in Acute Stroke
Authors: Nascimento Alves Pedro , Silva Cristiana , Baptista Joana , Lima Bárbara , Jacinto Margarida , Trigueiros Frederico , Martins André , Pinho e Melo Teresa , Fonseca Ana Catarina
Published: December 2016

Background/Aims: Previous studies demonstrated an alteration of diaphragmatic excursion on the paretic side after stroke; however, it is unclear if this change has clinical repercussions. We aimed to determine if there was an association between the paretic side and the laterality of pneumonia after stroke. Methods: A retrospective analysis of a consecutive cohort of patients admitted to a stroke unit from 2008 to May 2016 was performed. Patients with the diagnosis of acute stroke and pneumonia were included. The laterality of pneumonia was determined through the blinded observation of chest X-rays. Fisher's exact test was applied to study the association between the side of paresis and pneumonia. Results: One hundred and five patients were included. Sixty one percent (n = 64) had an ischemic stroke, 39% (n = 41) had brain hemorrhage, and 49.5% (n = 52) had right side paresis. We did not find in general an association between the side of paresis and the side of pneumonia (p = 1.00); however, we found a statistically significant association in patients with severe lower limb paresis (Medical Research Council, MRC ≤2; p = 0.035). Conclusion: We found an association between severe paresis of the lower limb (MRC ≤2) and ipsilateral pneumonia. We hypothesize that the proximity between the diaphragmatic and inferior limb corticospinal pathways could be the reason for this association.
The weekly rhythm of h uman activities and the climate in São Paulo Metropolitan Region
Authors: Azevedo Tarik Rezende de , Tarifa José Roberto
Published: December 2016

Este trabalho expõe onze evidencias de que o ritmo semanal das atividades humanas é um elemento significativo para explicar o sistema climático da Região Metropolitana de Sáo Paulo. Embora sugestivos, os resultados não são conclusivos, dada complexidade do próprio objeto, o clima, e a multiplicidade de hipó­teses em investigação em climatologia e meteorologia sob diversas abordagens metodológicas, espaciais e temporais. A conclusão deste trabalho é, tão somente, que o tema merece ser estudado com maior profundidade e maior abrangência espacial e temporal, exigindo o concurso de um montante de trabalho exeqüível apenas se realizado coletivamente. A principal e mais importante conclusão que pode advir de maior investigação do tema no futuro, e que já está expressa neste trabalho, é que parte das "alterações climáticas" imputadas à ação humana sobre o planeta, sobretudo em áreas urbanas, tem um caráter reversível em prazos muito curtos possivelmente semanas ou meses)
The recovery of regional geography through a political concept of region
Authors: Albuquerque Edu Silvestre de
Published: December 2016

O artigo propõe o resgate do método regional, por meio de um conceito de região aplicável a Estados Federais. A existência de instituições estatais regionais com autonomia constitucional em ambiente de forte identidade regional delimitam com precisão o objeto regional. Aspecto também analisado é a transformação da solidariedade estatal em torno dessas instituições regionais autônomas em solidariedade regional, geradora de identidades regionais e de regionalismos
Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation
Authors: ElAmm Chantal A. , Al-Kindi Sadeer G. , Oliveira Guilherme H.
Published: December 2016

Background—

Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients.

Methods and Results—

We queried the UNOS database (United Network for Organ Sharing) for all adults listed for orthotopic heart transplantation (2000–2015) with a listed diagnosis of myocarditis. Comparative and survival analyses were performed. Of 45 941 adults listed for orthotopic heart transplantation during this period, we identified 299 patients (0.7%) with the diagnosis of myocarditis. Compared with patients with nonischemic cardiomyopathy (NICM) and ischemic cardiomyopathy (ICM), myocarditis patients were younger (myocarditis 43.4±14.2 years, NICM 49.8±12.4 years, and ICM 57.5±8.0 years;
P
<0.001) and more frequently listed as status 1A (myocarditis 44% versus NICM 21% versus ICM 21%;
P
<0.001), with significantly higher need for mechanical ventilation (myocarditis 11% versus NICM 2% versus ICM 4%;
P
<0.001), biventricular mechanical circulatory support (myocarditis 19% versus NICM 2%, versus ICM 2%;
P
<0.001), and extracoroporeal membrane oxygenation (myocarditis 5% versus NICM 0.4% versus ICM 1%;
P
<0.001). Additionally, patients with myocarditis had higher likelihood of delisting for clinical improvement (hazard ratio, 2.49 [95% confidence interval, 1.63–3.79] versus ICM and hazard ratio, 2.12 [95% confidence interval, 1.40–3.22] versus NICM;
P
<0.001). Despite higher allosensitization, patients with myocarditis had similar post-transplant rejection, retransplantation, and survival rates compared with other groups.

Conclusions—

Patients with the diagnosis of myocarditis listed for orthotopic heart transplantation are younger, sicker, and recover more frequently but require more biventricular mechanical circulatory support. Heart transplantation survival is comparable to that of patients with other types of heart failure.
High-Fiber Diet and Acetate Supplementation Change the Gut Microbiota and Prevent the Development of Hypertension and Heart Failure in Hypertensive Mice
Authors: Marques Francine Z. , Nelson Erin , Chu Po-Yin , Horlock Duncan , Fiedler April , Ziemann Mark , Tan Jian K. , Kuruppu Sanjaya , Rajapakse Niwanthi W. , El-Osta Assam , Mackay Charles R. , Kaye David M.
Published: December 2016

Background:

Dietary intake of fruit and vegetables is associated with lower incidence of hypertension, but the mechanisms involved have not been elucidated. Here, we evaluated the effect of a high-fiber diet and supplementation with the short-chain fatty acid acetate on the gut microbiota and the prevention of cardiovascular disease.

Methods:

Gut microbiome, cardiorenal structure/function, and blood pressure were examined in sham and mineralocorticoid excess–treated mice with a control diet, high-fiber diet, or acetate supplementation. We also determined the renal and cardiac transcriptome of mice treated with the different diets.

Results:

We found that high consumption of fiber modified the gut microbiota populations and increased the abundance of acetate-producing bacteria independently of mineralocorticoid excess. Both fiber and acetate decreased gut dysbiosis, measured by the ratio of Firmicutes to Bacteroidetes, and increased the prevalence of
Bacteroides acidifaciens
. Compared with mineralocorticoid-excess mice fed a control diet, both high-fiber diet and acetate supplementation significantly reduced systolic and diastolic blood pressures, cardiac fibrosis, and left ventricular hypertrophy. Acetate had similar effects and markedly reduced renal fibrosis. Transcriptome analyses showed that the protective effects of high fiber and acetate were accompanied by the downregulation of cardiac and renal
Egr1
, a master cardiovascular regulator involved in cardiac hypertrophy, cardiorenal fibrosis, and inflammation. We also observed the upregulation of a network of genes involved in circadian rhythm in both tissues and downregulation of the renin-angiotensin system in the kidney and mitogen-activated protein kinase signaling in the heart.

Conclusions:

A diet high in fiber led to changes in the gut microbiota that played a protective role in the development of cardiovascular disease. The favorable effects of fiber may be explained by the generation and distribution of one of the main metabolites of the gut microbiota, the short-chain fatty acid acetate. Acetate effected several molecular changes associated with improved cardiovascular health and function.
NCK Associated Protein 1 Modulated by miRNA‐214 Determines Vascular Smooth Muscle Cell Migration, Proliferation, and Neointima Hyperplasia
Authors: Afzal Tayyab Adeel , Luong Le Anh , Chen Dan , Zhang Cheng , Yang Feng , Chen Qishan , An Weiwei , Wilkes Edmund , Yashiro Kenta , Cutillas Pedro R. , Zhang Li , Xiao Qingzhong
Published: December 2016

Background

MicroRNA miR‐214 has been implicated in many biological cellular functions, but the impact of miR‐214 and its target genes on vascular smooth muscle cell (
VSMC
) proliferation, migration, and neointima smooth muscle cell hyperplasia is unknown.

Methods and Results

Expression of miR‐214 was closely regulated by different pathogenic stimuli in
VSMC
s through a transcriptional mechanism and decreased in response to vascular injury. Overexpression of miR‐214 in serum‐starved
VSMC
s significantly decreased
VSMC
proliferation and migration, whereas knockdown of miR‐214 dramatically increased
VSMC
proliferation and migration. Gene and protein biochemical assays, including proteomic analyses, showed that
NCK
associated protein 1 (
NCKAP
1)—a major component of the
WAVE
complex that regulates lamellipodia formation and cell motility—was negatively regulated by miR‐214 in
VSMC
s. Luciferase assays showed that miR‐214 substantially repressed wild‐type but not the miR‐214 binding site mutated version of
NCKAP
1 3′ untranslated region luciferase activity in
VSMC
s. This result confirmed that
NCKAP
1 is the functional target of miR‐214 in
VSMC
s.
NCKAP
1 knockdown in
VSMC
s recapitulates the inhibitory effects of miR‐214 overexpression on actin polymerization, cell migration, and proliferation. Data from cotransfection experiments also revealed that inhibition of
NCKAP
1 is required for miR‐214–mediated lamellipodia formation, cell motility, and growth. Importantly, locally enforced expression of miR‐214 in the injured vessels significantly reduced
NCKAP
1 expression levels, inhibited
VSMC
proliferation, and prevented neointima smooth muscle cell hyperplasia after injury.

Conclusions

We uncovered an important role of miR‐214 and its target gene
NCKAP
1 in modulating
VSMC
functions and neointima hyperplasia. Our findings suggest that miR‐214 represents a potential therapeutic target for vascular diseases.
Elusive does not always equal rare: genetic assessment of a protected Gila monster (Heloderma suspectum) population in Saguaro National Park, Arizona
Authors: Farrar Victoria Sophia , Edwards Taylor , Bonine Kevin Edward
Published: December 2016

Population genetic baselines for species perceived to be at-risk are crucial for monitoring population trends and making well-informed management decisions. We characterized the genetic status of a population of Gila monsters (Heloderma suspectum), a large venomous lizard native to deserts of the southwestern United States and northern Mexico, by sampling 100 individuals in Sonoran Desert upland habitat at Saguaro National Park, Arizona, USA. We used 18 microsatellite markers, along with 1195 bp of sequence data from the mitochondrial DNA 12S locus, to examine genetic diversity, estimate effective population size, and assess demographic history. Despite suburban development adjacent to the study area, we observed high genetic diversity with uninhibited gene flow within this protected population. We estimated effective population size (Ne) for the total sample area (80 km2) using the linkage disequilibrium method in NeEstimator to be 94 individuals (95% confidence interval: 80.7-111.2). In 2011, we used capture-recapture methods to estimate that 80 adult Gila monsters (95% CI = 37-225) inhabited the area along the 14-km transect that we surveyed most frequently; probability of detecting resident Gila monsters during surveys was <0.01, highlighting the challenges of studying the species. Despite being considered an elusive and thus potentially rare species, these data reveal that in this protected environment the population appears healthy and robust. The results provide an important genetic baseline for future studies and monitoring, and exemplify the success of protective population measures in National Parks and under Arizona state laws.
Motuotrichius yangi, a new genus and species from southeastern Tibet, China (Coleoptera: Scarabaeidae: Cetoniinae: Trichiini)
Authors: HUANG HAO , CHEN CHANG-CHIN
Published: December 2016

Motuotrichius yangi, new genus, new species is described from Motuo, southeastern Tibet. Motuotrichius seems to have a mixture of characters observed in the genera Epitrichius Tagawa, 1941, Indotrichius Krikken, 2009, Lasiotrichius Reitter, 1899, and Trichius Fabricius, 1775, but is separable from all the known Eurasian genera of Trichiina by the presence of a tooth on the inner side of the mesotibia in both sexes. The habitus, external characters, and male genitalia of Motuotrichius yangi are illustrated. The following new combinations are given: Gnorimotrichius albomaculatus (Moser, 1902), Gnorimotrichius signatus (Chûjô, 1940), Gnorimotrichius trilineatus (Ma, 1992), and Gnorimotrichius tronqueti (Antoine, 2002).
New species of Zenoria Mulsant (Coleoptera: Coccinellidae) from Brazil and Peru
Authors: SANTOS PAULA B. , GONZÁLEZ F. GUILLERMO
Published: December 2016

Four new species of Zenoria Mulsant, 1850 are described: Zenoria limitrophi sp. nov. from Brazil; and Z. westerduijni sp. nov., Z. carbo sp. nov., and Z. miroi sp. nov. from Peru. Diagnostic characters are illustrated and relationships with previously described species are discussed.
Surface-Sensitive Microwear Texture Analysis of Attrition and Erosion
Authors: Ranjitkar S. , Turan A. , Mann C. , Gully G.A. , Marsman M. , Edwards S. , Kaidonis J.A. , Hall C. , Lekkas D. , Wetselaar P. , Brook A.H. , Lobbezoo F. , Townsend G.C.
Published: December 2016

Scale-sensitive fractal analysis of high-resolution 3-dimensional surface reconstructions of wear patterns has advanced our knowledge in evolutionary biology, and has opened up opportunities for translatory applications in clinical practice. To elucidate the microwear characteristics of attrition and erosion in worn natural teeth, we scanned 50 extracted human teeth using a confocal profiler at a high optical resolution (X–Y, 0.17 µm; Z < 3 nm). Our hypothesis was that microwear complexity would be greater in erosion and that anisotropy would be greater in attrition. The teeth were divided into 4 groups, including 2 wear types (attrition and erosion) and 2 locations (anterior and posterior teeth; n = 12 for each anterior group, n = 13 for each posterior group) for 2 tissue types (enamel and dentine). The raw 3-dimensional data cloud was subjected to a newly developed rigorous standardization technique to reduce interscanner variability as well as to filter anomalous scanning data. Linear mixed effects (regression) analyses conducted separately for the dependent variables, complexity and anisotropy, showed the following effects of the independent variables: significant interactions between wear type and tissue type ( P = 0.0157 and P = 0.0003, respectively) and significant effects of location ( P < 0.0001 and P = 0.0035, respectively). There were significant associations between complexity and anisotropy when the dependent variable was either complexity ( P = 0.0003) or anisotropy ( P = 0.0014). Our findings of greater complexity in erosion and greater anisotropy in attrition confirm our hypothesis. The greatest geometric means were noted in dentine erosion for complexity and dentine attrition for anisotropy. Dentine also exhibited microwear characteristics that were more consistent with wear types than enamel. Overall, our findings could complement macrowear assessment in dental clinical practice and research and could assist in the early detection and management of pathologic tooth wear.
Biostability of the Proanthocyanidins-Dentin Complex and Adhesion Studies
Authors: Leme-Kraus A.A. , Aydin B. , Vidal C.M.P. , Phansalkar R.M , Nam J.W. , McAlpine J. , Pauli G.F. , Chen S. , Bedran-Russo A.K.
Published: December 2016

Oligomeric proanthocyanidins (OPACs) are potent and renewable natural bioactives possible to be refined into chemically standardized mixtures for biological applications. Herein, we found that multiscale interactions of OPACs with the dentin matrix create tight biointerfaces with hydrophobic methacrylate adhesives on wet surfaces. An enriched mixture of OPACs, with a known phytochemical profile, was produced from grape seed crude extract ( Vitis vinifera; enriched grape seed extract [e-GSE]) and applied to dentin matrices to determine changes to the mechanical properties and biodegradability of the dentin matrix and favorable resin adhesion mechanisms. Methods included a 3-point flexural test, quantification of hydroxyproline (collagen solubilization), static and dynamic nanomechanical analyses, resin-dentin microtensile bond strength, and micropermeability at the adhesive interface. The e-GSE-modified dentin matrix exhibited remarkably low collagen solubilization and sustained the bulk elastic properties over 12 mo. Tan δ findings reveal a more elastic-like behavior of the e-GSE-modified dentin matrix, which was not affected by H-bond destabilization by urea. Dentin-methacrylate biointerfaces with robust and stable adhesion were created on e-GSE-primed dentin surfaces, leading to a dramatic decrease of the interfacial permeability. Standardized OPAC mixtures provide a new mechanism of adhesion to type I collagen–rich tissues that does not rely on hydrophilic monomers. The bioadhesion mechanism involves physicochemical modifications to the dentin matrix, reduced tissue biodegradation, and bridging to methacrylate resins.
The making of a pro-cycling city: Social practices and bicycle mobilities
Authors: Larsen Jonas
Published: December 2016

This article explores the contemporary co-production of bicycle practices in Copenhagen and the heterogeneous work involved in making a city pro-cycling. Attention is given as much to the sayings and doings of everyday commuters, as to planners, physical designs and campaigns. I ask: why, and how, are cycling practices continually (re)produced in Copenhagen and how can they attract so many practitioners? The first section discusses and employs practice theory, as it is well suited for examining practices of cycling. The second section explores how Copenhagen Municipality designed and scripted a cycle-friendly space by installing bike infrastructure, promoting cultural meanings and nourishing user competences. I argue that this is done through a heterogeneous process of normalizing and mainstreaming cycling and making alliances with other commuters. The third section shows how cyclists co-produce cycling practices by performing cycling and by enlisting and passing on knowledge to new practitioners. The concluding section highlights the potentials of practice theory to fully understand cycling, and it unravels some of the problems of Copenhagenizing low-cycling cities.
When cervical pain is actually migraine: An observational study in 207 patients
Authors: Viana Michele , Sances Grazia , Terrazzino Salvatore , Sprenger Till , Nappi Giuseppe , Tassorelli Cristina
Published: December 2016

Introduction

A large proportion of migraine patients remain undiagnosed or misdiagnosed in Italy. In our experience, many migraineurs self-diagnose their condition as “cervical pain attack” or “cervical pain syndrome” (CP), assuming cervical spine pathology as the cause. We aimed to phenotype and classify the headache of patients with self-diagnosed CP, and to describe this sample of patients.

Methods

Consecutive patients aged 18 to 75 years, referred to the Headache Center of the Mondino Institute (Pavia, Italy) for a first visit for headache, completed a questionnaire about CP and were subsequently examined by an experienced clinician.

Results

Out of 207 patients, 132 (64%) believed they suffered from CP. According to ICHD-IIIβ criteria, these patients suffered from migraine or probable migraine in 91% of cases. The great majority of patients who believed that they suffered from CP underwent unnecessary medical exams (including radiation exposure in 40% of cases) and used treatments that were inadequate for their real diagnosis.

Conclusion

The majority of patients with CP suffer from typical migraine. The misdiagnosis produces an economic burden (for patients and the health care system) and leads to impaired quality of life of patients.
Shift from intravenous or 16% subcutaneous replacement therapy to 20% subcutaneous immunoglobulin in patients with primary antibody deficiencies
Authors: Canessa Clementina , Iacopelli Jessica , Pecoraro Antonio , Spadaro Giuseppe , Matucci Andrea , Milito Cinzia , Vultaggio Alessandra , Agostini Carlo , Cinetto Francesco , Danieli Maria Giovanna , Gambini Simona , Marasco Carolina , Trizzino Antonino , Vacca Angelo , De Mattia Domenico , Martire Baldassarre , Plebani Alessandro , Di Gioacchino Mario , Gatta Alessia , Finocchi Andrea , Licciardi Francesco , Martino Silvana , De Carli Marco , Moschese Viviana , Azzari Chiara
Published: December 2016

In patients with primary antibody deficiencies, subcutaneous administration of IgG (SCIG) replacement is effective, safe, well-tolerated, and can be self-administered at home. A new SCIG replacement at 20% concentration (Hizentra®) has been developed and has replaced Vivaglobin® (SCIG 16%).

An observational prospective multi-centric open-label study, with retrospective comparison was conducted in 15 Italian centers, in order to investigate whether and to what extent switching to Hizentra® would affect frequency of infusions, number of infusion sites, patients’ satisfaction, and tolerability in patients previously treated with Vivaglobin® or intravenous immunoglobulins (IVIG).

Any variations of dosage, frequency and duration of the infusions, and of number of infusion sites induced by Hizentra® with respect to the former treatment were recorded. Practical advantages and disadvantages of Hizentra®, with respect to the medicinal product formerly used, and the variations in patients’ therapy-related satisfaction were monitored by means of the TSQM (Treatment Satisfaction Questionnaire for Medication); number, frequency, and duration of infectious events and adverse effects were recorded.

Eighty-two patients switched to Hizentra®: 19 (23.2%) from IVIG and 63 (76.8%) from Vivaglobin®. The mean interval between infusions was not affected by the shift (7.0 ± 2.0 days with previous treatment versus 7.1 ± 1.2 during Hizentra®). A decrease in the number of infusion sites with Hizentra® was recorded in 12 out of 56 patients for whom these data were available. At 6 months, 89.7% of patients were satisfied with Hizentra®; no difference in terms of effectiveness, side effects, convenience, and global satisfaction was observed. No difference in the incidence of adverse events was reported.
Process modeling and parameter optimization based on assumed inherent sensor inversion for composite automated placement
Authors: Cheng Jinxiang , Zhao Dongbiao , Liu Kai , Wang Yangwei
Published: December 2016

Composite automated placement shows great potential for efficient manufacturing of large composite structures. In order to realize online layup quality detection and parameter optimization with high speed and desired layup quality, a methodology is developed based on assumed inherent sensor inversion. First, it is necessary to conduct sensitive analysis in order to analyze the importance of process parameters and their changes. Then the relationship between these process parameters and the layup quality could be established by assumed inherent sensor inversion, which is considered as the basis of parameter optimization. Simultaneously, genetic algorithm combined with the multi-objective optimization theory is applied to determine the optimum set for obtaining desired composite components with high speed and best layup quality. A series of experiments had been conducted to verify the feasibility of the developed approach. Results demonstrate that the model has high precision, and significant improvement could be achieved through parameter optimization.
Gasification: An alternative solution for energy recovery and utilization of vegetable market waste
Authors: Narnaware Sunil L , Srivastava NSL , Vahora Samir
Published: December 2016

Vegetables waste is generally utilized through a bioconversion process or disposed of at municipal landfills, dumping sites or dumped on open land, emitting a foul odor and causing health hazards. The presents study deals with an alternative way to utilize solid vegetable waste through a thermochemical route such as briquetting and gasification for its energy recovery and subsequent power generation. Briquettes of 50 mm diameter were produced from four different types of vegetable waste. The bulk density of briquettes produced was increased 10 to 15 times higher than the density of the dried vegetable waste in loose form. The lower heating value (LHV) of the briquettes ranged from 10.26 MJ kg−1 to 16.60 MJ kg−1 depending on the type of vegetable waste. The gasification of the briquettes was carried out in an open core downdraft gasifier, which resulted in syngas with a calorific value of 4.71 MJ Nm−3 at the gasification temperature between 889°C and 1011°C. A spark ignition, internal combustion engine was run on syngas and could generate a maximum load up to 10 kWe. The cold gas efficiency and the hot gas efficiency of the gasifier were measured at 74.11% and 79.87%, respectively. Energy recovery from the organic vegetable waste was possible through a thermochemical conversion route such as briquetting and subsequent gasification and recovery of the fuel for small-scale power generation.
Designing multi-actor implementation: A mechanism-based approach
Authors: Busetti Simone , Dente Bruno
Published: December 2016

The article offers analytical tools for designing multi-actor implementation processes. It does so by proposing a design approach centred on causal mechanisms. Such design strategy requires designers to focus primarily on causal theories explaining why implementers commit overtime to implementing policies. The central proposal is that design procedures should be reversed, i.e. start by reasoning on the causal mechanisms explaining implementers’ behaviour and then go looking for design features. Several advantages of this approach related to designing, reforming, or transferring successful practices are discussed throughout the article. Finally, the article provides six extended examples of such mechanisms in different policy fields: actor’s certification, blame avoidance, earning brownie points, repeated interactions, focusing events and attribution of opportunity or threat.
Validity of the Italian Code of Ethics for everyday nursing practice
Authors: Gobbi Paola , Castoldi Maria Grazia , Alagna Rosa Anna , Brunoldi Anna , Pari Chiara , Gallo Annamaria , Magri Miriam , Marioni Lorena , Muttillo Giovanni , Passoni Claudia , Torre Anna La , Rosa Debora , Carnevale Franco A
Published: December 2016

Background:

The research question for this study was as follows: Is the Code of Ethics for Nurses in Italy (Code) a valid or useful decision-making instrument for nurses faced with ethical problems in their daily clinical practice?

Method:

Focus groups were conducted to analyze specific ethical problems through 11 case studies. The analysis was conducted using sections of the Code as well as other relevant documents. Each focus group had a specific theme and nurses participated freely in the discussions according to their respective clinical competencies.

Ethical considerations:

The executive administrative committee of the local nursing licensing council provided approval for conducting this project. Measures were taken to protect the confidentiality of consenting participants.

Findings:

The answer to the research question posed for this investigation was predominantly positive. Many sections of the Code were useful for discussion and identifying possible solutions for the ethical problems presented in the 11 cases.

Conclusion:

We concluded that the Code of Ethics for Nurses in Italy can be a valuable aid in daily practice in most clinical situations that can give rise to ethical problems.
Men's Studies and Women's Studies: Should They Be Wed?
Authors: Sommer Vicki L.
Published: December 2016

The educational and sociopolitical consequences of institutional structuring of gender studies are discussed through the lens of personal experience at a small, liberal arts college in the Midwest. The relationship between the two studies, women's and men's, is discussed as complementary and essential to one another. Student resistance to gender analysis is addressed as a common occurrence, and suggestions are made regarding the use of feminist pedagogy methods for any gender teaching. Similarities and differences between women's and men's studies are identified with the conclusion reached that each can benefit if unified in efforts to inform about the cultural systems of sex and gender.
Understanding the Complexity of Love in Brokeback Mountain: An Analysis of the Film and Short Story
Authors: Rose Jane , Urschel Joanne
Published: December 2016

This essay examines the complexity of the love that develops between Ennis Del Mar and Jack Twist, the protagonists of Brokeback Mountain. We argue that the heterosexist mindset of 1960s-80s American culture and lack of a nurturing and empathetic upbringing from fathers in particular preclude the establishment of a healthy openly public partnership between two men in love. Both Ennis and Jack struggle with emotional repression resulting from childhood abuse and the expectations of hypermasculinity.
They're Bi Shepherds, Not Gay Cowboys: The Misframing of Brokeback Mountain
Authors: Brod Harry
Published: December 2016

Brokeback Mountain is routinely discussed as being about “gay” cowboys, but its characters are clearly shown to be bisexual. The misframing of the film results from our culture's ongoing tendency to polarize, dichotomize, and oversimplify issues of sexuality and sexual orientation. This tendency should be critiqued and resisted.
The Fine Line of Friendship
Authors: Soebbing Steven
Published: December 2016

The developing European idea that homoerotic relationships occurred between men of similar ages found representation in Wolfgang Amadeus Mozart’s Apollo et Hyacinthus, an early Classical opera, written for a graduation celebration hosted by the local Roman Catholic school, Salzburg University. From Greek antiquity until the early Renaissance, the myth of Hyacinth was often used synonymously with the myth of Ganymede to evoke homoeroticism. In the early Renaissance, the myth of Hyacinth (as well as Ganymede) took on more pederastic overtones, but gradually the myth of Hyacinth began to be differentiated from that of Ganymede: Hyacinth began to be used to evoke equitable male homoerotic relationships. The opera reflects this use and served to instruct students of Salzburg University on how to deal with homoerotic and sexual feelings.
Desperate Deeds, Desperate Men: Gender, Race, and Rape in Silent Feature Films, 1915–1927
Authors: Shrock Joel
Published: December 2016

Many of the top-grossing feature films spanning from 1915–1927 utilized rape as a device for defining manhood and thereby establishing power relationships. The images of rape in these silent films idealized the power of respectable white men over the men and women of other classes and races and subordinated the women from their own social station. These movies constructed white men as heroes and guardians of morality and civilization, white women as frail but morally superior figures, and African-American and immigrant men and women as uncontrollable sexual deviants who threatened civilization. These films reflected the fears of the white middle class that massive immigration, waves of black migration to the North, and the increasingly public role of women were irrevocably changing American society and threatening the power of the traditional dominant group in the United States: white middle- and upper-class men.
King Lear and Fathering: A Panel Discussion
Authors: Mayers Ozzie J. , Hendley Clark , Kronebusch Philip , Palm Glen
Published: December 2016

This panel discussion on King Lear and fathering was held on November 9, 1996, at the College of St. Benedict. The panel was part of a yearly Men's Series established at St. John's University (Collegeville, Minnesota) in 1995; the 1996 series focused on Men's Voices/Men's Lives. Six fathers (two of whom were unable to attend at the last minute) were invited to view a campus production of William Shakespeare's King Lear and then to discuss their responses to the play. The discussion thus explores issues of fathering in theoretical, personal, and experiential ways.
The Western as Male Soap Opera: John Ford's Rio Grande
Authors: Leighninger Robert D.
Published: December 2016

Conflicts between career and family are commonly assumed, in social science and popular culture, to be women's problems. Recognition that men might have similar problems has been slower in coming, perhaps because we assume that the superior power men often have in domestic and work situations can resolve or mitigate them. John Ford's 1950 Western Rio Grande presents a male-role conflict that neither institutional power nor violent physical action can resolve. The struggle must be waged within rigid institutional constraints, a pattern commonly seen in 1950s melodrama and soap opera. These films gave us a preview of the Women's Movement of the 1960s. This article investigates the film Rio Grande qua male soap opera as a possible preview of men's concerns.
Loud Men: The Poetic Visions of Robert Bly, Ice Cube, and Etheridge Knight
Authors: Seelow David
Published: December 2016

This paper describes three poets, Robert Bly, Ice Cube, and Etheridge Knight, and their poetic representations of masculinity. Their works are examined using the theoretical frame of “loudness.” Each poet's work exemplifies both a positive quality associated with loudness as well as a dangerous “silence” masked by their respective loudness.
Motivations toward Fathering: Two Minority Profiles within the Majority's Context
Authors: Coney Nancy S. , MacKey Wade C.
Published: December 2016

Recently, both the popular and academic press have shown increasing interest in American fathers, portraying them as simply additive to their children's well-being. In other words, if men enact their role as social fathers (i.e., providers) then there is a net social gain for the community. Earlier surveys found that, in the majority community, men have a shared motivational hierarchy that helps determine whether they will enter into and remain in the father role. Women, in the majority community, are accurate in their perception of this hierarchical profile. In relation to fathering incentives, the present study examines the relative congruence between men from the majority community and men and women from two minority communities, namely, Chinese-American and African-American men. The relative consonance of women's perceptions with the men's divulgences is also surveyed.
Male Circumcision: A Gender Perspective
Authors: Zoske Joseph
Published: December 2016

The practice of routine medical circumcision of newborn male infants remains the norm in the United States, occurring to more than one million baby boys annually. This article examines the history and continuing debate surrounding this surgery, and places it within the context of gender identity. The rise of the activist anti-circumcision movement is described, as medical, moral, psychological, and legal issues surrounding this controversy are identified. The continuing practice of male circumcision is framed as an abusive wounding of males, which holds lifelong implications. A differentiation is made between the conventional medical amputation of the foreskin, from that which is solely ritual, religious-based. Further, a societal double standard is noted between the moral outcry against female circumcision and the relative silence toward male circumcision.
The cost–quality relationship in European hospitals: a systematic review
Authors: Søgaard Rikke , Enemark Ulrika
Published: December 2016

Objective

To determine the relationship between cost and quality in European hospitals.

Methods

Juran’s cost–quality curve served as a theoretical framework, linked to basic efficiency concepts. Based on systematic database searches, citation searches and cross-referencing, we identify 1093 empirical studies. After exclusion of studies from outside Europe (699), non-hospital settings (10 studies), lack of a cost parameter (194) or a quality parameter (27 studies), 22 studies (28 analyses) were assessed for direction of association and methodological heterogeneity.

Results

There was evidence of positive, negative, two-directional and no association between cost and quality. We examined whether diagnosis, procedure, type of quality measure and specification of the econometric model could explain the inconsistent evidence, but no clear explanation is identified. Despite the significant policy relevance, evidence on the relationship between costs and quality is limited. The literature is characterized by substantial methodological heterogeneity and lack of explicit definitions of the chosen cost and quality parameters, the econometric model and the underlying hypothesis for the cost–quality relationship.

Conclusion

It has been more than 60 years since Juran introduced the idea of failure costs, which implied that the marginal costs of quality could be non-constant. It seems imperative to acknowledge this idea in future studies.