bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Supersensitive Anti-Drug Antibody Assay: Unexpected High Anti-Drug Antibody Incidence and Its Clinical Relevance
Authors: Song Sam , Yang Lili , Trepicchio William L. , Wyant Timothy
Published: May 2016

Numbers of biotherapeutic products in development have increased over past decade. Despite providing significant benefits to patients with unmet needs, almost all protein-based biotherapeutics could induce unwanted immunogenicity, which result in a loss of efficacy and/or increase the risk of adverse reactions, such as infusion reactions, anaphylaxis, and even life-threatening response to endogenous proteins. Recognizing these possibilities, regulatory agencies request that immunogenicity be assessed as part of the approval process for biotherapeutics. Great efforts have been made to reduce drug immunogenicity through protein engineering. Accordingly the immunogenicity incidence has been reduced from around 80% in murine derived products to 0–10% in fully human products. However, recent improvements in immunogenicity assays have led to unexpectedly high immunogenicity rates, even in fully human products, leading to new challenges in assessing immunogenicity and its clinical relevance. These new immunogenicity assays are becoming supersensitive and able to detect more of anti-drug antibodies (ADA) than with earlier assays. This paper intends to review and discuss our understanding of the supersensitive ADA assay and the unexpected high ADA incidence and its potential clinical relevance.
A Review of Risk Factors for Cognitive Impairment in Stroke Survivors
Authors: Mohd Zulkifly Mohd Faizal , Ghazali Shazli Ezzat , Che Din Normah , Singh Devinder Kaur Ajit , Subramaniam Ponnusamy
Published: May 2016

In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors.
Par-4/NF-κB Mediates the Apoptosis of IsletβCells Induced by Glucolipotoxicity
Authors: QiNan Wu , XiaGuang Gan , XiaoTian Lei , WuQuan Deng , Ling Zhang , Bing Chen
Published: May 2016

Apoptosis of isletβcells is a primary pathogenic feature of type 2 diabetes, and ER stress and mitochondrial dysfunction play important roles in this process. Previous research has shown that prostate apoptosis response-4 (Par-4)/NF-κB induces cancer cell apoptosis through endoplasmic reticulum (ER) stress and mitochondrial dysfunction. However, the mechanism by which Par-4/NF-κB induces isletβcell apoptosis remains unknown. We used a high glucose/palmitate intervention to mimic type 2 diabetes in vitro. We demonstrated that the high glucose/palmitate intervention induced the expression and secretion of Par-4. It also causes increased expression and activation of NF-κB, which induced NIT-1 cell apoptosis and dysfunction. Overexpression of Par-4 potentiates these effects, whereas downregulation of Par-4 attenuates them. Inhibition of NF-κB inhibited the Par-4-induced apoptosis. Furthermore, these effects occurred through the ER stress cell membrane and mitochondrial pathway of apoptosis. Our findings reveal a novel role for Par-4/NF-κB in isletβcell apoptosis and type 2 diabetes.
Hypophosphatemic Rickets in Siblings: A Rare Case Report
Authors: Sarat Gummadapu , Priyanka Nuthalapati , Prabhat Meka Purna Venkata , Raja Lakshmi Chintamaneni , Bhavana Sujana Mulk , Ayesha Thabusum Dharmavaram
Published: May 2016

Hypophosphatemic rickets (HR) is a type of hereditary rickets characterized by persistent hypophosphatemia and hyperphosphaturia. The most predominant type is inherited in an X-linked fashion and caused by mutation in the gene encoding the phosphate-regulating endopeptidase homolog, X-linked (PHEX), identified in 1995. The X-linked hypophosphatemic (XLH) rickets is a rare hereditary metabolic disorder with a prevalence of 1 in 20,000 and causes deficient calcification of mineralized structures such as bones and teeth resulting in dental problems in terms of delayed eruption, spontaneous periapical infections, and exfoliation. We report one such unique case of hypophosphatemic vitamin D-resistant rickets in siblings exhibiting classical features of rickets with emphasis on its treatment and dental considerations.
Silver Nanoparticles: Biosynthesis Using an ATCC Reference Strain ofPseudomonas aeruginosaand Activity as Broad Spectrum Clinical Antibacterial Agents
Authors: Quinteros Melisa A. , Aiassa Martínez Ivana M. , Dalmasso Pablo R. , Páez Paulina L.
Published: May 2016

Currently, the biosynthesis of silver-based nanomaterials attracts enormous attention owing to the documented antimicrobial properties of these ones. This study reports the extracellular biosynthesis of silver nanoparticles (Ag-NPs) using aPseudomonas aeruginosastrain from a reference culture collection. A greenish culture supernatant ofP. aeruginosaincubated at 37°C with a silver nitrate solution for 24 h changed to a yellowish brown color, indicating the formation of Ag-NPs, which was confirmed by UV-vis spectroscopy, transmission electron microscopy, and X-ray diffraction. TEM analysis showed spherical and pseudospherical nanoparticles with a distributed size mainly between 25 and 45 nm, and the XRD pattern revealed the crystalline nature of Ag-NPs. Also it provides an evaluation of the antimicrobial activity of the biosynthesized Ag-NPs against human pathogenic and opportunistic microorganisms, namely,Staphylococcus aureus,Staphylococcus epidermidis,Enterococcus faecalis,Proteus mirabilis,Acinetobacter baumannii,Escherichia coli,P. aeruginosa, andKlebsiella pneumonia. Ag-NPs were found to be bioactive at picomolar concentration levels showing bactericidal effects against both Gram-positive and Gram-negative bacterial strains. This work demonstrates the first helpful use of biosynthesized Ag-NPs as broad spectrum bactericidal agents for clinical strains of pathogenic multidrug-resistant bacteria such as methicillin-resistantS. aureus,A. baumannii, andE. coli. In addition, these Ag-NPs showed negligible cytotoxic effect in human neutrophils suggesting low toxicity to the host.
Pneumonia after Major Cancer Surgery: Temporal Trends and Patterns of Care
Authors: Trinh Vincent Q. , Ravi Praful , Abd-El-Barr Abd-El-Rahman M. , Jhaveri Jay K. , Gervais Mai-Kim , Meyer Christian P. , Hanske Julian , Sammon Jesse D. , Trinh Quoc-Dien
Published: May 2016

Rationale.Pneumonia is a leading cause of postoperative complication.Objective.To examine trends, factors, and mortality of postoperative pneumonia following major cancer surgery (MCS).Methods.From 1999 to 2009, patients undergoing major forms of MCS were identified using the Nationwide Inpatient Sample (NIS), a Healthcare Cost and Utilization Project (HCUP) subset, resulting in weighted 2,508,916 patients.Measurements.Determinants were examined using logistic regression analysis adjusted for clustering using generalized estimating equations.Results.From 1999 to 2009, 87,867 patients experienced pneumonia following MCS and prevalence increased by 29.7%. The estimated annual percent change (EAPC) of mortality after MCS was −2.4% (95% CI: −2.9 to −2.0,P<0.001); the EAPC of mortality associated with pneumonia after MCS was −2.2% (95% CI: −3.6 to 0.9,P=0.01). Characteristics associated with higher odds of pneumonia included older age, male, comorbidities, nonprivate insurance, lower income, hospital volume, urban, Northeast region, and nonteaching status. Pneumonia conferred a 6.3-fold higher odd of mortality.Conclusions.Increasing prevalence of pneumonia after MCS, associated with stable mortality rates, may result from either increased diagnosis or more stringent coding. We identified characteristics associated with pneumonia after MCS which could help identify at-risk patients in order to reduce pneumonia after MCS, as it greatly increases the odds of mortality.
Protecting Mobile Crowd Sensing against Sybil Attacks Using Cloud Based Trust Management System
Authors: Chang Shih-Hao , Chen Zhi-Rong
Published: May 2016

Mobile crowd sensing (MCS) arises as a new sensing paradigm, which leverages citizens for large-scale sensing by various mobile devices to efficiently collect and share local information. Unlike other MCS application challenges that consider user privacy and data trustworthiness, this study focuses on the network trustworthiness problem, namely, Sybil attacks in MCS network. The Sybil attack in computer security is a type of security attack, which illegally forges multiple identities in peer-to-peer networks, namely, Sybil identities. These Sybil identities will falsify multiple identities that negatively influence the effectiveness of sensing data in this MCS network or degrading entire network performance. To cope with this problem, a cloud based trust management scheme (CbTMS) was proposed to detect Sybil attacks in the MCS network. The CbTMS was proffered for performing active and passive checking scheme, in addition to the mobile PCS trustworthiness management, and includes a decision tree algorithm, to verify the covered nodes in the MCS network. Simulation studies show that our CbTMS can efficiently detect the malicious Sybil nodes in the network and cause 6.87 Wh power reduction compared with other malicious Sybil node attack mode.
A Dynamic and Heuristic Phase Balancing Method for LV Feeders
Authors: Taghipour Boroujeni Samad , Mardaneh Mohammad , Hashemi Zhale
Published: May 2016

Due to the single-phase loads and their stochastic behavior, the current in the distribution feeders is not balanced. In addition, the single-phase loads are located in different positions along the LV feeders. So the amount of the unbalanced load and its location affect the feeder losses. An unbalanced load causes the feeder losses and the voltage drop. Because of time-varying behavior of the single-phase loads, phase balancing is a dynamic and combinatorial problem. In this research, a heuristic and dynamic solution for the phase balancing of the LV feeders is proposed. In this method, it is supposed that the loads’ tie could be connected to all phases through a three-phase switch. The aim of the proposed method is to make the feeder conditions as balanced as possible. The amount and the location of single-phase loads are considered in the proposed phase balancing method. Since the proposed method needs no communication interface or no remote controller, it is inexpensive, simple, practical, and robust. Applying this method provides a distributed and dynamic phase balancing control. In addition, the feasibility of reducing the used switches is investigated. The ability of the proposed method in the phase balancing of the LV feeders is approved by carrying out some simulations.
The Auscultation of a Carbon Dioxide Embolization Event during Endoscopic Vein Harvest
Authors: Strauss Erik , Taylor Bradley , Mazzeffi Michael , Tanaka Kenichi , Odonkor Patrick
Published: May 2016

Endoscopic vein harvest in preparation for coronary artery bypass surgery has become a preferred method of procuring saphenous vein. Several case reports have documented carbon dioxide (CO2) embolization with this procedure as well as CO2embolization during other laparoscopic surgeries (Markar et al., 2010). Although uncommon, the potential for CO2entrainment through an open vein or through absorption by vascular structures exists and should be recognized (Lin et al., 2003). We report a case of CO2embolization during EVH for a 77-year-old patient who underwent CABG that was identified early by the cardiac surgeon through the indirect auscultation of a mill-wheel murmur after the pericardium was opened. This may be the first reported case of a murmur related to air emboli identified without the use of a precordial Doppler probe or a stethoscope. This diagnosis was further supported by TEE before systemic hypotension or cardiovascular collapse occurred.
Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma
Authors: Yoshie Hidekazu , Nakazawa Ryuto , Usuba Wataru , Kudo Hiroya , Sato Yuichi , Sasaki Hideo , Chikaraishi Tatsuya
Published: May 2016

We report the first case in Japan of paraneoplastic dermatomyositis with pure seminoma, a tumor that extremely rarely accompanies dermatomyositis. The patient presented to the hospital with muscle weakness and erythema and was diagnosed with dermatomyositis from skin biopsy. Routine radiological screening revealed testicular tumor and massive lymph node metastases. We initially performed orchiectomy along with conventional immunotherapy. However, muscle weakness gradually worsened, and he eventually showed dysphagia and forced respiration and became bedridden. Although he seemed close to being too unstable to tolerate further treatment, we started carefully adjusted chemotherapy comprising 4 courses of etoposide plus cisplatin, which proved highly successful. Lymph node metastases completely disappeared and swallowing and respiration fully normalized after completing chemotherapy. We believe that this clinical success was due to our decision to initiate chemotherapy even in such a weak patient.
Phytochemicals and Medicinal Properties of Indigenous Tropical Fruits with Potential for Commercial Development
Authors: Khoo Hock Eng , Azlan Azrina , Kong Kin Weng , Ismail Amin
Published: May 2016

Hundreds of fruit‐bearing trees are native to Southeast Asia, but many of them are considered as indigenous or underutilized. These species can be categorized as indigenous tropical fruits with potential for commercial development and those possible for commercial development. Many of these fruits are considered as underutilized unless the commercialization is being realized despite the fact that they have the developmental potential. This review discusses seven indigenous tropical fruits from 15 species that have been identified, in which their fruits are having potential for commercial development. As they are not as popular as the commercially available fruits, limited information is found. This paper is the first initiative to provide information on the phytochemicals and potential medicinal uses of these fruits. Phytochemicals detected in these fruits are mainly the phenolic compounds, carotenoids, and other terpenoids. Most of these phytochemicals are potent antioxidants and have corresponded to the free radical scavenging activities and other biological activities of the fruits. The scientific research that covered a broad range of in vitro to in vivo studies on the medicinal potentials of these fruits is also discussed in detail. The current review is an update for researchers to have a better understanding of the species, which simultaneously can provide awareness to enhance their commercial value and promote their utilization for better biodiversity conservation.
Biomechanical Analysis of a Novel Acetabulum Reconstruction Technique with Acetabulum Reconstruction Cage and Threaded Rods after Type II Pelvic Resections
Authors: Singh Vivek Ajit , Elbahri Hassan , Shanmugam Rukmanikanthan
Published: May 2016

Background. Periacetabular resections with reconstruction has high rates of complications due to the complexity of the reconstruction. We have improvised a novel technique of reconstruction for type II and type II + III pelvic resections with the use of a commercially available acetabulum reconstruction cage (gap II, Stryker) and threaded rods.Objectives. The aim of our study is to determine the biomechanical strength of our reconstruction compared to the traditional cemented total hip replacement (THR) designs in normal acetabulum and establish its mode of failure.Methods. Five sets of hemipelvises were biomechanically tested (Instron® 3848, MA, USA). These constructs were subjected to cyclic loading and load to failure.Results. The reconstructed acetabulum was stiffer and required a higher load to failure compared to the intact pelvis with a standard THR. The mean stiffness of the reconstructed pelvis was1738.6±200.3 Nmm−1compared to the intact pelvis, which was911.4±172.7 Nmm−1(Pvalue = 0.01). The mean load to failure for the standard acetabular cup construct was3297.3±117.7 N while that of the reconstructed pelvis with the acetabulum cage and threaded rods was4863.8±7.0 N.Conclusion. Reconstruction of the pelvis with an acetabular reconstruction cage and threaded rods is a biomechanical viable option.
Macroscopic Hematuria and a Bladder Mass: Eosinophilic Cystitis in a 7-Year-Old Boy
Authors: Runge Stine Bjerrum , Høyer Søren , Winding Louise
Published: May 2016

We report a case of eosinophilic cystitis in a 7-year-old boy with a history of atopic symptoms, with focus on the radiological findings. He presented with hematuria and dysuria and ultrasonography (US) showed irregular bladder wall thickening resembling a bladder mass. CT urography did not characterize the lesion any further and showed no local or distant spread. Biopsies revealed eosinophilic cystitis, a benign inflammatory condition. We found that US characterized the lesion at least as well as CT and should be the first choice of imaging. When staging is considered before biopsy, MRI should be preferred to CT. There are no specific radiological signs of eosinophilic cystitis. On follow-up, US was a safe, cost-effective imaging modality, but findings should be interpreted in a clinical context. In a child with hematuria and a bladder mass, eosinophilic cystitis is a relevant but rare differential diagnosis, especially when there is a known atopic history.
Study on Yang-Xu Using Body Constitution Questionnaire and Blood Variables in Healthy Volunteers
Authors: Chen Hong-Jhang , Lin Yii-Jeng , Wu Pei-Chen , Hsu Wei-Hsiang , Hu Wan-Chung , Wu Trong-Neng , Chen Fang-Pey , Lin Yun-Lian
Published: May 2016

Traditional Chinese medicine (TCM) formulates treatment according to body constitution (BC) differentiation. Different constitutions have specific metabolic characteristics and different susceptibility to certain diseases. This study aimed to assess the Yang-Xu constitution using a body constitution questionnaire (BCQ) and clinical blood variables. A BCQ was employed to assess the clinical manifestation of Yang-Xu. The logistic regression model was conducted to explore the relationship between BC scores and biomarkers. Leave‐one‐out cross‐validation (LOOCV) and K‐fold cross‐validation were performed to evaluate the accuracy of a predictive model in practice. Decision trees (DTs) were conducted to determine the possible relationships between blood biomarkers and BC scores. According to the BCQ analysis, 49% participants without any BC were classified as healthy subjects. Among them, 130 samples were selected for further analysis and divided into two groups. One group comprised healthy subjects without any BC (68%), while subjects of the other group, named as the sub‐healthy group, had three BCs (32%). Six biomarkers, CRE, TSH, HB, MONO, RBC, and LH, were found to have the greatest impact on BCQ outcomes in Yang-Xu subjects. This study indicated significant biochemical differences in Yang-Xu subjects, which may provide a connection between blood variables and the Yang-Xu BC.
Zeolite Y Films as Ideal Platform for Evaluation of Third-Order Nonlinear Optical Quantum Dots
Authors: Kim Hyun Sung
Published: May 2016

Zeolites are ideal host material for generation and stabilization of regular ultrasmall quantum dots (QDs) array with the size below 1.5 nm. Quantum dots (QDs) with high density and extinction absorption coefficient have been expected to give high level of third-order nonlinear optical (3rd-NLO) and to have great potential applications in optoelectronics. In this paper, we carried out a systematic elucidation of the third-order nonlinear optical response of various types of QDs including PbSe, PbS, CdSe, CdS, ZnSe, ZnS, Ag2Se, and Ag2S by manipulation of QDs into zeolites Y pores. In this respect, we could demonstrate that the zeolite offers an ideal platform for capability comparison 3rd-NLO response of various types of QDs with high sensitivities.
Exploring Methods to Measure the Prevalence of Ménière's Disease in the US Clinformatics™ Database, 2010-2012
Authors: Ricchetti-Masterson Kristen , Aldridge Molly , Logie John , Suppapanya Nittaya , Cook Suzanne F.
Published: May 2016

Recent studies on the epidemiology of the inner-ear disorder Ménière's disease (MD) use disparate methods for sample selection, case identification and length of observation. Prevalence estimates vary geographically from 17 to 513 cases per 100,000 people. We explored the impact of case detection strategies and observation periods in estimating the prevalence of MD in the USA, using data from a large insurance claims database. Using case detection strategies of ≥1, ≥2 and ≥3 ICD-9 claim codes for MD within a 1-year period, the 2012 prevalence estimates were 66, 27 and 14 cases per 100,000 people, respectively. For ≥1, ≥2 and ≥3 insurance claims within a 3-year observation period, the prevalence estimates were 200, 104 and 66 cases per 100,000 people, respectively. Estimates based on a single claim are likely to overestimate prevalence; this conclusion is aligned with the American Academy of Otolaryngology-Head and Neck Foundation criteria requiring ≥2 definitive episodes for a definite diagnosis, and it has implications for future epidemiologic research. We believe estimates for ≥2 claims may be a more conservative estimate of the prevalence of MD, and multiyear estimates may be needed to allow for adequate follow-up time.
Relations of Visceral and Abdominal Subcutaneous Adipose Tissue, Body Mass Index, and Waist Circumference to Serum Concentrations of Parameters of Chronic Inflammation
Authors: Schlecht Inga , Fischer Beate , Behrens Gundula , Leitzmann Michael F.
Published: May 2016

Background: Different measures of body fat composition may vary in their relations to parameters of chronic inflammation. Methods: We assessed the relations of visceral (VAT) and subcutaneous adipose tissue (SAT), BMI, and waist circumference (WC) to serum concentrations of high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), resistin, and adiponectin in 97 healthy adults using multivariate linear regression models, adjusted for age, sex, smoking, physical activity, menopausal status, and use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs). Parameters of chronic inflammation were mutually adjusted. Results: VAT (β = 0.34), SAT (β = 0.43), BMI (β = 0.40), and WC (β = 0.47) were all significantly associated with hs-CRP. BMI was additionally inversely related to adiponectin (β = -0.29). In exploratory subgroup analyses defined by gender, BMI, smoking, and use of aspirin or NSAIDs, VAT was the strongest indicator for increased levels of IL-6, SAT was the most consistent indicator for increased levels of hs-CRP, and BMI was the most consistent indicator for decreased levels of adiponectin. WC showed to be a weak indicator for increased levels of hs-CRP and decreased levels of adiponectin. Conclusion: VAT, SAT, BMI, and WC show distinct associations with parameters of chronic inflammation. Whether these differences reflect differential metabolic risks requires clarification by longitudinal studies.
Tinnitus: Evaluation of Intratympanic Injection of Combined Lidocaine and Corticosteroids
Authors: Elzayat Saad , El-Sherif Hossam , Hegazy Hassan , Gabr Takwa , El-Tahan Abdel-Rahman
Published: May 2016

Background: Tinnitus is an annoying problem and until now there is no consensus on its treatment. Aims: In this prospective study, we evaluated the effectiveness of intratympanic lidocaine and dexamethasone (ITLD) injections for the management of subjective idiopathic tinnitus (SIT). Methods: Forty patients with SIT attended the Department of Otorhinolaryngology, Tanta University Hospital, Egypt, between May 2013 and May 2014. The patients were categorized into two groups: group A included 20 patients treated with ITLD injection, and group B included 20 patients treated with intratympanic saline injection as a control. Intratympanic injections were performed four times within 4 weeks in a double-blind manner. At the end of the treatment program, we analyzed the improvement and worsening rates of tinnitus using the following parameters: tinnitus questionnaires, Tinnitus Handicap Index (THI), and loudness matching test. Results: The effectiveness rates of the ITLD group reported in the tinnitus questionnaires, the THI and the loudness matching test were 74.3% in all tests, compared to 26.7, 40.0 and 26.7%, respectively, in the saline group. There was a statistically significant difference between the groups within 2 months after injection. To analyze the therapeutic effect of ITLD on tinnitus of 6 months duration, the improvement rates reported in the tinnitus questionnaires, the THI and the loudness matching test were 78.5% in all tests in the ITLD group, compared to 40.0, 40.0 and 30.0%, respectively, in the saline group. Conclusion: There were statistically significant differences between both groups. ITLD seems to be effective for idiopathic tinnitus.
Normative Data for the Spanish Version of the Addenbrooke's Cognitive Examination III
Authors: Matías-Guiu Jordi A. , Fernández-Bobadilla Ramón , Fernández-Oliveira Aníbal , Valles-Salgado María , Rognoni Teresa , Cortés-Martínez Ana , Moreno-Ramos Teresa , Kulisevsky Jaime , Matías-Guiu Jorge
Published: May 2016

Background: Addenbrooke's Cognitive Examination III (ACE-III) is a cognitive test that has been validated for the diagnosis of cognitive disorders. The aim of this study was to provide normative data for the ACE-III for age, education and gender. Methods: The Spanish version of the ACE-III was administered to a group of 273 healthy subjects in a multicenter study in Spain. Correlation and determination coefficients for age, education and gender were estimated. The overlapping interval strategy and linear regression analyses were used to provide adjusted norms for demographic factors and to explore the potential influence of these factors in the performance of the test. Results: Age and education correlated significantly with the total score and with all the domains. Gender correlated only with the domains of attention and visuospatial skills. Norms for the total score and for cognitive domains (attention, memory, fluency, language, and visuospatial skills) are provided. Conclusion: This study confirms the influence of demographic factors (especially age and education) on the performance in the ACE-III and provides normative data for the Spanish version of the ACE-III.
A Prospective Randomized Study Comparing Manual and Wall Suction in the Performance of Bronchoalveolar Lavage
Authors: Seijo Luis M. , Flandes Javier , Somiedo Maria V. , Naya Alba , Manjón Josefina , Álvarez Susana , Fernández-Navamuel Iker
Published: May 2016

Background: Bronchoalveolar lavage (BAL) may be performed using a hand-held syringe or wall suction. Objectives: The aim was to study BAL volume and diagnostic yields based on BAL technique. Methods: A total of 220 consecutive patients undergoing BAL at our center were included. Manual aspiration was performed in 115 patients (group 1), and wall suction (<50 mm Hg of negative pressure) was used in 105 patients (group 2). All bronchoscopies were performed under conscious sedation applying topical anesthesia with lidocaine. Three 50-ml sterile saline aliquots were instilled in all patients. Results: The mean total amount of fluid recovered was 67 ± 20 ml in group 1 and 55 ± 22 ml in group 2 (p < 0.001). More patients in the manual aspiration group met American Thoracic Society criteria (recovery of ≥30% of instilled fluid) for an optimal BAL (81 vs. 59%; p < 0.001). The quantity of recovered fluid was also related to BAL location (p < 0.001) and radiologic findings (p = 0.002). Forty-eight (22%) BALs were diagnostic (23 in group 1 and 25 in group 2), including 37 positive bacterial cultures, 6 positive stains for Pneumocystis, and 5 cases of malignancy. No statistically significant difference in diagnostic yield was observed between the two groups. A BAL diagnosis was more likely in patients with certain radiologic (p = 0.033) and endoscopic findings (p = 0.001). When taking into account all bronchoscopic techniques performed during the procedure (e.g. biopsies, brushing, etc.), bronchoscopy was diagnostic in 37% of patients. Conclusions: Manual aspiration is superior to wall suction during BAL yielding a larger quantity of aspirate. Diagnostic yields are similar for both techniques.
Clinical Correlates of Reduced Physical Activity in Idiopathic Pulmonary Fibrosis
Authors: Bahmer Thomas , Kirsten Anne-Marie , Waschki Benjamin , Rabe Klaus F. , Magnussen Helgo , Kirsten Detlef , Gramm Marco , Hummler Simone , Brunnemer Eva , Kreuter Michael , Watz Henrik
Published: May 2016

Background: Little is known about the consequences of idiopathic pulmonary fibrosis (IPF) for physical activity (PA). Objectives: We aimed to investigate levels of PA in IPF and to study associations of PA with lung function, exercise capacity, symptoms, and quality of life. Methods: In stable patients with IPF we measured PA (steps per day, SPD; physical activity level, PAL; minutes of moderate activity, MMA) by accelerometry (SenseWear Armband) for 1 week. We also assessed lung function (forced vital capacity, FVC; diffusing capacity for carbon monoxide, DLCO); exercise capacity (6-minute walking distance, 6MWD); dyspnea (modified Medical Research Council, mMRC); fatigue (Multidimensional Fatigue Inventory, MFI-20), and generic (12-Item Short Form Survey, SF-12) and health-related quality of life (St. George's Respiratory Questionnaire) as further clinical variables. Results: We investigated 48 patients with IPF in two centers (mean age, 67 years; 75% male; 23% on long-term oxygen therapy; mean FVC 75%pred.; mean DLCO 43%pred.; mean 6MWD 355 ± 140 m; mean SPD 5,017 ± 3,360). On a bivariate level, all clinical variables were significantly associated with SPD (p < 0.05). The associations of mMRC, MFI-20, SF-12 (physical health), and 6MWD with SPD were independent of impaired lung function (p < 0.05). At multivariate analyses, either 6MWD (total explained variance of the model, total R2: 42%) or MFI-20 (total R2: 39%) were the strongest independent predictors of SPD. Conclusion: Fatigue and exercise capacity are strong and independent predictors of PA in patients with IPF, which suggests that both measures should be assessed when the consequences of IPF for PA in daily life are studied.
Cyclosporine A, a Potential Therapy of Ischemic Reperfusion Injury. A Common History for Heart and Brain
Authors: Nighoghossian Norbert , Ovize Michel , Mewton Nathan , Ong Elodie , Cho Tae-Hee
Published: May 2016

Background: Ischemic stroke (IS) and acute myocardial infarction require emergency reperfusion tissue in order to improve functional outcome. Intra-arterial thrombectomy recently showed very encouraging improvement in IS patients' outcome. However, endovascular methods enhancing reperfusion may expose patients to increase in ischemic reperfusion injury. Experimental evidence indicates that brain ischemic reperfusion injury may be attenuated by ischemic pre- and postconditioning. The opening of mitochondrial permeability transition pore plays a critical role in the onset of reperfusion damage. This mechanism can be inhibited by immunosuppressive drugs like cyclosporine A (CsA). Summary: In this review, we present existing experimental and clinical data suggesting that conditioning interventions may prevent brain ischemic reperfusion injury and future challenge for neuroprotection by CsA in acute IS. Key Messages: The concept of conditioning has been recently investigated clinically but to a lesser extent in the realm of IS. Recent experimental and phase II clinical research has suggested potential neuroprotective properties of cyclosporine; however, further larger clinical trials are needed to demonstrate that CsA improves clinical outcome in acute IS patients.
Current State of Value-Based Purchasing Programs
Authors: Chee Tingyin T. , Ryan Andrew M. , Wasfy Jason H. , Borden William B.
Published: May 2016

The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of value-based payment in Medicare. Many private insurers are following Medicare’s lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care.
Description of Idiomysis diadema sp. nov. (Mysida, Mysidae, Anisomysini), associated with Diadema urchins in the Red Sea; with nomenclatorial notes on its genus
Authors: Wittmann Karl J.
Published: May 2016

The mysidIdiomysis diademasp. nov. is described from small swarms hovering between the spines of the sea urchinDiadema setosum(Leske, 1778) at the reef flat of Dahab, Red Sea. The most striking characters within its genus are the subdivided antennal scale, endopod of uropods longer than exopod, and a pair of minute spines on the terminal margin of the telson. With this first description, a total of sixIdiomysisspecies are now known, two of which are associated with cnidarians and only the new one with echinoids. An updated definition is given for the genusIdiomysisW. M. Tattersall, 1922, in order to match the current species inventory. To avoid previously incorrect and ambivalent gender attribution, I propose using the feminine gender for this genus throughout. Consequently, the spelling of two of its taxa,I. mozambicaDeprez, Wooldridge & Mees, 2001, andI. robustaConnell, 2008, is changed.
The Democratic Implications of npos and the Control Strategy of the State
Authors: Geng Changjuan , Meijs Lucas
Published: May 2016

Liberal scholars attribute an essential role to nonprofit organizations (npos) in the process of democratization, due to their roles in raising public awareness and supervising the hegemony of the state. Nevertheless, the current literature has yet to pay sufficient attention to the ways in which governments respond to the dynamics of power. As argued inpublic rational choice theory, the government is a self-benefit maximizing bureaucrat that spares no effort to adopt various strategies aimed at keeping society under control. We have studied this postulation by comparing the two contrasting civil societies of China and the Netherlands. Results from our investigation of campaigningnpos from China and the Netherlands confirm that states tend to apply a range of strategies (e.g., political restrictions and financial instruments) in order to assimilatenpos into the developmental planning of the government (e.g., by stimulating the economic functions ofnpos while weakening their democratic functions in intangible ways).
The “Itako” as Mass Culture
Authors: Ōmichi Haruka
Published: May 2016

The folk shamans (minkan fusha 民間巫者) called itako イタコ, mainly active in Aomori and surrounding prefectures (Akita and Iwate), are well known nationwide thanks to mass media coverage. However, despite their increased visibility, there seems to be a gap between the itako as folk culture and the image of the “itako” as a component of the mass culture produced by the media. This article attempts to clarify the actual conditions of the itako from the 1970s to 1980s, especially focusing on the influence of the occult boom, by analyzing the discourse in print media. Beginning in the 1970s, the occult boom in Japan rediscovered the religiosity of the itako as the occult the masses wanted. As a result, the itako changed from being culturally other to part of “our” mysterious knowledge. Although this involved an attribution of value to the itako, it also meant that the religiosity of the itako was turned into an object of consumption for mass culture. This popularization of itako religiosity played a significant role in establishing the itako as a part of mass culture.
Multiscale Modeling of the Moist-Convective Atmosphere
Authors: Arakawa Akio , Jung Joon-Hee , Wu Chien-Ming
Published: May 2016

One of the most important contributions of Michio Yanai to tropical meteorology is the introduction of the concepts of apparent heat source Q1 and apparent moisture sink Q2 in the large-scale heat and moisture budgets of the atmosphere. Through the inclusion of unresolved eddy effects, the vertical profiles of apparent sources (and sinks) are generally quite different from those of true sources taking place locally. In low-resolution models, such as the conventional general circulation models (GCMs), cumulus parameterization is supposed to determine the apparent sources for each grid cell from the explicitly predicted grid-scale processes. Because of the recent advancement of computer technology, however, increasingly higher horizontal resolutions are being used even for studying the global climate, and, therefore, the concept of apparent sources must be expanded rather drastically. Specifically, the simulated apparent sources should approach and eventually converge to the true sources as the horizontal resolution is refined. For this transition to take place, the conventional cumulus parameterization must be either generalized so that it is applicable to any horizontal resolutions or replaced with the mean effects of cloud-scale processes explicitly simulated by a cloud-resolving model (CRM). These two approaches are called ROUTE I and ROUTE II for unifying low- and high-resolution models, respectively. This chapter discusses the conceptual and technical problems in exploring these routes and reviews the authors’ recent work on these subjects.
Middle Cranial Fossa Dehiscence as an Incidental Finding on CT
Authors: Valika Taher , Redleaf Miriam
Published: May 2016

Objectives:

This retrospective chart review demonstrates that the prevalence of middle cranial fossa (MCF) dehiscence on computed tomography (CT) scans increases with age.

Methods:

High-resolution temporal bone CT scans, which had been obtained for any otologic complaint, were reviewed independent of all clinical history. Scans showing soft tissue, fluid, trauma, or previous operations were excluded. The CTs from 183 patients (296 ears) were reviewed, blinded for age and body mass index (BMI). The MCF floor was divided into 7 regions and systematically inspected. Ages and BMIs of the patients were subsequently extracted from the medical record.

Results:

Logistic regression analysis confirmed increasing MCF dehiscence with age ( P < .05, odds ratio [OR] = 1.07, R = .584). Over all ages (range, 1-88 years; average, 38.5), 32% of MCF floors were dehiscent at any 1 site. For age 60 and over, 55% were dehiscent. The most common sites of MCF dehisence were directly above the malleus head and above the additus ad antrum (35% and 28%, respectively). Superior canal dehiscence (SCD) was seen in 7% of all patients and only in the context of MCF dehiscence. The prevalence of MCF dehiscence increased with age when patients were analyzed by BMI <25, BMI = 25-30, and BMI >30 ( P < .003, P < .04, P = .03).

Conclusion:

The increase of middle cranial fossa dehiscence with respect to age is statistically significant. Over all ages, approximately 32% of ears show dehiscence. Over 60 years, approximately 55% show dehiscence. The odds of having dehiscence double with a 10-year difference in age. The most common sites along the MCF floor are in the epitympanum over the malleus head and the additus ad antrum. There was a statistically significant increase in MCF dehiscence with age when patients with equivalent BMIs are compared.
Phenotype of a Belgian Family With 6p25 Deletion Syndrome
Authors: Weegerink Nicole J.D. , Swinnen Freya K.R. , Vanakker Olivier M. , Casselman Jan W. , Dhooge Ingeborg J.M.
Published: May 2016

Background:

The 6p25 deletion syndrome is one of the many syndromes with both hearing impairment as well as vision impairment. However, the audiometric characteristics and radiological findings of patients with 6p25 deletions are only scarcely described in literature. This study focused on characterizing the audiometric and radiological features of a Belgian family with a chromosome 6p25 deletion.

Objective:

To evaluate the hearing impairment, audiometric testing and radiological examination of the temporal bones in 3 family members with a 3.4 Mb deletion in chromosome band 6p25.

Results:

All 3 family members demonstrated slowly progressive sensorineural or mixed hearing impairment. Radiologic examination revealed thickened and sclerotic stapes in all patients and a minor internal partition type II of the cochlea in 2 patients.

Conclusion:

There is a significant phenotypic variability within and among families with the 6p25 deletion syndrome. A thorough genotype-phenotype correlation is difficult because of the small number of affected patients and the limited clinical data available. More clinical data of families with 6p25 deletions need to be published in order to create a reliable and precise phenotypic characterization. However, our findings can facilitate counseling of hearing impairment caused by 6p25 deletions.
The Effectiveness of Using a Content Acquisition Podcast to Teach Phonological Awareness, Phonemic Awareness, and Phonics to Preservice Special Education Teachers
Authors: Carlisle Abigail A. , Thomas Cathy Newman , McCathren Rebecca B.
Published: May 2016

The purpose of this study was to examine the effects of using a content acquisition podcast (CAP) to teach phonological awareness, phonemic awareness, and phonics (PA) to preservice special education teachers. Fifty undergraduate preservice special education teachers over 2 years were randomly assigned to either the CAP group or a comparison group during a semester-long course on language development. The CAP group watched a 10-min CAP on PA, and the comparison group read a practitioner-friendly article. As part of the course, both groups were instructed to complete a required textbook chapter reading before class and received an expert guest lecture on these topics following the experimental conditions. There were no pretest differences between groups, years, or between students who completed the required textbook reading and those who did not. Results indicated that the CAP group significantly outperformed the comparison group on declarative knowledge and application items in PA and grew in their learning at a faster rate. CAPs offer an effective and efficient method for teaching PA and, in this study, were more effective at teaching PA and at helping students apply that knowledge than reading alone.
Supporting incarcerated mothers in Ireland with their familial relationships; a case for the revival of the social work role
Authors: O’Malley Sinead , Devaney Carmel
Published: May 2016

All families need both formal and informal supports throughout their life course. Parents relationships with their children need to be promoted, supported and maintained. For parents living with their children and acting as their primary carer this role, although fulfilling, is filled with challenges. At particular points in time and for a variety of reasons parents need to be supported in carrying out this role, striving towards healthy family functioning. For parents where there are additional stressors associated with their relationship with their children. The impact of this can be significant and far reaching for all involved. Incarcerated mothers and their children face particular difficulties in maintaining their relationships and for mothers to ‘perform’ a mothering role. Throughout the stages of childhood, family breakdown and separation from their mother is a traumatic experience for children. This paper considers the current provision within the Irish Prison System for supporting incarcerated mothers in their efforts to maintain relationships with their children and wider family members and highlights the deficits within this. This paper argues the case for reviving the role of supportive social work practitioners to work alongside incarcerated mothers in an effort to retain and realise their parental rights and duties and to maintain relationships with their children.
Artificial Intelligence and the Problem of Digital Ontotheology
Authors: Crombez Joel , Dahms Harry F.
Published: May 2016

In utopian/science fiction literature, comprehensive knowledge is a familiar motif that also inspires recent policies to screen society through surveillance. In the late 20th century, a digital archive promised to facilitate quick access to abundant information and effective strategies to confront myriad challenges. Yet, today, the scale and scope of information accumulation in national and corporate repositories is reaching proportions whose intelligent processing excedes human capabilities, and triggering a shift in focus from dumb repository to artificial intelligence. Processing such accumulation of knowledge necessiates skills commonly attributed to divinity. Without a theory that recognizes this condition and informs the operations of artificial intelligence, the latter is likely to fail in human ways, e.g., by perceiving false patterns resulting from flawed theories assigning meaning to knowledge. For successful pattern recognition to occur, theories must rest on science fiction and a digital ontotheology of the machine as the form this archive assumes.