bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid and sensitive detection of Feline immunodeficiency virus using an insulated isothermal PCR-based assay with a point-of-need PCR detection platform
Authors: Wilkes Rebecca Penrose , Kania Stephen A. , Tsai Yun-Long , Lee Pei-Yu Alison , Chang Hsiu-Hui , Ma Li-Juan , Chang Hsiao-Fen Grace , Wang Hwa-Tang Thomas
Published: July 2015

Feline immunodeficiency virus (FIV) is an important infectious agent of cats. Clinical syndromes resulting from FIV infection include immunodeficiency, opportunistic infections, and neoplasia. In our study, a 5′ long terminal repeat/ gag region–based reverse transcription insulated isothermal polymerase chain reaction (RT-iiPCR) was developed to amplify all known FIV strains to facilitate point-of-need FIV diagnosis. The RT-iiPCR method was applied in a point-of-need PCR detection platform—a field-deployable device capable of generating automatically interpreted RT-iiPCR results from nucleic acids within 1 hr. Limit of detection 95% of FIV RT-iiPCR was calculated to be 95 copies standard in vitro transcription RNA per reaction. Endpoint dilution studies with serial dilutions of an ATCC FIV type strain showed that the sensitivity of lyophilized FIV RT-iiPCR reagent was comparable to that of a reference nested PCR. The established reaction did not amplify any nontargeted feline pathogens, including Felid herpesvirus 1, feline coronavirus, Feline calicivirus, Feline leukemia virus, Mycoplasma haemofelis, and Chlamydophila felis. Based on analysis of 76 clinical samples (including blood and bone marrow) with the FIV RT-iiPCR, test sensitivity was 97.78% (44/45), specificity was 100.00% (31/31), and agreement was 98.65% (75/76), determined against a reference nested-PCR assay. A kappa value of 0.97 indicated excellent correlation between these 2 methods. The lyophilized FIV RT-iiPCR reagent, deployed on a user-friendly portable device, has potential utility for rapid and easy point-of-need detection of FIV in cats.
Frequency control of smart base isolation system employing a novel adaptive magneto-rheological elastomer base isolator
Authors: Gu Xiaoyu , Li Jianchun , Li Yancheng , Askari Mohsen
Published: July 2015

In the past decades, base isolation techniques have become increasingly popular for seismic protection of civil structures owing to its capability of decoupling buildings from harmful ground motion. However, it has been recognised recently that the traditional passive base isolation technique could encounter a serious problem during earthquakes due its incapability in adjusting the isolation frequency to cope with the unpredictability and diversity of earthquakes. To address this challenge, a great deal of research efforts have been conducted to improve traditional base isolation systems, most of which focused on hybrid supplementary devices (passive, active and semi-active types) for the isolators to control displacement or to dissipate seismic energy. On the other hand, the most effective approach to address the aforementioned challenge should lay on varying isolator stiffness in real-time to achieve real-time spontaneous decoupling. A recent advance of the development of an adaptive magneto-rheological elastomer base isolator has brought such idea to reality as the new magneto-rheological elastomer base isolator is capable to alter its stiffness significantly in real-time. In this article, an innovative smart base isolation system employing such magneto-rheological elastomer isolator is proposed and a novel frequency control algorithm is developed to shift the fundamental frequency of the structure away from the dominant frequency range of earthquakes. Such design enables the building to avoid resonant state in real-time according to the on-coming spectrum of the earthquakes. Extensive simulation has been conducted using a five-storey benchmark model with the isolation system, and testing results indicate that the proposed control system is able to significantly suppress both the floor accelerations and inter-storey drifts simultaneously under different earthquakes.
Economic drivers of biological complexity
Authors: Phelps Steve , Russell Yvan I
Published: July 2015

The complexity that we observe in nature can often be explained in terms of cooperative behavior. For example, the major transitions of evolution required the emergence of cooperation among the lower-level units of selection, which led to specialization through division-of-labor ultimately resulting in spontaneous order. There are two aspects to address explaining how such cooperation is sustained: how free-riders are prevented from free-riding on the benefits of cooperative tasks and, just as importantly, how those social benefits arise. We review these problems from an economic perspective, and highlight how ideas from economics can help us to better understand how the benefits of social interactions arise, how they are sustained, and how they affect the underlying social dilemmas.
Extrapyramidal Reactions Associated With Serotonergic Antidepressants
Authors: Hawthorne Jessica M. , Caley Charles F.
Published: July 2015

Objective: Extrapyramidal reactions (EPRs) associated with serotonergic antidepressant treatments have been reported since 1958. These reactions can be distressing for patients and complicate treatment. Our objective was to complete a follow-up review of published EPR cases reported for serotonergic antidepressants. Data Sources: Published cases between January 1998 and May 2015 were collected through a medical literature search. Citation reference lists were also searched manually. Study Selection and Data Extraction: Identified cases were reviewed for patient age, gender, psychiatric diagnosis, dosage, time to reaction onset, concurrent medications, and EPR description. Cases were excluded when there was not a clear description, if descriptions were not consistent with accepted deﬁnitions, or if the written English was poor. We included cases of akathisia, dystonia, dyskinesia, parkinsonism, or mixed EPRs. Authors scored each case using the Naranjo adverse drug reaction probability scale. Data Synthesis: We identified 86 published reports involving 91 patients; selective serotonin reuptake inhibitors were implicated in 80.2% of cases. All EPR types were reported: 17 akathisia cases, 18 dyskinesia cases, 27 dystonia cases, 19 parkinsonism cases, and 10 mixed EPR cases. EPRs typically occurred within 30 days of either treatment initiation or dose increase. Age, gender, antidepressant dosing, or concurrent antipsychotic treatment did not appear to broadly contribute to EPR risk. Naranjo scores ranged from 2 to 8. Conclusions: Case reports associating serotonergic antidepressants with EPRs continue to be published. Practitioners are advised that monitoring for such is important. Rigorous research efforts are needed to better understand the clinical risk factors for these adverse drug reactions.
Idelalisib
Authors: Shah Arpita , Mangaonkar Abhishek
Published: July 2015

Objective: To review and summarize data on idelalisib, which was approved by the Food and Drug Administration (FDA) in July 2014 for use in combination with rituximab for relapsed chronic lymphocytic leukemia (CLL). Data Sources: A literature search using PubMed was conducted from January 2011 through May 2015 using the terms idelalisib, GS-101, CAL-101, PI3Kδ, and CLL. Data were also obtained through the FDA briefing documents, American Society of Clinical Oncology, and American Society of Hematology abstracts. Study Selection and Data Extraction: The literature search was limited to human studies published in English. Priority was placed on trials of idelalisib in CLL. Data Synthesis: Idelalisib is a potent, first-in-class selective inhibitor of phosphatidylinositol-3-kinaseδ (PI3Kδ) approved by the FDA in July 2014 for the treatment of relapsed CLL, in combination with rituximab, in patients for whom rituximab monotherapy would be considered appropriate due to other comorbidities. PI3Kδ is hyperactivated in B-cell malignancies and plays a vital role in the B-cell receptor pathway, a key oncogenic driver in various B-cell malignancies, including CLL. Several phase I/II studies have demonstrated clinical activity of idelalisib in CLL, particularly in the setting of relapsed/refractory disease, with overall response rate ranging from 70% to 82%. The FDA approval was based on a phase III, randomized trial of rituximab monotherapy (n = 110) or idelalisib in combination with rituximab (n = 110) in heavily, pre-treated patients (median of 3 prior therapies) with relapsed CLL. Idelalisib was administered as 150 mg orally twice daily. Idelalisib plus rituximab was associated with an overall response rate of 81% and overall survival of 91% at 12 months. The median progression-free survival was not reached in the idelalisib arm at the time of the first interim analysis. The incidence of grade 3 or higher adverse events in the idelalisib plus rituximab arm was as follows: neutropenia (34%), thrombocytopenia (10%), anemia (5%), elevation in transaminases (5%), and diarrhea (4%). Conclusion: Idelalisib in combination with rituximab is a safe and effective new treatment option for patients with relapsed CLL, including those with poor prognostic factors. As the results from various ongoing studies become available, the role of idelalisib will likely continue to expand.
Is it equivalent? Evaluation of the clinical activity of single agent Lipodox® compared to single agent Doxil® in ovarian cancer treatment
Authors: Smith Judith A , Costales Anthony B , Jaffari Mona , Urbauer Diana L , Frumovitz Michael , Kutac Christine K , Tran Huyentran , Coleman Robert L
Published: July 2015

Background

In response to the critical shortage of liposomal doxorubicin (Doxil®) in the United States, the Food and Drug Administration (FDA) approved temporary importation of doxorubicin hydrochloride liposome (Lipodox®). The objective was to compare toxicity and clinical activity of Lipodox® with Doxil®.

Methods

Recurrent ovarian cancer patients who received Lipodox® were compared 3:1 to matched control Doxil® patients who had received Doxil®. Patients were matched based on age, stage, dose, platinum sensitivity, and prior treatments from an existing de-identified database. Patients receiving combination regimens were excluded.

Results

The data from 40 Lipodox® patients was compared to 120 matched control Doxil® patients. In this study, 17 (42.5%) of the Lipodox® patients were switched to Doxil®. The overall response rate Lipodox® was 4.3% (1/23) compared to 18% (20/111) in matched control Doxil® patients. In the platinum-sensitive patients, 100% progressed in the Lipodox® group compared to 78.4% in matched control Doxil® patients. The mean time to progression was 4.1 ± 2.8 months for Lipodox® and 6.2 ± 7.2 months in control Doxil®s ( p = 0·25). Toxicity was similar in the Lipodox® group and control Doxil® group.

Conclusion

Lipodox® for treatment of recurrent ovarian cancer did not appear to have equivalent efficacy compared to Doxil®. A prospective clinical study is warranted before Lipodox® can be deemed equivalent substitution for Doxil®.
The Impact of a Couple’s Vibrator on Men’s Perceptions of Their Own and Their Partner’s Sexual Pleasure and Satisfaction
Authors: Watson Erin D. , Séguin Léa J. , Milhausen Robin R. , Murray Sarah H.
Published: July 2015

Recent research demonstrated that more men, particularly those in couple relationships, are using vibrators to enhance sexual pleasure. However, men’s perceptions of vibrator use with a partner have rarely been investigated. The purpose of this analysis was to study men’s perceptions of the impact of vibrator use on their and their partner’s sexual pleasure and sexual satisfaction. Forty-nine men, aged twenty-five to fifty-eight, in heterosexual relationships responded to a series of open-ended questions regarding their experience of incorporating a couple-oriented vibrator into their sexual repertoire over a six-week period. The data were analyzed using thematic analysis. The data were organized into four themes: physical pleasure, awareness of partner’s experience, novelty and variety, and intimacy. Men’s experiences of sexual pleasure were tied to perceptions of their partner’s pleasure and to the addition of novelty and variety in sexual encounters.
Does the body matter? Determining the right to asylum and the corporeality of political communication
Authors: Puumala Eeva , Kynsilehto Anitta
Published: July 2015

Analyses of political agency often take the Habermasian notion of an ideal speech situation and its related discourse ethics as the ultimate model of politically relevant communication. Our examination of Finnish asylum officers’ perspectives on their work leads us to consider the asylum interview as an event of the political, an event of the body politic. Our interest lies in acts of communication that go beyond speech, which necessitates an engagement with the corporeal element of communication. Based on our data, we show how a focus on spoken communication alone fails to capture manifold ways in which the encounter between asylum officers and asylum applicant produces the political. We argue that taking corporeality seriously would enhance our understanding of what is at stake in this encounter and also beyond it.
Comparison of Blood Flow in Branched and Fenestrated Stent-Grafts for Endovascular Repair of Abdominal Aortic Aneurysms
Authors: Kandail Harkamaljot , Hamady Mohamad , Xu Xiao Yun
Published: July 2015

Purpose: To report a computational study assessing the hemodynamic outcomes of branched stent-grafts (BSGs) for different anatomic variations. Methods: Idealized models of BSGs and fenestrated stent-grafts (FSGs) were constructed with different visceral takeoff angles (ToA) and lateral aortic neck angles. ToA was defined as the angle between the centerlines of the main stent-graft and side branch, with 90° representing normal alignment, and 30° and 120° representing angulated side branches. Computational simulations were performed by solving the conservation equations governing the blood flow under physiologically realistic conditions. Results: The largest renal flow recirculation zones (FRZs) were observed in FSGs at a ToA of 30°, and the smallest FRZ was also found in FSGs (at a ToA of 120°). For straight-neck stent-grafts with a ToA of 90°, mean flow in each renal artery was 0.54, 0.46, and 0.62 L/min in antegrade BSGs, retrograde BSGs, and FSGs, respectively. For angulated stent-grafts, the corresponding values were 0.53, 0.48, and 0.63 L/min. All straight-neck stent-grafts experienced equal cycle-averaged displacement forces of 1.25, 1.69, and 1.95 N at ToAs of 30°, 90°, and 120°, respectively. Angulated main stent-grafts experienced an equal cycle-averaged displacement force of 3.6 N. Conclusion: The blood flow rate in renal arteries depends on the configuration of the stent-graft, with an FSG giving maximum renal flow and a retrograde BSG resulting in minimum renal flow. Nevertheless, the difference was small, up to 0.09 L/min. Displacement forces exerted on stent-grafts are very sensitive to lateral neck angle but not on the configuration of the stent-graft.
Comparative Assessment of Guidewire and Microcatheter vs a Crossing Device–Based Strategy to Traverse Infrainguinal Peripheral Artery Chronic Total Occlusions
Authors: Banerjee Subhash , Sarode Karan , Patel Apurva , Mohammad Atif , Parikh Roosha , Armstrong Ehrin J. , Tsai Shirling , Shammas Nicolas W. , Brilakis Emmanouil S.
Published: July 2015

Purpose: To compare success rates of a guidewire and microcatheter strategy vs the use of specialized crossing devices to traverse infrainguinal peripheral artery chronic total occlusions (CTOs). Methods: For this analysis, data on 438 consecutive infrainguinal CTO interventions in 438 patients (mean age 63.2 years; 402 men) performed between August 2006 and May 2014 were extracted from the multicenter Excellence in Peripheral Artery Disease ( XLPAD) database ( ClinicalTrials.gov; identifier NCT01904851). Primary technical success constituted placement of a guidewire in the true lumen, past the distal CTO cap, with the initial crossing strategy. Results: A wire-catheter strategy was used in 295 (67.4%) and a specialized CTO crossing device in 143 (32.6%) patients (p<0.001). Primary crossing technical success was higher with CTO devices (72.1% vs 51.9%, p<0.001). The primary wire-catheter arm used significantly more secondary CTO devices (28.1% vs 17.5%) and/or provisional re-entry devices (26.7% vs 4.9%) compared with the primary CTO device arm (both p<0.001). Secondary crossing technical success (defined as crossing with an alternate strategy: 67.5% vs 71.4%, p=1.000), provisional crossing technical success (defined as use of a re-entry device: 84.2% vs 87.5%, p=0.768), and procedure success (93.6% vs 90.9%, p=0.332) were similar between the wire-catheter and CTO device strategies, respectively. No differences were observed in periprocedural complications or 30-day adverse events; however, at 12 months, there was a significantly higher surgical revascularization rate in the primary wire-catheter arm (8.8% vs 2.8%, p=0.025). Conclusion: Infrainguinal peripheral artery CTO crossing is frequently attempted with a wire-catheter technique; however, an initial CTO crossing device approach is associated with higher primary technical success. Overall procedure success is similar with both strategies.
An Endovascular-First Approach to the Treatment of Critical Limb Ischemia Results in Superior Limb Salvage Rates
Authors: Katib Nedal , Thomas Shannon D. , Lennox Andrew F. , Yang Jia-Lin , Varcoe Ramon L.
Published: July 2015

Purpose: To evaluate the effect of a shift to a primary endovascular revascularization (ER) strategy for patients presenting with critical limb ischemia (CLI) after a change in staff at our center in 2008 altered our revascularization strategy. Methods: Between 2004 and 2012, 344 critically ischemic limbs were treated in 279 patients (mean age 74.0±11.4 years; 179 men) during 546 separate hospital admissions. Limbs were analyzed according to (1) their principal revascularization strategy and (2) their date of presentation [early (2004–2008) or late (2008–2012)]. Results: Compared with the open revascularization (OR) and no revascularization (NR) groups, the ER group had an increased freedom from major amputation (92.3% vs 80.0% OR vs 69.3% NR, p<0.001), reduced hospital stay (15.2 vs OR 31.6 vs NR 25.9 days, p<0.001), intensive care unit (ICU) stay (2.3 vs OR 23.7 vs NR 7.2 hours, p=0.033), and operating time for ER vs OR (157.9 vs 316.8 minutes, respectively; p<0.0001). There was also a significant decrease in limbs requiring minor amputations (23.2% vs OR 29.3% vs NR 37.6%, p=0.041) and mean number of admissions/limb compared to OR (1.5 vs OR 1.9 vs NR 1.5, p=0.007). The late era saw the treatment of a larger number of limbs (223 vs 121) compared with the earlier time period. This institutional shift resulted in increased freedom from major amputation (87.4% vs 74.4%, p<0.01), reduced ICU stay (3.45 vs 16.98 hours, p<0.01), and shorter length of stay (20.9 vs 31.5 days, p<0.01) between the 2 eras, respectively. Conclusion: A shift to an endovascular-first treatment strategy is associated with fewer major amputations and shorter length of stay.
Better Clinical Practice Could Overcome Patient-Related Risk Factors of Vascular Surgical Site Infections
Authors: Maeda Koji , Kanaoka Yuji , Ohki Takao , Sumi Makoto , Toya Naoki , Fujita Tetsuji
Published: July 2015

Purpose: To clarify the current status of surgical site infection (SSI) during endovascular aortic repair and to define risk factors for SSI among the patients who underwent thoracic or abdominal stent-graft repair through a groin incision. Methods: Between 2006 and 2013, data were collected from 1604 patients (mean age 75.2±9.5 years; 1282 men) with 2799 groin incisions for transfemoral access during aortic stent-graft procedures. SSIs were classified as superficial or deep (both occurring within 30 days) or organ/space infections (occurring within 1 year after surgery) according to the Centers for Disease Control and Prevention guidelines. Strategies in place for minimizing SSIs were (1) employing oblique groin incisions, (2) covering the incision with saline-soaked gauze, (3) irrigating the incision thoroughly with saline per layer, and (4) using absorbable sutures. Results: Overall incidence of SSI was 0.4% (6 patients). The majority of SSIs were late-onset prosthetic graft infections (5, 0.3%). Five of the 6 were successfully treated with conservative therapy; one patient died of sepsis. Univariate analysis showed additional therapy (eg, coil embolization) with a stent-graft procedure was a risk factor for SSI. Conclusion: Appropriate antibiotic administration, oblique groin incision, meticulous operative technique, protection against airborne infection during the operation, and closed dressings may avert vascular wound SSIs.
Rheolytic Pharmacomechanical Thrombectomy for the Management of Acute Limb Ischemia
Authors: Leung Daniel A. , Blitz Lawrence R. , Nelson Teresa , Amin Ali , Soukas Peter A. , Nanjundappa Aravinda , Garcia Mark J. , Lookstein Robert , Simoni Eugene J.
Published: July 2015

Purpose: To present the results of rheolytic pharmacomechanical thrombectomy (PMT) for the management of acute limb ischemia (ALI) as reported in the PEARL Registry ( PEripheral Use of AngioJet Rheolytic Thrombectomy with a variety of catheter Lengths). Methods: A total of 283 patients (mean age 65±13 years; 170 men) presenting with ALI undergoing treatment with the AngioJet System at participating institutions were enrolled in the registry. Rutherford ALI categories included 26% with viable limbs, 38% with marginally threatened limbs, 35% with immediately threatened limbs, and <1% with irreversible damage. Procedure and follow-up data were collected for the calculation of outcomes. To control for patient selection bias, propensity score matching was used to compare outcomes for patients undergoing PMT with or without catheter-directed thrombolysis (CDT). Results: Procedure success was achieved in 235 (83%) of 283 patients. Half of the procedures (147, 52%) were completed without the need for adjunctive CDT. At 12-month follow-up, amputation-free survival and freedom from mortality were 81% and 91%, respectively; 12-month freedom from bleeding requiring transfusion was 91%, and freedom from renal failure was 95%. Subgroup analysis revealed significantly better outcomes in patients without infrapopliteal involvement and those who underwent PMT without CDT. In the matched cohorts, higher rates of procedure success, 12-month amputation-free survival, and 12-month freedom from amputation were observed in the PMT without CDT group (88% vs 74%, p=0.021; 87% vs 72%, p=0.028; 96% vs 81%, p=0.01, respectively). Conclusions: The results support the use of PMT as a first-line treatment for ALI, providing a rapid reperfusion to the extremity, reduced procedure time, and an acceptable risk profile without compromising limb salvage.
Anaphylactic Reaction During Implantation of the Ovation Stent-Graft System in a Patient With Abdominal Aortic Aneurysm
Authors: Sfyroeras George S. , Moulakakis Konstantinos G. , Antonopoulos Constantine N. , Manikis Dimitris , Vasdekis Spyridon N.
Published: July 2015

Purpose: To describe a case of anaphylactic reaction during implantation of the Ovation Abdominal Stent Graft System in a patient treated for abdominal aortic aneurysm (AAA). Case Report: An 82-year-old man with a 5.3-cm asymptomatic AAA underwent endovascular repair using an Ovation stent-graft. Polymer was infused into the inflatable rings of the aortic body under continuous angioscopy, but the rings were not filled, even though the entire amount of the polymer was administered. Simultaneously, the patient presented with a severe anaphylactic reaction resulting in cardiopulmonary arrest. He was successfully resuscitated, but the procedure was abandoned; the patient refused any further treatment. Conclusion: A rupture of the Ovation main body’s polymer-filled rings may lead to extremely severe anaphylactic reaction.
Preliminary Clinical Results and Mechanical Behavior of a New Double-Layer Carotid Stent
Authors: Wissgott Christian , Schmidt Wolfram , Brandt Christoph , Behrens Peter , Andresen Reimer
Published: July 2015

Purpose: To evaluate the in vitro mechanical and clinical implant behavior of a next-generation double-layer stent designed for the carotid artery. Methods: The new double-layer CASPER-RX stent was implanted in 12 patients (median age 69 years; 8 men) with high-grade symptomatic internal carotid artery stenoses (mean 82%). In the in vitro experiments, the CASPER-RX stent (8-×40-mm model) was investigated with respect to its radial force on expansion and the bending stiffness of the stent system and of the stent in its expanded state, as well as the collapse pressure in a thin, flexible sleeve. The wall adaptation of the expanded stents was assessed by fluoroscopy after release in a step and curve model. Results: Technical success was achieved in all patients without complications; there was no peri- or postinterventional stroke and no stroke or restenosis after 6 months. In the experimental studies, the bending stiffness of the stent on the delivery system (154.9 N mm2) was significantly lower than when expanded in a 7-mm flexible tube (467.4 N mm2). The radial force on expansion of the stent to 7 mm was low (0.011 N/mm). The collapse pressure was relatively high (0.56 bar) as a result of the stent’s particular stent structure. The stent exhibited significant foreshortening of 27.6%. The conformability to the wall in the step model was relatively smooth; in the curve model, straightening occurred with consecutive slight stenosis. Conclusion: The first clinical results showed a safe implantation behavior without the occurrence of any ischemia. The structure of the new CASPER-RX stent creates an acceptable flexibility, low radial force, and high collapse pressure. The large foreshortening during implantation should be considered as well as the higher bending stiffness, especially when used in elongated carotid arteries.
Targeted True Lumen Re-Entry With the Outback Catheter
Authors: Kitrou Panagiotis , Parthipun Aneeta , Diamantopoulos Athanasios , Paraskevopoulos Ioannis , Karunanithy Narayan , Katsanos Konstantinos
Published: July 2015

Purpose: To report a single-center experience with the Outback re-entry device for targeted distal true lumen re-entry during subintimal recanalization of chronic total occlusions (CTOs) and compare the results with a systematic review of the literature. Methods: Between February 2011 and July 2013, 104 Outback devices were employed in 91 patients (mean age 64±9 years; 57 men) for subintimal recanalization of 100 vessels with CTOs after initial failure of spontaneous reentry. Fifty-two cases involved a retrograde approach to aortoiliac occlusions and 48 were re-entry attempts in infrainguinal CTOs. Outcome measures included complications and technical success, defined as successful targeted re-entry at the preplanned site of the distal true lumen. To evaluate device accuracy, the re-entry distance (between the point of true vessel reconstitution and the eventual re-entry point) was measured. Results: Outback success was 93% (93/100); only 7 cases failed owing to heavy calcification (5/52 aortoiliac vs 2/48 infrainguinal, p=0.44). Re-entry was highly accurate, with a re-entry distance of ~1 cm in both subgroups (1.2±0.1 cm in aortoiliac vs 1.3±0.1 cm in infrainguinal, p=0.40). There were no major and 17 minor complications (9/52 aortoiliac vs 8/48 infrainguinal, p=0.93). Results are in line with the systematic review that identified 11 studies (only 1 randomized trial) involving mostly the femoropopliteal segment (119 aortoiliac and 464 infrainguinal segments). The pooled Outback success rate was 90% (95% confidence interval 85% to 94%) and the pooled complication rate was 4.3% (95% confidence interval 1.6% to 8.3%). Conclusion: The Outback device is safe and has a very high rate of achieving targeted true lumen re-entry, which minimizes the sacrifice of healthy vessel in the aortoiliac and infrainguinal arteries.
The Impact of Stent Graft Material on the Inflammatory Response After EVAR
Authors: Sartipy Fredrik , Lindström David , Gillgren Peter , Ternhag Anders
Published: July 2015

Background:

Patients undergoing endovascular aneurysm repair (EVAR) due to abdominal aortic aneurysm often develop an inflammatory response, postimplantation syndrome (PIS) where fever and leukocytosis are common. Previous studies suggest that type of stent graft material (polyester or polytetrafluoroethylene [PTFE]) plays a role.

Objectives:

To investigate the effect of stent graft material on the inflammatory response and length of hospital stay in patients undergoing standard elective EVAR.

Methods:

Sixty-nine elective EVAR patients were included in this observational study. To avoid comparing patients with a different graft location and stent graft burden, 12 cases were excluded as well as cases with complication or simultaneous open surgical procedures, leaving 45 patients (32 with polyester and 13 with PTFE graft) for final analysis. Tympanic temperature, C-reactive protein (CRP), white blood cell (WBC), and procalcitonin (PCT) were measured on days −1 and +1 and +3. Duration of in-hospital stay and frequency of PIS were recorded.

Results:

The PIS was diagnosed in 9 (28.1%) of the 32 polyester cases and in 1 (7.7%) of the 13 cases in the PTFE group ( P = .24). Median (interquartile range) in-hospital stay was 5 (5-6) days in the polyester group and 4 (4-5) days in the PTFE group ( P = .009). On day +3, in the polyester group, mean CRP was 154 (95% confidence interval: 127-182) mg/L, WBC 9.5 (8.4-10.5) ×109/L, and PCT 0.17 (0.12-0.21) ng/mL. In the PTFE group, mean CRP was 70 (32-109) mg/L ( P = .001), WBC 8.8 (6.4-11.1) ×109/L ( P = .37), and PCT 0.09 (0.06-0.13) ng/mL ( P = .009) on day +3.

Conclusion:

Standard EVAR with polyester stent grafts appears to result in a trend toward a more pronounced inflammatory reaction than similar EVAR using PTFE and is associated with a longer in-hospital stay.
Preliminary Lessons About Supporting Participation and Learning in Inclusive Classrooms
Authors: Morningstar Mary E. , Shogren Karrie A. , Lee Hyunjoo , Born Kiara
Published: July 2015

This descriptive study examined observational data collected in inclusive classrooms from six schools that were operating schoolwide inclusive policies and practices. Illustrative evidence of classroom practices supporting learning and participation of all students, including students with significant disabilities, adds to an understanding of structural methods supporting inclusion, as well as insights into instructional strategies and approaches used to support inclusive practices. Supports for participation were observed in several domains: (a) instructional staffing arrangements and roles, (b) methods of instructional groupings, (c) peer-supported learning, and (d) access to core academic curriculum. Supports for learning were also observed, including (a) universal design for learning, (b) behavioral interventions, and (c) accommodations and modifications. The results are discussed in relation to implementation of essential components of inclusive classrooms and the issues the field is facing with regard to effective practices leading to student learning and inclusion within classrooms and throughout schools.
Evaluating the agility of adaptive command and control networks from a cyber complex adaptive systems perspective
Authors: Tran Huy T , Domerçant Jean Charles , Mavris Dimitri N
Published: July 2015

Command and control (C2) networks are critical components of modern military systems, enabling information sharing and communications between systems. These systems operate in complex environments characterized by uncertain and evolving threats, creating a need for agile C2 networks. This paper presents a Cyber Complex Adaptive Systems approach for assessing the agility of adaptive C2 networks. Agent-based modeling is used to simulate the performance of a C2 network connecting unmanned aerial vehicles for a collaborative surveillance mission. Due to the importance of information sharing in C2, information entropy-based awareness is used to quantitatively evaluate C2 performance. Complex network methods are used to define initial network topologies and threats. Network adaptation through random rewiring is shown to recover lost C2 capabilities following network attacks, and in some cases improve performance relative to initial topologies. Inverse average path length and largest connected component fraction are shown to be important factors for maintaining C2 awareness, with inverse average path length being the better indicator of awareness.
Cartilage Degeneration and Alignment in Severe Varus Knee Osteoarthritis
Authors: Nakagawa Yasuaki , Mukai Shogo , Yabumoto Hiromitsu , Tarumi Eri , Nakamura Takashi
Published: July 2015

Objectives

The aim of this study was to examine the relationship between cartilage, ligament, and meniscus degeneration and radiographic alignment in severe varus knee osteoarthritis in order to understand the development of varus knee osteoarthritis.

Design

Fifty-three patients (71 knees) with primary varus knee osteoarthritis and who underwent total knee arthroplasty were selected for this study. There were 6 men and 47 women, with 40 right knees and 31 left knees studied; their mean age at operation was 73.5 years. The ligament, meniscus, degeneration of joint cartilage, and radiographic alignments were examined visually.

Results

The tibial plateau–tibial shaft angle was larger if the condition of the cartilage in the lateral femoral condyle was worse. The femorotibial angle and tibial plateau–tibial shaft angle were larger if the conditions of the lateral meniscus or the cartilage in the lateral tibial plateau were worse.

Conclusion

Based on the results of this study, progression of varus knee osteoarthritis may occur in the following manner: medial knee osteoarthritis starts in the central portion of the medial tibial plateau, and accompanied by medial meniscal extrusion and anterior cruciate ligament rupture, cartilage degeneration expands from the anterior to the posterior in the medial tibial plateau. Bone attrition occurs in the medial tibial plateau, and the femoro-tibial angle and tibial plateau–tibial shaft angle increase. Therefore, the lateral intercondylar eminence injures the cartilage of the lateral femoral condyle in the longitudinal fissure type. Thereafter, the cartilage degeneration expands in the whole of the knee joints.
Dendritic cells accumulate in the bone marrow of myeloma patients where they protect tumor plasma cells from CD8+ T-cell killing
Authors: Leone Patrizia , Berardi Simona , Frassanito Maria Antonia , Ria Roberto , De Re Valli , Cicco Sebastiano , Battaglia Stefano , Ditonno Paolo , Dammacco Franco , Vacca Angelo , Racanelli Vito
Published: July 2015

Key Points

Dendritic cells accumulate in the bone marrow of multiple myeloma patients. Bone marrow dendritic cells play a dual, but opposing, role in multiple myeloma.
An iterative method for split hierarchical monotone variational inclusions
Authors: Ansari Qamrul Hasan , Rehan Aisha
Published: July 2015

In this paper, we introduce a split hierarchical monotone variational inclusion problem (SHMVIP) which includes split variational inequality problems, split monotone variational inclusion problems, split hierarchical variational inequality problems, etc., as special cases. An iterative algorithm is proposed to compute the approximate solutions of an SHMVIP. The weak convergence of the sequence generated by the proposed algorithm is studied. We present an example to illustrate our algorithm and convergence result.
Marchenko imaging: Imaging with primaries, internal multiples, and free-surface multiples
Authors: Singh Satyan , Snieder Roel , Behura Jyoti , van der Neut Joost , Wapenaar Kees , Slob Evert
Published: July 2015

Recent work on retrieving the Green’s function with the Marchenko equation shows how these functions for a virtual source in the subsurface can be obtained from reflection data. The response to the virtual source is the Green’s function from the location of the virtual source to the surface. The Green’s function is retrieved using only the reflection response of the medium and an estimate of the first arrival at the surface from the virtual source. Current techniques, however, only include primaries and internal multiples. Therefore, all surface-related multiples must be removed from the reflection response prior to Green’s function retrieval. We have extended the Marchenko equation to retrieve the Green’s function that includes primaries, internal multiples, and free-surface multiples. In other words, we have retrieved the Green’s function in the presence of a free surface. The information needed for the retrieval is the same as the current techniques, with the only difference being that the reflection response now also includes free-surface multiples. The inclusion of these multiples makes it possible to include them in the imaging operator, and it obviates the need for surface-related multiple elimination. This type of imaging with Green’s functions is called Marchenko imaging.
Research Engagement after Disasters: Research Coordination before, during, and after the 2011–2012 Canterbury Earthquake Sequence, New Zealand
Authors: Beaven Sarah , Wilson Thomas , Johnston Lucy , Johnston David , Smith Richard
Published: July 2015

This article argues that active coordination of research engagement after disasters has the potential to maximize research opportunities, improve research quality, increase end-user engagement, and manage escalating research activity to mitigate the ethical risks posed to impacted populations. We focus on the coordination of research activity after the 22 February 2011 Mw6.2 Christchurch earthquake by the then newly formed national research consortium, the Natural Hazards Research Platform, which included a social science research moratorium during the declared state of national emergency. Decisions defining this organization's functional and structural parameters are analyzed to identify lessons concerning the need for systematic approaches to the management of post-disaster research, in collaboration with the response effort. Other lessons include the importance of involving an existing, broadly based research consortium, ensuring that this consortium's coordination role is fully integrated into emergency management structures, and ensuring that all aspects of decision-making processes are transparent and easily accessed.
2014 Update of the Pacific Northwest Portion of the U.S. National Seismic Hazard Maps
Authors: Frankel Arthur , Chen Rui , Petersen Mark , Moschetti Morgan , Sherrod Brian
Published: July 2015

Several aspects of the earthquake characterization were changed for the Pacific Northwest portion of the 2014 update of the national seismic hazard maps, reflecting recent scientific findings. New logic trees were developed for the recurrence parameters of M8-9 earthquakes on the Cascadia subduction zone (CSZ) and for the eastern edge of their rupture zones. These logic trees reflect recent findings of additional M8 CSZ earthquakes using offshore deposits of turbidity flows and onshore tsunami deposits and subsidence. These M8 earthquakes each rupture a portion of the CSZ and occur in the time periods between M9 earthquakes that have an average recurrence interval of about 500 years. The maximum magnitude was increased for deep intraslab earthquakes. An areal source zone to account for the possibility of deep earthquakes under western Oregon was expanded. The western portion of the Tacoma fault was added to the hazard maps.
Redesigning Advanced Cancer Care Delivery: Three Ways to Create Higher Value Cancer Care
Authors: Patel Manali I. , Moore David , Milstein Arnold
Published: July 2015

The authors believe their cancer care model constructed from quality-improving strategies has potential to help US clinicians respond effectively to an urgent policy imperative.
Role of the 340B Drug Discount Program in Recent Cancer Care Trends
Authors: Kantarjian Hagop M. , Chapman Robert
Published: July 2015

The role of the 340B drug discount program is reviewed, including its relevance to recent trends in cancer care and to the access of safety-net providers and vulnerable patients to much-needed drug support.
Optimal Frequency of Psychosocial Distress Screening in Radiation Oncology
Authors: Hess Clayton B. , Singer Maria , Khaku Aliasgher , Malinou Justin , Juliano Justin J. , Varlotto John M. , Wagner Henry , Liao Jason , Myers Kimberly R. , Levine Martha P. , Mackley Heath B.
Published: July 2015

Thirty-seven percent of radiation oncology patients reported distress at least once during treatment. Screening at every-other-week intervals optimized efficiency and frequency, identifying nearly 90 distressed patients with 12 screening events.
Use and Costs for Tumor Gene Expression Profiling Panels in the Management of Breast Cancer From 2006 to 2012: Implications for Genomic Test Adoption Among Private Payers
Authors: Roberts Megan C. , Dusetzina Stacie B.
Published: July 2015

Gene expression profiling has diffused into clinical practice. Reimbursements by insurers have increased, and average out-of-pocket costs to patients have decreased, seemingly driven by improved coverage for testing over time.
Patients and Physicians Can Discuss Costs of Cancer Treatment in the Clinic
Authors: Kelly Ronan J. , Forde Patrick M. , Elnahal Shereef M. , Forastiere Arlene A. , Rosner Gary L. , Smith Thomas J.
Published: July 2015

In an era of rising co-pays, patients with cancer want cost-of-treatment discussions, and these conversations do not lead to negative feelings in the majority of patients.
Obtaining Helpful Information From the Internet About Prognosis in Advanced Cancer
Authors: Chik Ivan , Smith Thomas J.
Published: July 2015

Oncologists should be aware that patients will not find estimates of survival or treatment effect on the Internet, which may contribute to overly optimistic estimates of survival.
Oncology Care Model: Short- and Long-Term Considerations in the Context of Broader Payment Reform
Authors: Clough Jeffrey D. , Kamal Arif H.
Published: July 2015

The authors discuss key factors to consider that may influence decisions to participate in the Oncology Care Model, by presenting comparable payment reform efforts outside of oncology.
Questioned validity of Gene Expression Dysregulated Domains in Down's Syndrome
Authors: Do Long H. , Mobley William C. , Singhal Nishant
Published: July 2015

Recently, in studies examining fibroblasts obtained from the tissues of one set of monozygotic twins (i.e. fetuses derived from the same egg) discordant for trisomy 21 (Down syndrome; DS), Letourneau et al., reported the presence of a defined pattern of dysregulation within specific genomic domains they referred to as Gene Expression Dysregulated Domains (GEDDs). GEDDs were described as alternating segments of increased or decreased gene expression affecting all chromosomes. Strikingly, GEDDs in fibroblasts were largely conserved in induced pluripotent cells (iPSCs) generated from the twin’s fibroblasts as well as in fibroblasts from the Ts65Dn mouse model of DS. Our recent analysis failed to find GEDDs. We reexamined the human iPSCs RNAseq data from Letourneau et al., and data from this same research group published earlier examining iPSCs from the same monozygotic twins. An independent analysis of RNAseq data from Ts65Dn fibroblasts also failed to confirm presence of GEDDs. Our analysis questions the validity of GEDDs in DS.
Personalidade e boca-a-boca: proposições de pesquisa
Authors: Basso Kenny , Laimer Claudionor Guedes , Baseggio Henrique Webber
Published: July 2015

Conhecer o consumidor, seus comportamentos e seu processo decisório tem sido um dos principais desafios do marketing nos últimos tempos. Dentre esses comportamentos, o boca-a-boca exerce uma grande importância no relacionamento entre empresa e consumidor. Este artigo propõe-se, através de um ensaio teórico identificar como as variáveis psicológicas de personalidade podem influenciar na constituição do boca-a-boca em processos de compra. Desse modo, o estudo suscita a importância do relacionamento de construtos psicológicos com construtos tradicionalmente trabalhados em comportamento do consumidor. Além disso, espera-se que, com o entendimento das possíveis relações entre as teorias, novos estudos apresentem evidências empíricas que corroborem para explicar o fenômeno. O estudo tem como proposição um modelo hierárquico de análise da personalidade para identificar as relações entre os construtos mais abstratos de personalidade e de intenção de boca-a-boca, à luz da teoria dos traços de personalidade, da teoria do controle e dos princípios evolucionários da psicologia. Com isso, o estudo instiga o surgimento de novos trabalhos para que a relação entre as dimensões de personalidade analisadas e o boca-a-boca possam ser analisadas empiricamente. A contribuição do artigo recai sobre a construção e proposição de um modelo conceitual que une teorias de personalidade e intenções de boca-a-boca, como um comportamento do consumidor.
Lei rouanet x crowdfunding: fomentando os empreendimentos culturais
Authors: Bier Clerilei Aparecida , Cavalheiro Ricardo Alves
Published: July 2015

O presente trabalho objetiva analisar os métodos de captação de recursos de empreendimentos culturais da Lei Rouanet e do Crowdfunding. A estratégia de investigação utilizada foi a de estudo multicasos, de cunho predominantemente qualitativo e descritivo, em uma visão contextual-processual, utilizando-se do método de investigação histórico-interpretativo. Embasado no resultado da pesquisa, propôs-se uma plataforma de financiamento cultural direcionada às pessoas físicas capaz de promover a emancipação da sociedade civil, no que tange a tomada das rédeas da produção cultural nacional, em especial na definição dos destinos de aplicação tanto dos recursos públicos quanto da efetivação das políticas culturais brasileiras. Dita plataforma se propõe ainda potencializar as políticas públicas culturais, bem como democratizar o processo decisório da tomada de decisão sobre a aplicação dos recursos públicos do Estado Brasileiro com participação e controle social, em harmonia com a Lei Rouanet.
Empreendedorismo feminino: desafios enfrentados por empreendedoras na gestão de pequenos negócios no setor de turismo
Authors: Bomfim Lea Cristina Silva , Teixeira Rivanda Meira
Published: July 2015

Embora as estatísticas relacionadas ao empreendedorismo feminino pareçam encorajadoras, empreender não é uma tarefa fácil, são muitos os desafios encontrados pelas empreendedoras na gestão de seus negócios. Este estudo tem como objetivo central identificar os maiores desafios enfrentados pelas empreendedoras no planejamento e gestão de seus negócios e também verificar como utilizam suas redes de relacionamento para superar esses desafios.  A estratégia de pesquisa adotada foi a de estudos de casos múltiplos e foram selecionadas quatro agências de viagens que foram criadas e são gerenciadas por empreendedoras. As empreendedoras que planejam e desenvolveram equipes eficientes, podem delegar e confiar em seus funcionários. Na gestão financeira o maior desafio é a dificuldade para acessar recursos financeiros, tais como financiamento e crédito de fornecedor. Com relação a gestão de pessoas, a maior dificuldade consiste na contratação de mão-de-obra qualificada e nos conflitos decorrentes das relações interpessoais. Verificou-se que, de modo geral, as redes de relacionamento se mostraram de fundamental importância para a manutenção, desenvolvimento ou crescimento das empresas.