bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of In-Stent Restenosis after Carotid Angioplasty: A Case-Control Study
Authors: Setacci Carlo , Pula Giorgio , Baldi Irene , de Donato Giammarco , Setacci Francesco , Cappelli Alessandro , Pieraccini Massimo , Cremonesi Alberto , Castriota Fausto , Neri Eugenio
Published: March 2015

Purpose:

To report a retrospective study that sought to identify clinical factors contributing to the development of in-stent restenosis in the carotid arteries, to profile the patients at greatest risk, and to review the treatment modalities evolved from our experience.

Methods:

Between December 2000 and April 2003, 195 carotid angioplasty/stenting (CAS) procedures (12 bilateral) were performed in 183 patients (131 men; median age 65.9 years, interquartile range 55.2–72.7). Stenting for de novo stenoses was performed in 119 (61%) carotid arteries; 76 (39%) vessels were treated for postsurgical restenosis. Nearly two thirds of the patients (117, 64%) were symptomatic. Patients were evaluated at 3 and 6 months and at 6-month intervals thereafter with duplex ultrasonography. Angiography was used to confirm any recurrent lesion detected on the ultrasound scan.

Results:

Overall perioperative neurological complications included 4 (2.2%) minor strokes, 1 (0.5%) intracranial hemorrhage, and 1 (0.5%) major stroke; both patients with major neurological complications died at 5 and 12 days, respectively, after the procedure. During the 12.5-month follow-up (range 0–27.2), 3 non-procedure-related late deaths and another 9 (4.9%) neurological events occurred (2 strokes and 7 transient ischemic attacks). In-stent restenosis after CAS was present in 10 (5.2%) of 193 carotid arteries (9/181 patients) in follow-up; all but 1 artery had been treated for postsurgical restenosis. All lesions were treated secondarily with endovascular procedures. Statistical analysis demonstrated that postsurgical restenosis was the only predictive factor for the development of in-stent restenosis (OR 15.5, 95% CI 2.05 to 125.6, p = 0.001) in this cohort.

Conclusions:

The present study, far from being exhaustive on the subject, indicates that patients who develop restenosis after carotid endarterectomy are also prone to develop restenosis after CAS; moreover, although strongly recommended for postsurgical restenosis, CAS carries a greater risk of in-stent restenosis in this subgroup, thus reducing the benefits of this procedure.
Complicated Acute Aortic Dissection Type B Caused by Femoral Cannulation for Endoscopic Coronary Artery Bypass Surgery
Authors: Fleck Tatiana , Wisser Wilfried , Cejna Manfred , Tschernko Edda , Lassnig Andrea , Wolner Ernst , Rand Thomas
Published: March 2015

Purpose:

To report endovascular treatment of a patient with complicated acute aortic type B dissection caused by cannulation of the femoral artery for endoscopic coronary artery bypass (CAB) surgery.

Case Report:

A 63-year-old man underwent single-vessel CAB surgery facilitated by the Da Vinci surgical system. After the procedure, acute lower limb ischemia led to the discovery of a type B dissection from the left subclavian artery to the iliac arteries. The subclavian artery was also dissected, with only minimal flow in the left mammary artery. The visceral and renal vessels originated from the false lumen and were not perfused. Emergent stent-graft placement was undertaken to close the entry tear and re-establish perfusion of the lower extremity as well as visceral and renal organs. Additional stent-grafts were placed in the dissected left subclavian artery to perfuse the left internal mammary bypass and in the inferior mesenteric artery, which arose from the false lumen. Six months after operation, the patient is well.

Conclusions:

Acute iatrogenic aortic dissection secondary to endoscopic CAB surgery can be treated emergently to restore distal perfusion to vital organs.
The Top 12 Advances in Vascular Medicine
Authors: Olin Jeffrey W. , Jang James , Jaff Michael R. , Beckman Joshua A. , Rooke Thom
Published: March 2015

In the past decade, impressive strides have been made in the diagnosis and management of atherosclerotic, aneurysmal, and thromboembolic diseases, thanks in large part to the explosive growth in both vascular biology and clinical vascular medicine. We review what we consider to be the top 12 advances in this field: the discovery of nitric oxide, the metabolic syndrome, new thrombophilic disorders, therapeutic angiogenesis, endoluminal treatment of chronic venous disease, and a variety of drugs, including sildenafil, cilostazol, low-molecular-weight heparins, oral direct thrombin inhibitors, clopidogrel, statins, and angiotensin-converting enzyme inhibitors and angiotensin-receptor blocking agents.
Local Endovascular Delivery, Gene Therapy, and Cell Transplantation for Peripheral Arterial Disease
Authors: Opie Shaun R. , Dib Nabil
Published: March 2015

Advances in catheter technology, gene identification, and cell biology may provide novel treatment options for patients with peripheral arterial disease (PAD) who are not candidates for standard revascularization procedures. Animal studies and recent results in human beings suggest that transfer of growth factors or regulatory genes and transplantation of progenitor cells may provide novel therapy options by inducing therapeutic angiogenesis or by inhibiting restenosis. This review will discuss the development of a variety of catheters for localized endovascular delivery, as well as the various cellular and genetic strategies that exist to restore blood flow to ischemic tissue and to reduce neointimal hyperplasia.
Regression of Left Ventricular Hypertrophy following Stenting of Renal Artery Stenosis
Authors: Zeller Thomas , Rastan Aljoscha , Schwarzwälder Uwe , Müller Christian , Frank Ulrich , Bürgelin Karlheinz , Sixt Sebastian , Schwarz Thomas , Noory Elias , Neumann Franz-Josef
Published: March 2015

Purpose:

To determine if angioplasty of atherosclerotic renal artery stenosis, which reduces the activation of the renin-angiotensin-aldosterone system (RAAS), may lead to regression of left ventricular hypertrophy.

Methods:

The study included 102 patients (58 men; mean age 67 years, range 66–69) who underwent stent-supported percutaneous transluminal renal angioplasty (PTRA) and were included in a clinical follow-up program (mean 24±14 months, range 6–60). As a control group, 101 contemporaneous patients (68 men; mean age 68 years, range 66–70) with essential hypertension were investigated. The primary endpoint was the change in left ventricular mass index (LVMI) determined by echocardiography.

Results:

Mean follow-up intervals were 24±14 months (range 6–60) in the study group and 27±14 months (range 6–60) in the controls (p=0.09). LVMI decreased significantly by −10±26 g/m2 in the study group, while it increased significantly by 9±28 g/m2 in the control group (p=0.001 between groups). In the study group, mean arterial blood pressure was significantly reduced from 99±11 mmHg to 90±11 mmHg (p<0.0001) during follow-up despite a significant reduction in medication, whereas it increased significantly from 102±11 mmHg to 105±11 mmHg (p=0.008) in the control group, although medication was significantly increased. After adjustment for various factors and covariables, PTRA prevailed as an independent predictor for regression of LVMI (p=0.038).

Conclusion:

PTRA induces regression of LVMI that is independent of the reduction in blood pressure induced by this procedure. Reduced activity of the RAAS may account for this regression.
Digital Embolization Due to Partially Uncovered Left Subclavian Artery Post TEVAR: Management with Amplatzer Vascular Plug Occlusion
Authors: Chaudhuri Arindam , Tibballs Jonathan , Nadkarni Sanjay , Garbowski Marek
Published: March 2015

Purpose:

To describe the use of the Amplatzer vascular plug to treat a partially uncovered left subclavian artery (LSA) causing digital embolism following thoracic endovascular aneurysm repair.

Case Report:

A 70-year-old man presented with digital ischemia of the left index and middle fingers due to embolism from a partially covered LSA orifice during thoracic endovascular aneurysm repair for a type I thoracic aortic aneurysm. The orifice was successfully occluded using the vascular plug, supplemented by a left carotid-subclavian bypass to treat ongoing arm and hand claudication. The patient has had no further embolic episodes.

Conclusion:

A partially uncovered LSA during thoracic endovascular aneurysm repair poses a risk of thromboembolism, with resultant upper limb claudication or tissue loss. If recognized at the time of the procedure, this should be treated by proximal extension; otherwise, proximal LSA occlusion using an Amplatzer occluder may be a safe and effective option in preventing further embolic episodes.
Treatment of Critical Limb Ischemia Using Ultrasound-Enhanced Thrombolysis (PARES Trial): Final Results
Authors: Wissgott Christian , Richter André , Kamusella Peter , Steinkamp Hermann J.
Published: March 2015

Purpose:

To evaluate the safety and performance of ultrasound-enhanced thrombolysis in the treatment of acute thrombotic or embolic occlusion of the lower limb arteries.

Methods:

From April 2005 to July 2006, 25 patients (15 men; mean age 64.1 years, range 37–82) presenting with acute (<14 days old) occlusions of the lower limb arteries were treated with local thrombolysis [recombinant tissue plasminogen activator (rtPA)] in a dosage of 1.0 mg/h using the EKOS Lysus Peripheral Catheter System with an ultrasound core. No bolus injection of rtPA was given. The mean occlusion length was 25.1 cm (range 2–70).

Results:

The technical success rate was 100%. Total clot removal was achieved in 22 (88%) patients after 16.9 hours (range 5–24) using a mean 17 mg (range 5–25) of rtPA. In 8 cases, total clot removal of the main lesion was achieved after 6 hours (6 mg of rtPA). In 1 patient, lysis was stopped after 2.5 hours because of bleeding due a dislocation of the introducer sheath. In 2 cases, total clot removal could not be achieved; these patients were successfully treated with thromboaspiration. At the 1-month follow-up, the treated vessel was still patent in 20 patients. Two reocclusions occurred; 1 was treated with a bypass graft and the other with conservative therapy. There were no cases of amputation or death during follow-up. There were no side effects related to rtPA or the catheter system.

Conclusion:

This study demonstrates that local lysis of acute arterial occlusions using the Lysus Peripheral Catheter System is safe and effective. Blood flow is restored quickly.
Role of the Hardman Index in Predicting Mortality for Open and Endovascular Repair of Ruptured Abdominal Aortic Aneurysm
Authors: Sharif Muhammad Anees , Lee Bernard , Makar Ragai Reda , Loan William , Soong Chee Voon
Published: March 2015

Purpose:

To correlate the Hardman prognostic index with perioperative mortality in patients undergoing open and endovascular repair of ruptured abdominal aortic aneurysm (rAAA).

Methods:

Over a 5-year period, 126 patients (109 men; mean age 74 years, range 51–91) underwent open (n=74) or endovascular (n=52) repair of rAAA in a single unit. Five Hardman factors (age >76 years, history of loss of consciousness, ECG evidence of ischemia, hemoglobin <9.0 g/dL, and serum creatinine >0.19 mmol/L) were assessed, and their association with in-hospital or 30-day mortality was evaluated retrospectively by chi-square or logistic regression analysis.

Results:

The mortality for open repair was 51.4% (38/74) in comparison to 32.7% (17/52) for the endovascular group (p=0.05). On multivariate analysis, loss of consciousness (p=0.03, OR 2.9, 95% CI 1.1 to 7.5) was the only significant predictor of mortality in both groups. The mortality rates for open repair patients with Hardman scores <2 were 43.5% (20/46) in comparison to 22.9% (8/35) for the endovascular group (p=0.06), whereas mortality rates for patients with scores ≥2 were 64.3% (18/28) and 52.9% (9/17) for the respective groups (p=0.54).

Conclusion:

The Hardman index correlates well with mortality in both the open and endovascular groups. Those with a score <2 have a trend toward better survival following endovascular repair compared to open repair, while this benefit is not obvious in patients with a score ≥2.
Impact of Randomized Trials Comparing Conventional and Endovascular Abdominal Aortic Aneurysm Repair on Clinical Practice
Authors: Baas Annette F. , Grobbee Diederick E. , Blankensteijn Jan D.
Published: March 2015

Purpose:

To report a retrospective study into the effects of trials on clinical decision-making regarding abdominal aortic aneurysm (AAA) patients suitable for both conventional open (OR) and endovascular aneurysm repair (EVAR).

Methods:

A questionnaire was sent to 1400 Dutch surgeons and trainees. Interviewees had to choose between OR and EVAR for AAA patients with and without comorbidity. Specifically, their preferences before and after the publication of 2 randomized trials (EVAR-1 and DREAM) were polled.

Results:

Of the 524 (37%) questionnaires returned, 223 (43%) respondents treated AAA patients. Before publication of the trials, 160 (72%) preferred OR for the patient without comorbidity and 169 (76%) preferred EVAR for the patient with comorbidity. In total, 72 (32%) respondents changed their preference after the trials were published; however, there was no overall major shift. Focusing on the different cases revealed that the OR preference was significantly enhanced for the patient without comorbidity (p<0.01), while the EVAR preference was significantly enhanced for the patient with comorbidity (p<0.05).

Conclusion:

The randomized trials have not induced major overall changes in surgical decision-making for AAA patients suitable for both EVAR and OR.
Toward Endografting of the Ascending Aorta: Insight into Dynamics Using Dynamic Cine-CTA
Authors: van Prehn Joffrey , Vincken Koen L. , Muhs Bart E. , Barwegen Gijsbrecht K. W. , Bartels Lambertus W. , Prokop Mathias , Moll Frans L. , Verhagen Hence J. M.
Published: March 2015

Purpose:

To evaluate pulsatility and movement along the ascending thoracic aorta using dynamic electrocardiographically-gated 64-slice cine computed tomographic angiography (CTA).

Methods:

Diameter and area change and center of mass (COM) movement of the ascending thoracic aorta was determined per cardiac cycle in 15 patients at surgically relevant anatomical levels: (A) 5 mm distal to the coronary arteries, (B) 5 mm proximal to the innominate artery, and (C) halfway up the ascending aorta. Additionally, COM movement was determined 1 cm (level P) and 2 cm (level Q) distal from the origins of the innominate, left carotid, and left subclavian arteries. Eight gated datasets covering the cardiac cycle were used to reconstruct images at each level perpendicular to the aortic lumen. The distance between important anatomical landmarks was determined.

Results:

All levels showed significant cardiac cycle—induced diameter and area changes (p<0.001), with the largest pulsatility 5 mm distal to the coronary arteries. Mean maximum diameter changes were (A) 17.4%±4.8% (range 7.5%–27.5%), (B) 13.9%±3.5% (range 10.6%–25.0%), and (C) 12.9%±3.4% (8.3%–19.6%). Mean area changes were (A) 12.7%±5.5% (range 4.3%–21.8%), (B) 7.5%±2.0% (range 4.1%–11.0%), and (C) 5.6%±2.2% (range 1.9%–11.4%). Mean maximum COM movements were (A) 6.1±2.0 mm (range 2.7–9.0), (B) 2.3±1.1 mm (range 1.1–5.6), and (C) 3.6±1.5 mm (range 1.4–6.5). Mean COM movements of the innominate, left carotid, and left subclavian arteries, respectively, were (P) 1.960.7 mm (range 0.9–3.7), 2.4±0.6 mm (range 1.4–3.3), and 1.9±0.6 mm (range 0.8–2.8), and (Q) 1.8±0.7 mm (range 0.8–3.5), 1.8±0.6 mm (range 0.8–2.7), 1.9±0.6 mm (range 1.1–3.4).

Conclusion:

The dynamics of the ascending thoracic aorta and the arch vessels are impressive, showing a wide range of 3-dimensional motions. Future ascending arch branched and fenestrated thoracic endograft designs must consider this active local environment, as it may have implications for durability, sealing, and ultimate clinical success.
An IVUS-Based Approach to Traumatic Aortic Rupture, with a Look at the Lesion from inside
Authors: Marty Bettina , Tozzi Piergiorgio , Ruchat Patrick , Huber Christoph , Doenz Francesco , von Segesser Ludwig Karl
Published: March 2015

Purpose:

To review a single-institution experience with endovascular repair of acute traumatic aortic rupture (ATAR) performed on an emergency basis using intravascular ultrasound (IVUS) exclusively as the navigation tool for stent-graft implantation (no arteriography).

Methods:

Between September 1998 and November 2006, 26 consecutive patients (19 men; mean age 38619 years, range 15 to 83) underwent endovascular repair of ATAR performed by a surgical team using IVUS and fluoroscopy for lesion characterization and stent-graft deployment guidance. Transesophageal echocardiography was routinely used in all patients to visualize the aortic lesion and rule out residual flow after device deployment. Sealing of the aortic tear was evaluated by postoperative contrast-enhanced computed tomography.

Results:

IVUS revealed an extensive disruption of the tunica intima and media (>180°) in 46% (12/26) of patients; the disruption was circumferential in 3 cases, with pseudocoarctation. The aortic diameter at the site of rupture measured 24±4 mm. Primary technical success was 92% (24/26); 1 persistent but small proximal endoleak and an intraoperative death (4% in-hospital mortality) from abdominal bleeding in an octogenarian accounted for the failures. Procedure-related complications (2, 8%) included the aforementioned endoleak and a minor stroke secondary to cerebral embolization. There was no paraplegia associated with the repairs. Conclusion: Endovascular repair of acute traumatic aortic disruption yields promising results, with high technical success and minimal procedure-related morbidity. IVUS as the primary navigation tool for device implantation allows prompt endovascular setup, instant aortic measurements, and precise visualization of the aortic disruption.
A Biodegradable Stent Based on Poly(L-Lactide) and Poly(4-Hydroxybutyrate) for Peripheral Vascular Application: Preliminary Experience in the Pig
Authors: Bünger Carsten Michael , Grabow Niels , Sternberg Katrin , Goosmann Martin , Schmitz Klaus-Peter , Kreutzer Hans J. , Ince Hüseyin , Kische Stefan , Nienaber Christoph A. , Martin David P. , Williams Simon F. , Klar Ernst , Schareck Wolfgang
Published: March 2015

Purpose:

To assess the technical feasibility and biocompatibility of a novel stent based on poly(L-lactide) (PLLA) and poly(4-hydroxybutyrate) (P4HB) for peripheral vascular applications.

Methods:

A polytetrafluoroethylene aortobi-iliac graft was implanted in 5 pigs through a midline abdominal incision. After transverse graft limb incision, 5 PLLA/P4HB stents and 5 metal stents (316L stainless steel) were randomly deployed at both iliac anastomotic sites with 6-mm balloon catheters. Angiography was performed to determine patency prior to sacrifice at 6 weeks. Stented segments were surgically explanted and processed for quantitative histomorphometry. Vascular injury and inflammation scores were assigned to the stented iliac segments.

Results:

No animals were lost during follow-up. All PLLA/P4HB stents were deployed within 2 minutes by balloon inflation to 8 bars without rupture of the stent struts or anastomotic suture. All stents were patent on postprocedural angiography. Histological analysis showed no signs of excessive recoiling or collapse. PLLA/P4HB stents demonstrated decreased residual lumen area and increased neointimal area after 6 weeks (12.27±0.62 and 8.40±1.03 mm2, respectively) compared to 316L stents (13.54±0.84 and 6.90±1.11 mm2, respectively) as the result of differences in stent areas (PLLA/P4HB: 4.31±0.15 mm2; 316L: 2.73±0.29 mm2). Vascular injury scores showed only mild vascular trauma for all stents (PLLA/P4HB: 0.41±0.59; 316L: 0.32±0.47). Inflammatory reaction was slightly higher around PLLA/P4HB stent struts (1.39±0.52) compared to 316L (1.09±0.50). Conclusion: Rapid balloon expansion of PLLA/P4HB stents is feasible without risk of strut rupture. PLLA/P4HB stents provide adequate mechanical stability after iliac anastomotic stenting in pigs. Smaller residual luminal areas in the PLLA/P4HB stents might have been caused by tissue ingrowth into the larger strut interspaces due to higher strut thickness (stent area) in this group. This limitation needs to be addressed in future work on the stent design.
Drug-Eluting Stent for Recurrent Mesenteric Artery In-Stent Restenosis
Authors: Cardaioli Paolo , Rigatelli Gianluca , Zattoni Luca , Giordan Massimo
Published: March 2015

Purpose:

To report the use of a drug-eluting stent (DES) for treatment of symptomatic in-stent restenosis (ISR) in the superior mesenteric artery (SMA).

Case Report:

A 79-year-old woman suffering from chronic renal failure and needing dialysis was admitted for vomiting, postprandial abdominal pain, and weight loss for 3 months. Computed tomographic angiography (CTA) documented massive calcification of the vascular bed, mainly in the aorta, and a very tight ostial stenosis of the SMA. A 4.5-x20-mm Genesis stent was deployed at the ostium, with good angiographic result and immediate symptomatic benefit. After 3 months, symptoms recurred; angiography demonstrated ISR. Percutaneous angioplasty with a 4-x15-mm cutting balloon was performed. The patient remained asymptomatic for only 2 months; recurrent ISR at this time was treated with a 3.5-x24-mm coronary TAXUS Express paclitaxel-eluting coronary stent deployed inside the previously implanted stent. Under prolonged double antiplatelet regimen, the patient was asymptomatic at the 8-month follow-up; CTA demonstrated patency of the SMA.

Conclusion:

Considering the high rate of restenosis and the periprocedural complications described with endovascular treatment of SMA stenosis, a drug-eluting stent may be a good option not only for the treatment of restenosis but also in de novo lesions, at least when the vessel diameter is <4.5 mm.
Sailing the “Seven C’s” of Leadership
Authors: Weismuller Penny C. , Willgerodt Mayumi A. , McClanahan Rachel , Helm-Remund Terri
Published: March 2015

Nurses are increasingly being called upon to lead changes within health care. How do nurses and, in particular, school nurses become leaders? School nurses lead daily in their work but often do not recognize themselves as leaders. The “Five C’s of Leadership”—character, commitment, connectedness, compassion, and confidence—identified by Kowalski and Yoder-Wise are foundational to the development of leadership and are particularly relevant to school nurses and their role. Two additional attributes found in the literature—courage and capacity—also undergird school nursing practice. In this article, we describe how school nurses already embody these leadership qualities. Each leadership attribute is reviewed in light of the literature, followed by specific examples to demonstrate how school nurses provide leadership. Through these illustrations, school nurses can recognize and embrace their present leadership abilities. In addition, by using the “Seven C’s” of leadership, school nurses can enhance their inherent leadership abilities.
Comparison of antiresorptive effect of hormone therapy and ibandronate in postmenopausal osteoporotic women by assessing type I collagen C-telopeptide levels
Authors: Srividhya NB , Singh Nilanchali , Goel Neerja , Gambhir JK , Rathi Vinita , Rajaram Shalini
Published: March 2015

Objectives

The aim of this study is to compare the antiresorptive effect of hormone therapy and oral ibandronate in postmenopausal osteoporotic women by measuring bone mineral density (BMD) and degradation products of C-terminal telopeptide of type I collagen (CTX) using serum crosslaps ELISA.

Study design

The study is a randomized comparative trial.

Methods

About 60 women with age > 40 years, having either surgical or medical menopause with T- or Z-score below -2.5 SD were included in the study. They were randomized into two groups of 30 each; one group received conventional hormone therapy (group I) and the other group received ibandronate monthly (group II). The treatment was given for 6 months.

Results

The BMD increased from 0.894 g/cm2 to 0.933 g/cm2 ( p < 0.01) in group I and from 0.865 g/cm2 to 0.934 g/cm2 ( p < 0.01) in group II. The increase in BMD in group I (4.3%) was less than group II (7.9%) which was significant ( p < 0.01). The serum CTX levels also showed significant reduction in both groups after 6 months of therapy; more reduction was seen in group II as compared to group I (41.5% vs. 4.6%, p < 0.01).

Conclusion

Ibandronate can be used as a substitute to hormone therapy in women presenting with osteoporosis. Long-term studies are needed to authenticate the observation.
Occupational Health Nursing in Turkey
Authors: Koseoglu Ornek Ozlem , Esin Melek Nihal
Published: March 2015

This article discussed Turkey’s occupational health system and the current education, legislation, and practice of occupational health nursing.
Relative deprivation and insurgency: What lessons from Nigeria’s flawed federalism?
Authors: Aaron Kiikpoye K.
Published: March 2015

In the heyday of insurgency in Nigeria’s oil-rich but poor Niger Delta region, much scholarly effort was made to explain this conflict as being borne out of relative deprivation. This paper contests the logic of using relative deprivation as the cause, as opposed to the reconfiguration of power in Nigeria’s national politics. This has seen the emergence of a president from the once marginalized Niger Delta region and the resultant dynamics of post-conflict peace-building. We also examine the consequences of a return to peace in the Niger Delta, in spite of the failure of the Nigerian state and oil transnational corporations to address the grievances that were widely canvassed as the reasons for rebellion. I conclude that insurgency in Nigeria is spawned not so much by conditions of relative deprivation, as by the nature of Nigeria’s fundamentally flawed federalism.
Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia
Authors: Rodrigo Chamira , Bewick Thomas , Sheppard Carmen , Greenwood Sonia , Mckeever Tricia M. , Trotter Caroline L. , Slack Mary , George Robert , Lim Wei Shen
Published: March 2015

Infant 13-valent pneumococcal conjugate vaccination (PCV13) was introduced to the UK in 2010. Its impact on serotypes implicated in adult non-bacteraemic pneumococcal pneumonia is not known.

Beginning in 2008, a 5-year prospective cohort study of adults admitted to hospital with community-acquired pneumonia (CAP) was conducted. Pneumococcal serotype was established using a validated multiplex immunoassay (Bio-Plex; Bio-Rad, Hercules, CA, USA).

The overall incidence for hospitalised CAP and pneumococcal CAP was 79.9 (95% CI 76.6–83.3) and 23.4 (95% CI 21.6–25.3) per 100 000 population, respectively. A decline in CAP (incidence rate ratio (IRR) per year 0.96, 95% CI 0.94–0.99; p=0.016) and pneumococcal CAP (IRR per year 0.84, 95% CI 0.80–0.89; p<0.001) was observed over the 5-year period of the study. Between the pre- and post-PCV13 periods of the study, the incidence of CAP due to serotypes included in the PCV7 declined by 88% (IRR 0.12, 95% CI 0.08–0.20; p<0.001), and CAP due to the additional 6 serotypes in PCV13 declined by 30% (IRR 0.70, 95% CI 0.51–0.96; p=0.024).

Incidence of adult pneumococcal pneumonia declined over the last 5 years, with serotypes included in PCV13 declining post-PCV13 introduction, indicating early herd protection effects from PCV13 infant vaccination on adult non-bacteraemic disease. These effects may accrue over the coming years with implications for national pneumococcal vaccination policies in adults.
Myeloid-related protein-14 deficiency promotes inflammation in staphylococcal pneumonia
Authors: Achouiti Ahmed , Vogl Thomas , Van der Meer Anne J. , Stroo Ingrid , Florquin Sandrine , de Boer Onno J. , Roth Johannes , Zeerleder Sacha , van ’t Veer Cornelis , de Vos Alex F. , van der Poll Tom
Published: March 2015

Staphylococcus aureushas evolved as an important cause of pneumonia in both hospital and community settings. Staphylococcal lung infection can lead to overwhelming pulmonary inflammation. During infection, neutrophils release complexes of myeloid-related protein (MRP)8 and MRP14 (MRP8/14). MRP8/14 has been shown to exert pro-inflammatory and chemotactic activity, and to assist in the killing ofS. aureus. In the current study we sought to determine the role of MRP8/14 in the host response duringS. aureuspneumonia.

Pneumonia was induced in wildtype and MRP14-deficient mice (mice unable to form MRP8/14) by intranasal inoculation of 1×107 CFU ofS. aureusUSA300. Mice were sacrificed at 6, 24, 48 or 72 h after infection for analyses.

S. aureuspneumonia was associated with a strong rise in MRP8/14 in bronchoalveolar lavage fluid and lung tissue. Surprisingly, MRP14 deficiency had a limited effect on bacterial clearance and was associated with increased cytokine levels in bronchoalveolar lavage fluid and aggravated lung histopathology.MRP14 deficiency in addition was associated with a diminished transmigration of neutrophils into bronchoalveolar lavage fluid at late time-points after infection together with reduced release of nucleosomes.

MRP8/14 serves in an unexpected protective role for the lung in staphylococcal pneumonia.
A facile hydrothermal approach to the synthesis of nanoscale rare earth hydroxides
Authors: Li Chengyin , Liu Hui , Yang Jun
Published: March 2015

Nanosized rare earth (RE) hydroxides including La(OH)3, Nd(OH)3, Pr(OH)3, Sm(OH)3, Gd(OH)3, and Er(OH)3 with rod-like morphology are fabricated via a convenient hydrothermal approach. This strategy calls for the first preparation of metal complexes between RE precursors and dodecylamine (DDA) in water/ethanol mixture at room temperature and subsequent thermal decomposition at elevated temperature. The influence of reaction time and water/ethanol volume ratios on the morphology and size of as-prepared RE hydroxides are investigated. CeO2 nanoparticles with spherical shape could be directly obtained by hydrothermal treatment of complexes formed between Ce precursors and DDA. In addition, by further calcinating the RE hydroxides at high temperature in air, RE oxide nanorods could be readily produced.
Taxation and female labor supply in Italy
Authors: Colonna Fabrizio , Marcassa Stefania
Published: March 2015

Italy has the lowest labor supply of married women among EU countries. Moreover, the participation rate of married women is positively correlated with their husbands’ income. We show that these two features can be partly explained by the tax system: a high tax rate together with tax credits and transfers raise the burden of two-earner households, generating disincentives to work. We estimate two structural models of labor supply: one where the husband’s labor supply is inelastic and one with joint couple decisions. Then we use the estimated parameters to simulate the effects of alternative revenue-neutral tax systems on labor supply. We find that working tax credit and gender-based taxation boost it, with the effects of the former being concentrated on low educated women. Conversely, joint taxation implies a drop in the participation rate.

JEL codes:J21, J22, H31
Multimodel adaptive subtraction with regularized parameter selection via generalized information criterion
Authors: Liu Kuang-Hung , Kostov Clément
Published: March 2015

Adaptive subtraction remains a critical part of today’s seismic data processing. Many existing adaptive subtraction methods can be formulated as a parameter estimation problem, and all of them, although fundamentally different, have a common restriction that the dimension of the unknown parameters must be determined in advance. We have developed an adaptive subtraction framework called multimodel adaptive subtraction (MMAS) that aims to relax this restriction as well as regularize the estimation of the parameters through a generalized information criterion combined with a nonconcave penalized likelihood function. MMAS is a fully general framework that can be applied to many existing adaptive subtraction methods. As an example, we determined how MMAS can be applied to the popular least-squares adaptive subtraction (LSAS) method, and we call the resulting algorithm the multimodel LSAS ([Formula: see text]); furthermore, we studied its computational complexity and developed an efficient implementation for [Formula: see text]. We applied our proposed [Formula: see text] method in the context of multiple attenuation, and we used computer simulations to demonstrate the advantages of our method over the traditional LSAS method, which included the capabilities to be more aggressive (use longer filters) in regions in which multiples occurred, to be less aggressive (use smaller filters) in regions dominated by primary reflections, and to be passive and take no effect (no filters used) in regions in which multiples were absent from the data.
Hydrocarbon storage space within lacustrine gas shale of the Triassic Yanchang Formation, Ordos Basin, China
Authors: Wang Xiangzeng , Zhang Lixia , Jiang Chengfu , Fan Bojiang
Published: March 2015

The Triassic Yanchang Formation lacustrine shale is a source of conventional oil accumulation in the Ordos Basin, China. The Yanchang Formation, a hybrid system of organic-rich shale, interbedded silty shale, and siltstone, is believed to be a potential unconventional oil and gas play. Our crossdisciplinary investigation of the storage space included the outcrop description, core observation, thin sections, and scanning electron microscope pore imaging. We evaluated the results from these techniques to reveal that the storage space within the Yanchang Formation shales included primary intergranular pores, secondary generated pores, tectonic fractures, and bedding-parallel fractures. We conducted adsorption experiments, combined with burial and thermal history, in which the primary migration process can be divided into three stages. In the Early Jurassic, organic matter did not reach the oil generation threshold. From the Late Jurassic to the Early Cretaceous, organic matter entered the oil generation window, and gas was generated and stored as adsorbed gas, dissolved gas, and free gas. From the Middle to Late Cretaceous, the storage of shale gas was dynamically transformed by tectonic uplift. Variations in chemical and carbon isotopic compositions from canister-core desorption were directly related to the gas supply in shales. An abrupt decrease in gas dryness and positive [Formula: see text] values indicated the depletion of gas supply drainage. Our ultimate recovery factor reached 70%.
Nb2O5 Blocking Layer for High Open-circuit Voltage Perovskite Solar Cells
Authors: Kogo Atsushi , Numata Youhei , Ikegami Masashi , Miyasaka Tsutomu
Published: March 2015

A solution-processed Nb2O5 film was employed as a thin blocking layer (BL) in CH3NH3PbI3−xClx-based solar cells for the first time. A cell with Nb2O5 BL exhibited larger open-circuit photovoltage than a cell with conventional TiO2 BL. Dark current behavior suggests that recombination from F-doped tin oxide electrode to perovskite layer was efficiently blocked by the Nb2O5 BL.
Oil Price and Consumer Price Nexus in South Africa Revisited: A Novel Asymmetric Causality Approach
Authors: Ajmi Ahdi Noomen , Gupta Rangan , Babalos Vassilios , Hefer Roulof
Published: March 2015

The relationship between oil and the price level has always garnered the attention from policy makers and researchers. Periods of high oil price volatility is thought to induce negative repercussions for domestic price levels in an oil importing country. Research in the past has revealed that there exists an asymmetric component in the causal relationship between oil prices and consumer prices. To this end, we opt for a novel asymmetric causality test developed by Hatemi-J (2012) to explore the relationship between international oil prices and the price level in South Africa for a period that runs from 1921: M02 to 2013: M10. This method disentangles the effects of positive shocks from negatives ones allowing to test for an asymmetric relationship. Our evidence are in favour of a causal relationship that runs from oil prices to the price level, but this relationship is observed only for the short term since there is no long run cointegrating relationship. The asymmetric tests reveal that both a positive and negative oil price shock leads to a positive price level shock, however the evidence in favour of a negative oil price shock is stronger.
Enumeration of Floor Plans Based on a Zero-Suppressed Binary Decision Diagram
Authors: Takizawa Atsushi , Miyata Yushi , Katoh Naoki
Published: March 2015

This paper presents novel algorithms for enumerating architectural floor plans. The enumeration approach attempts to generate all feasible solutions that satisfy given constraints. Therefore, such a method might usefully reveal the potential diversity of Open Building floor plans. However, combinatorial enumeration solutions easily explode even for small problem sizes. We represent a space by a set of cells and organize some cells into polyomino-like configurations. We then enumerate all cell combinations that can be tiled in the given space using an efficient search algorithm for combinatorial problems. We also propose queries for extracting specific floor plans that satisfy additional constraints from all enumerated floor plans without re-enumeration. Our approach solves a 56-cell configuration space within a realistic timeframe.
An Inductive Construction of Rigid Panel-Hinge Graphs and Their Applications to Form Design
Authors: Kobayashi Yuki , Katoh Naoki , Okano Tomohiro , Takizawa Atsushi
Published: March 2015

A panel-hinge framework is a structure composed of rigid panels connected by hinges. It was recently proved that at a generic position, the rigidity of panel-hinge frameworks can be predicted by examining a certain combinatorial property of the underlying graph. In this study, we apply such combinatorial characteristics to create design forms. When considering the application of design forms, we must also take into account non-generic cases. In this paper we develop two new approaches; the first one that the method inductively generates non-generic rigid panel-hinge frameworks consisting of orthogonal panels and the second one that inductively generates non-generic rigid panel-hinge frameworks based on fractal geometry coupled with space-filling convex polyhedron as a construction unit. We will give examples of forms created by the proposed method in order to demonstrate the applicability of the proposed methods to design forms.
Architects' Cognitive Behaviour in Parametric Design
Authors: Yu Rongrong , Gero John , Gu Ning
Published: March 2015

This paper presents the results of a protocol study of professional architects' cognitive behaviour in a parametric design environment. A design experiment was conducted in which eight professional architects completed an architectural conceptual design task in a typical parametric design environment –Rhino and Grasshopper. Protocol analysis was then applied to analyse the cognitive behaviour of the architects. In analysing the protocol data, the FBS ontology adopted for developing the coding scheme was sub-divided into design knowledge and rule algorithm classes as the means to capture designers' cognitive behaviour. Applying the method of cumulative analysis, results of the relative cognitive effort expended on design knowledge and rule algorithm classes have been compared and are discussed in the paper.
The Effectiveness of Field Price Discretion: Empirical Evidence from Auto Lending
Authors: Phillips Robert , Şimşek A. Serdar , van Ryzin Garrett
Published: March 2015

In many markets, it is common for headquarters to create a price list but grant local salespeople discretion to negotiate prices for individual transactions. How much (if any) pricing discretion headquarters should grant is a topic of debate within many firms. We investigate this issue using a unique data set from an indirect lender with local pricing discretion. We estimate that the local sales force adjusted prices in a way that improved profits by approximately 11% on average. A counterfactual analysis shows that using a centralized, data-driven pricing optimization system could improve profits even further, up to 20% over those actually realized. This suggests that centralized pricing—if appropriately optimized—can be more effective than field price discretion. We discuss the implications of these findings for auto lending and other industries with similar pricing processes.

This paper was accepted by Serguei Netessine, operations management.
Comparison of Health Promotion Lifestyles and Self-esteem of Korean and Chinese Nursing Students.
Authors: Cho Hee , Lee Suk Jeong , Cui Ren Shan
Published: March 2015

PURPOSE: The purpose of this study was to compare health promotion lifestyles and self-esteem of nursing students in Korea and China. METHODS: With a descriptive comparative design, a total of 305 Korean and 317 Chinese nursing students were recruited. The health promotion lifestyles was measured by Walker's Health-promoting Lifestyle Profile II instrument and self esteem was measured by Rosenberg's self esteem instrument. Data were analyzed by descriptive statistics and multiple regression. RESULTS: Korean students showed significantly higher levels of health responsibility, nutritional habit, interpersonal relations, and spiritual growth compared with Chinese students, but physical activity was higher in Chinese students. The factors influencing health promotion lifestyle were self-esteem, nation, and satisfaction of school life. The levels of health promotion lifestyles positively correlated with self-esteem in Korean and Chinese nursing students. CONCLUSION: Nurse educators should consider to develop health-promoting activities and programs reflecting curricular and cross-cultural perspectives.
Connecting with children
Authors: Thomas Beth
Published: March 2015

The way in which we, as practitioners, communicate daily with the children in our care can have a major impact on the way they engage with their environment and peers.
Small Animal Review
Authors: Tennant Bryn
Published: March 2015

Introduction:

C-reactive protein and α1-proteinase inhibitor may be useful markers to identify a protein-losing enteropathy.
The lame cat: inflammatory arthritis
Authors: Perry Karen L
Published: March 2015

Inflammatory arthritis occurs much less frequently than degenerative joint disease in cats. Synoviocentesis is essential in confirming a diagnosis but extensive testing may be required in order to determine the underlying cause. Inflammatory arthritis is classified into infectious and non-infectious and erosive or non-erosive forms, and differentiating between these is important when deciding on appropriate therapeutics and in giving owners an accurate prognosis. Idiopathic immune-mediated polyarthritis is relatively rare in cats in comparison to dogs, with infectious causes of inflammatory arthritis being far more common. It is critical therefore that both infectious and neoplastic causes of polyarthritis are definitively ruled out before considering treatment with immunosuppressive drugs.
The nutritional management of feline chronic kidney disease
Authors: Danks Lee
Published: March 2015

Chronic kidney disease (CKD) is a frequent disease seen in older cats and while it is a progressive condition, the veterinary practice team can play a key role in delaying the inevitable. Dietary modifications are key to slowing the progression of renal disease and alleviating its metabolic consequences. There are four main objectives of nutritional management. These are: a) provide sufficient energy to maintain a good body condition; b) alleviate the clinical manifestations of uraemia; c) minimise fluid, electrolyte and acid-base disturbances; and d) slow disease progression. This article reviews the nutritional concepts employed in the management of CKD, and demonstrates why a renal diet should be implemented early in the disease to maximise both its benefits and acceptance by the feline patient.
Multiple medicines: the issues surrounding polypharmacy
Authors: Kaufman Gerri
Published: March 2015

Older people are much more likely to be prescribed various different medications. Gerri Kaufman describes the dangers associated with polypharmacy and recommends ways in with those working in care homes can avoid negative health outcomes
Best practice in the latest care-related software
Authors: Dewsbury Guy , Ballard Debbie
Published: March 2015

A good knowledge of the latest technology in software can offer a range of options that might enable better quality of care. Guy Dewsbury and Debbie Ballard provide an overview of the benefits of understanding technological advancements
Champion equality, diversity and inclusion
Authors: Green Danielle
Published: March 2015

This unit assesses the learner's knowledge, understanding and skills as required for a whole systems approach to equality, diversity and inclusion. It requires the learner to demonstrate skills practically, explores models of practice and the understanding of systems and processes
How to…help residents cast their vote in the General Election
Authors: Ashurst Adrian
Published: March 2015

In this article Adrian Ashurst provides some points to consider when facilitating the opportunity for individuals to cast their vote in the forthcoming General Election
Somatic education and embodied discourses: Using the Feldenkrais Method to challenge dominant discourses in the sexually abused body context
Authors: Beaudry Lucie
Published: March 2015

In an autoethnographical study for a master’s degree in dance, the author shares how somatic education enabled her to challenge the dominant discourses that were integrated following the incest she experienced in her childhood. Considering that our identities are a function of the constraints that act on us and influence our subjectivity, the author explains how these discourses have influenced her relationship to her body and how the Feldenkrais Method made a new perception of self and of the world possible. She describes her experience of the self-educating process, a process that revealed the plasticity of a self capable of adapting to the whole of her life experiences. From the development of somatic authority to creative self-fashioning, the author draws from a variety of inspirations to nurture her thinking about, and show the role played by, somatic education.
Moving in, out, through, and beyond the tensions between experience and social construction in somatic theory
Authors: Green Jill
Published: March 2015

This article is a reflexive analysis of the author’s movement through the positions of different somatic theories. While some somatic theorists and practitioners focus on ideas of self and experiential knowledge, others are moving into a more postmodern realm by looking at bodies and somatic experience as social constructions. The author traces her movement through these theories and towards a non-binary postmodern view of somatics that does not dismiss the role of experience. Two narratives serve as a vehicle whereby the author wrestles with the issues.
Hematological effects of benzene in the petroleum industry
Authors: Liao Yen-Hsiung
Published: March 2015

Purpose: To follow up the hematological changes in petroleum workers with continuous exposure to benzene.Approach: The hematological data of two petroleum company male employees was obtained from the annual health check-ups during 2001 to 2005. Workers were classified into exposed and unexposed groups on the basis of their exposure operation performed, and the industrial hygiene surveys.Results: There was not any difference between the exposed and the unexposed groups in the frequency of abnormalities with CBC differential and WBC differential almost. The frequency of higher than the normal range with eosinophils was significantly higher in exposed group (31.73%) than in unexposed group (11.54%, p < 0.05) in 1994, only.Conclusion: The study suggested that the eosinophil counts could be a hematological effect maker among workers exposed to benzene in the petroleum industry.