bluuebunny/crossref_metadata_2025 huggingface dataset:
Contaminated sites from the past: experience of the US Environmental Protection Agency
Authors: Boyd M.A.
Published: March 2016

The purpose of this paper is to provide an overview of the experience of the US Environmental Protection Agency (EPA) in cleaning up radioactively contaminated sites. In the USA, EPA regulates the radiological clean-up of uranium mill tailings sites, some Department of Energy legacy sites within the US nuclear weapons complex, and Superfund National Priorities List sites. The approach to site remediation decisions, including the determination of clean-up levels, varies according to the enabling legislation granting EPA these authorities. Past practices that gave rise to many of the existing exposure situations at legacy sites were permissible before the advent of environmental clean-up legislation. The Uranium Mill Tailings Radiation Control Act of 1978 authorised EPA to set applicable radioactivity concentration standards for soil clean-up at inactive uranium mill sites and vicinity properties. For the other categories of sites mentioned above, remediation goals are typically based on not exceeding a target excess cancer risk range established under the Comprehensive Environmental Response, Compensation, and Liability Act (also known as ‘Superfund’). EPA’s regulations for cleaning up various contaminated sites in existing exposure situations often result in residual doses that are typical of optimised doses in planned exposure situations. Although the clean-up levels selected may differ from those adopted in other countries, recommendations from the International Commission on Radiological Protection are reflected in the exposure assessment methodologies used in their establishment.
A multicenter, randomized, placebo-controlled study to evaluate the efficacy and safety of Varithena® (polidocanol endovenous microfoam 1%) for symptomatic, visible varicose veins with saphenofemoral junction incompetence
Authors: Gibson Kathleen , Kabnick Lowell
Published: March 2016

Objectives

A randomized, placebo-controlled, multicenter study was conducted to evaluate the safety and efficacy of polidocanol endovenous microfoam (1%, Varithena® [polidocanol injectable foam], BTG International Ltd.).

Methods

Patients (n = 77) with symptomatic, visible varicose veins were randomized to treatment with either Varithena 1% or placebo.

Results

Varithena provided greater mean changes from Baseline in patient-reported assessments of symptoms (e.g., heaviness, achiness, swelling, throbbing, itching [HASTI®] score 30.7 points vs 16.7 points, p = 0.0009, primary endpoint; and modified Venous Insufficiency Epidemiological and Economic Study-Quality-of-Life/Symptoms [m-VEINES-QOL/Sym; p < 0.001]), physician-assessed VCSS, and physician- and patient-assessed appearance compared with placebo. The HASTI score correlated highly with the modified-VEINES-QOL/Sym and Chronic Venous Insufficiency Questionnaire-2 scores (r = 0.7 to > 0.9, p ≤ 0.001). Adverse events included contusion, incision-site hematoma, and limb discomfort. Venous thrombus adverse events were reported as mild and generally resolved without sequelae.

Conclusions

Varithena provided significantly greater symptom relief and improvement in leg appearance compared with placebo. Adverse events were generally mild and transient. ( www.clinicaltrials.gov [NCT00758420]).
Development and Evaluation of an Approach to Using Value of Information Analyses for Real-Time Prioritization Decisions Within SWOG, a Large Cancer Clinical Trials Cooperative Group
Authors: Bennette Caroline S. , Veenstra David L. , Basu Anirban , Baker Laurence H. , Ramsey Scott D. , Carlson Josh J.
Published: March 2016

Objective. Value of information (VOI) analyses can align research with areas with the greatest potential impact on patient outcome, but questions remain concerning the feasibility and acceptability of these approaches to inform prioritization decisions. Our objective was to develop a process for calculating VOI in “real time” to inform trial funding decisions within SWOG, a large cancer clinical trials group. Methods. We developed an efficient and scalable VOI modeling approach using a selected sample of 9 randomized phase II/III trial proposals from the Breast, Gastrointestinal, and Genitourinary Disease Committees reviewed by SWOG’s leadership between 2008 and 2013. There was bidirectional communication between SWOG investigators and the research team throughout the modeling development. Partial expected value of sample information for the treatment effect evaluated by the proposed trial’s primary endpoint was calculated using Monte Carlo simulation. Results. We derived prior uncertainty in the treatment effect estimate from the sample size calculations. Our process was feasible for 8 of 9 trial proposals and efficient: the time required of 1 researcher was <1 week per proposal. We accommodated stakeholder input primarily by deconstructing VOI metrics into expected health benefits and incremental healthcare costs and assuming treatment decisions within our simulations were based on health benefits. Following customization, feedback from over 200 SWOG members was positive regarding the overall VOI framework, specific retrospective results, and potential for VOI analyses to inform future trial proposal evaluations. Conclusions. We developed an efficient and customized process to calculate the expected VOI of cancer clinical trials that is feasible for use in decision making and acceptable to investigators. Prospective use and evaluation of this approach is currently underway within SWOG.
Prediction of the response of ocular adnexal lymphoma to chemotherapy using combined pretreatment dynamic contrast-enhanced and diffusion-weighted MRI
Authors: Guo Pengde , Liu Zhaohui , Yan Fei , Wang Jingwen , Wei Liqiang , Lv Han , Wang Zhenchang , Xian Junfang
Published: March 2016

Background

There are no established biomarkers predictive of the efficacy of treatment for ocular adnexal lymphoma (OAL).

Purpose

To evaluate the effectiveness of pretreatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in predicting the response of OAL to chemotherapy.

Material and Methods

Twenty-one patients, who were pathologically diagnosed with OAL, were retrospectively analyzed. According to the National Comprehensive Cancer Network (NCCN) response evaluation criteria for non-Hodgkin’s lymphoma, patients were divided into responders (n = 14) and non-responders (n = 7). The volume transfer constant (Ktrans), rate constant (Kep), extracellular extravascular volume fraction (Ve), and apparent diffusion coefficient (ADC) were computed. Two independent-sample tests were applied for statistical analysis. For significantly different parameters, receiver-operator characteristics curve analysis was performed.

Results

The Ktrans value (min−1), Kep value (min−1), and ADC value (10−3 mm2/s) were 0.76 ± 0.36 vs. 0.47 ± 0.18 (mean ± SD), 4.43 ± 1.29 vs. 3.14 ± 1.37, and 0.51 ± 0.12 vs. 0.66 ± 0.15, respectively, in the responders and non-responders groups. Significant differences were found between the two groups regarding these parameters ( P < 0.05). However, no significant difference was observed in Ve (min−1) between the groups ( P > 0.05). Ktrans, Kep, and ADC had a moderately predictive sensitivity or specificity. When Ktrans and ADC or the three parameters were combined, a considerably higher sensitivity (85.7%) and specificity (85.7%) with a significant discriminative accuracy (area under the curve = 0.929; P = 0.002) was found.

Conclusion

Ktrans, Kep, and ADC could potentially predict OAL response to chemotherapy. A combination of these DWI and DCE-MRI quantitative parameters might increase sensitivity and specificity.
Management of iatrogenic ureteric injury with retrograde ureteric stenting: an analysis of factors affecting technical success and long-term outcome
Authors: Chung Daniel , Briggs James , Turney Benjamin W , Tapping Charles Ross
Published: March 2016

Background

Iatrogenic ureteral injuries arise as serious complication following obstetrics, gynecological, general, and urological surgery with incidence in the range of 0.5–10%. Retrograde placement of double-J ureteric stent is a possible treatment option if the injury is not recognized at the time of surgery.

Purpose

To assess technical success and long-term outcome associated with retrograde ureteric stent insertion for iatrogenic ureteric injury.

Material and Methods

Between 1999 and 2011, 26 patients with initially unrecognized iatrogenic ureteric injury underwent initial management with retrograde ureteric stenting. Full case-notes were available for review in 25 patients.

Results

The mean interval from injury to attempted stenting was 19.4 days. Successful retrograde ureteric stenting was achieved in 21/25 patients (81%). Retrograde stenting failed in four patients, and nephrostomy followed by alternative procedures were performed instead. At a median follow-up interval of 9.7 months, normal anatomy was demonstrated on 12/21 patients (57%) and a stricture was observed in 6/21 patients (28%) with three requiring surgical intervention.

Conclusion

Retrograde stenting is a safe and efficient initial management in patients with iatrogenic ureteric injuries.
Renal acoustic radiation force impulse elastography in the evaluation of coronary artery disease
Authors: Alan Bircan , Göya Cemil , Aktan Adem , Alan Sait
Published: March 2016

Background

Renal insufficiency may occur in patients with coronary artery disease (CAD). Acoustic radiation force impulse (ARFI) is a method for quantifying tissue elasticity, which could be used as an additional diagnostic test for renal insufficiency and provide an additional contribution to the determination of CAD.

Purpose

To evaluate ARFI elastography with shear wave velocity (SWV) measurements in the diagnosis of mild-to-moderate chronic kidney disease (CKD) in CAD patients, and to analyze the relationship between the severity of CAD assessed by the Gensini scoring system and kidney stiffness.

Material and Methods

The study included 76 CAD patients and 79 healthy volunteers. SWV was measured for each kidney in the both groups. The CAD group was divided into two subgroups based on Gensini score: mild CAD and severe CAD. SWV values of the CAD patients were compared to those of the healthy volunteers; values of subgroups were also compared with each other.

Results

The patient group had significantly lower renal mean SWV values than those of the healthy group (1.87 ± 0.58 vs. 2.34 ± 0.38, P < 0.01). The SWV value decreased as the eGFR level decreased. Mean SWV values for kidneys of the patients with severe CAD were lower than those of the mild CAD patients (1.64 ± 0.39 vs. 2.42 ± 0.60, P < 0.01).

Conclusion

renal mean SWV values of CAD patients decreased in proportion to the reduction in eGFR, and the SWV values decreased as the severity of CAD increased. ARFI elastography is a novel technique for diagnosing CKD and defining illness severity in CAD patients.
Serotonergic mechanisms in the migraine brain – a systematic review
Authors: Deen Marie , Christensen Casper Emil , Hougaard Anders , Hansen Hanne Demant , Knudsen Gitte Moos , Ashina Messoud
Published: March 2016

Background

Migraine is one of the most common and disabling of all medical conditions, affecting 16% of the general population, causing huge socioeconomic costs globally. Current available treatment options are inadequate. Serotonin is a key molecule in the neurobiology of migraine, but the exact role of brain serotonergic mechanisms remains a matter of controversy.

Methods

We systematically searched PubMed for studies investigating the serotonergic system in the migraine brain by either molecular neuroimaging or electrophysiological methods.

Results

The literature search resulted in 59 papers, of which 13 were eligible for review. The reviewed papers collectively support the notion that migraine patients have alterations in serotonergic neurotransmission. Most likely, migraine patients have a low cerebral serotonin level between attacks, which elevates during a migraine attack.

Conclusion

This review suggests that novel methods of investigating the serotonergic system in the migraine brain are warranted. Uncovering the serotonergic mechanisms in migraine pathophysiology could prove useful for the development of future migraine drugs.
Predictive capabilities of micromechanical models for composite materials
Authors: Bennoura Mounia , Aboutajeddine Ahmed
Published: March 2016

Technology development is tied strongly to our ability to engineer materials that cope with the fast evolving requirements of innovative products. The best way to build this ability is by establishing a material design process from atomic scale to the system scale. An important building block of this process is micromechanical models that bridge microscale to mesoscale. Unfortunately, current micromechanical models remain short from material design perspective. To be able to improve these models, one must first assess and apprehend their prediction capabilities. In this respect, this paper seeks to analyze and compare some prominent micromechanical models with the objective to emphasize those capable of evaluating accurately the effective properties for composites. These models can, then, be candidates for a potential integration in the material design process. This work begins, therefore, with an overview of some well-known models, namely Mori–Tanaka model, self-consistent model, Lielen’s model, effective self-consistent, and its extension interaction direct derivative. The double-inclusion model in its original and new version is introduced and explained. Subsequently, the limitations of all the aforementioned models are discussed and their predictions in the case of both two-phase and multiphase composites are compared. Consequently, it is shown that the improved Double-inclusion model version of Aboutajeddine and Neale can be seen as a unified model, which includes some of the previously existing models as special cases. In addition, this last model is the only model that gives satisfactory predictions in the case of multiphase composite materials.
Physical characteristics and biocompatibility of the polycaprolactone–biphasic calcium phosphate scaffolds fabricated using the modified melt stretching and multilayer deposition
Authors: Thuaksuban Nuttawut , Luntheng Thunmaruk , Monmaturapoj Naruporn
Published: March 2016

Physical properties and biocompatibility of polycaprolactone (PCL)–biphasic calcium phosphate (BCP) scaffolds fabricated by the modified melt stretching and multilayer deposition (mMSMD) technique were evaluated in vitro. The PCL–BCP scaffold specimens included group A; PCL: BCP (wt%) = 80:20 and group B; 70:30. Mechanical properties of the scaffolds were assessed using a universal testing machine. Degradation behaviors of the scaffolds were assessed over 60 days. The amount of calcium and phosphate ions released from the scaffolds was detected over 30 days. Attachment and growth of osteoblasts on the scaffolds and indirect cytocompatibility to those cells were evaluated. The results showed that the scaffolds of both groups could withstand compressive forces on their superior aspect very well; however, their lateral aspect could only withstand light forces. Degradation of the scaffolds over 2 months was low (group A = 1.92 ± 0.47% and group B = 2.9 ± 1.3%, p > 0.05). The concentrations of calcium and phosphate ions released from the scaffolds of both groups significantly increased on day 7 ( p < 0.05). Growth of the cells seemed to relate to accumulative increase in those ions. All results between the two ratios of the scaffolds were not statistically different.
Nanofibrous poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate) scaffolds provide a functional microenvironment for cartilage repair
Authors: Ching Kuan Y , Andriotis Orestis G , Li Siwei , Basnett Pooja , Su Bo , Roy Ipsita , Tare Rahul S , Sengers Bram G , Stolz Martin
Published: March 2016

Articular cartilage defects, when repaired ineffectively, often lead to further deterioration of the tissue, secondary osteoarthritis and, ultimately, joint replacement. Unfortunately, current surgical procedures are unable to restore normal cartilage function. Tissue engineering of cartilage provides promising strategies for the regeneration of damaged articular cartilage. As yet, there are still significant challenges that need to be overcome to match the long-term mechanical stability and durability of native cartilage. Using electrospinning of different blends of biodegradable poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate), we produced polymer scaffolds and optimised their structure, stiffness, degradation rates and biocompatibility. Scaffolds with a poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate) ratio of 1:0.25 exhibit randomly oriented fibres that closely mimic the collagen fibrillar meshwork of native cartilage and match the stiffness of native articular cartilage. Degradation of the scaffolds into products that could be easily removed from the body was indicated by changes in fibre structure, loss of molecular weight and a decrease in scaffold stiffness after one and four months. Histological and immunohistochemical analysis after three weeks of culture with human articular chondrocytes revealed a hyaline-like cartilage matrix. The ability to fine tune the ultrastructure and mechanical properties using different blends of poly(3-hydroxybutyrate)/poly(3-hydroxyoctanoate) allows to produce a cartilage repair kit for clinical use to reduce the risk of developing secondary osteoarthritis. We further suggest the development of a toolbox with tailor-made scaffolds for the repair of other tissues that require a ‘guiding’ structure to support the body’s self-healing process.
Effect of machining parameters on deformation behaviour of Al-based metal matrix composites under tension
Authors: Pramanik Alokesh , Basak Animesh K
Published: March 2016

The effects of machining parameters, such as reinforcement size, machining speed and feed rate, on tensile strength, strain at break and fractured surfaces of Al-based metal matrix composites were analysed in this present investigation. It was found that larger particles (13 µm) induce higher stiffness on machined metal matrix composite parts machined at higher speed (2500 r/min) and lower feed (200 mm/min), providing constant input parameters are of low values and vice versa. The effect of reinforcement size on tensile strength is negligible and higher speed (2500 r/min) and lower feed (200 mm/min) give higher tensile strength when constant input parameters are of low values. The higher machining speed (2500 r/min) gives higher strain at break though reinforcement size and feed rate have minor effect on strain at break when the constant input parameters are of high values. When the constant input parameters are of low values, the smaller reinforcement (0.7 µm), machining speed (1500 r/min) and feed rate (200 mm/min) give higher strain at break. Ductile fracture occurs in all cases regardless of input variables and smaller nodules were formed on fractured surface in the case of smaller particle (0.7 µm)-reinforced metal matrix composites.
Stability research of the compression process of two-cylinder four-stroke single-piston hydraulic free piston engine
Authors: Hao-ling Ren , Tianliang Lin , Hai-bo Xie , Hua-yong Yang
Published: March 2016

An invariable compression ratio in certain conditions must be achieved to ensure a steady and efficient performance of the single-piston hydraulic free piston engine. The compression ratio is determined by the characteristics of the compression stroke. The mathematical models of the key components during the compression process are established. The kinematic characteristics of the free piston assembly are analyzed under two conditions. One condition is that free piston assembly is driven by the compression accumulator only and the other one is that free piston assembly is driven by the compression accumulator and the pump station. Pressures in compression accumulator and compression chamber are analyzed and compared in both conditions. According to the experimental results, pressures in the compression chamber and compression accumulator are not constant in both conditions during the compression process. The compression stroke and compression time vary with the changing of the pressure in the compression accumulator, which adds the complexity and changeability to the compression ratio control. An improved configuration is put forward to solve the pressure variation. The results show that the improved configuration can make the pressure invariable at the inlet of the compression chamber and the compression process keeps almost the same regardless of the pressure changing in the compression accumulator. With this new structure, there is about 2.5% energy loss, which is acceptable considering the stable compression stroke.
Diffuse HIV-associated seborrheic dermatitis – a case series
Authors: Forrestel Amy K , Kovarik Carrie L , Mosam Anisa , Gupta Deepti , Maurer Toby A , Micheletti Robert G
Published: March 2016

Seborrheic dermatitis (SD) is reported to have distinct clinical and histologic presentations in patients with HIV infection. Here we present 20 cases to further define some of these unique characteristics. Common features include erythematous, scaly papules, and plaques involving areas beyond the typical seborrheic distribution; thick, greasy scale on the scalp; and an increased frequency of erythroderma. Histologically, there is widespread parakeratosis, spongiosis, and necrotic keratinocytes. Treatment is often difficult, requiring prolonged use of oral and topical antifungals and corticosteroids as well as antibiotics for bacterial superinfection. SD with these features represents a marker for HIV infection and can aid in early diagnosis.
Efficacy of abatacept in systemic lupus erythematosus: a retrospective analysis of 11 patients with refractory disease
Authors: Danion F , Rosine N , Belkhir R , Gottenberg J E , Hachulla E , Chatelus E , Pugnet G , Pers Y M , Mariette X , Sibilia J , Seror R ,   for the Club Rhumatismes et Inflammation section of the French Society of Rheumatology
Published: March 2016

Objective

The objective of this study was to assess the safety and efficacy of abatacept in patients with SLE refractory to conventional treatment in routine clinical practice.

Methods

This retrospective study included 11 SLE patients treated with abatacept for an active and refractory disease. The primary endpoint was the change in SLE Disease Activity Index (SLEDAI) score at six months. Response was defined as a decrease of SLEDAI ≥4 in a patient continuing abatacept.

Results

Indications of abatacept treatment were articular ( n=8), renal ( n=1) and cutaneous ( n=1) involvement and autoimmune thrombocytopenia ( n=1). Abatacept was discontinued before six months in two patients, because of adverse event ( n=1) and/or lupus flare ( n=2). The median SLEDAI decreased from 6 (2–20) to 4 (0–20) ( p=0.031). Decrease of SLEDAI ≥4 was observed in 6/11 patients (55%) and response to treatment according to the physician's judgement in 8/11 (73%) patients. Improvement of articular involvement was observed in 7/8 (87.5%) patients. Four adverse events were observed in three patients, but no severe infection occurred.

Conclusion

This study suggests some efficacy of abatacept in patients with refractory disease in routine clinical practice, particularly in the case of articular manifestations, with an acceptable safety profile. These data support conducting new controlled trials of abatacept in SLE patients.
From Corruption to State Capture
Authors: Fazekas Mihály , Tóth István János
Published: March 2016

State capture and corruption are widespread phenomena across the globe, but their empirical study still lacks sufficient analytical tools. This paper develops a new conceptual and analytical framework for gauging state capture based on microlevel contractual networks in public procurement. To this end, it establishes a novel measure of corruption risk in government contracting focusing on the behavior of individual organizations. Then, it identifies clusters of high-corruption-risk organizations in the full contractual network of procuring authorities and their suppliers using formal social network analysis. Densely connected clusters of high-corruption-risk organizations are denoted as the domain of state capture. The paper demonstrates the power of the new analytical framework by exploring how the radical centralization of the governing elite following the 2010 elections in Hungary affected centralization of state capture. Findings indicate the feasibility and usefulness of such microlevel approach to corruption and state capture. Better understanding the network structure of corruption and state capture opens new avenues for research and policy on anticorruption, budget deficit, market competition, and quality of democracy. Supporting further empirical studies of corruption, the data are made available at digiwhist.eu/resources/data.
Who Supports Populism and What Attracts People to It?
Authors: Spruyt Bram , Keppens Gil , Van Droogenbroeck Filip
Published: March 2016

In this paper, we engage with the emerging literature that studies the support for populism by means of attitudes among the public at large. More specifically, our paper has two objectives. First, we extend recent research by Akkerman et al. by showing that their measure performs rather well in a context that differs from the one it was originally formulated in. Data from Flanders (the Dutch speaking part of Belgium, N = 1,577) also demonstrate that the support for populism can be empirically distinguished from feelings of lack of external political efficacy. Second, this is one of the first studies that assess who supports populism and why they do so. We show that populism is embedded in deep feelings of discontent, not only with politics but also with societal life in general. Moreover, we demonstrate that populism is strongest supported by stigmatized groups who face difficulties in finding a positive social identity. In the conclusion, we discuss the implications of our findings.
Prognostic Value of Renal Dysfunction Indicators in Normotensive Patients With Acute Pulmonary Embolism
Authors: Altınsoy Bülent , Öz İbrahim İlker , Örnek Tacettin , Erboy Fatma , Tanrıverdi Hakan , Uygur Fırat , Altintas Nejat , Atalay Figen , Tor Müge Meltem
Published: March 2016

Introduction:

Glomerular filtration rate (GFR) and blood urea nitrogen (BUN) are important prognostic indicators for cardiovascular disease. However, data on the relationship between renal dysfunction (RD) and prognosis in patients with acute pulmonary embolism (APE) are limited. The estimated-GFR (eGFR), based on the Modification of Diet in Renal Disease (MDRD) equation, has been suggested as a possible prognostic marker in patients with APE; however, at present, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is thought to be more accurate than the MDRD equation for the estimation of RD.

Objective:

We investigated whether eGFRCKD-EPIor BUN could predict adverse outcomes (AOs) better than eGFRMDRDin normotensive patients with APE.

Methods:

Ninety-nine normotensive patients with APE (aged 22-96, 56% male) were enrolled in the study retrospectively. Adverse outcomes were defined as the occurrence of any of the following: death, cardiopulmonary resuscitation, use of vasopressors, thrombolysis, or mechanical ventilation.

Results:

In univariate analyses, age, gender (male), heart rate (>110 bpm), serum creatinine, BUN, cardiac troponin (cTn) positivity, right ventricle–left ventricle ratio, eGFRMDRD, and eGFRCKD-EPIwere found to be significantly different between those with and without AOs. Comparing area under the curves for AO, we found statistically significant differences between eGFRCKD-EPIand eGFRMDRD( P = .01) but not between BUN and eGFRCKD-EPIor BUN and eGFRMDRD. Furthermore, 30-day mortality was 36% versus 11% in cTn-positive patients with an eGFRCKD-EPI< and ≥ 60 mL/min, respectively.

Conclusion:

There is a close relationship between RD and APE prognosis. We conclude eGFRCKD-EPIis a potential prognostic marker for risk stratification in normotensive patients with APE.
Development of a Scale to Measure Perceptions of Stewardship Strategies for Nonprofit Organizations
Authors: Pressgrove Geah
Published: March 2016

Through a survey of nonprofit stakeholders, this research builds on previous studies that have explored the construct of stewardship and advances a new measurement model. Findings provide a new conceptualization of the construct with five dimensions, rather than the previously theorized four-dimension solution. Theoretical, measurement, and practical applications are discussed.
Distraction adds to the cognitive burden in multiple sclerosis
Authors: Patel Viral P , Zambrana Aaron , Walker Lisa AS , Herrmann Nathan , Feinstein Anthony
Published: March 2016

Background:

Cognitive dysfunction in multiple sclerosis (MS) causes numerous limitations in activities of daily living.

Objectives:

To develop an improved method of cognitive assessment in people with MS using novel real-world distracters.

Methods:

A sample of 99 people with MS and 55 demographically matched healthy controls underwent testing with the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis (MACFIMS) and a modified version of the computerized Symbol Digit Modalities Test (c-SDMT). Half of the subjects completed the c-SDMT with built-in real-world distracters and half without.

Results:

The mean time on the c-SDMT was significantly greater in MS subjects than healthy controls for both distracter ( p = 0.001) and non-distracter ( p < 0.001) versions. Significantly more MS subjects were impaired on the c-SDMT with distracters than the traditional SDMT (47.1% vs 30.3%, p = 0.04). There were no differences in impairment between the c-SDMT with and without distracters (47.1% vs 37.5%, p = 0.34). The distracter version had a sensitivity of 81% and specificity of 88% in detecting global cognitive impairment.

Conclusions:

The incorporation of distracters improves the sensitivity of a validated computerized version of the SDMT relative to the non-distracter and traditional versions and offers a quick and easy means of detecting cognitive impairment in people with MS.
Cold-water extracts of Grifola frondosa and its purified active fraction inhibit hepatocellular carcinoma in vitro and in vivo
Authors: Lin Chia-Hung , Chang Ching-Yao , Lee Kuan-Rong , Lin Hui-Ju , Lin Wu-Chou , Chen Ter-Hsin , Wan Lei
Published: March 2016

Mushrooms are used in traditional Chinese medicine to treat a variety of diseases. Grifola frondosa (GF) is an edible mushroom indigenous to many Asian countries with a large fruiting body characterized by overlapping caps. In particular, GF is known for its anti-tumor activity, which has been targeted by scientific and clinical research. This study aimed to investigate the effects of the cold-water extract of GF (GFW) and its active fraction (GFW-GF) on autophagy and apoptosis, and the underlying mechanisms in vitro and in vivo. Our results revealed that GFW and GFW-GF inhibited phosphatidylinositol 3-kinase (PI3K) and stimulated c-Jun N-terminal kinase (JNK) pathways, thereby inducing autophagy. We also demonstrated that GFW and GFW-GF inhibited proliferation, induced cell cycle arrest, and apoptosis in Hep3B hepatoma cells. GFW and GFW-GF markedly arrested cells in S phase and promoted cleavage of caspase-3 and -9. In addition, GFW and GFW-GF decreased the expression levels of the anti-apoptotic proteins protein kinase B and extracellular signal-regulated kinase. We also found that GFW significantly inhibited tumor growth in nude mice implanted with Hep3B cells. Our work demonstrates that GF and its active fraction inhibit hepatoma growth by inducing autophagy and apoptosis.
Exploring traditional Indigenous leadership concepts: A spiritual foundation for Blackfeet leadership
Authors: Gladstone Joseph Scott , Pepion Donald D
Published: March 2016

Historically examining the cultural foundation for traditional leadership within the Blackfoot Confederacy, composed of the Blackfeet (Pikuni or South Piegan) in Montana, USA, and the North Piegan, Blood (Kainai), and Blackfoot (Siksika) in Alberta, Canada, reveals that authority for leadership is grounded in tribal spirituality. This spiritual authority is integrated within traditional and complex structures that organize the social structures of the Blackfeet, a structure of extended family, bands, and societies that all influence leadership. Traditional leadership authority arises through medicine bundle rituals, ceremonial rites, and protocols that exist within the Niitsítapi (Blackfeet people) worldview. Understanding the complex foundations of traditional tribal leadership facilitates future research and understanding of Indigenous leadership, especially when international borders separate tribes.
Dupuytren’s contracture in Ethiopia
Authors: Gebereegziabher A. , Baraki A. , Kebede Y. , Mohammed I. , Finsen V.
Published: March 2016

Dupuytren’s contracture is believed to be rare in Africa. We have observed the disease in many patients coming to our hospital. This study aimed to provide information concerning the occurrence of the disease and risk factors in these patients. All 75 patients who were referred to the hospital during a 2-year period because of a hand problem that was diagnosed as Dupuytren’s contracture were included. The demographic data of the patients and possible risk factors were recorded and compared with a control group. The male to female ratio was 18:1. The little and ring fingers were most commonly affected. A total of 43 had bilateral hand involvement. The condition affected only the left hand in one patient. Six men also had fibromatosis of the soles of the feet and three of the penis. There was a statistically significant association with hypertension and alcohol consumption, but not with diabetes mellitus. We conclude that there are more cases of Dupuytren’s contracture in Ethiopia than previously thought.

Level of evidence: III
A systematic critical review of epidemiological studies on public health concerns of municipal solid waste handling
Authors: Ncube France , Ncube Esper Jacobeth , Voyi Kuku
Published: March 2016

Aims:

The ultimate aim of this review was to summarise the epidemiological evidence on the association between municipal solid waste management operations and health risks to populations residing near landfills and incinerators, waste workers and recyclers. To accomplish this, the sub-aims of this review article were to (1) examine the health risks posed by municipal solid waste management activities, (2) determine the strengths and gaps of available literature on health risks from municipal waste management operations and (3) suggest possible research needs for future studies.

Methods:

The article reviewed epidemiological literature on public health concerns of municipal solid waste handling published in the period 1995–2014. The PubMed and MEDLINE computerised literature searches were employed to identify the relevant papers using the keywords solid waste, waste management, health risks, recycling, landfills and incinerators. Additionally, all references of potential papers were examined to determine more articles that met the inclusion criteria.

Results:

A total of 379 papers were identified, but after intensive screening only 72 met the inclusion criteria and were reviewed. Of these studies, 33 were on adverse health effects in communities living near waste dumpsites or incinerators, 24 on municipal solid waste workers and 15 on informal waste recyclers. Reviewed studies were unable to demonstrate a causal or non-causal relationship due to various limitations.

Conclusion:

In light of the above findings, our review concludes that overall epidemiological evidence in reviewed articles is inadequate mainly due to methodological limitations and future research needs to develop tools capable of demonstrating causal or non-causal relationships between specific waste management operations and adverse health endpoints.
A study to investigate the intra-rater and inter-rater reliability of goniometric measurements of dart throwers motion of asymptomatic wrists
Authors: Cliff Nicola J , Rust Philippa A
Published: March 2016

Introduction

This study investigated the intra-rater and inter-rater reliability of measuring dart throwers motion of asymptomatic wrists with a handheld manual goniometer typical of that used in the clinical setting.

Method

Working in pairs, each rater took three repeated measures of radial extension and of ulnar flexion of both wrists using a goniometer positioned on the radiodorsal aspect of the radius proximally and the second metacarpal distally. Both raters and subjects were blinded, and measurements were read by an independent observer. Subjects were of varied age, gender and with no history of wrist pathology. Subjects rated how difficult they found the dart throwers motion to perform using a 5-point Likert scale.

Results

Measurements were collected from both wrists of 37 subjects (74 wrists). The intraclass correlation coefficient for intra-rater measurements of radial extension was 0.89 (95% CI 0.86–0.92) and for ulnar flexion was 0.92 (95% CI 0.90–0.94). Standard deviation for radial extension was 4.2° and for ulnar flexion 3.6°. The intraclass correlation coefficient for inter-rater measurements of radial extension was 0.83 (95% CI 0.74–0.89) and for ulnar flexion was 0.81 (95% CI 0.72–0.88). Subjects rated the movement more difficult to perform with the non-dominant side (P=0.006), and standard deviation was greater when the subject found dart throwers motion difficult to perform. No significant associations were found (P<0.05) to suggest that reliability is influenced by hand dominance, gender, age, level of perceived difficulty or data collection site.

Discussion

Our study confirms good reliability when using this method to measure dart throwers motion. It is suggested that dart throwers motion can be measured to compare different subjects and monitor change; however, studies need to be undertaken with a symptomatic population.
Family history is an independent risk factor for the progression of gastric atrophy among patients with Helicobacter pylori infection
Authors: Nishizawa Toshihiro , Suzuki Hidekazu , Sakitani Kosuke , Yamashita Hiroharu , Yoshida Shuntaro , Hata Keisuke , Kanazawa Takamitsu , Fujiwara Naoto , Kanai Takanori , Yahagi Naohisa , Toyoshima Osamu
Published: March 2016

Background and aim

Risk factors for progression of gastric atrophy have not been fully elucidated. The aim of this study was to evaluate the risk factors for the development of atrophic gastritis in patients with Helicobacter pylori (H. pylori  ) infection.

Methods

We reviewed 206 H. pylori ‐infected patients retrospectively. Endoscopic gastric atrophy was classified into closed‐ and open‐type. We conducted univariate and multivariate logistic regression analyses on the contribution of age, sex, body mass index, past history of cancer, the first‐degree family history of gastric cancer, habitual smoking and alcohol drinking, and endoscopic findings of gastric ulcer or duodenal ulcer for open‐type gastric atrophy.

Results

On multivariate analysis, age (odds ratio = 1.079, 95% confidence interval = 1.048–1.11, p  < 0.001), family history of gastric cancer (odds ratio = 3.967, 95% confidence interval = 1.414–10.6, p  = 0.006) and duodenal ulcer (odds ratio = 0.834, 95% confidence interval = 0.711–0.977, p  = 0.024) were the factors independently associated with open‐type gastric atrophy.

Conclusions

A first‐degree family history of gastric cancer, absence of duodenal ulcer, and old age were independent risk factors for the progression of gastric atrophy among H. pylori ‐infected patients. Careful examination with upper gastrointestinal endoscopy is necessary in patients with such risk factors.
Lymph node parameters and complications following laparoscopic extended pelvic lymphadenectomy for prostate cancer in 1000 consecutive patients
Authors: Eden Christopher G , Soares Ricardo , Bott Simon RJ , Hindley Richard G , McGregor Roy G
Published: March 2016

Objective:

The purpose of this study was to investigate the short-term results of extended pelvic lymphadenectomy (ePLND) during laparoscopic radical prostatectomy (LRP).

Patients and methods:

Of 1330 consecutive patients undergoing LRP during a 90-month period 1000 (75%) had an ePLND for d’Amico intermediate- or high-risk prostate cancer.

Results:

Operating time, blood loss, conversion and transfusion rates and hospital stay were similar in patients having standard pelvic lymphadenectomy (sPLND) and ePLND. Median lymph node count was significantly greater following ePLND vs sPLND (17 vs 6; p⩽0.0001). Complication rates were also similar but trended ( p=0.06) towards a greater rate after ePLND vs sPLND: 9.0% and 5.5%. Lymph node involvement (LNI) was detected more frequently following ePLND in patients with: prostate specific antigen (PSA)=0–9.9 ( p=0.01) and PSA=10–19.9 ( p⩽0.0001); biopsy Gleason sum ⩽8 ( p⩽0.0001 to 0.03); intermediate- ( p⩽0.0001) and high-risk ( p⩽0.0001) cancer; pathological Gleason grade 7 ( p⩽0.0001) and pathological stage T3 ( p=0.0009 for pT3a and p⩽0.0001 for pT3b).

Conclusion:

ePLND is a more effective tool than sPLND in detecting LNI for patients in all prognostic clinical groups. This can be achieved without significant penalty with respect to operating time or complication rates.
Outcome of the Cementless Zweymüller BICON-PLUS Cup and SL-PLUS Stem in the Very Elderly Individuals
Authors: Veen Egbert J. D. , Schrier Joost C. M. , Van’t Riet Esther , Breslau Mark J. , Barnaart Alexander F. W.
Published: March 2016

Introduction:

There is current debate about which type of total hip prosthesis implants are best for the elderly patient. Implanting uncemented total hip arthroplasty (THA) in elderly people remains contested. The aim of present study was to evaluate the outcome of the uncemented Zweymüller BICON-PLUS THA in those with a minimum of 80 years of age.

Materials and Methods:

A retrospective data collection was performed in a regional teaching hospital in the Netherlands. The primary outcome of interest was the operation-free period. Secondary outcomes included the revision rates of the femoral and acetabular components and postoperative complications of the procedure. After a follow-up of at least 7 years, the surviving patients were reviewed on functionality using validated scores (Hip Disability and Osteoarthritis Outcome Score, Timed Up and Go, and Harris Hip Score) and radiographic analysis.

Results:

Between January 1999 and September 2004, 124 patients (128 THAs), aged 80 years and older, received an uncemented THA with a BICON-PLUS cup and SL-PLUS stem. The overall operation-free period was 6.5 years. One case of loosening of the cup was found among participants, with a survival rate of 99.2% of the BICON-PLUS cup in the analyzed group. In all, 28.8% of this group could be followed for a postoperative period of at least 7 years. The remainder of the patients died prior to the end of the 7-year period. Of these, 16.0% were eligible for clinical review. This group showed good function without evident signs of prosthetic loosening.

Conclusion:

The uncemented Zweymüller THA system, with threaded BICON-PLUS cup and SL-PLUS stem, showed good results, compared to outcome of other THA systems in elderly individuals. Therefore, it is a reliable option in older patients requiring THA.
Unified relation-theoretic metrical fixed point theorems under an implicit contractive condition with an application
Authors: Ahmadullah Md , Ali Javid , Imdad Mohammad
Published: March 2016

The main purpose of this article is to establish relation-theoretic metrical fixed point theorems via an implicit contractive condition which is general enough to yield a multitude of corollaries corresponding to several well known contraction conditions (e.g. Banach (Fundam. Math. 3:133-181, 1922), Kannan (Am. Math. Mon. 76:405-408, 1969), Reich (Can. Math. Bull. 14:121-124, 1971), Bianchini (Boll. Unione Mat. Ital. 5:103-108, 1972), Chatterjea (C. R. Acad. Bulg. Sci. 25:727-730, 1972), Hardy and Rogers (Can. Math. Bull. 16:201-206, 1973), Ćirić (Proc. Am. Math. Soc. 45:267-273, 1974) and several others) wherein even such corollaries are new results on their own. As an example we utilize our main results, to prove a theorem on the existence and uniqueness of the solution of an integral equation besides providing an illustrative example.
Bisphenol A Induces Fatty Liver by an Endocannabinoid-Mediated Positive Feedback Loop
Authors: Martella Andrea , Silvestri Cristoforo , Maradonna Francesca , Gioacchini Giorgia , Allarà Marco , Radaelli Giuseppe , Overby Darryl R. , Di Marzo Vincenzo , Carnevali Oliana
Published: March 2016

The xenoestrogen bisphenol A (BPA) is a widespread plasticizer detectable within several ecosystems. BPA is considered a metabolic disruptor, affecting different organs; however, little is known about its mechanism of action in the liver, in which it triggers triglyceride accumulation. Adult zebrafish (Danio rerio) exposed to BPA developed hepatosteatosis, which was associated with an increase in the liver levels of the obesogenic endocannabinoids 2-arachidonoylglycerol and anandamide and a concomitant decrease in palmitoylethanolamide. These changes were associated with variations in the expression of key endocannabinoid catabolic and metabolic enzymes and an increase in the expression of the endocannabinoid receptor cnr1. Acute and chronic in vitro treatments with nano- and micromolar BPA doses showed increased anandamide levels in line with decreased activity of fatty acid amide hydrolase, the main anandamide hydrolytic enzyme, and induced triglyceride accumulation in HHL-5 cells in a CB1-dependent manner. We conclude that BPA is able to produce hepatosteatosis in zebrafish and human hepatocytes by up-regulating the endocannabinoid system.
High technologies in induction melting in inductor and electro-magnetic crucible furnaces
Authors: Левшин Геннадий , Levshin Gennady
Published: March 2016

Merits and demerits in high technology of a induction crucible melting of casting alloys of two types: with vertical and horizontal electromagnetic streams are considered. The comparison of basic design and operation parameters of a fusion process and furnaces themselves is carried out. General and characteristic peculiarities are revealed. The use of techniques and furnaces of both types will allow widening the field of induction fusion application.
Method of seam friction welding for composition of high-temperature nickel alloys (BKHA-1BP with AP975-ID)
Authors: Супов А. , Supov A. , Даутов С. , Dautov S. , Ковальчук В. , Kovalchuk V. , Оспенникова О , Ospennikova O , Лукин В. , Lukin V. , Саморуков М. , Samorukov M.
Published: March 2016

The bondability by the method of seam friction welding of the combinations of heat resistant nickel VCNA-1VP alloys and EP975-ID is considered. The optimum parameters of seam friction welding are determined. The radiographic control of welds is carried out, The stress-strain properties at a bend and stretching are analyzed, a weld structure is investigated. The character of sample destructions is determined. The qualitative and quantitative micro-X-ray analysis is carried out and sample micro-hardness of a weld is examined.
Effect of tooth shaping method upon allowance shape for tooth finishing operations and their accuracy
Authors: Клепиков В. , Klepikov V. , Черепахин А. , Cherepakhin A.
Published: March 2016

The effect of a tooth profile formation method upon machining accuracy is considered. It is shown that under conditions of large-scale production the highest accuracy will be obtained with the aid of a technological chain “roughing – copying method – finishing – running-in method”.