bluuebunny/crossref_metadata_2025 huggingface dataset:
BGB-283, a Novel RAF Kinase and EGFR Inhibitor, Displays Potent Antitumor Activity in BRAF-Mutated Colorectal Cancers
Authors: Tang Zhiyu , Yuan Xi , Du Rong , Cheung Shing-Hu , Zhang Guoliang , Wei Jing , Zhao Yuan , Feng Yingcai , Peng Hao , Zhang Yi , Du Yunguang , Hu Xiaoxia , Gong Wenfeng , Liu Yong , Gao Yajuan , Liu Ye , Hao Rui , Li Shengjian , Wang Shaohui , Ji Jiafu , Zhang Lianhai , Li Shuangxi , Sutton David , Wei Min , Zhou Changyou , Wang Lai , Luo Lusong
Published: July 2015

Oncogenic BRAF, which drives cell transformation and proliferation, has been detected in approximately 50% of human malignant melanomas and 5% to 15% of colorectal cancers. Despite the remarkable clinical activities achieved by vemurafenib and dabrafenib in treating BRAFV600E metastatic melanoma, their clinical efficacy in BRAFV600E colorectal cancer is far less impressive. Prior studies suggested that feedback activation of EGFR and MAPK signaling upon BRAF inhibition might contribute to the relative unresponsiveness of colorectal cancer to the first-generation BRAF inhibitors. Here, we report characterization of a dual RAF kinase/EGFR inhibitor, BGB-283, which is currently under clinical investigation. In vitro, BGB-283 potently inhibits BRAFV600E-activated ERK phosphorylation and cell proliferation. It demonstrates selective cytotoxicity and preferentially inhibits proliferation of cancer cells harboring BRAFV600E and EGFR mutation/amplification. In BRAFV600E colorectal cancer cell lines, BGB-283 effectively inhibits the reactivation of EGFR and EGFR-mediated cell proliferation. In vivo, BGB-283 treatment leads to dose-dependent tumor growth inhibition accompanied by partial and complete tumor regressions in both cell line-derived and primary human colorectal tumor xenografts bearing BRAFV600E mutation. These findings support BGB-283 as a potent antitumor drug candidate with clinical potential for treating colorectal cancer harboring BRAFV600E mutation. Mol Cancer Ther; 14(10); 2187–97. ©2015 AACR.
Antitumor Activity and Acquired Resistance Mechanism of Dovitinib (TKI258) in RET-Rearranged Lung Adenocarcinoma
Authors: Kang Chan Woo , Jang Kang Won , Sohn Jinyoung , Kim Sung-Moo , Pyo Kyoung-Ho , Kim Hwan , Yun Mi Ran , Kang Han Na , Kim Hye Ryun , Lim Sun Min , Moon Yong Wha , Paik Soonmyung , Kim Dae Joon , Kim Joo Hang , Cho Byoung Chul
Published: July 2015

RET rearrangement is a newly identified oncogenic mutation in lung adenocarcinoma (LADC). Activity of dovitinib (TKI258), a potent inhibitor of FGFR, VEGFR, and PDGFR, in RET-rearranged LADC has not been reported. The aims of the study are to explore antitumor effects and mechanisms of acquired resistance of dovitinib in RET-rearranged LADC. Using structural modeling and in vitro analysis, we demonstrated that dovitinib induced cell-cycle arrest at G0–G1 phase and apoptosis by selective inhibition of RET kinase activity and ERK1/2 signaling in RET-rearranged LC-2/ad cells. Strong antitumor effect of dovitinib was observed in an LC-2/ad tumor xenograft model. To identify the acquired resistance mechanisms to dovitinib, LC-2/ad cells were exposed to increasing concentrations of dovitinib to generate LC-2/ad DR cells. Gene-set enrichment analysis of gene expression and phosphor-kinase revealed that Src, a central gene in focal adhesion, was activated in LC-2/ad DR cells. Saracatinib, an src kinase inhibitor, suppressed ERK1/2 phosphorylation and growth of LC-2/ad DR cells. Taken together, these findings suggest that dovitinib can be a potential therapeutic option for RET-rearranged LADC, in which acquired resistance to dovitinib can be overcome by targeting Src. Mol Cancer Ther; 14(10); 2238–48. ©2015 AACR.
Transcription Factor Runx2 Promotes Aortic Fibrosis and Stiffness in Type 2 Diabetes Mellitus
Authors: Raaz Uwe , Schellinger Isabel N. , Chernogubova Ekaterina , Warnecke Christina , Kayama Yosuke , Penov Kiril , Hennigs Jan K. , Salomons Florian , Eken Suzanne , Emrich Fabian C. , Zheng Wei H. , Adam Matti , Jagger Ann , Nakagami Futoshi , Toh Ryuji , Toyama Kensuke , Deng Alicia , Buerke Michael , Maegdefessel Lars , Hasenfuß Gerd , Spin Joshua M. , Tsao Philip S.
Published: July 2015

Rationale:

Accelerated arterial stiffening is a major complication of diabetes mellitus with no specific therapy available to date.

Objective:

The present study investigates the role of the osteogenic transcription factor runt-related transcription factor 2 (Runx2) as a potential mediator and therapeutic target of aortic fibrosis and aortic stiffening in diabetes mellitus.

Methods and Results:

Using a murine model of type 2 diabetes mellitus (db/db mice), we identify progressive structural aortic stiffening that precedes the onset of arterial hypertension. At the same time, Runx2 is aberrantly upregulated in the medial layer of db/db aortae, as well as in thoracic aortic samples from patients with type 2 diabetes mellitus. Vascular smooth muscle cell–specific overexpression of Runx2 in transgenic mice increases expression of its target genes,
Col1a1
and
Col1a2
, leading to medial fibrosis and aortic stiffening. Interestingly, increased Runx2 expression per se is not sufficient to induce aortic calcification. Using in vivo and in vitro approaches, we further demonstrate that expression of Runx2 in diabetes mellitus is regulated via a redox-sensitive pathway that involves a direct interaction of NF-κB with the Runx2 promoter.

Conclusions:

In conclusion, this study highlights Runx2 as a previously unrecognized inducer of vascular fibrosis in the setting of diabetes mellitus, promoting arterial stiffness irrespective of calcification.
The resurrection of Gutierrezia ameghinoi (Asteraceae, Astereae, Solidagininae), a species from Patagonia, Argentina
Authors: Ratto Francisco , Bartoli Adriana
Published: July 2015

Gutierrezia ameghinoi Speg., a species from the Argentinean Patagonia, is resurrected. Its geographical distribution and habitat are described. A key to distinguish G. ameghinoi from co-occurring relatives is included. The species is illustrated for the first time.
Common familial risk factors for schizophrenia and diabetes mellitus
Authors: Foley Debra L , Mackinnon Andrew , Morgan Vera A , Watts Gerald F , Castle David J , Waterreus Anna , Galletly Cherrie A
Published: July 2015

Objective:

The co-occurrence of type 2 diabetes and psychosis is an important form of medical comorbidity within individuals, but no large-scale study has evaluated comorbidity within families. The aim of this study was to determine whether there is evidence for familial comorbidity between type 2 diabetes and psychosis.

Method:

Data were analysed from an observational study of a nationally representative sample of 1642 people with psychosis who were in contact with psychiatric services at the time of survey (The 2010 Australian National Survey of Psychosis). Participants were aged 18–64 years and met World Health Organization’s International Classification of Diseases, 10th Revision diagnostic criteria for a psychotic disorder (857 with schizophrenia, 319 with bipolar disorder with psychotic features, 293 with schizoaffective disorder, 81 with depressive psychosis and 92 with delusional disorder or other non-organic psychoses). Logistic regression was used to estimate the association between a family history of diabetes and a family history of schizophrenia.

Results:

A positive family history of diabetes was associated with a positive family history of schizophrenia in those with a psychotic disorder (odds ratio = 1.35, p = 0.01, adjusted for age and gender). The association was different in those with an affective versus non-affective psychosis (odds ratio = 0.613, p = 0.019, adjusted for age and gender) and was significant only in those with a non-affective psychosis, specifically schizophrenia (odds ratio = 1.58, p = 0.005, adjusted for age and sex). Adjustment for demographic factors in those with schizophrenia slightly strengthened the association (odds ratio = 1.74, p = 0.001, adjusted for age, gender, diagnosis, ethnicity, education, employment, income and marital status).

Conclusion:

Elevated risk for type 2 diabetes in people with schizophrenia is not simply a consequence of antipsychotic medication; type 2 diabetes and schizophrenia share familial risk factors.
Personality disorders and the DSM-5: Scientific and extra-scientific factors in the maintenance of the status quo
Authors: Gøtzsche-Astrup Oluf , Moskowitz Andrew
Published: July 2015

Objective:

The aim of this study was to review and discuss the evidence for dimensional classification of personality disorders and the historical and sociological bases of psychiatric nosology and research.

Method:

Categorical and dimensional conceptualisations of personality disorder are reviewed, with a focus on the Diagnostic and Statistical Manual of Mental Disorders–system’s categorisation and the Five-Factor Model of personality. This frames the events leading up to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, personality disorder debacle, where the implementation of a hybrid model was blocked in a last-minute intervention by the American Psychiatric Association Board of Trustees. Explanations for these events are discussed, including the existence of invisible colleges of researchers and the fear of risking a ‘scientific revolution’ in psychiatry.

Results:

A failure to recognise extra-scientific factors at work in classification of mental illness can have a profound and long-lasting influence on psychiatric nosology. In the end it was not scientific factors that led to the failure of the hybrid model of personality disorders, but opposing forces within the mental health community in general and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Task Force in particular.

Conclusion:

Substantial evidence has accrued over the past decades in support of a dimensional model of personality disorders. The events surrounding the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Personality and Personality Disorders Work Group show the difficulties in reconciling two different worldviews with a hybrid model. They also indicate the future of a psychiatric nosology that will be increasingly concerned with dimensional classification of mental illness. As such, the road is paved for more substantial changes to personality disorder classification in the International Classification of Diseases, 11th Revision, in 2017.
Judgments on (in)justice in a mature neoliberal regime: Results of an empirical game-based research
Authors: Mac-Clure Oscar , Barozet Emmanuelle
Published: July 2015

Sharp social inequalities in Latin America persist not only as a result of structural elements, but also because people justify and legitimate them in everyday life. Thus, to overcome inequalities it is necessary that individuals subjectively perceive them as unjust. This is an issue that is especially relevant in Chile, one of the first countries to experience neoliberalism in the 1970s. More than social inequalities as such, which are widely studied by Latin American sociology, this article analyzes social justice as a subjective judgment about inequalities. On the basis of the findings of an empirical game-based research project, the article examines the justice criteria used by ordinary people regarding differences between members of society. The authors argue that according to these subjective criteria, social justice refers to aspects that differ from neoliberal discourse about distributive justice based on equality of opportunity and that procedural justice is also key in ordinary discourses about social justice.
Gender equality, community divisions, and autonomy: The Prospera conditional cash transfer program in Chiapas, Mexico
Authors: Gil-García Óscar F
Published: July 2015

This article examines the gender equality component of Prospera, a conditional cash transfer program in Mexico that provides cash contingent on three nodes of civic engagement: health, nutrition, and education. This article draws on ethnographic research in La Gloria, a settlement of indigenous Mayan refugees from Guatemala in the Mexican state of Chiapas. The article identifies the Prospera program’s neoliberal features, the impact its gender equality measures have in the lives of women, their families, and in the political structure of the community of La Gloria. The findings reveal how Prospera reinforces gender and racial hierarchy, and fosters community divisions that undercut efforts to promote community autonomy, which raises questions about the ability of conditional cash transfers to promote development and gender equality in indigenous communities in Mexico.
Robust Coefficients Alpha and Omega and Confidence Intervals With Outlying Observations and Missing Data
Authors: Zhang Zhiyong , Yuan Ke-Hai
Published: July 2015

Cronbach’s coefficient alpha is a widely used reliability measure in social, behavioral, and education sciences. It is reported in nearly every study that involves measuring a construct through multiple items. With non-tau-equivalent items, McDonald’s omega has been used as a popular alternative to alpha in the literature. Traditional estimation methods for alpha and omega often implicitly assume that data are complete and normally distributed. This study proposes robust procedures to estimate both alpha and omega as well as corresponding standard errors and confidence intervals from samples that may contain potential outlying observations and missing values. The influence of outlying observations and missing data on the estimates of alpha and omega is investigated through two simulation studies. Results show that the newly developed robust method yields substantially improved alpha and omega estimates as well as better coverage rates of confidence intervals than the conventional nonrobust method. An R package coefficientalpha is developed and demonstrated to obtain robust estimates of alpha and omega.
Improving the Factor Structure of Psychological Scales
Authors: Zhang Xijuan , Savalei Victoria
Published: July 2015

Many psychological scales written in the Likert format include reverse worded (RW) items in order to control acquiescence bias. However, studies have shown that RW items often contaminate the factor structure of the scale by creating one or more method factors. The present study examines an alternative scale format, called the Expanded format, which replaces each response option in the Likert scale with a full sentence. We hypothesized that this format would result in a cleaner factor structure as compared with the Likert format. We tested this hypothesis on three popular psychological scales: the Rosenberg Self-Esteem scale, the Conscientiousness subscale of the Big Five Inventory, and the Beck Depression Inventory II. Scales in both formats showed comparable reliabilities. However, scales in the Expanded format had better (i.e., lower and more theoretically defensible) dimensionalities than scales in the Likert format, as assessed by both exploratory factor analyses and confirmatory factor analyses. We encourage further study and wider use of the Expanded format, particularly when a scale’s dimensionality is of theoretical interest.
Effect of atmospheric pressure plasma treatment for repair of polymer matrix composite for aerospace applications
Authors: Kumar Sarath , Abhishek G , Ullattil Akhil , Elangundran TVA , Bhowmik Shantanu , Devadathan Saji , Kim Chun-Gon , Baluch Abrar
Published: July 2015

This paper investigates the repair of polymer matrix composites and validates the repair by static testing. Scarf repair is carried out on the laminates and cured under vacuum. It is observed that 80% of tensile strength is recovered due to this process. Therefore, this investigation highlights the significance of atmospheric pressure plasma treatment on repair of graphite epoxy laminate. It is observed that the surface energy of graphite epoxy laminate has improved significantly due to atmospheric pressure plasma treatment. Atmospheric pressure plasma treatment results in noteworthy increase in oxygen functionalities as detected by X-ray photoelectron spectroscopy, as well as surface roughness as detected by atomic force microscopy. The improvement in adhesion properties is correlated with lap shear strength of adhesive bonded joints and mode of failure has been analyzed by scanning electron microscopy. The plasma-treated laminates, when used for repair, provided an additional 12% in the tensile strength and thereby retaining a strength increase up to 92%.
Microstructural characterization and wear properties of in situ AlB2–reinforced Al–4Cu metal matrix composite
Authors: Ficici Ferit , Koksal Sakip
Published: July 2015

Aluminium matrix composites have been extensively studied for several decades due to the potential advantages over classical low-density materials. Low-density composites can offer high wear and corrosion resistance, high strength, and favorable thermal electrical properties that attract the attention of various industries such as aerospace and automotive. This study investigates the dry sliding wear behavior of AlB2–Al–4Cu composites with 5, 10, 20, and 30% weight reinforcement. In situ developed AlB2 flakes were incorporated as the reinforcing compound in the Al–4Cu matrix. The composite samples were tested against a steel disk using a pin-on-disk wear rig. The effect of reinforcement ratio, applied load, sliding velocity on the wear rate and friction coefficient of the composite samples was investigated. In addition, the worn surfaces have been characterized in terms of wear patterns. Compared to the matrix alloy, composite samples exhibited better wear resistance and lower friction coefficient to varying degrees of magnitudes.
Scale-dependent failure of stereolithographic polymer microtrusses in three-point bending
Authors: Lausic AT , Bird AG , Steeves CA , Hibbard GD
Published: July 2015

Microtrusses fabricated by a combination of stereolithography and nanocrystalline electrodeposition are composites at both a global architectural scale and at an individual strut scale. This fabrication route is especially attractive in producing high performance lightweight materials because the key stages of forming optimally efficient templates and depositing ultra high strength material are fully decoupled. Using novel 3-D printing techniques, this study analyzes microtrusses built bottom-up from photopolymerizable polymer where the complex structure can be constructed of unit cells a few millimeters in length. While the predicted failure mechanisms matched the experimental observations, deterministic energetic size effects were needed to account for the critical loads. For strut radii <5 × the 3-D printer layer thickness, stochastic size effects became important.
Fabrication of functionally graded composites using a homogenised low-frequency electromagnetic field
Authors: Golak Slawomir , Dolata Anna J
Published: July 2015

A characteristic feature of functionally graded materials is the continuous spatial change of their mechanical, thermal or electrical properties. Deliberate controlling of the spatial distribution of reinforcement in the metal matrix composite is one way of these materials. The article describes the theoretical basis and experimental verification of a new method using a homogenised low-frequency electromagnetic field to produce particle-reinforced metal matrix composites with a controlled distribution of reinforcement. The method developed allows for obtaining local reinforcement of the composite casting, analogous to radial centrifugal casting. The article describes the methodology for designing a casting system, which allows such control of the electromagnetic field distribution in the liquid casting, which makes it possible to obtain the desired reinforcement distribution. Experimental verification of the method developed was carried out using the example of a sleeve made of AlSi12CuMg alloy reinforced with SiC particles at the outer wall.
Evaluation of the effective mechanical properties of shape memory wires/epoxy composites using representative volume element
Authors: Khalili S Mohammad Reza , Saeedi Ali , Fakhimi Emad
Published: July 2015

The mechanical properties of shape memory alloy/epoxy composites are evaluated using cylindrical representative volume element for long and short shape memory alloy wires considering the effect of interface between shape memory alloy wires and epoxy resin. The cohesive zone model is used to simulate the interface region between the shape memory alloy wire and the resin. An experimental pullout test is performed on the cylindrical specimens of resin containing single-shape memory alloy wire in order to achieve cohesive zone parameters. The finite element method is utilized to characterize the elastic properties of shape memory alloy/epoxy composites including axial modulus, transverse modulus, and Poisson’s ratio. The effect of length ratio between the shape memory alloy wire and the representative volume element on the mechanical properties of composite is investigated. Moreover, the critical aspect ratio for short shape memory alloy wires is calculated using shear-lag model.
Viscoelastic behavior and model simulations of poly(butylene adipate-co-terephthalate) biocomposites with carbon nanotubes: Hierarchical structures and relaxation
Authors: Ding Kunshan , Wei Nengxin , Zhou Yanan , Wang Yi , Wu Defeng , Liu Haiyun , Yu Hai , Zhou Chao , Chen Jianxiang , Chen Chong
Published: July 2015

Poly(butylene adipate- co-terephthalate) (PBAT) biocomposites containing carbon nanotubes (CNTs) were prepared by melt compounding. The linear viscoelasticity of composites, including creep, creep recovery and stress relaxation in the solid state, and dynamic shear flow in the molten state, were studied and then further described by the viscoelastic models, aiming at exploring relaxation of hierarchical structures of CNTs and obtaining structural parameters of CNTs in PBAT matrix. The results reveal that CNTs are dispersed mainly as flocs or small aggregates in PBAT, which is further confirmed by the structural parameters of CNTs obtained through model simulations on the dynamic rheological responses of composites. The presence of CNTs retards overall kinetics of creep and stress relaxation of PBAT. This is attributed to highly restrained viscoelastic and viscoplastic deformation of PBAT chain coils, rather than slightly confined elastic deformation of chain segments because the chain coils is in the same size-scale with the CNT flocs.
Influence of two different molecular weight epoxy resins on the glass transition of composites manufactured with expanded graphite
Authors: Pistor V , Soares BG , Mauler RS
Published: July 2015

Developing composites of epoxy resins containing graphite is important for technological and scientific research. The applications of these systems in electronic devices have been seen as a promising research field. To contribute to this field, we evaluated the influence of exfoliated graphite dispersed in two resins with different molecular weights ( Mw). The glass transition was estimated by dynamic-mechanic analysis (DMA) and the modulated differential scanning calorimetry (MDSC). We calculated the parameters of the phantom model, Williams–Landel–Ferry (WLF) and Vogel–Fulcher–Tumman (VFT) equations, and the parameters correlated with the Angell fragility. The results demonstrated a strong influence of the Mw on the glass transition and its crosslinking density. A more homogeneous system with lower fluctuations of potential energy was achieved with higher Mw resin suggesting advantageous for the structural stability of crosslinking.
Analysis of symmetric and asymmetric glass fiber reinforced plastic laminates subjected to low-velocity impact
Authors: Singh Kalyan Kumar , Singh Nand Kishore , Jha Ratneshwar
Published: July 2015

Low-velocity impact induced damage in symmetric and asymmetric laminates is analyzed. A generalized lay-up sequence is proposed for asymmetric laminate. Asymmetric laminate fabricated according to the proposed lay-up sequence have its stiffness characteristic almost identical to those of a symmetric laminates. Proposed lay-up sequence provides a laminate which have zero bending-extension coupling and behaves as quasi-isotropic laminate. A cylindrical impactor with hemispherical nose having mass 5.23 kg is impacted with a velocity of 3 ms−1, 4 ms−1, and 6 ms−1. Damage pattern and energy–time relation of proposed asymmetric laminate are compared with symmetric laminate having similar stiffness matrices. Energy absorbed by proposed quasi-isotropic asymmetric and symmetric laminate is also compared with laminate of different stacking sequence proposed by various researchers. Numerical analysis is done by commercially available software LS-DYNA.
Social Class, Workplace Experience, and Child-Rearing Values of Mothers and Fathers in Southern Brazil
Authors: Martins Gabriela Dal Forno , Gonçalves Tonantzin Ribeiro , Marin Angela Helena , Piccinini Cesar Augusto , Sperb Tânia Mara , Tudge Jonathan
Published: July 2015

We investigated associations among social class, parents’ work experiences, and their child-rearing values in a sample of mothers and fathers drawn from southern Brazil, testing Kohn’s hypothesis that parents who experience greater decision-making autonomy at work and who perceive their jobs to be more complex will be more likely to value self-direction and less likely to value conformity in their children. We also tested the hypothesis that the relation between social class and values would be mediated by workplace experiences. Participants included 68 parents (38 mothers, 30 fathers; 46 working class, 22 middle class) of 36-month-old children who were part of a longitudinal study. Correlation analyses revealed few associations among social class, workplace experiences, and child-rearing values among the mothers, but among the fathers these variables associated in the expected direction. The results also indicated that workplace experience mediates the relation between social class and values, although only for fathers. Our findings supported Kohn’s hypothesis regarding differences between social-class groups and highlighted that the relation between work experience and parental values varied by parents’ gender. Social and cultural issues regarding work context and parental values between women and men in southern Brazil are discussed.
Fatal air embolism during endoscopic retrograde cholangiopancreatography (ERCP): An ‘impossible’ diagnosis for the forensic pathologist
Authors: Marchesi Matteo , Battistini Alessio , Pellegrinelli Moira , Gentile Guendalina , Zoja Riccardo
Published: July 2015

Fatal air embolism related to endoscopic retrograde cholangiopancreatography is a very rare phenomenon. The authors describe the case of a 51-year-old female patient who developed this mortal complication; a computed tomography (CT) examination was performed in articulo mortis by the physicians. Autopsy was unreliable because of bizarre post-mortem changes (reabsorption of intra-cardiac gas vs. conservation of intra-cranial gas) and a lack of strong diagnostic value of histological findings. The right diagnosis was possible thanks only to the CT examination that permitted the assumption of this possible cause of death before the autopsy and to prepare the necessary procedures to recognise and probe air embolism. This case exemplifies how early post-mortem imaging can be crucial to avoid a wrong diagnosis.
Estimation of height from the length of the sternum in an adult Indian population
Authors: Tumram Nilesh Keshav , Parchake Soniya Bhaurao , Bardale Rajesh Vaijnathrao , Dixit Pradeep Gangadhar
Published: July 2015

Stature estimation is one of the essential early steps during forensic investigation of human skeletal remains. The aim of the present study was to obtain a linear regression formula for estimating stature from sternal length of a central Indian population. The study includes 92 male cadavers brought for medico-legal autopsies. The linear regression equations were derived from manubrium, mesosternum and the total sternal length. The regression model provided a 95% confidence interval of ±14.8 cm and a correlation coefficient of 0.55. Compared with other studies, regression formulae based on the length of the sternum provided considerably larger standard errors than that based on long bone lengths. The study indicates that sternal length in relation with body stature shows a moderate positive correlation and relatively low reliability in estimating stature, and has limited forensic value.
Is estimated intra-operative blood loss a reliable predictor of surgical outcomes in laparoscopic colorectal cancer surgery?
Authors: Saleh A , Ihedioha U , Babu B , Evans J , Kang P
Published: July 2015

Background

Studies have shown that laparoscopic surgery for colorectal cancer is often associated with significantly reduced intra-operative blood loss compared to the corresponding open procedures. Increased intra-operative blood loss can be associated with increased risk of post-operative morbidity and mortality. We sought to determine whether estimated intra-operative blood loss was a reliable predictor of post-operative surgical outcomes.

Method

Prospective data were collected for patients undergoing elective laparoscopic colorectal cancer resections from July 2011 to November 2013. Weighing swabs and measuring blood volume in suction devices calculated the estimated intra-operative blood loss. The operative outcome data including post-operative 30 day morbidity and mortality, length of hospital stay, re-admission and re-operation within 30 days were collected. The operative blood loss was grouped into Group 1 (less than 50 ml, Group 2 (50–150 ml) and Group 3 (over 150 ml). Patients who underwent open operations and laparoscopic conversions were excluded.

Results

The median age, length of hospital stay, male to female ratio and body mass index were similar in the three groups. There was no 30-day mortality in any of the groups. The number of re-admissions within 30 days was similar in all groups. The re-operation rates within 30 days were higher in Groups 2 and 3 at 11% and 8.6%, respectively. The post-operative complications were 12.5%, 16.7%, and 26% in groups 1, 2 and 3, respectively. There were no anastomotic leaks requiring re-operation noted in Group 3.

Discussion

This study has shown that intra-operative blood loss was not associated with increased median length of stay nor did it increase the 30 day re-admission rate. However, increased intra-operative blood loss was associated with increased incidence of post-operative morbidity and risk of reoperation within 30 days.
A before and after study of warfarin monitoring in a single region as part of the Scottish patient safety programme in primary care
Authors: McNab Duncan , McKay John , Bowie Paul
Published: July 2015

Introduction

Warfarin is an effective drug for patients at risk of thromboembolic events, but sub-optimal pharmacological management may cause significant harm. As part of the Scottish patient safety programme in primary care, one health board region aimed to determine if the international normalised ratio control for patients taking warfarin in general practice improved over the first 12 months of participation.

Methods

A before and after study of a multi-intervention improvement strategy was employed that combined financial incentivisation, a regional learning collaborative, clinical care bundle implementation, audit and feedback and clinical ‘safety champions’. The main patient outcome measures were: mean time in therapeutic range; proportion with good control (time in therapeutic range >60%) and excellent control (time in therapeutic range > 75%); and the proportion of very abnormal results (international normalised ratio < 1.5 or >5). Chi-square tests were used to determine statistical differences.

Results

In total, 49 of 55 general practices participated (89%) with 33/55 providing usable data (60%) on 1480 patients (before) and 1946 patients (after), respectively. Improvements were observed in mean time in therapeutic range ( P < 0.05) as well as in the proportion of patients with good control (time in therapeutic range > 60%, P < 0.01) and excellent control (time in therapeutic range > 75%, P = 0.06). A reduction in the proportion of very abnormal results (international normalised ratio < 1.5 or >5) was also observed ( P < 0.01), while the mean number of patient attendances reduced ( P < 0.05).

Conclusions

The introduction of a complex safety improvement intervention via a national patient safety programme has resulted in modest improvements in the control of warfarin monitoring in a single region. These improvements may potentially reduce the incidence of serious adverse events. The study method, interventions and findings should be of interest to primary care settings with similar warfarin management arrangements internationally.
A survey of morbidity and mortality review meetings in the general surgical units of the West of Scotland
Authors: Khine Myo , Leung Edward , McGregor John R
Published: July 2015

Background and aims

There is little consensus as to the conduct of surgical morbidity and mortality review meetings. The aim of this survey was to determine how surgical morbidity and mortality meetings in the surgical units in the West of Scotland are carried out and to explore possible areas for improvement.

Methods and results

Forty six surgical trainees distributed between the 15 general surgery units of the West of Scotland were asked to provide details of their surgical morbidity and mortality meetings for the training year 2012–2013. Twenty-five of 46 (54%) specialty trainees responded with all units being represented. All had designated time for surgical morbidity and mortality review. Meeting frequency varied as follows: weekly (3 units), fortnightly (1 unit), monthly (10 units), three monthly (1 unit). Fewer than half the units (6) included Foundation Trainees, and only one meeting was attended by nursing staff. Five units had clear criteria for morbidity, but only three included morbidity collected from outpatient follow-up. A standardised proforma was used to present the cases in only 2 units.

Conclusions

All 15 surgical units in the West of Scotland have a regular surgical morbidity and mortality meeting but significant variations were observed as to frequency and participating personnel. A more robust system for reporting morbidities should be considered.
Urgent History
Authors: Morefield Jeanne
Published: July 2015

This article argues for the recovery and re-incorporation of lost voices and debates into the history of political thought by focusing on the issue of sovereignty. It begins by examining why such a narrow understanding of the canon has come to dominate the sub-discipline and argues for critical approaches that treat the past as a “contested terrain” rather than an unfolding plot. It then turns to early twentieth-century Britain as an example of an era when thinkers who have been largely forgotten by today’s political theorists argued loudly about the future of state sovereignty. It next focuses on a 1916 exchange of essays entitled “The Nature of the State in View of Its External Relations” by Delisle Burns, Bertrand Russell, and G.D.H. Cole, as an example of some of the most innovative and radical ideas to emerge from the period. The article concludes by arguing that re-engaging the work of these forgotten thinkers can broaden our conceptual horizons about sovereignty, speak to some of the most urgent issues of our time, and force open the concept of “the political” to radical reinterpretation.
The Critique of Possessive Individualism
Authors: Kohn Margaret
Published: July 2015

This essay investigates a strand of left-republicanism that emerged in France in the late nineteenth and early twentieth centuries. The solidarists developed a distinctive theory of social property and a thorough critique of the liberal, republican, and socialist alternatives. Solidarism rests on the claim that the modern division of labor creates a social product that does not naturally belong to the individuals who control it as their private property; property, therefore, should be conceived as “common wealth,” divided into individual and public shares. When the wealthy appropriate a disproportionate share, they have a quasi-contractual debt to society that they are obliged to repay. The concepts of social debt, common-wealth, reparations, and rent (“unearned increment”) played an important role in legitimizing egalitarian policies, but they have been largely forgotten today. This article resuscitates the theoretical arguments introduced by the solidarists and explains their relevance for contemporary debates about alternative economic arrangements.
Understanding China’s Relations with the Latin American and Caribbean Countries
Authors: Harris Richard L.
Published: July 2015

Since the formation of the People’s Republic of China (PRC) in 1949, its political leaders have been concerned with securing the country’s sovereignty, national unification, and territorial integrity as well as creating an international environment favorable to its peaceful development as a socialist society and to the development of a new multipolar world order based on peace and international cooperation rather than hegemony, extreme inequality, and war. In pursuit of these strategic goals, the PRC’s political leaders seek to foster long-term economic and political cooperation with the Latin American and Caribbean countries.

Desde la formación de la República Popular China (RPC) en 1949, sus líderes políticos se han ocupado de asegurar la soberanía, unificación nacional, e integridad territorial del país, como también de crear un ambiente internacional favorable a su desarrollo pacífico como sociedad socialista y al desarrollo de un nuevo orden multipolar basado en la paz y la cooperación internacional en vez de la hegemonía, desigualdad extrema, y guerra. En la prosecución de estos objetivos estratégicos, los dirigentes políticos de la RPC buscan fomentar la cooperación económica y política de largo plazo con los países de América Latina y el Caribe.
An integrated framework for elevator traffic design under general traffic conditions using origin destination matrices, virtual interval, and the Monte Carlo simulation method
Authors: Al-Sharif Lutfi , Abu Alqumsan Ahmad M
Published: July 2015

The conventional design methodology for elevator traffic analysis has been applied to the case of up-peak traffic (or incoming traffic conditions). The only user requirements are usually the expected arrival rate ( AR%) expressed as a percentage of the building population requesting service in the peak 5 min and the target interval. The interval as classically used will be referred to as the physical interval in this paper as it is only relevant for the case of a single entrance and incoming traffic conditions. This paper presents an integrated methodology for the design of elevator traffic systems for the general case of mixed traffic conditions. It presents a fully integrated framework that covers the steps from user requirements to the selection of the number of required elevators. The user requirements describing the traffic conditions can be specified by the user, expressed as the AR%, the mix of incoming traffic, outgoing traffic, and interfloor traffic. This paper derives equations that can be used to combine the mix of traffic, the floor arrival percentages, and the floor population percentages into an origin–destination matrix. The origin–destination matrix is then adjusted and normalized in order to account for rational passenger behavior (i.e., a passenger will not travel to the same floor that he or she is at). A method is presented for the random generation of passenger origin–destination pairs using the origin–destination matrix (which is necessary when using the Monte Carlo Simulation ( MCS) method to calculate the round trip time). A novel equation for evaluating the round trip time under the assumption of equal floor heights and top speed attained in one floor journey is derived and used. The equation is derived using a stepwise derivation and verification process. The verification is carried out against the MCS method for finding the value of the round trip time. The concept of a virtual interval (as opposed to the conventionally used physical interval usually used in elevator traffic system design) is introduced in order to allow the selection of the number of elevators to be carried out. The virtual interval is the average value of the time between the consecutive reversals of the elevators in the group.

Practical application The methodology presented in this paper allows the elevator traffic system designer to convert the user requirements specification (in the form of an arrival rate and the percentage floor strengths) into an origin–destination matrix. The origin–destination matrix is a more suitable tool for calculating the expected value of the round trip time and consequently carrying out an elevator traffic design. Thus, this methodology represents a vital step in the design process.
Post-occupancy evaluation of sunshades and balconies’ effects on luminous comfort through a questionnaire survey
Authors: Xue Peng , Mak Cheuk Ming , Cheung Hiu Dan , Chao Jiangyue
Published: July 2015

To protect and improve the built environment, the Hong Kong government recommends sunshades and balconies as two daylighting green features to be incorporated into new buildings. A questionnaire survey was conducted to investigate the effects of these green features on subjective luminous comfort in housing units. The results showed that some practical functions decided the preferences of residents for tilted or horizontal sunshades and balconies with glass walls and parapets. Both features had direct effects on reducing glare and overheating problems, but at the same time, they decreased daylight uniformity. Further, balconies provided poor privacy, which forced residents to use internal shading and artificial lighting more often. Based on the analysis, green features affected residents’ luminous comfort indirectly by unconsciously affecting their feelings and behavior.

Practical application: These results may help the government to understand the status quo and establish appropriate guidelines and help researchers and architects improve green features that provide residents with better luminous environments. The data can be used for further studies that adopt the climate-based simulation to present the real luminous condition of the units whose residents were involved in this survey. The luminous comfort could then be quantified by some cumulative metrics, and those metrics can be treated as the standard for the energy-efficient building design.
Analysis on combinations of indoor thermal microclimate parameters in radiant cooled residential buildings and drawing of new thermal comfort charts
Authors: Sui Xuemin , Zhang Xu
Published: July 2015

This paper proposed to discuss some issues about indoor microclimate parameters design in radiant cooled residential buildings. Based on the thermal comfort model, the relationships between low mean radiant temperature and other thermal microclimate parameters such as indoor air temperature, air velocity, and relative humidity were analyzed. The improved and reasonable combinations of four thermal microclimate parameters including radiant cooling surface temperature, air temperature, air velocity, and relative humidity were further derived. Furthermore, a number of new thermal comfort charts using radiant cooling surface temperature and air temperature as dominant parameters were drawn. The results show that the air temperature can be increased 1–3℃ within the recommended thermal comfort range when the mean radiant temperature is reduced 3℃. Under the design goal of thermal neutral, when the chilled ceiling surface temperature is in the range of 16–26℃, the air temperature should be set at 25.3–29.3℃; when the chilled floor surface temperature is in the range of 19–26℃, the air temperature should be set at 25.8–29.2℃. The design values of air velocity and relative humidity are not recommended to be changed, and still can follow the design standards for conventional all-air systems.

Practical application : In this paper, some issues about indoor microclimate parameters design in radiant cooled buildings were discussed. A number of new thermal comfort charts using radiant cooling surface temperature and air temperature as dominant parameters were provided, and the design values of indoor air temperature, mean radiant temperature, air velocity, and relative humidity for radiant cooling system in residential buildings were also suggested. The research results can provide a more intuitive reference for the design of radiant cooling systems in residential buildings.
Medical Nutrition Therapy for Patients With Advanced Systemic Sclerosis (MNT PASS): A Pilot Intervention Study
Authors: Doerfler Bethany , Allen Tara S. , Southwood Courtney , Brenner Darren , Hirano Ikuo , Sheean Patricia
Published: July 2015

Background:The objective of this study was to demonstrate the feasibility and associations with short‐term outcomes of a medical nutrition therapy (MNT) intervention in patients with systemic scleroderma (SSc).Materials and Methods:Eighteen patients with SSc, gastrointestinal (GI) involvement, and unintentional weight loss were consented and recruited for a 6‐week MNT intervention, in addition to their usual medical management. MNT emphasized increased calorie and protein intake, modified textures, and lifestyle modifications. Symptoms, anthropometrics, diet (24‐hour recall), and body composition (dual‐energy x‐ray absorptiometry) were assessed pre‐ and postintervention. Sarcopenia was defined as appendicular lean height (ALH) for women <5.45 kg/m2and for men <7.26 kg/m2. Descriptive, parametric, and nonparametric statistics were conducted.Results:Participants (n = 18) were predominantly white (78%), female (89%), malnourished (83%), and 51.3 ± 11.0 years of age with a body mass index of 22.6 ± 6.7 kg/m2. Significant decreases in nutrition symptom scores (12.8 vs 7.6,P< .05) and improvements in ALH (5.6 ± 0.8 vs 5.8 ± 0.8 kg/m2, respectively;P= .05) occurred pre‐ vs postintervention, respectively (n = 14). Sarcopenia was observed in 54% of participants at baseline and 39% at follow‐up (P= .02). Caloric intake (1400 vs 1577 kcal/d,P= .12) and macronutrient distribution (ie, % fat, protein, carbohydrate) did not change significantly pre‐ vs postintervention, respectively.Conclusions:Individually tailored MNT can improve symptom burden and potentially ALH in patients with SSc involving the GI tract. This study underscores the clinical potential of multidisciplinary patient management and the need for larger nutrition intervention trials of longer duration in these patients.