bluuebunny/crossref_metadata_2025 huggingface dataset:
Body weight gain and risk of colorectal cancer: a systematic review and meta‐analysis of observational studies
Authors: Schlesinger S. , Lieb W. , Koch M. , Fedirko V. , Dahm C. C. , Pischon T. , Nöthlings U. , Boeing H. , Aleksandrova K.
Published: April 2015

While the relationship between body mass index as an indicator of excess body weight and the risk of colorectal cancer (CRC) is well established, the association between body weight gain in adulthood and risk of CRC remains unresolved. We quantified this association in a meta‐analysis of 12 observational studies published until November 2014 with a total of 16,151 incident CRC cases. Random effect models were used to obtain summary relative risks (RR) and 95% confidence intervals (95% CIs). Between‐study heterogeneity was assessed using I2 statistics. Overall, the summary RR (95% CI) was 1.22 (1.14–1.30) for high body weight gain (midpoint: 15.2 kg) compared with stable weight (P for heterogeneity = 0.182; I2 = 21.2%). In a dose‐response analysis, each 5 kg weight gain was associated with a 4% (95% CI: 2%–5%) higher risk of CRC. The association persisted after adjustment for body weight at younger age and was present for both men and women, as well as for colon and rectal cancer. Differences by sex were detected for colon cancer (P for interaction = 0.003, with higher risk for men than women), but not for rectal cancer (P for interaction = 0.613). In conclusion, these data underscore the importance of body weight management from early adulthood onwards for the prevention of CRC development.
Histamine reduces boron neutron capture therapy‐induced mucositis in an oral precancer model
Authors: Monti Hughes A , Pozzi ECC , Thorp SI , Curotto P , Medina VA , Martinel Lamas DJ , Rivera ES , Garabalino MA , Farías RO , Gonzalez SJ , Heber EM , Itoiz ME , Aromando RF , Nigg DW , Trivillin VA , Schwint AE
Published: April 2015

Objectives

Searching for more effective and selective therapies for head and neck cancer, we demonstrated the therapeutic effect of boron neutron capture therapy (BNCT) to treat oral cancer and inhibit long‐term tumor development from field‐cancerized tissue in the hamster cheek pouch model. However, BNCT‐induced mucositis in field‐cancerized tissue was dose limiting. In a clinical scenario, oral mucositis affects patients’ treatment and quality of life. Our aim was to evaluate different radioprotectors, seeking to reduce the incidence of BNCT‐induced severe mucositis in field‐cancerized tissue.

Materials and Methods

Cancerized pouches treated with BNCT mediated by boronophenylalanine at 5 Gy were treated as follows: control: saline solution; Hishigh: histamine 5 mg kg−1; Hislow: histamine 1 mg kg−1; and JNJ7777120: 10 mg kg−1.

Results

Hislow reduced the incidence of severe mucositis in field‐cancerized tissue to 17% vs CONTROL: 55%; Hishigh: 67%; JNJ7777120: 57%. Hislow was non‐toxic and did not compromise the long‐term therapeutic effect of BNCT or alter gross boron concentration. Conclusion: Histamine reduces BNCT‐induced mucositis in experimental oral precancer without jeopardizing therapeutic efficacy. The fact that both histamine and boronophenylalanine are approved for use in humans bridges the gap between experimental work and potential clinical application to reduce BNCT‐induced radiotoxicity in patients with head and neck cancer.
Poplar trees for phytoremediation of high levels of nitrate and applications in bioenergy
Authors: Castro‐Rodríguez Vanessa , García‐Gutiérrez Angel , Canales Javier , Cañas Rafael A. , Kirby Edward G. , Avila Concepción , Cánovas Francisco M.
Published: April 2015

The utilization of high amounts of nitrate fertilizers for crop yield leads to nitrate pollution of ground and surface waters. In this study, we report the assimilation and utilization of nitrate luxuriant levels, 20 times more than the highest N fertilizer application in Europe, by transgenic poplars overexpressing a cytosolic glutamine synthetase (GS1). In comparison with the wild‐type controls, transgenic plants grown under high N levels exhibited increased biomass (171.6%) and accumulated higher levels of proteins, chlorophylls and total sugars such as glucose, fructose and sucrose. These plants also exhibited greater nitrogen‐use efficiency particularly in young leaves, suggesting that they are able to translocate most of the resources to the above‐ground part of the plant to produce biomass. The transgenic poplar transcriptome was greatly affected in response to N availability with 1237 genes differentially regulated in high N, while only 632 genes were differentially expressed in untransformed plants. Many of these genes are essential in the adaptation and response against N excess and include those involved in photosynthesis, cell wall formation and phenylpropanoid biosynthesis. Cellulose production in the transgenic plants was fivefold higher than in control plants, indicating that transgenic poplars represent a potential feedstock for applications in bioenergy. In conclusion, our results show that GS transgenic poplars can be used not only for improving growth and biomass production but also as an important resource for potential phytoremediation of nitrate pollution.
Susceptibility‐weighted imaging in acute‐stage pediatric convulsive disorders
Authors: Iwasaki Hiroki , Fujita Yukihiko , Hara Mitsuhiko
Published: April 2015

Background

The aim of this preliminary study was to investigate the clinical use of acute‐stage susceptibility‐weighted imaging (SWI) in children with prolonged convulsive disorder.

Methods

Ten children with prolonged convulsive disorder who underwent SWI within 2 h after termination of seizure (acute‐stage SWI group) and 15 control children who underwent SWI > 2 h after their seizures terminated or for other purposes were enrolled. The cerebral venous vasculature was compared between the groups. The acute‐stage SWI group was further divided into three subgroups: normal group, those with regional low signals in the cerebral veins (regional group) and those with diffuse low signals in the cerebral veins (generalized group). Inter‐ictal electroencephalography (EEG) and venous blood gas findings during seizure activity were compared between these subgroups.

Results

All patients in the acute‐stage SWI group had low cerebral vein signal. Four patients were assigned to the regional group and six patients to the generalized group. Decrease of venous pH and the increase of venous pCO2 during seizure activity was more prominent in the regional group than in the generalized group. In the regional group, low‐signal areas in the cerebral veins were consistent with abnormal areas on EEG; these low‐signal areas resolved completely in all patients on follow‐up SWI. Ten patients in the control group had normal SWI, and five had a generalized low signal.

Conclusions

Acute‐stage SWI may be a useful alternative for identifying lateralization of seizures in children with prolonged convulsive disorder.
A Spatiodynamic Model for Assessing Frost Risk in South-Eastern Australia
Authors: Bakar K. Shuvo , Kokic Philip , Jin Huidong
Published: April 2015

Previous climate research concluded that causal influences which have contributed to changes in frost risk in south-eastern Australia include greenhouse gas concentration, El-Niño southern oscillation and other effects. Some of the climatic indices representing these effects have spatiotemporal misalignment and may have a spatially and temporally varying effect on observed data. Other indices are constructed from grid-referenced physical models, which creates a point-to-area problem. To address these issues we use a spatiodynamic model, which comprises a blending of spatially varying and temporally dynamic parameters. For the data that we examine the model proposed performs well in out-of-sample validation compared with a spatiotemporal model.
The adaptation of aDanish version of thePainSelf‐EfficacyQuestionnaire: reliability and construct validity in a population of patients with fibromyalgia inDenmark
Authors: Rasmussen Marianne U. , Rydahl‐Hansen Susan , Amris Kirstine , Danneskiold Samsøe Bente , Mortensen Erik L.
Published: April 2015

The aim of this study was to translate, culturally adapt and evaluate the psychometric properties of thePainSelf‐EfficacyQuestionnaire (PSEQ) in a population of patients with fibromyalgia inDenmark. The study sample included 102 patients diagnosed with fibromyalgia referred to a specialist clinic. ThePSEQwas translated and adapted to a Danish setting using a standard stepw‐ise forward–backward translation procedure, followed by initial testing and focus group interview. Reliability was examined by analysing internal consistency and test–retest agreement. Construct validity was exami‐ned by investigating dimensionality, targeting, local independence, category functioning and differential item functioning (DIF). Reliability was high: Cronbach's alpha 0.88, test–retest correlation 0.93, intraclass correlation coefficient (ICC) 0.89 and item–total correlations 0.44–0.70. Factor analyses and item response (IRT) models indicated unidimensionality, and thePSEQ‐DKwas well targeted to the sample. High interitem correlation was observed between two items, indicating local dependence, and item misfit andDIFwere observed for a few items. However, the overall fit of the scale to a single‐factor model andIRTmodels supported acceptable construct validity. ThePSEQ‐DKshowed acceptable psychometric properties and can therefore represent a reliable and valid measure for evaluating self‐efficacy in patients with fibromyalgia inDenmark.
Environmental Justice and Patterns of State Inspections*
Authors: Spina Francesca
Published: April 2015

Objective

This article analyzes state patterns of environmental inspections to determine if the government enforces environmental laws equitably.

Methods

This article examines state inspections of the Resource Conservation and Recovery Act (RCRA) nationwide from 2002 to 2011. It uses negative binomial regression models to test for disparities in levels of inspections at the county level.

Results

Results indicate evidence of race‐based disparities in levels of state inspections in counties with larger populations of African Americans. Results also suggest evidence of age‐based disparities in levels of inspections, as well as disparities in socially disorganized counties.

Conclusions

Although the Environmental Protection Agency (EPA) has addressed class‐based disparities in levels of inspections of the RCRA, the findings indicate that the EPA should examine its inspection efforts based on age and structural characteristics of communities.
Health literacy and diabetic foot ulcer healing
Authors: Margolis David J. , Hampton Michelle , Hoffstad Ole , Scot Malay D. , Thom Stephen
Published: April 2015

The adherence by patients to diabetic foot ulcer therapy is often difficult. The goal of this study was to begin to understand how a patient's health literacy affects their foot ulcer management decisions. Initially using a cross‐sectional study design, we evaluated diabetics with foot ulcers within 4 weeks of being asked to participate in a longitudinal study. We assessed health literacy using measures of general health literacy, diabetes health literacy, diabetes self‐efficacy, and diabetes numeracy. Individuals enrolled in the study had higher health literacy based on the Short Test of Functional Health Literacy in Adults [33.8 (SD 2.3) versus 27.3 (SD 9.6); p = 0.009] as compared to individuals who previously declined an invitation to enroll in the study. Furthermore, patients with lower Short Test of Functional Health Literacy in Adults scores had larger (p = 0.04) and older (p = 0.125) wounds (markers for poorer prognosis). Other measures of literacy showed similar results. In conclusion, those with diminished health literacy were less likely to enroll in an investigational study and had wounds that were less likely to heal.
An Overview of Uncertainty Concepts Related to Mechanical and Civil Engineering
Authors: Corotis Ross B.
Published: April 2015

Infrastructure decisions reflect multiple social, political, and economic aspects of society, leading to information/partial knowledge and uncertainty in many forms. Alternatives to classical probability theory may be better suited to situations involving partial information, especially when the sources and nature of the uncertainty are disparate. Methods under the umbrella of generalized information theory enhance the treatment of uncertainty by incorporating notions of belief, evidence, fuzziness, possibility, ignorance, interactivity, and linguistic information. This paper presents an overview of some of these theories and examines the use of alternate mathematical approaches in the treatment of uncertainty, with structural engineering examples.
Wetting & Wicking Effects of Superhydrophilic Nano-Structured Coatings
Authors: Girard Adam , Amaya Miguel , Wi Hyoseong
Published: April 2015

Superhydrophilic Nano-Structured Coatings (SHNC) were discovered during pool boiling experiments using nanofluids with alumina nanoparticles. During nucleate boiling, the nanoparticles are deposited on the heater surface, forming a uniform oxide coating. These coatings have been demonstrated to greatly decrease the liquid contact angle observed on the surfaces, both by increased surface roughness and increased surface energy. An illustration of this roughness, within 1 μm thickness, can be seen in the 3-D optical microscope mapping of a SHNC surface, top right. These highly wetting structures can greatly enhance macro-level mass transfer effects, such as capillary action. The series of images on the left depict the wickability enhancement achieved by SHNC coating inside a 0.92 mm internal diameter aluminum tube. In the tube coated with SHNC, a 21 μl water droplet disappeared in 183 milliseconds, resulting in an average wicking speed along the pipe of 17 cm/sec. The bare aluminum tube does not wick at all, even as it is pushed into the droplet. The bottom right sequence shows the wettability enhancement responsible for this behavior; an 8 μl water droplet is dropped onto both a SHNC-coated and a bare aluminum surface from a height of 1 cm. The droplet on the SHNC-coated surface spreads instantaneously due to the high wettability of the SHNC, while the droplet on the bare aluminum remains aggregated as a hemisphere.
Call For Photographs
Authors: Choi Chang K. , Pratt David M.
Published: April 2015

NA
Tribological changes in the articular cartilage of a human femoral head with avascular necrosis
Authors: Seo Eun-Min , Shrestha Suman K. , Duong Cong-Truyen , Sharma Ashish Ranjan , Kim Tae-Woo , Vijayachandra Ayyappan , Thompson Mark S. , Cho Myung Guk , Park Sungchan , Kim Kwanghoon , Park Seonghun , Lee Sang-Soo
Published: April 2015

The present study evaluated the tribological properties of the articular cartilage surface of the human femoral head with postcollapse stage avascular necrosis (AVN) using atomic force microscopy. The cartilage surface in the postcollapse stage AVN of the femoral head was reported to resemble those of disuse conditions, which suggests that the damage could be reversible and offers the possibilities of success of head-sparing surgeries. By comparing the tribological properties of articular cartilage in AVN with that of osteoarthritis, the authors intended to understand the cartilage degeneration mechanism and reversibility of AVN. Human femoral heads with AVN were explanted from the hip replacement surgery of four patients (60–83 years old). Nine cylindrical cartilage samples (diameter, 5 mm and height, 0.5 mm) were sectioned from the weight-bearing areas of the femoral head with AVN, and the cartilage surface was classified according to the Outerbridge Classification System (AVN0, normal; AVN1, softening and swelling; and AVN2, partial thickness defect and fissuring). Tribological properties including surface roughness and frictional coefficients and histochemistry including Safranin O and lubricin staining were compared among the three groups. The mean surface roughness Rq values of AVN cartilage increased significantly with increasing Outerbridge stages: Rq = 137 ± 26 nm in AVN0, Rq = 274 ± 49 nm in AVN1, and Rq = 452 ± 77 nm in AVN2. Significant differences in Rq were observed among different Outerbridge stages in all cases (p < 0.0001). The frictional coefficients (μ) also increased with increasing Outerbridge stages. The frictional coefficient values were μ = 0.115 ± 0.034 in AVN0, μ = 0.143 ± 0.025 in AVN1, and μ = 0.171 ± 0.039 in AVN2. Similarly to the statistical analysis of surface roughness, significant statistical differences were detected between different Outerbridge stages in all cases (p < 0.05). Both surface roughness and frictional coefficient of cartilage, which were linearly correlated, increased with increasing Outerbridge stages in postcollapse AVN. The underlying mechanism of these results can be related to proteoglycan loss within the articular cartilage that is also observed in osteoarthritis. With regard to the tribological properties, the cartilage degeneration mechanism in AVN was similar to that of osteoarthritis without reversibility.
Thermal conductivity of nitride films of Ti, Cr, and W deposited by reactive magnetron sputtering
Authors: Jagannadham Kasichainula
Published: April 2015

Nitride films of Ti, Cr, and W were deposited using reactive magnetron sputtering from metal targets in argon and nitrogen plasma. TiN films with (200) orientation were achieved on silicon (100) at the substrate temperature of 500 and 600 °C. The films were polycrystalline at lower temperature. An amorphous interface layer was observed between the TiN film and Si wafer deposited at 600 °C. TiN film deposited at 600 °C showed the nitrogen to Ti ratio to be near unity, but films deposited at lower temperature were nitrogen deficient. CrN film with (200) orientation and good stoichiometry was achieved at 600 °C on Si(111) wafer but the film deposited at 500 °C showed cubic CrN and hexagonal Cr2N phases with smaller grain size and amorphous back ground in the x-ray diffraction pattern. An amorphous interface layer was not observed in the cubic CrN film on Si(111) deposited at 600 °C. Nitride film of tungsten deposited at 600 °C on Si(100) wafer was nitrogen deficient, contained both cubic W2N and hexagonal WN phases with smaller grain size. Nitride films of tungsten deposited at 500 °C were nonstoichiometric and contained cubic W2N and unreacted W phases. There was no amorphous phase formed along the interface for the tungsten nitride film deposited at 600 °C on the Si wafer. Thermal conductivity and interface thermal conductance of all the nitride films of Ti, Cr, and W were determined by transient thermoreflectance technique. The thermal conductivity of the films as function of deposition temperature, microstructure, nitrogen stoichiometry and amorphous interaction layer at the interface was determined. Tungsten nitride film containing both cubic and hexagonal phases was found to exhibit much higher thermal conductivity and interface thermal conductance. The amorphous interface layer was found to reduce effective thermal conductivity of TiN and CrN films.
Public and Private Spaces: Sport and the Construction of Middle Class Femininity in Sydney Independent Girls’ Schools 1880-1922
Authors: Georgakis Steve
Published: April 2015

This article documents the history of sport in independent girls’ schools in Sydney, Australia, from the introduction of compulsory education in 1880 until the formation of the Girls Secondary School Sports Union in 1922 to organize interschool sporting connections. While there have been many vigorous studies that have followed the history of sport in Australian independent boys’ schools, this has not been replicated in the role of sport in Australian independent girls’ schools. The Australian independent girls’ school sector, however, accounts for a significant portion of the total student population. This article demonstrates that sport was significant in Australian independent girls’ schools and became dominant to the education of middle class girls. Modeled after the English Public Schools that had embraced the educational ideology of ‘athleticism’, Australian girls’ independent schools also reinforced the ideology that sport was a part of a well-rounded education. By the early 1920s sport was part of the independent girls’ schools extracurricular accomplishments and the sporting landscape became a ‘public space’ where middle-class femininity was constructed.
Rx’d and Shirtless: An Examination of Gender in a Crossfit Box
Authors: Knapp Bobbi A.
Published: April 2015

Scholars have examined the ways in which gender is reproduced and resisted in various physical activities and their designated spaces such as aerobics (Markula, 2003), weight training (Dworkin, 2001), and fitness training (Ginsberg, 2000). CrossFit, a relatively new entrant on the fitness scene, has seen an increase in popularity and popular media coverage in the past few years. One of the core tenets of CrossFit is the belief that it is accessible to everyone through scaling. Using a critical feminist geographical approach, the purpose of this research was to examine the ways in which gender was reproduced and resisted in one CrossFit box. This ethnographic study incorporated participant observation, semistructured, in-depth interviews, and online archival work. The themes that emerged included sense of community, pushing through physical limits, coed workouts, beat by a girl, and spatial influence. The results indicate that even though there are ways in which gender norms are reinforced in this space there were also multiple ways in which ideal femininity and hegemonic masculinity were resisted.
American medical education at a crossroads
Authors: Feldman Arthur M. , Runge Marschall S. , N. Garcia Joe G. , Rubenstein Arthur H.
Published: April 2015

New research-deficient systems of medical education could diminish the translation of biomedical advances to patients.
Childhood memory
Authors: Suzuki Masako
Published: April 2015

Epigenetic profile maturation in blood lymphocytes appears to occur during early childhood development in human females.
Following the Fate of Bacterial Cells Experiencing Sudden Chromosome Loss
Authors: Elbaz Maya , Ben-Yehuda Sigal
Published: April 2015

Chromosomal DNA is a constant source of information, essential for any given cell to respond and adapt to changing conditions. Here, we investigated the fate of exponentially growing bacterial cells experiencing a sudden and rapid loss of their entire chromosome. Utilizing
Bacillus subtilis
cells harboring an inducible copy of the endogenous toxin
yqcG
, which encodes an endonuclease, we induced the formation of a population of cells that lost their genetic information simultaneously. Surprisingly, these DNA-less cells, termed DLCs, did not lyse immediately and exhibited normal cellular morphology for a period of at least 5 h after DNA loss. This cellular integrity was manifested by their capacity to maintain an intact membrane and membrane potential and cell wall architecture similar to those of wild-type cells. Unlike growing cells that exhibit a dynamic profile of macromolecules, DLCs displayed steady protein and RNA reservoirs. Remarkably, following DLCs by time lapse microscopy revealed that they succeeded in synthesizing proteins, elongating, and dividing, apparently forming
de novo
Z rings at the midcell position. Taken together, the persistence of key cellular events in DLCs indicates that the information to carry out lengthy processes is harbored within the remaining molecular components.

IMPORTANCE
Perturbing bacterial growth by the use of antibiotics targeting replication, transcription, or translation has been a subject of study for many years; however, the consequences of a more dramatic event, in which the entire bacterial chromosome is lost, have not been described. Here, we followed the fate of bacterial cells encountering an abrupt loss of their entire genome. Surprisingly, the cells preserved an intact envelope and functioning macromolecules. Furthermore, cells lacking their genome could still elongate and divide hours after the loss of DNA. Our data suggest that the information stored in the transient reservoir of macromolecules is sufficient to carry out complex and lengthy processes even in the absence of the chromosome. Based on our study, the formation of DNA-less bacteria could serve as a novel vaccination strategy, enabling an efficient induction of the immune system without the risk of bacterial propagation within the host.
Thinking Globally, Acting Locally: Harnessing the Immune System to Deal with Recalcitrant Pathogens
Authors: Russell Michael W.
Published: April 2015

Traditional approaches to harnessing the immune system to confront infectious diseases depend on vaccines, which have generally proven highly effective, but for many infections these either are not available or are of limited effectiveness. Although antibiotic therapy has been extremely successful in reducing the burden of bacterial disease, the emergence of resistance among several important pathogens threatens to undermine this accomplishment, and despite some successes chemotherapeutic treatments for viral, fungal, and parasitic infections are more limited. Understanding the mechanisms whereby pathogens manipulate the immune system to favor their survival, or exploit weaknesses in host immunity, can lead to novel approaches for the treatment of infections by redirecting host immune responses against the pathogen. Such treatments may be most effectively applied at the mucosal locations which are frequently the sites of initial infection and may also suggest new approaches for vaccine development.
Ipsilateral supracondylar humerus fracture and Monteggia lesion with a 5-year follow-up: a rare injury in a young girl
Authors: Cobanoglu Mutlu , Şavk Şevki Oner , Cullu Emre , Duygun Fatih
Published: April 2015

Although elbow injuries and fractures of the forearm are common in children, the combination of these injuries is rare. We present a case of a 5-year-old patient with a concomitant ipsilateral supracondylar humerus fracture and Monteggia lesion. After physical and radiographic examination of the injured extremity in the emergency department, closed reduction and percutaneous pinning were performed under image intensifier under general anaesthesia. A long-arm cast was applied for postoperative immobilisation. Excellent radiological and functional outcomes were obtained at the end of 1-year follow-up and no deformity was observed at 5-year follow-up.
A suprasellar arachnoid cyst resulting from an intraventricular haemorrhage and showing complete resolution following endoscopic fenestration
Authors: Palin Martin , Anderson Ian , O'Reilly Gerard , Goodden John Robert
Published: April 2015

We present the case of a premature neonate who developed a large, acquired arachnoid cyst as a consequence of intraventricular haemorrhage. The child was managed with endoscopic fenestration and made an excellent recovery.
Successful treatment of ulcerative bronchiolitis in a woman with refractoryMycobacterium intracellulareinfection
Authors: Egan John Patrick , Seides Benjamin J , Olivier Kenneth N , Addrizzo-Harris Doreen
Published: April 2015

We present a case of a woman with medically refractory ulcerative colitis (UC) who developed severe bronchiectasis, bronchitis, bronchiolitis andMycobacterium intracellulare(MAC) infection 2 years after total colectomy. Despite being on optimal therapy for her MAC and sterilising multiple consecutive sputum cultures, she remained highly symptomatic, and this led to further investigations that revealed the presence of UC-related airways disease. Addition of immunosuppressive therapy to her antimycobacterial treatment resulted in sustained and complete clinical remission of her disease. To our knowledge, this is the only case published in the literature that describes a case of successful treatment of concomitant UC-related pulmonary disease and symptomatic MAC.
Quality improvement and person-centredness: a participatory mixed methods study to develop the ‘always event’ concept for primary care
Authors: Bowie Paul , McNab Duncan , Ferguson Julie , de Wet Carl , Smith Gregor , MacLeod Marion , McKay John , White Craig
Published: April 2015

Objectives

(1) To ascertain from patients what really matters to them on a personal level of such high importance that it should ‘always happen’ when they interact with healthcare professionals and staff groups. (2) To critically review existing criteria for selecting ‘always events’ (AEs) and generate a candidate list of AE examples based on the patient feedback data.

Design

Mixed methods study informed by participatory design principles.

Subjects and setting

Convenience samples of patients with a long-term clinical condition in Scottish general practices.

Results

195 patients from 13 general practices were interviewed (n=65) or completed questionnaires (n=130). 4 themes of high importance to patients were identified from which examples of potential ‘AEs’ (n=8) were generated: (1) emotional support, respect and kindness (eg, “I want all practice team members to show genuine concern for me at all times”); (2) clinical care management (eg, “I want the correct treatment for my problem”); (3) communication and information (eg, “I want the clinician who sees me to know my medical history”) and (4) access to, and continuity of, healthcare (eg, “I want to arrange appointments around my family and work commitments”). Each ‘AE’ was linked to a system process or professional behaviour that could be measured to facilitate improvements in the quality of patient care.

Conclusions

This study is the first known attempt to develop the AE concept as a person-centred approach to quality improvement in primary care. Practice managers were able to collect data from patients on what they ‘always want’ in terms of expectations related to care quality from which a list of AE examples was generated that could potentially be used as patient-driven quality improvement (QI) measures. There is strong implementation potential in the Scottish health service. However, further evaluation of the utility of the method is also necessary.
Prognostic utility of serum CRP levels in combination with CURB-65 in patients with clinically suspected sepsis: a decision curve analysis
Authors: Yamamoto Shungo , Yamazaki Shin , Shimizu Tsunehiro , Takeshima Taro , Fukuma Shingo , Yamamoto Yosuke , Tochitani Kentaro , Tsuchido Yasuhiro , Shinohara Koh , Fukuhara Shunichi
Published: April 2015

Objectives

The prognostic utility of serum C reactive protein (CRP) alone in sepsis is controversial. We used decision curve analysis (DCA) to evaluate the clinical usefulness of combining serum CRP levels with the CUBR-65 score in patients with suspected sepsis.

Design

Retrospective cohort study.

Setting

Emergency department (ED) of an urban teaching hospital in Japan.

Participants

Consecutive ED patients over 15 years of age who were admitted to the hospital after having a blood culture taken in the ED between 1 January 2010 and 31 December 2012.

Main outcome measures

30-day in-hospital mortality.

Results

Data from 1262 patients were analysed for score evaluation. The 30-day in-hospital mortality was 8.4%. Multivariable analysis showed that serum CRP ≥150 mg/L was an independent predictor of death (adjusted OR 2.0; 95% CI 1.3 to 3.1). We compared the predictive performance of CURB-65 with the performance of a modified CURB-65 with that included CRP (≥150 mg/L) to quantify the clinical usefulness of combining serum CRP with CURB-65. The areas under the receiver operating characteristics curves of CURB-65 and a modified CURB-65 were 0.76 (95% CI 0.72 to 0.80) and 0.77 (95% CI 0.72 to 0.81), respectively. Both models had good calibration for mortality and were useful among threshold probabilities from 0% to 30%. However, while incorporating CRP into CURB-65 yielded a significant category-free net reclassification improvement of 0.387 (95% CI 0.193 to 0.582) and integrated discrimination improvement of 0.015 (95% CI 0.004 to 0.027), DCA showed that CURB-65 and the modified CURB-65 score had comparable net benefits for prediction of mortality.

Conclusions

Measurement of serum CRP added limited clinical usefulness to CURB-65 in predicting mortality in patients with clinically suspected sepsis, regardless of the source.
How intravenous nitroglycerine transit time from bag-to-bloodstream can be affected by infusion technique: a simulation study
Authors: Douma Matthew J , O'Dochartaigh Domhnall , Corry Angela , Brindley Peter G
Published: April 2015

Objective

To measure the possible delays in intravenous nitroglycerine administration.

Methods

This was a simulation study of sham intravenous nitroglycerine using a standard nitroglycerine titration protocol. Variables studied were (i) common cannulae/needles, (ii) infusion accessories and (iii) presence of a parallel intravenous saline carrier line (or drive line) infusing at 30 mL/h. Outcomes were (i) delay from bag-to-bloodstream arrival and (ii) the dosage showing on the infusion pump when the sham drug first exits the cannula (aka the ‘presumed initial dosage’).

Results

There was a statistically significant difference in both (i) time-to-bloodstream arrival and (ii) the dosage showing on the infusion pump as the sham first exits the cannula with (i) different cannulae, (ii) different accessories and (iii) presence of a carrier line. The bag-to-bloodstream time varied 10-fold: 197–2062 s. The ‘presumed initial dosage’ varied sixfold: 5–30 µg/min. Adding the medication to an already flowing carrier line reduced the time for the sham to exit the cannula fourfold: from 2062 to 469 s.

Conclusions

Despite limitations, this study outlines the importance of cannula type, infusion accessories and carrier lines. Larger cannulae and greater priming volumes substantially delay drug delivery, whereas carrier lines/drive lines substantially accelerate drug delivery. Our study also shows how patients could be exposed to clinical delays, as well as incorrect presumptions about drug dosage. Guidelines, and education efforts, should highlight the clinical importance of factors that affect bag-to-bloodstream time.
The incidence of tuberculosis in patients treated with certolizumab pegol across indications: impact of baseline skin test results, more stringent screening criteria and geographic region
Authors: Mariette X , Vencovsky J , Lortholary O , Gomez-Reino J , de Longueville M , Ralston P , Weinblatt M , van Vollenhoven R
Published: April 2015

Objectives

We report the incidence of tuberculosis (TB) across certolizumab pegol (CZP) clinical trials in rheumatoid arthritis (RA), psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), before and after the introduction of stricter TB screening.

Methods

TB incidence rates (IRs) were assessed and stratified according to screening guidelines used at the time of CZP trials. Before 2007 (originaltrials), purified protein derivative (PPD) tuberculin skin test positivity varied according to local standards (induration ≥5 up to ≥20 mm). Since 2007, all CZP trial protocols have been amended, including trials spanning (intermediate) and initiated after 2007 (current), mandating that any patient with PPD≥5 mm receives treatment for latent TB infection (LTBI). All cases of suspected TB or PPD≥5 mm, in pooled data from 5402 CZP patients across all CZP trials up to 2012, underwent blinded central review by independent experts.

Results

44 TB cases were confirmed in pooled CZP RA trials (IR 0.47/100PY, patient-years) with no cases in Japanese RA trials (J-RAPID, HIKARI). Single TB cases were confirmed in psoriasis and axSpA trials (RAPID-axSpA), and no cases in the PsA trial (RAPID-PsA). IR of TB was 0.51/100PY acrossoriginalorintermediateRA trials and 0.18/100PY incurrenttrials. The majority of TB cases in RA occurred in Eastern (IR 1.02/100PY) and Central Europe (IR 0.58/100PY). Of 242/370 PPD≥5 mm patients who received 9 months isoniazid (INH) treatment for latent TB infection (LTBI), none developed TB, versus 7.8% of 128 untreated PPD≥5 mm patients.

Conclusions

Implementation of more stringent LTBI screening, plus treatment for LTBI, reduced the IR of TB, even when INH was administered after starting CZP therapy.
Influences on male reproductive success in long-lived Blanding’s Turtles (Emydoidea blandingii)
Authors: McGuire J.M. , Congdon J.D. , Kinney O.M. , Osentoski M. , Scribner K.T.
Published: April 2015

Knowing how the number and qualities of mates influence male reproductive success (RS) can help interpret mating-system dynamics that are important for conservation efforts. We combined parentage data (1999–2006) with data from a long-term life-history study (1953–2007) of Blanding’s Turtles (Emydoidea blandingii (Holbrook, 1838)) on the University of Michigan’s E.S. George Reserve to document the relative influence of mate number and quality on male RS. Blood samples were taken from >92% of resident adults and tissue samples were taken from 723 hatchlings from 92 nests of 54 females over eight nesting seasons. The incidence of multiple paternity averaged 41.6% (N = 77), was variable among years (minimum–maximum = 15.4%–55.6%), and was positively associated with female age, body size, and clutch size. Repeat paternity was observed in 69.9% of sequential clutches of the same female separated by 1–7 years. Male RS was variable (1–40 offspring) and was positively associated with the number of mates and clutches sired. The youngest male to sire offspring was 22 years old. Adult movements that result in encountering different mates and (or) the ability to use attributes (e.g., size or age) to identify high-quality mates have the potential to substantially increase RS.
Status of the MAJORANA DEMONSTRATOR: A search for neutrinoless double-beta decay
Authors: Efremenko Yu. , Abgrall N. , Arnquist I. J. , Avignone F. T. , Baldenegro-Barrera C. X. , Barabash A. S. , Bertrand F. E. , Bradley A. W. , Brudanin V. , Busch M. , Buuck M. , Byram D. , Caldwell A. S. , Chan Y.-D. , Christofferson C. D. , Cuesta C. , Detwiler J. A. , Ejiri H. , Elliott S. R. , Galindo-Uribarri A. , Gilliss T. , Giovanetti G. K. , Goett J. , Green M. P. , Gruszko J. , Guinn I. , Guiseppe V. E. , Henning R. , Hoppe E. W. , Howard S. , Howe M. A. , Jasinski B. R. , Keeter K. J. , Kidd M. F. , Konovalov S. I. , Kouzes R. T. , LaFerriere B. D. , Leon J. , MacMullin J. , Martin R. D. , Meijer S. J. , Mertens S. , Orrell J. L. , O'Shaughnessy C. , Poon A. W. P. , Radford D. C. , Rager J. , Rielage K. , Robertson R. G. H. , Romero-Romero E. , Shanks B. , Shirchenko M. , Snyder N. , Suriano A. M. , Tedeschi D. , Trimble J. E. , Varner R. L. , Vasilyev S. , Vetter K. , Vorren K. , White B. R. , Wilkerson J. F. , Wiseman C. , Xu W. , Yakushev E. , Yu C.-H. , Yumatov V. , Zhitnikov I. ,   The MAJORANA Collaboration
Published: April 2015

If neutrinos are Majorana particles, i.e. fermions that are their own antiparticles, then neutrinoless double-beta (0νββ) decay is possible. In such a process, two neutrons can simultaneously decay into two protons and two electrons without emitting neutrinos. Neutrinos being Majorana particles would explicitly violate lepton number conservation, and might play a role in the matter–antimatter asymmetry in the universe. The MAJORANA DEMONSTRATOR experiment is under construction at the Sanford Underground Research Facility in Lead, SD and will search for the neutrinoless double-beta (0νββ) decay of the 76Ge isotope. The goal of the experiment is to demonstrate that it is possible to achieve a sufficiently low background rate in the 4 keV region of interest (ROI) around the 2039 keV Q-value to justify building a tonne-scale experiment. In this paper, we discuss the physics and design of the MAJORANA DEMONSTRATOR, its approach to achieving ultra-low background and the status of the experiment.
A Normalized Numerical Scaling Method for the Unbalanced Multi-Granular Linguistic Sets
Authors: Wang Baoli , Liang Jiye , Qian Yuhua , Dang Chuangyin
Published: April 2015

Decision makers often express their evaluations on decision problems with multi-granular linguistic terms. This fact leads to the unification of the multi-granular linguistic terms into a single linguistic set in the literature. However, this unification process increases the complexity of computation and the subjectivity in the determination of transformation functions. To overcome this deficiency, this paper aims to develop a normalized numerical scaling method for determining the semantics of multi-granular linguistic terms in the same domain. We first introduce a class of numerical scaling functions to generate several balanced or unbalanced linguistic sets. Since these scaled linguistic sets have different domains, we then develop a normalized numerical scaling method to form them into the unique interval [0,1]. As a result of this development, two classes of normalized scaling functions are derived from the priori scale information and applications of piecewise linear interpolation and piecewise arc interpolation. Finally, an example is given to illustrate how the method works.
IFWA and IFWGM Methods for MADM under Atanassov's Intuitionistic Fuzzy Environment
Authors: Xu Yejun , Wang Huimin
Published: April 2015

In this paper, we first give the formula of possibility degree to rank the Atanassov's intuitionistic fuzzy numbers. Two methods called Atanassov's intuitionistic fuzzy weighted average (IFWA) and Atanassov's intuitionistic fuzzy weighted geometric mean (IFWGM) are developed to solve the multiple attribute decision making problems under Atanassov's intuitionistic fuzzy environment, in which the performance ratings of alternatives and relative importance of attributes are expressed with Atanassov's intuitionistic fuzzy sets. The IFWA and IFWGM methods, respectively, are treated as an auxiliary pair of fractional programming models and two linear programming (LP) solution procedures are proposed simultaneously by using Charnes and Cooper transformation. Furthermore, two algorithms which are based on the IFWA and IFWGM models, respectively, are developed to solve Atanassov's intuitionistic fuzzy decision making problems where attribute values and weights of attributes are all in Atanassov's intuitionistic fuzzy numbers. The order relationship between IFWA and IFWGM are investigated. Finally, a numerical example is illustrated to show the feasibility and effectiveness of the proposed methods.
Selberg integrals, super-hypergeometric functions and applications to β-ensembles of random matrices
Authors: Desrosiers Patrick , Liu Dang-Zheng
Published: April 2015

We study a new Selberg-type integral with n + m indeterminates, which turns out to be related to the deformed Calogero–Sutherland systems. We show that the integral satisfies a holonomic system of n + m non-symmetric linear partial differential equations. We also prove that a particular hypergeometric function defined in terms of super-Jack polynomials is the unique solution of the system. Some properties such as duality relations, integral formulas, Pfaff–Euler and Kummer transformations are also established. As a direct application, we evaluate the expectation value of ratios of characteristic polynomials in the classical β-ensembles of Random Matrix Theory.
Chinese Peace? An Emergent Norm in African Peace Operations
Authors: Kuo Steven C. Y.
Published: April 2015

The steady rise in Chinese participation in peace operations in Africa is a significant development in the post-Cold War collective security architecture. An aspect of China's rise and its challenge to the liberal global order is its contribution to post-conflict peacekeeping, peacebuilding, and peace-making in Africa, areas that have been dominated by the West. The purpose of this article is to bring together literatures that do not usually speak to one another: Chinese discourses on peacebuilding and the debate on the liberal peace in Africa. The subject of this article is the emerging "Chinese peace" discourse. By examining the "Chinese peace" — both its normative content and its on-the-ground participation in a comprehensive liberal peace project — as a part of the United Nations Mission in Liberia (UNMIL) — this article begins to highlight differences, identify tensions, and recognize complementarities between the dominant liberal and the emergent Chinese approach to peacebuilding.
Functional MRI detects perfusion impairment in renal allografts with delayed graft function
Authors: Hueper Katja , Gueler Faikah , Bräsen Jan Hinrich , Gutberlet Marcel , Jang Mi-Sun , Lehner Frank , Richter Nicolas , Hanke Nils , Peperhove Matti , Martirosian Petros , Tewes Susanne , Vo Chieu Van Dai , Großhennig Anika , Haller Hermann , Wacker Frank , Gwinner Wilfried , Hartung Dagmar
Published: April 2015

Delayed graft function (DGF) after kidney transplantation is not uncommon, and it is associated with long-term allograft impairment. Our aim was to compare renal perfusion changes measured with noninvasive functional MRI in patients early after kidney transplantation to renal function and allograft histology in biopsy samples. Forty-six patients underwent MRI 4–11 days after transplantation. Contrast-free MRI renal perfusion images were acquired using an arterial spin labeling technique. Renal function was assessed by estimated glomerular filtration rate (eGFR), and renal biopsies were performed when indicated within 5 days of MRI. Twenty-six of 46 patients had DGF. Of these, nine patients had acute rejection (including borderline), and eight had other changes (e.g., tubular injury or glomerulosclerosis). Renal perfusion was significantly lower in the DGF group compared with the group with good allograft function (231 ± 15 vs. 331 ± 15 ml·min−1·100 g−1, P < 0.001). Living donor allografts exhibited significantly higher perfusion values compared with deceased donor allografts ( P < 0.001). Renal perfusion significantly correlated with eGFR ( r = 0.64, P < 0.001), resistance index ( r = −0.57, P < 0.001), and cold ischemia time ( r = −0.48, P < 0.01). Furthermore, renal perfusion impairment early after transplantation predicted inferior renal outcome and graft loss. In conclusion, noninvasive functional MRI detects renal perfusion impairment early after kidney transplantation in patients with DGF.
Accessory stimulus modulates executive function during stepping task
Authors: Watanabe Tatsunori , Koyama Soichiro , Tanabe Shigeo , Nojima Ippei
Published: April 2015

When multiple sensory modalities are simultaneously presented, reaction time can be reduced while interference enlarges. The purpose of this research was to examine the effects of task-irrelevant acoustic accessory stimuli simultaneously presented with visual imperative stimuli on executive function during stepping. Executive functions were assessed by analyzing temporal events and errors in the initial weight transfer of the postural responses prior to a step (anticipatory postural adjustment errors). Eleven healthy young adults stepped forward in response to a visual stimulus. We applied a choice reaction time task and the Simon task, which consisted of congruent and incongruent conditions. Accessory stimuli were randomly presented with the visual stimuli. Compared with trials without accessory stimuli, the anticipatory postural adjustment error rates were higher in trials with accessory stimuli in the incongruent condition and the reaction times were shorter in trials with accessory stimuli in all the task conditions. Analyses after division of trials according to whether anticipatory postural adjustment error occurred or not revealed that the reaction times of trials with anticipatory postural adjustment errors were reduced more than those of trials without anticipatory postural adjustment errors in the incongruent condition. These results suggest that accessory stimuli modulate the initial motor programming of stepping by lowering decision threshold and exclusively under spatial incompatibility facilitate automatic response activation. The present findings advance the knowledge of intersensory judgment processes during stepping and may aid in the development of intervention and evaluation tools for individuals at risk of falls.