bluuebunny/crossref_metadata_2025 huggingface dataset:
Changing Parental Nutrition Administration Sets Every 24 h versus Every 48 h in Newborn Infants
Authors: Fox Miriam , Molesky Marion , Van Aerde John E , Muttitt Sarah
Published: March 2016

OBJECTIVE: To determine whether changing total parenteral nutrition fluid administration sets (TAS) every 48 h rather than every 24 h results in a greater infusate contamination rate.

PATIENTS AND METHODS: Prospectively, 166 infants were assigned at random to have TAS changed either every 24 h or every 48 h. Samples of the infusate were cultured to determine contamination rates of the infusate in the sets and were tested from 149 of these infants. TAS was replaced every 24 h in the control group, and 445 amino acid plus dextrose solutions (AADS) and 449 lipid emulsions samples were taken for bacterial culture. Fungal cultures were also performed on 449 samples. The study group had TAS replaced every 48 h, and 454 samples of AADS were cultured for bacteria. The numbers of lipid emulsion samples sent for bacterial culture and fungal culture were 449 and 440, respectively. Information on type of intravenous access device, administration of antibiotics and blood cultures was also collected.

RESULTS: There was no difference in bacterial contamination rates for AADS or lipid emulsion from TAS changed every 24 or 48 h (Χ2, P>0.05). Lipid emulsion sampled from the 24 h group showed a statistically significant higher rate of fungal contamination than specimens from the 48 h group (P<0.01).

CONCLUSIONS: Changing TAS every 48 h versus 24 h does not increase the contamination rate of infusate in newborns.
Serological Testing in Screening for Adult Celiac Disease
Authors: Gillett Helen Rachel , Freeman Hugh James
Published: March 2016

Assays for celiac-related antibodies are becoming widely available, and the present review aims to clarify the use of these investigations in the diagnosis of, management of and screening for adult celiac disease. The sensitivities and specificities of various antibody tests are discussed, along with their clinical use as an adjunct to small bowel biopsy, and as a first-line investigation for patients with atypical symptoms of celiac disease or patients at high risk of developing sprue.
Rhabdomyolysis Complicating Unrecognized Hypophosphatemia in an Alcoholic Patient
Authors: Kumar Deepali , McAlister Finlay A
Published: March 2016

Rhabdomyolysis occurring as a complication of hypophosphatemia has been infrequently described. A 58‐year‐old male with a history of daily alcohol consumption presented with two generalized tonic clonic seizures secondary to hypovolemic hyponatremia. He was volume‐resuscitated, and antiepileptic medication was administered. After three days of hospitalization, the patient developed severe rhabdomyolysis despite the absence of further seizure activity. Serum phosphate levels were depressed. He was treated with intravenous mannitol, alkaline diuresis, and intravenous and oral phosphate supplementation. He recovered uneventfully. Hypophosphatemia can potentially lead to multisystem organ dysfunction including severe rhabdomyolysis. It is, therefore, important to maintain a low threshold for measuring serum phosphate levels in patients admitted to hospital.
Omeprazole and Ranitidine in the Prevention of Relapse in Patients with Duodenal Ulcer Disease
Authors: Lauritsen K , Rutgersson K , Bolling E , Brunner G , Eriksson S , Galmiche JP , Walan A , Archambault AP , Gudjónsson H , Bailey RJ , Bianchi Porro G , Frison L , Havu N , Thompson ABR
Published: March 2016

BACKGROUND: Although the eradication ofHelicobacter pyloriis of primary importance when initiating treatment, it is also important to have a strategy for patients who areH pylori-negative, fail to demonstrate eradication or have a tendency to become re-infected or relapse.

PATIENTS AND METHODS: In a double-blind, parallel-group clinical trial of 928 patients (from 70 centres in 16 countries) with duodenal ulcers who after a short term study had relief of symptoms and healed ulcers proved endoscopically, 308 were randomly assigned to receive omeprazole 10 mg in the morning, 308 to receive omeprazole 20 mg in the morning and 312 to receive ranitidine 150 mg at bedtime for up to 12 months. Symptoms were assessed every three months and endoscopy repeated at three, six and 12 months, or more often if indicated by recurrence of symptoms. The safety screening included basal serum gastrin concentrations and gastric mucosal histopathology.

RESULTS: The remission rates up to 12 months were 87% for the omeprazole 20 mg group, 71% for the omeprazole 10 mg group and 63% for the ranitidine group. Omeprazole 20 mg differed significantly from both omeprazole 10 mg (P=0.0001, 95% CI 9 to 23) and ranitidine (P=0.0001, 95% CI 17 to 31). There was no statistically significant difference between omeprazole 10 mg and ranitidine over the 12-month period, but the 95% confidence interval allowed differences between 0% and 16% in favour of omeprazole at 12 months. A Cox regression analysis revealed that longer treatment courses to heal, smoking, a long ulcer history and young age negatively contributed to the odds of staying in remission. The treatments were well tolerated. There was a slight increase in basal serum gastrin concentrations, reflecting the different degrees of acid inhibition induced by the three treatments. No dysplastic or neoplastic lesions were found in any biopsies.

CONCLUSIONS: More duodenal ulcer patients are maintained in remission with omeprazole 20 mg daily than with omeprazole 10 mg daily or with ranitidine 150 mg at bedtime.
Role ofHelicobacter pyloriin the Pathogenesis of Gastric Carcinoma and Progression of Lymphoid Nodules to Lymphoma
Authors: Guindi M
Published: March 2016

The pathology of gastritis associated withHelicobacter pyloriinfection is summarized. The literature is reviewed regarding the role ofH pyloriin the pathogenesis of gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. The potential mechanisms of gastric carcinogenesis include transformation of the gastric mucosa by metabolic products ofH pylori, transformation of the host cell by incorporation ofH pyloriDNA and genotoxic effects of the inflammatory response to the organism. A model for gastric carcinogenesis is proposed in whichH pyloricauses cell proliferation, and the risk of DNA damage is increased, leading to inadequate repair and malignant transformation. Investigation of early gastric carcinomas concluded that two main pathways operated in gastric carcinogenesis, both starting fromH pylorigastritis and leading to phenotypically variable gastric or intestinal tumour growth. The histological features and molecular genetics of MALT lymphoma are briefly reviewed. There is evidence that tumour cells of low grade B cell MALT lymphoma proliferate specifically in response toH pylori. This response is dependent on T cell activation byH pylori. A proposed model for the pathogenesis of MALT lymphoma postulates that B lymphocytes with a genetic change acquire a growth advantage resulting in a monoclonal proliferation in response toH pylori-activated T cells. Further genetic changes may result in escape from T cell dependency.
Crohn’s Disease and the Melkersson‐Rosenthal Syndrome
Authors: Ilnyckyj Alexandra , Aldor Thomas AM , Warrington Richard , Bernstein Charles N
Published: March 2016

A 30‐year‐old woman with a 10‐year history of recurrent bloody diarrhea and documented colitis of the descending colon, consistent with Crohn’s disease, presented with an exacerbation of her gastrointestinal disease and an 18‐month history of recurrent facial and genital swelling. Her course evolved to include severe ear pain, dysphagia and colonic dysmotility. She was diagnosed with Melkersson‐Rosenthal syndrome and treated with multiple agents. The neurological aspects of her presentation are highlighted, and the Melkersson‐Rosenthal syndrome is reviewed.
Colonoscopy ‘My Way’: Preparation, Anticoagulants, Antibiotics and Sedation
Authors: Waye Jerome D
Published: March 2016

Colonoscopy was introduced in the 1960s. The facility with which this technique is performed has been enhanced by vast improvements in instrumentation. In spite of this, physician attitudes concerning colonoscopy have changed little over the past several decades. The diet for precolonoscopic preparation has not been altered for 30 years. Colonoscopists have a great reluctance to use a new preparation instead of the 4 L electrolyte solution, perhaps because this was such a significant advance in colonoscopic cleansing, its predecessor being castor oil and enemas. Physicians continue to be wary of the patient who is taking acetylsalicylic acid in the absence of any studies that show that this is detrimental for polypectomy. The management of the patient on warfarin anticoagulation remains a subject for debate. As for antibiotic prophylaxis, most endoscopy units do not have a standardized approach, although there are good guidelines that, if followed, should decrease the risk of infective endocarditis. Sedation for the endoscopic examination is usually administered by the colonoscopist, although anesthesiologists may, in some countries (and in some defined areas of the United States) be the primary administrators of sedation and analgesia. The present article is a personal approach to the following issues: the preparation of the colon for an examination, current thoughts about anticoagulation and acetylsalicylic acid, antibiotic prophylaxis for colonoscopy and the technique for sedation out of the hospital.
Immunomodulation of Helicobacter Infection
Authors: Croitoru Ken
Published: March 2016

Helicobacter pylorileads to a chronic infection in humans that is associated with gastric inflammation and a vigorous immune response. Despite the humoral and cellular responses that can be detected in both human and animal models of helicobacter infection, the immune response fails to eliminate the organism. Eradication failure may be due to the niche in whichH pyloriconfines itself, well away from direct contact with elements of the immune system. Alternatively, the general tendency of the intestinal immune response to down- regulate reactivity to noninvasive luminal bacteria also may contribute to the failure to eliminatehelicobacterinfection. Results of vaccine studies in mouse models indicate that modulating the helper T cell response from a T helper cell type 1 to a T helper cell type 2 response likely is required for the prevention and elimination of helicobacter infection. Understanding the mechanisms by which the immune response controls bacterial infections will allow for the design of novel strategies of immune modulation and the development of vaccines for both the treatment and prevention ofH pylori.
Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury
Authors: Lam Eric CS , Janzen Rhonda M , Meloche R Mark , Trepanier Paul J , Yoshida Eric M
Published: March 2016

Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance‐abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis C seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.
Acceptability and Feasibility of Sexually Transmitted Infection Testing and Treatment among Pregnant Women in Gaborone, Botswana, 2015
Authors: Wynn Adriane , Ramogola-Masire Doreen , Gaolebale Ponatshego , Moshashane Neo , Agatha Offorjebe Ogechukwu , Arena Kaitlin , Klausner Jeffrey D. , Morroni Chelsea
Published: March 2016

Introduction.Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG), andTrichomonas vaginalis(TV) are curable sexually transmitted infections (STIs) that can cause adverse maternal and birth outcomes. Most countries do not conduct routine testing during antenatal care. We present data on the acceptability and feasibility of testing and treating pregnant women for STIs in an antenatal clinic in Gaborone, Botswana.Materials and Methods. We offered CT, NG, and TV testing using self-collected vaginal swabs to eligible pregnant women. Participants received same-day test results. Those who tested positive were given treatment.Results. Among the 225 women who were eligible and recruited, 200 (89%) agreed to participate. The median age of our study sample was 30 years; most were unmarried (77%), with a median gestational age of 27 weeks and a 23% HIV prevalence. All participants received their results with at least 72% (n=143) on the same day. Thirty participants (15%) tested positive for an STI, all were treated, and 24 (80%) were treated on the same day.Conclusion. The acceptability of STI testing was high, and the intervention was feasible. This study provides support for continued research into STI prevalence, cost-effectiveness, and the association of STIs with adverse maternal and infant outcomes.
Cytotoxic Effect and TLC Bioautography‐Guided Approach to Detect Health Properties of Amazonian Hedyosmum sprucei Essential Oil
Authors: Guerrini Alessandra , Sacchetti Gianni , Grandini Alessandro , Spagnoletti Antonella , Asanza Mercedes , Scalvenzi Laura
Published: March 2016

Bioautography has been used as rapid and easy strategy to detect and identify bioactive fractions/molecules in the never before investigated Hedyosmum sprucei Solms (Chloranthaceae) essential oil (EO). The antioxidant activity, performed through DPPH bioautographic assay and spectrophotometric evaluations (IC50 = 230 ± 10 µg/mL), seemed to be mainly due to α‐cadinol and α‐muurolol. (HP)TLC bioautography, focused on antimicrobial capacities, pointed out α‐cadinol, α‐muurolol, τ‐muurolol, caryophyllene oxide, and methyleugenol as the most effective compounds against Staphylococcus aureus, considered as testing strain. Moreover, the microdilution method, assessed among a wide panel of microorganisms, revealed Listeria grayi and Staphylococcus aureus as the most sensitive among human tested strains and Clavibacter michiganensis among phytopathogens. GC‐MS chemical profile showed that bioactive molecules represented only a small quantity of the whole EO: germacrene D (23.16%), β‐caryophyllene (15.53%), δ‐cadinene (5.50%), α‐copaene (5.08%), and α‐phellandrene (3.48%) were the main compounds, highlighting an uncommon composition among the genus Hedyosmum. Finally, H. sprucei EO was checked for cytotoxic potential against A549 (lung cancer) and MCF‐7 (breast cancer) cell lines showing promising cytotoxic effects against both cell lines after 48 h (IC50 A549 = 44.05 ± 2.35 µg/mL; IC50 MCF‐7 = 32.76 ± 4.92 µg/mL) and 72 h (IC50 A549 = 43.55 ± 2.80 µg/mL; IC50 MCF‐7 = 33.64 ± 0.43 µg/mL).
Clinical Features, Diagnosis, and Treatment Strategies of Gastrointestinal Diaphragm Disease Associated with Nonsteroidal Anti-Inflammatory Drugs
Authors: Wang Yan-Zhi , Sun Gang , Cai Feng-Chun , Yang Yun-Sheng
Published: March 2016

Background. To demonstrate the clinical features, diagnosis, and treatment of nonsteroidal anti-inflammatory drug- (NSAID-) induced diaphragm disease (DD).Methods. A literature search between January 1973 and August 2015 was undertaken. The clinical data of patients with NSAID-induced DD were recorded and analyzed.Results. 159 patients were included. The ratio of male to female was 1 : 2.3; the mean age was65±11years. The most common clinical manifestations were gastrointestinal bleeding and obstruction. 121 (84%) patients took traditional NSAIDs. The durations of NSAIDs use ranged from 2 to 300 months. A majority (59.7%) of DD were seen in the small bowel, were seen secondly in the colon (30.2%), and were mainly located in the ileum (57.9%) and right colon (91.7%), respectively. 80% of patients had multiple diaphragms. 41.5% of small bowel DD were diagnosed preoperatively by capsule endoscopy and/or double-balloon enteroscopy, 52.1% at laparotomy. Nearly 75% of patients underwent surgery, endoscopic balloon dilation was performed in 22 patients, and NSAIDs were withdrawn in 53 patients.Conclusions. NSAID-induced DD is relatively rare. The small bowel is most commonly involved. Preoperative diagnosis of small bowel DD is relatively difficult. Discontinuation of the NSAIDs is recommended, surgical resection is the main treatment presently, and endoscopic balloon dilation should be considered as an alternative therapy.
A Type of Energy Hole Avoiding Method Based on Synchronization of Nodes in Adjacent Annuluses for Sensor Network
Authors: Sha Chao , Chen Huan , Yao Chen , Liu Yao , Wang Ru-chuan
Published: March 2016

For the purpose of balancing energy consumption of nodes in Wireless Sensor Networks (WSNs for short), a type of energy hole avoiding method based on synchronization of nodes in adjacent annuluses (SNAA for short) is proposed in this paper. The circular network is divided into virtual annuluses with the same width. Nodes are deployed nonuniformly and their number increases in geometric progression from the outer annuluses to the inner ones which could effectively reduce the work load on nodes near the center. Moreover, each node could find its optimal parent by considering the residual energy of each candidate as well as the distance between the two nodes in adjacent annuluses. And on the basis of synchronization of nodes between adjacent annuluses during their transmitting and receiving phases, a sleep scheduling strategy is also proposed to further reduce the energy consumption of nodes in idle listening mode. Simulation results show that SNAA has a superior performance on energy consumption balance compared to the algorithm proposed (Liu et al., 2013; Wu et al., 2008) and it could also mitigate the energy hole problem in WSNs.
Solid Right Ventricular Compression by Intraventricular Septum-Hematoma Induced after Percutaneous Coronary Intervention
Authors: El-Battrawy Ibrahim , Akin Ibrahim , Münz Benedikt , Leistner David Manuel , Behnes Michael , Henzler Thomas , Haubenreisser Holger , Papavassiliu Theano , Borggrefe Martin , Lehmann Ralf
Published: March 2016

Intraventricular septum-hematoma is a rare complication following percutaneous coronary intervention (PCI). This complication may represent a challenge for accurate diagnosis and treatment. This case report is about a 60-year-old male patient being admitted with an acute coronary syndrome. Despite successful PCI with drug eluting stent implantation into the right coronary artery (RCA) the patient complained about recurrent angina pectoris according to Canadian Cardiovascular Society (CCS) class IV. Cardiac magnetic resonance imaging and transthoracic echocardiography revealed a massive 4.9×9.2 cm sized end-diastolic septum-hematoma, which compromised right ventricular cavity. Emergent recoronary angiography ruled out further contrast extravasation from the RCA. Conservative treatment was intended after discussion in the “heart-team.” The patient completely recovered with nearly complete resolution of the hematoma after 6 months.
Case Report of a Traumatic Atlantoaxial Rotatory Subluxation with Bilateral Locked Cervical Facets: Management, Treatment, and Outcome
Authors: Hawi Nael , Alfke Dirk , Liodakis Emmanouil , Omar Mohamed , Krettek Christian , Müller Christian Walter , Meller Rupert
Published: March 2016

The aim was to report a rare case of isolated traumatic atlantoaxial rotatory subluxation without ligamentous injury. Management consisted of analgesia, sedation, and application of a halo skull traction device. After removing halo skull traction, full reduction and recovery were achieved without instability.
Assessment of the Water and Sediment Quality of Tropical Forest Streams in Upper Reaches of the Baleh River, Sarawak, Malaysia, Subjected to Logging Activities
Authors: Ling Teck-Yee , Soo Chen-Lin , Sivalingam Jagath-Retchahan , Nyanti Lee , Sim Siong-Fong , Grinang Jongkar
Published: March 2016

The study of the impact of logging activities on water and sediment quality of Sarawak forest streams is still scarce despite Sarawak being the largest exporter of timber in Malaysia. This study was aimed at determining the water and sediment quality of forest streams in Sarawak and the potential impact of logging activities. In situ parameters were measured, and water and sediment samples were collected at six stations before rain. Additionally, water quality was investigated at three stations after rain. The results showed that canopy removal resulted in large temperature variation and sedimentation in the forest streams. Lower suspended solids were found at stations with inactive logging (<2 mg/L) compared to active logging (10–16 mg/L) activities. The highest concentration of total nitrogen and total phosphorus in water and sediment was 4.4 mg/L, 77.6 μg/L, 0.17%, and 0.01%, respectively. Besides, significantly negative correlation of sediment nitrogen and water total ammonia nitrogen indicated the loss of nitrogen from sediment to water. Water quality of the streams deteriorated after rain, in particular, suspended solids which increased from 8.3 mg/L to 104.1 mg/L. This study reveals that logging activities have an impact on the water quality of Sarawak forest streams particularly in rainfall events.
Entrevista de Jean-Marie Klinkenberg a Amir Biglari
Authors: Biglari Amir
Published: March 2016

Em uma entrevista com Amir Biglari – publicada em francês em Entretiens sémiotiques (org. Amir Biglari, Limoges, Lambert-Lucas, 2014, pp. 293-321) – Jean-Marie Klinkenberg conta sobre a criação do Groupe μ e comenta sua evolução e formação atual. Klinkenberg dá detalhes tanto da história do Groupe, como dos modos de colaboração entre seus membros. Em primeiro plano, focaliza a atuação do Groupe na semiótica, porém, num horizonte mais amplo, aborda vários pontos a respeito dessa área de pesquisa: as relações entre a semiótica e as ciências cognitivas, o lugar da semiótica no campo das humanidades, o papel da semiótica nas sociedades contemporâneas, as lacunas em seu arcabouço e as perspectivas que a ela se abrem, além de apresentar a situação atual da semiótica na Bélgica.
Imagem de. . . Entre indivíduo e categoria, da lógica à retórica
Authors: Le Guern Odile
Published: March 2016

A imagem, na interação que mantém com sua legenda, pode propor a leitura daquilo que representa como tipo ou ocorrência, pode servir a um projeto de significação orientado para o indivíduo ou para a classe de indivíduos ou categoria. Essa dupla vocação associa-se à formulação de sua legenda, a qual é assumida por um enunciador e dirigida a um enunciatário e a uma visada particular, didática e documental ou retórica. Se é uma questão de referência e de abordagem, trata-se acima de tudo do estatuto semiótico da imagem que, de ícone a índice, acentuará preferencialmente ou a soma das similaridades que aproximam o sujeito representado a outros sujeitos da mesma classe, ou a soma das diferenças que os distingue. As duas leituras não são incompatíveis e pode-se até fazer a hipótese de que a icônica é a base necessária para a indicial, em um processo semiótico dinâmico.
A figura, o fundo e o abismo (Em homenagem ao Groupe μ)
Authors: Beyaert-Geslin Anne
Published: March 2016

O artigo homenageia os trabalhos do Groupe μ, destacando o refinamento de suas colocações e formulações. Examina o estatuto da figura e do fundo em obras pictóricas, apoiando-se em uma precisão apontada pelo Groupe μ, em seu Traité du signe visuel (Tratado do signo visual), que credita esses estatutos a uma “decisão” do observador. Que argumentos determinam tal “decisão” perceptiva? O artigo conduz a pesquisa pelo exame de obras de Henri Matisse, Jean Dubuffet e Francisco Goya, e evidencia uma busca da figuratividade, que privilegia a percepção em função da proporção das figuras.
Cinco perguntas para Francis Edeline e Jean-Marie Klinkenberg
Authors: Andersson Fred
Published: March 2016

Cinco perguntas são colocadas ao Groupe μ e respondidas por seus integrantes: 1. No início, o que os atraiu à teoria dos signos e da significação?; 2. Como vocês definiriam a sua contribuição para o domínio?; 3. Qual é a verdadeira função de uma teoria dos signos e da significação frente a outras disciplinas acadêmicas?; 4. Quais são, para vocês, os conceitos e/ou contribuições mais importantes para a teoria da significação e dos signos?; e 5. Quais questões permanecem abertas na área e quais são as perspectivas de desenvolvimentos?
Relations of Central Hemodynamics and Aortic Stiffness with Left Ventricular Structure and Function: The Framingham Heart Study
Authors: Kaess Bernhard M. , Rong Jian , Larson Martin G. , Hamburg Naomi M. , Vita Joseph A. , Cheng Susan , Aragam Jayashree , Levy Daniel , Benjamin Emelia J. , Vasan Ramachandran S. , Mitchell Gary F.
Published: March 2016

Background

The differing relations of steady and pulsatile components of central hemodynamics and aortic stiffness with cardiac dimensions and function have not been fully elucidated.

Methods and Results

Central hemodynamics and carotid‐femoral pulse wave velocity (
CFPWV
, a measure of aortic stiffness) were measured by arterial tonometry in 5799 participants of the Framingham Heart Study (mean age 51 years, 54% women) and related to echocardiographic left ventricular (
LV
) dimensions and systolic and diastolic function using multivariable‐adjusted partial Pearson correlations. Mean arterial pressure (
MAP
, steady component of central blood pressure) was associated positively with
LV
wall thickness (
r
=0.168;
P
<0.0001) but showed only a weak direct association with
LV
diastolic dimension (
r
=0.035,
P
=0.006). Central pulse pressure (pulsatile component of central blood pressure) showed a direct correlation with both
LV
diastolic dimension and
LV
wall thickness (
r
=0.08 and 0.044, both
P
<0.0001 in multivariable models that included
MAP
).
CFPWV
was not associated with
LV
structure (all
P
≥0.27) in
MAP
‐adjusted models). Both
MAP
and
CFPWV
were associated inversely with
LV
diastolic function (E′;
r
=−0.140 and −0.153, respectively; both
P
<0.0001), and these associations persisted after additional adjustment for
LV
mass and central pulse pressure (
r
=−0.142 and −0.108, both
P
<0.0001).
MAP
and
CFPWV
were not associated with
LV
fractional shortening (
P
≥0.10), whereas central pulse pressure was positively related (
r
=0.064,
P
<0.0001).

Conclusions

Pulsatile and steady components of central pressure are conjointly yet variably related to
LV
structure.
CFPWV
is related to
LV
diastolic function but not to systolic function. Additional studies are warranted to confirm these observations.
Dyslipidemia and the Risk of Developing Hypertension in a Working‐Age Male Population
Authors: Otsuka Toshiaki , Takada Hirotaka , Nishiyama Yasuhiro , Kodani Eitaro , Saiki Yoshiyuki , Kato Katsuhito , Kawada Tomoyuki
Published: March 2016

Background

Hypertension is one of the main comorbidities associated with dyslipidemia. This study aimed to examine the extent to which dyslipidemia increases the risk of developing hypertension in a Japanese working‐age male population.

Methods and Results

We analyzed data from 14 215 nonhypertensive male workers (age 38±9 years) who underwent annual medical checkups. Subjects were followed up for a median of 4 years to determine new‐onset hypertension, defined as blood pressure (
BP
) ≥140/90 mm Hg or use of antihypertensive medication. The associations between serum lipid levels and development of hypertension were examined. During the follow‐up period, 1483 subjects developed hypertension. After adjusting for age, body mass index, impaired fasting glucose/diabetes, baseline
BP
category, alcohol intake, smoking, exercise, and parental history of hypertension, subjects with a total cholesterol (
TC
) level ≥222 mg/dL were at a significantly increased risk of developing hypertension (hazard ratio: 1.28; 95%
CI
: 1.06–1.56) compared to subjects with a
TC
level ≤167 mg/dL. Similar results were observed for subjects with high low‐density lipoprotein cholesterol (
LDLC
) and non‐high‐density lipoprotein cholesterol (
HDLC
) levels. A U‐shaped relationship was found between
HDLC
level and risk of hypertension; compared to the third quintile, the multiadjusted hazard ratio was 1.22 (95%
CI
: 1.03–1.43) in the lowest quintile and 1.34 (95%
CI
: 1.12–1.60) in the highest quintile.

Conclusions

Elevated serum levels of
TC
,
LDLC
, and non‐
HDLC
were associated with an increased risk of hypertension in working‐age Japanese men. For
HDLC
, risk of hypertension was increased at both low and high levels.
Cerebrovascular Disease in Rheumatic Diseases
Authors: Wiseman Stewart J. , Ralston Stuart H. , Wardlaw Joanna M.
Published: March 2016

Background and Purpose—

Some rheumatic diseases are associated with stroke. Less is known about associations with stroke subtypes or stroke risk by age. We quantified the association between stroke, its subtypes, and rheumatic diseases and identified when stroke risk is greatest.

Methods—

Searches of EMBASE (from 1980) and MEDLINE (from inception) to end 2014 and manual search of reference lists for studies of stroke and stroke subtypes in rheumatic diseases as well as studies measuring cerebrovascular disease from magnetic resonance imaging.

Results—

Prior published meta-analyses and new pooled analyses of any stroke in rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, gout, and psoriasis show an excess risk of stroke over the general population with odds ratio (OR) ranging from 1.51 (95% confidence interval: 1.39–1.62) to 2.13 (1.53–2.98). New meta-analyses of stroke subtypes in rheumatoid arthritis [ischemic: OR, 1.64 (1.32–2.05); hemorrhagic: OR, 1.68 (1.11–2.53)] and systemic lupus erythematosus [ischemic: OR, 2.11 (1.66–2.67); hemorrhagic: OR, 1.82 (1.07–3.09)] show an excess risk of stroke over the general population. Stroke risk across rheumatic diseases is highest in those aged <50 years [OR, 1.79 (1.46–2.20)] and reduces relatively with ageing [>65 years: OR, 1.14 (0.94–1.38); difference
P
<0.007]. Inflammatory arthropathies conveyed higher stroke risk than noninflammatory diseases (OR, 1.3, 1.2–1.3). It was not possible to adjust ORs for risk factors or treatments.

Conclusions—

Risk of any stroke is higher in most rheumatic diseases than in the general population, particularly <50 years. Rheumatoid arthritis and systemic lupus erythematosus increase ischemic and hemorrhagic stroke risk by 60% to 100% relative to the general population.
Role of PHOSPHO1 in Periodontal Development and Function
Authors: Zweifler L.E. , Ao M. , Yadav M. , Kuss P. , Narisawa S. , Kolli T.N. , Wimer H.F. , Farquharson C. , Somerman M.J. , Millán J.L. , Foster B.L.
Published: March 2016

The tooth root and periodontal apparatus, including the acellular and cellular cementum, periodontal ligament (PDL), and alveolar bone, are critical for tooth function. Cementum and bone mineralization is regulated by factors including enzymes and extracellular matrix proteins that promote or inhibit hydroxyapatite crystal growth. Orphan Phosphatase 1 ( Phospho1, PHOSPHO1) is a phosphatase expressed by chondrocytes, osteoblasts, and odontoblasts that functions in skeletal and dentin mineralization by initiating deposition of hydroxyapatite inside membrane-limited matrix vesicles. The role of PHOSPHO1 in periodontal formation remains unknown and we aimed to determine its functional importance in these tissues. We hypothesized that the enzyme would regulate proper mineralization of the periodontal apparatus. Spatiotemporal expression of PHOSPHO1 was mapped during periodontal development, and Phospho1-/- mice were analyzed using histology, immunohistochemistry, in situ hybridization, radiography, and micro–computed tomography. The Phospho1 gene and PHOSPHO1 protein were expressed by active alveolar bone osteoblasts and cementoblasts during cellular cementum formation. In Phospho1-/- mice, acellular cementum formation and mineralization were unaffected, whereas cellular cementum deposition increased although it displayed delayed mineralization and cementoid. Phospho1-/- mice featured disturbances in alveolar bone mineralization, shown by accumulation of unmineralized osteoid matrix and interglobular patterns of protein deposition. Parallel to other skeletal sites, deposition of mineral-regulating protein osteopontin (OPN) was increased in alveolar bone in Phospho1-/- mice. In contrast to the skeleton, genetic ablation of Spp1, the gene encoding OPN, did not ameliorate dentoalveolar defects in Phospho1-/- mice. Despite alveolar bone mineralization defects, periodontal attachment and function appeared undisturbed in Phospho1-/- mice, with normal PDL architecture and no evidence of bone loss over time. This study highlights the role of PHOSPHO1 in mineralization of alveolar bone and cellular cementum, further revealing that acellular cementum formation is not substantially regulated by PHOSPHO1 and likely does not rely on matrix vesicle–mediated initiation of mineralization.
A teacher residency melds classroom theory with clinical practice
Authors: Dennis Danielle V.
Published: March 2016

The University of South Florida has designed and initiated a two-year teacher residency program that intends to meld classroom preservice teacher instruction with work in classrooms with children from low-income and urban backgrounds. The Urban Teacher Residency Partnership Program is a joint effort between the University of South Florida and Hillsborough County Public Schools. Six elementary schools are part of the program. Clinical preparation is central to the program. So is collaboration between USF faculty and the Hillsborough school district. The author calls for more study and research into the residency model for preparing preservice teachers.
Teacher-led reforms have a big advantage — Teachers
Authors: Stanulis Randi N. , Cooper Kristy S. , Dear Benita , Johnston Amanda M. , Richard-Todd Rhonda R.
Published: March 2016

Becoming a better teacher by learning and implementing new ways of teaching requires time, effort, persistence, and a belief that new strategies will enhance student learning. But when educational leaders try to improve teachers and teaching from the outside, by bringing in reformers to transform how teachers engage in the core business of teaching, reforms rarely stick because the first transformation that must occur is in the perspective of initially resistant teachers. This transformation in perspective comes, in part, from teachers working to improve the quality of teachers and teaching in their own schools by developing a common vision, trust in teacher leadership, and openness to learning. Teachers who promote change can make a lasting impact.
Building a culture of collaboration in schools
Authors: Sutton Paul S. , Shouse Andrew W.
Published: March 2016

Teaching is complex; teachers and school leaders crave more meaningful collaborative experiences to make sense of that complexity. However, the structural, cultural, and historical factors involved with schooling impede the extent to which teachers can collaborate. Teachers spend five to six periods of the day teaching classes, largely working in isolation from each other; their remaining time is spent tending to administrative tasks, answering emails, or grading. For schools to work around the persistent structural constraints to establish a sincere and thoughtful collaborative culture they must approach collaboration differently. Collaborative cultures emerge from authentic and relevant problem solving. Teachers will see collaboration as an integral feature of their work when the problems they are asked to solve are specific to their practice, are common to a majority of teachers in a particular school, and when solving the problem demands they collaborate with colleagues.
Sensemaking, Sense-Censoring and Strategic Inaction: The Discursive Enactment of Power and Politics in a Multinational Corporation
Authors: Whittle Andrea , Mueller Frank , Gilchrist Alan , Lenney Peter
Published: March 2016

In this paper we contribute to knowledge of power and politics in international business by developing the understanding of the role of discourse and sensemaking in the subsidiary–headquarters relationship. Based on an ethnographic action research study in a British subsidiary of an American multinational corporation, we conduct an ethnomethodologically informed discourse analysis of the accounts, stories and metaphors through which power and politics in the subsidiary–headquarters relationship were created as social facts. We then broaden the analytic frame to trace longitudinally how these facts led the subsidiary managers to hide, dilute or restrict their ‘local sense’ from the headquarters, including their knowledge of the local market and their preferred strategic direction for the firm: a process we term sense-censoring. We reveal how the subsidiary used power and politics as reasoning procedures to decide against pursuing a preferred course of action, despite a strongly held belief to the contrary, due to anticipated reactions or counter-actions, thereby transforming potential strategic action into inaction. Sense-censoring is significant for international business management, we propose, because it impacts upon knowledge flows, innovation diffusion and organizational learning. We conclude by outlining the implications of systems of sense-censoring and strategic inaction for the management of global–local relations in multinational corporations.
Reduction in blood transfusion in a cohort of infants having cardiac surgery with cardiopulmonary bypass after instituting a goal-directed transfusion policy
Authors: Machovec Kelly A , Smigla Gregory , Ames Warwick A , Schwimer Courtney , Homi H Mayumi , Dhakal Ishwori B , Jaquiss Robert D B , Lodge Andrew J , Jooste Edmund H
Published: March 2016

Background:

Current trends in pediatric cardiac surgery and anesthesiology include goal-directed allogeneic blood transfusion, but few studies address the transfusion of platelets and cryoprecipitate. We report a quality improvement initiative to reduce the transfusion of platelets and cryoprecipitate in infants having cardiac surgery with cardiopulmonary bypass (CPB).

Methods:

Data from 50 consecutive patients weighing four to ten kilograms having cardiac surgery with CPB were prospectively collected after the institution of a policy to obtain each patient’s platelet and fibrinogen levels during the rewarming phase of CPB. Data from 48 consecutive patients weighing four to ten kilograms having cardiac surgery with CPB prior to the implementation of the policy change were retrospectively collected. Demographics, laboratory values and blood product transfusion data were compared between the groups, using the Chi-square/Fisher’s exact test or the T-Test/Wilcoxon Rank-Sum test, as appropriate.

Results:

The results showed more total blood product exposures in the control group during the time from bypass through the first twenty-four post-operative hours (median of 2 units versus 1 unit in study group, p=0.012). During the time period from CPB separation through the first post-operative day, 67% of patients in the control group received cryoprecipitate compared to 32% in the study group (p=0.0006). There was no difference in platelet exposures between the groups.

Conclusion:

Checking laboratory results during the rewarming phase of CPB reduced cryoprecipitate transfusion by 50%. This reproducible strategy avoids empiric and potentially unnecessary transfusion in this vulnerable population.
Recent advances in twist drill design for composite machining: A critical review
Authors: Ismail Sikiru Oluwarotimi , Dhakal Hom Nath , Dimla Eric , Popov Ivan
Published: March 2016

In the field of composite technology, inefficient and poor designs of twist drills contribute immensely to the challenges facing drilling of composite materials. An attempt to report some of the drill design methods and their inherent challenges confronting composite machining necessitates the writing of this article. A critical review has been conducted to offer a clear understanding of the current advances in the field of mechanical drilling of composite materials, focusing on geometry, material and parametric tool designs. The inter-dependable effects of thrust force, cutting speed, feed rate, cutting force and torque on drill design are similarly reviewed. This article also reveals other associated issues facing composite drilling including delamination, surface roughness, rapid tool wear and drill breakage. Well-designed drill geometry and good knowledge of drilling parameters afford the producers of polycrystalline diamond, carbide and high-speed steel tooling materials better opportunity of developing a drill that will minimise delamination of the reinforced composites and tool wear and produce a high-quality surface. Twist drill manufacturers and users will benefit from this article as they seek to have well-designed and improved drills.
Using a Health Behavior Model to Inform Understanding of Therapy Engagement in Child Therapy: A Qualitative Study
Authors: Christon Lillian M. , McLeod Bryce D. , Wheat Emily , Corona Rosalie , Islam Nadia Y.
Published: March 2016

The present study assessed the potential of a health behavior model used to explain adherence to treatment for chronic illnesses, the Integrative Behavioral Prediction Model (IBPM), to better understand therapy engagement (e.g., low participation) for child therapy in community-based service settings. Qualitative interview methods were used to assess the fit of the IBPM to therapy engagement. Caregivers of children ( n = 17) who had successfully completed therapy, were at risk of dropping out, or terminated prematurely at a community mental health clinic were interviewed. Clinic therapists and administrative staff were also interviewed ( n = 8). From the perspective of caregivers, therapists, and administrative staff, most IBPM elements—cognitions, intentions, and environmental/contextual factors—appear to be relevant to therapy engagement. Other factors, such as personal and psychological barriers (e.g., poor fit with therapist), not found in the IBPM also may influence therapy engagement. It appears that the core elements of the IBPM may translate to child therapy, though future research is needed to evaluate the generalizability of the study findings. Thus, health behavior models (e.g., IBPM) may improve our understanding of factors contributing to poor therapy engagement for children receiving psychosocial therapy in community-based service settings.
Optimizing ship energy efficiency: Application of particle swarm optimization algorithm
Authors: Wang Kai , Yan Xinping , Yuan Yupeng , Tang Daogui
Published: March 2016

Greenhouse gas emission and subsequent global warming have attracted more and more attention all over the world. As one of the biggest emission sources, shipping industry is suffering great emission reduction pressure from the public. Although shipping industry can improve the energy efficiency by exploring new strategies to reduce the fuel cost and the emission to air, some deficiencies may be discovered in practice due to lack of a comprehensive consideration of other significant factors, such as safety factors. Therefore, energy efficiency management strategies that consider both safety and economy factors have more practical significance for enhancing the ship energy efficiency. In this article, a power supply model considering economy, emission reduction and safety was established, and a multi-objective optimization problem to keep the system working at a high safety level, a low CO2 emission and a moderate fuel consumption was proposed. Furthermore, the particle swarm optimization algorithm was adopted to solve the multi-objective optimization problem, and the obtained non-inferior solutions could help officers on duty to select the optimum main engine speed by weighing the economy and the safety of the ship. The results show that the proposed method of energy efficiency management could reduce the greenhouse gas emission and the energy efficiency operation index (EEOI) of the ship effectively. The trade-off between ship economy, emission and robustness of the power supply system was studied, which is meaningful to the energy efficiency improvement and the CO2 emission reduction under the safety requirement of power supply.
Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients
Authors: Yoo Joonsang , Song Dongbeom , Baek Jang-Hyun , Lee Kijeong , Jung Yohan , Cho Han-Jin , Yang Jae Hoon , Cho Hyun Ji , Choi Hye-Yeon , Kim Young Dae , Nam Hyo Suk , Heo Ji Hoe
Published: March 2016

Background

Stroke may occur during hospital admission (in-hospital stroke). Although patients with in-hospital stroke are potentially good candidates for reperfusion therapy, they often do not receive treatment as rapidly as expected.

Aims

We investigated the effect of a code stroke program for in-hospital stroke, which included the use of computerized physician order entry, specific evaluation and treatment protocols for in-hospital stroke patients, and regular education of medical staffs.

Methods

We implemented the program in the cardiology and cardiovascular surgery departments/wards (target-ward group) in November 2008. We compared time intervals from symptom onset to evaluation and reperfusion treatment before and after program implementation between the target-ward and other departments/wards (other-ward group).

Results

Among 70 consecutive in-hospital stroke patients who received reperfusion therapy between July 2002 and February 2015, 28 and 42 were treated before and after program implementation, respectively. After program implementation, time intervals from symptom onset to neurology notification (50 min vs. 28 min; P = 0.033), symptom onset to brain imaging (91 min vs. 41 min; P < 0.001), and symptom recognition to notification (22 min vs. 9 min; P = 0.011) were reduced in the target-ward group. Finally, times from symptom onset to intravenous tissue plasminogen activator administration and to arterial puncture were reduced by 55 min (120 min vs. 65 min; P < 0.001) and 130 min (295 min vs. 165 min; P < 0.001), respectively. However, time reductions in the other-ward group were not significant.

Conclusions

The comprehensive program for in-hospital stroke that included the use of computerized physician order entry was effective in reducing time intervals to evaluation and reperfusion therapy.