bluuebunny/crossref_metadata_2025 huggingface dataset:
The work of living with a rare cancer: multiple myeloma
Authors: Stephens Moira , McKenzie Heather , Jordens Christopher F.C.
Published: April 2014

Aim

To report findings from a qualitative study of the experiences of long‐term survivors of multiple myeloma.

Background

Multiple Myeloma is a malignant disease of the bone marrow. Until recently, it was rapidly fatal. Although it remains incurable, people diagnosed with it are living longer on average, largely due to new treatments, some of which have onerous side effects.

Design

Prospective descriptive study.

Method

A series of 47 in‐depth interviews were conducted at 6–12 month intervals over 18 months in 2008–2010 with 10 long‐term survivors of myeloma and their primary support person. Interviews were analysed using the constant comparative method (Grounded Theory).

Findings

To adapt to the effects of both the disease and ongoing medical treatments, participants undertook extensive ‘illness work’. Most of this work fell into two broad categories. Risk work aimed to mitigate risks to the well‐being of both the person with myeloma and his/her carer. Emotion work aimed to manage the feelings of self and others in a protracted cycle of remission and relapse.

Conclusion

The experience of myeloma is increasingly characterized by issues associated with chronic disease and ‘survivorship’. It is important for nurses working with people with myeloma to understand the overwhelming nature of illness work in this context. Nurses can put in place supportive measures to address the two main ‘drivers’ of this work: constant risk to well‐being of survivors (including carers) and the recurrent need to manage emotions in social interactions.
Microglial activation mediates host neuronal survival induced by neural stem cells
Authors: Wu Hui‐Mei , Zhang Li‐Feng , Ding Pei‐Shang , Liu Ya‐Jing , Wu Xu , Zhou Jiang‐Ning
Published: April 2014

The rational of neural stem cells (NSCs) in the therapy of neurological disease is either to replace dead neurons or to improve host neuronal survival, the latter of which has got less attention and the underlying mechanism is as yet little known. Using a transwell co‐culture system, we reported that, in organotypic brain slice cultures, NSCs significantly improved host neuronal viability. Interestingly, this beneficial effect of NSCs was abrogated by a microglial inhibitor minocycline, while it was mimicked by a microglial agonist, Toll‐like receptor 9 (TLR9) ligand CpG‐ODN, which supports the pro‐vital mediation by microglia on this NSCs‐improved neuronal survival. Moreover, we showed that NSCs significantly induced host microglial movement and higher expression of a microglial marker IBA‐1, the latter of which was positively correlated with TLR9 or extracellular‐regulated protein kinases 1/2 (ERK1/2) activation. Real‐time PCR revealed that NSCs inhibited the expression of pro‐inflammatory molecules, but significantly increased the expression of molecules associated with a neuroprotective phenotype such as CX3CR1, triggering receptor expressed on myeloid cells‐2 (TREM2) and insulin growth factor 1 (IGF‐1). Similarly, in the microglia cells, NSCs induced the same microglial response as that in the slices. Further treatment with TLR9 ligand CpG‐ODN, TLR9 inhibitor chloroquine (CQ) or ERK1/2 inhibitor U0126 demonstrated that TLR9‐ERK1/2 pathway was involved in the NSCs‐induced microglial activation. Collectively, this study indicated that NSCs improve host neuronal survival by switching microglia from a detrimental to a neuroprotective phenotype in adult mouse brain, and the microglial TLR9‐ERK1/2 pathway seems to participate in this NSCs‐mediated rescue action.
Contrasting patterns of selection on the size and coloration of a female plumage ornament in common yellowthroats
Authors: Freeman‐Gallant C. R. , Schneider R. L. , Taff C. C. , Dunn P. O. , Whittingham L. A.
Published: April 2014

Females often possess ornaments that appear smaller and duller than homologous traits in males. These ornaments may arise as nonfunctional by‐products of sexual selection in males and cause negative viability or fecundity selection in females in proportion to the cost of their production and maintenance. Alternatively, female ornaments may function as signals of quality that are maintained by sexual or social selection. In a 4‐year study of 83 female common yellowthroats (Geothlypis trichas) and their 222 young, we found strong viability and fecundity selection on the yellow bib, a carotenoid‐based plumage ornament that is a target of sexual selection in males. Females with larger bibs were older, larger and more fecund than females with smaller bibs. However, bib size positively covaried with bib total brightness and carotenoid chroma, aspects of bib coloration that were under negative viability and fecundity selection. Females with more colourful bibs laid fewer eggs in their first clutch, were more likely to suffer total brood loss due to predation and were less likely to return to the study area. Selection against bib coloration limits the value of bib size as a quality indicator in females and may constrain the elaboration of bib attributes in males.
Positioning of 18F‐fluorodeoxyglucose‐positron emission tomography imaging in the management algorithm of hepatocellular carcinoma
Authors: Kawamura Etsushi , Shiomi Susumu , Kotani Kohei , Kawabe Joji , Hagihara Atsushi , Fujii Hideki , Uchida‐Kobayashi Sawako , Iwai Shuji , Morikawa Hiroyasu , Enomoto Masaru , Murakami Yoshiki , Tamori Akihiro , Kawada Norifumi
Published: April 2014

Background and Aim

18F‐fluorodeoxyglucose (FDG)‐positron emission tomography (PET) may detect primary lesions (PLs) and extrahepatic metastases (EHMs) only in advanced hepatocellular carcinoma (HCC) patients. We investigated the requirement of PET and the optimal timing of PET scanning for accurate staging and treatment planning.

Methods

We conducted a retrospective investigation of 64 HCC patients who underwent PET (median age, 74 years; male/female, 41/23; etiology, 46 hepatitis C virus/4 hepatitis B virus/4 alcoholic/10 others). To determine the best timing for PET examinations, we analyzed PET result‐based recommended treatment changes and characteristics of patients with FDG‐avid PLs or EHMs.

Results

FDG‐avid PLs were detected by PET in 22 patients (34%): 18 with hypervascular PL, 11 with serum α‐fetoprotein levels ≥ 200 ng/mL, and 11 beyond Milan criteria. EHMs were detected in 21 patients (33%: lymph nodes, 8; lung, 5; abdominal wall, 4; bone, 3; other organs, 4 [including overlapping]). Recommended treatments changed for 16 patients (25%) because of Barcelona Clinic Liver Cancer stage increases based on PET scanning. In multivariate analyses, serum α‐fetoprotein levels ≥ 200 ng/mL and beyond Milan criteria were independent factors for FDG‐avid PLs and a maximum standardized uptake value (SUVmax) of PLs of ≥ 4.0 was an independent factor for FDG‐avid EHMs (P = 0.002, 0.008, and 0.045, respectively).

Conclusions

PET allows detection of HCC spread in patients with elevated serum α‐fetoprotein levels or those beyond Milan criteria and detects EHMs in patients with PLs with high SUVmax values. Optimally timed PET scans can complement conventional imaging for accurate staging and treatment strategy determination.
Gastric Helicobacter pylori infection associated with risk of diabetes mellitus, but not prediabetes
Authors: Yang Gi‐Hua , Wu Jin‐Shang , Yang Yi‐Ching , Huang Ying‐Hsiang , Lu Feng‐Hwa , Chang Chih‐Jen
Published: April 2014

Backgrounds and Aim

The association between Helicobacter pylori infection and diabetes was inconsistent in previous studies. Moreover, there are no studies on the relationship between H. pylori infection and prediabetes in the literature. The aim of this study is thus to assess the association of Helicobacter infection, diagnosed by pathology from gastric biopsy, with diabetes and prediabetes.

Methods

This cross‐sectional study included 1285 subjects aged 19–85 who underwent esophagogastroduodenoscopy and gastric biopsy during health examinations at National Cheng Kung University Hospital from 2000 to 2009. Subjects were divided into three groups, including normal glucose tolerance, prediabetes, and diabetes. Diabetes and prediabetes were assessed according to the American Diabetes Association diagnostic criteria. Gastric Helicobacter infection was an independent variable. Chi‐square tests, analysis of variance, and multinomial logistic regression models were used to analyze the effects of Helicobacter infection on the risk of diabetes and prediabetes while controlling for age, lifestyle, pathological conditions, and laboratory variables.

Results

There were significant differences in the prevalence of gastric Helicobacter infection among the three groups. The results of multivariate analysis showed that age, obesity, family history of diabetes, hypertension, and hypertriglyceridemia were significantly related to both prediabetes and diabetes. Helicobacter pylori infection was positively associated with diabetes (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.01–2.01), but not prediabetes (OR 1.02, 95% CI 0.77–1.36), in addition to male gender, education level (≤ 9 vs > 12 years), pre‐hypertension, and low high‐density lipoprotein cholesterol.

Conclusions

Gastric H. pylori infection is associated with diabetes, but not prediabetes.
Serum ferritin as a new prognostic factor in hepatocellular carcinoma patients treated with radiofrequency ablation
Authors: Facciorusso Antonio , Del Prete Valentina , Antonino Matteo , Neve Viviana , Crucinio Nicola , Di Leo Alfredo , Carr Brian I , Barone Michele
Published: April 2014

Background and Aim

Hepatic iron accumulation is considered to be a cofactor that influences liver injury and hepatocarcinogenesis. Aim of this study is to determine whether serum ferritin (SF) levels relate to overall survival (OS) and time to recurrence (TTR) in hepatocellular carcinoma (HCC) patients treated with percutaneous radiofrequency ablation (RFA).

Methods

We measured SF levels in 103 HCC patients (median age 70, M/F = 82.5%/17.5%) who underwent RFA between 2005 and 2010. Correlation between SF and other prognostic factors at baseline was analyzed. SF levels were entered into a Cox model and their influence on OS and TTR was evaluated in univariate and multivariate analyses.

Results

SF did not correlate with α‐fetoprotein (rho: −0.12, P = 0.22), neutrophil/lymphocyte ratio (rho: −0.1020, P = 0.30), Model for End‐Stage Liver Disease (rho: 0.18, P = 0.06), Child‐Pugh score (P = 0.5), or Barcelona Cancer of the Liver Clinic stage (P = 0.16). A log‐rank test found the value of 244 ng/mL as the optimal prognostic cut‐off point for SF. Median OS was 62 months (54–78) and survival rate was 97%, 65%, and 52% at 1, 4, and 5 years, respectively. Performance status and SF were the only predictors of OS at multivariate analysis. Median TTR was 38 months (34–49) with a recurrence‐free survival rate of 82.5%, 26.2%, and 23.3% at 1, 4, and 5 years, respectively, while SF and age were the only predictors of TTR.

Conclusions

SF level, possibly reflecting the degree of hepatic inflammation and fibrosis, is a negative risk factor for survival and recurrence after percutaneous RFA in HCC patients.
Patterns of Surgical Care and Complications in Elderly Adults
Authors: Deiner Stacie , Westlake Benjamin , Dutton Richard P.
Published: April 2014

Objectives

To determine whether procedures, hospitals visited, and complications would differ according to decade in elderly adults and from those of younger adults.

Design

Retrospective cohort study.

Setting

The Anesthesia Quality Institute National Anesthesia Clinical Outcomes Registry (NACOR) is the largest database of anesthesia cases from academic and community hospitals and includes all insurance and facility types across the United States.

Participants

Eight million six hundred thirty‐two thousand nine hundred seventy‐nine cases from January 2010 to March 2013 were acquired. After exclusion of individuals younger than 18, nonapplicable locations, and brain death, 2,851,114 remained and were placed into age categories (18–64, 65–69, 70–79, 80–89, ≥90).

Measurements

Participant, surgical, anesthetic, and hospital descriptors and short‐term outcomes (major complications, mortality at <48 hours).

Results

The largest number of older adults had surgery in medium‐sized community hospitals. The oldest age group (≥90) underwent the smallest range of procedures; hip fracture, hip replacement, and cataract procedures accounted for more than 35% of all surgeries. Younger old adults underwent these procedures plus a significant proportion of spinal fusion, cholecystectomy, and knee surgery. Older adults had greater mortality and more complications than younger adults. Participants undergoing exploratory laparotomy had the greatest likelihood of death in any age category except 90 and older, in which small bowel resection predominated. The proportion of emergency surgery and the mortality associated with emergency surgery was 30% higher in the oldest group (≥90) than in adults aged 18 to 64.

Conclusion

This article reports the pattern of surgical procedures, complications, and mortality found in NACOR, which is one of the few data sets that contains data from community hospitals and individuals with all types of insurance. Because the outcomes portion of the data set is under development, it is not possible to investigate the relationship between hospital type and complications or mortality, but this study underscores the magnitude of geriatric surgery that occurs in community hospitals as an area for future outcomes studies.
Two Shi‘i Jurisprudential Methodologies to Address Medical and Bioethical Challenges: Traditional Ijtihād and Foundational Ijtihād
Authors: Mavani Hamid
Published: April 2014

The legal‐ethical dynamism in Islamic law which allows it to respond to the challenges of modernity is said to reside in the institution of ijtihād (independent legal thinking and hermeneutics). However, jurists like Mohsen Kadivar and Ayatollah Faḍlalla have argued that the “traditional ijtihād” paradigm has reached its limits of flexibility as it allows for only minor adaptations and lacks a rigorous methodology because of its reliance on vague and highly subjective juridical devices such as public welfare (maṣlaḥa), imperative necessity (ḍarūra), emergency (iḍtirār), need (ḥāja), averting difficulty (‘usr) and distress (ḥaraj), hardship (mashaqqa), and harm (ḍarar) without interrogating the fundamentals (uṣūl) of ijtihād. In contrast, in the “foundational ijtihād” model theology, ethics, intellect, epistemology, linguistics, hermeneutics, modern sciences, history, cosmology, anthropology, and the sources of Islamic legal theory (uṣūl al‐fiqh) interact with one another to obtain resolutions that are just and non‐discriminatory.
The Seminal Contribution of Rabbi Moshe Feinstein to the Development of Modern Jewish Medical Ethics
Authors: Jotkowitz Alan
Published: April 2014

The purpose of this essay is to show how, on a wide variety of issues, Rabbi Moshe Feinstein broke new ground with the established Orthodox rabbinic consensus and blazed a new trail in Jewish medical ethics. Rabbi Feinstein took power away from the rabbis and let patients decide their treatment, he opened the door for a Jewish approach to palliative care, he supported the use of new technologies to aid in reproduction, he endorsed altruistic living organ donation and recognized brain death (thus laying the groundwork for Orthodox Jewish acceptance of heart transplantation), he downplayed the value of social worth in triage decisions, and was a fierce defender of the rights of the fetus. I develop broader theological principles from Rabbi Feinstein's ethical positions and compare them to those of his Jewish and Christian contemporaries.
Protective effect of Euterpe oleracea Mart (açaí) extract on programmed changes in the adult rat offspring caused by maternal protein restriction during pregnancy
Authors: de Bem Graziele Freitas , da Costa Cristiane Aguiar , de Oliveira Paola Raquel Braz , Cordeiro Viviane Silva Cristino , Santos Izabelle Barcellos , de Carvalho Lenize Costa Reis Marins , Souza Marcelo Augusto Vieira , Ognibene Dayane Texeira , Daleprane Julio Beltrame , Sousa Pergentino José Cunha , Resende Angela Castro , de Moura Roberto Soares
Published: April 2014

Objectives

This study examined the effect of açaí (Euterpe oleracea Mart.) seed extract (ASE) on cardiovascular and renal alterations in adult offspring, whose mothers were fed a low-protein (LP) diet during pregnancy.

Methods

Four groups of rats were fed: control diet (20% protein); ASE (200 mg/kg per day); and LP (6% protein); LP + ASE (6% protein + ASE) during pregnancy. After weaning, all male offspring were fed a control diet and sacrificed at 4 months old. We evaluated the blood pressure, vascular function, serum and urinary parameters, plasma and kidney oxidative damage, and antioxidant activity and renal structural changes.

Key findings

Hypertension and the reduced acetylcholine-induced vasodilation in the LP group were prevented by ASE. Serum levels of urea, creatinine and fractional excretion of sodium were increased in LP and reduced in LP + ASE. ASE improved nitrite levels and the superoxide dismutase and glutathione peroxidase activity in LP, with a corresponding decrease of malondialdehyde and protein carbonyl levels. Kidney volume and glomeruli number were reduced and glomerular volume was increased in LP. These renal alterations were prevented by ASE.

Conclusions

Treatment of protein-restricted dams with ASE provides protection from later-life hypertension, oxidative stress, renal functional and structural changes, probably through a vasodilator and antioxidant activity.
Structural insights into the T6SS effector protein Tse3 and the Tse3–Tsi3 complex from Pseudomonas aeruginosa reveal a calcium‐dependent membrane‐binding mechanism
Authors: Lu Defen , Shang Guijun , Zhang Heqiao , Yu Qian , Cong Xiaoyan , Yuan Jupeng , He Fengjuan , Zhu Chunyuan , Zhao Yanyu , Yin Kun , Chen Yuanyuan , Hu Junqiang , Zhang Xiaodan , Yuan Zenglin , Xu Sujuan , Hu Wei , Cang Huaixing , Gu Lichuan
Published: April 2014

The opportunistic pathogen Pseudomonas aeruginosa uses the type VI secretion system (T6SS) to deliver the muramidase Tse3 into the periplasm of rival bacteria to degrade their peptidoglycan (PG). Concomitantly, P. aeruginosa uses the periplasm‐localized immunity protein Tsi3 to prevent potential self‐intoxication caused by Tse3, and thus gains an edge over rival bacteria in fierce niche competition. Here, we report the crystal structures of Tse3 and the Tse3–Tsi3 complex. Tse3 contains an annexin repeat‐like fold at the N‐terminus and a G‐type lysozyme fold at the C‐terminus. One loop in the N‐terminal domain (Loop 12) and one helix (α9) from the C‐terminal domain together anchor Tse3 and the Tse3–Tsi3 complex to membrane in a calcium‐dependent manner in vitro, and this membrane‐binding ability is essential for Tse3's activity. In the C‐terminal domain, a Y‐shaped groove present on the surface likely serves as the PG binding site. Two calcium‐binding motifs are also observed in the groove and these are necessary for Tse3 activity. In the Tse3–Tsi3 structure, three loops of Tsi3 insert into the substrate‐binding groove of Tse3, and three calcium ions present at the interface of the complex are indispensable for the formation of the Tse3–Tsi3 complex.
Influence of systemic corticotherapy on the triggering of pityriasis versicolor
Authors: da Fraga Clarissa Matarangas Moreira , de Cássia Birschiner Rita , Naseri Alice Pignaton , Diniz Lucia Martins
Published: April 2014

Pityriasis versicolor is a frequent mycosis and the use of systemic corticotherapy is one of its predisposing factors. This is an observational, cross‐sectional, analytical and comparative study, conducted from January 2012 to January 2013 in the following outpatient clinics: Dermatology Service, Cassiano Antonio Moraes Hospital (HUCAM), Vitória, ES, Brazil; Nephrology Service, HUCAM; and Leprosy Department, Maruípe Health Unit, Vitória, ES, Brazil. Patients, undergoing long‐term systemic corticotherapy (or not), were assessed with respect to the presence of pityriasis versicolor. If there was mycosis, a direct mycological examination would be carried out. The spss 17.0 software was used for the statistical analysis. From the total of 100 patients, nine had pityriasis versicolor, being eight from the corticotherapy group and one from the group with no use of corticosteroids. Regarding the patients with mycosis, the prevalent age ranged from 20 to 39 years, with six patients; six were women; seven mixed race; eight were undergoing long‐term systemic corticotherapy; seven were taking low‐dose systemic corticosteroids; four had leucocytosis; five had normal total cholesterol and triglycerides; and four had normal glycaemia. There was increased frequency of pityriasis versicolor in the group undergoing systemic corticotherapy with statistical significance, corroborating the only study on the topic (1962).
Effects of potassium and sodium supply on drought‐adaptive mechanisms in Eucalyptus grandis plantations
Authors: Battie‐Laclau Patricia , Laclau Jean‐Paul , Domec Jean‐Christophe , Christina Mathias , Bouillet Jean‐Pierre , de Cassia Piccolo Marisa , de Moraes Gonçalves José Leonardo , Moreira Rildo Moreira e , Krusche Alex Vladimir , Bouvet Jean‐Marc , Nouvellon Yann
Published: April 2014

A basic understanding of nutrition effects on the mechanisms involved in tree response to drought is essential under a future drier climate.

A large‐scale throughfall exclusion experiment was set up in Brazil to gain an insight into the effects of potassium (K) and sodium (Na) nutrition on tree structural and physiological adjustments to water deficit.

Regardless of the water supply, K and Na supply greatly increased growth and leaf area index (LAI) of Eucalyptus grandis trees over the first 3 yr after planting. Excluding 37% of throughfall reduced above‐ground biomass accumulation in the third year after planting for K‐ supplied trees only. E. grandis trees were scarcely sensitive to drought as a result of the utilization of water stored in deep soil layers after clear‐cutting the previous plantation. Trees coped with water restriction through stomatal closure (isohydrodynamic behavior), osmotic adjustment and decrease in LAI. Additionally, droughted trees showed higher phloem sap sugar concentrations.

K and Na supply increased maximum stomatal conductance, and the high water requirements of fertilized trees increased water stress during dry periods. Fertilization regimes should be revisited in a future drier climate in order to find the right balance between improving tree growth and limiting water shortage.
Technical considerations for maize flour and corn meal fortification in public health: consultation rationale and summary
Authors: Peña‐Rosas Juan Pablo , Garcia‐Casal Maria Nieves , Pachón Helena , Mclean Mireille Seneclauze , Arabi Mandana
Published: April 2014

Fortification is the purposeful addition of vitamins and minerals to foods during their industrial processing, as a way to improve the nutrition and health of populations who consume these foods. Twelve countries have mandatory maize (Zea mays subsp. Mays) flour or meal fortification. The World Health Organization (WHO) is updating evidence‐informed guidelines for the fortification of staple foods in public health, including the fortification of maize flour and corn meal with iron and other micronutrients. Although there is limited experience with fortification of maize, mass fortification of maize flour with at least iron has been practiced for many years in several countries in the Americas and Africa: Brazil, Costa Rica, El Salvador, Kenya, Mexico, Nigeria, Rwanda, South Africa, Tanzania, Uganda, the United States, and Venezuela. The WHO, in collaboration with the Sackler Institute for Nutrition Science and the Flour Fortification Initiative (FFI), convened a consultation on technical considerations for fortification of maize flour and corn meal in public health in New York, New York on April 8–9, 2013 to provide input into the guideline‐development process and to discuss technical considerations of the fortification processes for maize flour and corn meal.
Efficacy of orthopedic treatment with protraction facemask on skeletal Class III malocclusion: a systematic review and meta‐analysis
Authors: Cordasco G. , Matarese G. , Rustico L. , Fastuca S. , Caprioglio A. , Lindauer S. J. , Nucera R.
Published: April 2014

The objective of this systematic review was to estimate the efficacy of protraction facemask on the correction of Class III malocclusion in the short term. A systematic review of articles was performed using different electronic databases (PubMed, Ovid, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, and Google Scholar). Search terms comprised ‘orthopedic treatment’ and ‘Class III malocclusion’. The selection criteria were set in order to include in this review only randomized clinical trials (RCTs) performed treating with facemask Class III growing patients. Studies' selection, data extraction, and risk of bias's assessment were executed independently by two authors using pre‐defined data forms. All pooled analyses of data were based on random effects models. A pre‐specified subgroup analysis was planned to evaluate the effect of preliminary rapid palatal expansion on facemask efficacy. Three RCTs met our inclusion criteria. In total, data from 155 patients (92 treated and 63 controls) were collected. The treated group showed the following significant changes: ANB° +3.66° [95%CI (2.58, 4.74)]; SNA° +2.10 [95%CI (1.14, 3.06)]; SNB° −1.54 [95%CI (−2.13, −0.95)]; SN‐palatal plane −0.82° [95%CI (−1.62, −0.02)]; and SN‐mandibular plane +1.51 [95%CI (0.61, 2.41)]. Heterogeneity varied from low to moderate (mean I2 value: 41.4 ± 20.8). Facemask is effective correcting Class III malocclusion in the short term. The skeletal modifications induced by facemask are forward displacement of maxilla, backward displacement of mandible, clockwise rotation of the mandibular plane, and counterclockwise rotation of the maxillary plane.
Interacting effects of pollination, water and nutrients on fruit tree performance
Authors: Klein A.‐M. , Hendrix S. D. , Clough Y. , Scofield A. , Kremen C.
Published: April 2014

Pollination is critical to fruit production, but the interactions of pollination with plant resources on a plant's reproductive and vegetative features are largely overlooked. We examined the influences of pollination, irrigation and fertilisation on the performance of almond,Prunus dulcis, in northern California. We used a full‐factorial design to test for the effects of pollination limitation on fruit production and foliage variables of whole trees experiencing four resource treatments: (i) normal water and nutrients, (ii) reduced water, (iii) no nutrients, and (iv) reduced water and no nutrients. In each of these combinations, we applied three pollination treatments: hand‐cross pollination, open‐pollination and pollinator exclusion. Pollination strongly affected yield even under reduced water and no nutrient applications. Hand‐cross pollination resulted in over 50% fruit set with small kernels, while open‐pollinated flowers showed over 30% fruit set with moderate‐sized kernels. Pollinator‐excluded flowers had a maximum fruit set of 5%, with big and heavy kernels. Reduced water interacted with the open‐ and hand‐cross pollination treatments, reducing yield more than in the pollinator exclusion treatment. The number of kernels negatively influenced the number of leaves, and reduced water and no nutrient applications interacted with the pollination treatments. Overall, our results indicate that the influences of pollination on fruit tree yield interact with the plant availability of nutrients and water and that excess pollination can reduce fruit quality and the production of leaves for photosynthesis. Such information is critical to understand how pollination influences fruit tree performance.
“Here we're all in the same boat” – a qualitative study of group based rehabilitation for sick‐listed citizens with chronic pain
Authors: Andersen Lotte Nygaard , Kohberg Maria , Herborg Lene Gram , Søgaard Karen , Roessler Kirsten Kaya
Published: April 2014

Musculoskeletal pain impacts upon everyday life. A degree of chronicity may pose an increased risk of sickness absence. One of two rehabilitative interventions, “Tailored Physical Activity” or “Chronic Pain Self‐Management Program”, was offered to sick‐listed citizens who experienced pain. The objectives of this paper were to: (1) Assess what factors are experienced as problematic for sick‐listed citizens in everyday life with chronic pain, and (2) Evaluate the significance of two distinct rehabilitative interventions on the future everyday lives of sick‐listed citizens. Seven semi‐structured interviews with sick‐listed citizens were analyzed using a phenomenological‐hermeneutical approach. Results were discussed by applying the theoretical framework of Antonovsky's salutogenetic model and Yaloms principles for group psychology. The potential for development of citizen's coping is evaluated based on Roessler's notion ofprogression. The analysis revealed four main themes: (1) Living with pain and unemployment; (2) “Putting my foot down” and “asking for help”; (3) Significance of the group, including instructors, and; (4) Aspects significant to progression. Unemployment is a major life event that promotes stress and can be accompanied by problems related to depressed mood, acceptance of the life situation, feelings of not being useful, feelings of losing control and identity conflicts. Group characteristics that gave a significant basis for progression in the self‐management program are both emotional and instrumental, while the physical training program offers a “here‐and‐now”‐experience and motivation to participate. This study indicates that the self‐management program could potentially improve coping while the physical activity program revealed one example of a means of progression.
Welfare State Changes and Outcomes – The Cases of Portugal and Denmark from a Comparative Perspective
Authors: Alves Sónia
Published: April 2014

It is well known that welfare states ensure a certain level of social protection affecting levels of well‐being and the extent of inequalities in society. Changes within crucial domains of social policy, such as education, health, or social protection, have, therefore, a major effect upon individuals' opportunities. In this article I compare the effects of these changes in two countries from the mid‐1980s to the financial crisis of 2008. Portugal that was a latecomer in welfare state development and Denmark was at the forefront of de‐commodification and universalization of social rights. The conclusion of this article is that income inequality has been steadily increasing in Danish society; while in Portugal, despite improvements in many social domains (healthcare, poverty alleviation, unemployment protection), problems of inequality remain deeply embedded in the country's social and institutional structures.
HLA‐DRB1*07:01 allele is primarily associated with the Diego a alloimmunization in a Brazilian population
Authors: Baleotti Wilson , Ruiz Marcelo Ortega , Fabron Antonio , Castilho Lilian , Giuliatti Silvana , Donadi Eduardo Antonio
Published: April 2014

Background

The Diego blood group presents a major polymorphic site at Residue 854, causing a proline (Dib antigen) to leucine (Dia antigen) substitution. Dia alloimmunization has been observed among Asian and Native South American populations. Considering that Brazilians represent a genetically diverse population, and considering that we have observed a high incidence of Dia alloimmunization, we typed HLA‐DRB1 alleles in these patients and performed in silico studies to investigate the possible associated mechanisms.

Study Design and Methods

We studied 212 alloimmunized patients, of whom 24 presented immunoglobulin G anti‐Dia, 15 received Di(a+) red blood cells and were not immunized, and 1008 were healthy donors. HLA typing was performed using commercial kits. In silico analyses were performed using the TEPITOPEpan software to identify Diego‐derived anchor peptide binding to HLA‐DRB1 molecules. Residue alignment was performed using the IMGT/HLA for amino acid identity and homology analyses.

Results

HLA‐DRB1*07:01 allele was overrepresented in Dia‐alloimmunized patients compared to nonimmunized patients and to healthy donors. Two motifs were predicted to be potential epitopes for Dia alloimmunization, the WVVKSTLAS motif was predicted to bind several HLA‐DR molecules, and the FVLILTVPL motif exhibited highest affinity for the HLA‐DRB1*07:01 molecule. Pocket 4 of the DRB1*07:01 molecule contained specific residues not found in other HLA‐DRB1 molecules, particularly those at Positions 13(Y), 74(Q), and 78(V).

Conclusion

Individuals carrying the HLA‐DRB1*07:01 allele present an increased risk for Dia alloimmunization. The identification of susceptible individuals and the knowledge of potential sensitization peptides are relevant approaches for transfusion care, diagnostic purposes, and desensitization therapies.
Experiments on Thermosyphon Loops for Low-Temperature Waste-Heat Recovery
Authors: Matsubara Koji , Tachikawa Suguru , Kourakata Itaru , Matsudaira Yusaku
Published: April 2014

We tested a thermosyphon loop with water as the working fluid using heating rates between 100 W and 400 W. Four kinds of core blocks were installed in the evaporator and tested: a hollow block, and blocks with narrow holes: Φ 2.2 mm × 90; Φ 2.5 mm × 55; and Φ 4.0 mm × 30. The temperature distribution indicated stable flow circulation inside the thermosyphon at low volume ratios but was unstable when the volume ratio was increased higher than 30%. The characteristics of the flow pattern are summarized as a flow map showing the heating rate versus the volume ratio. The recovered heat and the thermal resistance of the thermosyphon loop were clearly improved by using the core blocks with narrow holes instead of hollow blocks for the treated volume ratios from 20% to 80%. The thermal resistance increased when the volume ratio reached high values, suggesting that the effects from the abnormality of the flow circulation affected thermal resistance. The velocity of the gas stream in the thermosyphon was estimated by assuming an isothermal state, and it is diagrammed showing the heating rate at different temperatures. The current experiment of the thermosyphon loop is plotted in this diagram, which indicates the need for a wide margin due to the limitations of the sonic velocity and the pressure head at the full height of the heat pipe.
Minimum Energy Control of Redundant Linear Manipulators
Authors: Halevi Yoram , Carpanzano Emanuele , Montalbano Giuseppe
Published: April 2014

In redundant manipulation systems, the end-effector path does not completely determine the trajectories of all the individual degrees of freedom (dof) and the additional dofs can be used to enhance the performance in some sense. The paper deals with utilizing the redundancy to minimize energy consumption. A full linear electromechanical model is used, and the exact energy consumption is calculated. The optimization includes also displacement limits via penalty functions that are included in the cost function. The optimal trajectory is feasible in the sense that it can be obtained by a finite input voltage and all the velocities are continuous. The solution is based on projections that separate the system and the input into two parts. One that is completely determined by the end-effector path and the other that is free for optimization. The important and delicate issue of boundary conditions is resolved accordingly. Simulation results show that redundancy, even with limited joint motion, can lead to a considerable reduction in energy consumption.
Porous Media Modeling of Two-Phase Microchannel Cooling of Electronic Chips With Nonuniform Power Distribution
Authors: Jie Liu Jun , Zhang Hua , Yao S. C. , Li Yubai
Published: April 2014

Compared to single-phase heat transfer, two-phase microchannel heat sinks utilize latent heat to reduce the needed flow rate and to maintain a rather uniform temperature close to the boiling temperature. The challenge in the application of cooling for electronic chips is the necessity of modeling a large number of microchannels using large number of meshes and extensive computation time. In the present study, a modified porous media method modeling of two-phase flow in microchannels is performed. Compared with conjugate method, which considers individual channels and walls, it saves computation effort and provides a more convenient means to perform optimization of channel geometry. The porous media simulation is applied to a real chip. The channels of high heat load will have higher qualities, larger flow resistances, and lower flow rates. At a constant available pressure drop over the channels, the low heat load channels show much higher mass flow rates than needed. To avoid this flow maldistribution, the channel widths on a chip are adjusted to ensure that the exit qualities and mass flow rate of channels are more uniform. As a result, the total flow rate on the chip is drastically reduced, and the temperature gradient is also minimized. However, it only gives a relatively small reduction on the maximum surface temperature of chip.
Investigation on Operating Processes for a New Solar Cooling Cogeneration Plant
Authors: Shankar R. , Srinivas T.
Published: April 2014

Some commercial units and industries need more amount of cooling than the power such as cold storage, shopping complex, etc. In this work, a new cooling cogeneration cycle (Srinivas cycle) has been proposed and solved to generate more cooling with adequate power generation from single source of heat at hot climatic conditions with ammonia–water mixture as a working fluid. The operational processes conditions for the proposed cooling cogeneration plant are different compared to the power-only (Kalina cycle system) system and cooling-only (vapor absorption refrigeration) system. This work focused to generate the optimum working conditions by parametric analysis from thermodynamic point of view. An increase in cycle maximum temperature is only supporting the power generation but not the cooling output. Cooling output is also 15 times more than power generation. So, it has been recommended to operate the integrated plant with low temperature heat recovery. The resulted cycle thermal efficiency, plant thermal efficiency, specific power, specific cooling, cycle power efficiency, cycle coefficient of performance (COP), and solar collector's specific area are 27%, 10%, 15 kW, 220 kW, 1.8%, 0.25, and 10 m2/kW, respectively.
Fractional Skin Harvesting: Device Operational Principles and Deployment Evaluation
Authors: Franco Walfre , Jimenez-Lozano Joel N. , Tam Joshua , Purschke Martin , Wang Ying , Sakamoto Fernanda H. , Farinelli William A. , Doukas Apostolos G. , Rox Anderson R.
Published: April 2014

As an alternative method to conventional split-thickness skin grafts (STSGs), we recently proposed fractional skin grafting (FSG), which consists in harvesting hundreds of microscopic skin tissue columns (MSTCs) to place them directly into the skin wound (Tam et al., 2013, “Fractional Skin Harvesting: Autologous Skin Graft Without Donor Site Morbidity,” Plast. Reconstructive Surgery–Global Open, 1(6)). This paper (i) introduces the concept and operational principles of a simple but robust fractional skin harvesting (FSH) device and (ii) presents the quantitative evaluation of the deployment of the FSH device with respect to different harvesting-needle sizes. The device utilizes a hypodermic needle with a specific cutting-geometry to core skin tissue mechanically. The tissue core is removed from the donor site into a collecting basket by air and fluid flows. The air flow transports the tissue core, while the fluid flow serves the purpose of lubrication for tissue transport and wetting for tissue preservation. The design and functionality of the device were validated in an animal study conducted to establish preclinical feasibility, safety and efficacy of the proposed FSH device and FSG method. The FSH device, operating at 55.16 kPa (8 psi) gauge pressure and 208 ml/min saline flow rate, cored 800 μm diameter × 2.5 mm length skin columns using a 1.05/0.81 mm outer/inner diameter needle. The MSTC harvesting rate was established by the user at 1 column/sec. For this columns size, about 50 MSTCs are required to cover a 1.5 cm × 1.5 cm wound. In comparison to STSGs, the proposed FSG method results in superior healing outcomes on the donor and wound sites. Most important, the donor site heals without morbidity by remodeling tissue, as opposed to scarring. The FSH device has the capability of extracting full-thickness skin columns while preserving its viability and eliminating the donor site morbidity associated with skin grafting.
Numerical Study of Turbulent Confined Jets Impinging on a Heated Substrate for Thin Film Deposition
Authors: Nizard Harry , Toutant Adrien , Massines Françoise
Published: April 2014

This paper reports on the study of confined jets and jets interaction in terms of increasing chemical transport. The context of this study is the atmospheric pressure plasma-enhanced chemical vapor deposition, higher thin film growth rate being desired, while maintaining total flow rate as low as possible. Turbulence mixing and enhanced heat transfer are the physical mechanisms identified as being capable of increasing the growth rate at atmospheric pressure. A numerical study of jets impinging on a heated substrate was carried out using quasicompressible Reynolds-Averaged Navier–Stokes (RANS) equations. Abe–Kondoh–Nagano (AKN) low-Reynolds k-ε and standard k-ε models were tested using an unconfined impinging jet at Reynolds number Re = 23,750 for jet diameter to plate-spacing ratios of H/d = 2 and H/d = 6. Results were compared with experimental data from the literature. Based on numerical results and in accordance with existing findings, the AKN low-Reynolds k-ε was shown to be reasonably accurate and was thus chosen for the numerical study. The effects of flow rate, hole diameter and length, jet-to-jet spacing, confinement width, and jet number were investigated numerically for inline jets confined between two vertical planes for jet Reynolds numbers between 810 and 5060. The configurations with the greatest turbulent intensity were studied, with the addition of diluted species transport and consumption. A laminar flow setup with a slot jet (Re = 79.5) was compared to two injection designs consisting of a simple set of 12 impinging gas jets (Rej = 2530; H/d = 3) with and without the adjunction of a wire to break the jets (Rej = 1687; H/d = 2). The two turbulent injection methods improved growth rate by 15%, which mainly resulted from a larger gas heating by the surface due to turbulent heat exchange in the jet impact zone.
Viscous and Joule Heating in the Stagnation Point Nanofluid Flow Through a Stretching Sheet With Homogenous–Heterogeneous Reactions and Nonlinear Convection
Authors: Nandkeolyar R. , Motsa S. S. , Sibanda P.
Published: April 2014

The combined effects of viscous and Joule heating on the stagnation point flow of a nanofluid through a stretching/shrinking sheet in the presence of homogeneous–heterogeneous reactions are investigated. The nanoparticle volume fraction model is used to describe the nanofluid. In this study, the density temperature relation is nonlinear which causes a nonlinear convective heat transfer. The surface of the sheet is assumed to be convectively heated with a hot fluid. The governing nonlinear differential equations are solved using the successive linearization method (SLM), and the results are validated by comparison with numerical approximations obtained using the Matlab in-built boundary value problem solver bvp4c and with existing results in literature. The nanofluid problem finds applications in heat transfer devices where the density and temperature relations are complex and the viscosity of the fluid has significant effect on the heat transfer rate.
Does Physical Exercise Help Maintain Mental Health During Pregnancy? A Comparison of Changes in Mental Health in Participants of Physical Exercise Classes and Childbirth Classes
Authors: Guszkowska Monika , Langwald Marta , Sempolska Katarzyna
Published: April 2014

Background:

This study aims to compare the changes in the negative indices of mental health in pregnant women who participated in programs of either physical exercise classes or childbirth classes.

Methods:

The study was quasi-experimental in nature and run on 109 healthy primigravidae aged from 22 to 37, including 62 women participating in an exercise program (exercise group, E-group) for pregnant women and 47 women attending traditional childbirth classes (childbirth classes group, CC-group). The mental health assessment was performed using Goldberg’s General Health Questionnaire (GHQ-28).

Results:

The negative indices of mental health did not change over time. Lower levels of somatic symptoms and severe depression, as well as total score, were observed in the E-group (condition effect). Time × condition interactions, as well as analysis of change within the groups, indicated that in the CC-group all indices of disorders increased significantly, whereas in the E-group, only the increase of depression was significant.

Conclusions:

Regular physical exercises during pregnancy may constitute a factor in the prophylaxis of mental health disorders in pregnant women.
The Environment Can Explain Differences in Adolescents’ Daily Physical Activity Levels Living in a Deprived Urban Area: Cross-Sectional Study Using Accelerometry, GPS, and Focus Groups
Authors: Moore Helen J. , Nixon Catherine A. , Lake Amelia A. , Douthwaite Wayne , O’Malley Claire L. , Pedley Claire L. , Summerbell Carolyn D. , Routen Ashley C.
Published: April 2014

Background:

Evidence suggests that many contemporary urban environments do not support healthy lifestyle choices and are implicated in the obesity pandemic. Middlesbrough, in the northeast of England is one such environment and a prime target for investigation.

Methods:

To measure physical activity (PA) levels in a sample of 28 adolescents (aged 11 to 14 years) and describe the environmental context of their activity and explore where they are most and least active over a 7-day period, accelerometry and Global Positioning System (GPS) technology were used. Twenty-five of these participants also took part in focus groups about their experiences and perceptions of PA engagement.

Results:

Findings indicated that all participants were relatively inactive throughout the observed period although bouts of moderate-vigorous physical activity (MVPA) were identified in 4 contexts: school, home, street, and rural/urban green spaces, with MVPA levels highest in the school setting. Providing access to local facilities and services (such as leisure centers) is not in itself sufficient to engage adolescents in MVPA.

Conclusion:

Factors influencing engagement in MVPA were identified within and across contexts, including ‘time’ as both a facilitator and barrier, perceptions of ‘gendered’ PA, and the social influences of peer groups and family members.