bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between maternal anaemia and pregnancy outcomes: a cohort study in Assam, India
Authors: Nair Manisha , Choudhury Manoj K , Choudhury Saswati S , Kakoty Swapna D , Sarma Umesh C , Webster Premila , Knight Marian
Published: April 2016

Objectives

To examine the association between maternal anaemia and adverse maternal and infant outcomes, and to assess the feasibility of conducting epidemiological studies through the Indian Obstetric Surveillance System–Assam (IndOSS-Assam).

Design

Retrospective cohort study using anonymised hospital records. Exposure: maternal iron deficiency anaemia; outcomes: postpartum haemorrhage (PPH), low birthweight, small-for-gestational age babies, perinatal death.

Setting

5 government medical colleges in Assam.

Study population

1007 pregnant women who delivered in the 5 medical colleges from January to June 2015.

Main outcome measures

ORs with 95% CIs to estimate the association between maternal iron deficiency anaemia and the adverse maternal and infant outcomes. Potential interactive roles of infections and induction of labour on the adverse outcomes were explored.

Results

35% (n=351) pregnant women had moderate–severe anaemia. Women with severe anaemia had a higher odds of PPH (adjusted OR (aOR) =9.45; 95% CI 2.62 to 34.05), giving birth to low birthweight (aOR=6.19; 95% CI 1.44 to 26.71) and small-for-gestational age babies (aOR=8.72; 95% CI 1.66 to 45.67), and perinatal death (aOR=16.42; 95% CI 4.38 to 61.55). Odds of PPH increased 17-fold among women with moderate–severe anaemia who underwent induction of labour, and 19-fold among women who had infection and moderate–severe anaemia.

Conclusions

Maternal iron deficiency anaemia is a major public health problem in Assam. Maternal anaemia was associated with increased risks of PPH, low birthweight, small-for-gestational age babies and perinatal death. While the best approach is prevention, a large number of women present with severe anaemia late in pregnancy and there is no clear guidance on how these women should be managed during labour and delivery.
Role of relatives of ethnic minority patients in patient safety in hospital care: a qualitative study
Authors: van Rosse Floor , Suurmond Jeanine , Wagner Cordula , de Bruijne Martine , Essink-Bot Marie-Louise
Published: April 2016

Objective

Relatives of ethnic minority patients often play an important role in the care process during hospitalisation. Our objective was to analyse the role of these relatives in relation to the safety of patients during hospital care.

Setting

Four large urban hospitals with an ethnic diverse patient population.

Participants

On hospital admission of ethnic minority patients, 20 cases were purposively sampled in which relatives were observed to play a role in the care process.

Outcome measures

We used documents (patient records) and added eight cases with qualitative interviews with healthcare providers, patients and/or their relatives to investigate the relation between the role of relatives and patient safety. An inductive approach followed by selective coding was used to analyse the data.

Results

Besides giving social support, family members took on themselves the role of the interpreter, the role of substitutes of the patient and the role of care provider. The taking over of these roles can have positive and negative effects on patient safety.

Conclusions

When family members take over various roles during hospitalisation of a relative, this can lead to a safety risk and a safety protection for the patient involved. Although healthcare providers should not hand over their responsibilities to the relatives of patients, optimising collaboration with relatives who are willing to take part in the care process may improve patient safety.
Impact of the great east Japan earthquake on the body mass index of preschool children: a nationwide nursery school survey
Authors: Yokomichi Hiroshi , Zheng Wei , Matsubara Hiroko , Ishikuro Mami , Kikuya Masahiro , Isojima Tsuyoshi , Yokoya Susumu , Tanaka Toshiaki , Kato Noriko , Chida Shoichi , Ono Atsushi , Hosoya Mitsuaki , Tanaka Soichiro , Kuriyama Shinichi , Kure Shigeo , Yamagata Zentaro
Published: April 2016

Objective

To evaluate the impact of the 2011 great east Japan earthquake on body mass index (BMI) of preschool children.

Design

Retrospective cohort study and ecological study.

Setting

Affected prefectures (Fukushima, Miyagi and Iwate) and unaffected prefectures in northeast Japan.

Participants

The cohort study assessed 2033 and 1707 boys and 1909 and 1658 girls in 3 affected prefectures and unaffected prefectures, respectively, all aged 3–4 years at the time of the earthquake. The ecological study examined random samples of schoolchildren from the affected prefectures.

Primary and secondary outcome measures

The cohort study compared postdisaster changes in BMIs and the prevalence of overweight and obese children. The ecological study evaluated postdisaster changes in the prevalence of overweight children.

Results

1 month after the earthquake, significantly increased BMIs were observed among girls (+0.087 kg/m2vs unaffected prefectures) in Fukushima and among boys and girls (+0.165 and +0.124 kg/m2, respectively vs unaffected prefectures) in Iwate. 19 months after the earthquake, significantly increased BMIs were detected among boys and girls (+0.137 and +0.200 kg/m2, respectively vs unaffected prefectures) in Fukushima, whereas significantly decreased BMIs were observed among boys and girls (−0.218 and −0.082 kg/m2, respectively vs unaffected prefectures) in Miyagi. 1 month after the earthquake, Fukushima, Miyagi and Iwate had a slightly increased prevalence of overweight boys, whereas Fukushima had a slightly decreased prevalence of overweight girls, compared with the unaffected prefectures. The ecological study detected increases in the prevalence of overweight boys and girls in Fukushima who were 6–11 and 6–10 years of age, respectively.

Conclusions

These results suggest that in the affected prefectures, preschool children gained weight immediately after the earthquake. The long-term impact of the earthquake on early childhood growth was more variable among the affected prefectures, possibly as a result of different speeds of recovery.
Making Quality Improvement Happen in the Real World: Building Capability and Improving Multiple Projects at the Same Time
Authors: Daniel Malcolm , Puxty Alex , Miles Barbara
Published: April 2016

Improving work as part of clinical practice is challenging. Plans for improvement are often made, but not followed through.

A recent experience of failure in an ICU led to a change in approach. Members of the multi-professional team committed to meet weekly to learn about quality improvement by working on improvement projects.

The group selected four topics they wanted to work on. These were: a bundle for patients admitted with septic shock; early (≤4 hours) sedation vacation after admission to ICU to allow titration of sedation to effect; achieving ≥ 20 minutes of mobilisation per day in ventilated patients; and medicines reconciliation.

This quality improvement meeting was built into another regular weekly meeting. Initially the meeting ran for 30 minutes; each week some focused quality improvement teaching was provided in addition to talking about each individual project.

The team found the meeting useful, they saw the progress they were making but felt the allotted time was too short. After 6 weeks, the initial early results persuaded the team to increase the duration of this meeting to 45 minutes.

At the start reliability of each process was low (between 10% and 38%). All four projects achieved their stated process reliability aim. This took between 165 and 334 days for each project. Many tests of change ideas were required to achieve this.

We have been able to improve multiple topics in a short period and produce sustainable change. The weekly meeting provided the focus to this improvement work. The teaching and coaching on quality improvement methodology that occurred as part of this meeting helped accelerate our rate of progress.

We believe this experience and the learning we have gained will help provide ideas for others who also want to improve healthcare delivery in different settings.
Referral Finder: Saving Time and Improving The Quality of In-hospital Referrals
Authors: Cathcart Jennifer , Cowan Neil , Tully Vicki
Published: April 2016

Making referrals to other hospital specialties is one of the key duties of the foundation doctor, which can be difficult and time consuming. In Ninewells hospital, Scotland, in our experience the effectiveness of referrals is limited by contact details not being readily accessible and foundation doctors not knowing what information is relevant to each specialty.

We surveyed foundation doctors on their experience of the existing referral process to identify where we needed to focus to improve the process. The doctors reported significant delays in obtaining contact details from the operator, and found they did not know the specific information needed in each referral.

To increase the information available to foundation doctors, we set up a page on the staff intranet called ‘Referral Finder’. This page includes contact details, guidelines for referral, and links to relevant protocols for each specialty. By making this information readily accessible our objective was to increase the speed and quality of referrals.

When surveyed two months after the web page was established, foundation doctors reported a reduction in calls to operator from baseline and reported achieving more effective referrals. When asked to comment, many doctors asked if the page could include details for other hospitals in our health board and provide more specialty specific information.

This feedback prompted us to extend the scope of the page to include the district general hospital in our region, and update many of the existing details. Doctors were then surveyed after the updates, 100% agreed that the website saved time and there was a 49.3% reduction in doctors who reported not knowing the specific information needed for a referral.

Having adequate information improved referrals and resulted in time saved. This would allow more time for patient care. The quality improvement project was praised among doctors as a useful, innovative and replicable project.
Validation of ABCD2 scores ascertained by referring clinicians: a retrospective transient ischaemic attack clinic cohort study
Authors: Dutta Dipankar , Bailey Sarah-Jane
Published: April 2016

Introduction

Transient ischaemic attack (TIA) services routinely use ABCD2 scores ascertained by referring clinicians to triage patients. Most ABCD2 validation studies have used ABCD2 scores calculated by stroke-specialist investigators and not referring clinicians. This study aimed to assess the usefulness of referring clinicians' ABCD2 scores in predicting strokes.

Methods

A retrospective study of a TIA clinic cohort from Gloucester, UK, followed up for 4 years from 2010 to 2012. ABCD2 scores were dichotomised to high risk—ABCD2≥4 and low risk—ABCD2<4. Outcomes of interest were subsequent stroke and stroke or TIA. Survival analysis was used determine the cumulative probability of these outcomes and to identify if ABCD2 risk category was associated with stroke.

Results

Of 1067 (284 high risk, 783 low risk) patients, 49.6% were classified by the clinic stroke physicians as TIA/minor stroke and 50.4% as mimics. Follow-up was for a median of 34.9 (IQR 27.7–41.6) months with 56 strokes and 106 strokes/TIA. The number of strokes by 7 days, 90 days and 48 months, respectively, were: high risk 0, 2 and 20 and low risk 2, 6 and 36 (p=0.21). Unadjusted HR for subsequent stroke was 1.41 (95% CI 0.82 to 2.46) in the high-risk group compared with the low-risk group and HR adjusted for the diagnosis of TIA/stroke was 1.2 (95% CI 0.69 to 2.08).

Conclusions

ABCD2 scores recorded by referring clinicians did not identify patients at high risk of subsequent stroke, suggesting that the score should not be used for TIA clinic triage.
Does parenting help to explain socioeconomic inequalities in children's body mass index trajectories? Longitudinal analysis using the Growing Up in Scotland study
Authors: Parkes Alison , Sweeting Helen , Young Robert , Wight Daniel
Published: April 2016

Background

Pathways leading to socioeconomic inequalities in young children's body mass index (BMI) are not well understood. This study examined whether parenting related to the physical and social context of children's food consumption helped to explain associations between maternal educational level and child BMI trajectory.

Methods

The study used data from 2957 families in a nationally representative birth cohort study surveyed from 2004 to 2011, with child BMI z-score measured 3 times (46, 70 and 94 months). Latent growth curve models examined associations between maternal education and BMI z-score trajectory, exploring mediating effects of parenting (positive mealtime interaction, informal meal setting and child bedroom TV) and unhealthy child diet.

Results

After adjusting for maternal BMI, maternal education predicted increased inequality in child BMI z-score trajectory slope over the study period. The slope index of inequality coefficient for maternal education, that is, the change in z-score associated with the lowest relative to the highest maternal education level, was 0.17, p<0.001. Indirect effects of lower maternal education on steeper BMI trajectory via parenting and/or unhealthy diet represented 89% of the total effect. Pathways via parenting and then unhealthy diet accounted for 68% of significant indirect pathways, with the remainder via unhealthy diet only. Bedroom TV was the most important parenting pathway, followed by informal meal setting.

Conclusions

Pathways via parenting helped to explain the emergence of inequalities in young children's BMI related to maternal education. Interventions targeting parental provision of child bedroom TV and informal meal setting might reduce these inequalities.
Muscle damage, physiological changes, and energy balance in ultra-endurance mountain-event athletes
Authors: Ramos-Campo Domingo Jesús , Ávila-Gandía Vicente , Alacid Fernando , Soto-Méndez Fulgencio , Alcaraz Pedro E. , López-Román Francisco Javier , Rubio-Arias Jacobo Ángel
Published: April 2016

The biological response to ultra-endurance mountain race events is not yet well understood. The aim of this study was to determine the biochemical and physiological changes after performing an ultra-endurance mountain race in runners. We recruited 11 amateur runners (age: 29.7 ± 10.2 years; height: 179.7 ± 5.4 cm; body mass: 76.7 ± 10.3 kg). Muscle damage, lactate concentration, energy balance, rating of perceived exertion (RPE), heart rate (HR), heart rate variability (HRV), body composition changes, and jump performance were analyzed before, during (only lactate, HR, and HRV), and after the race. Athletes completed 54 km in 6 h, 44 min (±28 min). After the race, myoglobin and creatine kinase concentration increased from 14.9 ± 5.2 to 1419.9 ± 1292.1 μg/L and from 820.0 ± 2087.3 to 2421.1 ± 2336.2 UI/L, respectively (p < 0.01). In addition, lactate dehydrogenase and troponin I significantly increased after the race (p < 0.01). Leukocyte and platelet count increased by 180.6% ± 68.9% and 23.7% ± 11.2%, respectively (p < 0.001). Moreover, after the competition, athletes presented a 3704 kcal negative energy balance; a significant increase in RPE values; a decrease in countermovement and squat jump height; and a decrease in body mass and lower limb girths. During the event, lactate concentration did not change and subjects presented a mean HR of 158.8 ± 17.7 beats/min, a significant decrement in vagal modulation, and a significant increase in sympathetic modulation. Despite the relative “low” intensity achieved, ultra-endurance mountain race is a stressful stimulus that produces a high level of muscle damage in the athletes. These findings may help coaches to design specific training programs that may improve nutritional intake strategies and prevent muscle damage.
Model-assisted forest inventory with parametric, semiparametric, and nonparametric models
Authors: Kangas Annika , Myllymäki Mari , Gobakken Terje , Næsset Erik
Published: April 2016

Survey sampling with model-assisted estimation has been gaining popularity in forest inventory recently, as the availability of cheap, good-quality remotely sensed data that can be used as auxiliary information has improved. Most of the studies have been carried out using parametric (linear or nonlinear) models. However, nonparametric and semiparametric models such as k nearest neighbor, kernel, and generalized additive are widely used in forest inventory. The results are usually calculated using the difference estimator (i.e., assuming an external model), even though the models used are based on the sample (i.e., an internal model). In that case, variances will likely be underestimated. In this study, we analyze how well the difference estimator works for different types of models, both internal and external. The study is based on simulated populations produced using a C-vine copula model with empirical marginals. The external model is based on real data, and the internal models are estimated from samples from the simulated population. The results show that the analytical variance estimates for a difference estimator based on an overfitted kernel model can seriously underestimate the true variance.
Comments on the nilpotent constraint of the goldstino superfield
Authors: Ghilencea D. M.
Published: April 2016

Superfield constraints were often used in the past, in particular, to describe the Akulov–Volkov action of the goldstino by a superfield formulation with [Formula: see text] endowed with the nilpotent constraint [Formula: see text] for the goldstino superfield ([Formula: see text]). Inspired by this, such constraint is often used to define the goldstino superfield even in the presence of additional superfields, for example, in models of “nilpotent inflation”. In this review, we show that the nilpotent property is not valid, in general, under the assumption of a microscopic (ultraviolet (UV)) description of the theory with linear supermultiplets. Sometimes only weaker versions of the nilpotent relation are true such as [Formula: see text] or [Formula: see text] ([Formula: see text]) in the infrared (far below the UV scale) under the further requirement of decoupling all additional scalars (coupling to sgoldstino), something not always possible (e.g. if light scalars exist). In such cases, the weaker nilpotent property is not specific to the goldstino superfield anymore. We review the restrictions for the Kahler curvature tensor and superpotential [Formula: see text] under which [Formula: see text] remains true in infrared, assuming linear supermultiplets in the microscopic description. One can reverse the arguments to demand that the nilpotent condition, initially an infrared property, be extended even in the presence of additional superfields, but this may question the nature of supersymmetry breaking or the existence of a perturbative UV description with linear supermultiplets.
The mean first passage time and stochastic resonance in gene transcriptional system with time delay
Authors: Feng Y. L. , Zhu J. , Zhang M. , Gao L. L. , Liu Y. F. , Dong J. M.
Published: April 2016

In this paper, the gene transcriptional dynamics driven by correlated noises are investigated, where the time delay for the synthesis of transcriptional factor is introduced. The effects of the noise correlation strength and time delay on the stationary probability distribution (SPD), the mean first passage time and the stochastic resonance (SR) are analyzed in detail based on the delay Fokker–Planck equation. It is found that both the time delay and noise correlation strength play important roles in the bistable transcriptional system. The effect of the correlation strength reduces but the time delay enhances the mean first passage time (MFPT). Finally, the SR for this gene transcriptional system is found to be enhanced by the time delay.
Technical Survey Graph Databases and Applications
Authors: Wang Shao-Ting , Jin Jennifer , Rivett Pete , Kitazawa Atsushi
Published: April 2016

Graph databases can be defined as databases that use graph structures with nodes, edges and properties to store data. Semantic queries and graph-oriented operations are used to access them. With a rapidly growing amount of information on the Internet in recent years, relational databases suffer performance degradation as a large number of nodes are added due to the number of entries in join tables. Therefore, based on the network nature of Internet activities, graph databases are designed for fast access to complex data found in social networks, recommendation engines and networked system. The main objective of this survey is to present the work that has been done in the area of graph database, including query languages, processing, and related application.
Key problems of stratigraphy in the Eastern Crimea Peninsula: some insights from new dating and structural data
Authors: Sheremet Yevgeniya , Sosson Marc , Muller Carla , Gintov Oleg , Murovskaya Anna , Yegorova Tamara
Published: April 2016

The tectonic evolution of the Eastern Black Sea Basin has previously been explained based on offshore and onshore data, some of the latter from the Crimean Mountains (CM). However, changes in the stratigraphy of the CM have recently been proposed: the Late Triassic–Early Jurassic Tauric Group was assigned as younger (Albian). To clarify the stratigraphy and the tectonic evolution of this area, we sampled the eastern CM for micropalaeontological datings (nannoplankton). The results demonstrate an Early Cretaceous age for the Tauric Group in the eastern CM. The samples contained substantial amounts of volcanic ash, indicating a period of magmatic activity along all the eastern CM. Our field observations allowed us to propose a new structural map and cross-sections, using which three main tectonic units were distinguished. We define a phase of extension during the Early Cretaceous and one of shortening during the Paleocene–Early Eocene, before the main Middle Eocene limestone unconformity. These two phases are related to: (1) the opening of the Eastern Black Sea Basin along NNW–SSE-trending normal faults and the associated magmatism; and (2) north–south shortening that could be comparable with the inversion in Dobrogea and/or with north–south shortening linked to the collision of continental blocks in the Pontides and Taurides domains.
Optimal Design and Acoustic Assessment of Low-Vibration Rotor Blades
Authors: Bernardini G. , Piccione E. , Anobile A. , Serafini J. , Gennaretti M.
Published: April 2016

An optimal procedure for the design of rotor blade that generates low vibratory hub loads in nonaxial flow conditions is presented and applied to a helicopter rotor in forward flight, a condition where vibrations and noise become severe. Blade shape and structural properties are the design parameters to be identified within a binary genetic optimization algorithm under aeroelastic stability constraint. The process exploits an aeroelastic solver that is based on a nonlinear, beam-like model, suited for the analysis of arbitrary curved-elastic-axis blades, with the introduction of a surrogate wake inflow model for the analysis of sectional aerodynamic loads. Numerical results are presented to demonstrate the capability of the proposed approach to identify low vibratory hub loads rotor blades as well as to assess the robustness of solution at off-design operating conditions. Further, the aeroacoustic assessment of the rotor configurations determined is carried out in order to examine the impact of low-vibration blade design on the emitted noise field.
Teddy and I Get a Check-Up: A Pilot Educational Intervention Teaching Children Coping Strategies for Managing Procedure-Related Pain and Fear
Authors: Dalley Jessica S. , McMurtry C. Meghan
Published: April 2016

Background. Pediatric medical information provision literature focuses on hospitalization and surgical procedures, but children would also benefit from an educational program regarding more commonly experienced medical procedures (e.g., needles, general check-up).Objective. To determine whether an evidence-based educational program reduced children’s ratings of fear of and expected pain from medical stimuli and increased their knowledge of procedural coping strategies.Methods. An educational, interactive, developmentally appropriate Teddy Bear Clinic Tour was developed and delivered at a veterinary clinic. During this tour, 71 5–10-year-old children (Mage=6.62years,SD=1.19) were taught about medical equipment, procedures, and coping strategies through modelling and rehearsal. In a single-group, pretest posttest design, participants reported their fear of and expected pain from medical and nonmedical stimuli. Children were also asked to report strategies they would use to cope with procedural fear.Results. Children’s ratings for expected pain during a needle procedure were reduced following the intervention. No significant change occurred in children’s fear of needles. Children reported more intervention-taught coping strategies at Time 2.Conclusions. The results of this study suggest that an evidence-based, interactive educational program can reduce young children’s expectations of needle pain and may help teach them procedural coping strategies.
The Effect of Initial State Error for Nonlinear Systems with Delay via Iterative Learning Control
Authors: Qunli Zhang
Published: April 2016

An iterative learning control problem for nonlinear systems with delays is studied in detail in this paper. By introducing theλ-norm and being inspired by retarded Gronwall-like inequality, the novel sufficient conditions for robust convergence of the tracking error, whose initial states are not zero, with time delays are obtained. Finally, simulation example is given to illustrate the effectiveness of the proposed method.
Sacroiliitis and Polyarteritis Nodosa in a Patient with Familial Mediterranean Fever
Authors: Ugan Yunus , Doğru Atalay , Şencan Hüseyin , Şahin Mehmet , Ercan Tunç Şevket
Published: April 2016

Familial Mediterranean fever (FMF) is an autoinflammatory disorder with autosomal recessive inheritance, characterized by recurrent fever and episodes of serositis. The condition is known to be caused by mutations in the MEFV (Mediterranean FeVer) gene, located in the short arm of chromosome 16. While more than 310 sequence variants in the MEFV gene have been described to date, the diagnosis is still established clinically. FMF may be accompanied by sacroiliitis and various forms of vasculitis. The most common forms of associated vasculitis are Henoch-Schonlein purpura and polyarteritis nodosa (PAN). We have presented here a fairly rare case of FMF, accompanied by both sacroiliitis and PAN.
Personality and Perceived Health in Spousal Caregivers of Patients with Lung Cancer: The Roles of Neuroticism and Extraversion
Authors: Hoerger Michael , Coletta Maria , Sörensen Silvia , Chapman Benjamin P. , Kaukeinen Kim , Tu Xin , Duberstein Paul R.
Published: April 2016

Purpose. Family members’ responsibilities for patients with cancer have increased dramatically over the past decade and will likely continue to rise. Given that caregiving is associated with declines in self-care, there is a need for research on caregivers’ perceptions of their own health. The purpose of this study was to examine whether personality is associated with four self-report perceived health items from the SF-36.Methods. The sample consisted of 114 spouses of lung cancer patients who completed cross-sectional measures as part of a larger cohort study on adjustment to the diagnosis and treatment of lung cancer. Predictors of interest were Neuroticism and Extraversion scores from the NEO-FFI. Covariates were age, gender, conscientiousness, depressive symptoms, and objective illness burden.Results. Multivariate analyses revealed that caregivers with higher Extraversion scores were less likely to respond affirmatively to the item “I expect my health to get worse” (OR = 0.90,p<0.05). Neuroticism was associated with poorer perceived health (ORs from 1.11 to 1.12,p’s < 0.05).Conclusions. The present cross-sectional findings suggest that personality is associated with responses to SF-36 perceived health items beyond what can be accounted for by objective illness burden and other covariates. The potential overestimation of health among extraverted caregivers may have implications for their health outcomes.
Multiple Model Adaptive Tracking Control Based on Adaptive Dynamic Programming
Authors: Wang Kang , Li Xiaoli , Li Yang
Published: April 2016

Adaptive dynamic programming (ADP) has been tested as an effective method for optimal control of nonlinear system. However, as the structure of ADP requires control input to satisfy the initial admissible control condition, the control performance may be deteriorated due to abrupt parameter change or system failure. In this paper, we introduce the multiple models idea into ADP, multiple subcontrollers run in parallel to supply multiple initial conditions for different environments, and a switching index is set up to decide the appropriate initial conditions for current system. By taking this strategy, the proposed multiple model ADP achieves optimal control for system with jumping parameters. The convergence of multiple model adaptive control based on ADP is proved and the simulation shows that the proposed method can improve the transient response of system effectively.
Application of Unit Commitment with Market Pool in a Peaking Power Generation Firm in the Philippines for a Cost Reduction Case Study
Authors: Santillan Luke Rey , Senen Kenn Brylle , Wamilda Robert , Ocampo Lanndon , Seva Rafael , Bacalso Reuella J. , Liggayu Alaine
Published: April 2016

This paper attempts to provide an optimum loading schedule of power generating units with the least cost by solving a unit commitment (UC) problem and to present good estimates of cost differences when UC problem is not applied. UC is a fundamental optimization problem of power generation systems which determines the optimum schedule of generating units which minimizes generation costs. However, for small power generation firms which are situated in developing countries, UC-based problems are poorly understood if not implemented and the scheduling of generating units is based on some methodologies which may provide results that are not optimal. Thus, a case study in a small power generation firm in central Philippines is carried out to elucidate these objectives. The case requires a solution of the mixed-integer nonlinear programming (MINLP) problem. Results show that the proposed UC-based problem yields optimal costs and the cost disparity from the current scheduling scheme is approximately at 27% which may be considered as potential cost savings. This shows that UC-based problem provides a reliable platform in achieving minimal generation costs. These results are significant to decision-makers particularly in small power generation firms and to engineering practitioners in the Philippines and in some developing countries as these provide an overview of the disparity of cost figures of not implementing UC.
The Noncentral Version of the Whitney Numbers: A Comprehensive Study
Authors: Mangontarum Mahid M. , Cauntongan Omar I. , Macodi-Ringia Amila P.
Published: April 2016

This paper is a comprehensive study of a certain generalization of Whitney-type and Stirling-type numbers which unifies the classical Whitney numbers, the translated Whitney numbers, the classical Stirling numbers, and the noncentral Stirling (orr-Stirling) numbers. Several identities, applications, and occurrences are also presented.
Guidance Law and Neural Control for Hypersonic Missile to Track Targets
Authors: Fu Wenxing , Yan Binbin , Chang Xiaofei , Yan Jie
Published: April 2016

Hypersonic technology plays an important role in prompt global strike. Because the flight dynamics of a hypersonic vehicle is nonlinear, uncertain, and highly coupled, the controller design is challenging, especially to design its guidance and control law during the attack of a maneuvering target. In this paper, the sliding mode control (SMC) method is used to develop the guidance law from which the desired flight path angle is derived. With the desired information as control command, the adaptive neural control in discrete time is investigated ingeniously for the longitudinal dynamics of the hypersonic missile. The proposed guidance and control laws are validated by simulation of a hypersonic missile against a maneuvering target. It is demonstrated that the scheme has good robustness and high accuracy to attack a maneuvering target in the presence of external disturbance and missile model uncertainty.
Lycium barbarum Polysaccharides Protect against Trimethyltin Chloride‐Induced Apoptosis via Sonic Hedgehog and PI3K/Akt Signaling Pathways in Mouse Neuro‐2a Cells
Authors: Zhao Wanyun , Pan Xiaoqi , Li Tao , Zhang Changchun , Shi Nian
Published: April 2016

Trimethyltin chloride (TMT) is a classic neurotoxicant that can cause severe neurodegenerative diseases. Some signaling pathways involving cell death play pivotal roles in the central nervous system. In this study, the role of Sonic Hedgehog (Shh) and PI3K/Akt pathways in TMT‐induced apoptosis and protective effect of Lycium barbarum polysaccharides (LBP) on mouse neuro‐2a (N2a) cells were investigated. Results showed that TMT treatment significantly enhanced apoptosis, upregulated proapoptotic Bax, downregulated antiapoptotic Bcl‐2 expression, and increased caspase‐3 activity in a dose‐dependent manner in N2a cells. TMT induced oxidative stress in cells, performing reactive oxygen species (ROS) and malondialdehyde (MDA) excessive generation, and superoxide dismutase (SOD) activity reduction. TMT significantly decreased phosphorylated glycogen synthase kinase‐3β (GSK‐3β) and inhibited Shh and PI3K/Akt pathways. However, the addition of LBP upregulated GSK‐3β phosphorylation, activated Shh and PI3K/Akt pathways, and eventually reduced apoptosis and oxidative stress caused by TMT. The interaction between Shh and PI3K/Akt pathways was clarified by specific PI3K inhibitor LY294002 or Shh inhibitor GDC‐0449. Moreover, LY294002 and GDC‐0449 pretreatment both induced phosphorylated GSK‐3β downregulation and significantly promoted apoptosis induced by TMT. These results suggest that LBP could reduce TMT‐induced N2a cells apoptosis by regulating GSK‐3β phosphorylation, Shh, and PI3K/Akt signaling pathways.
Hematopoietic Age at Onset of Triple-Negative Breast Cancer Dictates Disease Aggressiveness and Progression
Authors: Marsh Timothy , Wong Irene , Sceneay Jaclyn , Barakat Amey , Qin Yuanbo , Sjödin Andreas , Alspach Elise , Nilsson Björn , Stewart Sheila A. , McAllister Sandra S.
Published: April 2016

Triple-negative breast cancer (TNBC) is considered an early onset subtype of breast cancer that carries with it a poorer prognosis in young rather than older women for reasons that remain poorly understood. Hematopoiesis in the bone marrow becomes altered with age and may therefore affect the composition of tumor-infiltrating hematopoietic cells and subsequent tumor progression. In this study, we investigated how age- and tumor-dependent changes to bone marrow–derived hematopoietic cells impact TNBC progression. Using multiple mouse models of TNBC tumorigenesis and metastasis, we found that a specific population of bone marrow cells (BMC) upregulated CSF-1R and secreted the growth factor granulin to support stromal activation and robust tumor growth in young mice. However, the same cell population in old mice expressed low levels of CSF1R and granulin and failed to promote tumor outgrowth, suggesting that age influences the tumorigenic capacity of BMCs in response to tumor-associated signals. Importantly, BMCs from young mice were sufficient to activate a tumor-supportive microenvironment and induce tumor progression in old mice. These results indicate that hematopoietic age is an important determinant of TNBC aggressiveness and provide rationale for investigating age-stratified therapies designed to prevent the protumorigenic effects of activated BMCs. Cancer Res; 76(10); 2932–43. ©2016 AACR.
TRX-E-002-1 Induces c-Jun–Dependent Apoptosis in Ovarian Cancer Stem Cells and Prevents Recurrence In Vivo
Authors: Alvero Ayesha B. , Heaton Andrew , Lima Eydis , Pitruzzello Mary , Sumi Natalia , Yang-Hartwich Yang , Cardenas Carlos , Steinmacher Sahra , Silasi Dan-Arin , Brown David , Mor Gil
Published: April 2016

Chemoresistance is a major hurdle in the management of patients with epithelial ovarian cancer and is responsible for its high mortality. Studies have shown that chemoresistance is due to the presence of a subgroup of cancer cells with stemness properties and a high capacity for tumor repair. We have developed a library of super-benzopyran analogues to generate potent compounds that can induce cell death in chemoresistant cancer stem cells. TRX-E-002-1 is identified as the most potent analogue and can induce cell death in all chemoresistant CD44+/MyD88+ ovarian cancer stem cells tested (IC50 = 50 nmol/L). TRX-E-002-1 is also potent against spheroid cultures formed from cancer stem cells, chemosensitive CD44−/MyD88− ovarian cancer cells, and heterogeneous cultures of ovarian cancer cells. Cell death was associated with the phosphorylation and increased levels of c-Jun and induction of caspases. In vivo, TRX-E-002-1 given as daily intraperitoneal monotherapy at 100 mg/kg significantly decreased intraperitoneal tumor burden compared with vehicle control. When given in combination with cisplatin, animals receiving the combination of cisplatin and TRX-E-002-1 showed decreased tumor burden compared with each monotherapy. Finally, TRX-E-002-1 given as maintenance treatment after paclitaxel significantly delayed disease recurrence. Our results suggest that TRX-E-002-1 may fill the current need for better therapeutic options in the control and management of recurrent ovarian cancer and may help improve patient survival. Mol Cancer Ther; 15(6); 1279–90. ©2016 AACR.
T Cells Expressing CD19/CD20 Bispecific Chimeric Antigen Receptors Prevent Antigen Escape by Malignant B Cells
Authors: Zah Eugenia , Lin Meng-Yin , Silva-Benedict Anne , Jensen Michael C. , Chen Yvonne Y.
Published: April 2016

The adoptive transfer of T cells expressing anti-CD19 chimeric antigen receptors (CARs) has shown remarkable curative potential against advanced B-cell malignancies, but multiple trials have also reported patient relapses due to the emergence of CD19-negative leukemic cells. Here, we report the design and optimization of single-chain, bispecific CARs that trigger robust cytotoxicity against target cells expressing either CD19 or CD20, two clinically validated targets for B-cell malignancies. We determined the structural parameters required for efficient dual-antigen recognition, and we demonstrate that optimized bispecific CARs can control both wild-type B-cell lymphoma and CD19– mutants with equal efficiency in vivo. To our knowledge, this is the first bispecific CAR capable of preventing antigen escape by performing true OR-gate signal computation on a clinically relevant pair of tumor-associated antigens. The CD19-OR-CD20 CAR is fully compatible with existing T-cell manufacturing procedures and implementable by current clinical protocols. These results present an effective solution to the challenge of antigen escape in CD19 CAR T-cell therapy, and they highlight the utility of structure-based rational design in the development of receptors with higher-level complexity. Cancer Immunol Res; 4(6); 498–508. ©2016 AACR.

See related Spotlight by Sadelain, p. 473.

An addendum has been published.
Obesity Management in Adolescents: Comparison of a Low-Intensity Face-to-Face Therapy Provided by a Trained Paediatrician with an Intensive Multidisciplinary Group Therapy
Authors: Chamay-Weber Catherine , Farpour-Lambert Nathalie J. , Saunders Gasser Catherine , Martin Xavier E. , Gal Claudine , Maggio Albane B.
Published: April 2016

Objective: This study aimed to compare the effects of a low-intensity face-to-face therapy provided by a trained paediatrician to an intensive group therapy provided by a multidisciplinary team on the BMI of adolescents with obesity. Methods: This longitudinal cohort study included 233 adolescents aged 11-18 years (mean 13.1 ± 1.7 years). Patients and their parents choose either a low-intensity face-to-face therapy or an intensive group therapy (total 88 h). Results: At baseline, the mean BMI was 29.4 ± 4.9 kg/m2. Within groups changes of BMI z-scores were significant at the end of follow-up both in the face-to-face (-0.2 ± 0.5) and the group therapy (-0.24 ± 0.5). There was no difference among groups. Younger age (12-14 years), gender, follow-up duration as well as BMI z-score at inclusion were significantly related to BMI z-score changes, independently of the type of intervention. As expected, the face-to-face therapy was far less expensive than the group therapy (USD 1,473.00 ± 816.00 vs. USD 6,473.00 ± 780.00). Conclusion: A low-intensity face-to-face therapy resulted in similar changes of the BMI z-score of adolescents than an intensive multidisciplinary group therapy. This approach could be easily disseminated in primary care settings with a specific training in obesity care.
Isolation and Culture of Single Cell Types from Rat Liver
Authors: Zhang Qidi , Qu Ying , Li Zhenghong , Zhang Qingqing , Xu Mingyi , Cai Xiaobo , Li Fei , Lu Lungen
Published: April 2016

There have been few reports on the simultaneous isolation of multiple liver cell populations thus far. As such, this study was aimed at establishing a protocol for the simultaneous separation of hepatocytes (HCs), hepatic stellate cells (HSCs), liver sinusoidal endothelial cells (LSECs) and Kupffer cells (KCs) from the rat liver and assessing the in vitro culture of these cells. Single-cell suspensions from the liver were obtained by ethylene glycol tetraacetic acid/collagenase perfusion. After low-speed centrifugal separation of HCs, pronase was added to the nonparenchymal cell fraction to eliminate the remaining HCs. Subsequently, HSCs, LSECs and KCs were purified by two steps of density gradient centrifugation using Nycodenz and Percoll in addition to selective attachment. Pronase treatment increased the HSC yield (1.5 ± 0.2 vs. 0.7 ± 0.3 cells/g liver, p < 0.05) and improved LSEC purity (93.6 ± 3.6 vs. 82.5 ± 5.6%, p < 0.01). The isolated cells could also be cultured in vitro. LSEC apoptosis began on day 3 and reached a maximum on day 7. A few surviving LSECs began proliferating and split to form a cobblestone, sheet-like appearance on day 14. The LSECs on day 14 lost fenestrations but retained scavenger function. Thus, viable and purified liver cells were obtained with a high yield from the rat liver using the developed method, which may be useful for studying the physiology and pathology of the liver in the future.
Nevoid Basal Cell Carcinoma Syndrome: Report from the Zurich Nevoid Basal Cell Carcinoma Syndrome Cohort
Authors: Rehefeldt-Erne Susanne , Nägeli Mirjam C. , Winterton Nina , Felderer Lea , Weibel Lisa , Hafner Jürg , Dummer Reinhard
Published: April 2016

Background: Nevoid basal cell carcinoma syndrome (NBCCS, Gorlin-Goltz syndrome) presents various symptoms and can disfigure patients. The estimated prevalence is around 1:100,000. Objective: To systematically investigate the clinical manifestations of NBCCS patients of the Zurich register and compare them with those described in 4 epidemiological studies performed in other countries. Methods: We analyzed patient characteristics and clinical manifestations in a register of 30 NBCCS patients in Zurich, Switzerland. We compared our findings to the results of 4 epidemiological studies performed in America, Australia, Japan and the UK. Results: We obtained information concerning basal cell carcinomas (BCCs) and jaw cysts from 28 patients out of our population of 30 NBCCS patients. The mean age at onset of the first BCC was 24 years, and the mean age at diagnosis of the first jaw cyst was 15.6 years. The average number of jaw cysts was 8.4; the average number of BCCs was 207. 72.5% of the examined BCCs showed a nodular histology, but we also found scirrhous and superficial types. Conclusion: The disease burden associated with NBCCS diagnosed in Swiss patients is significant and comparable to that of other countries. Regular skin examination and oromaxillary examinations should be performed early in diagnosis, and patients should undergo early UV protection. Nodular BCC is the most common BCC subtype in this patient population.
Congenital C1-2 Lateral Translational Dislocation: Case Illustration with Pre- and Postoperative Imaging
Authors: Salunke Pravin , Sahoo Sushanta K. , Deepak Arsikere N. , Garg Ravi
Published: April 2016

Background: Congenital atlantoaxial dislocation has been commonly described in the antero-posterior or vertical plane (basilar invagination). However, dislocation in the lateral translational plane due to congenital deformity is rare. Case Report: We present a case of a young male who presented with os odontoideum with C1-2 dislocation in the lateral plane along with antero-posterior dislocation. He was operated on through a midline posterior incision, and the C1-2 facet was manipulated so as to correct the dislocation in all planes. Conclusion: With os odontoideum, the C1-2 joints can exhibit movements that are out of the ordinary, even in the lateral translational plane. It suggests that the ligaments and joint capsule may weaken with time. Careful radiological evaluation helps in diagnosing this rare condition. An understanding of 3D facetal anatomy is important to achieve complete correction.
Homozygous Mutation of the FGFR1 Gene Associated with Congenital Heart Disease and 46,XY Disorder of Sex Development
Authors: Mazen Inas , Amin Heba , Kamel Alaa , El Ruby Mona , Bignon-Topalovic Joelle , Bashamboo Anu , McElreavey Ken
Published: April 2016

Congenital heart diseases (CHDs) are the most common cause of all birth defects and account for nearly 25% of all major congenital anomalies leading to mortality in the first year of life. Extracardiac anomalies including urogenital aberrations are present in ∼30% of all cases. Here, we present a rare case of a 46,XY patient with CHD associated with ambiguous genitalia consisting of a clitoris-like phallus and a bifid scrotum. Exome sequencing revealed novel homozygous mutations in the FGFR1 and STARD3 genes that may be associated with the phenotype.
Management of HCV-Associated Liver Cirrhosis
Authors: Schneider Maximilian D. , Sarrazin Christoph
Published: April 2016

Background: Treatment of chronic hepatitis C infection is most urgent in patients with severe liver fibrosis and cirrhosis because of the high risk of decompensation, hepatocellular carcinoma, and consecutively death. The development and approval of several direct-acting antiviral drugs (DAA) in the past years has revolutionized antiviral therapy especially for patients with liver cirrhosis. Methods: This review will focus on recent data from clinical trials and recommendations for the therapy of hepatitis C-infected patients with compensated cirrhosis. Results: Clinical data for cirrhotic patients mainly exist for a combination of the nucleotide analog sofosbuvir with either a protease inhibitor (simeprevir) or an NS5A inhibitor (daclatasvir, ledipasvir) or a three-DAA combination consisting of an NS3 protease inhibitor, an NS5A inhibitor, and a non-nucleoside NS5B inhibitor (paritaprevir/ritonavir, ombitasvir, and dasabuvir). Rates of sustained virologic response in patients with compensated cirrhosis are comparable to patients without cirrhosis; however, the addition of ribavirin and/or longer treatment durations are especially recommended when other negative predictors are present, such as prior treatment failure, features of advanced cirrhosis, or the presence of baseline resistance. Conclusion: Nowadays, a highly active, short, and safe interferon-free treatment regimen is available for almost all patients.