bluuebunny/crossref_metadata_2025 huggingface dataset:
Subchondral Insufficiency Fracture of the Femoral Head Caused by Excessive Lateralization of the Acetabular Rim
Authors: Kimura Tetsuya , Goto Tomohiro , Hamada Daisuke , Tsutsui Takahiko , Wada Keizo , Fukuta Shoji , Nagamachi Akihiro , Sairyo Koichi
Published: May 2016

We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. A diagnosis of SIF was made by typical MRI findings of SIF. The lesion occurred at the antipodes of the extended rim. Increased mechanical stress over the femoral head due to impingement against the excess bone was suspected as a cause of SIF. The distinct femoral head deformity is consistent with this hypothesis. This is the first report of SIF associated with acetabular overcoverage.
An Advanced Auxiliary Delay-Weight Particle Filter with Linear Computation Cost
Authors: Li Chen , Sun Lin , Zheng Zengwei , Chen Dan
Published: May 2016

We investigate the problem of tracking mobile targets in wireless sensor networks. We propose an advanced auxiliary delayed-weight particle filter algorithm (ADWPF). We make a deep study on the evolvement of particles and formally define the tree-like structure relationship among particles based on observations. Most importantly, we add some auxiliary particles to these structures formed by sampled particles in order to obtain more efficient structures. Based on the newly tree-like structures formed by auxiliary particles and sampled particles, we design a well efficient delayed-weight algorithm with linear computation cost. Experiment results demonstrate that our algorithm can greatly improve the tracking accuracy of a mobile target, compared with bootstrap filter, auxiliary particle filter, and another delayed-weight particle filter.
Dynamic Behaviors and Energy Transition Mechanism of Droplets Impacting on Hydrophobic Surfaces
Authors: Huang Qiaogao , Zhang Ya , Pan Guang
Published: May 2016

The wettability of hydrophobic surfaces and the dynamic behaviors of droplets impacting on hydrophobic surfaces are simulated using a lattice Boltzmann method, and the condition for the rebound phenomenon of droplets impacting on solid surfaces is analyzed. The results show that there is a linear relationship between the intrinsic contact angle and the interaction strength of fluid-wall particles. For hydrophobic surfaces with the same intrinsic contact angle, the micromorphology can increase the surface hydrophobicity, especially the hierarchical micromorphology. The dynamic behaviors of droplets impacting on solid surfaces are affected by the wettability. The surface hydrophobicity is stronger, and the rebound phenomenon occurs easier. If the droplet’s kinetic energy is greater than the sum of the surface energy and the minimum conversion gravitational potential energy when the spreading and shrinking finish, the rebound phenomenon will occur. As the hydrophobic surface’s viscous dissipation is much smaller than the hydrophilic surface’s, the droplet still has high kinetic energy after the spreading and shrinking, which is advantageous to rebound for droplets.
Anterior Chamber Non-Hodgkin Lymphoma of the Iris Masquerading as Uveitis-Glaucoma-Hyphema Syndrome
Authors: Gauthier Angela C. , Nguyen Alexander , Munday William R. , Xu Mina L. , Materin Miguel A.
Published: May 2016

Purpose: To report a case of iris non-Hodgkin lymphoma initially thought to be uveitis-glaucoma-hyphema (UGH) syndrome. Methods: We reviewed the clinical, radiographic, and histopathologic findings in a patient with recurrent hyphemas and increased ocular pressure who eventually was found to have a rapidly growing iris mass. Results: An 89-year-old man with a history of cataract extraction and mantle cell lymphoma developed recurrent hyphema, which was subsequently revealed to be due to an iris mass. A biopsy revealed non-Hodgkin lymphoma that could not be formally subclassified but was suspicious for mantle cell lymphoma. The tumor showed a partial response to ibrutinib. Conclusion: Iris lymphoma can masquerade as a cause of recurrent hyphema after cataract extraction. Ophthalmologists should be aware of this presentation, especially in patients with a history of lymphoma.
Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients
Authors: Engbers Elsemiek M. , Timmer Jorik R. , Ottervanger Jan Paul , Mouden Mohamed , Knollema Siert , Jager Pieter L.
Published: May 2016

Background—

The prognostic value of coronary artery calcium (CAC) scoring on top of myocardial perfusion imaging with single-photon emission computed tomography (SPECT) in patients suspected for coronary artery disease is not well established.

Methods and Results—

Four thousand eight hundred ninety-seven symptomatic patients without a history of coronary artery disease referred for SPECT and CAC scoring were included. Major adverse cardiac events (MACEs) were defined as late revascularization (>90 days after scanning), nonfatal myocardial infarction, and all-cause mortality. The frequency of abnormal SPECT increased with higher CAC scores, from 12% in patients with CAC scores of 0 to 19%, 32%, 37%, and 50% among those with CAC scores 1 to 99, 100 to 399, 400 to 999, and ≥1000, respectively (
P
<0.001). During a median follow-up of 940 days (25th to 75th percentile, 581–1377), a total of 278 MACEs were observed. Overall incidence of MACE was 2.3% per year. A stepwise increase of MACE was present with increasing CAC scores, both in patients with normal SPECT (annual event rate CAC score 0: 0.6%; CAC score ≥1000: 5.5%) and abnormal SPECT (annual event rate CAC score 0: 0.4%; CAC score ≥1000: 7.6%). After multivariate analysis, both SPECT and CAC score were independent predictors of MACE (CAC score ≥1000: hazard ratio, 7.7;
P
<0.001 and large perfusion defect on SPECT: hazard ratio, 3.7;
P
<0.001).

Conclusions—

CAC score and SPECT are independent predictors of MACE in patients suspected for coronary artery disease. Our findings strongly support performing a CAC score in addition to SPECT in symptomatic patients to better define the risk of events during follow-up.
Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke
Authors: Bath Philip M. , Scutt Polly , Love Jo , Clavé Pere , Cohen David , Dziewas Rainer , Iversen Helle K. , Ledl Christian , Ragab Suzanne , Soda Hassan , Warusevitane Anushka , Woisard Virginie , Hamdy Shaheen
Published: May 2016

Background and Purpose—

Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials.

Methods—

We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks.

Results—

In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9),
P
=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred.

Conclusions—

In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia. Undertreatment of patients receiving PES may have contributed to the neutral result.

Clinical Trial Registration—

URL:
http://www.controlled-trials.com
. Unique identifier: ISRCTN25681641.
Aspirin for Stroke Prevention in Elderly Patients With Vascular Risk Factors
Authors: Uchiyama Shinichiro , Ishizuka Naoki , Shimada Kazuyuki , Teramoto Tamio , Yamazaki Tsutomu , Oikawa Shinichi , Sugawara Masahiro , Ando Katsuyuki , Murata Mitsuru , Yokoyama Kenji , Minematsu Kazuo , Matsumoto Masayasu , Ikeda Yasuo
Published: May 2016

Background and Purpose—

The effect of aspirin in primary prevention of stroke is controversial among clinical trials conducted in Western countries, and no data are available for Asian populations with a high risk of intracranial hemorrhage. The objective of this study was to evaluate the effect of aspirin on the risk of stroke and intracranial hemorrhage in the Japanese Primary Prevention Project (JPPP).

Methods—

A total of 14 464 patients (age, 60–85 years) with hypertension, dyslipidemia, and diabetes mellitus participated and were randomized into 2 treatment groups: 100 mg of aspirin or no aspirin. The median follow-up period was 5.02 years.

Results—

The cumulative rate of fatal or nonfatal stroke was similar for the aspirin (2.068%; 95% confidence interval [CI], 1.750–2.443) and no aspirin (2.299%; 95% CI, 1.963–2.692) groups at 5 years; the estimated hazard ratio was 0.927 (95% CI, 0.741–1.160;
P
=0.509). Aspirin nonsignificantly reduced the risk of ischemic stroke or transient ischemic attack (hazard ratio, 0.783; 95% CI, 0.606–1.012;
P
=0.061) and nonsignificantly increased the risk of intracranial hemorrhage (hazard ratio, 1.463; 95% CI; 0.956–2.237;
P
=0.078). A Cox regression adjusted by the risk factors for all stroke, which were age >70 years, smoking, and diabetes mellitus, supported the above result.

Conclusions—

Aspirin did not show any net benefit for the primary prevention of stroke in elderly Japanese patients with risk factors for stroke, whereas age >70 years, smoking, and diabetes mellitus were risk factors for stroke regardless of aspirin treatment.

Clinical Trial Registration—

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00225849.
Systematic Review and Meta-Analysis of Bone Marrow–Derived Mononuclear Cells in Animal Models of Ischemic Stroke
Authors: Vahidy Farhaan S. , Rahbar Mohammad H. , Zhu Hongjian , Rowan Paul J. , Bambhroliya Arvind B. , Savitz Sean I.
Published: May 2016

Background and Purpose—

Bone marrow–derived mononuclear cells (BMMNCs) offer the promise of augmenting poststroke recovery. There is mounting evidence of safety and efficacy of BMMNCs from preclinical studies of ischemic stroke; however, their pooled effects have not been described.

Methods—

Using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we conducted a systematic review of preclinical literature for intravenous use of BMMNCs followed by meta-analyses of histological and behavioral outcomes. Studies were selected based on predefined criteria. Data were abstracted by 2 independent investigators. After quality assessment, the pooled effects were generated using mixed-effect models. Impact of possible biases on estimated effect size was evaluated.

Results—

Standardized mean difference and 95% confidence interval for reduction in lesion volume was significantly beneficial for BMMNC treatment (standardized mean difference: −3.3; 95% confidence interval, −4.3 to −2.3). n=113 each for BMMNC and controls. BMMNC-treated animals (n=161) also had improved function measured by cylinder test (standardized mean difference: −2.4; 95% confidence interval, −3.1 to −1.6), as compared with controls (n=205). A trend for benefit was observed for adhesive removal test and neurological deficit score. Study quality score (median: 6; Q1–Q3: 5–7) was correlated with year of publication. There was funnel plot asymmetry; however, the pooled effects were robust to the correction of this bias and remained significant in favor of BMMNC treatment.

Conclusions—

BMMNCs demonstrate beneficial effects across histological and behavioral outcomes in animal ischemic stroke models. Although study quality has improved over time, considerable degree of heterogeneity calls for standardization in the conduct and reporting of experimentation.
Neural Correlates of Divided Attention in Natural Scenes
Authors: Fagioli Sabrina , Macaluso Emiliano
Published: May 2016

Individuals are able to split attention between separate locations, but divided spatial attention incurs the additional requirement of monitoring multiple streams of information. Here, we investigated divided attention using photos of natural scenes, where the rapid categorization of familiar objects and prior knowledge about the likely positions of objects in the real world might affect the interplay between these spatial and nonspatial factors. Sixteen participants underwent fMRI during an object detection task. They were presented with scenes containing either a person or a car, located on the left or right side of the photo. Participants monitored either one or both object categories, in one or both visual hemifields. First, we investigated the interplay between spatial and nonspatial attention by comparing conditions of divided attention between categories and/or locations. We then assessed the contribution of top–down processes versus stimulus-driven signals by separately testing the effects of divided attention in target and nontarget trials. The results revealed activation of a bilateral frontoparietal network when dividing attention between the two object categories versus attending to a single category but no main effect of dividing attention between spatial locations. Within this network, the left dorsal premotor cortex and the left intraparietal sulcus were found to combine task- and stimulus-related signals. These regions showed maximal activation when participants monitored two categories at spatially separate locations and the scene included a nontarget object. We conclude that the dorsal frontoparietal cortex integrates top–down and bottom–up signals in the presence of distractors during divided attention in real-world scenes.
Elements of a Historical-Materialist Theory of Racism
Authors: Camfield David
Published: May 2016

This article aims to advance the historical-materialist understanding of racism by addressing some central theoretical questions. It argues that racism should be understood as a social relation of oppression rather than as solely or primarily an ideology, and suggests that a historical-materialist concept of race is necessary in order to capture features of societies shaped by historically specific racisms. A carefully conceived concept of privilege is also required if we are to grasp the contradictory ways in which members of dominant racial groups are affected by social relations of racial oppression. The persistence of racism today should be explained as a consequence of two dimensions of the capitalist mode of production – imperialism and the contribution of racism to profitability – and of a social property emergent from racism: the efforts of members of dominant groups to preserve their advantages relative to the racially oppressed.
Italian Futurism in Cairo
Authors: Paniconi Maria Elena
Published: May 2016

Nelson Morpurgo was born to a Histrian family in Cairo. Raised between Cairo and Milan, he met Filippo Tommaso Marinetti and several other Futurists and, ultimately, helped secure a place for futurism in Cairo from the 1920s through to his departure in the 1940s. He organized theatrical performances, painting exhibitions, radio shows, cultural events and debates. My paper analyzes the cultural and linguistic bilingualism that this interstitial figure developed. Morpurgo’s activity is understood in three different ways: first, as the trans-national experience of a Futurist vanguard; second, as emblematic of the Italian community in Cairo; and third, as representative of the complexities of Egyptian cosmopolitanism. His writings allow us to reframe the relationships between the Egyptian arabophone scene and the often multi-lingual, eclectic foreign community. Morpurgo negotiates a position between the ideologically incongruous cultural lives of Marinetti and the local surrealist vanguard.
Climatology and Interannual Variability of Quasi-Global Intense Precipitation Using Satellite Observations
Authors: Ricko Martina , Adler Robert F. , Huffman George J.
Published: May 2016

Climatology and variations of recent mean and intense precipitation over a near-global (50°S–50°N) domain on a monthly and annual time scale are analyzed. Data used to derive daily precipitation to examine the effects of spatial and temporal coverage of intense precipitation are from the current Tropical Rainfall Measuring Mission (TRMM) Multisatellite Precipitation Analysis (TMPA) 3B42 version 7 precipitation product, with high spatial and temporal resolution during 1998–2013. Intense precipitation is defined by several different parameters, such as a 95th percentile threshold of daily precipitation, a mean precipitation that exceeds that percentile, or a fixed threshold of daily precipitation value (e.g., 25 and 50 mm day−1). All parameters are used to identify the main characteristics of spatial and temporal variation of intense precipitation. High correlations between examined parameters are observed, especially between climatological monthly mean precipitation and intense precipitation, over both tropical land and ocean. Among the various parameters examined, the one best characterizing intense rainfall is a fraction of daily precipitation ≥ 25 mm day−1, defined as a ratio between the intense precipitation above the used threshold and mean precipitation. Regions that experience an increase in mean precipitation likely experience a similar increase in intense precipitation, especially during the El Niño–Southern Oscillation (ENSO) events. Improved knowledge of this intense precipitation regime and its strong connection to mean precipitation given by the fraction parameter can be used for monitoring of intense rainfall and its intensity on a global to regional scale.
On the Origin of a Chain of Eddies in the Gulf of Eilat/Aqaba
Authors: Biton Eli , Gildor Hezi
Published: May 2016

The Gulf of Eilat/Aqaba is a terminal, elongated basin that exchanges water with the northern Red Sea via the Straits of Tiran. This study used energy budgets of mean kinetic energy (MKE) and eddy kinetic energy (EKE; differentiated by a simple horizontal averaging filter), instability analysis, and numerical simulations to study the horizontal circulation of the gulf, which is characterized by the existence of a chain of eddies along its main axis. The kinetic energy is predominantly in the form of EKE. Energy conversion between MKE and EKE is negligible where the main sources for both energy reservoirs are the conversions from the available potential energy (APE). This term is balanced by the work done by pressure at the straits in case of MKE and by dissipation in the case of EKE. The MKE balance represents the coupling between the exchange flow at the straits and the wintertime dense water formation. The dense water exits through the straits while sinking adiabatically along the gulf. The strong variation in the shoreline/bathymetry triggers a baroclinic instability that enhances the eddy activity in the gulf. Thus, the baroclinic instability is an effective mechanism that transfers energy from the APE to the EKE. The EKE–APE conversion term involves vertical adiabatic motions that occur through the upwelling of relatively warm water in anticyclonic circulation regions and downwelling of colder water in adjacent regions with cyclonic circulation. Through these processes, the horizontal circulation is powered by the energy transferred from the APE. This explains the coupling between the temperature gradient and the eddy formation along the gulf.
Comments on “The Interaction of an Eastward-Flowing Current and an Island: Sub- and Supercritical Flow”
Authors: Baines Peter G. , Hughes Roger L.
Published: May 2016

In regards to the recent paper by Pedlosky and Spall (Journal of Physical Oceanography, November 2015), this comment maintains that the steady-state solutions of Rossby waves in a uniform eastward current past an island have waves on the upstream side that are not caused by the island because of inappropriate boundary conditions and the assumed form of the solution. The solutions are interesting but are not the solutions to the problem as posed in their paper. Similar upstream waves in a time-dependent numerical model are also inconsistent with linear Rossby wave theory, though the reasons for their presence are uncertain.
Negative Association of Diabetes With Thoracic Aortic Dissection and Aneurysm
Authors: Takagi Hisato , Umemoto Takuya
Published: May 2016

We performed a meta-analysis to assess the association of diabetes mellitus (DM) with the presence of thoracic aortic dissection (TAD) and/or thoracic aortic aneurysm (TAA). MEDLINE and EMBASE were searched through December 2015 using PubMed and OVID. For each study, data regarding DM prevalence in both the TAD/TAA and control groups were used to generate unadjusted odds ratios (ORs) for DM and 95% confidence intervals (CIs). Alternatively, an unadjusted and/or adjusted OR was directly abstracted from each individual study. Eleven eligible studies enrolling a total of 47 827 participants were included. A primary pooled analysis of all the 11 studies demonstrated that TAD/TAA was associated with significantly lower DM prevalence than controls (OR, 0.43; 95% CI, 0.31-0.59; P < .00001). Separate pooled analyses of 6 TAD case studies and 4 TAA case studies demonstrated TAD (OR, 0.34; 95% CI, 0.19-0.61; P = .0003) and TAA (OR, 0.65; 95% CI, 0.45-0.94; P = .02) were associated with significantly lower DM prevalence than controls. In conclusion, DM may be negatively associated with the presence of TAD/TAA.
Application of Handheld Laser-Induced Breakdown Spectroscopy (LIBS) to Geochemical Analysis
Authors: Connors Brendan , Somers Andrew , Day David
Published: May 2016

While laser-induced breakdown spectroscopy (LIBS) has been in use for decades, only within the last two years has technology progressed to the point of enabling true handheld, self-contained instruments. Several instruments are now commercially available with a range of capabilities and features. In this paper, the SciAps Z-500 handheld LIBS instrument functionality and sub-systems are reviewed. Several assayed geochemical sample sets, including igneous rocks and soils, are investigated. Calibration data are presented for multiple elements of interest along with examples of elemental mapping in heterogeneous samples. Sample preparation and the data collection method from multiple locations and data analysis are discussed.
Field Analysis of Polychlorinated Biphenyls (PCBs) in Soil Using Solid-Phase Microextraction (SPME) and a Portable Gas Chromatography–Mass Spectrometry System
Authors: Zhang Mengliang , Kruse Natalie A. , Bowman Jennifer R. , Jackson Glen P.
Published: May 2016

An expedited field analysis method was developed for the determination of polychlorinated biphenyls (PCBs) in soil matrices using a portable gas chromatography–mass spectrometry (GC-MS) instrument. Soil samples of approximately 0.5 g were measured with a portable scale and PCBs were extracted by headspace solid-phase microextraction (SPME) with a 100 µm polydimethylsiloxane (PDMS) fiber. Two milliliters of 0.2 M potassium permanganate and 0.5 mL of 6 M sulfuric acid solution were added to the soil matrices to facilitate the extraction of PCBs. The extraction was performed for 30 min at 100 ℃ in a portable heating block that was powered by a portable generator. The portable GC-MS instrument took less than 6 min per analysis and ran off an internal battery and helium cylinder. Six commercial PCB mixtures, Aroclor 1016, 1221, 1232, 1242, 1248, 1254, and 1260, could be classified based on the GC chromatograms and mass spectra. The detection limit of this method for Aroclor 1260 in soil matrices is approximately 10 ppm, which is sufficient for guiding remediation efforts in contaminated sites. This method was applicable to the on-site analysis of PCBs with a total analysis time of 37 min per sample. However, the total analysis time could be improved to less than 7 min per sample by conducting the rate-limiting extraction step for different samples in parallel.
EDTA interference in electrochemiluminescence ACTH assay
Authors: Toprak Burak , Yalcin Hulya , Arı Elif , Colak Ayfer
Published: May 2016

Background

As plasma is the recommended sample type for Roche adrenocorticotropic hormone (ACTH) assay, we evaluated the effect of EDTA concentration on Cobas ACTH assay.

Methods

Samples containing twofold and fourfold higher concentrations of EDTA were prepared by adding plasma to empty K2EDTA tubes and by making under-filled EDTA tubes. All measurements were performed with four replicates.

Results

Increased EDTA concentration resulted in a significant decrease in ACTH concentration. Fifty-per cent-filled EDTA tube showed 19% decrease in ACTH concentration and 25% filled EDTA tube showed 50% decrease in ACTH concentration.

Conclusion

We recommend that inadequately filled EDTA specimens should be rejected when using Cobas ACTH assay.
Evaluation of two commercially available ELISA kits for the determination of melatonin concentrations in amniotic fluid throughout pregnancy
Authors: Bagci Soyhan , Altuntas Özlem , Katzer David , Berg Christoph , Willruth Arne , Reutter Heiko , Bartmann Peter , Müller Andreas , Zur Berndt
Published: May 2016

Background

The aim of the present study is to evaluate the utility of extraction versus non-extraction-based commercial melatonin ELISA kits for determining the melatonin concentration in amniotic fluid obtained in early and late pregnancy.

Methods

Pregnancy duration less than 28 weeks was defined as early and from 28 weeks until delivery as late gestation. Nine samples were obtained in early and 18 in late pregnancy. Two commercially available melatonin ELISA kits (melatonin ELISA RE54021, including methanol-based extraction and direct saliva melatonin ELISA RE 54041, not including an extraction step, both from IBL-International, Germany) were used to determine melatonin concentrations in amniotic fluid.

Results

The mean melatonin concentration in ELISAs assayed by the non-extraction was significantly lower than those assayed after extraction. Subgroup analysis showed that there was no significant difference between melatonin concentration measured by non-extraction versus extraction ELISA in early pregnancy (11.2 ± 7.4 vs. 12.2 ± 7.7, respectively, P = 0.463) but that the mean melatonin concentration in late pregnancy was significantly lower when assayed by non-extraction ELISA than when assayed by extraction ELISA (14.8 ± 9.3 vs. 145.1 ± 179.3, respectively; P < 0.001). Agreement between both measurements in late pregnancy was rather poor (r2 = 0.271, P = 0.022), as opposed to the good correlation found in early pregnancy (r2 = 0.929, P < 0.001).

Conclusions

The present study revealed that a melatonin assay without an extraction step, such as direct saliva ELISA, does not seem to be a valid method to determine the melatonin concentration of amniotic fluid, especially in late gestation.
Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted/seated patients
Authors: Casey R , Griffin TP , Wall D , Dennedy MC , Bell M , O’Shea PM
Published: May 2016

Background

The Endocrine Society Clinical Practice Guideline on Phaeochomocytoma and Paraganglioma recommends phlebotomy for plasma-free metanephrines with patients fasted and supine using appropriately defined reference intervals. Studies have shown higher diagnostic sensitivities using these criteria. Further, with seated-sampling protocols, for result interpretation, reference intervals that do not compromise diagnostic sensitivity should be employed.

Objective

To determine the impact on diagnostic performance and financial cost of using supine reference intervals for result interpretation with our current plasma-free metanephrines fasted/seated-sampling protocol.

Methods

We conducted a retrospective cohort study of patients who underwent screening for PPGL using plasma-free metanephrines from 2009 to 2014 at Galway University Hospitals. Plasma-free metanephrines were measured using liquid chromatography-tandem mass spectrometry. Supine thresholds for plasma normetanephrine and metanephrine set at 610 pmol/L and 310 pmol/L, respectively, were used.

Results

A total of 183 patients were evaluated. Mean age of participants was 53.4 (±16.3) years. Five of 183 (2.7%) patients had histologically confirmed PPGL (males, n=4). Using seated reference intervals for plasma-free metanephrines, diagnostic sensitivity and specificity were 100% and 98.9%, respectively, with two false-positive cases. Application of reference intervals established in subjects supine and fasted to this cohort gave diagnostic sensitivity of 100% with specificity of 74.7%. Financial analysis of each pretesting strategy demonstrated cost-equivalence (€147.27/patient).

Conclusion

Our cost analysis, together with the evidence that fasted/supine-sampling for plasma-free metanephrines, offers more reliable exclusion of PPGL mandates changing our current practice. This study highlights the important advantages of standardized diagnostic protocols for plasma-free metanephrines to ensure the highest diagnostic accuracy for investigation of PPGL.
Gender difference in type 2 diabetes and the role of body iron stores
Authors: Aregbesola Alex , Voutilainen Sari , Virtanen Jyrki K , Mursu Jaakko , Tuomainen Tomi-Pekka
Published: May 2016

Background

Studies of gender difference in type 2 diabetes have been inconclusive. We investigated gender difference in type 2 diabetes and the contribution of body iron, as assessed by serum ferritin to this difference.

Methods

We performed cross-sectional ( n = 1707) and prospective ( n = 1506) analyses in males and females aged 53–73 years in 1998–2001. Type 2 diabetes diagnosis was determined by questionnaire, blood glucose measurements and record linkage to type 2 diabetes registers. Gender difference in type 2 diabetes and serum ferritin contribution to the difference was examined in multivariable logistic and Cox regression models. Gender difference in fasting plasma glucose and insulin and homeostasis model assessment of insulin resistance was examined in linear regression analysis.

Results

In the cross-sectional analysis, a total of 201 type 2 diabetes cases were observed (males = 111 [55.2%] vs. female = 90 [44.8%], P = 0.032), and in adjusted models, males had higher odds of type 2 diabetes (OR = 1.61, 95% CI 1.10 to 2.34); higher fasting plasma glucose (β = 0.28, 95% CI 0.15 to 0.41), fasting plasma insulin (β = 0.73, 95% CI 0.26 to 1.19) and homeostasis model assessment of insulin resistance (β = 0.11, 95% CI 0.04 to 0.17). In the prospective analysis, males had increased risk of type 2 diabetes (HR = 1.46, 95% CI 1.03 to 2.07). With serum ferritin introduction (100  µg/L, log-transformed) into the models, the type 2 diabetes prevalence (OR = 1.35, 95% CI 0.91 to 1.99) and incidence (HR = 1.38, 95% CI 0.96 to 1.97) were appreciably attenuated.

Conclusions

These data suggest a gender difference in type 2 diabetes, with a higher prevalence and increased type 2 diabetes risk in males. Body iron explains about two-fifths and one-fifth of the gender difference in type 2 diabetes prevalence and incidence, respectively.
Analysis of the causes of discrepancies in troponin I concentrations as measured by ARCHITECT High-Sensitive Troponin I ST and STACIA CLEIA cTnI
Authors: Kondo Takashi , Kobayashi Daisuke , Mochizuki Maki , Asanuma Kouichi , Takahashi Satoshi
Published: May 2016

Background

Recently developed reagents for the highly sensitive measurement of cardiac troponin I are useful for early diagnosis of acute coronary syndrome. However, differences in measured values between these new reagents and previously used reagents have not been well studied. In this study, we aimed to compare the values between ARCHITECT High-Sensitive Troponin I ST (newly developed reagents), ARCHITECT Troponin I ST and STACIA CLEIA cardiac troponin I (two previously developed reagent kits).

Methods

Gel filtration high-performance liquid chromatography was used to analyse the causes of differences in measured values.

Results

The measured values differed between ARCHITECT High-Sensitive Troponin I ST and STACIA CLEIA cardiac troponin I reagents (r = 0.82). Cross-reactivity tests using plasma with added skeletal-muscle troponin I resulted in higher reactivity (2.17–3.03%) for the STACIA CLEIA cardiac troponin I reagents compared with that for the ARCHITECT High-Sensitive Troponin I ST reagents (less than 0.014%). In addition, analysis of three representative samples using gel filtration high-performance liquid chromatography revealed reagent-specific differences in the reactivity against each cardiac troponin I complex; this could explain the differences in values observed for some of the samples.

Conclusion

The newly developed ARCHITECT High-Sensitive Troponin I ST reagents were not affected by the presence of skeletal-muscle troponin I in the blood and may be useful for routine examinations.
The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey
Authors: Erdal Erik P , Mitra Debanjali , Khangulov Victor S , Church Stephen , Plokhoy Elizabeth
Published: May 2016

Background

Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored.

Methods

A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues.

Results

Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247.

Conclusions

Measures to improve blood sample quality present an important step towards improved laboratory operations.
Toward a complex system understanding of bipolar disorder: A chaotic model of abnormal circadian activity rhythms in euthymic bipolar disorder
Authors: Hadaeghi Fatemeh , Hashemi Golpayegani Mohammad Reza , Jafari Sajad , Murray Greg
Published: May 2016

Importance:

In the absence of a comprehensive neural model to explain the underlying mechanisms of disturbed circadian function in bipolar disorder, mathematical modeling is a helpful tool. Here, circadian activity as a response to exogenous daily cycles is proposed to be the product of interactions between neuronal networks in cortical (cognitive processing) and subcortical (pacemaker) areas of the brain.

Objective:

To investigate the dynamical aspects of the link between disturbed circadian activity rhythms and abnormalities of neurotransmitter functioning in frontal areas of the brain, we developed a novel mathematical model of a chaotic system which represents fluctuations in circadian activity in bipolar disorder as changes in the model’s parameters.

Design, Setting and Participants:

A novel map-based chaotic system was developed to capture disturbances in circadian activity across the two extreme mood states of bipolar disorder. The model uses chaos theory to characterize interplay between neurotransmitter functions and rhythm generation; it aims to illuminate key activity phenomenology in bipolar disorder, including prolonged sleep intervals, decreased total activity and attenuated amplitude of the diurnal activity rhythm. To test our new cortical-circadian mathematical model of bipolar disorder, we utilized previously collected locomotor activity data recorded from normal subjects and bipolar patients by wrist-worn actigraphs.

Results:

All control parameters in the proposed model have an important role in replicating the different aspects of circadian activity rhythm generation in the brain. The model can successfully replicate deviations in sleep/wake time intervals corresponding to manic and depressive episodes of bipolar disorder, in which one of the excitatory or inhibitory pathways is abnormally dominant.

Conclusions and Relevance:

Although neuroimaging research has strongly implicated a reciprocal interaction between cortical and subcortical regions as pathogenic in bipolar disorder, this is the first model to mathematically represent this multilevel explanation of the phenomena of bipolar disorder.
Mental health system development in Asia: Does Australia have a role?
Authors: Arandjelovic Katarina , Eyre Harris A , Forbes Malcolm P , Bauer Renee , Aggarwal Shilpa , Singh Ajeet B , Baune Bernhard T , Everall Ian , Berk Michael , Ng Chee
Published: May 2016

Background:

Socioeconomic trends herald what many describe as the Asian Century, whereby Asian economic, political and cultural influence is in global ascendency. Broadening relevant ties between Australia and Asia is evident and logical and may include strengthening alliances in mental health systems.

Aim:

We argue the importance of strengthening Asian mental health systems and some of the roles Australian mental health workers could have in promoting strengthening the Asian mental health system.

Methods:

This paper is a narrative review which sources data from reputable search databases.

Results:

A well-articulated Australian strategy to support strengthening the mental health system in Asia is lacking. While there are active initiatives operating in this space, these remain fragmented and underdeveloped. Coordinated, collaborative and culturally respectful efforts to enhance health education, research, policy, leadership and development assistance are key opportunities.

Conclusion:

Psychiatrists and other mental health professionals have a unique opportunity to contribute to improved mental health outcomes in Asia.
How many men did you sleep with before me? An auto-ethnography on gender violence
Authors: Silba Malvina
Published: May 2016

This article is a first-person account of gender violence that utilizes auto-ethnography as a methodological and narrative tool. In the article, the author analyzes a relationship with a violent man in which two differences, class and gender, functioned as hierarchies. By analyzing certain moments of this relationship from the perspective of gender theory, the author intends to provide insight into the complex and often contradictory features of the gender violence suffered by women in different regions of the world and in a range of social and cultural contexts. This personal story and the connections with the stories of other women in her family – themselves victims of gender violence and the same social hierarchies – allow the author to analyze the mandates for women in a patriarchal society. Finally, the article narrates the strategies of empowerment that she was able to construct in certain contexts, distinguishing individual and collective empowerment as a key analytical but also political concept in the struggle against gender violence.
Complexity of choice: Teachers’ and students’ experiences implementing a choice-based Comprehensive School Health model
Authors: Sulz Lauren , Gibbons Sandra , Naylor Patti-Jean , Wharf Higgins Joan
Published: May 2016

Background:

Comprehensive School Health models offer a promising strategy to elicit changes in student health behaviours. To maximise the effect of such models, the active involvement of teachers and students in the change process is recommended.

Objective:

The goal of this project was to gain insight into the experiences and motivations of teachers and students involved in a choice-based Comprehensive School Health model – Health Promoting Secondary Schools (HPSS).

Setting:

School communities in British Columbia, Canada.

Design and methods:

HPSS engaged teachers and students in the planning and implementation of a whole-school health model aimed at improving the physical activity and eating behaviours of high school students. The intervention components were specifically informed by self-determination theory. A total of 23 teachers and 34 school committee members participated in focus group interviews. The minutes of planning meetings were collected throughout the intervention process.

Results:

Analysis of the data revealed five themes associated with participants’ experiences and motivational processes: (a) lack of time for planning and preparation; (b) resources, workshops and collaboration; (c) teacher control impacts student engagement; (d) teacher job action inhibited implementation of HPSS action plans; and (e) choice-based design impacts participants’ experiences.

Conclusion:

Findings from this study can facilitate future school-based projects by providing insights into student and teacher perspectives on the planning and implementation of school-based health promotion programmes and implementing choice-based educational change initiatives.
Social influence and the invocation of rights: The effects of accountability, reputation and political skill on legal claiming
Authors: Hall Angela T , Wikhamn Wajda , Cardy Robert
Published: May 2016

Issues relating to litigation and other forms of employee legal claiming are at the forefront of the practice of human resource management. However, organizational scholars have paid scant attention to this important aspect of organizational life. Underrepresented in this collective research have been investigations into how social influence variables impact the legal claiming process. We add to the understanding of legal claiming by evaluating how perceived levels of accountability, reputation and political skill affect individuals’ willingness to engage in contentious and non-contentious legal claiming. We also investigate the impact that social influence has on individuals’ advice to other potential claimants. This study employed a longitudinal design utilizing both scenarios and survey data collection. Results from our study partially support the conclusion that individuals are more risk-averse in their own legal claiming considerations than they are in the advice they offer to similarly-situated others. Furthermore, accountability, reputation and interpersonal influence (one aspect of political skill) were found to significantly influence the likelihood of legal claiming. The pattern of results indicates that social influence variables play a role in determining whether legal claiming will be pursued and what type of claiming will be chosen.
Damage evaluation of laminated composites under low-velocity impact tests using acoustic emission method
Authors: Mahdian Ali , Yousefi Jalal , Nazmdar Mehrdad , Zarif Karimi Navid , Ahmadi Mehdi , Minak Giangiacomo
Published: May 2016

The main goal of this investigation is to characterize the damage in laminated composites under low-velocity impact tests using a new cost-effective approach. To this aim, a quasi-static test was first carried out to obtain initial information about impact tests. Low-velocity impact tests were then applied in unidirectional glass/epoxy composite specimens, and acoustic emission signals were captured during impact events. Next, acoustic emission signals were analyzed using wavelet approach to distinguish released energy related to each distinct damage mechanism. Besides, an approach was provided to estimate threshold impact energy from the quasi-static test, beyond which damage significantly extends. As a final point, the acoustic emission-based procedure using wavelet transform method was proposed to predict the total damage area. Finally, it was found that this acoustic emission methodology can be a capable approach in damage characterization under impact loads in composite structures.
Unpacking Party Unity: The Combined Effects of Electoral Systems and Candidate Selection Methods on Legislative Attitudes and Behavioural Norms
Authors: Itzkovitch-Malka Reut , Hazan Reuven Y
Published: May 2016

This article analyses the effect of electoral systems, candidate selection methods and the interplay between them on individual legislative attitudes and behavioural norms, specifically on two facets of party unity: party agreement and party loyalty. Our main argument is that one must take into account the effect of inter- as well as intra-party competition, and the interaction between the two, in order to explain individual legislative attitudes and norms. Using data from 34 European parties across 10 countries, we show that under exclusive candidate selection methods, there are large differences between proportional representation and single-member district electoral systems in their effect on party agreement and party loyalty. Under inclusive candidate selection methods, however, such differences are much less apparent. In other words, the candidate selection method conditions the influence of the electoral system on legislative attitudes and behavioural norms.
Wider-community Segregation and the Effect of Neighbourhood Ethnic Diversity on Social Capital: An Investigation into Intra-Neighbourhood Trust in Great Britain and London
Authors: Laurence James
Published: May 2016

Extensive research has demonstrated that neighbourhood ethnic diversity is negatively associated with intra-neighbourhood social capital. This study explores the role of segregation and integration in this relationship. To do so it applies three-level hierarchical linear models to two sets of data from across Great Britain and within London, and examines how segregation across the wider-community in which a neighbourhood is nested impacts trust amongst neighbours. This study replicates the increasingly ubiquitous finding that neighbourhood diversity is negatively associated with neighbour-trust. However, we demonstrate that this relationship is highly dependent on the level of segregation across the wider-community in which a neighbourhood is nested. Increasing neighbourhood diversity only negatively impacts neighbour-trust when nested in more segregated wider-communities. Individuals living in diverse neighbourhoods nested within integrated wider-communities experience no trust-penalty. These findings show that segregation plays a critical role in the neighbourhood diversity/trust relationship, and that its absence from the literature biases our understanding of how ethnic diversity affects social cohesion.