bluuebunny/crossref_metadata_2025 huggingface dataset:
Asymptomatic spinal cord lesions do not predict the time to disability in patients with early multiple sclerosis
Authors: Dekker Iris , Sombekke Madeleine H , Witte Birgit I , Geurts Jeroen JG , Barkhof Frederik , Uitdehaag Bernard MJ , Killestein Joep , Wattjes Mike P
Published: November 2017

Background:

The presence of asymptomatic spinal cord (SC) lesions in patients with clinically isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS) predicts conversion to clinically definite multiple sclerosis (CDMS). The relation between asymptomatic SC abnormalities and disability progression warrants further investigation.

Objective:

To determine the prognostic value of asymptomatic SC lesions in CIS and early RRMS with respect to the time to disability development.

Methods:

Clinical and demographic data, brain and SC magnetic resonance imaging (MRI) were collected of CIS or early RRMS patients. Two main analyses were performed. For the first analysis, patients were divided into two groups: (1) patients with asymptomatic SC lesions and (2) patients without SC lesions and patients with symptomatic SC lesions. The second analysis excluded patients with symptomatic SC lesions. Incidence curves were used to analyse differences between these groups in time to the development of disability and time to a second relapse.

Results:

A total of 178 patients were included, and 42 patients (23.6%) had asymptomatic SC lesions. No significant differences were found on the time to disability development or the time to a second event.

Conclusion:

Asymptomatic SC lesions early in the disease course do not predict the time to disability development in patients diagnosed with CIS or early RRMS.
The NAIMS cooperative pilot project: Design, implementation and future directions
Authors: Oh Jiwon , Bakshi Rohit , Calabresi Peter A , Crainiceanu Ciprian , Henry Roland G , Nair Govind , Papinutto Nico , Constable R Todd , Reich Daniel S , Pelletier Daniel , Rooney William , Schwartz Daniel , Tagge Ian , Shinohara Russell T , Simon Jack H , Sicotte Nancy L ,   on behalf of the NAIMS Cooperative Steering Committee
Published: November 2017

The North American Imaging in Multiple Sclerosis (NAIMS) Cooperative represents a network of 27 academic centers focused on accelerating the pace of magnetic resonance imaging (MRI) research in multiple sclerosis (MS) through idea exchange and collaboration. Recently, NAIMS completed its first project evaluating the feasibility of implementation and reproducibility of quantitative MRI measures derived from scanning a single MS patient using a high-resolution 3T protocol at seven sites. The results showed the feasibility of utilizing advanced quantitative MRI measures in multicenter studies and demonstrated the importance of careful standardization of scanning protocols, central image processing, and strategies to account for inter-site variability.
Children’s spirituality: Exploring spirituality in the lives of cancer survivors and a healthy comparison group
Authors: Moore Kelsey , Talwar Victoria , Gomez-Garibello Carlos , Bosacki Sandra , Moxley-Haegert Linda
Published: November 2017

This study found that children with a history of cancer had higher scores on certain measures of spirituality compared to their healthy peers. Health history was found to significantly moderate the relations among spirituality and outcome variables, such as depression and anxiety. Furthermore, parent–child dyadscancer had more highly correlated scores than parent–child dyadshealthy on both the Depression subscale and the Existential Well-Being subscale, whereas parent–child dyadshealthy had more highly correlated scores than parent–child dyadscancer on the Duality factor. Limitations and future directions are discussed.
Effect of loading rate on cyclic behavior of reinforced concrete beams
Authors: Xiao Shiyun , Li Jianbo , Mo Yi-Lung
Published: November 2017

The dynamic behavior of reinforced concrete beams are inevitably affected by loading rate. This article reports the effect of loading rate on the dynamic behavior of reinforced concrete beams under cyclic loading. Dynamic tests on reinforced concrete beams at various loading rates were carried out using the MTS electro-hydraulic servo system. The cyclic loading was controlled by displacement with a loading rate in the range from 0.1 to 10 mm/s. Based on the test results, the effect of the loading rate on the failure shape and the loading–displacement curve of reinforced concrete beams was investigated. The research focuses on the effect of loading rate on strength and deformation behavior, including cracking, yielding, ultimate, and failure strengths as well as displacements. Finally, the effect of loading rate on the ductility, stiffness degradation, and dissipated energy capabilities of reinforced concrete beams was also critically examined.
Probabilistic seismic demand assessment of steel frames braced with reduced yielding segment buckling restrained braces
Authors: Afsar Dizaj Ebrahim , Fanaie Nader , Zarifpour Arash
Published: November 2017

Buckling-restrained braces have adequate seismic performance characteristics such as high energy absorption due to their symmetric behaviour in compression and tension. However, low post-yield stiffness is one of the main disadvantages of these braces. The stiffness values of buckling-restrained brace frames can highly degrade when the core segments are yielded. Reducing the length of the yielding segments of buckling-restrained braces is being proposed and investigated by many researchers, considering the high strain capacity of steel in the post-elastic region. This article focuses on a type of buckling-restrained brace called reduced yielding segment buckling restrained brace or in short, ‘reduced length buckling restrained brace’. In such frames, the length of the yielding part is reduced and placed in one end of the brace element. In this research, the seismic performances of the above-mentioned buckling-restrained braces were investigated through probabilistic approach and compared with those of conventional buckling-restrained braces. Their performances were quantitatively assessed in terms of two limit states, immediate occupancy and collapse prevention. The fragility curves, the mean annual limit states frequencies and the seismic demand hazard curves of the frames were plotted using probabilistic seismic demand analysis. According to the results obtained for immediate occupancy limit state, the frames braced with reduced length buckling restrained braces show better seismic performances compared to those braced with conventional buckling-restrained braces. However, for collapse prevention limit state, it is hard to comment accurately because in some cases, reduced length buckling restrained braced frames show enhanced seismic performance while in other cases, conventional ones exhibit improved response.
Combustion stratification study of partially premixed combustion using Fourier transform analysis of OH* chemiluminescence images
Authors: Izadi Najafabadi Mohammad , Somers Bart , Johansson Bengt , Dam Nico
Published: November 2017

A relatively high level of stratification (qualitatively: lack of homogeneity) is one of the main advantages of partially premixed combustion over the homogeneous charge compression ignition concept. Stratification can smooth the heat release rate and improve the controllability of combustion. In order to compare stratification levels of different partially premixed combustion strategies or other combustion concepts, an objective and meaningful definition of “stratification level” is required. Such a definition is currently lacking; qualitative/quantitative definitions in the literature cannot properly distinguish various levels of stratification. The main purpose of this study is to objectively define combustion stratification (not to be confused with fuel stratification) based on high-speed OH* chemiluminescence imaging, which is assumed to provide spatial information regarding heat release. Stratification essentially being equivalent to spatial structure, we base our definition on two-dimensional Fourier transforms of photographs of OH* chemiluminescence. A light-duty optical diesel engine has been used to perform the OH* bandpass imaging on. Four experimental points are evaluated, with injection timings in the homogeneous regime as well as in the stratified partially premixed combustion regime. Two-dimensional Fourier transforms translate these chemiluminescence images into a range of spatial frequencies. The frequency information is used to define combustion stratification, using a novel normalization procedure. The results indicate that this new definition, based on Fourier analysis of OH* bandpass images, overcomes the drawbacks of previous definitions used in the literature and is a promising method to compare the level of combustion stratification between different experiments.
Usability of contemporary tools for the computational design of architectural objects: Review, features evaluation and reflection
Authors: Nisztuk Maciej , Myszkowski Paweł B
Published: November 2017

This article is an overview focused on functionality and usability of selected contemporary approaches for the computational floor plan generation of architectural objects. This article describes current solutions for generative architectural design and focuses on their usability from the point of view of architectural design practice. Recent research papers and prototypes, as well as the most important tools (selected computer-aided design and BIM software) for generative design from the architectural perspective, are described. The functionalities and level of usability of present-day software and prototypes are described. In addition, the descriptive review of the research prototypes architectural design outcomes is present. Furthermore, the survey among active architects regarding the usage of computational tools in the professional practice and possible guidelines for the development of such tools are present. This article summarises with the conclusion about the current state of generative floor plan design tools, the lack of fully functional and developed commercial tools of this type on the market and future directions for the development of generative floor plans tools.
MicroRNA-29a mitigation of endoplasmic reticulum and autophagy aberrance counteracts in obstructive jaundice-induced fibrosis in mice
Authors: Huang Ying-Hsien , Yang Ya-Ling , Huang Fu-Chen , Tiao Mao-Meng , Lin Yen-Cheng , Tsai Ming-Horng , Wang Feng-Sheng
Published: November 2017

Hepatic fibrosis was caused by a number of signaling pathways that damage liver integrity. We have previously shown that microRNA-29a (miR-29a) protects against liver fibrosis. Aberrant endoplasmic reticulum (ER) and autophagy function reportedly exaggerate hepatic disorders. The aim of this study was to characterize the biological influence of miR-29a on ER function in injured livers with bile duct ligation (BDL). We performed BDL on miR-29a transgenic mice (miR-29aTg) and wild-type mice to induce cholestatic liver injury. Rat T6 cells were transfected with miR-29a mimic and tunicamycin. Compared to the wild-type mice, the BDL deterioration of liver function in terms of total bilirubin, alanine transaminase, and aspartate transaminase activity in the miR-29aTg mice was significantly reduced. Affected livers in the miR-29aTg mice demonstrated a slight fibrotic matrix formation. miR-29a over-expression reduced the BDL disturbance of the expressions of inositol-requiring kinase 1alpha, double-stranded RNA-activated protein kinase-like endoplasmic reticulum kinase, spliced-X-box binding protein 1 (sXBP1), CCAAT/enhancer-binding protein homologous protein (CHOP), ULK, LC3BII, p62, and cleaved caspase-8, 9 and 3. In vitro, T6 cells exposed to tunicamycin by increasing abundances of CHOP, sXBP1, cleaved caspase-3, and LC3BII were diminished in the cell cultures transfected with the miR-29a mimic. On the other hand, we observed that miR-29a signaling protected liver tissues from BDL-mediated metabolic dysfunction and excessive fibrosis histopathology. This study provides new molecular insight into the miR-29a stabilization of ER integrity that slows the progression of cholestatic liver deterioration.

Impact statement

Long-term hepatic damage caused by hepatitis and cholestasis can accelerate fibrosis matrix over-production, which is a harmful process attributed to the dysregulation of a number of cellular and molecular events. The purpose of this study is to characterize the biological influence of miR-29a on endoplasmic reticulum (ER) function in bile duct ligation (BDL)-injured livers. To the best of our knowledge, this report is the first demonstration that miR-29a over-expression diminishes BDL provocation of ER stress (unfolded protein response, UPR) effector protein expression. This work also demonstrates that miR-29a decreased caspases protein expression in cholestatic livers, while an increase in miR-29a function reduced sXBP1 and CHOP expressions in T6 cells in mice. Analyses of this study highlight that controlling miR-29a signaling can serve as an innovative strategy in the future for microRNA regulation of ER homeostasis to combat cholestasis induction hepatic disorders.
Results of scaphocapitate arthrodesis with lunate excision in advanced Kienböck disease at 10.7-year mean follow-up
Authors: Charre Amaury , Delclaux Stephanie , Apredoai Costel , Ayel Jean-Emmanuel , Rongieres Michel , Mansat Pierre
Published: November 2017

Scaphocapitate arthrodesis with lunate excision was performed for treatment of advanced Kienböck disease in 17 patients (18 wrists). Ten were women and seven men. Five were Lichtmann Stage IIIA, 12 Stage IIIB, and one Stage IV. Minimum follow-up period was 24 months; mean follow-up was 10.7 years (range 2.3 to 22 years, SD 7.1). At the latest follow-up, six patients were very satisfied, nine were satisfied and two were disappointed. Pain was significantly decreased in all cases. Wrist mobility was unchanged. Grip strength was significantly increased. Consolidation of the arthrodesis was confirmed in 17 wrists. We encountered a scaphocapitate nonunion at 12 years follow-up and two cases of styloscaphoid arthritis at 17 and 22 years. Scaphocapitate arthrodesis with lunate excision performed in an advanced stage of Kienböck disease significantly alleviates pain, while preserving functional mobility and satisfactory grip strength in the long term.

Level of evidence: IV
Swan neck deformity due to chronic radial collateral ligament injury of the little finger proximal interphalangeal joint
Authors: Hamada Yoshitaka , Takai Hiroaki , Satoh Ryousuke , Hibino Naohito , Ueda Yukiko , Minamikawa Yoshitaka
Published: November 2017

We present seven cases of a relatively rare swan neck deformity resulting from chronic radial collateral ligament (RCL) injury of the proximal interphalangeal (PIP) joint in the little finger. All patients were middle-aged women (mean 51 years old, range 42–55), and the duration between the initial injury and surgery was 20 years (range 5–40). The chief complaint was painful snapping of the PIP joint. All patients had hyperextension and ulnar deviation of the PIP joint with mobile swan neck deformities that had not improved with conservative treatment. Radiographs revealed osteoarthritis and ulnar deviation of the PIP joints in all cases. We describe a method for reconstruction of both the palmar plate and the RCL of the affected PIP joint using a distally-based ulnar slip of flexor superficialis tendon. The prevention of PIP joint hyperextension was critical for successful resolution of symptoms; the aim of RCL augmentation was to prevent the recurrence of the deformity.

Level of evidence: IV
The morphology of proximal pole scaphoid fractures: implications for optimal screw placement
Authors: Luchetti Timothy J. , Hedroug Youssef , Fernandez John J. , Cohen Mark S. , Wysocki Robert W.
Published: November 2017

The purpose of this study was to measure the radiographic parameters of proximal pole scaphoid fractures, and calculate the ideal starting points and trajectories for antegrade screw insertion. Computed tomography scans of 19 consecutive patients with proximal pole fractures were studied using open source digital imaging and communications in medicine (DICOM) imaging measurement software. For scaphoid sagittal measurements, fracture inclination was measured with respect to the scaphoid axis. The ideal starting point for a screw in the proximal pole fragment was then identified on the scaphoid sagittal image that demonstrated the largest dimensions of the proximal pole, and hence the greatest screw thread purchase. Measurements were then taken for a standard screw trajectory in the axis of the scaphoid, and a trajectory that was perpendicular to the fracture line. The fracture inclination in the scaphoid sagittal plane was 25 (SD10) °, lying from proximal palmar to dorsal distal. The fracture inclination in the coronal plane was 9 (SD16) °, angling distal radial to proximal ulnar with reference to the coronal axis of the scaphoid. Using an ideal starting point that maximized the thread purchase in the proximal pole, we measured a maximum screw length of 20 (SD 2) mm when using a screw trajectory that was perpendicular to the fracture line. This was quite different from the same measurements taken in a trajectory in the axis of the scaphoid. We also identified a mean distance of approximately 10 mm from the dorsal fracture line to the ideal starting point. A precise understanding of this anatomy is critical when treating proximal pole scaphoid fractures surgically.
Variation of the drafting effect on the trailing rider for different numbers of riders in a cycling group
Authors: Shirasaki Keita , Yamanobe Kaoru , Akashi Keita , Takashima Wataru
Published: November 2017

The technique of following another rider to reduce aerodynamic drag (drafting) is a basic tactic in cycling. This study clarifies the trailing rider’s drafting effect for different numbers of riders and relative positions in the traveling group. Wind tunnel experiments were conducted with a static mannequin as the subject measured. Measurements were made with a floor-mounted six-component force balance. Athletes sat on bicycles mounted on bicycle stands and provided the drafting effect; experiments were conducted for riding groups of two riders (2R) and four riders (4R). The aerodynamic drag of the most trailing rider (i.e. mannequin) was measured for a wind speed of 16.67 m/s and different relative spatial positions (a longitudinal distance of 0–0.75 m and lateral distance of 0–0.90 m) to the rider ahead. When the approximate tandem arrangement had a lateral distance of 0–0.25 m, the aerodynamic drag increased with the longitudinal distance in both 2R and 4R. However, the increase was much smaller in the 4R than in the 2R. In the range of lateral distance in which there is a drafting effect, the drafting effect was stronger in the 4R than in the 2R. It is thought that the fourth position without tight separation can achieve a drafting effect comparable to that of the second position with tight separation.
The combined shoulder assessment: a convenient method for obtaining equivalent outcome scores
Authors: Torrance Emma , Hallam Linda , Walton Michael J. , Monga Puneet , Watts Adam C. , Funk Lennard
Published: November 2017

Background

Outcome scores are useful tools with respect to quantifying how pain and limitations in strength and movement affect the patient’s functionality and lifestyle. Three shoulder outcome methods [Oxford, Constant and QuickDASH (Disability of the Arm, Shoulder and Hand)] are commonly used in practice but collectively consist of 34 questions, taking approximately 7 min to complete. We have developed a concise shoulder assessment to derive three equivalent outcome scores in a 12-item patient-reporting questionnaire.

Methods

Outcome scores from 1285 outpatients of an upper limb clinic were collected. The patient cohort consisted of 462 females and 823 males with a mean (SD) age of 47.2 (16.79) years (range 13 years to 90 years). Using a correlation matrix, a 12-item questionnaire was drafted. The combined shoulder assessment was validated by 227 patients; consisting of 101 females and 126 males with a mean (SD) age of 47.91 (16.63) years (range 13 years to 88 years).

Results

Agreement was achieved between the two methods, with an equivalent Oxford Shoulder Score intraclass correlation (ICC) of 0.930, equivalent Constant Shoulder Score ICC of 0.942 and equivalent QuickDASH ICC of 0.869. Bland–Altman analyses showed no systematic differences. Large effect sizes highlighted the responsiveness to change.

Conclusions

The new combined shoulder assessment is a more convenient and patient-friendly method to obtain equivalent Oxford, Constant and QuickDASH shoulder outcome scores.
DNM3, p65 and p53 from exosomes represent potential clinical diagnosis markers for glioblastoma multiforme
Authors: Yang Jian-kai , Song Jian , Huo Hao-ran , Zhao Yin-long , Zhang Guang-yu , Zhao Zong-mao , Sun Guo-zhu , Jiao Bao-hua
Published: November 2017

Background:

Glioblastoma multiforme (GBM) is the most aggressive and deadly primary brain cancer that arises from astrocytes and classified as grade IV. Recently, exosomes have been reported as an essential mediator in diverse cancer carcinogenesis and metastasis. However, their role in GBM is still unclear. In this study, we aimed to investigate whether blood exosomes can be potential clinical diagnostic markers for GBM.

Methods:

We used a xenograft orthotopic mouse model to detect the differentially expressed genes in the brain and blood exosomes of original/recurrent GBM.

Results:

We found that recurrent GBM had stronger growth capacity and lethality than original GBM in the mouse model. A gene microarray of original tumors and blood exosomes from GBM orthotopic xenografts results showed that DNM3, p65 and CD117 expressions increased, whereas PTEN and p53 expressions decreased in both original tumors and blood exosomes. In the recurrent GBM tumor model, DNM3 and p65 showed increased expressions, whereas ST14 and p53 showed decreased expressions in tumor and blood exosomes of the recurrent GBM mouse model.

Conclusion:

In summary, we found that DNM3, p65 and p53 had a similar trend in brain and blood exosomes both for original and recurrent GBM, and could serve as potential clinical diagnostic markers for GBM.
Epidemiology and Impact on Performance of Lower Extremity Stress Injuries in Professional Basketball Players
Authors: Khan Moin , Madden Kim , Burrus M. Tyrrell , Rogowski Joseph P. , Stotts Jeff , Samani Marisa J. , Sikka Robby , Bedi Asheesh
Published: November 2017

Background:

Professional basketball players in the National Basketball Association (NBA) subject their lower extremities to significant repetitive loading during both regular-season and off-season training. Little is known about the incidence of lower extremity bony stress injuries and their impact on return to play and performance in these athletes.

Hypothesis:

Stress injuries of the lower extremity will have significant impact on performance.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

All bony stress injuries from 2005 to 2015 were identified from the NBA. Number of games missed due to injury and performance statistics were collected from 2 years prior to injury to 2 years after the injury. A linear regression analysis was performed to determine the impact of injury for players who returned to sport.

Results:

A total of 76 lower extremity bony stress injuries involving 75 NBA players (mean age, 25.4 ± 4.1 years) were identified. Fifty-five percent (42/76) involved the foot, and most injuries occurred during the regular season (82.9%, 63/76), with half occurring within the first 6 weeks. Among players who sustained a fifth metatarsal stress fracture, 42.9% were unable to return to professional play. Players who sustained stress injuries had reduced play performance, specifically related to number of games played ( P = 0.014) and number of steals per game ( P = 0.004). Players who had surgery had significantly better performance at 2 years than those who were managed nonoperatively, independent of the type of injury (β = 4.561; 95% CI, 1.255-7.868).

Conclusion:

Lower extremity bony stress injuries may significantly affect both short- and long-term player performance and career length. Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics compared with those treated using conservative methods.

Clinical Relevance:

Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics.
Noninvasive Liver Assessment in Adult Patients With Fontan Circulation Using Acoustic Radiation Force Impulse Elastography and Hepatic Magnetic Resonance Imaging
Authors: Buendía-Fuentes F. , Melero-Ferrer J. L. , Plaza-López D. , Rueda-Soriano J. , Osa-Saez A. , Aguero J. , Calvillo-Batllés P. , Fonfria-Esparcia C. , Ballesta-Cuñat A. , Martí-Bonmatí L. , Martínez-Dolz L.
Published: November 2017

Background:

Patients who have undergone the Fontan procedure are at risk of developing hepatic dysfunction. However, broad recommendations regarding liver monitoring are limited. The purpose of this study was to characterize the frequency of liver disease in adult Fontan patients using multimodality imaging (hepatic magnetic resonance imaging [MRI], acoustic radiation force impulse [ARFI] elastography, or hepatic ultrasound).

Methods:

In a prospective cross-sectional analysis of adult patients palliated with a Fontan procedure, hepatic MRI, ARFI, and hepatic ultrasound were used to assess for liver disease. The protocol compared (1) varying prevalence of liver disease based on each imaging technique, (2) agreement between different techniques, and (3) association between noninvasive imaging diagnosis of liver disease and clinical variables, including specific liver disease biomarkers.

Results:

Thirty-seven patients were enrolled. The ARFI results showed high wave propagation velocity in 35 patients (94.6%). All patients had some abnormality in the hepatic MRI. Specifically, 8 patients (21.6%) showed signs of chronic liver disease, 10 patients (27%) had significant liver fibrosis, and 27 patients (73%) had congestion. No correlation was found between liver stiffness measured as propagation velocity and hepatic MRI findings. Only 7 patients had an abnormal hepatic ultrasound study.

Conclusions:

There is an inherent liver injury in adult Fontan patients. Signs of liver disease were observed in most patients by both hepatic MRI and ARFI elastography but not by ultrasound imaging. Increased liver stiffness did not identify specific disease patterns from MRI, supporting the need for multimodality imaging to characterize liver disease in Fontan patients.
Bhagavadgeetha in Professional Life
Authors: Kumar Naren
Published: November 2017

Since time immemorial, ancient philosophical texts have spiritually provoked people to awaken from the delusion incurred from being baffled at life’s myriad circumstances. Today’s rapid advance in applied science and technology has not only removed problems of daily activities such as transportation, communication, information exchange etc, but also has greatly improved our comfort and lifestyle. Despite such major benefits brought by globalization, mankind is facing higher levels of competition and the struggle for success is becoming intense in almost all professional fields such as research, medicine, commerce, management, production technology and intellectual property rights to name a few. As a result, our progress can be obscured by normal human tendencies to quickly achieve the desired results in short time, thus sacrificing on quality and other values that inevitably lead to failure and frustration due to possible conflicts. This paper sheds light on ancient Hindu philosophy, namely the Bhagavad-geetha (popularly known as the Bhagavad-Gita), and attempts to correlate certain successful strategic decisions and guidelines made in the past – with the modern day human activity management by expounding the similarities in both situations. Such profound knowledge of the ‘Geetha may not necessarily be restricted solely to religious grounds, but also applied as insights to the modern-day human interaction, perception and behavioral transactions to not only achieve success but primarily to eliminate personal differences and conflicts.
A Decade of Performance Management Reforms in Bhutan: Problems and Prospects
Authors: Ugyel Lhawang
Published: November 2017

Bhutan has implemented two bold performance management reforms within the last decade. These reforms are based on the business and neoclassical economics models focusing on outputs and strict performance measures. The first of these reforms, performance management system, was implemented as one of the main components of the Position Classification System (PCS) reforms in 2006. The second reform, Managing for Excellence (MaX) was introduced in 2017. Both these reforms have sought to improve the performance of the public sector in Bhutan. However, the implementation of the performance management system faced major challenges. This commentary describes the two performance management reforms, and briefly examines some of the challenges in their implementation.
“Scripts Are Beautiful”: Managers’ and Agents’ Views of Script Use in Call Centers
Authors: Woydack Johanna , Lockwood Jane
Published: November 2017

Some recent studies have reported how call centers employ low-skilled workers and how agents work robotically using scripts when assisting customers on the phone; other studies have focused on how they need to be “native speaker”–like in their language fluency when serving customers; and yet others talk of the repressive nature of the industry where agents become emotionally, culturally, and linguistically exhausted, exacerbated by the prescriptive and highly regulated use of scripts at work. While acknowledging that the use of scripts in call centers can result in agent disengagement and customers feeling they are talking to robots, this is not the complete story. This study aims to report on the use of scripts in the global call center industry, which may place their use in a more positive light. After first defining what is meant by “scripting” in this context, two case studies are reported on where line managers and agents found script use to be helpful in a number of ways. The first case study uses data gathered in an offshored monolingual call center in Manila, and the second study uses data gathered in a multilingual call center in London. How both managers and agents use scripts and how they perceive them are the focus areas of this study, and while arguably there are a number of problems with this practice, there are also self-reported benefits in supporting effective communication and positive business outcomes in the call centers.
Loud Music Exposure and Cochlear Synaptopathy in Young Adults: Isolated Auditory Brainstem Response Effects but No Perceptual Consequences
Authors: Grose John H. , Buss Emily , Hall Joseph W.
Published: November 2017

The purpose of this study was to test the hypothesis that listeners with frequent exposure to loud music exhibit deficits in suprathreshold auditory performance consistent with cochlear synaptopathy. Young adults with normal audiograms were recruited who either did ( n = 31) or did not ( n = 30) have a history of frequent attendance at loud music venues where the typical sound levels could be expected to result in temporary threshold shifts. A test battery was administered that comprised three sets of procedures: (a) electrophysiological tests including distortion product otoacoustic emissions, auditory brainstem responses, envelope following responses, and the acoustic change complex evoked by an interaural phase inversion; (b) psychoacoustic tests including temporal modulation detection, spectral modulation detection, and sensitivity to interaural phase; and (c) speech tests including filtered phoneme recognition and speech-in-noise recognition. The results demonstrated that a history of loud music exposure can lead to a profile of peripheral auditory function that is consistent with an interpretation of cochlear synaptopathy in humans, namely, modestly abnormal auditory brainstem response Wave I/Wave V ratios in the presence of normal distortion product otoacoustic emissions and normal audiometric thresholds. However, there were no other electrophysiological, psychophysical, or speech perception effects. The absence of any behavioral effects in suprathreshold sound processing indicated that, even if cochlear synaptopathy is a valid pathophysiological condition in humans, its perceptual sequelae are either too diffuse or too inconsequential to permit a simple differential diagnosis of hidden hearing loss.
Hepatocyte nuclear factor 1A deficiency causes hemolytic anemia in mice by altering erythrocyte sphingolipid homeostasis
Authors: von Wnuck Lipinski Karin , Weske Sarah , Keul Petra , Peters Susann , Baba Hideo A. , Heusch Gerd , Gräler Markus H. , Levkau Bodo
Published: November 2017

Key Points

HNF1A deficiency in mice leads to non–cell-autonomous anemia caused by altered red blood cell (RBC) sphingolipids leading to hemolysis. Sphingosine loading of WT RBCs phenocopies osmotic fragility and high calcium of HNF1A−/− RBCs due to suppressed plasma-membrane Ca2+-ATPase.
High Circulating Free Thyroxine Levels May Increase the Risk of Frailty: The Rotterdam Study
Authors: Bano Arjola , Chaker Layal , Schoufour Josje , Ikram M Arfan , Kavousi Maryam , Franco Oscar H , Peeters Robin P , Mattace-Raso Francesco U S
Published: November 2017

Context

Thyroid hormones affect metabolism in various tissues, organs, and systems. However, the overall impact of thyroid function on an individual’s vulnerability to adverse outcomes remains unclear.

Objective

To investigate the cross-sectional and prospective association of thyroid function with the frailty index, a well-established measure of overall health.

Design and Setting

The Rotterdam Study, a population-based, prospective cohort study.

Participants and Main Outcome Measurements

Participants with baseline measurements of thyroid function and the frailty index were eligible. The frailty index was measured at baseline and after a median follow-up time of 10.1 years (interquartile range, 5.7 to 10.8 years). A higher frailty index indicated a worse health state. We assessed the association of thyroid function with frailty at baseline, frailty at follow-up, and frailty changes over time, adjusting for age, sex, cohort, smoking, alcohol, and education.

Results

We included 9640 participants (mean age, 64.9 years). There was a U-shaped association of thyrotropin (TSH; P < 0.0003) and free thyroxine (FT4; P < 0.0001) with frailty at baseline. There was no association of TSH, but a positive association of FT4 with frailty at follow-up and frailty changes over time (β, 1.22; confidence interval, 0.73 to 1.72 per 1 unit FT4).

Conclusion

In this population-based study, participants with low and high thyroid function were more likely to be frail than participants with normal thyroid function. However, only those with higher FT4 levels had an increased risk of becoming more frail over time. The identification of FT4 as a potential marker of health deterioration could have future implications regarding the prediction and prevention of frailty.
Lysyl oxidases regulate fibrillar collagen remodelling in idiopathic pulmonary fibrosis
Authors: Tjin Gavin , White Eric S. , Faiz Alen , Sicard Delphine , Tschumperlin Daniel J. , Mahar Annabelle , Kable Eleanor P. W. , Burgess Janette K.
Published: November 2017

Idiopathic pulmonary fibrosis (IPF) is a progressive scarring disease of the lung with few effective therapeutic options. Structural remodelling of the extracellular matrix [i.e. collagen cross-linking mediated by the lysyl oxidase (LO) family of enzymes (LOX, LOXL1-4)] might contribute to disease pathogenesis and represent a therapeutic target. This study aimed to further our understanding of the mechanisms by which LO inhibitors might improve lung fibrosis. Lung tissues from IPF and non-IPF subjects were examined for collagen structure (second harmonic generation imaging) and LO gene (microarray analysis) and protein (immunohistochemistry and western blotting) levels. Functional effects (collagen structure and tissue stiffness using atomic force microscopy) of LO inhibitors on collagen remodelling were examined in two models, collagen hydrogels and decellularized human lung matrices. LOXL1/LOXL2 gene expression and protein levels were increased in IPF versus non-IPF. Increased collagen fibril thickness in IPF versus non-IPF lung tissues correlated with increased LOXL1/LOXL2, and decreased LOX, protein expression. β-Aminoproprionitrile (β-APN; pan-LO inhibitor) but not Compound A (LOXL2-specific inhibitor) interfered with transforming growth factor-β-induced collagen remodelling in both models. The β-APN treatment group was tested further, and β-APN was found to interfere with stiffening in the decellularized matrix model. LOXL1 activity might drive collagen remodelling in IPF lungs. The interrelationship between collagen structural remodelling and LOs is disrupted in IPF lungs. Inhibition of LO activity alleviates fibrosis by limiting fibrillar collagen cross-linking, thereby potentially impeding the formation of a pathological microenvironment in IPF.
Comprehensive analysis of gene expression patterns in Friedreich's ataxia fibroblasts by RNA sequencing reveals altered levels of protein synthesis factors and solute carriers
Authors: Napierala Jill Sergesketter , Li Yanjie , Lu Yue , Lin Kevin , Hauser Lauren A. , Lynch David R. , Napierala Marek
Published: November 2017

Friedreich's ataxia (FRDA) is an autosomal recessive neurodegenerative disease usually caused by large homozygous expansions of GAA repeat sequences in intron 1 of the frataxin (FXN) gene. FRDA patients homozygous for GAA expansions have low FXN mRNA and protein levels when compared with heterozygous carriers or healthy controls. Frataxin is a mitochondrial protein involved in iron–sulfur cluster synthesis, and many FRDA phenotypes result from deficiencies in cellular metabolism due to lowered expression of FXN. Presently, there is no effective treatment for FRDA, and biomarkers to measure therapeutic trial outcomes and/or to gauge disease progression are lacking. Peripheral tissues, including blood cells, buccal cells and skin fibroblasts, can readily be isolated from FRDA patients and used to define molecular hallmarks of disease pathogenesis. For instance, FXN mRNA and protein levels as well as FXN GAA-repeat tract lengths are routinely determined using all of these cell types. However, because these tissues are not directly involved in disease pathogenesis, their relevance as models of the molecular aspects of the disease is yet to be decided. Herein, we conducted unbiased RNA sequencing to profile the transcriptomes of fibroblast cell lines derived from 18 FRDA patients and 17 unaffected control individuals. Bioinformatic analyses revealed significantly upregulated expression of genes encoding plasma membrane solute carrier proteins in FRDA fibroblasts. Conversely, the expression of genes encoding accessory factors and enzymes involved in cytoplasmic and mitochondrial protein synthesis was consistently decreased in FRDA fibroblasts. Finally, comparison of genes differentially expressed in FRDA fibroblasts to three previously published gene expression signatures defined for FRDA blood cells showed substantial overlap between the independent datasets, including correspondingly deficient expression of antioxidant defense genes. Together, these results indicate that gene expression profiling of cells derived from peripheral tissues can, in fact, consistently reveal novel molecular pathways of the disease. When performed on statistically meaningful sample group sizes, unbiased global profiling analyses utilizing peripheral tissues are critical for the discovery and validation of FRDA disease biomarkers.
A superhydrophobic cone to facilitate the xenomonitoring of filarial parasites, malaria, and trypanosomes using mosquito excreta/feces
Authors: Cook Darren A.N. , Pilotte Nils , Minetti Corrado , Williams Steven A. , Reimer Lisa J.
Published: November 2017

Background: Molecular xenomonitoring (MX), the testing of insect vectors for the presence of human pathogens, has the potential to provide a non-invasive and cost-effective method for monitoring the prevalence of disease within a community. Current MX methods require the capture and processing of large numbers of mosquitoes, particularly in areas of low endemicity, increasing the time, cost and labour required. Screening the excreta/feces (E/F) released from mosquitoes, rather than whole carcasses, improves the throughput by removing the need to discriminate vector species since non-vectors release ingested pathogens in E/F. It also enables larger numbers of mosquitoes to be processed per pool. However, this new screening approach requires a method of efficiently collecting E/F.

Methods: We developed a cone with a superhydrophobic surface to allow for the efficient collection of E/F. Using mosquitoes exposed to either Plasmodium falciparum, Brugia malayi or Trypanosoma brucei brucei, we tested the performance of the superhydrophobic cone alongside two other collection methods.

Results: All collection methods enabled the detection of DNA from the three parasites. Using the superhydrophobic cone to deposit E/F into a small tube provided the highest number of positive samples (16 out of 18) and facilitated detection of parasite DNA in E/F from individual mosquitoes. Further tests showed that following a simple washing step, the cone can be reused multiple times, further improving its cost-effectiveness.

Conclusions: Incorporating the superhydrophobic cone into mosquito traps or holding containers could provide a simple and efficient method for collecting E/F. Where this is not possible, swabbing the container or using the washing method facilitates the detection of the three parasites used in this study.
Implementation and process analysis of pilot scale multi-phase anaerobic fermentation and digestion of faecal sludge in Ghana
Authors: Shih Justin , Fanyin-Martin Ato , Taher Edris , Chandran Kartik
Published: November 2017

Background.  In Ghana, faecal sludge (FS) from on-site sanitation facilities is often discharged untreated into the environment, leading to significant insults to environmental and human health. Anaerobic digestion offers an attractive pathway for FS treatment with the concomitant production of energy in the form of methane. Another innovative option includes separating digestion into acidogenesis (production of volatile fatty acids (VFA)) and methanogenesis (production of methane), which could ultimately facilitate the production of an array of biofuels and biochemicals from the VFA. This work describes the development, implementation and modeling based analysis of a novel multiphase anaerobic fermentation-digestion process aimed at FS treatment in Kumasi, Ghana. 

Methods.  A pilot-scale anaerobic fermentation process was implemented at the Kumasi Metropolitan Assembly’s Oti Sanitary Landfill Site at Adanse Dompoase.  The process consisted of six 10 m3 reactors in series, which were inoculated with bovine rumen and fed with fecal sludge obtained from public toilets.  The performance of the fermentation process was characterized in terms of both aqueous and gaseous variables representing the conversion of influent organic carbon to VFA as well as CH4.  Using the operating data, the first-ever process model for FS fermentation and digestion was developed and calibrated, based on the activated sludge model framework.

Results and Conclusions.  This work represents one of the first systematic efforts at integrated FS characterization and process modeling to enable anaerobic fermentation and digestion of FS. It is shown that owing to pre-fermentation of FS in public septage holding tanks, one could employ significantly smaller digesters (lower capital costs) or increased loading capabilities for FS conversion to biogas or VFA. Further, using the first-ever calibrated process model for FS fermentation and digestion presented herein, we expect improved and more mechanistically informed development and application of different process designs and configurations for global FS management practice.
Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity
Authors: Sudhinaraset May , Afulani Patience , Diamond-Smith Nadia , Bhattacharyya Sanghita , Donnay France , Montagu Dominic
Published: November 2017

Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care—across its many dimensions—is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care.

Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women’s reproductive health: societal and community determinants of health equity, women’s health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health.

Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women’s reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.
Air sampling during flow cytometric analysis of unfixed bacterial suspensions; a risk assessment
Authors: Carson Christine F , Inglis Timothy JJ
Published: November 2017

This study investigated airborne bacteria in a university research laboratory during operation of an acoustic-enhanced flow cytometer for antimicrobial susceptibility testing by sampling room air before, during and after flow cytometer use. Air sampling in a nearby clinical laboratory was conducted for comparison during the same period. The three species of bacteria undergoing analysis by flow cytometry were Klebsiella pneumoniae, Burkholderia thailandensis and Streptococcus pneumoniae. These species were not detected from multiple 1000 L air samples acquired in the confined research laboratory environment. The main cultured bacteria were skin commensal and environmental bacteria, presumed to have been disturbed or dispersed in laboratory air by personnel movements during routine laboratory operation. The concentrations of bacteria detected in air samples were reduced after laboratory cleaning measures were introduced and were lower than those in a diagnostic clinical microbiology laboratory located nearby on the same biomedical campus.