bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurship education and the role of universities in entrepreneurship
Authors: Davey Todd , Hannon Paul , Penaluna Andy
Published: July 2016

Despite the considerable political and academic interest in concepts such as the triple helix of government, business and higher education as well as entrepreneurship and entrepreneurial universities, relatively little has been written about the role of the university in developing entrepreneurship. More specifically, the questions of how the university can contribute through education, entrepreneurial support and network functions and be entrepreneurial in its endeavours have lacked academic focus and rigour, particularly in relation to fostering entrepreneurial mindsets. This introductory article therefore provides a thorough discussion of the role of the university in entrepreneurship and then summarizes the contribution to that debate of the articles in this special issue of Industry and Higher Education.
New approach of suppressing cavitation in water hydraulic components
Authors: Zuti Zhang , Shuping Cao , Xiaohui Luo , Weijie Shi , Yuquan Zhu
Published: July 2016

Cavitation frequently appears in high pressure water hydraulic components and leads to serious hydraulic erosions and horrible hydrodynamic noises. In this paper, a novel approach of suppressing cavitation was proposed, inducing the outlet pressure back to the orifice to improve the pressure distribution of throttle valves. In order to realize this approach, an optimized throttle valve chamber structure was designed. After that, the anticavitation performance of the valve was investigated. A theoretical cavitation cloud model was built based on bubble dynamics. In order to solve the mathematic cavitation model, the velocity field and pressure distribution of the novel throttle valve were simulated through Computational Fluid Dynamics(CFD). Combining the simulation results, the mathematic cavitation cloud model was solved through numerical calculations. Moreover, new indexes estimating cavitation intensity were proposed scientifically to investigate cavitation phenomenon. Then, the comparison of the novel throttle valve (with an innovative valve chamber) and traditional throttle valve in anticavitation performance was conducted under different conditions. Finally, the experiment about anticavitation performance was completed on the test rig. The calculation and experiment results indicated that the approach, inducing the outlet pressure back to the orifice, was effective in suppressing cavitation.
Modal characteristics and unbalance responses of fan rotor system with flexible support structures in aero-engine
Authors: Wang Meiling , Han Qingkai , Wen Baogang , Zhang Hao , Guan Tianmin
Published: July 2016

This paper investigates the vibration patterns, i.e. rigid motions of shaft and elastic deformation of support structures, of fan rotor system in aero-engine, which differs from traditional flexible rotor systems, and together with its shaft transverse motions due to unbalanced mass. The fan rotor system commonly is composed of one rigid shaft and two flexible support structures (such as squirrel cages), which is effective to decrease the critical speeds avoiding serious shaft vibration due to unbalance. Scaled test rig for realistic fan rotor system is set up according to similarity principles, governing differential equations of which are deduced by means of Lagrangian approach with four degrees of freedom. In contrast to modeling a traditional flexible rotor system, the system stiffness is not determined by the shaft but the two flexible support structures. The rigid shaft only contributes to the inertial items of the governing equations. Parameter values of dynamic model are identified from measurements on the scaled test rig, the modal shapes and the modal energy distributions are calculated. These modal characteristics of the fan rotor system are quite different from those of a traditional flexible rotor system whose stiffness mainly contributed by its elastic shaft even the system values are consistent. The obtained modal characteristics are compared and confirmed by using the simulation results of a corresponding finite element model, in which shaft is built by rotating beam elements and its flexible structures are built by equivalent spring elements. Campbell diagrams of the fan rotor system are used to illustrate the gyroscopic effect with the increasing speeds. And then the unbalance responses are calculated through the deduced analytical formula rapidly and comparisons, including the response spectrum and orbits, the amplitude and phase frequency response curves, and operating deflection shapes, are carried out in the sub- and super-critical range.
Nonlinear motion control of the hydraulic press based on an extended piecewise disturbance observer
Authors: Zhang Qiang , Wei Jianhua , Fang Jinhui , Li Mingjie
Published: July 2016

This article presents a nonlinear motion controller based on an extended piecewise disturbance observer to track desired motion trajectory for the hydraulic press. The proposed extended piecewise disturbance observer accounts for external load by applying the double-drive parameter adaptation. Considering the special work principle of the separate meter-in separate meter-out drive system adopted in the hydraulic press, the nonlinear cascade controller is extended to synthesize the motion controller. The outer motion tracking loop uses the sliding mode control to compensate for load estimation error with desired driving force as control output. The inner pressure control loop is designed based on the backstepping technique. The minimum equivalent load criterion is proposed to function as the bridge linking the outer and inner loops. The stability of the overall close-loop system is proved based on the Lyapunov theory. Both simulation and experiment results demonstrate that the proposed nonlinear cascade controller, together with the extended piecewise disturbance observer, provides an excellent motion tracking performance for the hydraulic press in the presence of complex external load, which typically consists of the deformation force and the friction.
Pro-inflammatory S100 proteins are associated with glomerulonephritis and anti-dsDNA antibodies in systemic lupus erythematosus
Authors: Tydén H , Lood C , Gullstrand B , Jönsen A , Ivars F , Leanderson T , Bengtsson A A
Published: July 2016

Objectives

Systemic lupus erythematosus (SLE) is associated with elevated levels of S100A8/A9, pro-inflammatory proteins mainly secreted by activated polymorphonuclear neutrophils (PMNs). The underlying mechanisms for increased S100A8/A9 levels and their relation to the clinical phenotype have not been carefully investigated. We assessed S100A8/A9 and S100A12 levels in SLE patient sera in relation to disease activity, clinical phenotype, presence of anti-dsDNA antibodies and ability to promote phagocytosis of necrotic cells (NCs) by PMNs.

Methods

Serum levels of S100A8/A9 and S100A12 were measured by ELISA in paired samples of 100 SLE patients at time points of higher and lower disease activity. Serum-mediated phagocytosis of NCs by PMNs was analysed by flow cytometry. Clinical data were recorded at time points of blood sampling.

Results

Serum levels of S100A8/A9 and S100A12 were increased in SLE patients with high disease activity compared to paired samples at low disease activity ( p = 0.01 and p = 0.008, respectively). Elevated levels of S100A8/A9 were particularly seen in patients with anti-dsDNA antibodies ( p = 0.01) and glomerulonephritis before treatment ( p = 0.02). Immunosuppressive therapy was associated with a reduction of S100A8/A9 serum levels ( p = 0.002). The ability of serum to support phagocytosis of NCs by PMNs was related to increased S100A8/A9 levels ( p = 0.01).

Conclusions

Elevated serum levels of S100A8/A9 may be used to monitor disease activity and response to treatment in SLE patients, especially in patients with glomerulonephritis. S100A12 may be a marker of disease activity in SLE. Increased S100A8/A9 levels may reflect immune-pathological processes involving phagocytosis of immune complexes by PMNs.
Risk-taking Propensity, Managerial Network Ties and Firm Performance in an Emerging Economy
Authors: Danso Albert , Adomako Samuel , Damoah John Ofori , Uddin Moshfique
Published: July 2016

The objective of the study was to examine the effect of entrepreneurs’ risk-taking propensity on firm performance and the moderating role of managerial network ties on this relationship in a sub-Saharan economy. This theoretically derived research model is empirically validated using survey data from 298 small and medium-sized enterprises (SMEs) in Ghana. The study’s empirical findings are that high levels of entrepreneurs’ risk-taking propensity enhance firm performance. This relationship is amplified when entrepreneurs cultivate stronger business, political and community network ties.
Book Review: Rodney D. Ryder and Ashwin Madhavan, Intellectual Property and Business: The Power of Intangible Assets
Authors: Nithyananda K.V.
Published: July 2016

Rodney D. Ryder and Ashwin Madhavan, Intellectual Property and Business: The Power of Intangible Assets, New Delhi: SAGE Response Business Books, 2014, 317 pp.
Comorbidity Action in the North: a study of services for people with comorbid mental health and drug and alcohol disorders in the northern suburbs of Adelaide
Authors: Liu Dennis , de Crespigny Charlotte , Procter Nicholas , Kelly Janet , Francis Hepsibah , Posselt Miriam , Cairney Imelda , Galletly Cherrie
Published: July 2016

Objective:

This study identified barriers to and facilitators of mental health (MH) and alcohol and drug (AOD) comorbidity services, in order to drive service improvement.

Method:

Participatory action research enabled strong engagement with community services, including Aboriginal and refugee groups. Surveys, interviews and consultations were undertaken with clinicians and managers of MH, AOD and support services, consumers, families, community advocates and key service providers. Community participation occurred through consultation, advisory and working party meetings, focus groups and workshops.

Results:

Barriers included inadequate staff training and poor community and workforce knowledge about where to find help. Services for Aboriginal people, refugees, the elderly and youth were inadequate. Service fragmentation (‘siloes’) occurred through competitive short-term funding and frequent re-structuring. Reliance on the local hospital emergency department was concerning. Consumer trust, an important element in engagement, was often lacking.

Conclusions:

Comorbidity should be core business of both MH and AOD services by providing consistent ‘no wrong door’ care. Non-governmental organisations (NGOs) need longer funding cycles to promote stability and retain skilled workers. Comorbidity workforce training for government and NGO staff is required. Culturally appropriate comorbidity services are urgently needed. Despite the barriers, collaboration between clinicians/workers was valued.
Applying principles of the Neurosequential Model of Therapeutics across an adolescent day program and inpatient unit
Authors: de Nooyer Karen M , Lingard Michelle W
Published: July 2016

Objective:

The process of applying the principles of the Neurosequential Model of Therapeutics (NMT) as a practice framework in an Adolescent Day Program and Adolescent Inpatient Unit is described.

Conclusions:

NMT as a practice framework guided construction of a neurobiologically sensitive group therapy program whereby specific group therapies can be selected to target a young person’s specific clinical needs within the context of a broader mental health treatment plan. The practice framework has been practical, logical and feasible to implement and may encourage other child and adolescent mental health services to consider the application of neuroscience-informed models such as NMT.
Trends in the diagnosis of bipolar disorder: Has the story changed?
Authors: Parker Gordon , Graham Rebecca
Published: July 2016

Objective:

A recent study reported an 8% increase in bipolar diagnoses in public and community mental health services in New South Wales from 2003 to 2014, an increase interpreted by the authors as reflecting increasing diagnostic boundaries of bipolar disorder, and bipolar II in particular. If valid, we would expect an increase in hospital admissions for hypomania as well as for mania and so analysed a relevant dataset to test that hypothesis.

Methods:

Data were examined for 27,255 individuals hospitalised in NSW psychiatric hospitals over a 14-year period (2000–2014) for ICD-10 diagnosed mania or hypomania and with analyses examining rates of hospitalisation/per year for both mania and for hypomania.

Results:

While overall admissions for mania and hypomania increased over the study period by 16.4%, admissions for mania increased by 31.0% and admissions for hypomania actually decreased by 32.1%.

Conclusion:

The increased rate in admissions of those with a bipolar disorder appears to reflect a trend over more than four decades. The hypothesis that any increase in the diagnostic boundaries of bipolar II disorder would be associated with an increase in hospitalisation rates was rejected, with the converse trend being identified.
Mania associated with self-prescribed acetyl-l-carnitine in a man with bipolar I disorder
Authors: Goodison Geraldine , Overeem Kathie , de Monte Veronica , Siskind Dan
Published: July 2016

Objective:

Complementary medicines are readily available and becoming increasingly popular. Acetyl-l-carnitine (ALC) is widely recognised as a safe dietary supplement to aid weight loss. We present the case of a patient who had a relapse of mania in the context of ALC use for weight loss over a two week period, on the background of bipolar I disorder previously in remission. The patient’s symptoms resolved a few days after ALC was ceased.

Conclusions:

Given the high rates of obesity among people with mental illness, it is possible ALC may be utilised in the hope of aiding weight loss. This case highlights the importance of psychiatrists maintaining open communication with their patients about use of complementary medicines, and the risks and benefits of their use.
Embedded magnetohydrodynamic liquid metal thermal transport: validated analysis and design optimization
Authors: Hartl Darren J , Frank Geoffrey J , Baur Jeffery W
Published: July 2016

This work addresses the multi-fidelity analysis-driven design of a thermal transport system based on the flow of liquid metal through a structural laminate as induced by a solid-state magneto-hydro-dynamic (MHD) pump. A full three-dimensional model of the thermal transport system is both simplified to a reduced-order algebraic model, which correctly captures trends in the global system response, and alternatively implemented in an finite element framework, which captures essential global and local aspects of the system response not attainable via reduced-order modeling. The predictions of each model are validated against previously published experimental data. It is shown in detail for the first time in the context of MHD systems that a multi-fidelity approach to the multi-objective design optimization problem can leverage both the speed of the algebraic model and the accuracy of the finite element model, leading to effective predictions of optimal system designs in a reasonable amount of time. A relatively new algorithm for multi-objective and parameterized Pareto optimization is employed, and a clear path of continued development is identified.
Psychotic-Like Experiences and Psychological Distress
Authors: Barahmand Usha , Heydari Sheikh Ahmad Ruhollah
Published: July 2016

BACKGROUND: The occurrence of psychotic-like experiences and schizotypal features in the general nonclinical population may imply a connection with psychosis-related liability. OBJECTIVE: This study was designed to examine the role of resilience in the relationship of hallucination and delusion–like experiences and schizotypal features to psychological distress in a nonclinical sample. DESIGN: The study sample ( n = 432 university students) was selected through a stratified cluster sampling procedure, and measures of hallucination proneness, delusion proneness, schizotypal personality, and psychological distress were administered. RESULTS: While all three indices of psychotic-like experiences correlated with one another, only hallucination proneness and schizotypal personality features correlated with psychological distress and only schizotypal traits correlated with resilience. Schizotypy was found to have an indirect effect on distress through resilience. CONCLUSIONS: Findings imply the possibility of two types of schizotypy, with high or low resilience. It appears that schizotypes with low resilience may be susceptible to adversity and mental disorders, while high resilience may be protective.
Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview
Authors: Stadnick Nicole , Chlebowski Colby , Baker-Ericzén Mary , Dyson Margaret , Garland Ann , Brookman-Frazee Lauren
Published: July 2016

Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4–14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non–autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen’s kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06–0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.
Analytical solutions of the torsional mechanism for a new hybrid fiber-reinforced polymer–aluminum twin-trackway space truss bridge
Authors: Zhang Dongdong , Li Feng , Zhao Qilin , Duan Yingchang
Published: July 2016

For emergency purposes, a lightweight space truss bridge was designed. The bridge is composed of twin triangular deck-truss beams incorporating new structural forms and advanced fiber-reinforced polymer profiles. As a new structure, the structural properties of its triangular deck-truss beam have been studied in detail; however, a design-oriented study facilitating the application of the entire twin-trackway bridge under pure torsion remains to be undertaken. The objective of this article is to analytically explore the torsional mechanism of the twin-trackway bridge, which is characterized by torsional angle and torsional stiffness. To verify the derivation procedures and formulae, the pure torsion test and numerical analysis are conducted on a full-scale specimen. The results indicate that the analytical solutions compare well with the experimental and numerical results. The torsional moment is primarily resisted by the vertical bending of twin triangular deck-truss beams. The simplified analytical model can be used with sufficient accuracy for the design of the bridge.
Probabilistic analysis of stress concentration factors in unstiffened gap tubular KT-joints of jacket structures under the out-of-plane bending moment loads
Authors: Ahmadi Hamid , Mousavi Nezhad Benam Mir Amin
Published: July 2016

The stress concentration factor, which is one of the primary input parameters for the fatigue reliability analysis of tubular joints commonly found in offshore jacket structures, shows substantial scatter that highlights the importance of accurate derivation of its governing probability function. In this article, results of 144 finite element stress analyses, validated using experimental data, were used to derive the probability density functions for the stress concentration factors in unstiffened gap tubular KT-joints under four types of out-of-plane bending moment loadings. Based on a parametric finite element study, a sample database was prepared for the maximum chord-side stress concentration factors of central and outer braces, and density histograms were generated for these samples. Nine different probability density functions were fitted to these histograms. The maximum likelihood method was used to estimate the parameters of fitted distributions. In each case, Kolmogorov–Smirnov test was applied to assess the goodness-of-fit. Finally, the inverse Gaussian model was selected as the best-fitted distribution, and after substituting the values of estimated parameters, six fully defined probability density functions were proposed for the maximum chord-side stress concentration factors of central and outer braces in unstiffened gap KT-joints under four types of out-of-plane bending loading.
The Art of Social Reproduction
Authors: Horne Victoria
Published: July 2016

This article considers how the museum produces knowledge about the past and present of feminist politics through its framing of marginal, activist artworks that have engaged the sphere of social reproduction or care labour. It is contended that neoliberalism’s assault on social reproduction in our current ‘age of austerity’ – which sees responsibility displaced from the state onto individuals – has sparked a reengagement with earlier socialist–feminist discourse and, as a result, we are perceptibly enmeshed within a new age of social reproduction debates. The Hackney Flashers’ germinal photographic project Who’s Holding the Baby? (1976–1978), acquired by Madrid’s Reina Sofia in 2010, is taken as a case study to explore a range of contextual, temporal and historical contradictions in further detail. Examining the ambiguous relocation of this photographic project provokes vital questions about the contribution of culture to the troubled terrains of art, property and care labour in the 21st century.
Conservatoires in society: Institutional challenges and possibilities for change
Authors: Tregear Peter , Johansen Geir , Jørgensen Harald , Sloboda John , Tulve Helena , Wistreich Richard
Published: July 2016

Educational sociologists and philosophers have long recognised that educational institutions play a significant role in shaping as well as supporting societal norms. In the face of growing global social, political, and environmental challenges, should conservatoires be more overt in expressing a mission to sustain and improve the societies in which they are located? In times of ever-increasing scepticism emanating from governments and the broader populace alike about the efficacy of public spending, if not the public sphere itself, this essay suggests it is both timely and necessary for conservatoires to reconsider, reinvigorate and re-articulate their capacity to contribute to broader social goods. Drawing on the authors’ professional experience as well as current literature and debates, the essay is both deliberately provocative and open-ended, articulating a number of points of departure that institutions might consider in addressing the challenge of maintaining and exercising their relevance to broader society.
Reflection as creative process: Perspectives, challenges and practice
Authors: Guillaumier Christina
Published: July 2016

This paper explores the challenges and opportunities for embedding reflection in practice-based curricula in the arts. Following the root and branch curriculum reform project recently completed at the Royal Conservatoire of Scotland, the paper presents a hermeneutic and analytical narrative of the challenges emerging from presenting reflection as a creative, active and interactive process. The paper outlines a working version of reflection as a creative and embodied process. In order to demonstrate that creativity and reflection are inextricably linked in the arts, and more importantly, that they are crucial to a student’s practice, the term itself often needs to be humanized. While written reflection remains a crucial component of our courses, here I consider different approaches to reflection, drawn from current practice, where it becomes a practical and generative platform for creativity. In the process of exploring these practices, the paper draws on Ken Robinson’s insightful exploration of the concept of creativity and articulates with Csikszentmihayli’s thought-provoking study on its location.
Developing employability in higher education music
Authors: Bennett Dawn
Published: July 2016

The development of employability in higher music education concerns students, musicians, educators, administrators and funding bodies, and yet employability is both impossible to measure and poorly defined. This paper sets the context for a set of short papers that explore employability from the perspective of music. Because many of the issues they raise have relevance across the creative industries, this paper discusses research that positions them within this broader context. The paper highlights the need for both the functional (how-to) aspects of employability and those that are cognitive: development of students’ cognitive dispositions and their capacity to engage as professionals. As such, the paper argues that employability requires collaborative action on three fronts: enhancement of the ways in which employment outcomes are defined and measured; initiatives that engage students in career- and life-relevant activities; and advocacy work that re-aligns stakeholder perceptions of graduate work and employability itself.
Classical music as enforced Utopia
Authors: Leech-Wilkinson Daniel
Published: July 2016

In classical music composition, whatever thematic or harmonic conflicts may be engineered along the way, everything always turns out for the best. Similar utopian thinking underlies performance: performers see their job as faithfully carrying out their master’s (the composer’s) wishes. The more perfectly they represent them, the happier the result. But why should performers not have a critical role to play in re-presenting a score, just as actors are permitted – required even – to find new meanings and new relevance in texts? And what or whom are performers obeying, the long dead composer (and what is the ethical basis for that?) or a policing system (teachers, examiners, adjudicators, critics, agents, promoters, record producers) that enforces an imaginary tradition from childhood to grave? Starting from the evidence of early recordings, showing that composers are misrepresented, this article seeks to unpick some of the delusions that support classical music practice.
Making mavericks: Preparing musicians for independent artistic culture
Authors: Canham Nicole L
Published: July 2016

This essay explores the role that maverick qualities – ‘independent or unorthodox behaviour’ ( The Oxford Dictionary, 2015) – play in developing and sustaining musician employability. Whilst career education for musicians often highlights new career models (Bridgstock, 2005), there is limited evidence of how these concepts work in practice (McCowan and Wyganowska, 2008). Savickas (2011) suggests that ‘individuals take possession of their lives by connecting who they are to what they do’ (13). Findings from my recent study of the beliefs, values, work and learning of eight independent professional musicians highlight the links between independent beliefs and values (who they are) and subsequent pathways (what they do). These approaches suggest new roles Higher Education might play in fostering the attributes needed to navigate the often self-directed career pathways of musicians.
The performer’s body in creative interpretations of repertoire music
Authors: Hubrich Sara G B
Published: July 2016

Recent developments in the performing arts have led Western classical instrumentalists to reconsider their own creative input in their interpretative practice. Still recognising the composer as a main creative source, a fresh approach to interpretation specifically embraces possibilities for shared creativity. Such a shift of perception is particularly obvious when working collaboratively with artists from other genres including dance, theatre, literature or mixed media. In these combinations, several performative elements such as, for example, each performer’s corporeality, presence, actions and perspectives become part of the interpretative concept and product. This paper introduces a recent practice-based research project called Creative Embodiment of Music, which focuses on possibilities for a musician’s extended creativity and how this can be realised in live music performance.
A Call for Computational Thinking in Undergraduate Psychology
Authors: Anderson Nicole D.
Published: July 2016

Computational thinking is an approach to problem solving that is typically employed by computer programmers. The advantage of this approach is that solutions can be generated through algorithms that can be implemented as computer code. Although computational thinking has historically been a skill that is exclusively taught within computer science, there has been a more recent movement to introduce these skills within other disciplines. Psychology is an excellent example of a discipline that would benefit from computational thinking skills because of the nature of questions that are typically asked within the discipline. However, there has not been a formal curriculum proposed to teach computational thinking within psychology and the behavioural sciences. I will argue that computational thinking is a fundamental skill that can easily be introduced to psychology students throughout their undergraduate education. This would provide students with the skills necessary to become successful researchers, and would also provide a practical and marketable skill to all psychology graduates.
Tofogliflozin, a selective inhibitor of sodium-glucose cotransporter 2, suppresses renal damage in KKAy/Ta mice, obese and type 2 diabetic animals
Authors: Ishibashi Yuji , Matsui Takanori , Yamagishi Sho-ichi
Published: July 2016

Objective:

Inhibitors of sodium-glucose cotransporter 2 ameliorate hyperglycaemia in diabetes by increasing urinary glucose excretion. However, the effects of sodium-glucose cotransporter 2 inhibitors on tubulointerstitial damage in diabetic nephropathy are not fully elucidated. We examined whether tofogliflozin, an inhibitor of sodium-glucose cotransporter 2, suppressed renal damage in KKAy/Ta mice, obese and type 2 diabetic animals.

Materials and methods:

Male 8-week-old KKAy/Ta mice or control C57BL/6J mice were kept on a standard diet with or without 0.015% tofogliflozin for 5 weeks. Blood glucose and blood pressure, body and kidney weight, urinary N-acetyl-β-d-glucosaminidase activity and albumin excretion levels were monitored.

Results:

Although tofogliflozin treatment did not affect blood pressure, body weight or serum creatinine values, it improved hyperglycaemia and blocked the elevation of urinary N-acetyl-β-d-glucosaminidase activity in KKAy/Ta diabetic mice at 9, 11 and 13 weeks. Furthermore, compared with control mice, urinary albumin excretion levels and kidney weight were increased in 13-week-old KKAy/Ta mice, both of which were suppressed by the treatment with tofogliflozin.

Conclusion:

Our present results demonstrated that tofogliflozin could suppress albuminuria and tubulointerstitial injury in obese and type 2 diabetic mice. Inhibition of glucose entry into tubular cells by tofogliflozin may exert renoprotective properties in diabetes.
Characteristics of Traditional Chinese Medicine Use in Pediatric Cancer Patients: A Nationwide, Retrospective, Taiwanese-Registry, Population-Based Study
Authors: Yen Hung-Rong , Lai Wan-Yu , Muo Chih-Hsin , Sun Mao-Feng
Published: July 2016

Background. Large-scale surveys of complementary traditional Chinese medicine (TCM) use in pediatric cancer patients are lacking. The aim of our study was to investigate the use of TCM in pediatric cancer patients. Methods. We analyzed cancer patients younger than 18 years (n = 12 965) who were registered in the National Health Insurance Research Database in Taiwan between 2001 and 2011. Patients were categorized into TCM or non–TCM users based on their use of TCM. Results. In Taiwan, 8086 (62.4%) children with cancer sought TCM treatment at some point. Children in older age groups, including school-aged children and adolescents, were more likely to use TCM. There was no significant difference in the distributions of gender and urbanization. The 3 most common diseases for which TCM users visited the clinic were neoplasm (33.2%), respiratory system disease (32.9%), and infectious disease (8.86%). The most commonly utilized TCM therapy was Chinese herbal remedies. Patients who had comorbid conditions such as allergic rhinitis, dyspepsia, disorders of menstruation, and disease of the musculoskeletal system and connective tissue tended to visit TCM clinics. Conclusions. Adjunctive TCM use is not low in Taiwanese children with cancer. Further studies to investigate the efficacy and safety of TCM in children with cancer are warranted.
TXR1 and TSP1 expression varies by the molecular subtypes of breast cancer patients who received previous docetaxel-based first-line chemotherapy
Authors: Zhang Huiming , Qu Xiang , Ma Xuemei , Wang Tingting , Yang Yao , Ge Zhicheng , Zhang Zhongtao , Bai Zhigang , Gao Yinguang , Yuan Zhu , Wang Zihan
Published: July 2016

The expression of taxol resistance gene 1 and thrombospondin 1 remains unknown in human breast cancer tissues. In the current study, we sought to measure the mRNA expression levels of taxol resistance gene 1 and thrombospondin 1 in breast cancer tissue and adjacent normal tissue specimens and further analyzed their expression according to the molecular subtypes and age of breast cancer patients who had received taxane-containing regimens. Archived breast cancer and adjacent non-tumor tissue specimens were obtained at Beijing Friendship Hospital, Beijing, China. The mRNA transcript levels of taxol resistance gene 1, thrombospondin 1 and multi-drug resistance 1 were determined by quantitative RT-PCR . Taxol resistance gene 1 and multi-drug resistance 1 protein levels were measured by immunoblotting assays. Forty-nine archived breast cancer tissue specimens were included. The majority of the specimens (65.3%) were of the molecular subtype A followed by triple negative breast cancer (14.3%). The mRNA transcript levels of taxol resistance gene 1 , thrombospondin 1 and multi-drug resistance 1 in breast cancer tissues were higher than those of adjacent normal tissues. The mRNA expression of TXR1 in the HER2 subtype (4.513 ± 0.810) was the highest and in the Luminal B subtype was the lowest (3.103 ± 0.417) among the four molecular subtypes. The HER2 subtype also had the highest mRNA expression of thrombospondin 1(4.827 ± 0.927) and the Luminal B subtype had the lowest TSP1 mRNA level (3.197 ± 0.565) among the four molecular subtypes. Our study represents the first attempt in delineating taxol resistance gene 1 and thrombospondin 1 expression in breast cancer and we demonstrate that taxol resistance gene 1 and thrombospondin 1 expression may vary according to the molecular subtypes of breast cancer.
The Insulin Resistance Intervention after Stroke trial: A perspective on future practice and research
Authors: Bath Philip M , Appleton Jason P , Sprigg Nikola
Published: July 2016

The prevention of recurrent events after ischaemic stroke and transient ischaemic attack is well established and based on lifestyle changes, antithrombotics, statins, antihypertensives and carotid surgery. The international IRIS trial assessed whether pioglitazone, a glucose-lowering insulin-sensitizing drug, would reduce recurrent vascular events in patients with ischaemic stroke or transient ischaemic attack. After 4.8 years, pioglitazone therapy was associated with reduced vascular events and new diabetes, and an increase in weight, oedema and bone fractures. Pioglitazone may add to the strategies for preventing further events in patients with stroke or transient ischaemic attack.
Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH – General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial
Authors: Simonsen Claus Z , Sørensen Leif H , Juul Niels , Johnsen Søren P , Yoo Albert J , Andersen Grethe , Rasmussen Mads
Published: July 2016

Rationale

Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome.

Aim and hypothesis

The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether the choice of anesthetic regime during endovascular therapy for acute ischemic stroke influence patient outcome. Our hypothesis is that that conscious sedation is associated with less infarct growth and better functional outcome.

Methods

GOLIATH is an investigator-initiated, single-center, randomized study. Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation.

Study outcomes

The primary outcome measure is infarct growth after 48–72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary outcomes include 90-day modified Rankin Scale score, time parameters, blood pressure variables, use of vasopressors, procedural and anesthetic complications, success of revascularization, radiation dose, and amount of contrast media.

Discussion

Choice of anesthesia may influence outcome in acute ischemic stroke patients undergoing endovascular therapy. The results from this study may guide future decisions regarding the optimal anesthetic regime for endovascular therapy. In addition, this study may provide preliminary data for a multicenter randomized trial.
Predictors of outcome after primary flexor tendon repair in zone 1, 2 and 3
Authors: Rigo I. Z. , Røkkum M.
Published: July 2016

We retrospectively reviewed the outcomes of flexor tendon repairs in zones 1, 2 and 3 in 356 fingers in 291 patients between 2005 and 2010. The mean (standard deviation) active ranges of motion of two interphalangeal joints of the fingers were 98° (40) and 114° (45) at 8 weeks postoperatively and at the last follow-up (mean 7 months, range 3–98), respectively. Using the Strickland criteria, ‘excellent’ or ‘good’ function was obtained in 95 (30%) out of 322 fingers at 8 weeks and 107 (48%) out of 225 fingers at the last follow-up. A total of 48 (13%) fingers required reoperation because of rupture, adhesion, contracture or other complications. The prevalence of rupture was 4%. We carried out multiple linear regression analysis to identify the predictors of the active digital motion. The following variables were found as negative predictors: age; smoking; injury localization between subzones 1C and 2C; injury to the little finger; the extent of soft tissue damage; concomitant skeletal injury; delay to surgery; use of a 2-strand Kessler repair technique; attempted suture or preservation of the tendon sheath–pulley system; and resecting or leaving the concomitant superficial flexor tendon cuts untreated. Analysing the 8 weeks results of tendon repairs in zones 1 and 2, early active mobilization was found to be superior to Kleinert’s regime.

Level of evidence: III
Development of an enhanced health-economic model and cost-effectiveness analysis of tiotropium + olodaterol Respimat® fixed-dose combination for chronic obstructive pulmonary disease patients in Italy
Authors: Selya-Hammer Carl , Gonzalez-Rojas Guix Nuria , Baldwin Michael , Ternouth Andrew , Miravitlles Marc , Rutten-van Mölken Maureen , Goosens Lucas M.A. , Buyukkaramikli Nasuh , Acciai Valentina
Published: July 2016

Background:

The objective of this study was to compare the cost-effectiveness of the fixed-dose combination (FDC) of tiotropium + olodaterol Respimat® FDC with tiotropium alone for patients with chronic obstructive pulmonary disease (COPD) in the Italian health care setting using a newly developed patient-level Markov model that reflects the current understanding of the disease.

Methods:

While previously published models have largely been based around a cohort approach using a Markov structure and GOLD stage stratification, an individual-level Markov approach was selected for the new model. Using patient-level data from the twin TOnado trials assessing Tiotropium + olodaterol Respimat® FDC versus tiotropium, outcomes were modelled based on the trough forced expiratory volume (tFEV1) of over 1000 patients in each treatment arm, tracked individually at trial visits through the 52-week trial period, and after the trial period it was assumed to decline at a constant rate based on disease stage. Exacerbation risk was estimated based on a random-effects logistic regression analysis of exacerbations in UPLIFT. Mortality by age and disease stage was estimated from an analysis of TIOSPIR trial data. Cost of bronchodilators and other medications, routine management, and costs of treatment for moderate and severe exacerbations for the Italian setting were included. A cost-effectiveness analysis was conducted over a 15-year time horizon from the perspective of the Italian National Health Service.

Results:

Aggregating total costs and quality-adjusted life years (QALYs) for each treatment cohort over 15 years and comparing tiotropium + olodaterol Respimat® FDC with tiotropium alone, resulted in mean incremental costs per patient of €1167 and an incremental cost-effectiveness ratio (ICER) of €7518 per additional QALY with tiotropium + olodaterol Respimat® FDC. The lung function outcomes observed for tiotropium + olodaterol Respimat® FDC in TOnado drove the results in terms of slightly higher mean life-years (12.24 versus 12.07) exacerbation-free months (11.36 versus 11.32) per patient and slightly fewer moderate and severe exacerbations per patient-year (0.411 versus 0.415; 0.21 versus 0.24) versus tiotropium. Probabilistic sensitivity analyses showed tiotropium + olodaterol Respimat® FDC to be the more cost-effective treatment in 95.2% and 98.4% of 500 simulations at thresholds of €20,000 and €30,000 per QALY respectively.

Conclusion:

Tiotropium + olodaterol Respimat® FDC is a cost-effective bronchodilator in the maintenance treatment of COPD for the Italian health care system.
Factors influencing medication label viewing in Malaysia
Authors: Cheah Yong Kang , Chong Yen Wan
Published: July 2016

The misuse of medicine is a serious public health issue worldwide. An important factor that contributes to the misuse of medicine is the lack of medication label viewing by consumers. The objective of the present study is to examine the socio-economic, demographic and lifestyle factors associated with medication label viewing among Malaysian adults. The empirical analysis is based on a nationally representative data set of 30,992 respondents. An ordered probit model is used to examine different types of medication label viewers. The results of this study suggest that socio-economic (i.e. age, income level, education level, location of residence), demographic (i.e. gender, ethnicity, marital status) and lifestyle factors (i.e. physical activity, smoking) have significant effects on medication label viewing. It is found that age, low-income and low-education level reduce the likelihood of viewing medication label. Based on these findings, several policy implications are suggested. The present study provides policy makers with baseline information regarding which cohorts of individuals to focus on in efforts to increase the frequency of medication label viewing.
NGO Publicity and Reinforcing Path Dependencies
Authors: Powers Matthew
Published: July 2016

Previous research finds that nongovernmental organization (NGO) publicity strategies—despite digital technologies—continue to focus heavily on garnering coverage in the mainstream news media. Drawing on theories of path dependence and interviews with NGO professionals, this paper identifies three factors that explain why this should be so. First, donors continue to value media coverage as a platform to learn about advocacy groups, as well as a mechanism for measuring their impact on political discourse. Second, political officials still value media coverage as a way to learn about advocacy demands. Third, NGOs occupy a position that is socially proximate to journalism, which leads the former to see the latter as an ally in the pursuit of publicity. Together, these factors confirm and extend the new institutional concept of “path dependence” by demonstrating how path dependence in one field (philanthropy, politics) can reinforce path dependence in another (NGO). These “reinforcing path dependencies” in turn interact with established mechanisms of institutional production (start-up costs, feedback effects, knowledge accumulation) to explain why NGOs continue to persist in media-centered publicity strategies despite new technological possibilities.
Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan
Authors: Lewis Jane EA , Williams Paul , Davies Jane H
Published: July 2016

Objectives:

This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan.

Methods:

Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard.

Results:

Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%.

Conclusion:

Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.