bluuebunny/crossref_metadata_2025 huggingface dataset:
Surface and Buildup Region Dose Measurements with Markus Parallel-Plate Ionization Chamber, GafChromic EBT3 Film, and MOSFET Detector for High-Energy Photon Beams
Authors: Akbas Ugur , Donmez Kesen Nazmiye , Koksal Canan , Bilge Hatice
Published: June 2016

The aim of the study was to investigate surface and buildup region doses for 6 MV and 15 MV photon beams using a Markus parallel-plate ionization chamber, GafChromic EBT3 film, and MOSFET detector for different field sizes and beam angles. The measurements were made in a water equivalent solid phantom at the surface and in the buildup region of the 6 MV and 15 MV photon beams at 100 cm source-detector distance for 5 × 5, 10 × 10, and 20 × 20 cm2field sizes and 0°, 30°, 60°, and 80° beam angles. The surface doses using 6 MV photon beams for 10 × 10 cm2field size were found to be 20.3%, 18.8%, and 25.5% for Markus chamber, EBT3 film, and MOSFET detector, respectively. The surface doses using 15 MV photon beams for 10 × 10 cm2field size were found to be 14.9%, 13.4%, and 16.4% for Markus chamber, EBT3 film, and MOSFET detector, respectively. The surface dose increased with field size for all dosimeters. As the angle of the incident radiation beam became more oblique, the surface dose increased. The effective measurement depths of dosimeters vary; thus, the results of the measurements could be different. This issue can lead to mistakes at surface and buildup dosimetry and must be taken into account.
Pretransplant Immune- and Apoptosis-Related Gene Expression Is Associated with Kidney Allograft Function
Authors: Kamińska Dorota , Kościelska-Kasprzak Katarzyna , Chudoba Paweł , Mazanowska Oktawia , Banasik Mirosław , Żabinska Marcelina , Boratyńska Maria , Lepiesza Agnieszka , Gomółkiewicz Agnieszka , Dzięgiel Piotr , Klinger Marian
Published: June 2016

Renal transplant candidates present immune dysregulation, caused by chronic uremia. The aim of the study was to investigate whether pretransplant peripheral blood gene expression of immune factors affects clinical outcome of renal allograft recipients.Methods. In a prospective study, we analyzed pretransplant peripheral blood gene expression in87 renal transplant candidates with real-time PCR on custom-designed low density arrays (TaqMan).Results. Immediate posttransplant graft function (14-day GFR) was influenced negatively byTGFB1(P=0.039) and positively byIL-2gene expression (P=0.040). Pretransplant blood mRNA expression of apoptosis-related genes (CASP3,FAS,andIL-18) and Th1-derived cytokine geneIFNGcorrelated positively with short- (6-month GFRCASP3:P=0.027,FAS:P=0.021, andIFNG:P=0.029) and long-term graft function (24-month GFRCASP3:P=0.003,FAS:P=0.033,IL-18:P=0.044, andIFNG:P=0.04).Conclusion. Lowered pretransplant Th1-derived cytokine and apoptosis-related gene expressions were a hallmark of subsequent worse kidney function but not of acute rejection rate. The pretransplantIFNGandCASP3andFASandIL-18genes’ expression in the recipients’ peripheral blood is the possible candidate for novel biomarker of short- and long-term allograft function.
New Alternatives for Autoimmune Disease Treatments: Physicochemical and Clinical Comparability of Biosimilar Etanercept
Authors: Miranda-Hernández Mariana P. , López-Morales Carlos A. , Perdomo-Abúndez Francisco C. , Salazar-Flores Rodolfo D. , Ramírez-Ibanez Nancy D. , Pérez Nestor O. , Molina-Pérez Aarón , Revilla-Beltri Jorge , Flores-Ortiz Luis F. , Medina-Rivero Emilio
Published: June 2016

Etanercept is a recombinant fusion protein approved for the treatment of TNF-αmediated diseases such as rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, and ankylosing spondylitis. Herein, we present an evaluation of the physicochemical and biological properties of a biosimilar etanercept and its reference product followed by a clinical study in patients diagnosed with RA intended to demonstrate comparability of their immunomodulatory activity. Identity analyses showed a total correspondence of the primary and higher-order structure between the two products. In regard to intrinsic heterogeneity, both products showed to be highly heterogenous; however the biosimilar etanercept exhibited similar charge and glycan heterogeneity intervals compared to the reference product. Apoptosis inhibition assay also showed that, despite the high degree of heterogeneity exhibited by both products, no significant differences exist in theirin vitroactivity. Finally, the clinical assessment conducted in RA-diagnosed patients did not show significant differences in the evaluated pharmacodynamic markers of both products. Collectively, the results from the comparability exercise provide convincing evidence that the evaluated biosimilar etanercept can be considered an effective alternative for the treatment of RA.
Interactions of established risk factors and a GWAS-based genetic risk score on the risk of venous thromboembolism
Authors: Crous-Bou Marta , Vivo Immaculata De , Camargo Carlos A. , Varraso Raphaëlle , Grodstein Francine , Jensen Majken K. , Kraft Peter , Goldhaber Samuel Z. , Lindström Sara , Kabrhel Christopher
Published: June 2016

Multiple genetic and environmental risk factors contribute to venous thromboembolism (VTE) risk. Understanding how genes and environmental risk factors interact may provide key insight into the pathophysiology of VTE and may identify opportunities for targeted prevention and treatment. It was our aim to examine the main effects and the potential effect-modification between single nucleotide polymorphisms (SNPs) at established loci and lifestyle risk factors for VTE. We performed a nested case-control study using data on 1,040 incident VTE cases and 16,936 controls from the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study cohorts, who gave blood, were selected as participants in a previous genome-wide association study (GWAS), and completed a biennial questionnaire at time of blood draw. We selected SNPs that were associated with VTE risk in previous GWAS studies. A genetic risk score (GRS) was constructed to evaluate the combined effect of the 16 SNPs that have reached genome-wide significance in previous GWAS of VTE. Interactions between SNPs and VTE risk factors (BMI and smoking) were also assessed. We found a significant association between our GRS and VTE risk. The risk of VTE among individuals in the highest GRS tertile was 2.02 times that of individuals in the lowest GRS tertile (p-trend = 9.69x10-19). The OR was 1.52 (p=1.03x10-8) for participants in the highest GRS tertile compared to those in the medium GRS tertile. However, while BMI and smoking were associated with VTE, and their effects were additive to each other we did not observe any significant multiplicative gene-environment interactions.

Supplementary Material to this article is available online at www.thrombosis-online.com.
Morphological clarifications of Australian hylid and limnodynastid tadpoles
Authors: ANSTIS MARION , ROWLEY JODI J. L. , ALTIG Ronald
Published: June 2016

Tadpole morphology usually is consistent within taxa and ecologies (Altig & Johnston 1989), but the occurrences of unique morphologies offer informative perspectives on the potential diversity of these structures. Anstis (2013) characterized most of the tadpoles of Australia, but a thorough understanding of certain morphological features requires closer examinations. Until we understand the morphological features of anuran larvae, and preferably their ontogeny, we cannot productively discuss their evolution or ecological significance.
New diagnosis for species of Plutomurus Yosii (Collembola, Tomoceridae), with descriptions of two new species from Georgian caves
Authors: BARJADZE SHALVA , BAQUERO ENRIQUE , SOTO-ADAMES FELIPE N. , GIORDANO ROSANNA , JORDANA RAFAEL
Published: June 2016

Two new species of the genus Plutomurus, P. revazi sp. nov. from Prometheus and Satsurblia caves and P. eristoi sp. nov. from Satevzia Cave are described, illustrated and differentiated from other morphologically closely related species. A high variability in the number of teeth in the claw, unguiculus and mucro of P. revazi sp. nov. demonstrate that these characters are not useful for species diagnosis. However, dorsal chaetotaxy was shown to be stable character for this purpose. Analysis of DNA sequences for the COI and 28S genes is congruent with species-level groups delimited by chaetotaxy, and provide additional support for chaetotaxy as the most reliable morphological character system to distinguish species in Plutomurus. A key to species of the genus Plutomurus found in Georgia is provided, which for the first time includes characters of the macrochaetotaxy.
Amnestus mendeli sp. n., the first burrower bug species (Hemiptera: Heteroptera: Cydnidae) recorded on Ascension Island, central Atlantic Ocean
Authors: LIS JERZY A. , LIS BARBARA
Published: June 2016

A new species of the genus Amnestus Dallas, 1851, Amnestus mendeli, is described from the cloud zone of Green Mountain, Ascension Island, and compared with its closest relatives, the Brazilian Amnestus lenkoi Froeschner, 1975 and Amnestus pequinus Froeschner, 1975. It is the first representative of the family Cydnidae recorded on the island thus far. The species is presumed to be an introduction from the Americas, but the hypothesis that it might be endemic to Ascension Island is also not excluded.
Immediate Extinction Attenuates Spontaneous Recovery and Reinstatement in a Passive Avoidance Paradigm
Authors: Briggs James F. , Fava Devin A.
Published: June 2016

Recent research suggests that extinction occurring shortly after fear conditioning attenuates spontaneous recovery and reinstatement of fear. Two experiments investigated whether immediate extinction would prevent spontaneous recovery and reinstatement of fear using a passive avoidance paradigm. In Experiment 1, naive female adult rats ( N = 40) received extinction training either immediately or 24 hours (delayed) after fear conditioning. Both extinction groups showed a significant reduction in fear at a 1-day test. At a 15-day test, spontaneous recovery was observed in the delayed extinction group while the immediate extinction group continued to show significant extinction. In Experiment 2, using a naive group of adult female rats ( N = 16), the extinction result was replicated in both the immediate and delayed extinction groups at the 1-day interval. Reinstatement of fear, elicited by foot-shock in a neutral environment, was observed for the delayed group but not for the immediate group. By utilizing the passive-avoidance paradigm, these experiments replicate and extend previous findings that immediate extinction attenuates spontaneous recovery and reinstatement of fear.
“You’re Supposed to Help Me”: The Perils of Mass Counseling Norms for Working-Class Black Students
Authors: Gast Melanie Jones
Published: June 2016

How do educators reconcile the growing college-for-all norm—the notion that all students should pursue college—with the diverse needs of students in urban settings? What is the impact on Black students across social-class background? Using interviews and fieldwork with teachers, counselors, and diverse Black students in a large Californian high school, I examine college-counseling norms under a social capital framework. With high caseloads, I find that educators support mass outreach and vague encouragements for 4-year colleges. Ultimately, my findings problematize one-size-fits-all counseling norms and highlight the need for more targeted counseling for urban and working-class Black students.
‘You be my body for me’
Authors: Kellogg Catherine
Published: June 2016

Judith Butler and Catherine Malabou’s recent exchange, ‘You Be My Body for Me: Body, Shape and Plasticity in Hegel’s Phenomenology of Spirit’, is remarkable because in their rereading of Hegel’s famous lord and bondsman parable, rather than focusing on recognition, work, or even desire, Butler and Malabou each wonder about how Hegel contributes to a new way of thinking about ‘having’ a body and how coming to ‘be’ a body necessarily involves a kind of dispossession. Butler and Malabou’s reading of Hegel is congruent with a current shift on the left away from a liberal politics of recognition to a (post-)Marxist analytic of dispossession: a move, in other words, away from liberal ‘solutions’ of redistribution – of either goods or recognition – towards thinking through issues of settler colonialism, forced migration and empire. Butler and Malabou’s piece points towards the insight that Hegel’s parable must be thought in terms of the political history of possessive individualism, and so in terms of the history of juridically defined property relations; the history of regarding both the body and the land as property. The ‘two valences’ of dispossession, in other words, refers in fact to a logic of property relations, one between those who ‘have’ property (either land or the property of their own bodies) and those who are juridically defined as propertyless.
Evaluating different standard-setting methods in an ESL placement testing context
Authors: Shin Sun-Young , Lidster Ryan
Published: June 2016

In language programs, it is crucial to place incoming students into appropriate levels to ensure that course curriculum and materials are well targeted to their learning needs. Deciding how and where to set cutscores on placement tests is thus of central importance to programs, but previous studies in educational measurement disagree as to which standard-setting method (or methods) should be employed in different contexts. Furthermore, the results of different standard-setting methods rarely converge on a single set of cutscores, and standard-setting procedures within language program placement testing contexts specifically have been relatively understudied. This study aims to compare and evaluate three different standard-setting procedures – the Bookmark method (a test-centered approach), the Borderline group method (an examinee-centered approach), and cluster analysis (a statistical approach) – and to discuss the ways in which they do and do not provide valid and reliable information regarding placement cut-offs for an intensive English program at a large Midwestern university in the USA. As predicted, the cutscores derived from the different methods did not converge on a single solution, necessitating a means of judging between divergent results. We discuss methods of evaluating cutscores, explicate the advantages and limitations associated with each standard-setting method, recommend against using statistical approaches for most English for academic purposes (EAP) placement contexts, and demonstrate how specific psychometric qualities of the exam can affect the results obtained using those methods. Recommendations for standard setting, exam development, and cutscore use are discussed.
Standardized patient simulation versus didactic teaching alone for improving residents’ communication skills when discussing goals of care and resuscitation: A randomized controlled trial
Authors: Downar James , McNaughton Nancy , Abdelhalim Tarek , Wong Natalie , Lapointe-Shaw Lauren , Seccareccia Dori , Miller Kim , Dev Shelly , Ridley Julia , Lee Christie , Richardson Lisa , McDonald-Blumer Heather , Knickle Kerry
Published: June 2016

Background:

Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care.

Objective:

To determine whether standardized patient simulation offers benefit over didactic sessions alone for improving skill and comfort discussing goals of care.

Design and intervention:

Single-blind, randomized, controlled trial of didactic teaching plus standardized patient simulation versus didactic teaching alone.

Participants:

First-year internal medicine residents.

Main measures:

Changes in communication comfort and skill between baseline and 2 months post-training assessed using the Consultation and Relational Empathy measure.

Key results:

We enrolled 94 residents over a 2-year period. Both groups reported a significant improvement in comfort when discussing goals of care with patients. There was no difference in Consultation and Relational Empathy scores following the workshop ( p = 0.79). The intervention group showed a significant increase in Consultation and Relational Empathy scores post-workshop compared with pre-workshop (35.0 vs 31.7, respectively; p = 0.048), whereas there was no improvement in Consultation and Relational Empathy scores in the control group (35.6 vs 36.0; p = 0.4). However, when the results were adjusted for baseline differences in Consultation and Relational Empathy scores in a multivariable regression analysis, group assignment was not associated with an improvement in Consultation and Relational Empathy score. Improvement in comfort scores and perception of benefit were not associated with improvements in Consultation and Relational Empathy scores.

Conclusion:

Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose.
Lithium intoxication: Incidence, clinical course and renal function – a population-based retrospective cohort study
Authors: Ott Michael , Stegmayr Bernd , Salander Renberg Ellinor , Werneke Ursula
Published: June 2016

When prescribing lithium, the risk of toxicity remains a concern. In this study, we examined a cohort of patients exposed to lithium between 1997 and 2013. The aims of this study were to determine the frequency of lithium intoxication and to evaluate the clinical course and changes in renal function. Of 1340 patients, 96 had experienced at least one episode of lithium levels ⩾1.5 mmol/L, yielding an incidence of 0.01 per patient-year. Seventy-seven patients available for review had experienced 91 episodes, of whom 34% required intensive care and 13% were treated with haemodialysis. There were no fatalities. Acute kidney injury occurred, but renal function at baseline was not different to renal function after the episode. Renal impairment was often associated with co-morbidities and other factors. Both intermittent and continuous-venovenous haemodialysis were used, but the clearance of continuous-venovenous haemodialysis can be too low in cases where large amounts of lithium have been ingested. Saline and forced diuresis have been used and are safe. Lithium intoxication seems rare and can be safely managed in most cases. Physicians should not withhold lithium for fear of intoxication in patients who benefit from it. Yet, physicians should have a low threshold to screen for toxicity.
Metabolic connectomics targeting brain pathology in dementia with Lewy bodies
Authors: Caminiti Silvia P , Tettamanti Marco , Sala Arianna , Presotto Luca , Iannaccone Sandro , Cappa Stefano F , Magnani Giuseppe , Perani Daniela ,   for the Alzheimer’s Disease Neuroimaging Initiative (ADNI)
Published: June 2016

Dementia with Lewy bodies is characterized by α-synuclein accumulation and degeneration of dopaminergic and cholinergic pathways. To gain an overview of brain systems affected by neurodegeneration, we characterized the [18F]FDG-PET metabolic connectivity in 42 dementia with Lewy bodies patients, as compared to 42 healthy controls, using sparse inverse covariance estimation method and graph theory. We performed whole-brain and anatomically driven analyses, targeting cholinergic and dopaminergic pathways, and the α-synuclein spreading. The first revealed substantial alterations in connectivity indexes, brain modularity, and hubs configuration. Namely, decreases in local metabolic connectivity within occipital cortex, thalamus, and cerebellum, and increases within frontal, temporal, parietal, and basal ganglia regions. There were also long-range disconnections among these brain regions, all supporting a disruption of the functional hierarchy characterizing the normal brain. The anatomically driven analysis revealed alterations within brain structures early affected by α-synuclein pathology, supporting Braak’s early pathological staging in dementia with Lewy bodies. The dopaminergic striato-cortical pathway was severely affected, as well as the cholinergic networks, with an extensive decrease in connectivity in Ch1-Ch2, Ch5-Ch6 networks, and the lateral Ch4 capsular network significantly towards the occipital cortex. These altered patterns of metabolic connectivity unveil a new in vivo scenario for dementia with Lewy bodies underlying pathology in terms of changes in whole-brain metabolic connectivity, spreading of α-synuclein, and neurotransmission impairment.
Impairment of the glymphatic system after diabetes
Authors: Jiang Quan , Zhang Li , Ding Guangliang , Davoodi-Bojd Esmaeil , Li Qingjiang , Li Lian , Sadry Neema , Nedergaard Maiken , Chopp Michael , Zhang Zhenggang
Published: June 2016

The glymphatic system has recently been shown to clear brain extracellular solutes and abnormalities in glymphatic clearance system may contribute to both initiation and progression of neurological diseases. Despite that diabetes is known as a risk factor for vascular diseases, little is known how diabetes affects the glymphatic system. The current study is the first investigation of the effect of diabetes on the glymphatic system and the link between alteration of glymphatic clearance and cognitive impairment in Type-2 diabetes mellitus rats. MRI analysis revealed that clearance of cerebrospinal fluid contrast agent Gd-DTPA from the interstitial space was slowed by a factor of three in the hippocampus of Type-2 diabetes mellitus rats compared to the non-DM rats and confirmed by florescence imaging analysis. Cognitive deficits detected by behavioral tests were highly and inversely correlated to the retention of Gd-DTPA contrast and fluorescent tracer in the hippocampus of Type-2 diabetes mellitus rats. Type-2 diabetes mellitus suppresses clearance of interstitial fluid in the hippocampus and hypothalamus, suggesting that an impairment of the glymphatic system contributes to Type-2 diabetes mellitus-induced cognitive deficits. Whole brain MRI provides a sensitive, non-invasive tool to quantitatively evaluate cerebrospinal fluid and interstitial fluid exchange in Type-2 diabetes mellitus and possibly in other neurological disorders, with potential clinical application.
Migraine classification using magnetic resonance imaging resting-state functional connectivity data
Authors: Chong Catherine D , Gaw Nathan , Fu Yinlin , Li Jing , Wu Teresa , Schwedt Todd J
Published: June 2016

Background

This study used machine-learning techniques to develop discriminative brain-connectivity biomarkers from resting-state functional magnetic resonance neuroimaging ( rs-fMRI) data that distinguish between individual migraine patients and healthy controls.

Methods

This study included 58 migraine patients (mean age = 36.3 years; SD = 11.5) and 50 healthy controls (mean age = 35.9 years; SD = 11.0). The functional connections of 33 seeded pain-related regions were used as input for a brain classification algorithm that tested the accuracy of determining whether an individual brain MRI belongs to someone with migraine or to a healthy control.

Results

The best classification accuracy using a 10-fold cross-validation method was 86.1%. Resting functional connectivity of the right middle temporal, posterior insula, middle cingulate, left ventromedial prefrontal and bilateral amygdala regions best discriminated the migraine brain from that of a healthy control. Migraineurs with longer disease durations were classified more accurately (>14 years; 96.7% accuracy) compared to migraineurs with shorter disease durations (≤14 years; 82.1% accuracy).

Conclusions

Classification of migraine using rs-fMRI provides insights into pain circuits that are altered in migraine and could potentially contribute to the development of a new, noninvasive migraine biomarker. Migraineurs with longer disease burden were classified more accurately than migraineurs with shorter disease burden, potentially indicating that disease duration leads to reorganization of brain circuitry.
Resource recovery from waste by Roma in the Balkans: A case study from Zavidovici (BiH)
Authors: Vaccari Mentore , Perteghella Andrea
Published: June 2016

Roma communities represent the main involved actors in the informal activities in the Balkan regions, especially because the state does not formally recognize them as formal inhabitants. The Roma community in Zavidovici, despite being resident since the beginning of the 20th century, is still considered a marginalized and vulnerable group. They are actively involved in and dependent on the informal solid waste sector. Waste collection is a ‘family business’, a kind of self-employment and the main source of income for households. Informal recyclers have a central role in the solid waste management system and they recover a significant amount of materials, especially iron, copper, brass, lead and exhausted batteries. Despite the negative fluctuations of the raw material prices, because of the international economic crisis, informal recyclers remain dependent on the waste recycling sector. They are crucial actors in the value chain of recyclables: though they cannot access the final buyers of recyclables, they provide more than 50% of the market to the middle dealers in the Zenica-Doboj Canton. This research activity consists of a deep socio-economic analysis of the informal recyclers’ community living in Zavidovici city. In particular, this paper describes the composition and welfare status of informal recyclers’ households, the role of informal recyclers in waste collection, the geographical coverage and the related pattern of waste picking, types, volumes and price fluctuations of recyclable materials, and the middle dealers involved in the informal recycling system.
The Practice of School Psychology in Quebec English Schools
Authors: Finn Cindy A.
Published: June 2016

In Quebec, school psychology is alive and well. This article outlines current challenges and opportunities related to the practice of psychology in Quebec English schools. Changes to the practice of psychology in Quebec over the last decade have had an impact on the delivery of psychological services in schools. Modifications of the admission criteria to the Order of Psychologists and the passage of Bill 21 have affected the profession both positively and negatively. For the English-speaking educational community, school psychology remains highly valued, particularly in light of the overall paucity of services in the province for these youth.
Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits
Authors: Nelson Gary R. , Filloux Francis M. , Kerr Lynne M.
Published: June 2016

In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement.
Side force over slender body with rings at different location at subsonic speed
Authors: Kumar P , Prasad JK
Published: June 2016

Investigations have been made adopting experiments and computations on an ogive-nosed slender body at different angles of attack and Reynolds number of 29,000 based on the model base diameter diameter. The results indicated an increase in the side force at large angles of attack, which is mainly due to the presence of asymmetric vortices in the leeward of the body. The inclusion of a rectangular cross-sectioned ring in the initial portion of the body reduced the side force at higher angles of attack. However, significant side force was experienced at lower angles of attack (30° < α < 40°). Use of a ring of 3% height was found to be suitable for reducing the side force at a higher angle of attack. From the results obtained it was observed that a ring if placed at a different axial location alters the flow field and changes the side force at higher angles of attack. Further studies indicated that placing of rings pair at an axial location of 3.5 and 4.5 times the base diameter reduced the side force to a very low value at all the angles of attack for the present shape of body and flow conditions.
Correlation between circulating osteopontin level in systemic lupus erythematosus and disease activity and associations between osteopontin polymorphisms and disease susceptibility: A meta-analysis
Authors: Lee Y H , Song G G
Published: June 2016

Objective

This study aimed to systemically review the evidence regarding the relationship between circulating blood osteopontin (OPN) level and systemic lupus erythematosus (SLE), correlation between serum OPN levels and SLE activity, and association between OPN polymorphisms and SLE susceptibility.

Methods

We conducted a meta-analysis on the serum/plasma OPN levels in SLE patients and healthy controls, correlation coefficients between the circulating OPN level and SLE Disease Activity Index (SLEDAI) in SLE patients, and the association between OPN polymorphisms and SLE risk.

Results

Nine studies with 1938 SLE patients and 3037 controls were included. Meta-analysis revealed that, compared with the control group, the OPN level was significantly higher in the SLE group (SMD = 0.965, 95% CI = 0.337–1.393, p = 0.001) and in the SLE group with renal disease (SMD = 2.219, 95% CI = 0.681–3.757, p = 0.005). Meta-analysis of correlation coefficients showed a trend of positive correlation between the circulating OPN level and SLEDAI (correlation coefficient = 0.590, 95% CI = −0.025 to 0.881, p = 0.059). While no association was found between SLE and the OPN 707 T/C and 1083 G/A polymorphisms, a significant association was identified between the OPN 1239 C allele and SLE (OR = 1.192, 95% CI = 1.008–1.410, p = 0.040), and between the OPN 9250 C allele and SLE in Asians (OR = 2.070, 95% CI = 1.570–2.730, p = 2.5 × 10−7).

Conclusions

Our meta-analysis revealed a significantly higher circulating OPN level in SLE patients, a trend of positive correlation between OPN levels and SLE activity, and a significant association between OPN 1239 C/A and 9250 C/T polymorphisms, and SLE development.
Risk Mitigation in Automotive Supply Chain: An Empirical Exploration of Enablers to Implement Supply Chain Risk Management
Authors: Sharma Satyendra Kumar , Bhat Anil
Published: June 2016

Supply chain (SC) risk management (SCRM) is a high-level concern for SC professionals. Supply chain risk management implementation is a difficult task because it requires involvement of various firms across the SC. For effective SCRM implementation, managers need to know the enabling factors and their relative importance. In this research, an empirical study on SC risk mitigation enablers was carried out in Indian automotive industry to examine the relationship between SCRM enablers and SCRM implementation. This relationship was tested using discriminant analysis. The research shows that the most important enabler is information visibility and it is followed by incentives alignment. Contingency planning is the third-most important enabler and last is risk management governance (RMG). Success of the SCRM implementation in terms of its efficiency and effectiveness can be assured by following the sequence of SCRM enablers suggested in this research.
The Continuum of Pharmacist Prescriptive Authority
Authors: Adams Alex J. , Weaver Krystalyn K.
Published: June 2016

Recently momentum has been building behind pharmacist prescriptive authority for certain products such as oral contraceptives or naloxone. To some, prescriptive authority by pharmacists represents a departure from the traditional role of pharmacists in dispensing medications. Nearly all states, however, currently enable pharmacist prescriptive authority in some form or fashion. The variety of different state approaches makes it difficult for pharmacists to ascertain the pros and cons of different models. We leverage data available from the National Alliance of State Pharmacy Associations (NASPA), a trade association that tracks pharmacy legislation and regulations across all states, to characterize models of pharmacist prescriptive authority along a continuum from most restrictive to least restrictive. We identify 2 primary categories of current pharmacist prescriptive authority: (1) collaborative prescribing and (2) autonomous prescribing. Collaborative prescribing models provide a broad framework for the treatment of acute or chronic disease. Current autonomous prescribing models have focused on a limited range of medications for which a specific diagnosis is not needed. Approaches to pharmacist prescriptive authority are not mutually exclusive. We anticipate that more states will pursue the less-restrictive approaches in the years ahead.
Medication Adherence Affects Risk of New Diabetes Complications
Authors: Simpson Scot H. , Lin Mu , Eurich Dean T.
Published: June 2016

Background: Previous outcomes-based studies of adherence to diabetes medications have focused on glycemic control and are limited by questions of temporality and uncontrolled confounding. Objective: This retrospective cohort study of new oral antidiabetic medication users examined the effect of adherence on risk of incident macrovascular and microvascular complications. Methods: A nationwide integrated insurance claims and laboratory database was used to identify new oral antidiabetic medication users between January 2004 and December 2009. People with preexisting complications were excluded and the remaining cohort was followed until development of a new diabetes complication or December 2010. Medication adherence was calculated at 3-month intervals and entered as a time-dependent variable in a Cox proportional hazards model. Covariables entered in the model included patient demographics, clinical laboratory data, a medical frailty indicator and a mortality risk score from the Johns Hopkins adjusted clinical groups system, and medication use at baseline. Results: Among the 54 505 included patients, the median age was 60 years, 28 125 (52%) were men, 1447 (3%) were considered frail, the mean mortality risk score was 33.7 (±11.1), and 9793 (18%) developed a new diabetes complication. Good adherence (medication possession ratio ≥0.8) was associated with a lower risk of a new microvascular or macrovascular diabetes complication (adjusted hazard ratio = 0.96; 95% CI = 0.92-1.00; P = 0.05). Conclusions: This study design addresses limitations of previous studies and found a small but significantly lower risk of new diabetes complications associated with good adherence to oral antidiabetic medications.
Clinical Utility of Routine Cardiac Monitoring in Breast Cancer Patients Receiving Trastuzumab
Authors: Davis Christine C. , Zelnak Amelia , Eley J. William , Goldstein Daniel A. , Switchenko Jeffrey M. , McKibbin Trevor
Published: June 2016

Background: Trastuzumab targets the human epidermal growth factor receptor-2 (HER2). Cardiotoxicity is a potential adverse effect, manifesting as either an asymptomatic decline in left-ventricular ejection fraction or infrequently as largely reversible symptomatic heart failure (HF). Monitoring recommendations differ between product labeling and 2012 guidelines, and the clinical utility of serial cardiac monitoring in patients with metastatic breast cancer remains controversial. Objective: The objectives of this study were to describe the frequency of monitoring, incidence of symptomatic or asymptomatic HF, overall effect on treatment, and cost of monitoring for cardiotoxicity. Methods: We preformed an institutional review board–approved retrospective chart review of breast cancer patients receiving trastuzumab from January 1, 2009, through January 1, 2014, at an academic medical center. Results: Out of 154 treatments, 72% were adjuvant, and 28% were metastatic. In the adjuvant setting, a mean of 4.5 (interquartile range [IQR] = 4-5) echocardiograms (echos) over a mean of 11.5 (IQR = 11-12) months were performed. In the metastatic setting, a mean of 3.1 (IQR = 1-5) echos over a mean of 20.2 (IQR = 9-31) months were performed. Symptomatic HF events occurred in 4 adjuvant (3.6%) and 2 metastatic patients (6.5%); 10 patients (6.5%) had a treatment interruption, with 9 (90%) tolerating restart of trastuzumab. Two patients (1.3%) changed treatment as a result of cardiotoxicity. Using population incidence of HER2-positive breast cancer, $13 million could be saved if monitoring were reduced by 1 echo per patient. Conclusions: Given the low incidence of clinically significant HF and cost of monitoring, less frequent monitoring may be justified.
Treatment of Pediatric Type 2 Diabetes
Authors: Smith Jennifer D. , Mills Elizabeth , Carlisle Sara E.
Published: June 2016

Objective: To review the current literature for the efficacy and safety of available treatments for type 2 diabetes (T2DM) in the pediatric population. Data Sources: A search from January 1990 to April 2016 was conducted using PubMed and clinicaltrials.gov using the search terms diabetes mellitus, type 2; adolescent; child; and pediatric. Bibliographies of chosen articles were reviewed. Study Selection and Data Extraction: Relevant articles and preliminary data from clinical trials on metformin, insulin, sulfonylureas, thiazolidinediones (TZDs), glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and α-glucosidase inhibitors for the treatment of pediatric T2DM were reviewed. Studies included randomized controlled, observational, and open-label designs. Data Synthesis: Metformin, studied in 4 of the reviewed trials, and premixed insulin appear to be safe and effective in pediatric patients with T2DM. TZDs were well tolerated and yielded favorable results, but may have limited applicability. A sulfonylurea had favorable hemoglobin A1C reduction, but was associated with significant weight gain. Studies of incretin-based agents also showed favorable results in the pediatric population but have limited safety and efficacy data. Several trials for other agents are reported on clinicaltrials.gov with unpublished results, but no statistical analyses are reported. Conclusion: Metformin and insulin remain the mainstay of treatment for T2DM in pediatric patients. More robust studies are needed to assist in the provision of evidence-based guidance for the treatment of T2DM in youth.
Orifice compensated performance characteristics of hybrid hole-entry conical journal bearing
Authors: Khakse Prashant G , Phalle Vikas M , Mantha SS
Published: June 2016

Influence of semi-cone angles on the performance of the non-recessed hybrid/hydrostatic hole-entry conical journal bearing compensated with orifice restrictor has been carried out analytically. The analysis comprises two rows of symmetric hole-entry contour in the circumferential direction of hybrid/hydrostatic conical journal bearing. An orifice restrictor is used in the hole-entry contour to allow the restricted flow in the clearance space of a journal and bearing. Well-known finite element method and Newton–Raphson method for restrictor have been used to solve the Reynolds equation, governing the fluid flow in the clearance space of a hybrid/hydrostatic conical journal and bearing. Further, the spherical coordinate system has been employed to solve Reynolds equation instead of cylindrical coordinate system. Performance characteristics in terms of stiffness coefficient, damping coefficient, bearing pressure, bearing flow, and minimum fluid film thickness have been discussed for variable external radial load ([Formula: see text]) = 0.25–1.5. The performance characteristics in terms of [Formula: see text], [Formula: see text], and [Formula: see text] is found to be quite significant for hybrid hole-entry conical journal bearing when compared with hydrostatic hole-entry conical journal bearing, which allows the designer to choose appropriate non-recessed hybrid hole-entry conical journal bearing.
Chronic pain experience on depression and physical disability: The importance of acceptance and mindfulness-based processes in a sample with rheumatoid arthritis
Authors: Costa Joana , Pinto-Gouveia José , Marôco João
Published: June 2016

The mediating effect of acceptance and mindfulness in the relationship between pain, depression, and physical disability was examined in 55 rheumatoid arthritis patients. Results showed that the relationship between pain and depression was mediated by both nonreact and acceptance. By contrast, the relationship between pain and physical disability was mediated by acceptance but not by nonreact. This study provides evidences that the influence of these processes is different on depression and on physical disability. These findings support models that take both general measures of mindfulness and content-specific measures of acceptance into account when conceptualizing rheumatoid arthritis. Theoretical and clinical implications are discussed.
A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: Stepped wedge cluster randomised trial
Authors: Rasmussen Charlotte Diana Nørregaard , Holtermann Andreas , Jørgensen Marie Birk , Ørberg Anders , Mortensen Ole Steen , Søgaard Karen
Published: June 2016

Aims: The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain. Methods: A stepped wedge cluster randomised, controlled trial with 594 nurses’ aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect. Results: Significant reduction in occupational lifting (–0.35 (95% confidence interval −0.61 to −0.08)), and improvement in two measures of fear avoidance ((–0.75 (95% confidence interval −1.05 to −0.45) and −0.45 (95% confidence interval −0.80 to −0.11)) were found for the intervention group compared to the control. There were no significant effects on physical exertion, muscle strength, support from management, work ability or sickness absence due to low back pain. After the intervention, significant increased physical capacity and improvements in kinesiophobia were found, but no change in need for recovery. Conclusions: The intervention was significantly effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence due to low back pain. To improve work ability or reduce sickness absence due to low back pain more specific interventions should probably be developed.
Ignorance-unmasking questions in the Royal–Sarkozy presidential debate: A resource to claim epistemic authority
Authors: Vincze Laura , Bongelli Ramona , Riccioni Ilaria , Zuczkowski Andrzej
Published: June 2016

The article presents an analysis of the ways in which knowledge is displayed, contested and renegotiated in the 2007 French presidential debate between Ségolène Royal and Nicolas Sarkozy. Knowledge displays can be achieved through a series of ‘neutral’ resources, such as informing, explanation or comment, or through face-damaging resources, such as questioning an unknowledgeable interlocutor to prove his inferior epistemic status (K−) and boost one’s own. The article focuses on this latter type of knowledge display where a knowledgeable participant (K+) engages in question–answer sequences with an unknowledgeable respondent (K−) in front of a third party (the audience). The article also undertakes an analysis of the multimodal strategies employed by the (K+) participant to discredit the (K−) opponent (ironic smiles and laughter). The article intends to contribute to the existent literature on epistemic stance by offering a prototypical example of incongruence between the epistemic status (K+) of the questioner and the epistemic stance he adopts (unknowing K).
Benevolent absolutisms, incentives and Rawls’ The Law of Peoples
Authors: Maffettone Pietro
Published: June 2016

Rawls’ The Law of Peoples does not offer a clear principled account of the way in which liberal and decent peoples should deal with benevolent absolutisms. Within the Rawlsian framework, benevolent absolutisms are a type of society that respects basic human rights and is not externally aggressive. Rawls rules out the use of coercion to engage with benevolent absolutisms but does not provide an alternative strategy. The article develops one, namely, it argues that liberal and decent peoples should use positive incentives to induce benevolent absolutisms to make their transition to the status of well-ordered peoples. In so doing, it offers a principled way to expand Rawls’ international nonideal theory and, in the process, provides a more nuanced approach to the promotion of political participation in international society. The article draws on the literature on economic statecraft and political theory and constructs an incentive model with seven distinct parameters attached to its definition of incentives. Finally, the article provides a real-world example, of how to concretely implement the incentive mechanism.
Bayesian semiparametric density ratio modelling with applications to medical malpractice reform
Authors: Dayaratna Kevin D , Kedem Benjamin
Published: June 2016

This study examines the efficacy of tort reforms instituted throughout the country during the last decade, improving upon existing semiparametric density ratio estimation (DRE) methodologies in the process. DRE is a well-known semiparametric modelling technique that has been used for well over two decades. Although the approach has been demonstrated to be extremely useful in statistical modelling, it has suffered from one main limitation—the methodology has thus far not been capable of modelling individual-level heterogeneity. We address this issue by presenting a novel adaptation of DRE to model individual level heterogeneity. We do so by marginalizing the associated empirical likelihood function involving density ratios to provide an overall distribution of the entire population despite having extremely limited initial information about each individual in the dataset. We apply this approach to medical malpractice loss data from the previous decade to quantify the probability of changes in tort losses. Our results demonstrate the success of a number of recently implemented malpractice reforms. Comparisons to existing DRE methods, as well as standard regression methods, illustrate the efficacy of our approach.