bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum concentration and clinical significance of brain-derived neurotrophic factor in patients with Parkinson’s disease or essential tremor
Authors: Huang Yixian , Yun Wenwei , Zhang Min , Luo Weifeng , Zhou Xianju
Published: January 2018

Objectives

The serum concentration of brain-derived neurotrophic factor (BDNF) was compared among patients with Parkinson’s disease (PD), patients with essential tremor (ET), and healthy participants, and its association with clinical features of PD and ET was assessed.

Methods

Demographic and clinical data were collected from 60 patients with PD at different clinical stages, 60 patients with ET, and 60 controls. All participants’ serum BDNF concentrations were measured. Their motor abilities and activity were assessed by the Unified PD Rating Scale and the Hoehn and Yahr (H-Y) staging scale.

Results

Serum BDNF was significantly lower in patients with PD than in patients with ET and controls. BDNF decreased only in the early disease stages (H-Y stages I and II), but increased markedly in the advanced stages (H-Y stages III–V). There was no significant difference between patients with ET and controls. The BDNF concentration was negatively correlated with age at PD onset and positively associated with disease duration, severity of PD symptoms, and treatment with L-DOPA.

Conclusions

A low serum BDNF concentration may serve as a biomarker in the early stages of PD, whereas a high concentration with PD progression may be due to treatment with L-DOPA in the advanced stages.
CD204-Expressing Tumor-Associated Macrophages Are Associated With Malignant, High-Grade, and Hormone Receptor–Negative Canine Mammary Gland Tumors
Authors: Seung Byung-Joon , Lim Ha-Young , Shin Jong-Il , Kim Hyun-Woo , Cho Seung-Hee , Kim Soo-Hyeon , Sur Jung-Hyang
Published: January 2018

Tumor-associated macrophages (TAMs) are an important component of leukocyte infiltration in tumors. TAMs can be classified into M1 and M2 phenotypes. In the present study, the expression of CD204, an M2-polarized macrophage receptor, was investigated by immunohistochemistry in the area surrounding TAMs in 101 cases of canine mammary gland tumor (CMT). We examined the relationship between M2-polarized TAMs and malignancy, histological subtype, histological grade, molecular subtype, hormone receptor (HR) status, and clinical obesity indices. The mean number of CD204-positive macrophages was significantly higher in malignant CMTs than in benign CMTs ( P = .000). The number of CD204-positive macrophages differed significantly between histological grades ( P = .000) and were significantly higher in grade III than in grades I and II. Moreover, the mean number of CD204-positive macrophages was significantly higher in HR-negative malignant CMTs than in HR-positive malignant CMTs ( P = .035) and in malignant CMTs with lymphatic invasion compared to malignant CMTs without lymphatic invasion ( P = .000). These findings suggest that CD204-positive macrophages might affect the development and behavior of CMTs and highlight the potential of CD204 as a prognostic factor.
Tissue-Engineered Heart Valve Leaflets: An Effective Method of Obtaining Acellularized Valve Xenografts
Authors: Kim W.G. , Park J.K. , Lee W.Y.
Published: January 2018

To determine the most effective method of producing the acellularized xenograft heart valve leaflets, we compared pathological findings of the xenograft heart valve leaflets produced by three methods; freeze-thawing, Triton and NaCl-SDS treatment and further analyzed the pattern of endothelial cells seeded onto them.

Materials and methods

Two pigs were sacrificed and three pulmonary valve leaflets were harvested from each animal. They were immediately stored in a tissue preservation solution and assigned in one of the three preparation methods for acellularization. Endothelial cells from the jugular vein of a goat were isolated and seeded onto the acellularized xenograft heart valve leaflets. Light and Electron microscopic analyses were performed.

Result and conclusion

H & E stain showed that cells were almost absent in the leaflet treated with NaCl-SDS, while cells were partly present in the leaflets treated, one with Triton and the other Freeze-thawing. Transmission microscopic analyses showed cell-free matrix with well preserved collagen architecture under the seeded endothelial cells in the leaflets treated with NaCl-SDS. In conclusion, the valve leaflets treated with NaCl-SDS among three representative methods of acellularization of tissues (freeze-thawing, Triton X-l00, and NaCl-SDS) showed the better results than the others in terms of the efficacy of decellularization and response to endothelial cell seeding.
Clinical Outcome of Orthotopic Liver Transplantation
Authors: Berlakovich G.A.
Published: January 2018

Orthotopic liver transplantation (OLT) has become a standard procedure for end-stage cirrhosis. The purpose of this anlysis is to give a brief overview on the clinical outcome of OLT. According to a current survey of primary indications for liver transplantation in Europe, virus-induced cirrhosis represents the largest proportion with 25%. The next frequent indication is alcoholic cirrhosis with 19%. Cholestatic diseases amount to 13%, malignancy in cirrhosis 10%, and acute hepatic failure 10%. The outcome of these main indications will be discussed and critical considerations pointed out. Patient survival rates demonstrate for cirrhosis at 1-and 5-year about 80% and 70%, respectively. In acute hepatic failure, more patients are lost in the perioperative period. Not surprisingly, patients transplanted for malignancy show decreased long-term survival. Considering an average of 5-year survival in patients with end-stage liver disease of 20% or less, excellent patient survival can be achieved by liver transplantation.
Hepatic Encephalopathy and Cerebral Blood Flow Improved by Liver Dialysis Treatment
Authors: Huang K.-W. , Chao A. , Chou N.-K. , Ko W.-J
Published: January 2018

Eight acute liver failure patients, all in grade IV hepatic encephalopathy, were administered liver dialysis treatment with the Hemo Therapies Unit (Hemo Therapies Inc, San Diego, CA, USA). The patients were evaluated to determine whether the Glasgow Coma Scale score and cerebral blood flow improved with treatment. After the initial treatment, consciousness levels as measured by the Glasgow Coma Scale improved from a pre-treatment median of 5 (range 3 to 6) to a post-treatment median of 7 (range 5 to 9) (p=0.0005 by paired Wilcoxon test); mean blood flow velocity in the middle cerebral arteries as shown by transcranial Doppler sonography increased from a median of 37.85 cm/sec (range 20.3 to 114.0) to 57.90 (32.5 to 135.0) post-treatment(p=0.022); however, there was no significant change in the pulsatility index from a median of 1.18 (range 0.61 to 1.71) to 0.85 (range 0.70 ~ 1.79) post-treatment (p=0.13). The 8 patients received 2 to 7 (median 5.5) times of daily 6-h liver dialysis treatments. Following the completion of all liver dialysis treatments, hepatic coma was fully resolved in 4 of 8 patients (50%) Three of 8 patients (37.5%) survived to hospital discharge, whereas 5 patients did not survive due to irreversible liver function and associated complications. In conclusion, liver dialysis treatment could improve hepatic encephalopathy, but the prognosis still depended on the underlying diseases.
Delivery of High Dose VEGF Plasmid Using Fibrin Carrier does not Influence its Angiogenic Potency
Authors: Jozkowicz A. , Fügl A. , Nanobashvili J. , Neumayer C. , Dulak J. , Valentini D. , Funovics P. , Polterauer P. , Redl H. , Huk I.
Published: January 2018

Delivery of DNA mixed with a degradable matrix carrier was supposed to improve transgene expression. Using a rabbit hind-limb ischemia model, we tested the angiogenic potency of plasmid encoding human vascular endothelial growth factor (pSG5-VEGF165) entrapped in fibrin sealant. Animals were injected intramuscularly with 500 μg of pSG5-VEGF165 or control plasmid, dissolved in saline (PBS) or fibrin glue. After 14 days, presence of delivered constructs and expression of transgene was confirmed in injected muscles of all animals. There were no significant differences in the levels of human VEGF mRNA and protein between VEGF-PBS and VEGF-fibrin groups (Mann-Whitney test). Accordingly, pSG5-VEGF165 regardless of the way of delivery, induced similar increases in capillary density within treated muscles (ANOVA). Control plasmid did not show any effects. In conclusion, injection of pSG5-VEGF165 into ischemic adductor muscle leads to synthesis of human VEGF and increases the number of capillaries. Fibrin carrier does not influence its angiogenic potential.
Comparison of Myocardial Infarction with Sequential Ligation of the Left Anterior Descending Artery and Its Diagonal Branch in Dogs and Sheep
Authors: Kim W.G. , Shin Y.C. , Hwang S.W. , Lee C. , Na C.Y.
Published: January 2018

We report a comparison of the effects of myocardial infarction in dogs and sheep using sequential ligation of the left anterior descending artery (LAD) and its diagonal branch (DA), with hemodynamic, ultrasonographic and pathological evaluations. Five animals were used in each group. After surgical preparation, the LAD was ligated at a point approximately 40% of the distance from the apex to the base of the heart, and after one hour, the DA was ligated at the same level. Hemodynamic and ultrasonographic measurements were performed preligation, 30 minutes after LAD ligation, and 1 hour after DA ligation. As a control, two animals in each group were used for the simultaneous ligation of the LAD and the DA. Two months after the coronary ligation, the animals were evaluated as previously, and killed for postmortem examination of their hearts. All seven animals in the dog group survived the experimental procedures, while in the sheep group only animals with sequential ligation of the LAD and DA survived. Statistically significant decreases in systemic arterial blood pressure and cardiac output, and an increase in the pulmonary artery capillary wedge pressure (PACWP) were observed one hour after sequential ligation of the LAD and its DA in the sheep, while only systemic arterial pressures decreased in the dog. Ultrasonographic analyses demonstrated variable degrees of anteroseptal dyskinesia and akinesia in all sheep, but in no dogs. Data two months after coronary artery ligation showed significant increases in central venous pressure, pulmonary artery pressure, and PACWP in the sheep, but not in the dog. Left ventricular end-diastolic dimension and left ventricular end-systolic dimension in ultrasonographic studies were also increased only in the sheep. Pathologically, the well-demarcated thin-walled transmural anteroseptal infarcts with chamber enlargement were clearly seen in all specimens of sheep, and only-mild-to-moderate chamber enlargements with endocardial fibrosis were observed in the dog hearts. In conclusion, this study confirms that the dog is not a suitable model for myocardial infarction with failure by coronary artery ligation despite negligent operative mortality, when compared directly with an ovine model.
In Vitro Evaluation of the PUCA II Intra-Arterial LVAD
Authors: Vandenberghe S. , Van Loon J.-P. , Segers P. , Rakhorst G. , Verdonck P.
Published: January 2018

The “pulsatile catheter” (PUCA) pump is a minimally invasive intra-arterial left ventricular assist device intended for acute support of critically ill heart failure patients. To assess the hydrodynamic performance of the PUCA II, driven by an Arrow AutoCat IABP driver, we used a (static) mock circulatory system in which the PUCA II was tested at different loading conditions. The PUCA II was subsequently introduced in a (dynamic) cardiovascular simulator (CVS) to mimic actual in vivo operating conditions, with different heart rates and 2 levels of left ventricular (LV) contractility. Mock circulation data shows that PUCA II pump performance is sensitive to afterload, pump rate and preload. CVS data demonstrate that PUCA II provides effective LV unloading and augments diastolic aortic pressure. The contribution of PUCA II to total flow is inversely related to LV contractility and is higher at high heart rates. We conclude that, with the current IABP driver, the PUCA II is most effective in 1:1 mode in left ventricles with low contractility.
Estimation of Coupled Assist Flows in a Moving-Actuator Bi-Ventricular Assist Device using Interventricular Pressure
Authors: Choi J. , Park J.W. , Jo Y.H. , Lee J.J. , Kim W.E. , Park C.Y. , Kim J. , Min B.G.
Published: January 2018

An assist flow estimation scheme for a moving-actuator biventricular assist device (MA-BVAD) using interventricular pressure (IVP) has been developed. The scheme uses a waveform feature parameter of IVP, peak IVP time (PIT), for estimation of the filling volumes of both left and right blood sacs simultaneously. In a regression analysis on data from an in vivo test in an 85 Kg male calf for 20 days, the PIT was found to have high correlation with the blood sac filling volume (R=0.883: left filling volume, R=0.967: right filling volume). A conceptual equation hypothesizing this correlation between PIT and filling volume was established based on the observation and the unknown parameters were identified using least squares parameter optimization. The estimation equation identified proved highly accurate (R=0.916 for left flow, R=0.970 for right flow). The accuracy of the estimation scheme promises very good practical applicability.
Super High Flux Hemodialysis at High Dialysate Flows: An Ex Vivo Assessment
Authors: Lee W.C.R. , Uchino S. , Fealy N. , Baldwin I. , Panagiotopoulos S. , Goehl H. , Morgera S. , Neumayer H.-H. , Bellomo R.
Published: January 2018

Background and objectives

The removal of cytokines by standard hemofiltration is limited. Super high flux membranes may significantly improve removal even when used in dialysis mode. We sought to measure cytokine clearance using a large surface super high-flux membrane and a standard hemodialysis setting.

Setting

ICU laboratory of a tertiary institution.

Subjects

Six healthy volunteers.

Methods

Blood form healthy volunteers was incubated for 4 hours with E. coli endotoxin to stimulate cytokine production. Cytokine containing blood was then circulated through a dialysis circuit at 3 different dialysate flow rates. Blood and dialysate were sampled for cytokine and albumin measurements and calculation of clearances.

Results

Super high-flux dialysis achieved high median cytokine clearances (IL-1 clearance of 106 ml/min, IL-6 clearance of 66.8 ml/min, IL-8 clearance of 61.7 ml/min and TNF clearance of 36.1 ml/min). Increasing dialysate flow rate from 300 to 500 ml/min did not significantly increase cytokine clearances. Albumin clearances however were between 2.7 and 5.4 ml/min.

Conclusions

Cytokine dialysis is feasible at high dialysate flow rates yielding high cytokine clearances. Albumin loss, however, is appreciable and may require separate supplementation in the clinical setting.
Von Willebrand Factor and Autoantibodies against Oxidized LDL in Hemodialysis Patients Treated with Vitamin E-Modified Dialyzers
Authors: Bufano G. , Usberti M. , Mandolfo S. , Malberti F. , Piroddi M. , Galli F.
Published: January 2018

Oxidant stress is a well known cause of damage in the atherosclerotic process. Vitamin E is one of the most promising natural antioxidants. In this study we investigated if a vitamin E-coated dialyzer was able to reduce the plasma levels of auto-antibodies against oxidized-LDL, von Willebrand factor (vWf) and thrombomodulin (TM) as markers of endothelial damage.

In this controlled 6-month prospective study, we investigated these markers in two matched groups (n= 16 each) of patients on regular hemodialysis not yet diagnosed for atherosclerosis cardiovascular disease (ACVD) (mean age= 58.3±7.0 yrs, mean dialysis age = 30.1±10.0 months), in which cellulosic (CLS) and vitamin E-modified dialyzers (CLE) were compared. At inclusion all the patients were treated with CLS. Then, the study group was shifted to CLE for 6 months.

At baseline the patients showed normal levels of vitamin E and high levels of oxLDL-Ab, vWf and TM compared to healthy subjects. In the CLE group oxLDL-Ab and vWf, but not TM levels, decreased progressively (from 472±287 to 264±199 mU/mL, p<0.0001 and from 101.1±7.5% to 76.7±18.5%; p<0.001, respectively), and vitamin E increased from 4.40±0.81 to 7.81±1.16 μg/mg of cholesterol. At the end of the study, 8 of the patients treated with CLE were randomly selected and went back to the membrane without Vitamin E for six months. They showed an significant increase in OxLDL-Ab and vWf levels and a significant reduction in tocoferol levels. In conclusion, CLE compared to cellulosic dialyzers can lower some indices of damage to LDL and endothelial cells.
A Short Review of Experimental Peritoneal Sclerosis: From Mice to Men
Authors: Gotloib L. , Wajsbrot V. , Shostak A.
Published: January 2018

Peritoneal sclerosis has been induced in rodents in vivo by exposing the membrane to a variety of experimental interventions: asbestos, 0.1% chlorexidine, iron dextran, glucose degradation products, AGE deposits derived from uremia per se, sodium hypochlorite, lypopolysaccharide, low pH, pure water, silica or zymosan. With a few exceptions (pure water, chlorhexidine and low pH), the other substances mentioned operate setting out different degrees of oxidative stress. This short review describes several experimental interventions in rodents, aimed at acute exfoliation or long-term, sustained injury of the mesothelial monolayer performed by means of intraperitoneal injections of different oxidant agents.

Acute exfoliation induced by deoxycholate resulted in a depopulated monolayer coincident with immediate alteration of the peritoneal permeability, evidenced by increased urea D/P ratio, higher glucose absorption rate, elevated albumin losses in the effluent and significant reduction of the ultrafiltration rate.

In the long term (30 days), these manifestations of membrane failure persisted and coincided with substantial peritoneal sclerosis.

Peritoneal sclerosis was also induced by IP injections of 0.125% trypsin and 6.6 mM/L solution of formaldehyde. Using the doughnut rat model of mesothelial regeneration, exposure to 4.25% glucose or 7.5% icodextrin solutions severely hampered repopulation of the monolayer, which was replaced by a thick sheet of fibrous tissue.

It is concluded that peritoneal sclerosis derives mostly from sustained oxidative injury to the peritoneal membrane. Loss of the mesothelial monolayer is the first step in the chain of events leading to this complication.
Effects of Rapamycin on the Epithelial-to-mesenchymal Transition of Human Peritoneal Mesothelial Cells
Authors: Aguilera A. , Aroeira L.S. , Ramírez-Huesca M. , Pérez-Lozano M.L. , Cirugeda A. , Bajo M.A. , Del Peso G. , Valenzuela-Fernández A. , Sánchez-Tomero J.A. , López-Cabrera M. , Selgas R.
Published: January 2018

The preservation of the peritoneal membrane is crucial for long-term survival in peritoneal dialysis. Epithelial-to-mesenchymal transition (EMT) is a process demonstrated in mesothelial cells (MC), responsible for negative peritoneal changes and directly related to PD. EMT enables neovascularization and fibrogenic capabilities in MC. Vascular endothelial growth factor (VEGF) is the mediator for neo-vascularization. Rapamycin is a potent immunosuppressor with antifibrotic action in renal allografts and has a demonstrated anti-VEGF effect. We performed this study with the hypothesis that rapamycin may regulate the EMT of MC.

MC from human omentum were cultured. When mesothelial cells reached confluence, some of them were stimulated with r-TGF-ß (1 ng/mL) to induce EMT, co-administered with rapamycin (0.2, 2, 4, 20 and 40 nM). Other groups of cells received similar doses of rapamycin or r-TGF-ß, separately. Cells were analyzed at 6, 24, 48 hours and 7 days. As markers of EMT we included α-SMA, E-cadherin and snail nuclear factor by quantitative RT-PCR.

EMT markers and regulators demonstrated the following changes with rapamycin: E-cadherin (a protective gene for EMT) increased 2.5-fold relative to controls under 40 nM, at 24h. Importantly, rapamycin inhibited snail expression induced by TGF-ß at 6h, whereas TGF-ß increased snail 10fold. At day 7, rapamycin showed no anti-EMT properties. An important decrease in α-SMA expression by MC after rapamycin addition was observed.

In conclusion, rapamycin shows a mild protective effect on EMT, as it increases E-cadherin and decreases α-SMA expression. Consequently, rapamycin might partially regulate the epithelial-to-mesenchymal transition of mesothelial cells.
Clinical Behavior of Implant Infections Due to Staphylococcus Epidermidis
Authors: Presterl E. , Lassnigg A. , Parschalk B. , Yassin F. , Adametz H. , Graninger W.
Published: January 2018

Surgical implants and other foreign material are increasingly used in modern medicine to restore or to improve the function of the human body. Infection of an implant is associated with considerable morbidity due to frequent hospitalizations, surgery and antimicrobial treatment. The underlying mechanism is the formation of a bacterial biofilm on the surface of the implanted body. The recognition and diagnosis of implant infections is essential for further therapy and, above all, the decision to remove and exchange the implant.

Methods

We compared the data of 60 patients with implant infections with those of 60 patients with transient bacteremia caused by Staphylococcus epidermidis. The pathogens isolated from blood were characterized with regard to antimicrobial susceptibility and formation of biofilms using a static microtiter plate model. Wild type skin isolates from non-hospitalized healthy volunteers served as control with regard to antimicrobial susceptibility and biofilm formation.

Results

Clinical signs and symptoms, underlying diseases and outcome were not different in either group. However, patients with implant infection had fever over a longer time (mean 12 days versus 3 days, respectively, p & 0.05) and more often positive blood cultures than patients with transient bacteremia (3.1 versus 1.2, p & 0.05). Thrombocytopenia was observed in patients with implant infections but not in patients with transient bacteremia (p & 0.05). Biofilms were formed in 86.4 % of the isolates in implant infection, in 88.8 % in transient bacteremia and in 76.9 % of the isolates from healthy volunteers (not significant). Multi-resistance to penicillin, oxacillin, erythromycin, clindamycin, ciprofloxacin and trimethoprim was more common in the hospital strains than in the wild type strains (75.6 % versus 48.7 %, p & 0.05).

Conclusions

The clinical features of implant infections are indistinguishable from those of transient bacteremia. Persisting fever and multiple blood culture yielding the growth of skin flora bacteria are strong indicators for infection of implanted material. Biofilm formation and antimicrobial multiresistance, as common in implant infection as in transient bacteremia, seem to be accessory factors in infections due to Staphylococcus epidermidis.
A Stimulation Unit for the Application of Mechanical Strain on Tissue Engineered Anulus Fibrosus Cells: A New System to Induce Extracellular Matrix Synthesis by Anulus Fibrosus Cells Dependent on Cyclic Mechanical Strain
Authors: Gokorsch S. , Weber C. , Wedler T. , Czermak P.
Published: January 2018

A bioreactor system consisting of a multifunctional stimulation unit and common 6-well culture plate is introduced to activate extracellular matrix synthesis in intervertebral disc cells due to cyclic mechanical strain. The developed stimulation unit is sterilizable and reusable. It is viable for cultivation and mechanical stimulation of cartilage tissue and tissue engineered cell matrix constructs in combination with the common 6-well culture plate. The custom made device allows long-term cultivations in batch- or continuous operation mode. Manual handling and thereby the risk of contamination is reduced. Sampling, changing the medium, and addition of supplements are easily performed from the connected conditioning vessel. This bioreactor system enables stimulation of different samples independently during one run.

For the work presented here anulus fibrosus cells from pigs were taken and immobilized in agarose to obtain three-dimensional cell matrix constructs. Over a period of 14 days the constructs were subjected to 10% compression under cyclic mechanical pressure with a frequency of 0.1 Hz. Afterwards the constructs were biochemically examined for hydroxyproline and sulphated glycosaminoglycanes. These proven constituents of extracellular matrix were found to be released depending on the applied compressive strain.
Severe Sepsis and Septic Shock in Adult Patients: An Approach to Management and Future Trends
Authors: See K.C. , Phua J. , Lee K.H.
Published: January 2018

Severe sepsis is sepsis associated with acute organ dysfunction. Septic shock in turn, implies severe sepsis that has led to circulatory shock refractory to fluid resuscitation alone. The immediate approach to severe sepsis follows the ABCs of resuscitation: Airway, Breathing, and Circulation. Special emphasis on the circulation involves early goal-directed therapy, adequate fluid resuscitation, and vasopressor/inotropic support. Once the patient's cardiorespiratory status is stabilized, efforts must be directed at uncovering the source and empirically yet accurately treating the infective underpinnings of severe sepsis. Following that, each of the patient's other organ systems at risk needs to be addressed: Renal/metabolic, gastrointestinal, hematological, and endocrine. Novel treatments will target both the proinflammatory and procoagulation cascades of sepsis.
Resin-Based Dentin Restorative Materials under Accelerated Ageing: Bio-Functional Behavior
Authors: Mattioli-Belmonte M. , Natali D. , Tosi G. , Torricelli P. , Totaro I. , Zizzi A. , Fini M. , Sabbatini S. , Giavaresi G. , Biagini G.
Published: January 2018

Object

The aim of the present study was the evaluation of the effect of different polishing and finishing procedures on Filtek Z250 FZ ESPE restorative material. Particularly, the consequence of artificial aging (UV-irradiation) on this resin-based dental material was investigated determining also its outcome on cell behavior.

Methods

96 specimens of restorative material were prepared using a light emitting diode curing unit and randomly divided into four finishing and polishing groups: (I) No treatment (FZ); (II) Identoflex rubbers (ID); (III) Enhance System (EN) and (IV) Sof-Lex Pop-on XT discs (SF). The surface morphology of native and artificially aged materials was assessed with Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM). FTIR and biological (biocompatibility and bacterial adhesion) analyses were also performed.

Results

Among all, the ID procedure represented an acceptable compromise for efficiency of polymerization and biocompatibility both before and after artificial ageing. SF and EN techniques showed better interactions with the biological environment.

Conclusion

UV artificial ageing of the tested specimens has shown an acceleration of the surface degrading processes, favoring a possible decrease in the mechanical properties and the release of toxic free radicals. Finishing and polishing procedure seemed to affect the photodegrading pathways, even though no differences among the techniques were observed. As the cytotoxicity of materials undergoing accelerated aging is relevant, further improvement of dental restorative materials are required to limit the long-term biological damage.
Treatment of Acute Carbon Monoxide Poisoning with Extracorporeal Membrane Trioxygenation
Authors: Yin Lianghong , Cai Qide , Zhen Qiyi , Chen Zhanhua , Li Fuolan , Yan Petian , Feng Gui-juan , Hu Bo , Yu Meng , Liu Fanna , Guan Baozhang
Published: January 2018

Objective

To treat acute carbon monoxide poisoning (ACOP) with extracorporeal membrane trioxygenation (ECMO3), and to determine the efficacy and safety of ECMO3.

Method

Thirty-two New Zealand white rabbits were divided randomly into four groups including ECMO3 group (G1-ECMO3) oxygen treatment group (G2–FIO2), untreated ACOP group (G3-ACOP), and control group (G4-control). Rabbits in the first three groups were intraperitoneally injected with 99.99% CO at a dosage of 200 ml/kg, and those in the control group were treated with placebo. The dynamic changes in carboxyhemoglobin (COHb) concentration, blood oxygen saturation (SO2) level, base excess of blood (BE-B) as well as the vital signs of the rabbits were monitored.

Results

All the experimental rabbits had significantly higher levels of COHb (p = 0.000<0.05) than those in the control group after 30 min of CO injection with poisoning reactions. The respiration and heart rate of the rabbits in the ECMO3 group and FIO2 group were recovered to a level close to those of the rabbits in the control group by the end of the treatment, and they were significantly lower than those in the ACOP group (p = 0.000, <0.05). The COHb levels of rabbits in the G1–ECMO3 group were significantly lower than those in the G2-FIO2 and the G3-ACOP groups (F = 42.799, p = 0.000), and were similar to those in the control group. After 0.5 h of treatment, the SO2 and BE-B levels of rabbits in the G1-ECMO3 and the G2-FIO2 groups were higher than those in the G3-ACOP group (p<0.05, p = 0.000<0.05).

Conclusions

ECMO3 treatment effectively lowered the COHb levels, increased SO2 levels, and cured acid poisoning, making it a safe and promising ACOP treatment strategy.
Second Screening for News and Digital Divides
Authors: Barnidge Matthew , Diehl Trevor , Rojas Hernando
Published: January 2018

Second screening is a relatively new set of media practices that arguably empower audiences to shape public narratives alongside news organizations and political elites. But in developing countries such as Colombia, it is important to examine who participates in this process, as substantial inequalities in both access to and use of information and communication technologies (ICTs) persist. This study examines how socioeconomic status (SES) relates to the adoption of second screening practices in Colombia, a country in which the technological access and literacy necessary to engage in these practices are becoming widespread but are not yet ubiquitous. Based on a random sample of face-to-face interviews, results show evidence of persistent digital divides in Colombia in terms of ICT access, ICT use, and second screening for news. Additionally, results indicate that the relationship between SES and second screening for news is indirect, mediated through technological access and public affairs engagement.
The Influence of Multimorbidity on Leading Causes of Death in Older Adults With Cognitive Impairment
Authors: Schiltz Nicholas K. , Warner David F. , Sun Jiayang , Smyth Kathleen A. , Gravenstein Stefan , Stange Kurt C. , Koroukian Siran M.
Published: January 2018

Objective: The aim of this study is to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. Method: This is a population-based study using data from the linked 1992-2010 Health and Retirement Study and National Death Index ( n = 9,691). Multimorbidity is defined as a combination of chronic conditions, functional limitations, and geriatric syndromes. Regression trees and Random Forest identified which combinations of multimorbidity associated with causes of death. Results: Multimorbidity is common in the study population. Heart disease is the leading cause in all groups, but with a larger percentage of deaths in the mild and moderate/severe cognitively impaired groups than among the noncognitively impaired. The different “paths” down the regression trees show that the distribution of causes of death changes with different combinations of multimorbidity. Discussion: Understanding the considerable heterogeneity in chronic conditions, functional limitations, geriatric syndromes, and causes of death among people with cognitive impairment can target care management and resource allocation.
Recreating Experiences: Improving the Validity of Data
Authors: Roberts David
Published: January 2018

This paper explores the dynamics of peoples' responses to questions and uses case studies to explore ways in which the validity of data can be improved. Much social research takes for granted that the process of asking questions through interview, survey or focus groups provides accurate data about behaviour, perceptions and attitudes. However, the literature suggests that many questionnaires produce inaccurate data. Cognitive psychologists report that people tend to minimise the difficult recall or imaginative tasks when answering questions. Instead, respondents use ‘schemas’ or ‘scripts’ to interpret and respond to their immediate situation. A schema provides a ‘logic’ or ‘rationality’ that informs their responses. Some practitioners have found that they get more robust results by asking respondents to recreate mentally, specific events before asking questions based on those events.
Satisfying Competing Stakeholder Needs in a Depression Awareness Project
Authors: Rutter Anthea , McGuiness Maggie , Sundram Suresh , Chamley Wayne , Bellingham Kylee , Trauer Tom , Cole Neil , Macbean Catherine
Published: January 2018

The Depression Awareness Research Project was funded to develop, implement and evaluate a community-focused model designed to raise awareness of major depression1. It was piloted in five locations in Victoria from 2001-2004. This paper presents the findings of an analysis of qualitative data collected from a variety of stakeholders during and after the project.
The influence of evaluation in higher education
Authors: Fjellström Mona
Published: January 2018

The increasingly ritualized and instrumental evaluation of higher education, initiated mainly from above, has resulted in little consideration of what is needed if evaluation is truly to support the development of higher education. Strategies for quality enhancement and accountability rarely consider the distinctive features of higher education development. This article describes the influence of an evaluation strategy that was locally initiated and deliberately involved stakeholders in the process. The evaluation was designed to support the development of an undergraduate medical education programme in Sweden. Based on experiences from the case, I argue that evaluations should, in the context of higher education, be made the responsibility of the teachers. Making the teachers responsible should develop both their ability to work with educational development and to a greater extent enable definitions of educational quality specific to education.

The case describes an evaluation strategy that distinctly emanated from the need for knowledge by those who were responsible for the development of an undergraduate medical education programme in Sweden. The programme board established a dialogue with 10 of the stakeholders. The core aim was to learn more about the stakeholders’ expectations and views about the programme, but also to identify important areas for programme development. The dialogue with the stakeholders contributed to the creation of a qualified and nuanced development process and illuminated an evaluation process more associated with learning than quality enhancement. The commitment to cooperation, dialogue and enlightenment was, however, constantly threatened by a higher education culture that is increasingly characterized by productivity and efficiency.
Evaluating Capacity Development: What do We Really want to Know?
Authors: Kotvojs Fiona , Hurworth Rosalind
Published: January 2018

Capacity development is core to the activities supported by most development assistance agencies. However, the development of capacity is rarely evaluated. Where it is evaluated, the quality of evaluations is usually poor. Furthermore, evaluations of capacity development programs have rarely met the utility standard. In particular, they seldom provide the types of information that intended users need. Consequently, where evaluations have been undertaken, it is difficult to identify the influence these have made on program implementation or capacity development policy.

Patton (2002) suggests that for evaluations to be utilised, they need to answer questions that are of interest to intended users. Consequently, this article attempts to identify the types of questions intended users of evaluations of donor-funded capacity development programs want addressed.

The article outlines the first stage of broader research that investigates a framework for evaluating capacity development initiatives. The research aimed to identify questions that intended users would want answered by an evaluation of capacity development.

Findings presented in this article result from an analysis of 54 interviews held with a range of intended user groups. These groups include: donors (those responsible for the program, senior managers and internal evaluation specialists); those in the partner agency (partner government executive, counterparts 1 and managers); those working directly on the program (managers and advisers/consultants); and evaluators. This research found that there was one particular question each user group wanted evaluations of capacity development to answer. Beyond this, the broad questions user groups wanted answered and the focus of these varied. Finally, there appeared to be little relationship between questions users wanted answered and those generally used for capacity development evaluations, which are based on the criteria established by the Development Assistance Committee (DAC 1991).
Developing Evaluation Cultures in Human Service Organisations
Authors: McCoy Alicia , Rose David , Connolly Marie
Published: January 2018

Evaluation is currently receiving significant attention in the not-for-profit sector in Australia as a changing external environment augments its role in human service organisations. These bodies typically make use of three models to carry out evaluation activities to meet funding and organisational requirements: the use of external evaluators to carry out specific projects; creating internal evaluation functions to manage evaluation needs independently; or a combination of the two. This article outlines the characteristics of an internal evaluation culture in the context of a learning organisation, and describes the increasingly common approach of evaluation capacity building. In conclusion, the relevance of utilising an organisational change process to create sustainable and valued cultural change is discussed.
System evaluation theory (SET): A practical framework for evaluators to meet the challenges of system evaluation
Authors: Renger Ralph
Published: January 2018

This article presents a guiding framework for evaluators to conduct systems evaluation: system evaluation theory (SET). The article firstly defines ‘systems’, ‘system theory’, and ‘system thinking’; it then discusses the confusion in the evaluation literature surrounding the use of these terms (noting their application is primarily in evaluating programs, not evaluating modern day systems). Three guiding principles for evaluating modern day systems are then presented demonstrating: a) their relationship to systems theory; and b) how they assist the evaluator in accomplishing an evaluation.
Reviewing a Homeless Program in Tasmania
Authors: Donoghue Jed , Ang Yan Nee
Published: January 2018

The aim of the Oakleigh Accommodation Service (Oakleigh) review, undertaken in late 2013, was to analyse service activities, including staff work hours, rosters and client episodes, to inform recommendations on how to improve the crisis and transitional accommodation service delivered to people who were homeless, at risk of homelessness, or escaping domestic violence. To achieve this aim internal evaluators collected feedback from staff, clients and external stakeholders to evaluate the homeless program's performance, and identify any program issues, opportunities, challenges and gaps in service delivery. This review also compared the Oakleigh staff roster, work hours and client episodes with another Salvation Army homeless program McCombe House (McCombe). The review found that the staff, external stakeholders and clients were generally very satisfied with the Oakleigh service, which they regard as both valuable and worthwhile. However, the review identified areas needing improvement in terms of teamwork, program planning, vehicle usage, access to tenancy information and after-care support. A key recommendation was the redrafting of the staff roster to achieve consistency across the two sites, Oakleigh and McCombe, to enhance the delivery of emergency accommodation for clients.
Vocal Loudness as Contributory to the Occurrence of Obligatory Posterior Nasal Turbulence
Authors: Zajac David J. , Eshghi Marziye
Published: January 2018

Two cases are presented that show increased loudness as contributory to the occurrence of audible posterior nasal turbulence as an obligatory symptom. Case 1 was an 18-month-old boy with repaired cleft palate who exhibited sporadic posterior nasal turbulence with velar flutter that was associated with increased loudness. Case 2 was a 4-year-old boy with repaired cleft palate who exhibited relatively frequent posterior nasal turbulence with velar flutter that was associated with pervasive and excessive loudness. Following 3 therapy sessions, loudness was reduced and audible nasal turbulence was eliminated. Clinical implications are discussed.
An Initial Assessment of the Utility of Validated Alcohol and Drug Screening Tools in Predicting 30-Day Readmission to Adult General Medicine Wards
Authors: Gerke Steven P. , Agley Jon D. , Wilson Cynthia , Gassman Ruth A. , Forys Philip , Crabb David W.
Published: January 2018

Previous studies have identified drug and alcohol use as risk factors for readmission using claims data, but not by using substance use screening scores. This preliminary study tested the hypothesis that prevalence of 30-day readmission would be higher among patients screening positive on the 10-item Alcohol Use Disorders Identification Test (AUDIT-10) or the 10-item Drug Abuse Screening Test (DAST-10) tools at intake than among the general patient population. Social workers screened 4708 adult inpatients using prescreening questions followed by the AUDIT-10 and/or DAST-10. Patients with positive screens were followed for readmissions within 30 days of discharge. A positive screening score on the AUDIT-10 or DAST-10 instrument at intake was associated with higher risk of readmission to the general medicine wards within 30 days; this relationship appears complex and subject to mediation. Post hoc chart review found that the majority of readmissions among patients with positive screens were not immediately attributable to substance use. Further study is needed to verify these preliminary findings.
Effects of Same-Sex Legislation on Attitudes toward Homosexuality
Authors: Redman Shane M.
Published: January 2018

Despite the long historical battle of members of the gay and lesbian community to gain equal rights as their heterosexual counterparts, the adoption of public policies at the national level that recognize same-sex partnerships and marriages is a relatively recent political development across the globe. Consequently, we know little about whether, and how, this type of legislation affects public attitudes toward homosexuality. This study examines the relationship between same-sex couple legislation and public opinion using data from the World Values Survey from the years 1989 to 2014. While previous studies examining this relationship in the European context have found a positive relationship, the results presented in this paper paint a less optimistic picture of the impacts that same-sex couple legislation has on attitudes toward homosexuality. Specifically, I find that instead of same-sex partnership legislation increasing favorable attitudes across the entire population, it only affects individuals who are already generally supportive of homosexuality. Implications for gay and lesbian rights are discussed.
Beta-Adrenergic Antagonists in the Treatment of Glaucoma
Authors: Gandolfi S.A. , Cimino L.
Published: January 2018

Purpose

Beta-blockers have been used since the late 1970's as ‘first-choice’ in the treatment for glaucoma. Since the introduction of new molecules in clinical routine, the current role of beta-blockers in glaucoma therapy has been rediscussed. In particular, concerns have been raised regarding their actual safety profile.

Methods

This review will focus on the latest advances on the efficacy and safety profiles of non-selective beta-blockers.

Conclusions

The data provided will help to trace a more appropriate role for beta-blockers in glaucoma therapy.
Scanning Laser Ophthalmoscope-Evoked Multifocal-ERG (SLO-m-ERG) by Using Short m-sequences
Authors: Rudolph G. , Kalpadakis P. , Bechmann M. , La Rocca G. , Hörmann C. , Berninger T.
Published: January 2018

Purpose

To demonstrate the possibility of topographic mapping of retinal function under simultaneous control of fixation in humans, by scanning laser ophthalmoscope evoked multifocal electroretinography (SLO-m-ERG).

Methods

A confocal scanning laser ophthalmoscope was used as a stimulator and trigger unit to take m-ERGs. Short m-sequences based on a modified algorithm were used, with the advantage that each measurement cycle can be evaluated separately. We examined 78 normal subjects; in 62 a distortion factor of 1:1 was applied, and a factor of 1:4 in 16.

Results

The recorded amplitudes decreased with eccentricity, approximately following the decrease of retinal cone density. Amplitudes were higher in the central hexagonal element in the group with 1:4 distortion than in the group with the 1:1 distortion setting.

Conclusions

SLO-m-ERG is a reliable technique for topographic mapping of retinal function under simultaneous control of fixation
Valsalva Retinopathy Induced by Labour
Authors: Ladjimi A. , Zaouali S. , Messaoud R. , Ben Yahia S. , Attia S. , Jenzri S. , Khairallah M.
Published: January 2018

Purpose

To describe a patient with Valsalva retinopathy induced by labour.

Methods

Case report.

Results

A 29-year-old woman at her second pregnancy complained of a sudden loss of vision in her left eye during spontaneous labour. Visual acuity was reduced to counting fingers. Funduscopy revealed a large pre-retinal hemorrhage at the macula in the left eye. Three weeks after delivery, the hematoma was treated with Nd:YAG laser. Two weeks after treatment, visual acuity was 20/20 and the premacular hemorrhage had resolved.

Conclusions

A rise in intra-abdominal pressure during labour may result in Valsalva retinopathy. Nd:YAG laser may be useful in treating such hemorrhage.
Management of Scleral Rupture during Retinal Detachment Surgery: A Case Report
Authors: Carpineto P. , Ciancaglini M. , Scaramucci S. , Nubile M. , Mastropasqua L.
Published: January 2018

Purpose

Rupture of the sclera occurring during retinal detachment surgery is generally associated with unfavourable anatomic and visual outcomes. Re-operation after a failed scleral buckle procedure and pre-existing scleral thinning are considered the main risk factors for scleral rupture.

Case Report

We describe the management and the favourable outcome of a case of scleral rupture in a 71-year-old woman during re-operation for retinal detachment.

Conclusions

We managed this case of scleral rupture in accordance with current indications concerning the anatomical recovery, by scleral suture and patch graft, restoring IOP by gas tamponade. The positive outcome was partly related to the prompt closure of the retinal hole which led to reattachment, and partly to favourable events such as the moderate intensity of vitreous hemorrhage and the lack of any more serious intraoperative and postoperative complications.