bluuebunny/crossref_metadata_2025 huggingface dataset:
The Palliative Treatment Plan as a Bone of Contention between Attending Physicians and Nurses
Authors: Lederer Wolfgang , Graube Stefanie , Feichtner Angelika , Medicus Elisabeth
Published: October 2015

Acute vital crisis in end-of-life situations may result in hospitalization and intensive care without recognizable benefit in many cases. Advance directives regarding indications for resuscitation, hospitalization, and symptomatic treatment help ensure that acute complications can be managed quickly and satisfactorily in the patient’s customary surroundings. A plan was designed and implemented in Austrian nursing homes to provide emergency physicians with rapidly obtainable information on the patient’s current situation, and whether resuscitation attempts and hospitalization are advised or not. This palliative treatment plan is arranged by a physician together with caregivers, close relatives, and the patient or his court-appointed health care guardian or holder of power of attorney. Four years after implementation of the plan, a user satisfaction survey was carried out. The majority of participating nurses, emergency physicians and family doctors judged application and design of the palliative treatment plan positively. However, the low response rate of family doctors indicates nonconformity. In particular, the delegation of symptomatic treatment to nurses proved to be controversial. There is still a need to provide up-to-date information and training for health professionals in order for them to understand advance directives as extended autonomy for patients who have lost their ability to make their own decisions.
Changes in Active Commuting to School in Czech Adolescents in Different Types of Built Environment across a 10-Year Period
Authors: Dygrýn Jan , Mitáš Josef , Gába Aleš , Rubín Lukáš , Frömel Karel
Published: October 2015

Active commuting (AC) to school represents a great opportunity to incorporate walking or cycling into adolescents’ everyday routine. The objective of the study was to describe changes in AC in Czech adolescents across a 10-year period in different built environments. Data from the 2001 and 2011 Czech Census of Population and Housing were used to examine the mode of transportation taken to school in 6236 adolescents. Changes in AC over time were analyzed for low and high walkable areas separately in two Czech regional cities, Olomouc and Hradec Králové. Between 2001 and 2011, the proportion of adolescents actively commuting to school decreased by 47%, from an absolute rate of 49.1% to 26%. The proportion of active commuters fell in low walkable areas by 61% and in high walkable areas by 39%. The results indicated that adolescents in 2011 were 2.7 times less (OR = 0.365, p < 0.001) likely to actively commute than in 2001. The AC behavior in Czech adolescents has a negative tendency to replicate travel-to-school patterns in adolescents previously described in more developed countries. The findings might serve as a recommendation for municipal policy.
Relationships between Sleep Behaviors and Unintentional Injury in Southern Chinese School-Aged Children: A Population-Based Study
Authors: Tan Yafei , Ma Di , Chen Ying , Cheng Fuyuan , Liu Xiangxiang , Li Liping
Published: October 2015

The purpose of this study is to explore the relationships between sleep behaviors and injury occurrence among Chinese school-aged children. Data were collected with self-administered questionnaires of a cross-sectional survey which covered the school-aged children from southeastern Chinese urban and rural areas in April 2010. Information was collected on unintentional injury in the past year, sleep duration, napping and daytime fatigue, sleeping pill use, and social-demographic variables. Multivariable logistic regression analyses, controlling for confounding factors, were conducted to assess sleep-related variables that were associated with injuries. Students who slept for less than 8 h had a 30% increased risk of injury (OR: 1.30; 95%CI: 1.01–1.69) compared with those who slept for 8–9 h. Lack of napping, snoring and use of sleeping pills were significantly associated with injury. Among different genders, the slight difference in sleep behaviors predicted the occurrence of injury. Rural children displayed more sleep behaviors associated with injury than urban children. The sleep behaviors of primary school students were more negatively correlated with injury occurrence than junior/senior high school children. Consideration should be given to the prevention of problematic sleep behaviors as a potential risk factor in order to decrease injury rates and promote the health of school-aged children.
Help Received for Perceived Needs Related to Mental Health in a Montreal (Canada) Epidemiological Catchment Area
Authors: Fleury Marie-Josée , Bamvita Jean-Marie , Grenier Guy , Caron Jean
Published: October 2015

This study sought to identify variables associated with help received in terms of information, medication, counselling and total help received (including other needs) among 571 individuals needing health care services for mental health problems. Study participants were randomly selected from an epidemiological survey. Data on help received were collected using the Canadian version of the Perceived Need for Care Questionnaire (PNCQ), and were analyzed using a multinomial logistic regression model. Most help received was in the form of counselling, followed by medication and information. Compared with individuals who received no help, those who reported receiving help for all their needs were more likely to have psychological distress, to be non-verbally aggressive, to consult more healthcare professionals, to be men and to be somewhat older. Compared with individuals who received no help, those who received partial help were more likely to be not addicted to drugs or alcohol, to consult more healthcare professionals, and to be older. Healthcare services should prioritize strategies (e.g., early detection, outreach, public education on mental and addiction disorders) that address barriers to help seeking among youth, as well as individuals addicted to drugs and alcohol or those presenting with aggressive behavior.
Association of Sand Dust Particles with Pulmonary Function and Respiratory Symptoms in Adult Patients with Asthma in Western Japan Using Light Detection and Ranging: A Panel Study
Authors: Watanabe Masanari , Noma Hisashi , Kurai Jun , Shimizu Atsushi , Sano Hiroyuki , Kato Kazuhiro , Mikami Masaaki , Ueda Yasuto , Tatsukawa Toshiyuki , Ohga Hideki , Yamasaki Akira , Igishi Tadashi , Kitano Hiroya , Shimizu Eiji
Published: October 2015

Light detection and ranging (LIDAR) can estimate daily volumes of sand dust particles from the East Asian desert to Japan. The objective of this study was to investigate the relationship between sand dust particles and pulmonary function, and respiratory symptoms in adult patients with asthma. One hundred thirty-seven patients were included in the study. From March 2013 to May 2013, the patients measured their morning peak expiratory flow (PEF) and kept daily lower respiratory symptom diaries. A linear mixed model was used to estimate the correlation of the median daily levels of sand dust particles, symptoms scores, and PEF. A heavy sand dust day was defined as an hourly concentration of sand dust particles of >0.1 km−1. By this criterion, there were 8 heavy sand dust days during the study period. Elevated sand dust particles levels were significantly associated with the symptom score (0.04; 95% confidence interval (CI); 0.03, 0.05), and this increase persisted for 5 days. There was no significant association between PEF and heavy dust exposure (0.01 L/min; 95% CI, −0.62, 0.11). The present study found that sand dust particles were significantly associated with worsened lower respiratory tract symptoms in adult patients with asthma, but not with pulmonary function.
Coarse Particulate Air Pollution Associated with Increased Risk of Hospital Admissions for Respiratory Diseases in a Tropical City, Kaohsiung, Taiwan
Authors: Cheng Meng-Hsuan , Chiu Hui-Fen , Yang Chun-Yuh
Published: October 2015

This study was undertaken to determine whether there was an association between coarse particles (PM2.5–10) levels and frequency of hospital admissions for respiratory diseases (RD) in Kaohsiung, Taiwan. Hospital admissions for RD including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia, and ambient air pollution data levels for Kaohsiung were obtained for the period from 2006 to 2010. The relative risk of hospital admissions for RD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased rate of admissions for RD were significantly associated with higher coarse PM levels only on cool days (<25 °C), with a 10 µg/m3 elevation in PM2.5–10 concentrations associated with a 3% (95% CI = 1%–5%) rise in COPD admissions, 4% (95% CI = 1%–7%) increase in asthma admissions, and 3% (95% CI = 2%–4%) rise in pneumonia admissions. No significant associations were found between coarse particle levels and the number of hospital admissions for RD on warm days. In the two-pollutant models, PM2.5–10 levels remained significantly correlated with higher rate of RD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM2.5–10 enhance the risk of hospital admissions for RD on cool days.
Structural Analysis of Crystalline R(+)-α-Lipoic Acid-α-cyclodextrin Complex Based on Microscopic and Spectroscopic Studies
Authors: Ikuta Naoko , Endo Takatsugu , Hosomi Shota , Setou Keita , Tanaka Shiori , Ogawa Noriko , Yamamoto Hiromitsu , Mizukami Tomoyuki , Arai Shoji , Okuno Masayuki , Takahashi Kenji , Terao Keiji , Matsugo Seiichi
Published: October 2015

R(+)-α-lipoic acid (RALA) is a naturally-occurring substance, and its protein-bound form plays significant role in the energy metabolism in the mitochondria. RALA is vulnerable to a variety of physical stimuli, including heat and UV light, which prompted us to study the stability of its complexes with cyclodextrins (CDs). In this study, we have prepared and purified a crystalline RALA-αCD complex and evaluated its properties in the solid state. The results of 1H NMR and PXRD analyses indicated that the crystalline RALA-αCD complex is a channel type complex with a molar ratio of 2:3 (RALA:α-CD). Attenuated total reflection/Fourier transform infrared analysis of the complex showed the shift of the C=O stretching vibration of RALA due to the formation of the RALA-αCD complex. Raman spectroscopic analysis revealed the significant weakness of the S–S and C–S stretching vibrations of RALA in the RALA-αCD complex implying that the dithiolane ring of RALA is almost enclosed in glucose ring of α-CD. Extent of this effect was dependent on the direction of the excitation laser to the hexagonal morphology of the crystal. Solid-state NMR analysis allowed for the chemical shift of the C=O peak to be precisely determined. These results suggested that RALA was positioned in the α-CD cavity with its 1,2-dithiolane ring orientated perpendicular to the plane of the α-CD ring.
Bioactive Compounds and Antioxidant Activity in Different Types of Berries
Authors: Skrovankova Sona , Sumczynski Daniela , Mlcek Jiri , Jurikova Tunde , Sochor Jiri
Published: October 2015

Berries, especially members of several families, such as Rosaceae (strawberry, raspberry, blackberry), and Ericaceae (blueberry, cranberry), belong to the best dietary sources of bioactive compounds (BAC). They have delicious taste and flavor, have economic importance, and because of the antioxidant properties of BAC, they are of great interest also for nutritionists and food technologists due to the opportunity to use BAC as functional foods ingredients. The bioactive compounds in berries contain mainly phenolic compounds (phenolic acids, flavonoids, such as anthocyanins and flavonols, and tannins) and ascorbic acid. These compounds, either individually or combined, are responsible for various health benefits of berries, such as prevention of inflammation disorders, cardiovascular diseases, or protective effects to lower the risk of various cancers. In this review bioactive compounds of commonly consumed berries are described, as well as the factors influencing their antioxidant capacity and their health benefits.
Design Principles as a Guide for Constraint Based and Dynamic Modeling: Towards an Integrative Workflow
Authors: Sehr Christiana , Kremling Andreas , Marin-Sanguino Alberto
Published: October 2015

During the last 10 years, systems biology has matured from a fuzzy concept combining omics, mathematical modeling and computers into a scientific field on its own right. In spite of its incredible potential, the multilevel complexity of its objects of study makes it very difficult to establish a reliable connection between data and models. The great number of degrees of freedom often results in situations, where many different models can explain/fit all available datasets. This has resulted in a shift of paradigm from the initially dominant, maybe naive, idea of inferring the system out of a number of datasets to the application of different techniques that reduce the degrees of freedom before any data set is analyzed. There is a wide variety of techniques available, each of them can contribute a piece of the puzzle and include different kinds of experimental information. But the challenge that remains is their meaningful integration. Here we show some theoretical results that enable some of the main modeling approaches to be applied sequentially in a complementary manner, and how this workflow can benefit from evolutionary reasoning to keep the complexity of the problem in check. As a proof of concept, we show how the synergies between these modeling techniques can provide insight into some well studied problems: Ammonia assimilation in bacteria and an unbranched linear pathway with end-product inhibition.
Structure–Activity Relationship of Oligomeric Flavan-3-ols: Importance of the Upper-Unit B-ring Hydroxyl Groups in the Dimeric Structure for Strong Activities
Authors: Hamada Yoshitomo , Takano Syota , Ayano Yoshihiro , Tokunaga Masahiro , Koashi Takahiro , Okamoto Syuhei , Doi Syoma , Ishida Masahiko , Kawasaki Takashi , Hamada Masahiro , Nakajima Noriyuki , Saito Akiko
Published: October 2015

Proanthocyanidins, which are composed of oligomeric flavan-3-ol units, are contained in various foodstuffs (e.g., fruits, vegetables, and drinks) and are strongly biologically active compounds. We investigated which element of the proanthocyanidin structure is primarily responsible for this functionality. In this study, we elucidate the importance of the upper-unit of 4–8 condensed dimeric flavan-3-ols for antimicrobial activity against Saccharomyces cerevisiae (S. cerevisiae) and cervical epithelioid carcinoma cell line HeLa S3 proliferation inhibitory activity. To clarify the important constituent unit of proanthocyanidin, we synthesized four dimeric compounds, (−)-epigallocatechin-[4,8]-(+)-catechin, (−)-epigallocatechin-[4,8]-(−)-epigallocatechin, (−)-epigallocatechin-[4,8]-(−)-epigallocatechin-3-O-gallate, and (+)-catechin-[4,8]-(−)-epigallocatechin and performed structure–activity relationship (SAR) studies. In addition to antimicrobial activity against S. cerevisiae and proliferation inhibitory activity on HeLa S3 cells, the correlation of 2,2-diphenyl-l-picrylhydrazyl radical scavenging activity with the number of phenolic hydroxyl groups was low. On the basis of the results of our SAR studies, we concluded that B-ring hydroxyl groups of the upper-unit of the dimer are crucially important for strong and effective activity.
Melatonin as a Potent and Inducible Endogenous Antioxidant: Synthesis and Metabolism
Authors: Tan Dun-Xian , Manchester Lucien , Esteban-Zubero Eduardo , Zhou Zhou , Reiter Russel
Published: October 2015

Melatonin is a tryptophan-derived molecule with pleiotropic activities. It is present in almost all or all organisms. Its synthetic pathway depends on the species in which it is measured. For example, the tryptophan to melatonin pathway differs in plants and animals. It is speculated that the melatonin synthetic machinery in eukaryotes was inherited from bacteria as a result of endosymbiosis. However, melatonin’s synthetic mechanisms in microorganisms are currently unknown. Melatonin metabolism is highly complex with these enzymatic processes having evolved from cytochrome C. In addition to its enzymatic degradation, melatonin is metabolized via pseudoenzymatic and free radical interactive processes. The metabolic products of these processes overlap and it is often difficult to determine which process is dominant. However, under oxidative stress, the free radical interactive pathway may be featured over the others. Because of the complexity of the melatonin degradative processes, it is expected that additional novel melatonin metabolites will be identified in future investigations. The original and primary function of melatonin in early life forms such as in unicellular organisms was as a free radical scavenger and antioxidant. During evolution, melatonin was selected as a signaling molecule to transduce the environmental photoperiodic information into an endocrine message in multicellular organisms and for other purposes as well. As an antioxidant, melatonin exhibits several unique features which differ from the classic antioxidants. These include its cascade reaction with free radicals and its capacity to be induced under moderate oxidative stress. These features make melatonin a potent endogenously-occurring antioxidant that protects organisms from catastrophic oxidative stress.
The Association of a Mediterranean-Style Diet Pattern with Polycystic Ovary Syndrome Status in a Community Cohort Study
Authors: Moran Lisa , Grieger Jessica , Mishra Gita , Teede Helena
Published: October 2015

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. While lifestyle management is first-line treatment in PCOS, the dietary intake of women with PCOS is unclear and there is no research assessing dietary patterns of women with and without PCOS. The aim of this study was to examine dietary patterns in a large cohort of women with and without PCOS. Data were from 7569 participants in the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health population assessed at 2009 (Survey 5) (n = 414 PCOS, n = 7155 non-PCOS). Dietary patterns were evaluated using factor analysis and multiple logistic regressions assessed their associations with PCOS status. Three dietary patterns were identified that explained 27% of the variance in food intake between women with and without PCOS: Non-core foods; Meats and take-away and Mediterranean-style. The Mediterranean-style dietary pattern was independently associated with PCOS status. On adjusted analysis for each 1 SD increase in the Mediterranean-style dietary pattern, there was a 26% greater likelihood that women had PCOS. This may indicate an improvement in the quality of dietary intake following a diagnosis of PCOS. Future research should examine the contribution of dietary patterns to the incidence and severity of PCOS and the potential for modification of dietary patterns in the lifestyle management of PCOS.
Reactivity Comparison of ω-Alkenols and Higher 1-Alkenes in Copolymerization with Propylene Using An Isospecific Zirconocene-MMAO Catalyst
Authors: Nyangoye Benard Oloo , Li Tianyou , Chen  Long , Cai Zhengguo
Published: October 2015

Copolymerizations of propylene with ω-alkenols (aluminum-protected 5-hexene-1-ol (AH) and 10-undecene-1-ol (AU)) and non-polar analogues (1-hexene and 1-dodecene) were conducted with a rac-[Me2Si(2-Me-4-Ph-Ind)2]ZrCl2 activated by modified methylaluminoxane. The catalytic system showed high activity for each copolymerization, of which value was independent on the comonomer used and decreased with the increase of the comonomer concentration. The comonomer content of the copolymers obtained also decreased with the increase of the comonomer concentration in each copolymer. The evaluation of the monomer reactivity ratios indicates a preference for the propylene insertion regardless of the last inserted monomer unit in growing polymer chain in all the copolymerizations. The relative reactivity of ω-alkenols was however significantly lower than that of non-polar analogues. These results suggested that the aluminum protection of polar monomer do not affect the activity of copolymerization but significantly decrease the comonomer reactivity.
The Green Revolution in the World’s Religions: Indonesian Examples in International Comparison
Authors: Reuter Thomas
Published: October 2015

Similar to progressive political movements, the programs of many religious and spiritual groups today are converging around a shared commitment to address the impending global ecological crisis. The paper explores this convergence by looking at the impact of environmentalist thought on religious discourses in modern Indonesia, the author’s primary research area, and comparing the findings to similar trends elsewhere. The research shows that the environmental movement is causing a transformation in how people understand the character and practical relevance of religion and spirituality today, in Indonesia and beyond. For some eco-spiritual groups, a heightened environmental awareness has become the central tenet of their monistic religious cosmology. The more significant phenomenon, however, is a socially much broader shift toward more science-friendly and contemporary religious cosmologies within the mainstream of major world religions. Islam and Christianity now officially accept that other forms of life have a right to exist and that humanity has a custodial obligation to protect nature. This new outlook rectifies the previous tendency within dualist religions to view nature as vastly inferior and servile to human interests. It simultaneously is a rejection of materialist-scientific cosmologies widely prevalent in late modern consumer societies, which deny any notion of the sacred. This trend in the world’s religions toward a re-evaluation of the cosmological status of humanity in relation to nature and the sacred, I argue, will enhance the prospects of the global environmental movement’s campaign for environmental sustainability.
Experimental Validation of Normalized Uniform Load Surface Curvature Method for Damage Localization
Authors: Jung Ho-Yeon , Sung Seung-Hoon , Jung Hyung-Jo
Published: October 2015

In this study, we experimentally validated the normalized uniform load surface (NULS) curvature method, which has been developed recently to assess damage localization in beam-type structures. The normalization technique allows for the accurate assessment of damage localization with greater sensitivity irrespective of the damage location. In this study, damage to a simply supported beam was numerically and experimentally investigated on the basis of the changes in the NULS curvatures, which were estimated from the modal flexibility matrices obtained from the acceleration responses under an ambient excitation. Two damage scenarios were considered for the single damage case as well as the multiple damages case by reducing the bending stiffness (EI) of the affected element(s). Numerical simulations were performed using MATLAB as a preliminary step. During the validation experiments, a series of tests were performed. It was found that the damage locations could be identified successfully without any false-positive or false-negative detections using the proposed method. For comparison, the damage detection performances were compared with those of two other well-known methods based on the modal flexibility matrix, namely, the uniform load surface (ULS) method and the ULS curvature method. It was confirmed that the proposed method is more effective for investigating the damage locations of simply supported beams than the two conventional methods in terms of sensitivity to damage under measurement noise.
Sensor and Methodology for Dielectric Analysis of Vegetal Oils Submitted to Thermal Stress
Authors: Stevan Sergio , Paiter Leandro , Galvão José , Roque Daniely , Chaves Eduardo
Published: October 2015

Vegetable oils used in frying food represent a social problem as its destination. The residual oil can be recycled and returned to the production line, as biodiesel, as soap, or as putty. The state of the residual oil is determined according to their physicochemical characteristics whose values define its economically viable destination. However, the physicochemical analysis requires high costs, time and general cost of transporting. This study presents the use of a capacitive sensor and a quick and inexpensive method to correlate the physicochemical variables to the dielectric constant of the material undergoing oil samples to thermal cycling. The proposed method allows reducing costs in the characterization of residual oil and the reduction in analysis time. In addition, the method allows an assessment of the quality of the vegetable oil during use. The experimental results show the increasing of the dielectric constant with the temperature, which facilitates measurement and classification of the dielectric constant at considerably higher temperatures. The results also confirm a definitive degradation in used oil and a correlation between the dielectric constant of the sample with the results of the physicochemical analysis (iodine value, acid value, viscosity and refractive index).
Anonymous Multi-Receiver Identity-Based Authenticated Encryption with CCA Security
Authors: Fan Chun-I , Tseng Yi-Fan
Published: October 2015

In a multi-receiver encryption system, a sender chooses a set of authorized receivers and sends them a message securely and efficiently, as the message is well encrypted and only one ciphertext corresponding to the message is generated no matter how many receivers the sender has chosen. It can be applied to video conferencing systems, pay-per-view channels, remote education, and so forth. Due to privacy considerations, an authorized receiver may not expect that his identity is revealed. In 2010, anonymous multi-receiver identity-based (ID-based) encryption was first discussed, and furthermore, many works on the topic have been presented so far. Unfortunately, we find that all of those schemes fail to prove the chosen ciphertext attacks (CCA) security in either confidentiality or anonymity. In this manuscript, we propose the first anonymous multi-receiver ID-based authenticated encryption scheme with CCA security in both confidentiality and anonymity. In the proposed scheme, the identity of the sender of a ciphertext can be authenticated by the receivers after a successful decryption. In addition, the proposed scheme also is the first CCA-secure one against insider attacks. Moreover, only one pairing computation is required in decryption.
Emerging Roles of Viroporins Encoded by DNA Viruses: Novel Targets for Antivirals?
Authors: Royle Jamie , Dobson Samuel , Müller Marietta , Macdonald Andrew
Published: October 2015

Studies have highlighted the essential nature of a group of small, highly hydrophobic, membrane embedded, channel-forming proteins in the life cycles of a growing number of RNA viruses. These viroporins mediate the flow of ions and a range of solutes across cellular membranes and are necessary for manipulating a myriad of host processes. As such they contribute to all stages of the virus life cycle. Recent discoveries have identified proteins encoded by the small DNA tumor viruses that display a number of viroporin like properties. This review article summarizes the recent developments in our understanding of these novel viroporins; describes their roles in the virus life cycles and in pathogenesis and speculates on their potential as targets for anti-viral therapeutic intervention.
A Synthetic Virus-Like Particle Streptococcal Vaccine Candidate Using B-Cell Epitopes from the Proline-Rich Region of Pneumococcal Surface Protein A
Authors: Tamborrini Marco , Geib Nina , Marrero-Nodarse Aniebrys , Jud Maja , Hauser Julia , Aho Celestine , Lamelas Araceli , Zuniga Armando , Pluschke Gerd , Ghasparian Arin , Robinson John
Published: October 2015

Alternatives to the well-established capsular polysaccharide-based vaccines against Streptococcus pneumoniae that circumvent limitations arising from limited serotype coverage and the emergence of resistance due to capsule switching (serotype replacement) are being widely pursued. Much attention is now focused on the development of recombinant subunit vaccines based on highly conserved pneumococcal surface proteins and virulence factors. A further step might involve focusing the host humoral immune response onto protective protein epitopes using as immunogens structurally optimized epitope mimetics. One approach to deliver such epitope mimetics to the immune system is through the use of synthetic virus-like particles (SVLPs). SVLPs are made from synthetic coiled-coil lipopeptides that are designed to spontaneously self-assemble into 20–30 nm diameter nanoparticles in aqueous buffer. Multivalent display of epitope mimetics on the surface of SVLPs generates highly immunogenic nanoparticles that elicit strong epitope-specific humoral immune responses without the need for external adjuvants. Here, we set out to demonstrate that this approach can yield vaccine candidates able to elicit a protective immune response, using epitopes derived from the proline-rich region of pneumococcal surface protein A (PspA). These streptococcal SVLP-based vaccine candidates are shown to elicit strong humoral immune responses in mice. Following active immunization and challenge with lethal doses of streptococcus, SVLP-based immunogens are able to elicit significant protection in mice. Furthermore, a mimetic-specific monoclonal antibody is shown to mediate partial protection upon passive immunization. The results show that SVLPs combined with synthetic epitope mimetics may have potential for the development of an effective vaccine against Streptococcus pneumoniae.
The Longitudinal Course of Fatigue in Rheumatoid Arthritis: Results from the Norfolk Arthritis Register
Authors: Druce Katie L. , Jones Gareth T. , Macfarlane Gary J. , Verstappen Suzanne M.M. , Basu Neil
Published: October 2015

Objective.

Fatigue is common and burdensome in rheumatoid arthritis (RA). Despite RA fatigue progression varying significantly between individuals in practice, existing longitudinal analyses only examine symptom advancement on a population level. This study aimed to determine fatigue trajectories at an individual level and to characterize those patients with the poorest prognosis, with a view to enabling earlier interventions.

Methods.

Patients with RA reporting clinically relevant baseline fatigue (≥ 20 mm on a 0–100 mm visual analog scale) were identified from a longterm inflammatory polyarthritis cohort (the Norfolk Arthritis Register). Fatigue changes from baseline to 1- and 4-year followups were calculated, and sex-stratified group-based trajectory modeling (GBTM) determined trajectories of the symptom between which baseline characteristics were compared.

Results.

Among 338 patients, only minimal average changes were observed between recruitment to 1 year (6.0 mm, SD 26.9) and 4 years (5.5 mm, SD 29.3). This was despite 45.6% and 40.7% of participants reporting clinically significant improvements (≥ 10 mm) at these respective followups. GBTM revealed varied trajectories of fatigue, which for both sexes consisted of Improved (men, n = 48 and women, n = 81) or persistent Moderate-high paths (n = 54, n = 105), and further included a persistent High trajectory in women (n = 50). Participants who followed persistent trajectories were best distinguished from improvers by patient-reported rather than demographic or clinical variables.

Conclusion.

Among patients with RA presenting with clinically relevant fatigue, distinct longitudinal symptom trajectories were identified on an individual level despite nominal average changes in fatigue on a group level. It is possible to identify and characterize subgroups of participants who report persistent fatigue and should therefore be targeted to receive future fatigue-alleviating interventions.
La place du care dans le diagnostic éducatif de l’infirmière en éducation thérapeutique du patient
Authors: Farrayre Annie
Published: October 2015

Cet article porte sur l’intérêt de l’usage du care dans la pratique diagnostique de l’infirmière en éducation thérapeutique du patient. Le cadre théorique fait principalement appel aux travaux sur le care de Joan Tronto. Le care est une forme d’activité particulière qui consiste à ce qu’une personne fonde son action sur la saisie des préoccupations et des besoins des autres. Le care est à la fois pensée et action. Ceci pose la question de savoir comment se traduit la disposition de care de l’infirmière lors du diagnostic éducatif. Cette recherche qualitative a été conduite auprès de quatre infirmières accueillant dans un programme éducatif des patients atteints de diabète. L’analyse de contenu des entretiens d’explicitation montre comment la disposition au care de l’infirmière se traduit dans sa pratique diagnostique. Les infirmières mettent en place un dispositif spatio-temporel pour réaliser l’entretien d’accueil du patient à son arrivée dans le programme éducatif. Ce rituel est une pratique de care qui facilite l’entretien avec le patient afin d’identifier les émotions inhérentes au vécu avec la maladie chronique et d’élaborer un diagnostic éducatif qui en tienne compte.
Necrotizing Enterocolitis in the Full-Term Infant
Authors: Chu Alison , Chiu Harvey K.
Published: October 2015

Necrotizing enterocolitis in full-term infants is relatively rare. When seen, it is usually associated with perinatal asphyxia, sepsis, or specific forms of congenital heart disease. It can also be associated with endocrinopathies. In this review, a full-term infant was found to have necrotizing enterocolitis and persistent hypoglycemia. Evaluation for hypoglycemia revealed pan-hypopituitarism, and magnetic resonance imaging confirmed this diagnosis. Timely evaluation and early initiation of hormone replacement therapy is essential to minimize long-term morbidities and mortality associated with pan-hypopituitarism.

[
Pediatr Ann
. 2015;44(10):e237–e242.]
Vein of Galen Arteriovenous Malformation in a Neonate
Authors: De Beritto Theodore , Khan Owais A. , Hageman Joseph R. , Schreiber Michael
Published: October 2015

The vein of Galen is the most common type of arteriovenous malformation in the fetus and neonate. Most vein of Galen arteriovenous malformations (VGAMs) are diagnosed in the neonatal period, with the remainder being identified in early childhood, typically via computed tomography scan. The VGAM is found in five different patterns where the vein of Galen and straight sinus extending to the torcula Herophili are dilated. This dilation can lead to significant compression of the posterior fossa structures. Clinically, the infant with this malformation can present with seizures or most commonly, high output cardiac failure. It is important, however, to keep a broad differential diagnosis as more prevalent neonatal conditions arise similarly. These conditions can include developmental delay, cerebral palsy, epilepsy, superior vena cava syndrome, hemangioendothelioma, and other arteriovenous fistulae. Treatment begins with early diagnosis and testing of initial sequelae. This is often accomplished in consultation with different pediatric subspecialists, particularly neurologists and cardiologists. The mainstay of therapy is with neurosurgical intervention. Although the mortality of a fetus or neonate with VGAM is very high, prognosis is dependent on the size of the malformation, age at diagnosis, and successful neurosurgical outcome.

[
Pediatr Ann
. 2015;44(10):e243–e246.]
Unilateral Congenital Lacrimal Gland Agenesis With Contralateral Lacrimal Gland Hypoplasia
Authors: Talsania Sonali D. , Robson Caroline D. , Mantagos Iason S.
Published: October 2015

Congenital alacrima is a form of primary lacrimal deficiency characterized by aplasia or hypoplasia of the lacrimal gland. The puncta and salivary glands may also be aplastic. The case of a 5-year-old girl with congenital alacrima secondary to lacrimal gland agenesis and hypoplasia without punctal or salivary gland involvement and without other systemic comorbidities is reported.

[
J Pediatr Ophthalmol Strabismus
. 2015;52:e52–e54.]
COMPARISON OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS IN HEALTHY COMMUNITY HOSPITAL VISITORS[CA-MRSA] AND HOSPITAL STAFF [HA-MRSA]
Authors: Pathare Nirmal A , Pathare Anil
Published: October 2015

Background: The prevalence of community associated methicillin resistant Staphylococcus aureus [CA-MRSA] in unknown in Oman.Methods: Nasal and cell phones swabs were collected from hospital visitors and health-care workers on sterile polyester swabs and directly inoculated onto a mannitol salt agar containing oxacillin, allowing growth of methicillin-resistant microorganisms. Antibiotic susceptibility tests were performed using Kirby Bauer’s disc diffusion method on the isolates. A brief survey questionnaire was requested be filled to ascertain the exposure to known risk factors for CA-MRSA carriage.Results: Overall, nasal colonization with CA-MRSA was seen in 34 individuals (18%, 95% confidence interval [CI] =12.5%-23.5%), whereas, CA-MRSA was additionally isolated from the cell phone surface in 12 participants (6.3%, 95% CI =5.6%-6.98%). Nasal colonization prevalence with HA-MRSA was seen in 16 individuals (13.8%, 95% confidence interval [CI] =7.5%-20.06%), whereas, HA-MRSA was additionally isolated from the cell phone surface in 3 participants (2.6%, 95% CI =1.7-4.54).  Antibiotic sensitivity was 100% to linezolid and rifampicin in the CA-MRSA isolates. Antibiotic resistance to vancomycin and clindamycin varied between 9-11 % in the CA-MRSA isolates.  There was no statistically significant correlation between CA-MRSA nasal carriage and the risk factors (P>0.05, Chi-square test).Conclusions: The prevalence of CA-MRSA in the healthy community hospital visitors was 18 % (95% CI, 12.5% to 23.5%) as compared to 13.8% [HA-MRSA] in the hospital health-care staff. In spite of a significant prevalence of CA-MRSA, these strains were mostly sensitive. Recommendation the universal techniques of hand washing, personal hygiene and sanitation are thus warranted.
BACTERIAL INFECTIONS FOLLOWING SPLENECTOMY FOR MALIGNANT AND NONMALIGNANT HEMATOLOGIC DISEASES
Authors: Leone Giuseppe , Pizzigallo Eligio
Published: October 2015

Splenectomy, while often necessary in otherwise healthy patients after major trauma, find its primary indication for patients with an underlying malignant or nonmalignant hematologic diseases. Indications of splenectomy for hematologic diseases have been reducing in the last few years, due to improved diagnostic and therapeutic tools. In high-income countries, there is a clear decrease over calendar time in the incidence of all indication splenectomy except nonmalignant hematologic diseases. However, splenectomy, even if with different modalities including laparoscopic splenectomy and partial splenectomy, continue to be a current surgical practice both in nonmalignant hematologic diseases, such as Immune Thrombocytopenic Purpura (ITP), Autoimmune Hemolytic Anemia (AIHA), Congenital Hemolytic Anemia such as Spherocytosis, Sickle Cell Anemia and Thalassemia and Malignant Hematological Disease, such as lymphoma. Today millions of people in the world are splenectomized. Splenectomy, independently of its cause, induces an early and late increase in the incidence of venous thromboembolism and infections. Infections remain the most dangerous complication of splenectomy. After splenectomy, the levels of antibody are preserved but there is a loss of memory B cells against pneumococcus and tetanus, and the loss of marginal zone monocytes deputed to immunological defense from capsulated bacteria. Commonly, the infections strictly correlated to the absence of the spleen or a decreased or absent splenic function are due to encapsulated bacteria that are the most virulent pathogens in this set of patients. Vaccination with polysaccharide and conjugate vaccines again Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis should be performed before the splenectomy. This practice reduces but does not eliminate the occurrence of overwhelming infections due to capsulated bacteria. At present, most of infection found in splenectomized patients are due to  Gram-negative (G-) bacteria. The underlying disease is the most important factor in determining the frequency and severity of infections.So, splenectomy for malignant diseases has the major risk of infections.Keywords: Splenectomy, Infections, Bacteria,Str. Pneumoniae, Vaccine.
Glas in beeld – beeld in glas. Verkondiging in fragment en fragmente van verkondiging ...
Authors: Kloppers Elsabé , Kloppers Wian
Published: October 2015

Glass in the image – image in glass. Preaching in fragments and fragments of preaching . . . The view that the sermon is an ‘open work of art’, promoted the awareness that the ‘meaning’ of a sermon is not fixed, but that possibilities are presented for the listeners to ‘assign meaning’. ‘Assigning meaning’ does not mean something fully ad libitum: ‘meaning’ is formed within the guidelines of the text from which a sermon stems. Visual works of art could also be based on Biblical texts or stories, analysed and interpreted by the artist. The artist could mould the encounter with the Biblical text into various forms of art, proclaiming the gospel in ways similar to that of a spoken sermon: a work of art could present possibilities for assigning meaning related to faith. In this article the new stained glass windows, symbolically depicting the Liturgical Year, in a Dutch Reformed church in Pretoria, are discussed with a view to the possibilities they present to form part of experience-based religious education in ‘bringing home’ stories from the Bible and aspects of the Liturgical Year. Also asked is how they could function as visual ‘sermons’, speaking and communicating the ‘Word of God’ to the people inside the church, as well as to people on the outside.
Torre de los Escipiones: de la interpretación a la divulgación del patrimonio
Authors: Gris Jeremías Ferran , Ruiz de Arbulo Bayona Joaquín
Published: October 2015

The Torre de los Escipiones is a tower shape monument 6 km away from the city of Tarragona. Although it is incomplete, its good state of preservation makes it an iconic landmark of the area. It is an isolated construction in the landscape, which favours a certain misunderstanding. We believe it is necessary to develop a strategy to help its dissemination. In this case, the disclosure not only understood as the reconstruction of an hypothetical appearance in Roman times but also to imply the symbolic and social dimensions of Roman funerary world and how this is reflicted in its architecture. On the other hand, the Torre de los Escipiones has also been used as a study to test the ability of scientific research to connect with the disclosure to the public. That is, to develop from the working group itself the graphic sequence in which the work is shown: from the documentation of the remains to the analysis, interpretation and proposed restitution. Thus, not only the disclosure of the monument itself is achieved, but also demostrates how science contributes to the cultural enrichment of society.
Avances en Sistemas de Información Espacial 3D. Aplicaciones en patrimonio y arqueología virtual
Authors: Robles Ortega María Dolores , Ortega Alvarado Lidia , Feito Higueruela Francisco Ramón
Published: October 2015

Large point clouds from radars and these-dimensional scanners are commonly used in Archaeology. However, in most cases these models cannot be properly integrated and used in software such as heritage management due to its large size. Therefore, some tools to make this management easier and optimize the processing are needed. In this work, we propone the integration between OpenVDB and GRASS in a C++ module to combine the widen functionality of GRASS GIS with the 3D models management efficiency of OpenVDB. Specifically, this application is used to combine the topographic information of a city with the 3D models of the most significant buildings. This application can be useful for both current cities as well as for virtual reconstruction of existing villages in the olden days and currently disappeared. 
Functional Deficits and Quality of Life Among Cancer Survivors: Implications for Occupational Therapy in Cancer Survivorship Care
Authors: Hwang Eric J. , Lokietz Nicole C. , Lozano Rachel L. , Parke Megan A.
Published: October 2015

This study aimed to explore functional deficits and perceived quality of life (QoL) among cancer survivors. Sixty-six participants completed the Post Cancer Outcome Survey developed for the purpose of this study. The results indicated (1) modest to moderate degrees of functional deficits in 28 of the 70 items measuring areas of occupation, performance skills, body functions, and psychosocial well-being within the first year after cancer treatment; (2) significantly lower perceived QoL during the first year of survivorship compared with that before diagnosis, at present, and 5 yr hereafter (p < .001); (3) significant moderate negative correlations between the reported functional deficits and QoL (rs = –.45 to –.57); and (4) a very low percentage of participants (4.5%) receiving occupational therapy during the first year posttreatment. Functional difficulties and compromised QoL identified in this study indicate the need for occupational therapy among cancer survivors. Increasing clients’ awareness of occupational therapy for postcancer care is also suggested.
Perspectives on the Use of Standardized Parents to Teach Collaboration to Graduate Occupational Therapy Students
Authors: Cahill Susan M.
Published: October 2015

OBJECTIVE. Pediatric occupational therapy practitioners interview parents on a daily basis to gain important patient information and develop collaborative intervention goals. A standardized parent experience was developed to help master’s-level occupational therapy students gain the skills needed to interview parents after their child’s traumatic injury. This article describes the pedagogical approach used to develop the standardized parent experience and reports the students’ general perspectives related to this assignment.

METHOD. Outcome data were collected through focus groups (n = 9) and document review (n = 12) and then analyzed for themes.

RESULTS. Two main themes emerged from the data: It felt real and It helped me to think deeper.

CONCLUSION. A standardized parent experience may help occupational therapy students develop the habits of mind associated with collaboration.