bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel starters for old processes: use of Saccharomyces cerevisiae strains isolated from artisanal sourdough for craft beer production at a brewery scale
Authors: Marongiu Antonella , Zara Giacomo , Legras Jean-Luc , Del Caro Alessandra , Mascia Ilaria , Fadda Costantino , Budroni Marilena
Published: November 2014

The deliberate inoculation of yeast strains isolated from food matrices such as wine or bread, could allow the transfer of novel properties to beer. In this work, the feasibility of the use of baker's yeast strains as starters for craft beer production has been evaluated at laboratory and brewery scale. Nine out of 12 Saccharomyces cerevisiae strains isolated from artisanal sourdoughs metabolized 2 % maltose, glucose and trehalose and showed growth rates and cell populations higher than those of the brewer’s strain Safbrew-S33. Analysis of allelic variation at 12 microsatellite loci clustered seven baker’s strains and Safbrew-S33 in the main group of bread isolates. Chemical analyses of beers produced at a brewery scale showed significant differences among the beers produced with the baker’s strain S38 or Safbrew-S33, while no significant differences were observed when S38 or the brewer’s strain Safbrew-F2 was used for re-fermentation. The sensory profile of beers obtained with S38 or the brewer’s yeasts did not show significant differences, thus suggesting that baker’s strains of S. cerevisiae could represent a reservoir of biodiversity for the selection of starter strains for craft beer production.
Lipid Analysis of Airway Epithelial Cells for Studying Respiratory Diseases
Authors: Zehethofer Nicole , Bermbach Saskia , Hagner Stefanie , Garn Holger , Müller Julia , Goldmann Torsten , Lindner Buko , Schwudke Dominik , König Peter
Published: November 2014

Airway epithelial cells play an important role in the pathogenesis of inflammatory lung diseases such as asthma, cystic fibrosis and COPD. Studies concerning the function of the lipid metabolism of the airway epithelium are so far based only on the detection of lipids by immunohistochemistry but quantitative analyses have not been performed. Although recent advances in mass spectrometry have allowed to identify a variety of lipid classes simultaneously in isolated tissue samples, up until now, these methods were not suitable to analyze lipids in the airway epithelium. To determine all major lipid classes in airway epithelial cells, we used an LC–MS-based approach that can easily be combined with the specific isolation procedure to obtain epithelial cells. We tested the suitability of this method with a mouse model of experimental asthma. In response to allergen challenge, perturbations in the sphingolipids were detected, which led to increased levels of ceramides. We expanded the scope of this approach analysing human bronchus samples without pathological findings of adenocarcinoma patients. For the human lung epithelium an unusual lipid class distribution was found in which ceramide was the predominant sphingolipid. In summary, we show that disease progression and lipid metabolism perturbation can be monitored in animal models and that the method can be used for the analysis of clinical samples.
Pharmacokinetic study of aldoxorubicin in patients with solid tumors
Authors: Mita Monica M. , Natale Ronald B. , Wolin Edward M. , Laabs Brenda , Dinh Hillary , Wieland Scott , Levitt Daniel J. , Mita Alain C.
Published: November 2014

Introduction Aldoxorubicin, a prodrug of doxorubicin, binds covalently to serum albumin in the bloodstream and accumulates in tumors. Aldoxorubicin can be administered at doses several-fold higher than doxorubicin can, without associated acute cardiotoxicity. Purpose This study fully evaluated the pharmacokinetic profile of aldoxorubicin (serum and urine). Methods Eighteen patients with advanced solid tumors received aldoxorubicin 230 or 350 mg/m2 (equivalent in drug load to doxorubicin at doses of 170 or 260 mg/m2, respectively) once every 21 days. Blood samples were taken in cycle 1 before aldoxorubicin infusion, and at 5, 15, 30, and 60 min, and at 2, 4, 8, 12, 16, 24, 48, and 72 h after infusion. Urine samples were taken in cycle 1 at 24, 48, and 72 h after infusion. Limited blood sampling was done in cycle 3, before aldoxorubicin infusion, and at 60 min and at 2, 4, and 8 h after infusion. Results The long mean half-life (20.1–21.1 h), narrow mean volume of distribution (3.96–4.08 L/m2), and slow mean clearance rate (0.136–0.152 L/h/m2) suggest that aldoxorubicin is stable in circulation and does not accumulate readily in body compartments outside of the bloodstream. Very little doxorubicin and its major metabolite doxorubicinol, which has been implicated in doxorubicin-associated cardiotoxicity, are excreted in urine. This might explain the lack of cardiotoxicity observed thus far with aldoxorubicin. Conclusions Our findings support dosing and administration schemas used in an ongoing phase 3 clinical study of aldoxorubicin in soft tissue sarcoma, and phase 2 clinical studies in small cell lung cancer, glioblastoma, and Kaposi’s sarcoma.
The new randomised controlled trials (RCT) movement in public policy: challenges of epistemic governance
Authors: Pearce Warren , Raman Sujatha
Published: November 2014

Since 2012, a new movement of government departments, think tanks and high-profile individuals within the UK has sought to promote the increased usage of randomised controlled trials (RCTs) in public policy. They promote RCTs as an evidence-based corrective for the inappropriate certainties of experts. Recent government reports and public debate around this initiative are reviewed and analysed within a framework for epistemic governance: normative insights into how knowledge for policymaking should be understood and governed drawn from science and technology studies and the policy sciences. The legitimacy of RCT evidence within policymaking is found to rest on the recognition of three key features: (1) how multiple meanings of evidence limit generalisability, (2) ensuring a plurality of evidence inputs, including those from other forms of research and expertise, and (3) building institutions for governing the use of RCTs in the public interest. Producing evidence for policymaking is a hybrid activity that necessarily spans both science and politics. Presenting RCTs as naively neutral evidence of what policy interventions work is misleading. The paper concludes by calling for more work on how the new RCT movement might engage with its own history in social and policy research on the value of experiments for policymaking.
Intra-articular Analgesia and Discharge to Home Enhance Recovery following Total Knee Replacement
Authors: Duggal Shivi , Flics Susan , Cornell Charles N.
Published: November 2014

Background

The increasing demand for total knee arthroplasty (TKR) and the initiatives to reduce health care spending have put the responsibility for efficient care on hospitals and providers. Multidisciplinary care pathways have been shown to shorten length of stay and result in improved short-term outcomes. However, common problems such as post-op nausea, orthostasis, and quad weakness remain, while reliance on discharge to rehabilitation facilities may also prolong hospital stay.

Questions/Purposes

Our aim was to document that combined modifications of our traditional clinical pathway for unilateral TKR could lead to improved short-term outcomes. We pose the following research questions. Can pathway modifications which include intra-articular infusion and saphenous nerve block (SNB) provide adequate pain relief and eliminate common side effects promoting earlier mobilization? Can planning for discharge to home avoid in-patient rehab stays? Can these combined modifications decrease length of stay even in patients with complex comorbidities indicated by higher ASA class? Will discharge to home incur an increase in complications or a failure to achieve knee range of motion?

Patients and Methods

A retrospective review was performed and identified two cohorts. Group A included 116 patients that underwent unilateral TKR for osteoarthritis between August 2009 and August 2010. Group B included 171 patients that underwent unilateral TKR for osteoarthritis between February 2012 to February 2013. Group A patients were treated with spinal anesthesia with patient-controlled epidural analgesia (PCEA)/femoral nerve block (FNB) for the first 48 h after surgery. Discharge planning was initiated after admission. Group B had spinal anesthesia with SNB and received a continuous intra-articular infusion of 0.2% ropivicaine for 48 h post-op. Discharge planning was initiated with a case manager prior to hospitalization and discharge to home was declared the preferred approach. An intensive home PT program was made available through a program with our local home care agency. Outcomes assessed and compared between groups included length of stay, incidence of post-op nausea, dizziness, in-hospital falls, occurrence of complications including wound infection and the recovery of range of motion at 6 weeks, 3 months, and 1 year post-op.

Results

Pain control was similar between the groups but Group B had fewer side effects. With the new pathway, length of stay (LOS) was reduced from 4.32 to 3.64 days with a similar LOS reduction across all ASA classes. There was no increase in Group B wound or other complications. Return of ROM was similar between groups.

Conclusions

Our findings suggest that replacing PCEA and FNB with intra-articular analgesia with a SNB allows for improved early recovery following TKR. That, combined with pre-op discharge planning and initiation of an intensive home PT program, reduced average length of stay.
Alternatives to Sural Nerve Grafts in the Upper Extremity
Authors: Poppler Louis H. , Davidge Kristen , Lu Johnny C. Y. , Armstrong Jim , Fox Ida K. , Mackinnon Susan E.
Published: November 2014

Background

The sural nerve is the most common nerve graft donor despite requiring a second operative limb and causing numbness of the lateral foot. The purposes of this study were to review our experience using nerve autografts in upper extremity nerve reconstruction and develop recommendations for donor selection.

Methods

A retrospective case series study was performed of all consecutive patients undergoing nerve grafting procedures for upper extremity nerve injuries over an 11-year period (2001–2012).

Results

Eighty-six patients received 109 nerve grafts over the study period. Mean patient age was 42.9±18.3 years; 57 % were male. There were 51 median (59 %), 26 ulnar (30 %), 14 digital (13 %), 13 radial (16 %), and 3 musculocutaneous (4 %) nerve injuries repaired with 99 nerve autografts (71 from upper extremity, 28 from lower extremity). Multiple upper extremity nerve autograft donors were utilized, including the medial antebrachial cutaneous nerve (MABC), third webspace branch of median, lateral antebrachial cutaneous nerve (LABC), palmar cutaneous, and dorsal cutaneous branch of ulnar nerve. By using an upper-extremity donor, a second operative limb was avoided in 58 patients (67 %), and a second incision was avoided in 26 patients (30 %). The frequency of sural graft use declined from 40 % ( n=17/43) to 11 % ( n=7/64).

Conclusions

Our algorithm for selecting nerve graft material has evolved with our growing understanding of nerve internal topography and the drive to minimize additional incisions, maximize ease of harvest, and limit donor morbidity. This has led us away from using the sural nerve when possible and allowed us to avoid a second operative limb in two thirds of the cases.
Characterization of Turkish Olive Oils by Triacylglycerol Structures and Sterol Profiles
Authors: Yorulmaz Aslı , Yavuz Huseyin , Tekin Aziz
Published: November 2014

A characterization study of Turkish monovarietal olive oils using chemical variables such as fatty acid, sn‐2 fatty acid, triacylglycerol, and sterol composition is presented. A total of 101 samples of Olea europaea L. fruits from 18 cultivars were collected for two crop years from west, south, and southeast regions of Turkey. Olives were processed to oil and olive oil samples were evaluated for their triacylglycerol structures and sterol composition. Oleic acid content ranged from 60.15 to 80.46 % of total fatty acids and represented 70.90–89.02 % of sn‐2 position triacylglycerols. Major triglycerides of oil samples were triolein, palmitodiolein, dioleolinolein, palmitooleolinolein, dipalmitoolein, and stearodiolein. Triolein values were between 24.72 and 48.64 % and compatible with the fatty acid composition. Total sterol content varied from 1,145.32 to 2,211.77 mg/kg and Edremit yaglık stood out because of its high sterol content. A one‐way analysis of variance revealed significant differences for variables among cultivars. Principle component analysis enabled the classification of common varieties on the basis of analytical data. Sterol composition achieved more relevant discrimination than fatty acid and triglyceride composition. Classification according to geographical origin was performed by discriminant analysis.
Phenolic Compounds and Antioxidant Capacity of Monovarietal Olive Oils Produced in Argentina
Authors: de Fernandez María de los Angeles , SotoVargas Verónica Carolina , Silva María Fernanda
Published: November 2014

Virgin olive oil has high levels of phenolic compounds that are highly bioavailable; these compounds are receiving considerable attention for their antioxidant activity, closely related to the prevention of non‐communicable chronic diseases. The aim of this work was to characterize the phenolic profile and antioxidant capacity of monovarietal olive oils cvs. Arauco, Arbequina, Farga and Empeltre produced in Argentina. This study focused on the relationship between the single molecules or classes of molecules quantified by SPE‐CZE, the corresponding Folin‐Ciocalteu results, and antioxidant capacity using three different tests. Fifteen compounds were simultaneously determined: tyrosol, vinylphenol, oleuropein, hydroxytyrosol, rutin, catechin, naringenin, cinnamic acid, chlorogenic acid, syringic acid, luteolin, apigenin, vanillin acid, quercetin, and caffeic acid. The phenolic contents of the monovarietal olive oils show significant differences between different varieties (p < 0.05), with positive and significant Pearson's correlation found between Folin–Ciocalteu and CZE. Besides, the correlation between the content of total polyphenols and antioxidant capacity was high for all the antioxidant assays performed. When analyzing the correlation coefficients of the different families of phenolic compounds studied, simple phenols and cinnamic acid derivatives show a higher correlation with antioxidant capacity. Thus, findings obtained in this study demonstrated that Arauco olive oil, autochthonous for Argentina, possesses the highest antioxidant/free‐radical scavenging properties, which are very likely due to the presence of high contents of phenolic compounds.
The Properties of Lauric Acid and Their Significance in Coconut Oil
Authors: Dayrit Fabian M.
Published: November 2014

The primary fatty acid of coconut oil is lauric acid, which is present at approximately 45–53 %. The metabolic and physiological properties of lauric acid account for many of the properties of coconut oil. Coconut oil is rapidly metabolized because it is easily absorbed and lauric acid is easily transported. Detailed studies have shown that the majority of ingested lauric acid is transported directly to the liver where it is directly converted to energy and other metabolites rather than being stored as fat. Such metabolites include ketone bodies, which can be used by extrahepatic tissues, such as the brain and heart, as an immediate form of energy. Studies on the effect of lauric acid on serum cholesterol are contradictory. Among saturated fatty acids, lauric acid has been shown to contribute the least to fat accumulation. Lauric acid and monolaurin have demonstrably significant antimicrobial activity against gram positive bacteria and a number of fungi and viruses. Today there are many commercial products that use lauric acid and monolaurin as antimicrobial agents. Because of the significant differences in the properties of lauric acid relative to longer chain fatty acids, they are typically differentiated as medium‐chain fatty acids covering C6–C12, and long‐chain fatty acids covering C14 and longer.
Is nonoperative treatment of pediatric type I open fractures safe and effective?
Authors: Bazzi Ahmed A. , Brooks Jaysson T. , Jain Amit , Ain Michael C. , Tis John E. , Sponseller Paul D.
Published: November 2014

Purpose

There is limited literature on nonoperative treatment of open type I pediatric fractures. Our purpose was to evaluate the rate of infection in pediatric patients with type I open fractures treated nonoperatively at our institution without admission from the emergency department (ED).

Methods

We performed a retrospective chart review of all patients who sustained a type I open fracture of the forearm or tibia from 2000 through 2013. Forty patients fit the inclusion criteria: <18 years old with type I open fracture treated nonoperatively with irrigation and debridement, followed by closed reduction and casting of the fracture under conscious sedation in the ED. All patients were discharged home. The primary outcome was presence of infection. Secondary outcomes included occurrence of a delayed union, time to union, complications, and residual angulation.

Results

There were no reported or documented infections. There was one case of a retained foreign body (<1 cm) in a mid-diaphyseal forearm fracture, which was removed in clinic at 4 weeks after the patient developed a granuloma with no infectious sequela. There was one case of a delayed union; all patients eventually had complete bony union. There was minimal residual angulation in both upper and lower extremities at last follow-up.

Conclusions

Nonoperative treatment of type I open fractures in pediatric patients can be performed safely with little risk of infection. This preliminary evidence may serve as a foundation for future prospective studies.
Selective ultrasound screening is inadequate to identify patients who present with symptomatic adult acetabular dysplasia
Authors: Sink Ernest L. , Ricciardi Benjamin F. , Torre Katrina Dela , Price Charles T.
Published: November 2014

Purpose

One goal of neonatal screening for developmental dysplasia of the hip (DDH) is the prevention of late surgery. However, the majority of patients with acetabular dysplasia at skeletal maturity are not diagnosed with DDH during infancy. Selective ultrasound screening may identify patients with neonatal hip instability, but may be ineffective for the prevention of dysplasia presenting in adulthood. The purpose of this study is to identify the prevalence of risk factors for DDH that would have warranted selective ultrasound screening in patients with symptomatic acetabular dysplasia after skeletal maturity.

Methods

A prospective hip specialty center registry was used to identify 68 consecutive skeletally mature patients undergoing corrective osteotomy for symptomatic acetabular dysplasia. Risk factors for DDH evaluated in all patients included sex, family history of hip osteoarthritis or DDH, breech, method of delivery, previous hip treatments, and birth order. Radiographs [lateral center edge angle (CEA), anterior CEA, Tönnis grade, and Tönnis angle] were measured preoperatively.

Results

Sixty-seven females and one male were identified. No patients were previously diagnosed with DDH or received treatment for their hips. The majority of patients (85.3 %) did not meet selective ultrasound screening guidelines following a stable neonatal hip exam and, therefore, would not have been screened in a selective screening program. Of the findings outside of screening guidelines, 98.5 % were females, 52.9 % were first born, and 36.8 % had a family history of hip osteoarthritis.

Conclusions

The majority (85.3 %) of patients with symptomatic acetabular dysplasia at skeletal maturity would not have met current recommendations for selective ultrasound screening in the USA had they been born today.
Acrolein-Induced Oxidative Stress and Cell Death Exhibiting Features of Apoptosis in the Yeast Saccharomyces cerevisiae Deficient in SOD1
Authors: Kwolek-Mirek Magdalena , Zadrąg-Tęcza Renata , Bednarska Sabina , Bartosz Grzegorz
Published: November 2014

The yeastSaccharomyces cerevisiaeis a useful eukaryotic model to study the toxicity of acrolein, an important environmental toxin and endogenous product of lipid peroxidation. The study was aimed at elucidation of the cytotoxic effect of acrolein on the yeast deficient in SOD1, Cu, Zn-superoxide dismutase which is hypersensitive to aldehydes. Acrolein generated within the cell from its precursor allyl alcohol caused growth arrest and cell death of the yeast cells. The growth inhibition involved an increase in production of reactive oxygen species and high level of protein carbonylation. DNA condensation and fragmentation, exposition of phosphatidylserine at the cell surface as well as decreased dynamic of actin microfilaments and mitochondria disintegration point to the induction of apoptotic-type cell death besides necrotic cell death.
Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study
Authors: Bats Anne-Sophie , Frati Albane , Froissart Marc , Orliaguet Isabelle , Querleu Denis , Zerdoud Slimane , Leblanc Eric , Gauthier Hélène , Uzan Catherine , Deandreis Désirée , Darai Emile , Kerrou Khaldoun , Marret Henri , Lenain Emilie , Mathevet Patrice , Lecuru Fabrice
Published: November 2014

Objective

To evaluate feasibility, SLN detection rate, and SLN location of lymphoscintigraphy in sentinel lymph node (SLN) biopsy for early cervical cancer.

Methods

Ancillary analysis of data from the multicenter prospective SENTICOL study (January 2005–June 2007) of patients with early cervical cancer (FIGO stage IA with emboli to IB1) was conducted. Preoperative lymphoscintigraphy was performed after intracervical administration of 60 or 120 MBq of 99mTc-labeled radiocolloid on the day before (long protocol) or morning of (short protocol) surgery. SLNs were identified intraoperatively using combined radioactivity/patent blue detection. SLNs were sampled electively and routine bilateral pelvic lymphadenectomy was performed by laparoscopy. A centralized review of lymphoscintigraphies was performed to assess feasibility, detection rates, and anatomic SLN location.

Results

Of 139 patients included in the SENTICOL study, 133 received radiocolloid injection, and 131 (98.5 %) underwent preoperative lymphoscintigraphy, with the long protocol in three-fourths of cases. The lymphoscintigraphic detection rate was 87.8 %, with a median of 2 (1–4) SLNs per patient. By multivariate analysis, factors independently associated with lymphoscintigraphic SLN detection were age [odds ratio (OR) 0.91, 95 % confidence interval (95 % CI) 0.87–0.96; P < 0.001], and protocol (long vs. short; OR 8.23, 95 % CI 1.87–36.25; P = 0.005). Bilateral SLN identification by lymphoscintigraphy occurred in 67 % of cases and was independently influenced by age (OR 0.95, 95 % CI 0.92–0.98, P < 0.001) and protocol (OR 5.42, 95 % CI 2.21–13.27; P < 0.001). Although 60.5 % of preoperative SLNs were in the external iliac territory, unusual drainage patterns included the common iliac (19.6 %), para-aortic (10.8 %), and parametrial (6 %) basins.

Conclusions

Our study demonstrates the feasibility and good detection rate of preoperative lymphoscintigraphy, with better detection in younger patients and with the long protocol. The high proportion of SLN basins in unexpected territories is of interest to guide intraoperative detection. Further studies are needed to better evaluate preoperative detection and to assess the contribution of lymphoscintigraphy to intraoperative detection.
Changes in CEBPB expression in circulating leukocytes following eccentric elbow-flexion exercise
Authors: Blackwell Jamie , Harries Lorna W. , Pilling Luke C. , Ferrucci Luigi , Jones Andrew , Melzer David
Published: November 2014

In mouse models, CCAAT enhancer-binding protein beta (CEBPB) is necessary for M2 macrophage-mediated regeneration after muscle injury. In humans, CEBPB expression in blood was strongly associated with muscle strength. In this study we aimed to test whether CEBPB expression in blood in people is increased 2 days after exercise designed to induce muscle damage and subsequent repair. Sixteen healthy male volunteers undertook elbow flexor exercises designed to induce acute muscle micro-damage. Peripheral blood samples were collected at baseline and days 1, 2, 4 and 7 following exercise. Expression of CEBPB and related genes were analysed by qRT-PCR. Extent of muscle damage was determined by decline in maximal voluntary isometric torque and by plasma creatine kinase activity. Nine subjects had peak (day 4) creatine kinase activity exceeding 10,000 U/l. In this subgroup, CEBPB expression was elevated from baseline to 2 days post exercise (paired-samples t
(1,8) = 3.72, p = 0.006). Related expression and selected cytokine changes after exercise did not reach significance. Muscle-damaging exercise in humans can be followed by induction of CEBPB transcript expression in peripheral blood. Associations between CEBPB expression in blood and muscle strength may be consistent with the CEBPB-dependent muscle repair process.
Effect of cooling rate on the crystallization behavior of perovskite in high titanium-bearing blast furnace slag
Authors: Liu Lu , Hu Mei-long , Bai Chen-guang , Lü Xue-wei , Xu Yu-zhou , Deng Qing-yu
Published: November 2014

The effect of cooling rate on the crystallization of perovskite in high Ti-bearing blast furnace (BF) slag was studied using confocal scanning laser microscopy (CSLM). Results showed that perovskite was the primary phase formed during the cooling of slag. On the slag surface, the growth of perovskite proceeded via the successive production of quasi-particles along straight lines, which further extended in certain directions. The morphology and structure of perovskite was found to vary as a function of cooling rate. At cooling rates of 10 and 30 K/min, the dendritic arms of perovskite crossed obliquely, while they were orthogonal at a cooling rate of 20 K/min and hexagonal at cooling rates of 40 and 50 K/min. These three crystal morphologies thus obtained at different cooling rates respectively corresponded to the orthorhombic, cubic and hexagonal crystal structures of perovskite. The observed change in the structure of perovskite could probably be attributed to the deficiency of O2−, when Ti2O3 was involved in the formation of perovskite.
Impact of Migration on Fertility and Abortion: Evidence From the Household and Welfare Study of Accra
Authors: Rokicki Slawa , Montana Livia , Fink Günther
Published: November 2014

Over the last few decades, total fertility rates, child morbidity, and child mortality rates have declined in most parts of sub-Saharan Africa. Among the most striking trends observed are the rapid rate of urbanization and the often remarkably large gaps in fertility between rural and urban areas. Although a large literature has highlighted the importance of migration and urbanization within countries’ demographic transitions, relatively little is known regarding the impact of migration on migrants’ reproductive health outcomes in general and abortion in particular. In this article, we use detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. We find that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated. Our results suggest that recent migrants have an increased risk of pregnancy but not an increased risk of live birth in the first years post-move compared with those who had never moved. This gap seems to be largely explained by an increased risk of miscarriage or abortion among recent migrants. Increasing access to contraceptives for recent migrants has the potential to reduce the incidence of unwanted pregnancies, lower the prevalence of unsafe abortion, and contribute to improved maternal health outcomes.
Heterogeneity in Expected Longevities
Authors: Pijoan-Mas Josep , Ríos-Rull José-Víctor
Published: November 2014

We develop a new methodology to compute differences in the expected longevity of individuals of a given cohort who are in different socioeconomic groups at a certain age. We address the two main problems associated with the standard use of life expectancy: (1) that people’s socioeconomic characteristics change, and (2) that mortality has decreased over time. Our methodology uncovers substantial heterogeneity in expected longevities, yet much less heterogeneity than what arises from the naive application of life expectancy formulae. We decompose the longevity differences into differences in health at age 50, differences in the evolution of health with age, and differences in mortality conditional on health. Remarkably, education, wealth, and income are health-protecting but have very little impact on two-year mortality rates conditional on health. Married people and nonsmokers, however, benefit directly in their immediate mortality. Finally, we document an increasing time trend of the socioeconomic gradient of longevity in the period 1992–2008, and we predict an increase in the socioeconomic gradient of mortality rates for the coming years.
Prevalence, incidence and clinical impact of cachexia: facts and numbers—update 2014
Authors: von Haehling Stephan , Anker Stefan D.
Published: November 2014

Cachexia is a serious but underrecognised consequence of many chronic diseases. Its prevalence ranges from 5–15 % in end‐stage chronic heart failure to 50–80 % in advanced cancer. Cachexia is also part of the terminal course of many patients with chronic kidney disease, chronic obstructive pulmonary disease (COPD) and rheumatoid arthritis. Mortality rates of patients with cachexia range from 10–15 % per year in COPD through 20–30 % per year in chronic heart failure and chronic kidney disease to 80 % in cancer. The condition is also associated with poor quality of life. In the industrialised world, the overall prevalence of cachexia (due to any disease and not necessarily associated with hospital admission) is growing and it currently affects around 1 % of the patient population, i.e. around 9 million people. It is also a significant health problem in other parts of the globe. Recently there have been advances in our understanding of the multifactorial nature of the condition, and particularly of the role of inflammatory mediators and the imbalance of anabolism and catabolism. Several promising approaches to treatment have failed to live up to the challenge of phase III clinical trials, but the ghrelin receptor agonist anamorelin seems to have fulfilled at least some early promise. Further advances are urgently needed.
The Cost of Being Lost in the Crowd: How Congregational Size and Social Networks Shape Attenders’ Involvement in Community Organizations
Authors: McClure Jennifer M.
Published: November 2014

Past research indicates that levels of social embeddedness in a congregation differ between small and large congregations. Since embeddedness in religious social networks is an important predictor of community involvement, this study contributes to the literature by examining whether the relationship between embeddedness in congregational social networks and involvement in community organizations varies based on congregation size. Using a sample of attenders and their congregations from the 2008/2009 U.S. Congregational Life Survey, a national survey representative of American congregations, this study examines the relationship between social embeddedness in a congregation and involvement in community organizations and the cross-level interaction between congregation size and social embeddedness. Results suggest that the relationship between social embeddedness and involvement in community organizations is positive overall, but stronger in larger congregations. Involvement in community organizations is the most likely for attenders of smaller congregations and attenders who are socially embedded in their congregations, but it is the least likely for attenders of large congregations who are not very embedded in them.
Speciality preferences in Dutch medical students influenced by their anticipation on family responsibilities
Authors: Alers Margret , Pepping Tess , Bor Hans , Verdonk Petra , Hamberg Katarina , Lagro-Janssen Antoine
Published: November 2014

Physician gender is associated with differences in the male-to-female ratio between specialities and with preferred working hours. We explored how graduating students’ sex or full-time or part-time preference influences their speciality choice, taking work-life issues into account. Graduating medical students at Radboud University Medical Centre, the Netherlands participated in a survey (2008–2012) on career considerations. Logistic regression tested the influence of sex or working hour preference on speciality choice and whether work-life issues mediate. Of the responding students (N = 1,050, response rate 83, 73.3 % women), men preferred full-time work, whereas women equally opted for part time. More men chose surgery, more women family medicine. A full-time preference was associated with a preference for surgery, internal medicine and neurology, a part-time preference with psychiatry and family medicine. Both male and female students anticipated that foremost the career of women will be negatively influenced by family life. A full-time preference was associated with an expectation of equality in career opportunities or with a less ambitious partner whose career would affect family life. This increased the likelihood of a choice for surgery and reduced the preference for family medicine among female students. Gender specifically plays an important role in female graduates’ speciality choice making, through considerations on career prospects and family responsibilities.
Facilitating the initiation of the physician’s professional identity: Cornell’s urban semester program
Authors: Goldstein Peter A. , Storey-Johnson Carol , Beck Sam
Published: November 2014

Calling for major reform in medical education, the Carnegie Institute report ‘Educating Physicians’ espoused the importance of assisting student trainees in forming their professional identities. Here, we consider the question: At what educational stage should future physicians begin this process? The literature suggests that the process begins when students matriculate in medical school; we posit, however, that premedical students can begin their proto-professional development as college undergraduates. We describe here the pedagogy of Cornell University’s urban semester program (USP), which enables college students to participate in shadowing experiences as part of an integrated structured study programme. USP students report improved communicative competency, changes in their perceptions and attitudes toward medical practice, and powerful influences on their personal and professional development upon completion of the programme. We suggest the solution to the question of ‘When and under what conditions should shadowing take place?’ is to utilize a structure that combines the exposure of college students to the professional environment with a didactic and self-reflective curriculum, thereby supporting students in their early professional development. We conclude that educational efforts aimed at developing professional identity and behaviour can begin before students enter medical school.
An Organizational Metamodel for Hospital Emergency Departments
Authors: Kaptan Kubilay
Published: November 2014

I introduce an organizational model describing the response of the hospital emergency department. The hybrid simulation/analytical model (called a “metamodel”) can estimate a hospital’s capacity and dynamic response in real time and incorporate the influence of damage to structural and nonstructural components on the organizational ones. The waiting time is the main parameter of response and is used to evaluate the disaster resilience of health care facilities. Waiting time behavior is described by using a double exponential function and its parameters are calibrated based on simulated data. The metamodel covers a large range of hospital configurations and takes into account hospital resources in terms of staff and infrastructures, operational efficiency, and the possible existence of an emergency plan; maximum capacity; and behavior both in saturated and overcapacitated conditions. The sensitivity of the model to different arrival rates, hospital configurations, and capacities and the technical and organizational policies applied during and before a disaster were investigated. This model becomes an important tool in the decision process either for the engineering profession or for policy makers.(Disaster Med Public Health Preparedness. 2014;8:436-444)
Workplace-based prevention and rehabilitation programs in Swedish public human service organisations
Authors: Vinberg Stig
Published: November 2014

Background: This presentation focuses on results from studies concerning workplace health and rehabilitation interventions in one Swedish rural municipality including 19 workplaces with a population of 311 individuals. The municipality has implemented a model for human resource accounting, an extensive leader and co-worker development program and specific workplace based health and rehabilitation measures.

Methods: The studies compare co-workers and leaders self-ratings of health and psychosocial working conditions, and investigate how workplace health and rehabilitation programs affect these ratings by analysing quantitative results before, during and after carried out interventions. Qualitative data collection consisted of semi-structured interviews with middle managers and an examination of documents reviewing content of the interventions that had been carried out.

Findings: Results indicate differences concerning how the leaders and the co-workers judge their health and psychosocial working conditions. When comparing mean changes in scores on indexes by individuals grouped in the high quality workplace-based program group with individuals grouped in the low quality workplace-based program group, there were more positive mean changes for the former group.

Discussion: The findings of differences concerning how public sector leaders and co-workers judge their health and psychosocial working conditions give support for different job characteristics for these two categories of employees. The rather strong relationships in the assumed direction between employees’ assessment of changes in health, and changes concerning stress and psychosocial working conditions that resulted are in line with other research studies. Comparing workplaces grouped as having high quality workplace-based programs with workplaces with low quality workplace-based programs indicates that workplace-based prevention and rehabilitation programs in public human service organizations using a broad change strategy with high levels of participation from both managers and co-workers, and developed leadership behaviour are more effective in improving employee health and psychosocial working conditions.
What lessons can be learned from the perspective of the different actors in DM, especially from companies and social security organisations?
Authors: Geisen Thomas
Published: November 2014

Background: In the context of demographic change and lack of qualified workers the preservation of the internal labour force gains importance for the companies. At the same time private and public income security organisations are increasingly interested in achieving better return to work out-comes in order to reduce their costs. Research shows that a functioning DM leads to more effective return to work in companies.

Objectives: The interaction between the welfare state, the companies and private insurers is quite different in each county and highly depending and formed by the established welfare state scheme. In the presentation we will describe the interplay between the different stakeholders in DM for the situation in Switzerland and derive specific challenges and opportunities that arise from this set-ting. Methods: The presentation is based on findings from two studies (2008 and 20013) on disability management in private companies in Switzerland relying on qualitative and quantitative data. The results of these studies will be enriched with first findings from an ongoing international study that compares DM programmes in Switzerland, Australia, Canada and China (2013–2015).

Findings: The cooperation between social insurances and the companies could be improved in various ways. Most important is the improvement of informal and institutional communication between the company and the social insurances representatives. But there is also a need to more effective and efficient cooperation in improving rehabilitation processes and the processes of work-place integration. In general the studies show not only that organisational development is needed but also the qualification of DMP’s, as key factors in the processes, need to be improved.

Discussion: We will present findings from a study on DM programmes in private companies from 2008, from a study on DM activities in small and medium sized companies 2013 and first results from an on-going international comparative research project mentioned above. What lessons can be learned from the perspective of the different actors in DM, especially from companies and social security organisations?

Conclusion: Companies, private insurers and social security organizations will gain new insights into challenges and opportunities of DM. The findings will help to enhance collaboration between these different stakeholders and might provide important insight to improve and enhance existing DM programmes.
The study of best practice for developing social enterprise for people with disabilities
Authors: Keeratiphantawong Sakulthip
Published: November 2014

The study of social enterprise development model for people with disability aimed to establish a fundamental knowledge to apply the concept of social entrepreneurship to enhance the quality of life for the disabled as well as to provide them with the capacity building. Equally importantly was the development of social enterprise sector particularly for those with impairment in Thailand based on the local context and pattern appropriate together with research in order sustain the model for the benefit of people with disability in the country. This research investigated case studies of social enterprises for those with disability from various businesses including group of disabled agriculturalists who operated a Goat Farm in Rayong Province, The Center for Intellectually Disabled Innovation as well as Betimes Solution Co.,Ltd. The study implemented literature review, in-depth interview, questionnaire as well as observation. Summary of the study is presented below. 1. Models of social enterprise based on case studies were different. This could be classified by using the three major components including organizational mobilization, stakeholder engagement and profit management. The study revealed that group of disabled agriculturalists who operated a Goat Farm in Rayong Province could be categorized as a philanthropic model while Betimes Solution Co.,Ltd could be regarded as a commercial pattern. Center for Intellectually Disabled Innovation, on the other hand, comprised of a hybrid model. All of these signified the fact that social enterprise development model could be various. 2. Key social enterprise factors for the business engaged with disabled people based on the case studies could be ranked with three major components including competitive advantage to compete with other businesses and sustain themselves, social entrepreneurship to be able to achieve both financial and social mission effectively with skills, knowledge and confidence and lastly stakeholder engagement to manage the relationships with key partners and become accepted by all parties concerned.
Developing the Social Security Organisation (SOCSO) of Malaysia's RTW case management system
Authors: Cheong Edmund Peck Huang
Published: November 2014

The Social Security Organisation (SOCSO) of Malaysia introduced the Return to Work (RTW) Program in 2007 which is a comprehensive multidisciplinary biopsychosocial rehabilitation program for its Insured Persons who are experiencing disability due to accidents in the workplace or those claiming for invalidity. This rehabilitation program is unique as it involves the concept of “disability management” in which each Insured Person who is referred to the program, is assigned to a Disability Case Manager who is actively involved throughout the return to work process. Up to date (December 2013), 11,090 workers were motivated to participate in the SOCSO RTW Programme, and this requires many work processes, countless paper-work and massive physical files and document management. Due to this massive information flow, the demand for a more efficient information system is needed. From the beginning, the whole idea was to create an accessible, quick and user-friendly application. The application is now used by the SOCSO RTW Department in managing their information. This application was built on an open source platform which can be access through the internet. It is also a “learning application” where it uses its historical data to assist the case managers to generate standard rehabilitation plans and forecast possible return to work outcomes. The beauty of such application is that it is easily replicated, configurable (email notifications, reminders, etc) to meet the needs of the case managers in various jurisdiction. The scope of the application can also be easily defined to meet the size of an enterprise using the application. With better management of information, this application has contributed in reducing processing time, repetitive paperwork, minimal storage areas and almost real-time flow of information in the SOCSO's RTW Case Management system. Apart from that, the application now stores a wealth of information such as rehabilitation strategies for various disability or illnesses or demographic backgrounds.