bluuebunny/crossref_metadata_2025 huggingface dataset:
Key Points of the Japanese Society of Hypertension Guidelines for the Management of Hypertension in 2014
Authors: Kario Kazuomi
Published: April 2015

The Japanese Society of Hypertension (JSH) published the new JSH guidelines for the management of hypertension in 2014, which is the revision of the JSH guidelines of 2009. The primary objective of the guideline is to provide physicians the standard treatment strategy of hypertension to prevent the hypertension-related target organ damage and cardiovascular events. The management of hypertension should be performed in hypertensive patients with a blood pressure of ≥140/90 mm Hg. As Asians have a higher prevalence of stroke than of coronary artery disease and stroke is more steeply associated with the level of blood pressure, the target blood pressure should be lower than 130/80 mm Hg for high-risk patients such as those with diabetes or chronic kidney disease. Because of the increasing prevalence of obesity and the related metabolic syndrome, more salt intake and higher salt sensitivity in the population, lifestyle modifications are necessary in hypertensive patients and subjects with high normal blood pressure. This guideline provides evidence-based recommendations for the management of patients with hypertension with the characteristics of our society.
Urine Osmolarity Predicts the Body Weight-Reduction Response to Tolvaptan in Chronic Kidney Disease Patients: A Retrospective, Observational Study
Authors: Iwatani Hirotsugu , Kawabata Hiroaki , Sakaguchi Yusuke , Yamamoto Ryohei , Hamano Takayuki , Rakugi Hiromi , Isaka Yoshitaka
Published: April 2015

Background/Aims: Tolvaptan, a vasopressin V2 receptor antagonist, promotes the excretion of electrolyte-free water. Patients with heart failure or liver cirrhosis, whose urine osmolarity is high due to increased vasopressin, show a good response to tolvaptan; however, it remains dubious whether tolvaptan is also effective in patients with low urine osmolarity due to decreased renal function. The aim of this study was to investigate whether urine osmolarity predicts the effect of tolvaptan in patients with decreased renal function. Methods: In this retrospective, observational study, 17 overhydrated chronic kidney disease patients with heart failure or liver cirrhosis who were admitted to Osaka University Hospital were included. They were treated with sodium-excreting diuretics first, and then tolvaptan was added. The clinically relevant parameters were evaluated before and after the use of tolvaptan, and they, including urine osmolarity before use of tolvaptan, were compared between the responder group and the non-responder group. The definition of responder was based on the decrease of body weight by ≥5% in one week, which is a more rigorous indicator of the effectiveness of tolvaptan than the increase in urine output. Results: The parameter that showed a significant difference between the responder and non-responder groups was urine osmolarity before the use of tolvaptan. The cut-off point derived from the receiver operating characteristic (ROC) curve analysis was 279 mOsm/kg H2O, with sensitivity of 0.86 and specificity of 0.80. Conclusions: In patients with decreased renal function, urine osmolarity before the use of tolvaptan predicted the effectiveness of diuretics in terms of body weight reduction.
Urine and Plasma Osmolality in Patients with Autosomal Dominant Polycystic Kidney Disease: Reliable Indicators of Vasopressin Activity and Disease Prognosis?
Authors: Casteleijn Niek F. , Zittema Debbie , Bakker Stephan J.L. , Boertien Wendy E. , Gaillard Carlo A. , Meijer Esther , Spithoven Edwin M. , Struck Joachim , Gansevoort Ron T.
Published: April 2015

Background: Vasopressin plays an essential role in osmoregulation, but has deleterious effects in patients with ADPKD. Increased water intake to suppress vasopressin activity has been suggested as a potential renoprotective strategy. This study investigated whether urine and plasma osmolality can be used as reflection of vasopressin activity in ADPKD patients. Methods: We measured urine and plasma osmolality, plasma copeptin concentration, total kidney volume (TKV, by MRI) and GFR (125I-iothalamate). In addition, change in estimated GFR (eGFR) during follow-up was assessed. Results: Ninety-four patients with ADPKD were included (56 males, age 40 ± 10, mGFR 77 ± 32 ml/min/1.73 m2, TKV 1.55 (0.99-2.40) l. Urine osmolality, plasma osmolality and copeptin concentration were 420 ± 195, 289 ± 7 mOsmol/l and 7.3 (3.2-14.6) pmol/l, respectively. Plasma osmolality was associated with copeptin concentration (R = 0.54, p < 0.001), whereas urine osmolality was not (p = 0.4). In addition, urine osmolality was not associated with TKV (p = 0.3), in contrast to plasma osmolality (R = 0.52, p < 0.001) and copeptin concentration (R = 0.61, p < 0.001). Fifty-five patients were followed for 2.8 ± 0.8 years. Baseline plasma and urine osmolality were not associated with change in eGFR (p = 0.6 and p = 0.3, respectively), whereas baseline copeptin concentration did show an association with change in eGFR, in a crude analysis (St. β = -0.41, p = 0.003) and also after adjustment for age, sex and TKV (St. β = -0.23, p = 0.05). Conclusions: These data suggest that neither urine nor plasma osmolality are valid measures to identify ADPKD patients that may benefit from increasing water intake. Copeptin appears a better alternative for this purpose.
Hypothalamic-Pituitary Axis in Non-Functioning Pituitary Adenomas: Focus on the Prevalence of Isolated Central Hypoadrenalism
Authors: Carosi Giulia , Malchiodi Elena , Ferrante Emanuele , Sala Elisa , Verrua Elisa , Profka Eriselda , Giavoli Claudia , Filopanti Marcello , Beck-Peccoz Paolo , Spada Anna , Mantovani Giovanna
Published: April 2015

Introduction: Non-functioning pituitary adenomas (NFPA) account for about 40% of pituitary tumors. Pituitary deficiencies are present at diagnosis in 60-80% of NFPA, and, classically, growth hormone (GH) secretion is lost first, while adrenocorticotropic hormone is expected to disappear last. The aim of this study was to evaluate the incidence of multiple or isolated pituitary deficiencies in a large series of NFPA. Materials and Methods: We retrospectively analyzed data on 218 NFPA cases (59% females, 59% with macroadenomas, average age: 50.2 ± 17 years) followed up at our center from 1990 to 2013. At diagnosis all patients had a complete evaluation of pituitary function in basal conditions and provocative tests for the hypothalamic-pituitary-adrenal axis, while tests for GH deficiency (GHD) were carried out in 38%. Results: 52.3% of patients (65.6% of macroadenomas, 33.3% of microadenomas) presented at least 1 pituitary deficiency: isolated deficiency in 29.8%, multiple deficiencies in 30% and panhypopituitarism in 9%. Isolated deficiencies were hypogonadism in 11.5% of patients (8% in micro-, 14% in macroadenomas), hypoadrenalism in 10.1% (14% in micro-, 7% in macroadenomas) and GHD in 8.3% (8.9% in micro-, 7.8% in macroadenomas). About 30% of microadenomas had at least 1 pituitary deficiency at diagnosis, independently of tumor localization within the sellar region. Conclusions: The presence of isolated hypoadrenalism suggests that the order of appearance of hypopituitarism does not always follow the one expected. Given the relatively high prevalence of isolated hypoadrenalism even in microadenomas, we suggest a full assessment of basal and dynamic pituitary function in all NFPA regardless of tumor size.
Glucose and Fat Metabolism in Acromegaly: From Mice Models to Patient Care
Authors: Dal Jakob , List Edward O. , Jørgensen Jens Otto L. , Berryman Darlene E.
Published: April 2015

Patients with active acromegaly are frequently insulin resistant, glucose intolerant, and at risk for developing overt type 2 diabetes. At the same time, these patients have a relatively lean phenotype associated with mobilization and oxidation of free fatty acids. These features are reversed by curative surgical removal of the growth hormone (GH)-producing adenoma. Mouse models of acromegaly share many of these characteristics, including a lean phenotype and proneness to type 2 diabetes. There are, however, also species differences with respect to oxidation rates of glucose and fat as well as the specific mechanisms underlying GH-induced insulin resistance. The impact of acromegaly treatment on insulin sensitivity and glucose tolerance depends on the treatment modality (e.g. somatostatin analogs also suppress insulin secretion, whereas the GH antagonist restores insulin sensitivity). The interplay between animal research and clinical studies has proven useful in the field of acromegaly and should be continued in order to understand the metabolic actions of GH.
Habitação social no Brasil em perspectiva crítica: políticas públicas, criação arquitetônica e formas de vida urbana
Authors: Marins Paulo César Garcez
Published: April 2015

OS PIONEIROS DA HABITAÇÃO SOCIAL, DE NABIL BONDUKI E ANA PAULA KOURY (ORGS.), SÃO PAULO, ED. UNESP/EDIÇÕES SESC, 2014, VOL. 1 – 400 P.; VOL. 2 – 512 P.; VOL. 3 – 296 P.
A copa do mundo e as cidade: “juntos num só ritmo”, #sóquenão
Authors: Silva Regina Helena Alves da , Ziviani Paula
Published: April 2015

A dinâmica global/local dos megaeventos foi atravessada pela dinâmica das mobilizações que andaram tomando alguns países nos últimos anos. Neste texto pretendemos discutir o atravessamento de várias temporalidades, que possibilitou a tensão nas cidades brasileiras no ano entre a Copa das Confederações e a Copa do Mundo da Fifa. Os problemas urbanos do Brasil são contrapostos às ações ordenadas pelas urgências dos megaeventos, que tentam instalar uma dinâmica da aceleração do tempo para o crescimento e desenvolvimento econômico de um país. Contudo, o que se verifica é que nem sempre essa idealização é confirmada. Ao contrário, movimentos de ocupação do espaço urbano procuram resistir às imagens de cidade impostas pelos megaeventos.
Role of Alternative Interventional Procedures When Endo- and Epicardial Catheter Ablation Attempts for Ventricular Arrhythmias Fail
Authors: Kumar Saurabh , Barbhaiya Chirag R. , Sobieszczyk Piotr , Eisenhauer Andrew C. , Couper Gregory S. , Nagashima Koichi , Mahida Saagar , Baldinger Samuel H. , Choi Eue-Keun , Epstein Laurence M. , Koplan Bruce A. , John Roy M. , Michaud Gregory F. , Stevenson William G. , Tedrow Usha B.
Published: April 2015

Background—

Ventricular tachycardia (VT) refractory to antiarrhythmic drugs and standard percutaneous catheter ablation techniques portends a poor prognosis. We characterized the reasons for ablation failure and describe alternative interventional procedures in this high-risk group.

Methods and Results—

Sixty-seven patients with VT refractory to 4±2 antiarrhythmic drugs and 2±1 previous endocardial/epicardial catheter ablation attempts underwent transcoronary ethanol ablation, surgical epicardial window (Epi-window), or surgical cryoablation (OR-Cryo; age, 62±11 years; VT storm in 52%). Failure of endo/epicardial ablation attempts was because of VT of intramural origin (35 patients), nonendocardial origin with prohibitive epicardial access because of pericardial adhesions (16), and anatomic barriers to ablation (8). In 8 patients, VT was of nonendocardial origin with a coexisting condition also requiring cardiac surgery. Transcoronary ethanol ablation alone was attempted in 37 patients, OR-Cryo alone in 21 patients, and a combination of transcoronary ethanol ablation and OR-Cryo (5 patients), or transcoronary ethanol ablation and Epi-window (4 patients), in the remainder. Overall, alternative interventional procedures abolished ≥1 inducible VT and terminated storm in 69% and 74% of patients, respectively, although 25% of patients had at least 1 complication. By 6 months post procedures, there was a significant reduction in defibrillator shocks (from a median of 8 per month to 1;
P
<0.001) and antiarrhythmic drug requirement although 55% of patients had at least 1 VT recurrence, and mortality was 17%.

Conclusions—

A collaborative strategy of alternative interventional procedures offers the possibility of achieving arrhythmia control in high-risk patients with VT that is otherwise uncontrollable with antiarrhythmic drugs and standard percutaneous catheter ablation techniques.
Temperature Variation over East Asia during the Lifecycle of Weak Stratospheric Polar Vortex
Authors: Woo Sung-Ho , Kim Baek-Min , Kug Jong-Seong
Published: April 2015

The authors investigate the circulation change during the life cycle of a weak stratospheric polar vortex (WSV) event and its impact on temperature variation over East Asia. The lower-tropospheric temperature over East Asia strongly fluctuates despite the slow decay of stratospheric circulation and the continuously negative Arctic Oscillation (AO) pattern during the WSV event. The temperature fluctuation is critically influenced by the variation of the East Asian upper-level coastal trough (EAT), which may be coupled to the stratospheric circulation during the WSV events. The EAT is deepened anomalously during the Peak phase (from lag −5 to lag 5 day) of the WSV, and East Asian temperature is lowest during this phase. During the next period (Decay-1 phase: from lag 6 to lag 16 day), in spite of the slowly decaying WSV condition, the cold temperature anomaly over East Asia is suddenly weakened; this change is caused by a westward-propagating signal of an anticyclonic anomaly from the North Pacific to East Asia. After about two weeks (Decay-2 phase: from lag 17 to lag 27 day), the cold conditions over East Asia are restrengthened by an intensification of EAT, which is related to the eastward propagation of a large-scale wave packet originating from a negative North Atlantic Oscillation (NAO)-type structure in the Decay-1 phase and its delayed influence on the East Asia region.
Musica e poesia
Authors: Fossati Ivano
Published: April 2015

Da quando il genere musicale conosciuto come “canzone d'autore” si è affermato come dominante in Italia, sono numerosissime le occasioni in cui gli autori di canzoni sono invitati a discutere del rapporto tra musica e poesia. Quello che manca è però una consapevolezza della musicalità della poesia. In realtà la poesia e la canzone sono “professioni” diverse, ma niente impedisce che il poeta e l'autore di canzoni possano percorrere un tratto di strada assieme, superare le reciproche diffidenze, scambiarsi idee e anche trucchi del mestiere.
Virtual reality applied to the study of the integration of transformers in substations of power systems
Authors: Barata Pebertli Nils Alho , Filho Manoel Ribeiro , Alves Nunes Marcus V
Published: April 2015

The study of electrical equipment in disciplines in the field of electric power systems can be frustrating and demotivating due to the lack of a clear vision of the function and operation of such equipment in a real situation. The use of virtual reality provides a more concrete representation for the students, who often do not have the opportunity to visit a substation or power plant for the generation of electric power to get to know the equipment and its mode of operation integrated into the system. This paper aims to improve the study of such equipment in the classroom and to motivate the students by providing a clear view of the equipment and its practical functions. A software for virtual reality was developed with an authoring module whereby it is possible to create virtual operating procedures and maintenance in an electric power substation, and an execution module, in which one can eventually perform the operating and maintenance procedures in a virtual environment. The students interact with the software by visualizing a transformer installed in a substation and performing operation and maintenance procedures in a virtual environment. Also, an evaluation of the influence of software on the general motivation and student performance was performed through questionnaires and reports.
Governing the smart city: a review of the literature on smart urban governance
Authors: Meijer Albert , Bolívar Manuel Pedro Rodríguez
Published: April 2015

Academic attention to smart cities and their governance is growing rapidly, but the fragmentation in approaches makes for a confusing debate. This article brings some structure to the debate by analyzing a corpus of 51 publications and mapping their variation. The analysis shows that publications differ in their emphasis on (1) smart technology, smart people or smart collaboration as the defining features of smart cities, (2) a transformative or incremental perspective on changes in urban governance, (3) better outcomes or a more open process as the legitimacy claim for smart city governance. We argue for a comprehensive perspective: smart city governance is about crafting new forms of human collaboration through the use of ICTs to obtain better outcomes and more open governance processes. Research into smart city governance could benefit from previous studies into success and failure factors for e-government and build upon sophisticated theories of socio-technical change. This article highlights that smart city governance is not a technological issue: we should study smart city governance as a complex process of institutional change and acknowledge the political nature of appealing visions of socio-technical governance.

Points for practitioners

The study provides practitioners with an in-depth understanding of current debates about smart city governance. The article highlights that governing a smart city is about crafting new forms of human collaboration through the use of information and communication technologies. City managers should realize that technology by itself will not make a city smarter: building a smart city requires a political understanding of technology, a process approach to manage the emerging smart city and a focus on both economic gains and other public values.
Cumulative Inequality in Child Health and Academic Achievement
Authors: Jackson Margot I.
Published: April 2015

Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered, the duration and stability of poor health, and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N = 9,252) to ask: (1) if child health is a source of cumulative inequality in academic achievement, (2) whether this relationship depends on the timing and duration of poor health, and (3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists and that whether we observe shrinking or widening inequality as children age depends on when we measure their health and whether children have access to compensatory resources.
Processing of Phonemic Consonant Length: Semantic and Fragment Priming Evidence from Bengali
Authors: Kotzor Sandra , Wetterlin Allison , Roberts Adam C. , Lahiri Aditi
Published: April 2015

Six cross-modal lexical decision tasks with priming probed listeners’ processing of the geminate–singleton contrast in Bengali, where duration alone leads to phonemic contrast ([pata] ‘leaf’ vs. [pat:a] ‘whereabouts’), in order to investigate the phonological representation of consonantal duration in the lexicon. Four form-priming experiments (auditory fragment primes and visual targets) were designed to investigate listeners’ sensitivity to segments of conflicting duration. Each prime derived from a real word ([kʰɔm]/[gʰenː]) was matched with a mispronunciation of the opposite duration (*[kʰɔmː]/*[gʰen]) and both were used to prime the full words [kʰɔma] (‘forgiveness’) and [gʰenːa] (‘disgust’) respectively. Although all fragments led to priming, the results showed an asymmetric pattern. The fragments of words with singletons mispronounced as geminates led to equal priming, while those with geminates mispronounced as singletons showed a difference. The priming effect of the real-word geminate fragment was significantly greater than that of its corresponding nonword singleton fragment. In two subsequent semantic priming tasks with full-word primes a stronger asymmetry was found: nonword geminates (*[kʰɔmːa]) primed semantically related words ([marjona] ‘forgiveness’) but singleton nonword primes (*[gʰena]) did not show priming. This overall asymmetry in the tolerance of geminate nonwords in place of singleton words is attributed to a representational mismatch and points towards a moraic representation of duration. While geminates require a mora which cannot be derived from singleton input, the additional information in geminate nonwords does not create a similar mismatch.
Information and Communication Technologies, Innovation, and Firm Productivity in Small and Medium-Sized Travel Agencies
Authors: Díaz-Chao Ángel , Miralbell-Izard Oriol , Torrent-Sellens Joan
Published: April 2015

This article analyzes new co-innovative sources of firm labor productivity. Using survey data for 120 small and medium-sized travel agencies based in Catalonia (a region in the northeast of Spain) and partial least square–structural equation modeling (PLS-SEM) estimation techniques, three main findings emerged from the study. First, labor productivity is directly explained by those agencies’ capacity to exploit their assets, to use local networks, and to make international transactions. Second, the analysis of indirect effects on labor productivity suggests a circular causality, which is determined by the influence of the workers’ local network use on a firm’s export capacity. In this circular relationship, a firm’s capacity to generate market-leading product innovations and the stock of human capital and training play a decisive role. Third, co-innovation practices exert a negative effect, which may be related to difficulties in terms of securing productivity improvements in the short term.
Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy
Authors: Rapinesi Chiara , Kotzalidis Georgios D , Casale Antonio Del , Ferri Vittoria Rachele , Di Pietro Simone , Scatena Paola , Serata Daniele , Danese Emanuela , Sani Gabriele , Koukopoulos Alexia E , Angeletti Gloria , Girardi Paolo
Published: April 2015

Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36-year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful. We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer–antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman.
Securities Regulation: Opportunities Exist for IIROC to Regulate Responsively
Authors: Lokanan Mark E.
Published: April 2015

This article examines the applicability of responsive regulation within an inter-agency framework in the financial sector. To do so, the article uses the self-regulatory organization that is responsible for governing Canada’s investment dealers and brokerage firms—the Investment Industry Regulatory Organization of Canada (IIROC)—as a prototype example to illustrate how responsive regulation may be encouraged within an inter-agency framework. While the theory aspires to general applicability, particular consideration is given to its ability to govern multiple agencies. In particular, the article pays attention to jurisdictional boundaries to ensure that inter-agency relationships have some legitimacy in market regulation.
Coherence-Weighted Synthetic Focusing Applied to Photoacoustic Imaging Using a High-Frequency Annular-Array Transducer
Authors: Chitnis Parag V. , Aristizábal Orlando , Filoux Erwan , Sampathkumar Ashwin , Mamou Jonathan , Ketterling Jeffrey A.
Published: April 2015

This paper presents an adaptive synthetic-focusing scheme that, when applied to photoacoustic (PA) data acquired using an annular array, improves focusing across a greater imaging depth and enhances spatial resolution. The imaging system was based on a 40-MHz, 5-element, annular-array transducer with a focal length of 12 mm and an 800-µm diameter hole through its central element to facilitate coaxial delivery of 532-nm laser. The transducer was raster-scanned to facilitate 3D acquisition of co-registered ultrasound and PA image data. Three synthetic-focusing schemes were compared for obtaining PA A-lines for each scan location: delay-and-sum (DAS), DAS weighted with a coherence factor (DAS + CF), and DAS weighted with a sign-coherence factor (DAS + SCF). Bench-top experiments that used an 80-µm hair were performed to assess the enhancement provided by the two coherence-based schemes. Both coherence-based schemes increased the signal-to-noise ratio by approximately 10 dB. When processed using the DAS-only scheme, the lateral dimension of the hair in a PA image with 20 dB dynamic range was between 300 µm and 1 mm for imaging depth ranging from 8 to 20 mm. In comparison, the DAS + CF scheme resulted in a lateral dimension of 200 to 450 µm over the same range. The DAS + SCF synthetic focusing further improved the smallest-resolvable dimension, which was between 150 and 400 µm over the same range of imaging depth. When used on PA data obtained from a 12-day-old mouse embryo, the DAS + SCF processing improved visualization of neurovasculature.
A Late Woodland red ocher burial cache from Madison County, Ohio
Authors: Nolan Kevin C , Sciulli Paul , Blatt Samantha , Thompson Christine K
Published: April 2015

An isolated human burial was discovered on a private property in Madison County, Ohio in the spring of 2009. The remains were recovered by the Ohio Bureau of Criminal Investigations and sent to The Ohio State University for analysis. We report the results of a generic descriptive analysis of the assemblage and remains. The individual was a robust young adult male, and the assemblage seemed typical of a terminal Archaic or Early Woodland period (1500–500 B.C.) deposit; however, a 14C AMS analysis run on collagen from a rib of the burial yielded an estimated age of 1520–1370 BP (A.D. 430–580). The dating result indicates that there is much potential variability in the archaeology of central Ohio that is not well accounted for by current classification systems.
Mapping from the Parkinson’s Disease Questionnaire PDQ-39 to the Generic EuroQol EQ-5D-3L
Authors: Kent Seamus , Gray Alastair , Schlackow Iryna , Jenkinson Crispin , McIntosh Emma
Published: April 2015

Objective. To compare a range of statistical models to enable the estimation of EQ-5D-3L utilities from responses to the Parkinson’s Disease Questionnaire 39 (PDQ-39). Methods. Linear regression, beta regression, mixtures of linear regressions and beta regressions, and multinomial logistic regression were compared in terms of their ability to accurately predict EQ-5D-3L utilities from responses to the PDQ-39 using mean error (ME), mean absolute error (MAE), and mean square error (MSE), overall and by Hoehn and Yahr stage. Models were estimated using data from the PD MED trial ( n = 9123) and assessed on both the estimation data as well as external data from the PD SURG trial ( n = 917). Results. Overall, the differences in the metrics of fit between models were small in both data sets, with performance poorer for all models in PD SURG. The performance across Hoehn and Yahr stages 1 to 3 were also similar, but multinomial logistic regression was found to exhibit less bias and better individual-level predictive accuracy in PD MED for those in Hoehn and Yahr stages 4 or 5. Overall, the multinomial logistic regression reported an ME of 0.038 out of sample and MAEs of 0.128 and 0.164 and MSEs of 0.030 and 0.044 in the estimation and external data sets, respectively. Poorer levels of the mobility domain score of the PDQ-39 were associated with increased odds of reporting problems for all EQ-5D domains except anxiety/depression. Conclusions. Finite mixture models with only few components can approximate the distribution of EQ-5D-3L utilities well but did not demonstrate improvements in predictive accuracy compared with multinomial logistic regression in the present data set.
Randomized controlled trial of the CGRP receptor antagonist telcagepant for prevention of headache in women with perimenstrual migraine
Authors: Ho Tony W , Ho Andrew P , Ge Yang (Joy) , Assaid Christopher , Gottwald Regina , MacGregor E Anne , Mannix Lisa K , van Oosterhout Willebrordus PJ , Koppenhaver Janelle , Lines Christopher , Ferrari Michel D , Michelson David
Published: April 2015

Aim

The aim of this article is to evaluate the safety and efficacy of perimenstrual telcagepant, a CGRP receptor antagonist, for headache prophylaxis.

Methods

We conducted a randomized, double-blind, placebo-controlled, six-month trial in women with migraine for ≥3 months who experienced perimenstrual headaches. Women were randomized to telcagepant 140 mg or placebo (2:1 ratio) for seven consecutive days perimenstrually. Safety was assessed by adverse events and laboratory tests. The primary efficacy endpoint was mean monthly headache days in the subset of women reporting perimenstrual migraine (−2 days to +3 days of menses onset) and ≥5 moderate or severe migraines per month prior to entering the trial.

Results

Telcagepant was generally well tolerated: 66/2660 (2.5%) on telcagepant and 36/1326 (2.7%) on placebo discontinued because of a clinical adverse event. The percentages of patients with clinical adverse events, laboratory adverse events, or discontinuation because of a laboratory adverse event were also similar between treatments. Alanine aminotransferase elevations ≥3× normal occurred in 0.6% of women on telcagepant and 0.4% on placebo. Three women on telcagepant vs none on placebo had alanine aminotransferase elevations ≥8× normal. In the efficacy subset there was no significant effect of telcagepant ( n = 887) vs placebo ( n = 447) in mean monthly headache days (treatment difference −0.5 day (95% CI: −1.1, 0.1)). However, telcagepant was associated with a reduction in on-drug headache days (treatment difference −0.4 day (95% CI: –0.5, –0.2), nominal p < 0.001).

Conclusions

Telcagepant 140 mg taken perimenstrually for seven days was generally well tolerated, but was associated with transaminase elevations . Telcagepant did not reduce monthly headache frequency, but did reduce perimenstrual headaches.
Effect of Leukocyte Concentration on the Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis
Authors: Riboh Jonathan C. , Saltzman Bryan M. , Yanke Adam B. , Fortier Lisa , Cole Brian J.
Published: April 2015

Background:

Leukocyte-poor platelet-rich plasma (LP-PRP) is hypothesized to be more suitable for intra-articular injection than leukocyte-rich PRP (LR-PRP) in the treatment of knee osteoarthritis.

Purpose:

To compare clinical outcomes and rates of adverse reactions between LP-PRP and LR-PRP for this application.

Study Design:

Meta-analysis.

Methods:

The MEDLINE, EMBASE, and Cochrane databases were reviewed. The primary outcome was the incidence of local adverse reactions. Secondary outcomes were the changes in International Knee Documentation Committee (IKDC) subjective score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score between baseline and final follow-up measurements. A Bayesian network meta-analysis was performed, with a post hoc meta-regression to correct for baseline differences in WOMAC scores. Treatment rankings were based on surface under the cumulative ranking (SUCRA) probabilities.

Results:

Included in the analysis were 6 randomized controlled trials (evidence level 1) and 3 prospective comparative studies (evidence level 2) with a total of 1055 patients. Injection of LP-PRP resulted in significantly better WOMAC scores than did injection of hyaluronic acid (mean difference, −21.14; 95% CI, −39.63 to −2.65) or placebo (mean difference, −17.84; 95% CI, −34.95 to −0.73). No such difference was observed with LR-PRP (mean difference, −14.28; 95% CI, −44.80 to 16.25). All treatment groups resulted in equivalent IKDC subjective scores. The SUCRA analysis showed that LP-PRP was the highest ranked treatment for both measures of clinical efficacy (WOMAC and IKDC). Finally, PRP injections resulted in a higher incidence of adverse reactions than hyaluronic acid (odds ratio, 5.63; 95% CI, 1.38-22.90), but there was no difference between LR-PRP and LP-PRP (odds ratio, 0.78; 95% CI, 0.05-11.93). These reactions were nearly always local swelling and pain, with a single study reporting medical side effects including syncope, dizziness, headache, gastritis, and tachycardia (17/1055 total patients).

Conclusion:

LP-PRP results in improved functional outcome scores compared with hyaluronic acid and placebo when used for treatment of knee osteoarthritis. LP-PRP and LR-PRP have similar safety profiles, although both induce more transient reactions than does hyaluronic acid. Adverse reactions to PRP may not be directly related to leukocyte concentration.
Prevalence of Ulnar Collateral Ligament Surgery in Professional Baseball Players
Authors: Conte Stan A. , Fleisig Glenn S. , Dines Joshua S. , Wilk Kevin E. , Aune Kyle T. , Patterson-Flynn Nancy , ElAttrache Neal
Published: April 2015

Background:

While the high rate of ulnar collateral ligament (UCL) injuries in professional baseball is widely discussed in the media and medical literature, the actual prevalence of UCL reconstruction has not been documented.

Hypothesis:

The prevalence of UCL reconstruction will be higher among pitchers than nonpitchers, and Major League Baseball (MLB) pitchers will have a higher prevalence than will minor league pitchers.

Study Design:

Descriptive epidemiology study.

Methods:

An online questionnaire was distributed to all 30 MLB organizations. Certified athletic trainers from each team administered the questionnaire to all players in the organization, including major league players and 6 levels of minor league players. Demographic data were compared between major and minor league players. Continuous variables (age, years of professional baseball, country of origin, etc) were compared with Student t tests ( P < .05). Categorical variables (level, position, etc) were compared using chi-square analysis ( P < .05).

Results:

A total of 5088 professional baseball players (722 major league and 4366 minor league) participated in the survey. Pitchers represented 53% of all players, and 497 players reported at least 1 UCL reconstruction, demonstrating a prevalence rate of 10% (497 of 5088). Pitchers reported a significantly higher prevalence of UCL reconstruction (16%; 437 of 2706) than nonpitchers (3%; 60 of 2382; P < .001). Among major league pitchers, 25% (96 of 382) had a history of UCL reconstruction, while minor league pitchers showed a 15% (341 of 2324) prevalence ( P < .001). Major league pitchers were also significantly older (28.8 ± 3.9 years) than minor league pitchers (22.8 ± 3.0; P < .001). The majority of major leaguers (86%) had their UCL reconstruction as professional pitchers, whereas the majority of minor league pitchers (61%) underwent their UCL reconstruction during high school and college ( P < .001). The rates of UCL revision, prior elbow surgery, prior shoulder surgery, and types of UCL graft were similar between the major league and minor league pitchers. No difference in prevalence was shown between pitchers born in the United States versus Latin American countries.

Conclusion:

Pitchers have a high prevalence of UCL reconstruction in professional baseball, with 25% of major league pitchers and 15% of minor league pitchers having a history of the surgery.
Simulation research on hydraulic hybrid assistant beam pumping unit
Authors: Liang Yijie , Wang Tongjian , Wang Xin , Liang Weiquan , Liu Xinhui
Published: April 2015

Conventional beam pumping units have occupied an important position in oilfield equipment due to such characteristics as simple structure, high reliability, simple operation, easy maintenance, and so on. In fact, there are about 90,000 sets of beam pumping units in China. However, the unbalanced structure of the beam pumping units cannot be entirely eliminated because of the inherent geometry and mechanical properties of four-bar linkage, that is the electromotor equivalent torque ripple cannot be absorbed or eliminated by counterweight in up-and-down travels, which causes the electromotor to work under greatly changed load rate with low power factor and high energy consumption. The mechanical relationship of a conventional beam pumping unit was derived first, and then parameters of a basic structure were optimized through dynamic optimization. On this basis, the hydraulic hybrid solution was proposed, and a secondary balance was conducted on the optimal pumping unit electrometer’s load torque. Computer simulation model was established to carry out a system dynamic analysis and the results showed that the scheme can reduce the motor load torque ripple, improve motor load rate and power factor, and reduce motor power effectively. It may bring tremendous decrease of electricity cost and have great significance for oilfield equipment energy saving, oil extraction cost reduction, and promotion of petroleum products’ competitiveness.
Lung cancer risk by years since quitting in 30+ pack year smokers
Authors: Pinsky Paul F , Zhu Claire S , Kramer Barnett S
Published: April 2015

Objective

Current United States recommendations for low-dose computed tomography (LDCT) lung cancer screening limit eligibility to ever-smokers with 30+ pack-years, with former smokers eligible only within 15 years of quitting. The 15 year limit is partly based on perceived decreases in lung cancer risk as years since quitting (YSQ) increase. We examine the relationship between lung cancer risk and YSQ among 30+ pack-year former smokers.

Methods

In the Prostate, Lung, Colorectal, and Ovarian trial, participants aged 55–74 were randomized to screening or usual care; screened subjects received annual chest-radiographs for lung cancer screening. Subjects completed a baseline questionnaire; smoking history included average cigarettes per day and age at starting and stopping smoking. Subjects were followed 13 years. Cox proportional hazards models were utilized to estimate hazard ratios (HRs) associated with YSQ, with YSQ treated as a time-varying covariate. The models adjusted for age and sex.

Results

Of 154899 subjects randomized, 27101 were former smokers with 30+ pack-years, and 69182 were never smokers. HRs relative to never smokers ranged from 30.8 (95% CI:23.4–40.5) for YSQ ≤5 to 6.4 (95% CI:5.1–8.0) for YSQ > 30. For YSQ of >10–15, >15–20, and >20–25, HRs were 14.8 (95% CI:11.9–18.2), 13.5 (95% CI:11.3–16.2), and 9.9 (95% CI: 8.1–12.0), respectively.

Conclusions

Lung cancer risk decreases gradually with YSQ in 30+ pack year former smokers. A range of upper limits on YSQ may be supportable for LDCT screening.
Workers’ transnational networks in times of austerity
Authors: Vogiatzoglou Markos
Published: April 2015

This article describes the development of cross-national labour movement networks between Italy and Greece and explains why some of their efforts produced concrete results, while others did not. A typology of transnational movement networking is presented and then specific instances are examined: (a) the Italian and Greek trade union confederations’ efforts to coordinate their actions for the European Days of Action; (b) the 2005/2006 attempt to import to Greece the experience and practices of precarious workers in Italy; and (c) the cross-national campaign by workers occupying factories to bring together their experiences and to construct a common discourse on alternative modes of production. The article, based on rich empirical data gathered during six years, concludes with three main points: (i) Collaborative networks are more difficult to construct, but may prove stronger and richer than any other networking type. (ii) Cross-national structural similarities are not considered sufficient for labour collaboration: each national discursive context needs to be taken into account. (iii) Transnational action stands more chance of success if its immediate goals are tangible and rooted in real-life experiences.
Pulling men into the care economy: The case of Canadian firefighters
Authors: Braedley Susan
Published: April 2015

Professional urban fire services across the United States and Canada are now engaged in care work, as a significant aspect of their work as emergency medical first responders. Given that the historically resilient world-wide unequal gendered division of labour continues to assign care to women, and to subaltern women in particular, the engagement of this primarily white, male labour force bears examination. In Canada, the late 1990s saw fire responses to ‘medical’ emergencies increase dramatically to become the dominant call category for fire services, as part of a tiered emergency response. Further, these responses are seldom to heart attack, stroke or catastrophic events for which firefighters are trained, but instead are responses to more predictable and recurring issues imperiling the health and well-being of people with chronic illnesses, disability or frailty. Using data collected from research in four Canadian cities, this article explains how fire services have been pulled into emergency care concurrent with health care and social services re-structuring and what this move tells us about re-structuring in terms of the fragility of the care economy and masculinized public sector work.
Is job control under threat in the human services? Evidence from frontline practitioners in Australia, 2003–2012
Authors: Cortis Natasha , Eastman Christine
Published: April 2015

This article examines a component of job quality which is particularly important for human service workers: the level of control they have over their work. Having control over work goals and tasks enables frontline workers to respond appropriately to the needs of the people they serve, so contributes to service quality and client outcomes, as well as employee wellbeing. However, much research has contended that job control is under threat in human service contexts, largely as a result of new public management. We examine these claims and contribute new data showing that levels of job control in the human service workforce have indeed been under pressure in recent years. From 2003 to 2012, Australia’s human service workforce did not experience the increase in job control experienced by other workers. In the education industry, levels of job control fell significantly. We discuss these trends in the context of debates about the impact of new public management on frontline human service work and challenges of securing the future provision of good quality services.
Ethical Decisions in Palliative Care
Authors: Hernández-Marrero Pablo , Pereira Sandra Martins , Carvalho Ana Sofia
Published: April 2015

Background:

Ethical decisions are part of contemporary practices in palliative care. The need of making such decisions is associated to higher burnout levels and other work related problems among healthcare professionals.

Aims:

As part of the project entitled “Decisions in End-of-Life Care in Spain and Portugal” (DELiCaSP), this study aims to (i) identify the most common ethical decisions made by Portuguese palliative care teams and (ii) understand how the making of such decisions relates to burnout.

Methods:

A mixed methods study was conducted with 9 palliative care teams, using (i) questionnaires of socio-demographic and professional variables, work-related experiences, (ii) the Maslach Burnout Inventory, (iii) interviews and (iv) observations. These teams were geographically dispersed across the country, covering the North, Centrum and South regions, and heterogeneous: Five palliative care units for inpatients; three home care teams; and one hospital support team. A total of 20 interviews and 240 hours of observations were completed until reaching saturation.

Results:

The most common ethical decisions were related to communication issues (information disclosure of the diagnosis and prognosis), forgoing treatment and sedation. Although perceived as stressful, emotionally demanding and challenging, ethical decisions were not significantly associated with burnout.

Conclusions:

Making ethical decisions is not associated with higher burnout levels among professionals working in Portuguese palliative care teams. This can be explained by the interprofessional decision-making process followed by these teams, which promotes a sense of shared-decision and team-based empowerment; and by the advanced level of interdisciplinary education in palliative care that these professionals have.
Examining the Usefulness of a Family Empowerment Program Guided by the Illness Beliefs Model for Families Caring for a Child With Thalassemia
Authors: Wacharasin Chintana , Phaktoop Maneerat , Sananreangsak Siriyupa
Published: April 2015

The purpose of this pilot study was to design, implement, and evaluate a Family Empowerment Program (FEP), guided by the Illness Beliefs Model. Participants included 25 Thai family members who were the primary caregivers of a child with thalassemia. In Phase I, data were collected from participants using individual in-depth interviews and focus groups before involvement in the FEP. In Phase II, 12 hr of FEP sessions were offered to groups of participants. Content analysis of the audiotaped FEP sessions is reported in this article. Family caregivers reported that the FEP helped them share beliefs and experiences related to caring for their child with thalassemia, make decisions related to families’ problems/needs and beliefs, provide each other mutual social support, and develop increased ability to manage care for their chronically ill child through sharing information and learning from other family caregivers about family functioning, family management, and family relationships. Future research is needed to examine the FEP intervention under more controlled conditions with measures that include family functioning and child health outcomes.
Improving Coordinated Responses for Victims of Intimate Partner Violence
Authors: Cerulli Catherine , Edwardsen Elizabeth A. , Hall Dale , Chan Ko Ling , Conner Kenneth R.
Published: April 2015

New York State law mandates specific intimate partner violence (IPV) documentation under all circumstances meeting the enumerated relationship and crime criteria at the scene of a domestic dispute. Law enforcement compliance with this mandate is unknown. We reviewed law enforcement completion rates of Domestic Violence Incident Reports (DVIRs) and assessed correlations with individual or legal factors. Law enforcement officers filed DVIRs in 54% of the cases ( n = 191), more often when injury occurred ( p < .01) and the defendant had prior court contact ( p < .05). The discussion explores policy implications and potential means to rectify the gap between mandated processes and implementation.