bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Life Among Families of Children With Intellectual Disabilities: A Slovene Study
Authors: Schmidt Jan , Schmidt Majda , Brown Ivan
Published: December 2016

The main goal of the study was to provide and contrast data on quality of life for families in Slovenia that have children with intellectual disabilities and developmental disabilities (IDD) and families that have children with intellectual disabilities and autism spectrum disorders (ASD). The sample comprised 25 families with children with IDD and 19 families with children with ASD selected from schools in several villages in Slovenia. The data were collected using the FQOLS‐2006. The data analysis exploring the relationship between the two study groups (IDD and ASD) using the six measurement dimensions (Importance, Attainment, Satisfaction, Opportunities, Initiative, Stability) showed the mean ratings for all six measurement dimensions were higher for the IDD group than for the ASD group, although both groups rated Importance quite highly. Within the nine domains examined, there were some differences between the two groups. For the two main outcome measures, Attainment and Satisfaction, the scores for Satisfaction were consistently higher for the IDD group than for the ASD group. A combination of qualitative and quantitative data revealed that two of the nine domains, Family Relationships and Community Interaction, appear to contribute positively to family quality of life for both groups in this sample, while family life relating to the other seven domains requires remediation. Data from this family quality of life study provides evidence to suggest to policy makers and service providers that there might be a substantial amount of work to be done in the future to provide appropriate and efficient support for families with children with disabilities, especially for those with ASD, so that these families can lead lives of quality.
Supporting Japanese Mothers of Children with ADHD: Cultural Adaptation of the New Forest Parent Training Programme
Authors: Shimabukuro Shizuka , Daley David , Thompson Margaret , Laver‐Bradbury Cathy , Nakanishi Emi , Tripp Gail
Published: December 2016

International practice guidelines recommend medication and behavioral intervention as evidenced‐based treatments for attention deficit hyperactivity disorder (ADHD). Currently in Japan, the availability of non‐pharmacological interventions for ADHD is limited. We report the results of a pilot and a proof‐of‐concept study for a new behavioral intervention for Japanese mothers of children with ADHD. The pilot study delivered a standard six‐session behavioral intervention and two parent‐support sessions. Participants approved the group format and requested additional support to change parenting practices and behavioral strategies targeting ADHD symptoms. For the proof‐of‐concept study, the intervention was revised to include five sessions of pre‐intervention support followed by six sessions of the New Forest Parent Training Programme (NFPP), an evidence‐based intervention for ADHD. The revised intervention, NFPP‐Japan, was associated with reductions in the mothers’ reports of children's ADHD symptoms and aggression, more effective parenting practices, and reduced parenting stress. The pilot and proof‐of‐concept studies indicate that it is possible to successfully modify Western behavioral interventions for Japanese mothers and to justify a randomized controlled trial evaluation of the NFPP‐Japan, which is currently underway.
Genetic population structure of the long‐tailed pygmy rice rat (Rodentia, Cricetidae) at different geographic scales in the Argentinean Patagonia
Authors: Ortiz N. , Polop F. J. , Andreo V. C. , Provensal M. C. , Polop J. J. , Gardenal C. N. , González‐Ittig R. E.
Published: December 2016

The population genetic structure of Oligoryzomys longicaudatus colilargo was examined at two geographical scales: (a) regional, including five populations of the Argentinean Patagonia separated by 60–315 km and (b) landscape scale, using five populations from different valleys of the locality of Cholila in the subantarctic forest separated by 6–27 km, and a nearby locality of the Patagonian steppe, with an average distance from Cholila of 33 km. Eight microsatellite loci specific for O. longicaudatus were used as genetic markers. At the regional scale, four genetic clusters were detected by the Geneland software. The genetic structure was found to follow a latitudinal pattern. This result was supported by the FST statistic, indicating low levels of current gene flow within the region. At the landscape level, genetic differentiation among the five populations was also found. Estimated migration rates were, in general, low and asymmetrical between nearby populations. Using a causal modeling approach, we detected that the combination of landscape features such as lakes, rivers, urban settlements and roads appear to constrain the dispersal of O. longicaudatus at this scale. This result would explain why nearby populations were so different in their genetic composition. The information about geographic features limiting rodent dispersal provided here could help to design more accurate prevention measures against the expansion of hantavirus pulmonary syndrome.
Combining Language Corpora With Experimental and Computational Approaches for Language Acquisition Research
Authors: Monaghan Padraic , Rowland Caroline F.
Published: December 2016

Historically, first language acquisition research was a painstaking process of observation, requiring the laborious hand coding of children's linguistic productions, followed by the generation of abstract theoretical proposals for how the developmental process unfolds. Recently, the ability to collect large‐scale corpora of children's language exposure has revolutionized the field. New techniques enable more precise measurements of children's actual language input, and these corpora constrain computational and cognitive theories of language development, which can then generate predictions about learning behavior. We describe several instances where corpus, computational, and experimental work have been productively combined to uncover the first language acquisition process and the richness of multimodal properties of the environment, highlighting how these methods can be extended to address related issues in second language research. Finally, we outline some of the difficulties that can be encountered when applying multimethod approaches and show how these difficulties can be obviated.
Household food insecurity in Mexico is associated with the co‐occurrence of overweight and anemia among women of reproductive age, but not female adolescents
Authors: Jones Andrew D. , Mundo‐Rosas Verónica , Cantoral Alejandra , Levy Teresa Shamah
Published: December 2016

We aimed to determine the association between household food insecurity (HFI) and the co‐occurrence of overweight and anemia among women of reproductive age in the Mexican population. We analyzed data on 4,039 nonpregnant female adolescents (15–19 years) and 10,760 nonpregnant adult women of reproductive age (20–49 years) from the 2012 National Health and Nutrition Survey of Mexico. The survey uses a two‐stage sampling design, stratified by rural and urban regions. The Latin American and Caribbean Food Security Scale was used to assess HFI. We assessed overweight and obesity in women based on World Health Organization classifications for body mass index, and BMI‐for‐age Z‐scores for female adolescents, and defined anemia as an altitude‐adjusted hemoglobin (Hb) concentration < 120 g/L based on measurement of capillary Hb concentrations. In multiple logistic regression models adjusting for potential confounding covariates, HFI was not associated with the co‐occurrence of anemia and overweight among female adolescents. The adjusted odds of women of reproductive age from mildly and moderately food‐insecure households, respectively, experiencing concurrent anemia and overweight were 48% (OR: 1.48; 95% CI: 1.15, 1.91) and 49% (OR: 1.49; 95% CI: 1.08, 2.06) higher than among women from food‐secure households. Severe HFI was not associated with concurrent overweight and anemia among female adolescents or women. HFI may be a shared mechanism for dual forms of malnutrition within the same individual, simultaneously contributing to overconsumption and dietary inadequacy.
Current perspectives in coronary microvascular dysfunction
Authors: Shome Joy S. , Perera Divaka , Plein Sven , Chiribiri Amedeo
Published: December 2016

The coronary arterial system consists of large epicardial coronary arteries, pre‐arterioles, and arterioles, which together closely regulate CBF. Structural, functional, and extravascular abnormalities of the microcirculation lead to CMD. CMD can present with symptoms suggestive of CAD, often in the absence of significant obstructive epicardial CAD. Conventional invasive angiography does not allow direct visualization of the microcirculation. Invasive indices, such as CBF and CFR, and non‐invasive imaging modalities, such as CMR and PET, can be used to quantify absolute MBF and enable a direct and accurate assessment of coronary microvascular function. CMD appears to be more prevalent in women, typically presenting with symptoms of ischemia with unobstructed coronary arteries, and has a relatively unfavorable prognosis. CMD is classified clinically depending on the presence or absence of epicardial CAD, myocardial disease, or iatrogenic causes. Although invasive intracoronary techniques can be used to detect CMD, these cannot provide insight into the mechanisms involved in its pathogenesis. Imaging modalities such as CMR and cardiac PET are becoming indispensable tools in the evaluation of suspected CMD.
Arteriogenesis in murine adipose tissue is contingent on CD68+/CD206+ macrophages
Authors: Seaman Scott A. , Cao Yiqi , Campbell Chris A. , Peirce Shayn M.
Published: December 2016

Objective

The surgical transfer of skin, fat, and/or muscle from a donor site to a recipient site within the same patient is a widely performed procedure in reconstructive surgeries. A surgical pretreatment strategy that is intended to increase perfusion in the flap, termed “flap delay,” is a commonly employed technique by plastic surgeons prior to flap transplantation. Here, we explored whether CD68+/CD206+ macrophages are required for arteriogenesis within the flap by performing gain‐of‐function and loss‐of‐function studies in a previously published flap delay murine model.

Methods and Results

Local injection of M2‐polarized macrophages into the flap resulted in an increase in collateral vessel diameter. Application of a thin biomaterial film loaded with a pharmacological agent (FTY720), which has been previously shown to recruit CD68+/CD206+ macrophages to remodeling tissue, increased CD68+/CD206+ cell recruitment and collateral vessel enlargement. Conversely, when local macrophage populations were depleted within the inguinal fat pad via clodronate liposome delivery, we observed fewer CD68+ cells accompanied by diminished collateral vessel enlargement.

Conclusions

Our study underscores the importance of macrophages during microvascular adaptations that are induced by flap delay. These studies suggest a mechanism for a translatable therapeutic target that may be used to enhance the clinical flap delay procedure.
Myopathology in congenital myopathies
Authors: Sewry C. A. , Wallgren‐Pettersson C.
Published: December 2016

Congenital myopathies are clinically and genetically a heterogeneous group of early onset neuromuscular disorders, characterized by hypotonia and muscle weakness. Clinical severity and age of onset are variable. Many patients are severely affected at birth while others have a milder, moderately progressive or nonprogressive phenotype. Respiratory weakness is a major clinical aspect that requires regular monitoring. Causative mutations in several genes have been identified that are inherited in a dominant, recessive or X‐linked manner, or arise de novo. Muscle biopsies show characteristic pathological features such as nemaline rods/bodies, cores, central nuclei or caps. Small type 1 fibres expressing slow myosin are a common feature and may sometimes be the only abnormality. Small cores (minicores) devoid of mitochondria and areas showing variable myofibrillar disruption occur in several neuromuscular disorders including several forms of congenital myopathy. Muscle biopsies can also show more than one structural defect. There is considerable clinical, pathological and genetic overlap with mutations in one gene resulting in more than one pathological feature, and the same pathological feature being associated with defects in more than one gene. Increasing application of whole exome sequencing is broadening the clinical and pathological spectra in congenital myopathies, but pathology still has a role in clarifying the pathogenicity of gene variants as well as directing molecular analysis.
Waiheke Island: An island paradise facing an uncertain future
Authors: Logie Mary June
Published: December 2016

Waiheke Island in Auckland's Hauraki Gulf shares similarities with once isolated coastal areas on the periphery of large cities. Now a commuter suburb and popular tourist destination only a 35‐min ferry ride from downtown Auckland, it is under increasing development pressure. However, it remains differentiated from other urban fringe settings by dimensions of its islandness: weak infrastructure, restricted transportation networks and robust community politics. The resulting pressure on infrastructure and services is now being compounded by debates related to the Auckland housing crisis. This report, based on interviews with permanent and part‐time residents, explores competing imaginaries of the island's futures.
Evaluation of the p‐AKT, p‐JNK and FoxO3a function in oral epithelial dysplasia
Authors: Chaves FN , Bezerra TMM , de Barros Silva PG , Oliveira FAF , Sousa FB , Costa FWG , Alves APNN , Pereira KMA
Published: December 2016

Objectives

To evaluate the expression of p‐AKT, p‐JNK, FoxO3a, and Ki‐67 in samples of oral squamous cell carcinoma (OSCC) and oral epithelial dysplasias (OEDs) to understand their possible involvement in the malignant transformation process of oral lesions.

Materials and Methods

Tissue samples of 20 cases of OSCCs, 20 OEDs, and normal oral mucosa were subjected to immunohistochemistry reactions for anti‐p‐AKT, anti‐p‐JNK, anti‐FoxO3a, and anti‐Ki‐67 antibodies. It was analyzed using quantitative (number of immunostained cells) and qualitative (immunostaining intensity) parameters in different cell immunostaining sublocations.

Results

Nuclear p‐AKT was observed significantly greater immunostaining in OSCC (21.2 ± 19.0) than in dysplasias (7.9 ± 8.1) and controls (1.8 ± 4.7) (P = 0.002). Immunostaining of strong nuclear p‐JNK was greater in controls (48.3 ± 13.7) than in OEDs (11.0 ± 10.3) and OSCCs (1.1 ± 1.3) (P < 0.001). Strong nuclear immunostaining of FoxO3a proved to be absent in OSCCs (0.0 ± 0.1) with little staining on dysplasias (3.2 ± 5.4) and increased expression in controls (13.5 ± 4.8) (P < 0.001). Immunostaining of strong nuclear Ki‐67 was grater in OSCCs (48.1 ± 49.6) than in OED (11.8 ± 10.6) and controls (1.9 ± 2.0) (P < 0.001).

Conclusions

Malignant process of OEDs in this research may involve the same mechanisms of established malignant lesions.
CAN PERFORMANCE MANAGEMENT FOSTER SOCIAL EQUITY? STAKEHOLDER POWER, PROTECTIVE INSTITUTIONS, AND MINORITY REPRESENTATION
Authors: KROLL ALEXANDER
Published: December 2016

Performance management has been criticized for harming or, at best, ignoring social equity outcomes. While there is evidence suggesting that performance management fosters an emphasis on efficiency and effectiveness at the expense of other public values, we are still in search of a theory linking performance management to social equity. The article takes a first step towards the development of such a theory and proposes the importance of contingency factors. It argues that managerial performance information use will benefit disadvantaged groups in the presence of powerful stakeholders, protective institutions, and minority representation in government. Using data on school districts in Texas, the article finds support for the first two contingency factors but not the third one. Performance information use by superintendents increases test scores of disadvantaged students if these students make up a sizeable, powerful group, and if superintendents put emphasis on complying with the No Child Left Behind Act.
Oxytocin receptors in dioestrous and anoestrous canine uteri
Authors: Tamminen TM , Sahlin L , Masironi B , Taponen J , Laitinen‐Vapaavuori O , Katila T
Published: December 2016

Contents

The aim of the study was to localize oxytocin receptors (OTR) and measure mRNA expression of OTR in the canine uterus with and without the influence of progesterone. Uterine samples were taken from nine anoestrous and eight dioestrous bitches during ovariohysterectomy. Histological changes were evaluated in haematoxylin and eosin (HE)‐stained samples. Purified polyclonal antibody for OTR was used in immunohistochemistry to localize receptors in uterine layers. Relative mRNA concentration of OTR was evaluated with real‐time PCR from full‐thickness uterine samples taken from the middle horn and the body. Myometrial smooth muscle cells, endometrial luminal epithelium (LE) and deep and superficial glandular epithelium were positively stained for oxytocin receptors in non‐pregnant animals. No significant difference in staining intensity was detected between uterine middle horn and body. However, the staining intensity of LE was significantly higher in dioestrous than in anoestrous uteri (p < .05). Leucocytes and endothelium of blood vessels were also positively stained for OTR. Real‐time PCR showed no significant differences in OTR mRNA expression between the middle horn and the body of the uterus, or between anoestrous and dioestrous uterus. No correlation was noted between OTR mRNA expression and blood progesterone concentration. In conclusion, despite the apparent inactivity, the uterus of the non‐pregnant bitch expresses OTR. The distribution or relative expression of OTR does not differ between uterine horn and body in dioestrus or anoestrus except in LE. LE may have more oxytocin‐dependent activity during dioestrus than anoestrus.
Can current native tree seedling production and infrastructure meet an increasing forest restoration demand in Brazil?
Authors: Moreira da Silva Ana P. , Schweizer Daniella , Rodrigues Marques Henrique , Cordeiro Teixeira Ana M. , Nascente dos Santos Thaiane V. M. , Sambuichi Regina H. R. , Badari Carolina G. , Gaudare Ulysse , Brancalion Pedro H. S.
Published: December 2016

Recent global commitments have placed forest and landscape restoration at the forefront of countries' efforts to recover ecosystem services, conserve biodiversity, and mitigate the effects of climate change. However, it needs to be asked if current native tree seedling supply meets an increase in demand for forest restoration? This study assessed the current configuration, distribution, and production capacity of forest nurseries producing native trees in Brazil. Brazil provides an interesting example of how global agreements aligned with national policies can lead to the proliferation of native seedling nurseries, and the challenges faced to restore species‐rich native forest ecosystems. We found that the nurseries in the Atlantic Forest region can still meet an increase in demand—both in terms of seedling quantity and diversity—because most of their production capacity is not currently used. However, not all Brazilian biomes have sufficient nurseries to meet restoration demands, thus there is a risk of using native species from a few biogeographical regions in a much spatially wider and ecologically diverse area. In addition, lack of seed supply and qualified labor can hamper the growth of the market. Barriers to seed supply may also lead to low levels of genetic variability and floristic representation in the populations and ecosystems to be restored. We conclude that restoration of high‐diversity forest ecosystems requires policies and supportive programs, with emphasis on private nurseries, to guarantee adequate supply of native tree seedlings and provide the necessary incentives to develop the emergent economy of forest restoration.
A framework for the practical science necessary to restore sustainable, resilient, and biodiverse ecosystems
Authors: Miller Ben P. , Sinclair Elizabeth A. , Menz Myles H. M. , Elliott Carole P. , Bunn Eric , Commander Lucy E. , Dalziell Emma , David Erica , Davis Belinda , Erickson Todd E. , Golos Peter J. , Krauss Siegfried L. , Lewandrowski Wolfgang , Mayence C. Ellery , Merino‐Martín Luis , Merritt David J. , Nevill Paul G. , Phillips Ryan D. , Ritchie Alison L. , Ruoss Sacha , Stevens Jason C.
Published: December 2016

Demand for restoration of resilient, self‐sustaining, and biodiverse natural ecosystems as a conservation measure is increasing globally; however, restoration efforts frequently fail to meet standards appropriate for this objective. Achieving these standards requires management underpinned by input from diverse scientific disciplines including ecology, biotechnology, engineering, soil science, ecophysiology, and genetics. Despite increasing restoration research activity, a gap between the immediate needs of restoration practitioners and the outputs of restoration science often limits the effectiveness of restoration programs. Regrettably, studies often fail to identify the practical issues most critical for restoration success. We propose that part of this oversight may result from the absence of a considered statement of the necessary practical restoration science questions. Here we develop a comprehensive framework of the research required to bridge this gap and guide effective restoration. We structure questions in five themes: (1) setting targets and planning for success, (2) sourcing biological material, (3) optimizing establishment, (4) facilitating growth and survival, and (5) restoring resilience, sustainability, and landscape integration. This framework will assist restoration practitioners and scientists to identify knowledge gaps and develop strategic research focused on applied outcomes. The breadth of questions highlights the importance of cross‐discipline collaboration among restoration scientists, and while the program is broad, successful restoration projects have typically invested in many or most of these themes. Achieving restoration ecology's goal of averting biodiversity losses is a vast challenge: investment in appropriate science is urgently needed for ecological restoration to fulfill its potential and meet demand as a conservation tool.
Informality in the Process of Development and Growth
Authors: Loayza Norman V.
Published: December 2016

‘Informality’ is a term used to describe the collection of firms, workers and activities that operate outside the legal and regulatory systems. It is widespread in the majority of developing countries – in a typical developing economy, the informal sector produces about 35 per cent of GDP and employs 70 per cent of the labour force. This paper studies informality in the context of economic development by presenting a model and projections that link informality, regulations, migration and economic growth. This analytical framework highlights the trade‐offs between formality and informality, the relationship between the different types of informality, and the connection between them and the forces of labour, capital and productivity growth. The paper models the behaviour of the informal sector based on the following fundamental asymmetry: formal firms confront higher labour costs, while informal firms face higher capital costs and lower productivity. Using mandated minimum wages as the policy‐induced distortion, the model first studies the static allocation of formal and informal capital and labour in a modern economy. Second, it opens the possibility of labour migration from a rudimentary economy with ample supply of labour (e.g. rural areas or less advanced neighbouring countries). Third, the model analyses the dynamic behaviour of the formal and informal sectors, considering how they affect and are affected by economic growth and labour migration. Then, the paper presents projections for the size of labour informality, in the modern and rudimentary economies, in the next two decades for a large group of countries representing all regions of the world. The projections are based on the calibration and simulation of the model and serve to discuss its usefulness and limitations.
Stable Transmission of Borrelia burgdorferi Sensu Stricto on the Outer Banks of North Carolina
Authors: Levine J. F. , Apperson C. S. , Levin M. , Kelly T. R. , Kakumanu M. L. , Ponnusamy L. , Sutton H. , Salger S. A. , Caldwell J. M. , Szempruch A. J.
Published: December 2016

The spirochaete (Borrelia burgdorferi) associated with Lyme disease was detected in questing ticks and rodents during a period of 18 years, 1991–2009, at five locations on the Outer Banks of North Carolina. The black‐legged tick (Ixodes scapularis) was collected at varied intervals between 1991 and 2009 and examined for B. burgdorferi. The white‐footed mouse (Peromyscus leucopus), house mouse (Mus musculus) marsh rice rat (Oryzomys palustris), marsh rabbit (Sylvilagus palustris), eastern cottontail (Sylvilagus floridanus) and six‐lined racerunner (Cnemidophorus sexlineatus) were live‐trapped, and their tissues cultured to isolate spirochaetes. Borrelia burgdorferi isolates were obtained from questing adult I. scapularis and engorged I. scapularis removed from P. leucopus, O. palustris and S. floridanus. The prevalence of B. burgdorferi infection was variable at different times and sites ranging from 7 to 14% of examined questing I. scapularis. Mitochondrial (16S) rRNA gene phylogenetic analysis from 65 adult I. scapularis identified 12 haplotypes in two major clades. Nine haplotypes were associated with northern/Midwestern I. scapularis populations and three with southern I. scapularis populations. Sixteen isolates obtained from tick hosts in 2005 were confirmed to be B. burgdorferi by amplifying and sequencing of 16S rRNA and 5S‐23S intergenic spacer fragments. The sequences had 98–99% identity to B. burgdorferi sensu stricto strains B31, JD1 and M11p. Taken together, these studies indicate that B. burgdorferi sensu stricto is endemic in questing I. scapularis and mammalian tick hosts on the Outer Banks of North Carolina.
Livestock vaccinations translate into increased human capital and school attendance by girls
Authors: Marsh Thomas L. , Yoder Jonathan , Deboch Tesfaye , McElwain Terry F. , Palmer Guy H.
Published: December 2016

African pastoralists’ decision to vaccinate cattle generates significant household income, translating into broad societal goals.
Trump team targets key climate metric
Authors: Malakoff David , Service Robert F. , Cornwall Warren
Published: December 2016

“Social cost of carbon” to get a critical look from incoming administration.
Some like it hot
Authors: Stone Richard
Published: December 2016

Iran's Lut Desert—Earth's hottest—is devoid of plants but somehow sustains a vibrant ecosystem.
Understanding induced seismicity
Authors: Elsworth Derek , Spiers Christopher J. , Niemeijer Andre R.
Published: December 2016

Observational data sets provide a clearer picture of the causes of induced seismicity
The TCF1-Bcl6 axis counteracts type I interferon to repress exhaustion and maintain T cell stemness
Authors: Wu Tuoqi , Ji Yun , Moseman E. Ashley , Xu Haifeng C. , Manglani Monica , Kirby Martha , Anderson Stacie M. , Handon Robin , Kenyon Elizabeth , Elkahloun Abdel , Wu Weiwei , Lang Philipp A. , Gattinoni Luca , McGavern Dorian B. , Schwartzberg Pamela L.
Published: December 2016

The transcription factor TCF1 determines the degree of CD8
+
T cell exhaustion in chronic infection.
Reinventing the community hospital: a retrospective population-based cohort study of a natural experiment using register data
Authors: Swanson Jayson O , Hagen Terje P
Published: December 2016

Objectives

To investigate whether implementation of municipal acute bed units (MAUs) resulting from the Norwegian Coordination Reform (2012) was associated with reductions in hospital admissions, particularly for the elderly.

Design

A municipality-based retrospective comparative cohort study using monthly population-based registry data analysed with fixed-effects log–log regressions.

Setting

Norwegian municipalities and hospitals.

Population

All patients admitted to secondary hospital care in Norway between 2010 and 2014, excluding psychiatric admissions, with additional focus on admission type and elderly age subgroups.

Main outcome measures

Monthly admission rates in total and by age group for all patients, patients admitted with acute conditions and with acute conditions at internal medicine departments.

Results

The introduction of MAUs was associated with a small yet significant overall negative effect on hospital admissions. The reduction in all admissions was significant for the entire population (−1.2%, 95% CI −2.0% to −0.0%) and slightly stronger for those aged 80 years and above (−1.9%, 95% CI −3.0% to −1.0%). The more detailed analysis of the elderly population aged 80 years and above revealed that effects were affected by the institutional characteristics of the MAUs. The significant effects ranged between −1.6% and −8.6%, depending on the availability of physicians on duty at the MAUs, the MAUs location or combinations thereof.

Conclusions

Introduction of MAUs following implementation of the Norwegian Coordination Reform in 2012 was associated with a significant reduction in hospital admissions primarily for the elderly. Our findings suggest that this type of intermediate care is a viable option in an effort to alleviate the burden on hospitals by reducing the acute secondary care admission volume. Further examinations focused on cost-effectiveness, health status of patients, number of patients treated at the MAUs and comparing other intermediate care alternatives would all add important perspectives to the issue.
Setting priorities for research in medical nutrition education: an international approach
Authors: Ball Lauren , Barnes Katelyn , Laur Celia , Crowley Jennifer , Ray Sumantra
Published: December 2016

Objectives

To identify the research priorities for medical nutrition education worldwide.

Design

A 5-step stakeholder engagement process based on methodological guidelines for identifying research priorities in health.

Participants

277 individuals were identified as representatives for 30 different stakeholder organisations across 86 countries. The stakeholder organisations represented the views of medical educators, medical students, doctors, patients and researchers in medical education.

Interventions

Each stakeholder representative was asked to provide up to three research questions that should be deemed as a priority for medical nutrition education.

Main outcome measures

Research questions were critically appraised for answerability, sustainability, effectiveness, potential for translation and potential to impact on disease burden. A blinded scoring system was used to rank the appraised questions, with higher scores indicating higher priority (range of scores possible 36–108).

Results

37 submissions were received, of which 25 were unique research questions. Submitted questions received a range of scores from 62 to 106 points. The highest scoring questions focused on (1) increasing the confidence of medical students and doctors in providing nutrition care to patients, (2) clarifying the essential nutrition skills doctors should acquire, (3) understanding the effectiveness of doctors at influencing dietary behaviours and (4) improving medical students' attitudes towards the importance of nutrition.

Conclusions

These research questions can be used to ensure future projects in medical nutrition education directly align with the needs and preferences of research stakeholders. Funders should consider these priorities in their commissioning of research.
Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis
Authors: Backholer Kathryn , Peters Sanne A E , Bots Sophie H , Peeters Anna , Huxley Rachel R , Woodward Mark
Published: December 2016

Background

Low socioeconomic status (SES) is a known risk factor for cardiovascular disease (CVD) but whether its effects are comparable in women and men is unknown.

Methods

PubMed MEDLINE was systematically searched. Studies that reported sex-specific estimates, and associated variability, of the relative risk (RR) for coronary heart disease (CHD), stroke or CVD according to a marker of SES (education, occupation, income or area of residence), for women and men were included. RRs were combined with those derived from cohort studies using individual participant data. Data were pooled using random effects meta-analyses with inverse variance weighting. Estimates of the ratio of the RRs (RRR), comparing women with men, were computed.

Results

Data from 116 cohorts, over 22 million individuals, and over 1 million CVD events, suggest that lower SES is associated with increased risk of CHD, stroke and CVD in women and men. For CHD, there was a significantly greater excess risk associated with lower educational attainment in women compared with men; comparing lowest with highest levels, the age-adjusted RRR was 1.24 (95% CI 1.09 to 1.41) and the multiple-adjusted RRR was 1.34 (1.09 to 1.63). For stroke, the age-adjusted RRR was 0.93 (0.72 to 1.18), and the multiple-adjusted was RRR 0.79 (0.53 to 1.19). Corresponding results for CVD were 1.18 (1.03 to 1.36), 1.23 (1.03 to 1.48), respectively. Similar results were observed for other markers of SES for all three outcomes.

Conclusions

Reduction of socioeconomic inequalities in CHD and CVD outcomes might require different approaches for men and women.
Pre-emptive administration of fibrinogen concentrate contributes to improved prognosis in patients with severe trauma
Authors: Yamamoto Koji , Yamaguchi Atsushi , Sawano Makoto , Matsuda Masaki , Anan Masahiro , Inokuchi Koichi , Sugiyama Satoru
Published: December 2016

Background

Patients with severe trauma often present with critical coagulopathy, resulting in impaired hemostasis, massive hemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation in correcting coagulopathy and restoring tissue perfusion has not been studied. We assessed a novel approach of pre-emptive administration of fibrinogen concentrate to improve critical coagulopathy in patients with severe trauma.

Methods

We retrospectively compared blood transfusion volumes and survival prognosis between three groups of patients with trauma, with an Injury Severity Score (ISS) ≥26 over three consecutive periods: group A, no administration of fibrinogen concentrate; group B, administration of 3 g of fibrinogen concentrate after evaluation of trauma severity and a plasma fibrinogen level <1.5 g/L; group C, pre-emptive administration of 3 g of fibrinogen concentrate immediately on patient arrival based on prehospital information, including high-severity injury or assessed need for massive transfusion before measurement of fibrinogen.

Results

∼56% of patients with an ISS ≥26 and transfused with red blood cell concentrates ≥10 units, had hypofibrinogenemia (fibrinogen <1.5 g/L) on arrival. Patients who received fibrinogen concentrate in group C showed significantly higher fibrinogen levels after treatment with this agent than those in group B (2.41 g/L vs 1.88 g/L; p=0.01). Although no significant difference was observed in blood transfusion volumes between the groups, the 30-day survival of patients in group C (all, and those with an ISS ≥26) was significantly better than in group A (p<0.05). The 48-hour mortality rate in patients with an ISS ≥26 was significantly lower in group C than in group A (8.6% vs 22.9%; p=0.005). Further, among patients with an ISS ≥41, the overall mortality was significantly lower in group C than in group A (20% vs 50%; p=0.02).

Conclusion

Pre-emptive administration of fibrinogen concentrate for patients with trauma with critical coagulopathy may contribute to improved survival.

Level of evidence

Level IV.
A membrane-type acoustic metamaterial muffler
Authors: Wang Fang , Chen Tianning , Wang Xiaopeng , Bao Kai , Wan Lele
Published: December 2016

Membrane-type acoustic metamaterials (MAMs) with negative dynamic mass have demonstrated the effects in the sound transmission loss (STL) at low-frequency range. This research aims to design a membrane-type acoustic metamaterial muffler (MAMM) based on the present MAMs, and to solve the problem that airflow cannot flow unimpededly in the channel once using the MAMs. For a better understanding of MAMM, the resonance frequency of the membrane was calculated and simulation was used to study the acoustic transmission performance of the MAMM. The simulation results were verified in comparison with the theoretical results of the membrane. This MAMM reduced the structural size of muffler compared with the traditional Helmholtz muffler and expand muffler, which can find application for the MAMs in acoustic absorption and noise control.
Fundamental invariants of many-body Hilbert space
Authors: Sunko Denis K.
Published: December 2016

Many-body Hilbert space is a functional vector space with the natural structure of an algebra, in which vector multiplication is ordinary multiplication of wave functions. This algebra is finite-dimensional, with exactly [Formula: see text] generators for N identical particles, bosons or fermions, in d dimensions. The generators are called shapes. Each shape is a possible many-body vacuum. Shapes are natural generalizations of the ground-state Slater determinant to more than one dimension. Physical states, including the ground state, are superpositions of shapes with symmetric-function coefficients, for both bosons and fermions. These symmetric functions may be interpreted as bosonic excitations of the shapes. The algebraic structure of Hilbert space described here provides qualitative insights into long-standing issues of many-body physics, including the fermion sign problem and the microscopic origin of bands in the spectra of finite systems.
On Optimal Employee Assignment in Constrained Role-Based Access Control Systems
Authors: Roy Arindam , Sural Shamik , Majumdar Arun Kumar , Vaidya Jaideep , Atluri Vijayalakshmi
Published: December 2016

Since any organizational environment is typically resource constrained, especially in terms of human capital, organization managers would like to maximize the utilization of available human resources. However, tasks cannot simply be assigned to arbitrary employees since the employee needs to have the necessary capabilities for executing a task. Furthermore, security policies constrain the assignment of tasks to employees, especially given the other tasks assigned to the same employee. Since role-based access control (RBAC) is the most commonly used access control model for commercial information systems, we limit our attention to consider constraints in RBAC. In this article, we define the Employee Assignment Problem (EAP), which aims to identify an employee to role assignment such that it permits the maximal flexibility in assigning tasks to employees while ensuring that the required security constraints are met. We prove that finding an optimal solution is NP-complete and therefore provide a greedy solution. Experimental evaluation of the proposed approach shows that it is both efficient and effective.
Accelerated deflation promotes homogeneous airspace liquid distribution in the edematous lung
Authors: Wu You , Nguyen Tam L. , Perlman Carrie E.
Published: December 2016

Edematous lungs contain regions with heterogeneous alveolar flooding. Liquid is trapped in flooded alveoli by a pressure barrier—higher liquid pressure at the border than in the center of flooded alveoli—that is proportional to surface tension, T. Stress is concentrated between aerated and flooded alveoli, to a degree proportional to T. Mechanical ventilation, by cyclically increasing T, injuriously exacerbates stress concentrations. Overcoming the pressure barrier to redistribute liquid more homogeneously between alveoli should reduce stress concentration prevalence and ventilation injury. In isolated rat lungs, we test whether accelerated deflation can overcome the pressure barrier and catapult liquid out of flooded alveoli. We generate a local edema model with normal T by microinfusing liquid into surface alveoli. We generate a global edema model with high T by establishing hydrostatic edema, which does not alter T, and then gently ventilating the edematous lungs, which increases T at 15 cmH2O transpulmonary pressure by 52%. Thus ventilation of globally edematous lungs increases T, which should increase stress concentrations and, with positive feedback, cause escalating ventilation injury. In the local model, when the pressure barrier is moderate, accelerated deflation causes liquid to escape from flooded alveoli and redistribute more equitably. Flooding heterogeneity tends to decrease. In the global model, accelerated deflation causes liquid escape, but—because of elevated T—the liquid jumps to nearby, aerated alveoli. Flooding heterogeneity is unaltered. In pulmonary edema with normal T, early ventilation with accelerated deflation might reduce the positive feedback mechanism through which ventilation injury increases over time.

NEW & NOTEWORTHY We introduce, in the isolated rat lung, a new model of pulmonary edema with elevated surface tension. We first generate hydrostatic edema and then ventilate gently to increase surface tension. We investigate the mechanical mechanisms through which 1) ventilation injures edematous lungs and 2) ventilation with accelerated deflation might lessen ventilation injury.
Exposure-response modeling of flow-mediated dilation provides an unbiased and informative measure of endothelial function
Authors: Van Brackle Charles H. , Harris Ryan A. , Hallow K. Melissa
Published: December 2016

The brachial artery flow-mediated dilation (FMD) test is the most widely utilized method to evaluate endothelial function noninvasively in humans by calculating the percent change in diameter (FMD%). However, the underutilized velocity and diameter time course data, coupled with confounding influences in shear exposure, noise, and upward bias, make the FMD test less desirable. In this study, we developed an exposure-response, model-based approach that not only quantifies FMD based on the rich velocity and diameter data, it overcomes previously acknowledged challenges. FMD data were obtained from 15 apparently healthy participants, each exposed to four different cuff occlusion durations. The velocity response following cuff release was described by an exponential model with two parameters defining peak velocity and rate of decay. Shear exposure derived from velocity was used to drive the diameter response model, which consists of additive constriction and dilation terms. Three parameters describing distinct aspects of the vascular response to shear (magnitude of the initial constriction response, and magnitude and time constant of the dilation response) were estimated for both the individuals and population. These parameters are independent of shear exposure. Thus this approach produces identifiable and physiologically meaningful parameters that may provide additional information for comparing differences between experimental groups or over time, and provides a means to completely account for shear exposure.

NEW & NOTEWORTHY While flow-mediated dilation (FMD) is a valuable tool for evaluating endothelial function, analytical challenges include confounding influences of shear exposure, upward bias, and underutilization of rich time course data collected during FMD testing. We have developed an exposure-response, model-based approach that quantifies endothelial function based on the velocity and diameter data and fully accounts for shear exposure. It produces physiologically meaningful parameters that may provide useful information for comparing differences between experimental groups or over time.
Abstract A05: Proteomic analysis of exosome content changes induced by gemcitabine in pancreatic cancer stromal cells
Authors: Huang Wei , Feist Peter , Hummon Amanda , Hill Reginald
Published: December 2016

Despite recent advances in multimodality therapy, pancreatic ductal adenocarcinoma (PDAC) remains the 3rd leading cause of cancer-related deaths in the United States with a 5-year survival rate of 8%. One hallmark of this disease is desmoplasia that consist largely of stromal cells and extracellular matrix (ECM) proteins. The abundant stromal cells provide a unique tumor microenvironment that aid tumorigenesis. Unfortunately, there is little data on the mechanism underlying the stromal cells’ ability to impact chemoresistance in neighboring cancer cells in response to drug treatment. Exosomes are small vesicles secreted into the extracellular environment from cells and evidence is accumulating that exosomes play a key role in intercellular signaling. Researchers have focused on exosomes secreted from cancer cells, but the function of stromal exosomes has not been investigated, especially in pancreatic cancer. As stromal cells comprise the majority of the pancreatic tumor bulk, we hypothesize that stromal cell-derived exosomes help pancreatic cancer cells resist chemotherapy. Thus, it is critical to characterize the complex composition of stromal exosomes. In this study, we analyzed the proteomic content of exosomes collected from stromal cell lines created from PDAC patients. Furthermore, we also determined the change in exosomal proteomic composition after the patient-derived stromal cells were treated with gemcitabine, the current standard of care chemotherapy for patients with PDAC. Our studies have identified possible diagnostic and prognostic biomarkers and suggest novel molecular mechanism responsible for the tumor microenvironment’s ability to regulate chemoresistance in neighboring pancreatic cancer cells.

Citation Format: Wei Huang, Peter Feist, Amanda Hummon, Reginald Hill.{Authors}. Proteomic analysis of exosome content changes induced by gemcitabine in pancreatic cancer stromal cells. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A05.