bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fenofibrate increases cardiac autophagy via FGF21/SIRT1 and prevents fibrosis and inflammation in the hearts of Type 1 diabetic mice
Authors: Zhang Jingjing , Cheng Yanli , Gu Junlian , Wang Shudong , Zhou Shanshan , Wang Yuehui , Tan Yi , Feng Wenke , Fu Yaowen , Mellen Nicholas , Cheng Rui , Ma Jianxing , Zhang Chi , Li Zhanquan , Cai Lu 
Published: January 2016

Fenofibrate (FF), as a peroxisome-proliferator-activated receptor α (PPARα) agonist, has been used clinically for decades to lower lipid levels. In the present study, we examined whether FF can be repurposed to prevent the pathogenesi of the heart in Type 1 diabetes and to describe the underlying mechanism of its action. Streptozotocin (STZ)-induced diabetic mice and their age-matched control mice were treated with vehicle or FF by gavage every other day for 3 or 6 months. FF prevented diabetes-induced cardiac dysfunction (e.g. decreased ejection fraction and hypertrophy), inflammation and remodelling. FF also increased cardiac expression of fibroblast growth factor 21 (FGF21) and sirtuin 1 (Sirt1) in non-diabetic and diabetic conditions. Deletion of FGF21 gene (FGF21-KO) worsened diabetes-induced pathogenic effects in the heart. FF treatment prevented heart deterioration in the wild-type diabetic mice, but could not do so in the FGF21-KO diabetic mice although the systemic lipid profile was lowered in both wild-type and FGF21-KO diabetic mice. Mechanistically, FF treatment prevented diabetes-impaired autophagy, reflected by increased microtubule-associated protein 1A/1B-light chain 3, in the wild-type diabetic mice but not in the FGF21-KO diabetic mice. Studies with H9C2 cells in vitro demonstrated that exposure to high glucose (HG) significantly increased inflammatory response, oxidative stress and pro-fibrotic response and also significantly inhibited autophagy. These effects of HG were prevented by FF treatment. Inhibition of either autophagy by 3-methyladenine (3MA) or Sirt1 by sirtinol (SI) abolished FF's prevention of HG-induced effects. These results suggested that FF could prevent Type 1 diabetes-induced pathological and functional abnormalities of the heart by increasing FGF21 that may up-regulate Sirt1-mediated autophagy.
Surface plasmon resonance immunoassay for cortisol determination with a self‐assembling denaturalised bovine serum albumin layer on surface plasmon resonance chip
Authors: Chen Xing , Zhang Lulu , Cui Dafu 
Published: January 2016

A surface modification method has been developed to fabricate surface plasmon resonance (SPR) chip for small molecule determination. A novel denaturalised bovine serum albumin (dBSA)‐SPR‐chip was fabricated by a self‐assembling method, while a dextran‐SPR‐chip was prepared by using a traditional method. The surface morphologies of the two chips were investigated by atomic force microscopy technology and their optical properties were characterised by using our home‐made SPR analytical instrument. The surface binding capacity of the dBSA‐SPR‐chip is 2.5 times higher than that of the dextran‐SPR‐chip. On the basis of the experiments of immune reactions between cortisol antibody and cortisol derivative, the sensitivity of the dBSA‐SPR‐chip is much higher than that of the dextran‐SPR‐based SPR‐chip. The antibody concentration was optimised at about 10 µg/ml in order to obtain high sensitivity, which was used in the followed inhibition immunoassays. The lowest detection limit for cortisol is 1 ng/ml with a linear range of 5–100 ng/ml by using the dBSA‐SPR‐chip. These dBSA‐SPR‐chips can also be applied to detect other small molecules based on the indirect inhibitive immunoassay.
Teacher deliberation within the context of Singaporean curricular change: pre‐ and in‐service PE teachers’ perceptions of outdoor education
Authors: Atencio Matthew , Tan Yuen Sze Michelle 
Published: January 2016

ABSTRACTThe study featured in this paper investigates pre‐ and in‐service Physical Education (PE) teachers' diverse views of OE (Outdoor Education) against the backdrop of numerous curricular changes underpinning Singaporean education. We highlight the potential challenges Singaporean schools and teachers may face in implementing the newly formalized OE curriculum. Findings revealed the teachers' prioritization of high elements and adventure activities within residential camps. Then, the teachers linked these ‘risky’ and ‘unfamiliar’ activities with transferrable learning outcomes, mostly in line with students' personal and social development. The more experienced teachers in the cohort tended to advocate that OE could be situated within local school and community environs. Yet, this envisioning of OE within a place‐based learning model reflected limited understanding of this concept. We conclude by suggesting that curriculum designers and teacher educators should draw upon pre‐ and in‐service PE teachers' perceptions of OE. It is imperative that these teachers' key concerns and beliefs, which currently structure their work in this recently formalized subject area, are used to contextualize the extensive curricular change and professional learning endeavors that are being implemented by the education ministry.
The Wheel of Writing: a model of the writing domain for the teaching and assessing of writing as a key competency
Authors: Berge Kjell Lars , Evensen Lars Sigfred , Thygesen Ragnar 
Published: January 2016

ABSTRACTThe model presented in this article aspires to represent a theoretically valid and coherent definition and description of writing, as a basis for teaching and assessing writing as a key competency in school. It represents a critique as well as an extension of previous alternatives in that it views writing as a culturally and individually intentional act of semiotic mediation. Its perspective is sociocultural and functional; focussing on the relation between writing acts and their purposes, and its dynamic construction captures flexible relations between these. The communicative aspects encapsulate semiotic tools which written mediation affords. A discussion of curricular and didactic potentials finishes the article, illustrating how the model may form a basis for a varied teaching of writing, as well as being a tool for learning and assessment within and across school subjects.
Estimated Survival of Subadult and Adult Atlantic Sturgeon in Four River Basins in the Southeastern United States
Authors: Hightower Joseph E. , Loeffler Michael , Post William C. , Peterson Douglas L. 
Published: January 2016

Abstract
Prompted by concerns about the status of Atlantic Sturgeon Acipenser oxyrinchus oxyrinchus, in 2012 the National Oceanic and Atmospheric Administration listed one distinct population segment (DPS) as threatened (Gulf of Maine) and listed the remaining four DPSs as endangered (New York Bight, Chesapeake Bay, Carolina, and South Atlantic). To provide information for recovery planning, we estimated the survival of subadult and adult Atlantic Sturgeon in two river basins within the Carolina DPS (Roanoke and Cape Fear rivers, North Carolina) and two basins within the South Atlantic DPS (Ashepoo–Combahee–Edisto rivers [ACE], South Carolina; Altamaha River, Georgia). Estimated detection probability varied strongly by season but was similar among river basins, likely reflecting a winter migration into marine waters with minimal receiver coverage. Apparent monthly survival was very high and precisely estimated for the Roanoke River (0.985; 95% credible interval [CI] = 0.970–0.995), Cape Fear River (0.979; 95% CI = 0.971–0.986), ACE (0.989; 95% CI = 0.979–0.993), and Altamaha River (0.985; 95% CI = 0.973–0.994) basins. A pooled estimate for 87 adults from all four basins was 0.988 (95% CI = 0.982–0.992). The monthly rates implied annual apparent survival rates of 0.839 (Roanoke River basin), 0.778 (Cape Fear River basin), 0.871 (ACE basin), and 0.842 (Altamaha River basin); the pooled estimate for adults was 0.860. Our estimated survival rates were similar to other recent estimates for Atlantic Sturgeon but lower than recent estimates for several populations of Gulf Sturgeon A. oxyrinchus desotoi. Recovery of Atlantic Sturgeon in these southeastern rivers will occur more quickly if survival can be increased to a level that is consistent with published estimates of true natural mortality (0.03–0.07; annual survival ≥ 0.93).
Received March 18, 2015; accepted August 26, 2015
Estimating productivity, technical and efficiency changes in the Western Pacific purse-seine fleets
Authors: Tidd Alex N. , Reid Chris , Pilling Graham M. , Harley Shelton J. 
Published: January 2016

AbstractThe purse-seine tuna fleet in the Western Pacific Ocean has undergone an accelerated expansion since the 1980s. The fishery is primarily managed using fishing effort limits. Constraining effort to ensure the biological health of the stock, while enhancing economic benefits generated by the fishery, is a major challenge faced by fisheries managers in this region. To maintain effort levels that achieve those objectives, there is a need to take into account technical and efficiency changes over time that influence the productivity of fleets. This study evaluates how the productivity of four of the region's purse-seine fleets has changed year on year between 1993 and 2010 using a robust bootstrapped Malmquist index approach. This index is separated into: technical change, which represents the change in productivity due to the introduction of new technology and efficiency change, the change in productivity resulting from a change in the level of efficiency in the use of inputs. The results show that half of the 56 purse-seine vessels examined displayed significant gains in productivity, which appeared to be driven primarily by technical change. The technical efficiency of fleets showed less marked changes, potentially due to the practical inability to maximize performance in the face of dramatic technological advances.
Outcomes of Older Adults With Sepsis at Admission to an Intensive Care Unit
Authors: Rowe Theresa , Araujo Katy L. B. , Van Ness Peter H. , Pisani Margaret A. , Juthani-Mehta Manisha 
Published: January 2016

Abstract
Background.  Sepsis is a major cause of morbidity and mortality among older adults. The main goals of this study were to assess the association of sepsis at intensive care unit (ICU) admission with mortality and to identify predictors associated with increased mortality in older adults.
Methods.  We conducted a prospective cohort study of 309 participants ≥60 years admitted to an ICU. Sepsis was defined as 2 of 4 systemic inflammatory response syndrome criteria plus a documented infection within 2 calendar days before or after admission. The main outcome measure was time to death within 1 year of ICU admission. Sepsis was evaluated as a predictor for mortality in a Cox proportional hazards model.
Results.  Of 309 participants, 196 (63%) met the definition of sepsis. Among those admitted with and without sepsis, 75 (38%) vs 20 (18%) died within 1 month of ICU admission (P &lt; .001) and 117 (60%) vs 48 (42%) died within 1 year (P &lt; .001). When adjusting for baseline characteristics, sepsis had a significant impact on mortality (hazard ratio [HR] = 1.80; 95% confidence interval [CI], 1.28–2.52; P &lt; .001); however, after adjusting for baseline characteristics and process covariates (antimicrobials and vasopressor use within 48 hours of admission), the impact of sepsis on mortality became nonsignificant (HR = 1.26; 95% CI, .87–1.84; P = .22).
Conclusions.  The diagnosis of sepsis in older adults upon ICU admission was associated with an increase in mortality compared with those admitted without sepsis. After controlling for early use of antimicrobials and vasopressors for treatment, the association of sepsis with mortality was reduced.
Tramadol-Paracetamol Combination for Postoperative Pain Relief in Elective Single-level Microdisectomy Surgery
Authors: Dogar Samie A. , Khan Fauzia A. 
Published: January 2016

Background:The tramadol and paracetamol combination is used frequently for postoperative pain management. The literature on the use of this combination for vertebral surgery is limited. Our objective was to compare a combination of paracetamol 1 g and a lower dose of tramadol (1 mg/kg: group 1T) with a combination of paracetamol 1 g and a higher dose of tramadol (1.5 mg/kg: group 1.5T) for postoperative pain after microdisectomy surgery. Our main outcome measure was Visual Analogue Scale pain scores for 4 hours postoperatively.Methods:This prospective randomized triple-blind clinical trial was conducted at Aga Khan University Hospital, Karachi. Ninety-four patients aged between 18 and 50 years scheduled for elective single-level microdisectomy were allocated randomly into 1 of 2 groups. Twenty minutes before the end of the surgery, patients received the study drugs.Results:There was no significant demographic difference between groups. None of the patients experienced severe pain (VAS>6). There was no significant difference in the mean pain score between groups. The mean score at 4 hours was 2.17 (1.38) in group 1.5T and 1.74 (1.37) in group 1T. The difference was not statistically significant (P=0.14). In group 1.5T, 13 patients reported having nausea and vomiting compared with 2 patients in group 1T. This was a statistically significant difference (P=0.004). The sedation score was similar between groups.ConclusionsThe combination of low-dose tramadol (1 mg/kg) and paracetamol has comparable analgesia and a decreased incidence of nausea and vomiting compared with the higher dose of tramadol (1.5 mg/kg) and paracetamol combination.
Development and Validation of a Clostridium difficile Health-related Quality-of-Life Questionnaire
Authors: Garey Kevin W. , Aitken Samuel L. , Gschwind Liliane , Goddu Sumana , Xie Yang , Duff Catherine , Barbut Frédéric , Shah Dhara N. , DuPont Herbert L. 
Published: January 2016

Goals and Background:
Patients with Clostridium difficile infection (CDI) can experience long-term symptoms and poor quality of life due to the disease. Despite this, a health-related quality of life (HRQOL) instrument specific for patients with CDI does not exist. The aim of this study was to develop and validate a disease-specific instrument to assess HRQOL in patients with CDI.

Study:
A systematic literature review was conducted to identify HRQOL instruments and questions related to general health (n=3) or gastrointestinal disease (n=12) potentially related to CDI HRQOL. Removing duplicate questions and using direct patient or clinician interviews, a 36-item survey was developed. The survey was then tested using 98 patients with CDI and compared with the RAND Short-Form 36 (SF-36) Health Survey. Psychometric analysis techniques were used to identify domains and remove redundant items.

Results:
Exploratory factor analysis identified 3 major domains (physical, mental, and social) with 4 associated subdomains. Survey overall and domain scores displayed good internal consistency (Cronbach α coefficient >0.87) and concurrent validity evidenced by significant correlation with SF-36 scores. The C. difficile survey scores were better able than the SF-36 to discriminate quality-of-life score differences in patients with primary versus recurrent CDI and increasing time since last episode of CDI. The final version contained 32 items related to the physical, mental, and social health of CDI patients.

Conclusion:
The properties of the newly developed Cdiff32 should make it appropriate to assess changes over time in HRQOL in patients with CDI.
Reporting on Outcome Measures of Functional Constipation in Children—A Systematic Review
Authors: Kuizenga‐Wessel Sophie , Heckert Sascha L. , Tros Willemijn , van Etten‐Jamaludin Faridi S. , Benninga Marc A. , Tabbers Merit M. 
Published: January 2016

ABSTRACTObjective:Standardized outcome measures provide a basis for comparing outcomes of different clinical trials. Consequently, they can serve as the foundation for determining which therapeutic interventions are most effective. The aim of the present study is to systematically assess how definitions and outcome measures are defined in therapeutic randomized controlled trials (RCTs) of children with functional constipation (FC).Methods:PubMed, EMBASE, and Cochrane databases were searched. Studies were included if it was a (systematic review of) therapeutic RCT, concerning children from 1 to 18 years old with FC, a definition of FC was provided, and if they were written in English. The Delphi list was used for quality assessment.Results:A total of 4092 articles were found but only 45 studies fulfilled our inclusion criteria. In these 45 trials, 22 different definitions of FC were used (17 studies used the Rome III‐criteria), 27 different interventions were investigated, and 29 different definitions of treatment success were used. Thirty RCTs (57%) reported primary outcomes of which treatment success was the most frequently used. Most trials (80%) used parental diaries of which only 2 RCTs stated that their instrument was validated. Twenty‐four trials (53%) were of good methodological quality.Conclusions:Inconsistency and heterogeneity exist in definitions and outcome measures used in RCTs on childhood FC. Standard definitions, outcome measures, and also validated instruments are needed. We recommend the development of a minimum core outcome set for clinical research in children with FC to make comparison possible between the effects of different therapeutic interventions across studies.
Long-Term Follow-Up of Quality of Life following DIEP Flap Breast Reconstruction
Authors: Hunsinger Vincent , Hivelin Mikael , Derder Mohamed , Klein Delphine , Velten Michel , Lantieri Laurent 
Published: January 2016

Background:
Sequelae resulting from breast cancer negatively impact patients’ quality of life. Although the deep inferior epigastric perforator (DIEP) flap has become a standard for autologous breast reconstruction, there are limited data regarding long-term quality of life. The authors studied patients’ quality of life more than 5 years after DIEP flap breast reconstruction and compare it with two French reference samples.

Methods:
A cross-sectional study of quality of life was performed in women who underwent DIEP flap breast reconstruction between 1995 and 2007 using the Medical Outcomes Study 36-Item Health Survey (Short Form-36). The first reference sample included subjects from the French general population (n = 3308), and the second included cancer survivors who underwent mastectomy with (n = 70) or without (n = 135) breast reconstruction.

Results:
One hundred eleven respondents were analyzed among 186 eligible women. The mean follow-up period after reconstruction was 8.6 years (range, 5 to 15 years). There were no statistically significant differences in the quality of life between women from 45 to 64 years old who underwent DIEP flap breast reconstruction and from the French general population. Five of the eight Short Form-36 dimensions were significantly better in the DIEP flap breast reconstruction group in the 65- to 74-year-old cohort. In addition, quality of life of our study population was significantly higher than that of women who underwent mastectomy with or without any type of breast reconstruction.

Conclusion:
These results indicate that DIEP flap breast reconstruction allows patients with breast cancer to maintain a good postoperative quality of life comparable to that of the general population.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Classification and Algorithmic Management of Constricted Ears: A 22-Year Experience
Authors: Park Chul , Park Jung Youl 
Published: January 2016

Background:
The classification and corrective methods for the constricted ears continue to be controversial. To clarify them, the authors have reviewed and analyzed cases operated on at their Center from January of 1992 to January of 2014.

Methods:
A total of 164 ear cases (involving 139 patients), showing features of lidded helix, compression of scapha and fossa triangularis, and/or cup-like protrusions, were included in their study (microtias with constricted ear features were excluded) and reviewed through medical records, photographs, analysis of surgical methods, and postoperative outcomes.

Results:
The deformed ears were classified into four graded types by means of the antihelical tubing test and the scapha-helix push test as follows: type I (n = 21), type II (n = 63), type III (n = 38), and type IV (n = 42). Throughout this series, the authors have continued the improvement and performance of consistent operative techniques. Antihelical tubing, concha cartilage grafting, tumbling concha-cartilage flap, antihelical wrapping, and helical expansion were the preferred techniques. A total of 144 ear cases (88 percent) were followed for 1 month to 14 years (average, 13.2 months). The average score of aesthetic outcomes, rated on a four-point Likert scale (i.e., 1 = poor, 2 = fair, 3 = good, and 4 = excellent), was 3.3. Corrective methods and aesthetic outcomes for patients with each graded type of deformity were described.

Conclusions:
Constricted ears were effectively corrected by a graded surgical approach. All corrections were performed in one stage, without removal of deformed auricular cartilage.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Importance-performance analysis of service quality dimensions for the customer groups segmented by DEA
Authors: Dabestani Reza , Shahin Arash , Saljoughian Mohammad , Shirouyehzad Hadi 
Published: January 2016

Purpose
– The purpose of this paper is to prioritize service quality dimensions (SQDs) using importance-performance analysis (IPA) and to compare the results for the customer groups segmented by data envelopment analysis (DEA).

Design/methodology/approach
– Customers of three four-star hotels located in Isfahan have been asked to report on their expectation of service prior to receiving it as well as their perception of the service after receiving it. Afterwards, DEA has been used to assign the customers into two groups of fastidious (with relatively high expectations but low perceptions) and ordinary (with relatively low expectations but high perceptions). Next, IPA has been exploited for prioritizing SQDs in each group. Eventually, the prioritized SQDs in each group have been compared and insightful information has been extracted for further research and practical purposes.

Findings
– Findings imply that despite occasional similarities, there is a significant difference in the way the two groups value SQDs. Also, the segmented groups have different priorities of SQDs.

Research limitations/implications
– Findings revealed that in order to decrease the ambiguity of customer voice in prioritizing SQDs, it might be helpful to first segregate the participants based on their attitudes towards the quality of service to have a more congruent sample and then, to analyze the data.

Practical implications
– In this study, a smarter approach for prioritizing SQDs based on the data of two major groups of customers has been proposed, which can help hoteliers in devoting their resources more efficiently.

Originality/value
– The combination of DEA and IPA in homogenizing the sample and prioritizing SQDs for each homogenized group within the sample seems relatively novel.