Students master courses by interacting with a multitude of learning objects. These interactions may include reading documents, watching explanatory videos, taking notes, completing assignments, and experimenting with physical objects. During these interactions, students often have to switch between different learning environments, including Web browsers, video players, textbooks, and workbooks. By integrating these different environments into a unified learning environment, we can save students' time. Moreover, thanks to an increasing adoption of tablets in schools and universities, we also have the opportunity to deploy this unified learning environment on a single mobile device, thus enabling anytime and anywhere learning. We refer to such a learning environment as a 'first-class' mobile learning environment. In this paper, we empirically investigate to what extent an EPUB 3-based e-TextBook can be used to facilitate a 'first-class' mobile learning environment. To that end, we created an EPUB 3-based prototype e-TextBook that has been enhanced in terms of both its presentation and representation, meeting requirements that are typically ascribed by the literature to mobile learning environments. Specifically, we integrated three interactive widgets into our e-TextBook that are able to (1) exchange information with each other (inter-widget communication) and (2) that are able to semi-automatically create new content (that is, that are able to act as semi-automatic content providers): a report maker widget, a sine formula widget, and a corresponding interactive graph maker widget. In addition, we integrated different types of learning objects into our e-TextBook, including multimedia objects, objects with augmented reality features (i.e., digital objects that allow for interaction with physical objects), and objects that offer contextualized content. Both the widgets and the learning objects can be used within a unified learning environment. Furthermore, we semantically annotated the learning content in order to improve its discoverability. We find that our e-TextBook complies with the requirements found in the literature. Moreover, our e-TextBook makes it possible to provide visual feedback on student actions, thus having positive effects on the learning process. In addition, our e-TextBook mitigates distraction by providing a unified mobile learning environment. Furthermore, the use of EPUB 3 allows for interoperable packaging of semantically annotated learning content. Finally, the use of EPUB 3 paves the way for mobile usage of learning content, and thus for anytime and anywhere learning.
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Πέμπτη 14 Ιανουαρίου 2016
Towards making EPUB 3-based e-textBooks a first-class mobile learning environment
Clustering media items stemming from multiple social networks
We have created and evaluated an algorithm capable of deduplicating and clustering exact- and near-duplicate media items of type photo and video that get shared on multiple social networks in the context of events. This algorithm works in an entirely ad hoc manner without requiring any pre-calculation. When people attend events, they more and more share event-related media items publicly on social networks to let their social network contacts relive and witness the attended events. In the past, we have worked on methods to accumulate such public user-generated multimedia content in order to summarize events visually, for example, in the form of media galleries or slideshows. In this paper, first, we introduce social-network-specific reasons and challenges that cause near-duplicate media items. Second, we detail an algorithm for the task of deduplicating and clustering exact- and near-duplicate media items stemming from multiple social networks. Finally, we evaluate the algorithm's strengths and weaknesses and thoroughly compare its performance with the state-of-the-art feature detection algorithms SIFT, ASIFT and SURF and show that for the given use case it performs almost equally well accuracy-wise, but strongly outperforms speed-wise.
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Linked data-as-a-service: the semantic web redeployed
Ad-hoc querying is crucial to access information from Linked Data, yet publishing queryable RDF datasets on the Web is not a trivial exercise. The most compelling argument to support this claim is that the Web contains hundreds of thousands of data documents, while only 260 queryable SPARQL endpoints are provided. Even worse, the SPARQL endpoints we do have are often unstable, may not comply with the standards, and may differ in supported features. In other words, hosting data online is easy, but publishing Linked Data via a queryable API such as SPARQL appears to be too difficult. As a consequence, in practice, there is no single uniform way to query the LOD Cloud today. In this paper, we therefore combine a large-scale Linked Data publication project (LOD Laundromat) with a low-cost server-side interface (Triple Pattern Fragments), in order to bridge the gap between the Web of downloadable data documents and the Web of live queryable data. The result is a repeatable, low-cost, open-source data publication process. To demonstrate its applicability, we made over 650,000 data documents available as data APIs, consisting of 30 billion triples.
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Direct Difunctionalization of Activated Alkynes via Domino Oxidative Benzylation/1,4-Aryl Migration/Decarboxylation Reactions under Metal-free Conditions
DOI: 10.1039/C5CC10084D, Communication
An oxidative difunctionalization of aryl alkynoate via benzyl radical initiated intramolecular 1,4-aryl migration and decarboxylation tandem process was developed in presence of tert-butyl hydroperoxide (TBHP) as an oxidant, which provides...
The content of this RSS Feed (c) The Royal Society of Chemistry
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A Fluorescent Molecular Capsule with a Flexible Polyaromatic Shell for Detecting Monoterpene Compounds in Water
DOI: 10.1039/C5CC09647B, Communication
A new molecular capsule with a flexible fluorescent shell was formed by the quantitative self-complementary assembly of amphiphilic, U-shaped polyaromatic subunits in water. The capsule can fully encapsulate a variety...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Increasing the quantitative bandwidth of NMR measurements
DOI: 10.1039/C5CC10206E, Communication
The frequency range of quantitative NMR is increased from tens to hundreds of kHz by a new pulse sequence, CHORUS. It uses chirp pulses to excite uniformly over very large...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Super-fast Synthesis of ZnO Nanowires by Microwave Air-Plasma
DOI: 10.1039/C5CC09051B, Communication
Microwave radiation is focussed on the sharp edges of the Zn swarf. Plasma is produced by the microwave in the atmospheric condition and successfully used to synthesize ZnO nanowires and...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Addition of Silylated Nucleophiles to [small alpha]-Oxoketenes
DOI: 10.1039/C5CC10217K, Communication
A general evaluation of silylated nucleophiles to intercept transient [small alpha]-oxoketenes generated by microwave-assisted Wolff rearrangement of 2-diazo-1,3-dicarbonyl compounds is presented. Original scaffolds and synthetic intermediates are accessed in a rapid,...
The content of this RSS Feed (c) The Royal Society of Chemistry
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The Obesity Epidemic — Understanding the Disease and the Treatment
The prevalence of severe obesity in the United States has increased dramatically, not only among adults but also among children. The increase in childhood severe obesity, defined as 120% of the age-specific 95th percentile of body-mass index (BMI), has been alarming; the prevalence has risen from…
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Influence of Initial Conditions on Propagation, Growth and Decay of Saturation Overshoot
Abstract
A sequence of drainage and imbibition shocks within the traditional theory of two-phase immiscible displacement can give rise to shallow non-monotone saturation profiles as shown in Hilfer and Steinle (Eur Phys J Spec Top 223:2323, 2014). This phenomenon depends sensitively on model parameters and initial conditions. The dependence of saturation overshoot on initial conditions is investigated more systematically in this article. The results allow to determine regions in the parameter space for the observation of saturation overshoot and to explore limitations of the underlying idealized hysteresis model. Numerical solutions of the nonlinear partial differential equations of motion reveal a strong dependence of the overshoot phenomenon on the boundary and initial conditions. Overshoot solutions with experimentally detectable height are shown to exist numerically. Extensive parameter studies reveal different classes of initial conditions for which the width of the overshoot region can decrease, increase or remain constant.
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A non-sense MCM9 mutation in a familial case of primary ovarian insufficiency
Abstract
Primary Ovarian Insufficiency (POI) results in an early loss of ovarian function, and remains idiopathic in about 80% of cases. Here, we have performed a complete genetic study of a consanguineous family with two POI cases. Linkage analysis and homozygosity mapping identified twelve homozygous regions with linkage, totalling 84 Mb. Whole-exome sequencing of the two patients and a non-affected sister allowed us to detect a homozygous causal variant in the MCM9 gene. The variant c.1483G>T [p.E495*], confirmed by Sanger sequencing, introduced a premature stop codon in coding exon 8 and is expected to lead to the loss of a functional protein. MCM9 belongs to a complex required for DNA repair by homologous recombination, and its impairment in mouse is known to induce meiotic recombination defects and oocyte degeneration. A previous study recently described two consanguineous families in which homozygous mutations of MCM9 were responsible for POI and short stature. Interestingly, the affected sisters in the family described here had a normal height. Altogether, our results provide the confirmation of the implication of MCM9 variants in POI and expand their phenotypic spectrum.
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Enriched Flavonoid Fraction from Cecropia pachystachya Trécul Leaves Exerts Antidepressant-like Behavior and Protects Brain Against Oxidative Stress in Rats Subjected to Chronic Mild Stress
Abstract
The purpose of this study was to assess the effect of an enriched C-glycosyl flavonoids fraction (EFF-Cp) from Cecropia Pachystachya leaves on behavior, mitochondrial chain function, and oxidative balance in the brain of rats subjected to chronic mild stress. Male Wistar rats were divided into experimental groups (saline/no stress, saline/stress, EFF-Cp/no stress, and EFF-Cp/stress). ECM groups were submitted to stress for 40 days. On the 35th ECM day, EFF-Cp (50 mg/kg) or saline was administrated and the treatments lasted until the 42nd day. On the 41st and 42nd days, the animals were submitted to the splash test and the forced swim test. After these behavioral tests, the enzymatic activity of mitochondrial chain complexes and oxidative stress were analyzed. EFF-Cp reversed the depressive-like behavior induced by ECM. It also reversed the increase in thiobarbituric acid reactive species, myeloperoxidase activity, and nitrite/nitrate concentrations in some brain regions. The reduced activities of the antioxidants superoxide dismutase and catalase in some brain regions were also reversed by EFF-Cp. The most pronounced effect of EFF-Cp on mitochondrial complexes was an increase in complex IV activity in all studied regions. Thus, it is can be concluded that EFF-Cp exerts an antidepressant-like effect and that oxidative balance may be an important physiological process underlying these effects.
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Socio-Technical Security Metrics (Dagstuhl Seminar 14491)
Gollmann, D; Herley, C; Koenig, V; Pieters, W; Sasse, MA; (2015) Socio-Technical Security Metrics (Dagstuhl Seminar 14491). Dagstuhl Reports , 4 (12) pp. 1-28. 10.4230/DagRep.4.12.1 . Green open access
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Global Dimension In Secondary Schools
Bourn, D; Hunt, F; (2011) Global Dimension In Secondary Schools. (Research Papers 1 ). Development Education Research Centre, Institute of Education, University College London: London, UK. Green open access
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Learner councils in South African schools: Adult involvement and learners' rights
Hunt, F; (2014) Learner councils in South African schools: Adult involvement and learners' rights. Education, Citizenship and Social Justice , 9 (3) pp. 268-285. 10.1177/1746197914545928 . Green open access
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What makes an "innovation champion"?
Sergeeva, N; (2016) What makes an "innovation champion"? European Journal of Innovation Management , 19 (1) pp. 72-89. 10.1108/EJIM-06-2014-0065 .
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Making as if to stand behind one's words: A theory of intentional deception and lying.
Ali, M.S.; (2004) Making as if to stand behind one's words: A theory of intentional deception and lying. Doctoral thesis, University of London. Green open access
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UN 'households' and local interpretations in Burkina Faso, Senegal, Uganda and Tanzania
Randall, SC; Coast, E; Dial, F-B; (2013) UN 'households' and local interpretations in Burkina Faso, Senegal, Uganda and Tanzania. Presented at: 5th ECAS conference: African dynamics in a multipolar world, Lisbon. Green open access
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Fragmentation and Democratic Transformations in Kenya: Ethnicity as an Outcome Rather Than a Cause (1992-2013)
Rigon, A; (2013) Fragmentation and Democratic Transformations in Kenya: Ethnicity as an Outcome Rather Than a Cause (1992-2013). ISPI Studies (170) Gold open access
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The convergence debate: more than getting an efficient process
Rigon, A; (2013) The convergence debate: more than getting an efficient process. [Digital scholarly resource]. http://ift.tt/1J4yCuF... Green open access
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Changing indicators to change the world: evidence from the ground
Rigon, A; (2013) Changing indicators to change the world: evidence from the ground. [Digital scholarly resource]. http://ift.tt/201J2iW... Green open access
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Ethnic Variation in Lipid Profile and Its Associations with Body Composition and Diet: Differences Between Iranians, Indians and Caucasians Living in Australia
Abstract
Dyslipidaemia is a known risk factor for developing cardiovascular disease. The impact of ethnicity on variations in lipid patterns has been studied in certain racial and ethnic groups with limited data on other ethnicities, particularly Asian subgroups. This cross-sectional study evaluated the ethnic variation in lipid profile and its association with body composition and diet in ninety-one overweight and obese Australians of European (n = 32), Indian (n = 28) and Iranian (n = 31) ancestries. Different measures of total and truncal adiposity were assessed using the method of whole body dual energy X-ray absorptiometry. The results showed that serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-chol) levels in Iranians were significantly lower than in Europeans and Indians. Both Iranian and Indian groups exhibited lower mean high density lipoprotein cholesterol (HDL-chol) relative to Europeans. Triglycerides (TG) and HDL-chol, but not TC and LDL-chol, were significantly associated with different truncal adiposity measurements; however the degree of associations varied in ethnic groups. Regression analysis showed ethnicity as a significant predictor of TC (p = 0.01), TG (p = 0.03) and HDL-chol (p = 0.04), after controlling for potential confounders. However, LDL-chol was significantly associated with the intake of total (p = 0.005), and saturated fats (p = 0.004), which were also other significant determinants of serum TC (p = 0.04 and p = 0.02, respectively). In conclusion, ethnicity was a strong predictor of serum lipids, except LDL-chol which was significantly determined by dietary fat intake. Prevention and management of obesity, particularly abdominal adiposity may effectively reduce the risk of low HDL-chol reported in Iranians and Indians.
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Fluoride toothpaste supplemented with sodium hexametaphosphate reduces enamel demineralization in vitro
Abstract
Objective
The aim of this study was to evaluate the effect of fluoride dentifrices combined with sodium hexametaphosphate (HMP) on enamel demineralization in vitro.
Material and methods
Enamel bovine blocks were selected by initial surface hardness (SHi) and then divided into five experimental groups (n = 12): placebo (without fluoride and without HMP); 1100 ppm F (1100F); and 1100F associated with HMP at 0.5 % (1100HMP0.5%), 1 % (1100HMP1%), and 2 % of HMP (1100HMP2%). Blocks were submitted to five pH cycles (demineralizing/remineralizing solutions) at 37 °C. After pH cycling, final surface hardness (SHf), percentage of surface hardness loss (%SH), integrated differential hardness (ΔIH), integrated loss of subsurface hardness (ΔKHN), and enamel firmly bound fluoride (F) were determined. Data were submitted to one-way ANOVA, followed by Student–Newman–Keuls test (p < 0.05).
Results
Significant differences were observed among all groups regarding %SH and ΔKHN. 1100HMP1% promoted the lowest mineral loss among all groups (p < 0.001), and led to significantly lower demineralization in the deeper regions of the subsurface lesion when compared with the other HMP-containing toothpastes (p < 0.001). Significantly higher mineral loss was observed for 1100HMP2% when compared to the other fluoridated dentifrices, mainly in the outer part of the lesion (p < 0.001). Enamel F uptake was similar for 1100F and 1100HMP1% but significantly reduced for other HMP concentrations.
Conclusion
The supplementation of a 1100-ppm F dentifrice with 1 % HMP promoted a higher inhibitory effect against enamel demineralization when compared to a dentifrice containing the same amount of fluoride in vitro.
Clinical relevance
This dentifrice could potentially be indicated to patients at high risk of caries.
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A 70% Ethanol Extract of Mistletoe Rich in Betulin, Betulinic Acid, and Oleanolic Acid Potentiated β-Cell Function and Mass and Enhanced Hepatic Insulin Sensitivity
We investigated that the long-term consumption of the water (KME-W) and 70% ethanol (KME-E) mistletoe extracts had antidiabetic activities in partial pancreatectomized (Px) rats. Px rats were provided with a high-fat diet containing 0.6% KME-E, 0.6% KME-W, and 0.6% dextrin (control) for 8 weeks. As normal-control, Sham-operated rats were provided with 0.6% dextrin. In cell-based studies, the effects of its main terpenoids (betulin, betulinic acid, and oleanolic acid) on glucose metabolism were measured. Both KME-W and KME-E decreased epididymal fat mass by increasing fat oxidation in diabetic rats. KME-E but not KME-W exhibited greater potentiation of first-phase insulin secretion than the Px-control in a hyperglycemic clamp. KME-E also made β-cell mass greater than the control by increasing β-cell proliferation and decreasing its apoptosis. In a euglycemic-hyperinsulinemic clamp, whole-body glucose infusion rate and hepatic glucose output increased with potentiating hepatic insulin signaling in the following order: Px-control, KME-W, KME-E, and normal-control. Betulin potentiated insulin-stimulated glucose uptake via increased PPAR-γ activity and insulin signaling in 3T3-L1 adipocytes, whereas oleanolic acid enhanced glucose-stimulated insulin secretion and cell proliferation in insulinoma cells. In conclusion, KME-E prevented the deterioration of glucose metabolism in diabetic rats more effectively than KME-W and KME-E can be a better therapeutic agent for type 2 diabetes than KME-W.
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PROX1 promotes secretory granule formation in medullary thyroid cancer cells
Endocrinology, Early Release.
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Low Oxygen Tension Modulates the Insulin-like Growth Factor -1 or -2 Signaling via Both Insulin-like Growth Factor-1 Receptor and Insulin Receptor to Maintain Stem Cell Identity in Placental Mesenchymal Stem Cells
Endocrinology, Early Release.
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‘Unusual Excrescences of Nature’. Collected Coral and the Study of Petrified Luxury in Seventeenth-Century Antwerp
Many seventeenth-century Antwerp collections contained red coral, both natural and crafted. Also, coral was a pictorial motif depicted by Antwerp artists on mythological scenes, still lifes, paintings of collector's cabinets, and allegories. This paper provides a 'biography of coral' in early seventeenth-century Antwerp to explain the interest in this naturalia. It argues that the interest in coral resulted from the fascination with metamorphoses – in particular the process of petrifaction, which highly interested naturalists, but also had artisanal, mythological, and religious connotations. Antwerp painters, engravers, gold- and silversmiths, jewellers, apothecaries, and collectors were knowledgeable about coral in different ways. Added up, their stories explain the multi-layered meaning of coral that was intrinsic to the value attached to this 'unusual excrescence of nature'. Coral was indeed many things at the same time: a commodity crafted into jewellery and artefacts, a popular collectable in its natural shape, a motif for Antwerp painters, an essential commodity in the European-Indian trade network, a naturalia associated with classical mythology, a substance associated with the Blood of Christ, and a problematic naturalia that raised questions about classification, origins and natural processes.
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Mendel at the sesquicentennial of 'Versuche uber Pflanzen-Hybriden' (1865): the root of the biggest legend in the history of science
In 1965, Mendel was still celebrated as the undisputed founder of genetics. In the ensuing 50 years, scholars questioned and undermined this traditional interpretation of his experiments with hybrid plants, without, however, managing to replace it: at the sesquicentennial of the presentation of his 'Versuche' (1865), the Moravian friar remains, to a vast majority, the heroic Father of genetics or at least some kind of geneticist. This exceptionally inert myth is nourished by ontological intuitions but can only continue to flourish, thanks to a long-standing conceptual void in the historiography of biology. It is merely a symptom of this more fundamental problem. 'Historians of science are trained and paid to replace simple stories (...).' (1)
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Negotiation of terms of address in a Chilean television talk show
This paper focuses on the negotiation and interactional shifts between the three pronominal terms of address in Chilean Spanish. The threefold Chilean address system is currently experiencing a linguistic change with an increasing use of verbal voseo, which results in a complex sociolinguistic and pragmatic variability. The few empirical studies on the topic in Chilean Spanish mainly consider sociolinguistic factors, while intraspeaker shifts, albeit common in the variety, are mostly neglected. This paper examines these particularities from a pragmatic viewpoint, based on the discursive approach to the study of politeness of Watts (2003). Diverse macro and micro pragmatic factors are explored through an analysis of interview and humoristic discourse of a television talk show to gain better insight into the variability and dynamic meaning negotiation of the Chilean terms of address.
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Chemotherapy for Tuberculous Meningitis
Tuberculous meningitis, the most destructive form of tuberculosis, continues to be associated with considerable mortality and morbidity; among children, it is the major cause of death resulting from tuberculosis. The consequences of tuberculous meningitis are yet again clearly shown in the article…
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Intensified Antituberculosis Therapy in Adults with Tuberculous Meningitis
Early treatment with antituberculosis chemotherapy and adjunctive treatment with glucocorticoids reduce the rate of death and disability from tuberculous meningitis, but the disease still kills or disables almost half the patients with the condition. The current guidelines recommend treatment with…
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Relationship between Nonmedical Prescription-Opioid Use and Heroin Use
The nonmedical use of prescription opioids is a major public health issue in the United States, both because of the overall high prevalence and because of marked increases in associated morbidity and mortality. In 2014, a total of 10.3 million persons reported using prescription opioids…
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Chronic refractory myofascial pain and denervation supersensitivity as global public health disease
Chronic pain with a 30.3% global prevalence significantly impacts universal health. Low back pain has a 9.4% prevalence worldwide causing the most widespread disability. Neck pain ranks 4th highest regarding years lived with disability with a 4.9% prevalence worldwide. The principal cause of pain in 85% of patients visiting a tertiary pain clinic has a myofascial origin. The root cause is multifocal neuromuscular ischaemia at myofascial trigger points from muscle tightening and shortening following spondylotic radiculopathy induced partial denervation. Chronic refractory myofascial pain (CRMP) is a neuromusculoskeletal disease needing management innovations. Using electrical twitch-obtaining intramuscular stimulation (eToims), we provide objective evidence of denervation supersensitivity in multiple myotomes as cause, aggravation and maintenance of CRMP. This study underscores our previous findings that eToims is safe and efficacious for long-term use in CRMP. eToims aids potential prevention (pre-rehabilitation), simultaneous diagnosis, treatment (rehabilitation) and prognosis in real time for acute and CRMP management.
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Evodiamine induces apoptosis and enhances apoptotic effects of erlotinib in wild-type EGFR NSCLC cells via S6K1-mediated Mcl-1 inhibition
Abstract
Erlotinib is effective in NSCLC patients with known drug-sensitizing EGFR mutations, but its clinical efficacy in patients with wild-type EGFR or acquired resistance to erlotinib remains modest. Evodiamine is a chemical extracted from the Evodia rutaecarpa (Juss.) Benth, we showed that evodiamine could induce anti-proliferation and apoptosis in four wild-type EGFR NSCLC cell lines, and combining evodiamine with erlotinib might successfully inhibit cell proliferation and survival in wild-type EGFR NSCLC cells, characterized as erlotinib-resistant. In addition, evodiamine plus erlotinib significantly increased the apoptotic rate of NSCLC cells, as compared to single agent treatment alone. Further investigation of the mechanism underlying these effects revealed that evodiamine plus erlotinib might downregulate Mcl-1 expression through the mTOR/S6K1 control of its translation. Thus, our study has revealed evodiamine as a pertinent sensitizer to erlotinib and the strategy of combining erlotinib with evodiamine appears to be an attractive option for reversing resistance to erlotinib.
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State Medicaid Expansion and Changes in Hospital Volume According to Payer
To the Editor: The Affordable Care Act (ACA) has many potential implications for the hospital industry. One of the most closely followed issues is the expansion of Medicaid, which became a state option as a result of the Supreme Court decision of 2012. As of this writing, 31 states and Washington,…
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Future of Long-Term Care and the Expanding Role of Medicaid Managed Care
America faces a complex policy challenge that lies at the intersection of social welfare and health care: the 12 million people who cope with one or more chronic disabling conditions requiring them to use long-term services and supports (LTSS) (also called long-term care) must negotiate a patchwork…
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A Randomized Trial of Low-Cost Mesh in Groin Hernia Repair
Repair of a groin hernia is one of the most frequently performed surgical procedures worldwide, with approximately 20 million operations performed annually. Groin hernia causes considerable illness and even death if left untreated, and its repair has been identified as a key intervention to reduce…
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Dependent Coverage under the ACA and Medicaid Coverage for Childbirth
To the Editor: In the United States, rates of uninsurance have been historically high among young adults (19 to 26 years of age). One of the first implemented provisions of the Affordable Care Act (ACA) was a mandate that all private-insurance family policies cover dependents until 26 years of age.…
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Relationship between Nonmedical Prescription-Opioid Use and Heroin Use
The nonmedical use of prescription opioids is a major public health issue in the United States, both because of the overall high prevalence and because of marked increases in associated morbidity and mortality. In 2014, a total of 10.3 million persons reported using prescription opioids…
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Mr. Gilbreth's Motion Pictures — The Evolution of Medical Efficiency
The efficiency movement of the early 20th century has long been seen as an infertile tangent to the story of American medicine and its modernization. Indeed, rationalized labor practices that started on the factory floor have found a difficult fit in the standard historical narrative describing…
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Shared Decision Making — Finding the Sweet Spot
The importance of shared decision making in health care has been increasingly recognized over the past several decades. Consensus has emerged that of the various types of decisions we make, those that involve choosing among more than one reasonable treatment option should be made through a process…
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Medical Taylorism
Frederick Taylor, a son of Philadelphia aristocrats who lived at the turn of the last century, became known as the "father of scientific management" — the original "efficiency expert." He believed that the components of every job could and should be scientifically studied, measured, timed, and…
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Investigating the Nature of the Left Periphery in Peninsular Spanish wh-Question Intonation
Background/Aims: In this paper we aim to resolve the phonological status of utterance-initial rises in Spanish wh-questions. Methods/Analysis 1: In analysis 1 we examine the scaling and alignment properties of utterance-initial rises produced by 14 speakers of Peninsular Spanish. Results/Analysis 1: The results provide evidence for a single bitonal pitch accent at the left periphery (L + amp;amp;lt;H*) despite multiple options at the right periphery. Conclusion/Analysis 1: Our analysis, relying on the notion of sparse tonal specification, helps to explain Sp_ToBI transcribers' past inconsistencies in labeling wh-question initial rises. Methods/Analysis 2: In analysis 2 we tested whether there are scaling differences between the wh-question contours produced in analysis 1 and statement contours produced by the same 14 speakers. Results/Analysis 2: We showed that speakers scale utterance-initial peaks higher in statements, and that they scale utterancefinal peaks higher in wh-questions. Conclusion/Analysis 2: This finding is incompatible with the notion that speakers of Spanish use a higher F0 level from the start of the utterance to distinguish questions from statements.
Phonetica 2016;73:1-32
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Case 1-2016: An 18-Year-Old Man with Fever, Abdominal Pain, and Thrombocytopenia
Presentation of Case. Dr. Emily R. Lynch (Pediatrics): An 18-year-old man was admitted to this hospital because of fever and pain in the lower abdomen, groin, and scrotum. The patient had been well until 4 days before admission, when fatigue, subjective fever, and chills developed. The next day, he…
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Squamous-Cell Carcinoma of the Penis with Human Papillomavirus
Figure 1.
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Squamous-Cell Carcinoma of the Penis with Human Papillomavirus
Figure 1.
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