Secondary Index Research Articles

Smoking Cessation Related to Improved Patient-Reported Pain Scores Following Spinal Care

Smoking is associated with low back pain, intervertebral disc disease, inferior patient outcomes following surgical interventions, and increased rates of postoperative complications. The purpose of the present study was to examine the effect of smoking and smoking cessation on pain and disability in patients with painful spinal disorders. We examined a prospectively maintained database of records for 5333 patients with axial or radicular pain from a spinal disorder with regard to smoking history and the patient assessment of pain on four visual analog scales during the course of care. Confounding factors, including secondary gain, sex, age, and body mass index, were also examined. The mean duration of follow-up was eight months. Multivariate statistical analysis was performed with variables including smoking status, secondary gain status, sex, depression, and age as predictors of pain and disability. Compared with patients who had never smoked, patients who were current smokers reported significantly greater pain in all visual analog scale pain ratings (p < 0.001). The mean improvement in reported pain over the course of care was significantly different between nonsmokers and current smokers (p <0.001). Compared with patients who had continued to smoke, those who had quit smoking during the course of care reported significantly greater improvement in pain in visual analog scale pain ratings for worst (p = 0.013), current (p < 0.05), and average weekly pain (p = 0.024). The mean improvement in the visual analog scale pain ratings was clinically important in patients in all three groups of nonsmokers. As a group, those who had continued smoking during treatment had no clinically important improvement in reported pain. Given a strong association between improved patient-reported pain and smoking cessation, this study supports the need for smoking cessation programs for patients with a painful spinal disorder.

Lipid oxidation of fat blends modified by monoacylglycerol

Model dispersions of fat blends (FBs) with monoacylglycerols (MAG) of saturated fatty acids with different lengths of the acyl chain (MAG10&amp;ndash;MAG18) and 1-octadecenoylglycerol and without MAG (as blank) were prepared. We find out the influence of the addition of monoacylglycerol on oxidation of the fat dispersion. Trihexadecanoylglycerol (tripalmitoylglycerol &amp;ndash; TAG48) was used as the dispersive phase and soybean oil was used as the dispersive medium. Primary (conjugated diens) and volatile secondary (by SPME in connection with GC-MS) lipid oxidation products and oil stability index (OSI) were measured during autoxidation of the fat blends in storage conditions. MAGs with a shorter (or the same) acyl chain length (MAG10&amp;ndash;MAG16) than the acyl chain length of the structured fat (TAG48) arrange tightly on the interface oil/crystals of structured fat, thus prevent lipid oxidation.

PHP87 Satisfaction Assessment of Insurance System for Urban Residents (URMS) of University Students in Shenyang

In the New Chinese Medical Reform, university students are included into the medical insurance system for urban residents (URMS) from 2010 to resolve their uninsured status. The current study aimed to evaluate the effect of new health system from the perspective of the insured students one year after program implementation. Based on the Chinese Customer Satisfaction Index and review of the literatures, we built a satisfaction evaluation system for URMS of university students, with one first-level, 7 second-level (Latent variable, xm) and 24 third-level indicators (Explicit variable, yn) to be scored on a five-point Likert-type scale. After pilot testing and subsequent adjustment, 400 questionnaires were issued to students in 4 universities in NE China. After obtaining the affecting order of third indexes to their corresponding secondary index through the correlation test, a Structural Equation Model (SEM) for the satisfaction assessment of URSM was built basing on the calculated Path coefficient between the xm and yn after multiple linear regressions. Goodness of fit statistics of SEM were used to assess the match between this model and satisfaction assessment. 393 questionnaires were returned giving a recovered rate 98.3%. The path coefficients between xm and yn were: customer trust 1.26, the perceived quality 0.88, customer complaints 0.80, customer expectations 0.44, public information 0.31, and image of the government 0.29. The satisfaction score of UMRS (29.06 out of 69.75 points) showed very low satisfaction level of university students towards the program. The results showed the satisfaction assessment model was suitable to this study. Based on the order of path coefficients, several reform proposals for improving university students' medical insurance are proposed, including establishing a multi-level medical insurance system with corresponding regulatory and monitoring mechanism of its performance; as well as enhancing awareness and education of students about health insurance.

Rituximab Maintenance Therapy After Autologous Stem-Cell Transplantation in Patients With Relapsed CD20+ Diffuse Large B-Cell Lymphoma: Final Analysis of the Collaborative Trial in Relapsed Aggressive Lymphoma

The standard treatment for relapsed diffuse large B-cell lymphoma (DLBCL) is salvage chemotherapy followed by high-dose therapy and autologous stem-cell transplantation (ASCT). The impact of maintenance rituximab after ASCT is not known. In total, 477 patients with CD20(+) DLBCL who were in their first relapse or refractory to initial therapy were randomly assigned to one of two salvage regimens. After three cycles of salvage chemotherapy, the responding patients received high-dose chemotherapy followed by ASCT. Then, 242 patients were randomly assigned to either rituximab every 2 months for 1 year or observation. After ASCT, 122 patients received rituximab, and 120 patients were observed only. The median follow-up time was 44 months. The 4-year event-free survival (EFS) rates after ASCT were 52% and 53% for the rituximab and observation groups, respectively (P = .7). Treatment with rituximab was associated with a 15% attributable risk of serious adverse events after day 100, with more deaths (six deaths v three deaths in the observation arm). Several factors affected EFS after ASCT (P < .05), including relapsed disease within 12 months (EFS: 46% v 56% for relapsed disease after 12 months), secondary age-adjusted International Prognostic Index (saaIPI) more than 1 (EFS: 37% v 61% for saaIPI < 1), and prior treatment with rituximab (EFS: 47% v 59% for no prior rituximab). A significant difference in EFS between women (63%) and men (46%) was also observed in the rituximab group. In the Cox model for maintenance, the saaIPI was a significant prognostic factor (P < .001), as was male sex (P = .01). In relapsed DLBCL, we observed no difference between the control group and the rituximab maintenance group and do not recommend rituximab after ASCT.

7,3′-dimethoxy hesperetin inhibits inflammation by inducing synovial apoptosis in rats with adjuvant-induced arthritis

Rheumatoid arthritis (RA) is an autoimmune disease characterized by pronounced inflammation and excessive synovial hyperplasia within affected joint. We previously reported 7, 3′-dimethoxy hesperetin (DMHP) as a highly anti-inflammatory active derivative of hesperidin showed apparent pro-apoptotic effect in vitro on fibroblast-like synoviocytes of rats with adjuvant arthritis (AA), an animal model of RA. Here, we investigated the therapeutic effects of DMHP on inflammation and synovial apoptosis in rats with AA in vivo. Paw swelling, arthritis index, TNF-α and IL-1β serum levels were measured to evaluate the effect of DMHP on inflammation in AA rats. DNA ladder detection and TUNEL assay were used to investigate the pro-apoptotic effect of DMHP on synovial apoptosis in vivo. Bcl-2, Bax mRNA and protein expressions in synovium were determined by real-time Q-PCR and western blot, respectively. We found DMHP inhibited secondary hind paw swelling and arthritis index, and decreased TNF-α and IL-1β serum levels in AA rats. Typical DNA ladder formation was found in DNA extraction of synovium from DMHP treated groups. The number of apoptotic synovial cells was elevated with DMHP treatment in TUNEL assay. DMHP markedly decreased Bcl-2 expression whereas increased Bax expression in synovium of AA rats at both transcription and protein levels. Moreover, DMHP treatment on AA rats significantly decreased the protein ratio of Bcl-2/Bax in synovium. In conclusion, DMHP has an apparent therapeutic effect on inflammation in rats with AA. Mechanisms of this effect are partly related to induction of synovial apoptosis through modulation of Bcl-2 and Bax expression.

Low secondary compressibility and shear strength of Shanghai Clay

In order to investigate the compressibility, particularly the secondary compression behaviour, soil structure and undrained shear strength of Shanghai Clay, a series of one-dimensional consolidation tests (some up to 70 d) and undrained triaxial tests on high-quality intact and reconstituted soil specimens were carried out. Shanghai Clay is a lightly overconsolidated soil (OCR=1.2–1.3) with true cohesion or bonding. Due to the influence of soil structures, the secondary compression index C α varies significantly with consolidation stress and the maximum value of C α occurs in the vicinity of preconsolidation stress. Measured coefficients of secondary compression generally fall in the range of 0.2%–0.8% based on which Shanghai Clay can be classified as a soil with low to medium secondary compressibility. The effect of soil structures on the compressibility of Shanghai Clay is found to reduce with an increase in depth. Soil structure has an important influence on initial soil stiffness, but does not appear to affect undrained shear strength significantly. Undrained shear strengths of intact Shanghai Clay from compression tests are approximately 20% higher than those from extension tests.

Effect of Stress Level and Binder Composition on Secondary Compression of an Artificially Stabilized Soil

This paper examines the effect on the compressibility of a Portuguese soft soil stabilized with binders, with a special emphasis on creep characteristics. The effects of vertical stress during curing time and binder composition (type and content) on the creep behavior of a sta- bilized material are analyzed with oedometer tests. The results show the decrease of the secondary compression index with the decrease of the vertical stress applied during creep phase and with the increment of the binder content. The best binder type for this soil, in terms of creep be- havior, iscomposedof portland cement and flyash witha dryweight proportionof 75/25, becausethis promotes thedevelopment of secondary pozzolanicreactions.Theresultsalsorevealthatthebindercompositionshouldhaveaminimumquantityofcementtoimprovethecompression characteristicsofthestabilizedsoiladequately.DOI:10.1061/(ASCE)GT.1943-5606.0000762. © 2013 American Society of Civil Engineers. CE Database subject headings: Mixing; Columns; Creep; Soil consolidation; Soft soils; Soil stabilization; Compression; Soil stress. Author keywords: Deep mixing columns; Creep; Secondary consolidation; Oedometer creep tests; Soft soils.

Comparison of Permeability and Groutability of Ostur Dam Site Rock Mass for Grout Curtain Design

The focus of this study is the empirical hydromechanical behaviour of the Ostur dam site rock mass. The area surrounding the dam mostly consists of diorite and andesite, with primary fractures and hydrothermal veins. The hydromechanical behaviour of the rocks was determined using 500 water pressure tests at 5-m intervals. The hydrothermal veins and 2,739 discontinuities were studied and mapped along the dam axis. As a result, it was possible to design an optimum grout curtain for the dam axis. The empirical hydromechanical behaviour of the rock was studied to determine water flow and grout pressurised flow during the field tests that were conducted on two representative A-series grouting operation boreholes (one borehole for each abutment). The secondary permeability index (SPI), Lugeon value (LU), rock quality designation (RQD) and cement take (CT) values are presented and compared in this article. It is concluded that permeability and groutability are mostly controlled by the specifications and characteristics of the veins, especially in shallow areas and lower depths. A procedure is proposed based on a comparison of the trends in the RQD–SPI and LU–CT, and it is suggested that the areas with diverging trends require no treatment and that those with converging trends require heavy treatment. Additional complementary studies that were conducted during the construction stage have validated these results.

Therapeutic effect of 7, 3′-dimethoxy hesperetin on adjuvant arthritis in rats through inhibiting JAK2-STAT3 signal pathway

In our previous study, we have demonstrated that 7, 3′-dimethoxy hesperetin (DMHP), an active derivative of hesperidin, showed pro-apoptotic effect on synoviocytes in vitro. The present study was to investigate the potential therapeutic effect of DMHP on adjuvant arthritis (AA) in rat and its possible mechanisms. Freund's complete adjuvant was used to induce AA in rats. DMHP were administered intragastrically once a day from days 12 to 21 after AA induction. Secondary paw swelling, arthritis index, and pathological assessments were observed. IL-6 production in serum and IL-6 mRNA expression in synovium was detected by ELISA and real-time RT-PCR respectively. The expression of mRNA (JAK2, STAT3) and protein (JAK2, p-JAK2, STAT3, p-STAT3) in synovium were determined. We found that DMHP significantly inhibited hind paw swelling and arthritis index, and ameliorated pathological changes of ankle joint in AA rats. DMHP suppressed the level of IL-6 in serum and the expression of IL-6 mRNA in synovium of AA rats in a dose-dependent manner. DMHP apparently decreased mRNA expression of JAK2 and STAT3 as well as protein expression of p-JAK2 and p-STAT3 in the synovium of the AA rats. Correlation analysis indicated that p-JAK2 or p-STAT3 protein expression was highly correlated with joint damage severity. In conclusion, DMHP has a powerful therapeutic effect on AA in rats and its mechanisms might be partly related to inhibiting excessive activation of JAK2-STAT3 pathway.

A Study of Enhanced Index-based Built-up Index Based on Landsat TM Imagery

A new method for extraction of built-up land information both in suburban area and in urban district by using Landsat TM/ETM+ imagery is proposed in this paper.Firstly,to suppress the information of bare soil with the middle-infrared(TM7),near-infrared(TM4) and green band(TM2),it is necessary to build a secondary index,which is called normalized difference bareness and built-up index(NDBBI).At the same time,to enhance the information of bare soil from existing indices of bare soil index(BSI)and modified normalized difference water index(MNDWI),another secondary index is built,which is called enhanced bare soil index(EBSI).Finally,the indices of NDBBI,EBSI,SAVI and MNDWI are applied to constructing a new index for delineating built-up land features in satellite imagery,which is called enhanced index-based built-up index(EIBI).The new index(EIBI)can be employed to extract the built-up land information both in suburban area and in urban district.This approach has been successful in Fuzhou and Zhangzhou experimental regions.Built-up features can be extracted objectively and sufficiently with the accuracy above 90%.

Correlation between C α/ Cc ratio and index parameters of soils

There is a general acceptance of constant C α/ Cc ratio (secondary compression index/ compression index) after many investigations made with different soil specimens. Therefore it should be possible to find useful correlations between soil properties and a soil’s unique C α/ Cc ratio. In this paper the secondary compression behaviour of Iranian soils was investigated through the performance of a series of conventional and long duration 1D consolidation tests conducted on undisturbed samples from 11 sites in different parts of Iran. The characteristics of the secondary compression index were examined and the relationship between the coefficient of secondary compression, C α, and compression index, Cc , was established for each site. Single and multiple regression models to estimate the ratio of C α/ Cc were investigated based on soil properties (liquid limit ( LL ), plasticity limit ( PL ), plasticity index ( PI ) and natural water content (ω 0 )), and various equations are presented to predict the value of the C α/ Cc ratio of soils.

Study on the Fuzzy Synthetic Evaluation for Pumping Units in Low Permeability Oilfield

In order to decrease the purchasing cost of pumping units and select the proper type of pumping units, the synthetic evaluation for pumping units based on fuzzy theory is studied. Firstly, the primary evaluation index and secondary evaluation index are built according to the oil and gas industry standard, and absolute comparison and relative comparison are also introduced. Then, the fuzzy weight factors of each evaluation index are determined and the fuzzy matrix operation for pumping units is made. Finally, the evaluation example for three pumping units is done to verify the correction and rationality of the method in this paper.

Localization of immunodominant linear B-cell epitopes of Vibrio mimicus outer membrane protein U (OmpU)

Outer membrane protein U (OmpU), an adhesion protein of Vibrio mimicus , is a good antigen, but its epitopes are still unclear. In order to locate the epitopes of OmpU protein, epitope prediction was performed using the amino acid sequence of OmpU protein of V. mimicus HX4 strain that was isolated from the diseased crass carp in Anhui province of China. The secondary structure, flexible regions, hydrophilicity, surface accessibility and antigenic index of the protein were analyzed using the DNAStar Protean program, and seven potential epitopes were screened. To verify the prediction, the potential epitope peptides were artificially synthesized and detected by peptide-enzyme linked immunosorbent assay (ELISA). The results show that the potential epitope peptides at amino acid positions 25 to 33, 90 to 98, 117 to 126, 173 to 180, 183 to 195, 211 to 218 and 239 to 250 were indeed immunodominant linear B-cell epitopes of the OmpU protein. Among them, the epitopes at amino acid positions 25 to 33, 90 to 98 and 239 to 250 were entirely exposed on the surface of the 3D structure model of OmpU protein, and they had a stronger immunoreactivity than others that were partially embedded inside the protein molecule. Keywords: Vibrio mimicus , outer membrane protein U (ompU), linear B-cell epitope, localization, enzyme-linked immunosorbent assay

Secondary Porosity Characterization in Carbonate Reservoirs and the Consequences in Permeability Forecasting

The main objective of this research is to predict permeability values precisely. One of the major challenges in carbonate formations is to analyze and quantify noneffective pores like secondary porosity. Three wells were chosen. The estimation model was built in the model well through core and well log data using two methods. Moreover, a secondary porosity index was calculated and imported to the model. This model was applied to predict permeability in two control wells and the outputs were cross-checked against core data. The results showed that recognizing secondary porosity in carbonates with dual pore systems is important for precise prediction of permeability values.

Time-dependent behaviour of the Bearpaw Shale in oedometric loading and unloading

Time-dependent behaviour can have a significant influence on the compressibility characteristics of soils. However, most of the research on this topic has investigated the behaviour of soft soils. In this paper, the time-dependent behaviour of a hard clay shale (Bearpaw Shale) is investigated using both one-dimensional multi-staged loading (MSL) oedometer and constant rate of strain (CRS) oedometer consolidation tests conducted on 25.0 and 16.9 mm diameter specimens. The results show that soft clays and hard clay shales that share the same Cαe/[Formula: see text] ratio (where Cαeis the secondary compression index and [Formula: see text] is the incremental compression index) will show the same approximately 7% change in pre-consolidation pressure for an increase of one log cycle of strain rate despite the many orders of magnitude difference in pre-consolidation pressure. In the case of the Bearpaw Shale, this 7% change in pre-consolidation pressure corresponds to approximately 700 kPa. The time-dependent behaviour of the Bearpaw Shale during unloading (Cαe/[Formula: see text], where [Formula: see text] is the incremental swelling index) was observed to follow a similar ratio to that observed in compression (Cαe/[Formula: see text]). While the exact nature of the compression and swelling events that have occurred over the life of the Bearpaw Formation is not clear, the influence of secondary compression cannot be ignored for interpretation of the geological history of this deposit.

Calcium nutritional status affects the interrelationships between α and β CTX bone markers in children in pre puberty ages

The bone marker α‐CTX is significantly affected by calcium nutritional status (CNS) during the phase of growth in children in the pre puberty ages whereas β‐CTX seems not to be related to that variable. This situation appears as a promissory secondary index to assess bone maturation through the ratio between both (α/β) at ranges of CNS as nutritional reference. Here, changes in bone maturity were related to three CNS in 180 both sex children 6 to 9 years old with paired data for the three determinations performed in basal urine samples: both CTX (NB‐Denmark) and the ratio between Ca to creatinine (Ca/Cr). Reference values for CNS were: Ca/Cr: &lt;0,07, deficient (D); 0,07–0,15, adequate (A) y &gt; 0,15, high (H). ANOVA test with GraphPad was used. When plotted versus age according CNSα/β ratio data adjusted to a binomial equation for D (y=−0,055x2 0,0798x+1,5666; R2=0,9936) and H (y=−0,0657x2 +0,2707x +1,2768 R2 = 0,8339) curves whereas for the A group the best fitting is the lineal one: (y= 0,1952x + 1,8416; R2=0,9174 being significantly different from D and H. Calcium nutritional status can modulate interrelationships between bone markers associated to maturity progress. Supported by UBACyT B/060.2.HD. Doctoral Fellowship from UBCyT

Gamma Radiation Induced Oxidation and Tocopherols Decrease in In-Shell, Peeled and Blanched Peanuts

In-shell, peeled and blanched peanut samples were characterized in relation to proximate composition and fatty acid profile. No difference was found in relation to its proximate composition. The three major fatty acids were palmitic acid, oleic acid, and linoleic acid. In order to investigate irradiation and storage effects, peanut samples were submitted to doses of 0.0, 5.0, 7.5 or 10.0 kGy, stored for six months at room temperature and monitored every three months. Peanuts responded differently to irradiation, particularly with regards to tocopherol contents, primary and secondary oxidation products and oil stability index. Induction periods and tocopherol contents were negatively correlated with irradiation doses and decreased moderately during storage. α-Tocopherol was the most gamma radiation sensitive and peeled samples were the most affected. A positive correlation was found among tocopherol contents and the induction period of the oils extracted from irradiated samples. Gamma radiation and storage time increased oxidation compounds production. If gamma radiation is considered an alternative for industrial scale peanut conservation, in-shell samples are the best feedstock. For the best of our knowledge this is the first article with such results; this way it may be helpful as basis for future studies on gamma radiation of in-shell crops.

A randomized study comparing yttrium‐90 ibritumomab tiuxetan (Zevalin) and high‐dose BEAM chemotherapy versus BEAM alone as the conditioning regimen before autologous stem cell transplantation in patients with aggressive lymphoma

High-dose chemotherapy combined with autologous stem-cell transplantation (ASCT) is the standard therapy for refractory/relapsed aggressive lymphoma. In the era of rituximab-containing frontline regimens, it is becoming more challenging to salvage patients in this setting, and novel approaches are required. This is a randomized study evaluating the safety and efficacy of standard-dose ibritumomab tiuxetan (Zevalin) combined with high-dose BEAM chemotherapy (Z-BEAM) and ASCT in refractory/relapsed aggressive lymphoma. Forty-three patients with CD20(+) -aggressive lymphoma were randomized to a treatment arm (Z-BEAM, n = 22) or control arm (BEAM alone, n = 21). Ibritumomab tiuxetan was given at 0.4 mCi/kg on day -14 before ASCT. Patient characteristics, engraftment kinetics, and toxicity profile were similar between the 2 groups. Two-year progression-free survival (PFS) for all patients was 48% (95% confidence interval, 32%-64%): 59% and 37% after Z-BEAM and BEAM alone, respectively (P = .2). Multivariate analysis identified advanced age (hazard ratio [HR], 8.3; P = .001), high-risk disease (relapse within 12 months of diagnosis and/or secondary International Prognostic Index >2; HR, 2.8; P = .04), positive positron emission tomography-computed tomography pretransplant (HR, 2.4; P = .07), and BEAM alone (HR, 2.8; P = .03) as poor prognostic factors. Intermediate-risk patients with 1 or 2 risk factors had better PFS with Z-BEAM compared with BEAM: 69% and 29%, respectively (P = .07). Two-year overall survival was 91% and 62% after Z-BEAM and BEAM, respectively (P = .05). Similar prognostic factors determined survival. The HR for BEAM alone in the multivariate analysis was 8.1 (P = .01). Standard-dose ibritumomab tiuxetan combined with BEAM high-dose chemotherapy is safe and possibly more effective than BEAM alone as a conditioning regimen for ASCT in the era of rituximab-containing chemotherapy regimens.

Regional Bitmap Index: A Secondary Index for Data Management in Could Computing Environment

The fast development of Cloud Computing technologies has brought new dawns to the storage and management of massive data.Nevertheless,due to the essential changes in the storage model,the matured indexing techniques used in traditional relational data management systems can neither be directly applied to massive data,nor be migrated to Cloud environment in an easy way.Based on comparisons between two basic approaches to secondary indexing,i.e.centralized and distributed approaches,the Regional Bitmap Index(RBI) is proposed to combine the advantages of both approaches and provide efficient supports to various queries against massive data in the Cloud.By means of fully utilizing the parallel computing resources provided by the Cloud,the query efficiency is dramatically improved.Meanwhile,based on global distribution information,RBI can avoid the unnecessary computing expenses on local nodes;therefore query throughputs can keep steady even if concurrency of the incoming queries increases.Experiments on real dataset show that the Regional Bitmap Index can significantly outperform other methods.

Cement Stabilization of Highly Organic Subgrade Soils to Control Secondary Compression Settlement

Many flexible pavements in western Palm Beach County, Florida, are underlain at shallow depths by thick deposits of organic soils and peats. These soils undergo long-term secondary compression as a result of sustained overburden pressure of the pavement and thereby cause excessive premature structural distress in the form of cracking, rutting, and differential settlement. Although cementitious materials have been successfully used to stabilize soft, expansive, and inorganic soils, research and experience regarding the stabilization of highly organic soils are limited. The authors’ main motivation for doing this research was to investigate the effects of cement stabilization on the compressibility of soils consisting of organic content in the range of 67% to 90%. The undisturbed soil samples were collected from the subsurface of the SR-15 (US-98) roadway, which had experienced severe distress attributable to organic layers and had undergone frequent and costly rehabilitation in recent years. It was found that cement stabilization at dosages between 35% and 55% (by dry weight) drastically reduced the ratio of the secondary compression index to the primary compression index of the organic soils to values that resembled a nearly granular soil with desirable compressibility characteristics. This optimized mix design may provide appropriate guidelines for deep mixing methods in subsurface organic layers for the long-term preservation of roadways built over problematic soils.