bluuebunny/crossref_metadata_2025 huggingface dataset:
Inquerito por telefone: pesos de pos-estratificacao para corrigir vicios de baixa cobertura em Rio Branco, AC
Authors: Bernal Regina Tomie Ivata , Malta Deborah Carvalho , de Araujo Thiago Santos , Silva Nilza Nunes da
Published: September 2013

OBJETIVO: Analisar efeitos do uso de pesos de pós-estratificação para corrigir vícios decorrentes da baixa cobertura de domicílios com telefone. MÉTODOS: Comparação dos resultados levantados pelo Inquérito Domiciliar com o Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel), em Rio Branco, AC, 2007, cuja cobertura era de 40% de telefonia fixa. O vício potencial do Vigitel foi expresso pela diferença entre as prevalências do Vigitel e do Inquérito Domiciliar, calculada a raiz quadrática do erro quadrático médio como medida de acurácia da estimativa. RESULTADOS: O procedimento de ponderação do Vigitel corrigiu o vício potencial nas prevalências de consumo de frutas, legumes e verduras, de carnes com gordura visível, o ser fumante, a autoavaliação do estado de saúde ruim e da morbidade referida de colesterol ou triglicéride. O procedimento adotado pelo Vigitel não reduziu o vício nas prevalências da prática de atividade física no tempo livre e de morbidade referida de asma, bronquite asmática, bronquite crônica ou enfisema. CONCLUSÕES: É necessário o uso de métodos alternativos de ponderação e a estratégia de seleção de variáveis externas para construção de pesos de pós-estratificação que minimizem o vício potencial das estimativas das variáveis decorrentes da baixa cobertura de domicílios com telefone fixo.
Survey of hearing disorders in an urban population in Rondonia, Northern Brazil
Authors: Bevilacqua Maria Cecilia , Banhara Marcos Roberto , de Oliveira Ariadnes Nobrega , Moret Adriane Lima Mortari , Alvarenga Katia de Freitas , Caldana Magali de Lourdes , Camargo Luis Marcelo Aranha , Costa Orozimbo Alves , Bastos Jose Roberto de Magalhaes
Published: September 2013

OBJECTIVE: To identify the prevalence of hearing loss for the population in the urban area. METHODS: A cross-sectional household survey based on the World Health Organization Ear and Hearing Disorders Survey Protocol was conducted in 298 households in the urban area of Monte Negro, Rondonia, Northern Brazil, from 2005 to 2007. Ear examinations, behavioral audiometry and pure tone audiometry were conducted on 577 individuals. RESULTS: The results showed that 3.8% (95%CI 2.17;5.45) of population were classified in the disabling hearing impairment category. The prevalence of moderate hearing impairment was 3.4%; severe impairment was 0.4%; and profound hearing impairment was not found. CONCLUSIONS: The impairing hearing loss prevalence found in this study is within of the international prevalence for this level of hearing loss and smaller than observed in a previous study in the South region of Brazil.
Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa
Authors: Brandao Cristina Mariano Ruas , Ferre Felipe , Machado Gustavo Pinto da Matta , Guerra Junior Augusto Afonso , Andrade Eli Iola Gurgel , Cherchiglia Mariangela Leal , Acurcio Francisco de Assis
Published: September 2013

OBJETIVO: Analisar os gastos com medicamentos para o tratamento da osteoporose na pós-menopausa e os fatores associados ao gasto médio per capita . MÉTODOS: Pareamento probabilístico-determinístico a partir das bases das Autorizações de Procedimentos de Alta Complexidade com o Sistema de Informação sobre Mortalidade, resultando em coorte histórica de pacientes que utilizaram medicamentos de alto custo para o tratamento da osteoporose na pós-menopausa de 2000 a 2006. O gasto médio mensal com medicamentos foi estratificado por faixas etárias e descrito de acordo com as características demográficas, clínicas e tipo de medicamento utilizado. Foi utilizado modelo de regressão linear para avaliar o impacto de características demográficas e clínicas sobre o gasto médio mensal per capita com os medicamentos. RESULTADOS: Foram identificadas 72.265 mulheres que receberam medicamentos para o tratamento da osteoporose na pós-menopausa. O gasto médio mensal per capita no primeiro ano de tratamento foi de R$ 90,00 (dp R$ 144,49). A maioria das mulheres tinha de 60 a 69 anos de idade, iniciaram tratamento em 2000, eram residentes na região Sudeste, tinham fraturas osteoporóticas prévias e o alendronato de sódio foi o medicamento mais utilizado no início do tratamento. A maioria das pacientes permaneceu em uso do mesmo princípio ativo durante o tratamento. Foram identificados 6.429 óbitos entre as participantes. Mais de um terço das mulheres permaneceram no programa por até 12 meses. Raloxifeno e calcitonina sintética foram as alternativas com maior impacto sobre o gasto médio mensal com medicamentos, tendo como padrão de referência o alendronato de sódio. CONCLUSÕES: Dado o alto impacto do tipo de medicamento utilizado no gasto com medicação, recomenda-se estabelecer critérios para prescrição e dispensação, com prioridade para aqueles com menores custos e maior efetividade. Isso pode otimizar o processo de assistência farmacêutica e a provisão de maior número de unidades farmacêuticas à população.
Assistencia ao cancer entre criancas e adolescentes: mapeamento dos fluxos origem-destino no Brasil
Authors: Grabois Marilia Fornaciari , de Oliveira Evangelina X G , Sa Carvalho Marilia
Published: September 2013

OBJETIVO: Analisar os fluxos de viagens de crianças e adolescentes com câncer, entre os locais de residência e serviço de saúde. MÉTODOS: Foram analisados os fluxos de viagens de crianças e adolescentes com câncer entre os locais de residência e de serviço de saúde atendidos no Sistema Único de Saúde (SUS), de 2000 a 2007. A unidade de análise foi a regional de saúde. Utilizou-se o sistema de informações geográficas e metodologia de redes por tipo de tratamento recebido (quimioterapia e radioterapia) e internações hospitalares. RESULTADOS: Foram emitidas 465.289 autorizações de quimioterapia, 29.151 de radioterapia e 383.568 de internações hospitalares de crianças e adolescentes com diagnóstico de câncer para tratamento no SUS. O fluxo dominante formou 48 redes para quimioterapia, 53 para radioterapia e 112 para internações hospitalares. A maior parte do volume de atendimento ocorreu nas regionais de saúde das 12 maiores metrópoles do País com grande relacionamento entre elas e extensa área de influência direta acompanhando a estrutura da rede urbana brasileira. CONCLUSÕES: A identificação das redes estabelecidas no âmbito do SUS para o atendimento de crianças e adolescentes com câncer mostra que a maioria dos pacientes está contemplada pelas redes estruturadas. Cerca de 10% das viagens ocorrem fora do fluxo dominante, indicando a necessidade de regionalização alternativa. Os resultados evidenciam a importância do planejamento da distribuição dos serviços de acordo com as necessidades da população usuária.
Material particulado originario de queimadas e doencas respiratorias
Authors: Silva Ageo Mario Candido da , Mattos Ines Echenique , Ignotti Eliane , Hacon Sandra de Souza
Published: September 2013

OBJETIVO: Analisar os efeitos da exposição de partículas finas de queimadas sobre as internações por doenças respiratórias em crianças e idosos. MÉTODOS: Estudo ecológico de série temporal em Cuiabá, estado de Mato Grosso, região da Amazônia brasileira, durante 2005. Níveis diários de material particulado fino PM2.5 foram estimados e disponibilizados pelo Instituto Nacional de Pesquisas Espaciais. Variáveis relacionadas a temperatura, umidade relativa e ajustes por tendência temporal, sazonalidade e efeitos de calendário foram incluídos no modelo. Utilizou-se a Regressão de Poisson por modelos aditivos generalizados. RESULTADOS: Crescimento de 10 mg/m3 nos níveis de exposição ao PM2.5 foi associado a aumentos de 9,1%, 9,2% e 12,1% das internações hospitalares de crianças, relacionados às médias móveis de 1, 2 e 5 dias, respectivamente. O nível de exposição ao material particulado foi associado a aumentos de 11,4%, 21,6% e 22,0% em crianças, referentes às médias móveis de 1, 5 e 6 dias, respectivamente, para a estação seca. Não foram observadas associações significativas para os idosos. CONCLUSÕES: Foi evidenciada a influência de PM2.5 sobre a ocorrência de internações por doenças respiratórias em crianças < 5 anos, na região estudada.
Low prevalence of hypertension with pharmacological treatments and associated factors
Authors: Gama Helena , Damasceno Albertino , Silva-Matos Carla , Diogo Domingos , Azevedo Ana , Lunet Nuno
Published: September 2013

OBJECTIVE: To assess the determinants of the lack of pharmacological treatment for hypertension. METHODS: In 2005, 3,323 Mozambicans aged 25-64 years old were evaluated. Blood pressure, weight, height and smoking status were assessed following the Stepwise Approach to Chronic Disease Risk Factor Surveillance. Hypertensives (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or antihypertensive drug therapy) were evaluated for awareness of their condition, pharmacological and non-pharmacological management, as well as use of herbal or traditional remedies. Prevalence ratios (PR) were calculated, adjusted for sociodemographic characteristics, cardiovascular risk factors and non-pharmacological treatment. RESULTS: Most of the hypertensive subjects (92.3%), and nearly half of those aware of their condition were not treated pharmacologically. Among the aware, the prevalence of untreated hypertension was higher in men {PR = 1.61; 95% confidence interval (95%CI 1.10;2.36)} and was lower in subjects under non-pharmacological treatment (PR = 0.58; 95%CI 0.42;0.79); there was no significant association with traditional treatments (PR = 0.75; 95%CI 0.44;1.26). CONCLUSIONS: The lack of pharmacological treatment for hypertension was more frequent in men, and was not influenced by the presence of other cardiovascular risk factors; it could not be explained by the use of alternative treatments as herbal/traditional medicines or non-pharmacological management. It is important to understand the reasons behind the lack of management of diagnosed hypertension and to implement appropriate corrective actions to reduce the gap in the access to healthcare between developed and developing countries.
Lost in Transition? Thoughts on Retirement—“Will You Still Need Me, Will You Still Feed Me, When I'm Sixty-Four?”
Authors: Clemons Mark J. , Vandermeer Lisa A. , Gunstone Ian , Jacobs Carmel , Kaizer Leonard , Paterson Alexander H.
Published: September 2013

Oncologists should plan for a future beyond full-time oncology, but there is little practical guidance for a successful transition into retirement. This paper provides strategies for various aspects of retirement planning and transitioning. More prospective information is needed.
Complex Regional Pain Syndrome (CRPS), Sudeck’s Dystrophy: EMDR Reprocessing Therapy Applied to the Psychotherapeutic Strategy
Authors: Gauvry Silvia B. , Lesta Pedro , Alonso Ana Larrarte , Pallia Roberto
Published: September 2013

Complex regional pain syndrome (CRPS) Type 1, formerly termed Sudeck’s dystrophy, is a disproportionate pain condition after a minor injury in a limb, with sensory, autonomic, motor dysfunction, and muscular atrophy without a demonstrated peripheral nerve injury. In children, its course can be self-limiting or evolve chronically and be accompanied with psychological distress and deterioration in life quality. CRPS may occur in association with posttraumatic stress disorder (PTSD) and may benefit from multidisciplinary treatment. The eye movement desensitization and reprocessing (EMDR) approach, with demonstrated efficacy in PTSD, has also been reported to be helpful with chronic pain. The application of EMDR in a case of uncontrolled pain during an adolescent’s hospitalization for CRPS is presented and its potential benefits are discussed.
Carotid Artery Stenosis Associated with Increased Mortality in Patients who Underwent Coronary Artery Bypass Grafting: A Single Center Experience
Authors: da Rosa Marcelo P. , Schwendler Ricardo , Lopes Rodrigo , Portal Vera L.
Published: September 2013

Background: Vascular disease resulting from arteriosclerosis is a severe worldwide health risk. Early diagnosis and intervention is important to control adverse cerebral and cardiovascular events. The aim of this study was to assess the potential predictors of mortality in patients submitted to coronary bypass surgery.

Methods: Cohort study included asymptomatic cerebrovascular disease patients scheduled for coronary artery bypass grafting admitted to the cardiology reference center. All patients were submitted to carotid artery ultrasound assessment prior to surgery and were followed up during the entire in-hospital postoperative period. Carotid artery stenosis was considered clinically significant when cross sectional area ≥50%. Significance was set at p <0.05. Logistic regression was used to identify independent predictors of mortality.

Results: Of 455 patients with a mean age of 62.2 years 65.6% were males. The prevalence of carotid artery stenosis was 18.7%. It was absent in 3.6% of the patients, below 50% in 77.8%, between 50 and 69% in 11.6%, and between 70 and 99% in 6.9%. The carotid artery was occluded in 0.2% of the sample. An overall mortality of 12%, affecting 35 men (P=0.001) with stenosis ≥50%. After logistic regression analysis, carotid artery stenosis ≥50% was confirmed as being an independent predictor of mortality (P=0.005).

Conclusion: In this series carotid artery stenosis showed a high prevalence in the sample assessed and was an independent predictor of mortality.
To be or not to be – a doctor
Authors: Davidson Sir Stanley
Published: September 2013

The publication of the first number of Res Medica, the Journal of the Royal Medical Society, is a matter of great interest not only to past, present and future members of the Society, but to all teachers and students in the famous Medical School of Edinburgh. Accordingly, it was both an honour and a privilege to be asked by the Editor to contribute an article which contains a personal message to students and prospective students who may have doubts about the future of the medical profession. It also gives me the opportunity of expressing my best wishes for the success of this journalistic venture.
The Royal Medical Society To-day
Authors: Gray J.A.
Published: September 2013

We have often heard that our University, with its paucity of halls of residence and common rooms used for the right purpose, is fast developing the atmosphere of a huge and impersonal technical college. The undergraduate, his brain dulled by the heavy aroma of haddock, emerges each morning from his “digs”. He returns in the early evening to decipher a sheaf of laboriously scribbled notes that might even be headed by the “good morning, ladies and gentlemen” with which his lecturer aroused him from complete coma into the semi-conscious state in which the rest of his day is spent. He has contributed nothing to, and has gained nothing from his day at the “University.”
Full issue Res Medica, Autumn 1958, Volume 1, Number 3
Authors: Haddow Alexander , Cormack J.J.C. , Learmonth Sir James , Shedden William Ian , Milne Allan , Drysdale Henry C. , Clark David J
Published: September 2013

TABLE OF CONTENTSEDITORIALSYLLABUS FOR 222nd SESSIONCANCER RESEARCH: ITS HISTORY AND PROSPECTS: Professor Alexander Haddow, M.D., D.Sc.,F.R.S.THE SOCIETY’S LIBRARY: J. J. C. CormackBIOLOGICAL RESERVES: Sir James Learmonth, K.C.V.O., C.B.E.,  F.R.S.Ed., F.R.C.S.Ed. and Eng., M.D.THE CAUSATION AND SPREAD OF EPIDEMIC INFLUENZA: William Ian Shedden, B.Sc.(Hons.)SOME ASPECTS OF POLIOMYELITIS: Allan Milne,M.B., Ch.B.BOOK REVIEWOPERA OCCULTA: Henry C. Drysdale
Spontaneous Subarachnoid Haemorrhage: Some Aspects of its Pathogenesis and Management
Authors: Turner F W
Published: September 2013

The recognition of spontaneous subarachnoid haemorrhage as a clinical entity, distinct from the many other conditions all previously grouped under the comprehensive heading of Apoplexy was first made by Collier in 1922. A year or so later Symonds reviewed 124 cases described m the literature and concluded that rupture of an intracranial aneurysm was probably the major cause of this syndrome. His opinion is now widely held, and it seems probable that on a proportionate basis the main aetiological factors are:-1. Rupture of an intracranial aneurysm responsible for 80% of cases.2. Arteriovenous malformations responsible for 10% of cases.3. Other diseases (e.g. neoplasm. blood dyscrasia)- responsible for I 0% of cases.The content of this article is largely referable to spontaneous subarachnoid haemorrhage following rupture of an intracranial aneurysm.
Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method
Authors: Milenkovic Sasa , Mitkovic Milorad , Micic Ivan , Mladenovic Desimir , Najman Stevo , Trajanovic Miroslav , Manic Miodrag , Mitkovic Milan
Published: September 2013

Background/Aim. Distal tibial pilon fractures include extra-articular
fractures of the tibial metaphysis and the more severe intra-articular tibial
pilon fractures. There is no universal method for treating distal tibial
pilon fractures. These fractures are treated by means of open reduction,
internal fixation (ORIF) and external skeletal fixation. The high rate of
soft-tissue complications associated with primary ORIF of pilon fractures led
to the use of external skeletal fixation, with limited internal fixation as
an alternative technique for definitive management. The aim of this study was
to estimate efficacy of distal tibial pilon fratures treatment using the
external skeletal and minimal internal fixation method. Methods. We presented
a series of 31 operated patients with tibial pilon fractures. The patients
were operated on using the method of external skeletal fixation with a
minimal internal fixation. According to the AO/OTA classification, 17
patients had type B fracture and 14 patients type C fractures. The rigid
external skeletal fixation was transformed into a dynamic external skeletal
fixation 6 weeks post-surgery. Results. This retrospective study involved 31
patients with tibial pilon fractures, average age 41.81 (from 21 to 60)
years. The average follow-up was 21.86 (from 12 to 48) months. The percentage
of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture
union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the
pins of the external skeletal fixator and one (3.22%) deep infections. The
ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients.
All arthroses appeared in patients who had type C fractures. The final
functional results based on the AOFAS score were excellent in 51.61%, good in
32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion.
External skeletal fixation and minimal internal fixation of distal tibial
pilon fractures is a good method for treating all types of inta-articular
pilon fractures. In fractures types B and C dynamic external skeletal
fixation allows early mobility in the ankle joint.
Insect repellents - transmissive disease vectors prevention
Authors: Stajkovic Novica , Milutinovic Radmila
Published: September 2013

nema
Drug-related pityriasis rubra pilaris with acantholysis
Authors: Gajinov Zorica , Matic Milan , Duran Verica , Vuckovic Nada , Prcic Sonja , Vujanovic Ljuba
Published: September 2013

Introduction. Acantholysis is rarely reported histological feature of
Pityriasis rubra pilaris (PRP), recently recognized as having diagnostic
specificity for differentiating PRP from psoriasis. Case report. Adult male
patient one week after the introduction of simvastatin had experienced
pruritic erythemo-squamous eruption on head and upper trunk that in a month
progressed to erythrodermia, with islands of sparing. Histological picture
combined pemphigus-like acantholysis with alternating hyper- and
parakeratosis, follicular plugs and dermal inflammation, and confirmed the
clinical diagnosis of classic adult type 1 PRP. Acitretin therapy resulted in
a resolution of skin disease. Patch test with simvastatin was negative,
scratch test was positive, and it was estimated that potential risk of oral
challenge with simvastatin outweighed actual need for it. Drug triggering PRP
episode is the most likely explanation for temporal relation between the
start of simvastatin treatment and skin eruption. Conclusion. In management
of rare inflammatory skin disease, such as PRP, we have to carefully observe
and evaluate not only diagnostic features but possible external influences on
its course also.
Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta
Authors: Kovacevic Pavle , Velicki Lazar , Popovic Dusan , Ivanovic Vladimir , Mojasevic Renata
Published: September 2013

Introduction. The term ?penetrating atherosclerotic ulcer? (PAU) of the aorta
describes the condition in which ulceration of an aortic atherosclerotic
lesion penetrates the internal elastic lamina into media. PAU is a high-risk
lesion due to its deleterious effects on the integrity of aortic wall, with
potentially fatal outcome. Case report. A patient with intensive, sharp chest
pain irradiating to the back but with no signs of myocardial ischemia on an
electrocardiogram was referred to our hospital. Transthoracic
echocardiography showed no pathological changes of the ascending aorta.
However, multislice computed tomography (CT) showed an aortic ulcer with
varying degree of the subadventitial hemorrhage in the region of the thoracic
aorta at the level of Th 8-9. Due to imminent rupture of the penetrating
aortic ulcer, the patient was promptly prepared for surgery. A 15 cm long
subadventitial hematoma was found intraoperatively in the right
posterolateral aspect of the descending aorta, 5 cm above the diaphragm and 7
cm below the origin of the left subclavial artery. The affected segment of
the aorta was resected, followed by an inlay aortic reconstruction with a
Dacron tube graft of 24 mm. Control CT revealed satisfactory reconstruction
of the descending aorta. Conclusion. PAU is a rare, but potentially fatal
disease. Open surgery in patients with PAU is an effective treatment
strategy, although endovascular treatment options are emerging.
Factors Associated With Maternal-Reported Actions to Prevent Type 1 Diabetes in the First Year of the TEDDY Study
Authors: Smith Laura B. , Lynch Kristian F. , Baxter Judith , Lernmark Barbro , Roth Roswith , Simell Tuula , Johnson Suzanne Bennett ,   the TEDDY Study Group
Published: September 2013

OBJECTIVE

Mothers of children at risk for type 1 diabetes report engaging in preventive behaviors. The purpose of this study is to further document these actions in an international, longitudinal sample and examine variables that predict whether mothers engage in these behaviors.

RESEARCH DESIGN AND METHODS

This study examined an international sample (from Finland, Germany, Sweden, and the U.S.) from the naturalistic, longitudinal The Environmental Determinants of Diabetes in the Young (TEDDY) study, which tracked children genetically at risk for type 1 diabetes from birth to age 15 years. Mothers of 7,613 infants aged 6 months and 6,503 infants aged 15 months completed questionnaires assessing psychosocial factors and actions intended to prevent diabetes.

RESULTS

Many mothers (29.9% at 6 months and 42.8% at 15 months) reported engaging in a behavior intended to prevent type 1 diabetes, with the largest percentages (20.9–29.2%) reporting making changes to their child’s diet (e.g., reducing the consumption of sweets and carbohydrates). Factors related to engaging in preventive behaviors include older maternal age; higher maternal education; minority status; having only one child; having a first-degree relative with type 1 diabetes; being from a country other than Sweden; having an accurate perception of the child’s increased risk for developing diabetes; having postpartum depression, maternal anxiety, and worry about the risk of diabetes; and believing that diabetes can be prevented.

CONCLUSIONS

The findings of this study suggest that many mothers engage in actions to prevent diabetes and highlight the importance of tracking these behaviors to ensure the validity of naturalistic observational studies.
Relationship Between Hypoglycemic Episodes and Ventricular Arrhythmias in Patients With Type 2 Diabetes and Cardiovascular Diseases: Silent Hypoglycemias and Silent Arrhythmias
Authors: Stahn Annett , Pistrosch Frank , Ganz Xenia , Teige Madlen , Koehler Carsta , Bornstein Stefan , Hanefeld Markolf
Published: September 2013

OBJECTIVE

In patients with type 2 diabetes and cardiovascular diseases (CVDs), intensive treatment with insulin and/or sulfonylurea (SU) may be associated with excessive increased risk of hypoglycemic episodes. To evaluate the risk of critical arrhythmias related to glycemic variability, we carried out an observational study in type 2 diabetes patients with CVD.

RESEARCH DESIGN AND METHODS

Thirty patients with type 2 diabetes and documented CVD who had been treated with insulin and/or SU underwent 5 days of monitoring with a continuous glucose measurement system along with parallel electrocardiogram recording for monitoring of ventricular arrhythmias. Twelve age-matched patients with documented CVD who received treatment with metformin and/or dipeptidyl peptidase-4 inhibitor served as the control group. Patients were receiving stable treatment, and were instructed to notice symptoms of arrhythmias and hypoglycemia, respectively.

RESULTS

We observed a high incidence of asymptomatic severe episodes of hypoglycemia (<3.1 mmol/L) in patients receiving treatment with insulin and/or SU, whereas severe hypoglycemia did not develop in any of the control subjects. Patients with severe hypoglycemia (n = 12) had a higher number of severe ventricular arrhythmias (patients with versus without severe hypoglycemia, respectively: ventricular couplets 41.7 ± 81.8 vs. 5.5 ± 16.7; ventricular tachycardia 1.0 ± 1.9 vs. 0.1 ± 0.3). No direct correlation could be found among different variables of glucose profile, corrected QT interval, and ventricular arrhythmias.

CONCLUSIONS

Our results suggest that severe episodes of hypoglycemia are associated with an increased risk of severe ventricular arrhythmias.
Highly Sensitive Diagnosis of 43 Monogenic Forms of Diabetes or Obesity Through One-Step PCR-Based Enrichment in Combination With Next-Generation Sequencing
Authors: Bonnefond Amélie , Philippe Julien , Durand Emmanuelle , Muller Jean , Saeed Sadia , Arslan Muhammad , Martínez Rosa , De Graeve Franck , Dhennin Véronique , Rabearivelo Iandry , Polak Michel , Cavé Hélène , Castaño Luis , Vaxillaire Martine , Mandel Jean-Louis , Sand Olivier , Froguel Philippe
Published: September 2013

OBJECTIVE

Accurate etiological diagnosis of monogenic forms of diabetes and obesity is useful as it can lead to marked improvements in patient care and genetic counseling. Currently, molecular diagnosis based on Sanger sequencing is restricted to only a few genes, as this technology is expensive, time-consuming, and labor-intensive. High-throughput next-generation sequencing (NGS) provides an opportunity to develop innovative cost-efficient methods for sensitive diabetes and obesity multigene screening.

RESEARCH DESIGN AND METHODS

We assessed a new method based on PCR enrichment in microdroplets (RainDance Technologies) and NGS using the Illumina HiSeq2000 for the molecular diagnosis of 43 forms of monogenic diabetes or obesity. Forty patients carrying a known causal mutation for those subtypes according to diagnostic laboratories were blindly reanalyzed.

RESULTS

Except for one variant, we reidentified all causal mutations in each patient associated with an almost-perfect sequencing of the targets (mean of 98.6%). We failed to call one highly complex indel, although we identified a dramatic drop of coverage at this locus. In three patients, we detected other mutations with a putatively deleterious effect in addition to those reported by the genetic diagnostic laboratories.

CONCLUSIONS

Our NGS approach provides an efficient means of highly sensitive screening for mutations in genes associated with monogenic forms of diabetes and obesity. As cost and time to deliver results have been key barriers to uncovering a molecular cause in the many undiagnosed cases likely to exist, the present methodology should be considered in patients displaying features of monogenic diabetes or obesity.
Perceived constraints on exercise in the group of the elderly: a pilot study
Authors: Baceviciene Migle , Alisauskas Justas
Published: September 2013

The aim of this study was to evaluate psychometric properties of the perceived constraints on the physical exercise scale and to indicate the most important perceived constraints that restrict the elderly from exercise.160 persons (aged 60–89) living in Lithuania, Kaunas city were interviewed in 2011. Physical activity was assessed using a short version of International Physical Activity Questionnaire. Constraints on physical exercise were determined according to a structured list of statements consisting of five domains: poor health, fear and negative experiences, lack of knowledge, lack of time and interest, and unsuitable environment. Perceived constraints on the exercise scale demonstrated satisfactory internal consistency and good construct validity: Cronbach’s alpha coefficients of internal reliability were above the standard (≥0.7) with the exception of lack of knowledge domain. Exploratory factor analysis revealed a fivefactor solution that accounted for 67.4% of the variance. Fear and negative experience during exercise increased the odds of insufficient physical activity by 3.3 (1.16–9.59) times whereas lack of time and interest — by 7.2 (2.98–17.31) times. Perceived constraints on the exercise scale is a suitable measure for the elderly investigations. Perceived constraints that most restrict elderly people from exercise were lack of time, interest, fear of falling and injuries.
Does Providing Transition Services Early Enable Students with ASD to Achieve Better Vocational Outcomes as Adults?
Authors: Cimera Robert Evert , Burgess Sloane , Wiley Andrew
Published: September 2013

This study investigated whether receiving transition services early (i.e., by age 14) promoted better vocational outcomes than receiving transition services later (i.e., by age 16) for young adults with ASD. To do this, the outcomes achieved by two matched groups were examined—453 young adults from states requiring transition services be addressed by age 14 and 453 young adults with ASD from states requiring transition services be addressed by age 16. In each of the four years examined (i.e., 2006–2009), individuals from the early transition states were significantly more likely to be employed than individuals from the later transition group. Further, early transition individuals who became employed appeared to earn more wages and cost less to serve.
The Effect of Postsecondary Coenrollment on College Success
Authors: Wang Xueli , McCready Bo
Published: September 2013

Drawing upon the latest data from the Beginning Postsecondary Students Longitudinal Study (BPS:04/09) and the Postsecondary Education Transcript Data (PETS:09), this study employed propensity score matching and postmatching logistic regression to estimate the extent to which postsecondary coenrollment affects persistence and attainment of students beginning at both community colleges and 4-year institutions. Coenrollment was defined as simultaneous enrollment at multiple postsecondary institutions during the same academic term. Findings suggest that coenrollment had a significant positive effect on educational attainment and postsecondary persistence for both student populations. This study has important implications for policy and future research surrounding coenrollment and complex pathways in postsecondary education.
Lab-on-a-Chip Magneto-Immunoassays: How to Ensure Contact between Superparamagnetic Beads and the Sensor Surface
Authors: Eickenberg Bernhard , Meyer Judith , Helmich Lars , Kappe Daniel , Auge Alexander , Weddemann Alexander , Wittbracht Frank , Hütten Andreas
Published: September 2013

Lab-on-a-chip immuno assays utilizing superparamagnetic beads as labels suffer from the fact that the majority of beads pass the sensing area without contacting the sensor surface. Different solutions, employing magnetic forces, ultrasonic standing waves, or hydrodynamic effects have been found over the past decades. The first category uses magnetic forces, created by on-chip conducting lines to attract beads towards the sensor surface. Modifications of the magnetic landscape allow for additional transport and separation of different bead species. The hydrodynamic approach uses changes in the channel geometry to enhance the capture volume. In acoustofluidics, ultrasonic standing waves force µm-sized particles onto a surface through radiation forces. As these approaches have their disadvantages, a new sensor concept that circumvents these problems is suggested. This concept is based on the granular giant magnetoresistance (GMR) effect that can be found in gels containing magnetic nanoparticles. The proposed design could be realized in the shape of paper-based test strips printed with gel-based GMR sensors.
Forthcoming Issue on Game Theory and Political Economy
Authors: Ferguson William
Published: September 2013

Game theory offers a rigorous set of concepts, relationships, and models that invite myriad applications to problems of political economy. Indeed, game theory can serve as a fundamental modeling technique that can bridge microfoundations of political and economic exchanges, with developmental processes and macro implications related to growth and distribution. Applications can range from localized interactions within workplaces, firms, political organizations, and community groups; to intermediate-level market, industry, community, or inter-organizational transactions; to encompassing national, regional, population, or global interactions. At any of these levels, game models can illustrate strategic responses of economic or political actors (individuals or organizations) to specifiable conditions concerning any or all of the following: prevailing social context—notably informal institutions (such as social norms) and formal institutions (such as mutually understood laws and regulations); available information (complete or not; accessible or strategically manipulated); agents’ motivations (material and/or social); and even levels of rationality—substantive (full cognition) or bounded (limited cognition). Applicable models may operate on the basis of given institutional context and preference orientations or may explore associated developmental processes, including adaptive social learning. Of particular interest are representations of one or more of the myriad social dilemmas (or collective-action problems) that inhabit political economy, associated exercises or distributions of power, and/or representations of potential resolutions to such dilemmas—perhaps with policy implications. Accordingly, this forthcoming issue of Economies seeks game-theoretic models based on classical, evolutionary, behavioral, or epistemic game theory that can be applied to one or more problems in political economy. [...]
Patterns of Smoking Prevalence among the Elderly in Europe
Authors: Lugo Alessandra , La Vecchia Carlo , Boccia Stefania , Murisic Bojana , Gallus Silvano
Published: September 2013

Scant information is available on determinants of smoking prevalence in the vulnerable population of the elderly, particularly in Europe. Therefore, we analyzed smoking patterns among older adults (≥65 years old), using data from a representative survey based on 3,071 elderly, conducted in 17 European countries in 2010, within the Pricing Policies And Control of Tobacco in Europe (PPACTE) project. Overall smoking prevalence in 17 European countries was 11.5% (15.3% in men and 8.6% in women). An inverse relation with level of education was observed among men, while no specific pattern was evident among women. Smoking prevalence was highest in eastern/central Europe for men (20.3%) and northern Europe for women (13.1%). In both sexes combined, smokers were more frequent in countries with low implementation of tobacco control activities (14.9%). Anti-tobacco campaigns and smoking cessation interventions specifically targeted to the elderly are urgently needed in Europe.
The Tension and Puncture Properties of HDPE Geomembrane under the Corrosion of Leachate
Authors: Xue Qiang , Zhang Qian , Li Zhen-Ze , Xiao Kai
Published: September 2013

To investigate the gradual failure of high-density polyethylene (HDPE) geomembrane as a result of long-term corrosion, four dynamic corrosion tests were conducted at different temperatures and durations. By combining tension and puncture tests, we systematically studied the variation law of tension and puncture properties of the HDPE geomembrane under different corrosion conditions. Results showed that tension and puncture failure of the HDPE geomembrane was progressive, and tensile strength in the longitudinal grain direction was evidently better than that in the transverse direction. Punctures appeared shortly after puncture force reached the puncture strength. The tensile strength of geomembrane was in inversely proportional to the corrosion time, and the impact of corrosion was more obvious in the longitudinal direction than transverse direction. As corrosion time increased, puncture strength decreased and corresponding deformation increased. As with corrosion time, the increase of corrosion temperature induced the decrease of geomembrane tensile strength. Tensile and puncture strength were extremely sensitive to temperature. Overall, residual strength had a negative correlation with corrosion time or temperature. Elongation variation increased initially and then decreased with the increase in temperature. However, it did not show significant law with corrosion time. The reduction in puncture strength and the increase in puncture deformation had positive correlations with corrosion time or temperature. The geomembrane softened under corrosion condition. The conclusion may be applicable to the proper designing of the HDPE geomembrane in landfill barrier system.
Can Biochemistry Usefully Guide the Search for Better Polymer Electrolytes?
Authors: Halley J.
Published: September 2013

I review some considerations that suggest that the biochemical products of evolution may provide hints concerning the way forward for the development of better electrolytes for lithium polymer batteries.
A pH-Sensitive Peptide-Containing Lasso Molecular Switch
Authors: Clavel Caroline , Fournel-Marotte Karine , Coutrot Frédéric
Published: September 2013

The synthesis of a peptide-containing lasso molecular switch by a self-entanglement strategy is described. The interlocked [1] rotaxane molecular machine consists of a benzometaphenylene[25]crown-8 (BMP25C8) macrocycle surrounding a molecular axle. This molecular axle contains a tripeptidic sequence and two molecular stations: a N-benzyltriazolium and a pH-sensitive anilinium station. The tripeptide is located between the macrocycle and the triazolium station, so that its conformation can be tailored depending on the shuttling of the macrocycle from one station to the other. At acidic pH, the macrocycle resides around the anilinium moiety, whereas it shuttles around the triazolium station after deprotonation. This molecular machinery thus forces the lasso to adopt a tightened or a loosened conformation.
Bioavailability of Polyphenol Liposomes: A Challenge Ahead
Authors: Mignet Nathalie , Seguin Johanne , Chabot Guy
Published: September 2013

Dietary polyphenols, including flavonoids, have long been recognized as a source of important molecules involved in the prevention of several diseases, including cancer. However, because of their poor bioavailability, polyphenols remain difficult to be employed clinically. Over the past few years, a renewed interest has been devoted to the use of liposomes as carriers aimed at increasing the bioavailability and, hence, the therapeutic benefits of polyphenols. In this paper, we review the causes of the poor bioavailability of polyphenols and concentrate on their liposomal formulations, which offer a means of improving their pharmacokinetics and pharmacodynamics. The problems linked to their development and their potential therapeutic advantages are reviewed. Future directions for liposomal polyphenol development are suggested.
Surface Electromyography Signal Processing and Classification Techniques
Authors: Chowdhury Rubana , Reaz Mamun , Ali Mohd , Bakar Ashrif , Chellappan Kalaivani , Chang Tae
Published: September 2013

Electromyography (EMG) signals are becoming increasingly important in many applications, including clinical/biomedical, prosthesis or rehabilitation devices, human machine interactions, and more. However, noisy EMG signals are the major hurdles to be overcome in order to achieve improved performance in the above applications. Detection, processing and classification analysis in electromyography (EMG) is very desirable because it allows a more standardized and precise evaluation of the neurophysiological, rehabitational and assistive technological findings. This paper reviews two prominent areas; first: the pre-processing method for eliminating possible artifacts via appropriate preparation at the time of recording EMG signals, and second: a brief explanation of the different methods for processing and classifying EMG signals. This study then compares the numerous methods of analyzing EMG signals, in terms of their performance. The crux of this paper is to review the most recent developments and research studies related to the issues mentioned above.
Stem Cell Enrichment with Selectin Receptors: Mimicking the pH Environment of Trauma
Authors: Cao Thong , Mitchell Michael , Liesveld Jane , King Michael
Published: September 2013

The isolation of hematopoietic stem and progenitor cells (HSPCs) is critical for transplantation therapy and HSPC research, however current isolation techniques can be prohibitively expensive, time-consuming, and produce variable results. Selectin-coated microtubes have shown promise in rapidly isolating HSPCs from human bone marrow, but further purification of HSPCs remains a challenge. Herein, a biomimetic device for HSPC isolation is presented to mimic the acidic vascular microenvironment during trauma, which can enhance the binding frequency between L-selectin and its counter-receptor PSGL-1 and HSPCs. Under acidic pH conditions, L-selectin coated microtubes enhanced CD34+ HSPC adhesion, as evidenced by decreased cell rolling velocity and increased rolling flux. Dynamic light scattering was utilized as a novel sensor to confirm an L-selectin conformational change under acidic conditions, as previously predicted by molecular dynamics. These results suggest that mimicking the acidic conditions of trauma can induce a conformational extension of L-selectin, which can be utilized for flow-based, clinical isolation of HSPCs.
Global Aquaculture Performance Index (GAPI): The First Global Environmental Assessment of Marine Fish Farming
Authors: Volpe John , Gee Jennifer , Ethier Valerie , Beck Martina , Wilson Amanda , Stoner Jenna
Published: September 2013

“Sustainable” is among the most sought after of all seafood product adjectives. Ironically it is also one of the most poorly defined and understood. The Global Aquaculture Performance Index (GAPI) is the first tool to assess environmental performance of global marine aquaculture production, permitting direct comparison of disparate species, production methods and jurisdictions. Clear patterns emerge from this analysis; significant variation of environmental performance is driven by the species being farmed, significant room for improvement exists across the entire sector, the worst performing players are also the fastest growing, particularly within Asia, and perhaps most importantly, this work highlights the potential trap awaiting policy makers who focus too narrowly on farm production efficiency alone as a solution to diminishing seafood availability.
Learning design Rashomon II: exploring one lesson through multiple tools
Authors: Prieto Luis P. , Dimitriadis Yannis , Craft Brock , Derntl Michael , Émin Valérie , Katsamani Mary , Laurillard Diana , Masterman Elizabeth , Retalis Symeon , Villasclaras Eloy
Published: September 2013

An increasing number of tools are available to support the learning design process at different levels and from different perspectives. However, this variety can make it difficult for researchers and teachers to assess the tool that is best suited to their objectives and contexts as learning designers. Several of the tools are presented elsewhere in this issue. In this article, the aforementioned tools are used as lenses to view the same learning design narrative – an inquiry-based learning lesson on healthy eating aimed at secondary-school students – from different perspectives, in a manner inspired by the plot structure of Kurosawa’s film “Rashomon”. In modelling the lesson on five tools, we uncovered similarities and differences in relation to the challenges posed by modelling a particular learning scenario, the ease of implementation of the computer-interpretable products’ output by the tools and their different target audiences and pedagogical specialities. This comparative analysis thus illustrates some of the current underlying issues and challenges in the field of Learning Design.Keywords: learning design; authoring tools; inquiry learning; personal inquiry(Published: 16 September 2013)Citation: Research in Learning Technology Supplement 2013, 21: 20057 - http://dx.doi.org/10.3402/rlt.v21i0.20057
Auditory Processing Following Consecutive Right Temporal Lobe Resections: A Prospective Case Study
Authors: Nagle Stephanie , Musiek Frank E. , Kossoff Eric H. , Jallo George , Boatman-Reich Dana
Published: September 2013

Background:The role of the right temporal lobe in processing speech is not well understood. Although the left temporal lobe has long been recognized as critical for speech perception, there is growing evidence for right hemisphere involvement. To investigate whether the right
temporal lobe is critical for auditory speech processing, we studied prospectively a normal-hearing patient who underwent consecutive right temporal lobe resections for treatment of medically intractable seizures.Purpose:To test the hypothesis that the right temporal lobe is critical
for auditory speech processing.Research Design:We used a prospective, repeated-measure, single-case design. Auditory processing was evaluated using behavioral tests of speech recognition (words, sentences) under multiple listening conditions (e.g., quiet, background noise, etc.). Auditory
processing of nonspeech sounds was measured by pitch pattern sequencing and environmental sound recognition tasks.Data Collection:Repeat behavioral testing was performed at four time points over a 2 yr period: before and after consecutive right temporal lobe resection surgeries.Results:Before
surgery, the patient demonstrated normal speech recognition in quiet and under real-world listening conditions (background noise, filtered speech). After the initial right anterior temporal resection, speech recognition scores declined under adverse listening conditions, especially for the
left ear, but remained largely within normal limits. Following resection of the right superior temporal gyrus 1 yr later, speech recognition in quiet and nonspeech sound processing (pitch patterns, environmental sounds) remained intact. However, speech recognition under adverse listening conditions
was severely impaired.Conclusions:The right superior temporal gyrus appears to be critical for auditory processing of speech under real-world listening conditions.