bluuebunny/crossref_metadata_2025 huggingface dataset:
Trading in the dark – The medicinal plants production network in Uttarakhand
Authors: Pauls Tim , Franz Martin
Published: July 2013

Medicinal plant cultivation and gathering can play a vital role in the course of livelihood diversification for the marginalized population living in remote areas. However, this requires an integration of the respective production networks that allows the producers a fair and reliable income and does not endanger rare plant species. This paper analyses the situation within the Indian state of Uttarakhand, and identifies structures and entities hindering medical plant cultivation and its potentials. Based on the broad network understanding of the Global Production Network approach, the case study focuses on the middlemen and their hidden embeddedness. It shows how governmental organizations and in particular non‐governmental organizations and farmers' institutions can help to overcome clandestine structures of illegal trade and contribute towards a redesign of the medicinal plant network in a more equitable and transparent way.
High cardiorespiratory fitness is inversely associated with incidence of overweight in adolescence: A longitudinal study
Authors: Savva S. C. , Tornaritis M. J. , Kolokotroni O. , Chadjigeorgiou C. , Kourides Y. , Karpathios T. , Yiallouros P. K.
Published: July 2013

To assess the association of baseline cardiorespiratory fitness (CRF) with incidence of overweight over a 4.6‐year period in adolescence. In a cohort of 4878 adolescents, we assessed body mass index in years 2001–2003 and 2007. CRF was assessed at baseline as maximal oxygen consumption (VO2max, mL/kg/min) using the 20‐m shuttle run test and was examined against incidence of overweight at follow‐up. Estimated VO2max at baseline was higher in males than in females, P < 0.001, and was lower in overweight and obese than in non‐overweight subjects. The incidence of overweight at follow‐up among non‐overweight participants at baseline was 15.5% [95% confidence interval (CI) 13.7% to 17.3%] in males and 5.6% (95% CI 4.9% to 7.0%) in females, P < 0.001. Adjusted odds ratio for incidence of overweight in participants in the fourth quartile of VO2max was 0.40 (95%CI 0.26 to 0.61) in males and 0.57 (95% CI 0.33 to 0.99) in females in comparison with participants in the first quartiles of VO2max. Incidence of overweight was three times more frequent in males than in females. Among non‐overweight at baseline, high fitness levels were inversely associated with incidence of overweight at follow‐up, suggesting that interventions aiming to increase CRF in early childhood might help reverse increasing trends in obesity.
Adolescent Emotion Socialization: A Longitudinal Study of Friends' Responses to Negative Emotions
Authors: Klimes‐Dougan Bonnie , Pearson Theresa E. , Jappe Leah , Mathieson Lindsay , Simard Melissa R. , Hastings Paul , Zahn‐Waxler Carolyn
Published: July 2013

Although peer influences are thought to be critically important to adolescent development, there is a paucity of research investigating the emotion socialization practices that take place between adolescents. This longitudinal study evaluated close friends' responses to negative emotion using a newly developed assessment tool of peer emotion socialization, you and your friends. Adolescent participants (N = 205) exhibiting a range of internalizing and externalizing problems between 11 and 17 years of age were assessed and re‐evaluated two years later. Participants were asked to rate the frequency with which their friends responded to them by encouraging, distracting, matching, ignoring, overtly victimizing, and/or relationally victimizing their emotions. The results indicated high levels of internal consistency and moderate levels of long‐term stability. Close friends most often responded supportively to the participants' emotional displays, but these responses differed by gender. Also, friends' emotion socialization responses were concurrently and predictively associated with participant problem status. This study contributes to a better understanding of the processes by which adolescents' emotions are socialized by their friends and has important implications for future prevention and intervention efforts.
Characterization of 27 novel HLA class II alleles from China Marrow Donor Program
Authors: Zhang Caifen , Wang Yu , Huang Changjian , Zhang Meiyan , Chen Caifen , Cao Hongzhi , Chai Xianghua , Li Jian
Published: July 2013

Twenty‐seven novel human leukocyte antigen (HLA) class II alleles in Chinese Marrow Donors are described: 10 HLA‐DRB1 alleles and 17 HLA‐DQB1 alleles.
Use of the Xpert® MTB/RIF assay for diagnosing pulmonary tuberculosis comorbidity and multidrug‐resistant TB in obstetrics and gynaecology inpatient wards at the University Teaching Hospital, Lusaka, Zambia
Authors: Bates Matthew , Ahmed Yusuf , Chilukutu Lophina , Tembo John , Cheelo Busiku , Sinyangwe Sylvester , Kapata Nathan , Maeurer Markus , O'Grady Justin , Mwaba Peter , Zumla Alimuddin
Published: July 2013

Objectives

In high‐tuberculosis (TB)‐endemic countries, comorbidity of pulmonary TB in hospitalised patients with non‐communicable diseases is well documented. In this study, we evaluated the use of the Xpert® MTB/RIF assay for the detection of concomitant pulmonary TB in patients admitted to the University Teaching Hospital, Lusaka, Zambia, with a primary obstetric or gynaecological condition.

Methods

The Study population were inpatients admitted with a primary obstetric or gynaecological problem who had a concomitant cough and were able to expectorate a sputum sample. Sputum samples from 94 patients were analysed for the presence of Mycobacterium tuberculosis (M.tb) by standard smear microscopy, MGIT culture, MGIT drug‐susceptibility testing (DST) and the Xpert® MTB/RIF assay. The sensitivity and specificity of the Xpert® MTB/RIF assay were evaluated against the culture gold standard.

Results

Twenty‐six of 94 (27.7%) patients had culture‐confirmed pulmonary TB. The Xpert® MTB/RIF assay had a sensitivity of 80.8% [95% CI: 60.0–92.7%]) compared against MGIT culture. The Xpert® MTB/RIF assay was more sensitive than sputum smear microscopy (21/26 (80.8%) vs. 13/26 (50.0%), P = 0.02) and detected an additional eight culture‐confirmed cases. Culture DST analysis identified two monoresistant M.tb strains: one resistant to rifampicin (rifampicin sensitive by the Xpert® MTB/RIF assay) and one to ethambutol. HIV infection was linked with a 3‐fold increase in risk of TB, accounting for 87.5% (21/24) of TB cases. 50% of cases presented as comorbidities with other communicable diseases (CDs) and non‐communicable diseases (NCDs).

Conclusions

As an alternative to sputum microscopy, the Xpert® MTB/RIF assay provides a sensitive, specific and rapid method for the diagnosis of pulmonary TB in obstetric or gynaecological inpatients. Pulmonary TB is an important cause of concomitant comorbidity to the obstetric or gynaecological condition necessitating admission. TB and HIV comorbidities with other communicable and non‐communicable diseases were also common. More proactive screening for TB comorbidity is required in obstetric and gynaecological wards.
Orodental diseases and dermatological disorders are highly associated in pet rabbits: a case–control study
Authors: d'Ovidio Dario , Santoro Domenico
Published: July 2013

Background

Dermatological disorders (DDs) and orodental diseases (ODDs) are a major source of morbidity in pet rabbits. Orodental diseases have anecdotally been associated with cutaneous disorders in rabbits.

Hypothesis/Objectives

The purpose of this study was to evaluate the possible association between DDs and ODDs and to determine whether ODD increases the risk of DD in pet rabbits.

Methods

This study was a retrospective review of 222 medical records of pet rabbits examined over 1 year in 20 private veterinary clinics. Records of rabbits diagnosed with DD were selected. Frequencies of ODDs and other variables were evaluated between rabbits with and without DDs using logistic regression. Rabbits seen during the same time period, but without a diagnosis of DD, were included as control animals.

Results

The prevalence of DD was 28.4% (63 of 222), and the prevalence of ODD was 23% (51 of 222). A significant association was present between DD and ODD. Rabbits diagnosed with ODD were 63 times (odds ratio 63.75; 95% confidence interval 23.9–170.2; P < 0.0001) more likely to be diagnosed with DD in comparison to rabbits without ODD.

Conclusions and clinical importance

The results of this study indicate a strong association between ODD and DD. In particular, rabbits with ODD have a greater risk of developing skin disease later in life. Although coat condition and hair quality can be influenced by many biological and environmental factors, ODDs should be carefully considered as a possible underlying condition in rabbits showing DDs. More prospective studies are needed to evaluate whether this association is due to a behavioural disorder or a metabolic condition.
Use of a hearing loss grading system and an owner‐based hearing questionnaire to assess hearing loss in pet dogs with chronic otitis externa or otitis media
Authors: Mason Carly L. , Paterson Susan , Cripps Peter J.
Published: July 2013

Background

Hearing loss is important when assessing the suitability of dogs with otitis externa/media for medical or surgical therapy.

Hypothesis/objectives

To assess an owner‐completed questionnaire as an indicator of hearing loss and a canine hearing loss scoring system in chronic canine otitis.

Animals

One hundred hospital population dogs referred for chronic otitis investigation.

Methods

Owners completed a questionnaire to assess their dog's response to common household noises. The presence of otitis externa or media was determined and brainstem auditory‐evoked response measurements were performed on each dog. The minimal hearing threshold (MHT) in decibels normal hearing level (dB NHL) was recorded and categorized according to the human World Health Organization grading system into five grades from 0 to 4 with cut‐off values of ≤25 dB NHL, 26–40 dB NHL, 41–60 dB NHL, 60–80 dB NHL and ≥81 dB NHL.

Results

The questionnaire correctly determined normal hearing in grade 0 cases, but did not reliably detect unilateral or grade 1 bilateral hearing loss. For dogs with bilateral hearing loss ≥ grade 2, questionnaire sensitivity was 83% [24 of 29, 95% confidence interval, (CI) 64–94%] and specificity was 94% (67 of 71, 95% CI 86–98%). Higher grades of hearing loss were significantly associated with the presence of otitis media (P < 0.01).

Conclusions and clinical importance

The questionnaire may be a useful in‐practice screening tool in chronic canine otitis for moderate to severe bilateral hearing deficits (MHT ≥41 dB NHL). The hearing loss grading system may help clinicians make therapeutic decisions. Chronic otitis media may be associated with higher grades of hearing loss.
Early histopathologic changes in the retina and optic nerve in canine primary angle‐closure glaucoma
Authors: Scott Erin M. , Boursiquot Natalie , Beltran William A. , Dubielzig Richard R.
Published: July 2013

Objective

To characterize the morphology of canine globes enucleated 1–5 days after the onset of overt clinical disease recognized by the owner.

Procedures

Paraffin‐embedded globes from 47 dogs with acute primary angle‐closure glaucoma (PACG) and 10 control dogs free of ocular disease were sectioned in the vertical plane sampling the optic nerve. Hematoxylin and eosin (H&E)‐stained sections were used to count ganglion cell numbers. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was used to quantify cell death, andMHCIIimmunohistochemistry was used to evaluate for antigen‐presenting phagocytes in a smaller subset of cases.

Results

MHCII‐labeled phagocytes were present in the optic nerve and retina within the first 24 h of documented glaucoma suggesting an early up‐regulation. Globes removed within 1 day of overt clinical disease had a mild neutrophilic infiltrate in the retina and optic nerve as well as marked ganglion cell necrosis. By 5 days after clinical signs appear, there is a rapid decline in the number of ganglion cells and cell death detected byTUNELlabeling in the outer and inner nuclear layers of the retina, but not the ganglion cell layer. The neuropil of the optic nerve progresses from edema and neutrophilia to malacia.

Conclusions

These findings suggest that retinal and optic nerve degeneration in dogs withPACGprogresses rapidly to irreversible tissue loss within days of recognizable clinical disease.
Efficacy of prophylactic antiglaucoma and anti‐inflammatory medications in canine primary angle‐closure glaucoma: a multicenter retrospective study (2004–2012)
Authors: Dees D. Dustin , Fritz Kevin J. , MacLaren Nicole E. , Esson Douglas W. , Sheehan Gaerig Annora M. , Atkins Rosalie M. , Knollinger Amy M.
Published: July 2013

Purpose

To evaluate long‐term efficacy of antiglaucoma medications with or without combined topical anti‐inflammatory treatment in preventing increased intraocular pressure and clinical signs of glaucoma in eyes considered at risk of the development of the disease.

Methods

Retrospective analysis identified 88 canine patients presenting with unilateral acute congestive primary angle‐closure glaucoma (IOP > 25 mm Hg) and gonioscopic findings of pectinate ligament dysplasia and/or narrow or closed iridocorneal angle in the contralateral nonglaucomatous eye. Patients with histopathologic confirmation of pectinate ligament dysplasia or angle closure in the initial glaucomatous eye receiving prophylactic medical therapy in the contralateral eye were included. Time to medical failure for each antiglaucoma medication and efficacy of the combination therapy were evaluated.

Results

The most commonly affected pure‐breds were theAmericanCockerSpaniel (20.4%) andBassetHound (11.36%). The patients receiving demecarium bromide 0.125% had the longest estimated median time to medical failure at 330.0 days, followed by latanoprost 0.005%, dorzolamide hydrochloride 2.0%, and demecarium bromide 0.25% at 284.0 days, 272.5 days, and 143.0 days, respectively. The estimated median time to medical failure for patients receiving topical antiglaucoma and anti‐inflammatory medication was 324.0 days versus 195.0 days in patients receiving antiglaucoma medication alone. Survival analysis showed no statistical significance.

Conclusions

None of the four antiglaucoma medications evaluated statistically delayed medical failure when compared to each other. Although significance was not achieved, our data suggest that adjunctive use of topical anti‐inflammatory medications may be beneficial in these cases.
Seasonal variation in sprouting capacity from intact rhizome systems of three perennial weeds
Authors: Boström U , Andersson L , Forkman J , Hakman I , Liew J , Magnuski E
Published: July 2013

The three rhizomatous perennials Elytrigia repens, Equisetum arvense and Tussilago farfara are all problematic in Scandinavian agriculture, due to their low susceptibility to soil cultivation. While repeated soil tillage is a fundamental part of the integrated control of these species, it is highly energy consuming and inefficient during periods when little sprout regrowth occurs. Substituting cultivation with mowing will reduce the environmental impact and labour costs, but its efficiency will still depend on the capacity of plants to sprout. Therefore, we studied the seasonal pattern in emergence and rhizome biomass allocation from July to April in six populations for each of the species. Plants were grown outdoors in pots buried in soil and exhumed at regular intervals in a two‐year experiment. In all three species, biomass allocation to rhizomes continued until late in the autumn. Emergence was severely impaired in E. arvense and T. farfara in September–October, while in E. repens, there was no such reduction in the number of emerged shoots. However, in the latter species, the shoot/rhizome ratio decreased and remained low until the plants had been exposed to a period of low temperatures. The increase in shoot/rhizome ratio for E. repens coincided with the resumed capacity to emerge for E. arvense and T. farfara. These results imply that there is no need to repeat a defoliation of E. arvense and T. farfara, if carried out in September–October. However, removal of the aerial plant parts early in the autumn is important to interrupt the upload of storage compounds to the rhizome systems of all species.
Swine Influenza in Sub‐Saharan Africa – Current Knowledge and Emerging Insights
Authors: Meseko C. , Olaleye D. , Capua I. , Cattoli G.
Published: July 2013

Pigs have been associated with several episodes of influenza outbreaks in the past and are considered to play a significant role in the ecology of influenza virus. The recent 2009 pandemic influenza A/H1N1 virus originated from swine and not only did it cause widespread infection in humans, but was also transmitted back to swine in Asia, Europe and America. What may be the prevailing situation in Africa, particularly in sub‐Saharan Africa, with respect to the circulation of classical swine or pandemic influenza? The ecology of influenza viruses, as well as the epidemiology of human or animal influenza, is poorly understood in the region. In particular, little is known about swine influenza in Africa despite the relevance of this production in the continent and the widespread pig husbandry operations in urban and rural areas. In this review, the gap in the knowledge of classical and pandemic swine influenza is attributed to negligence of disease surveillance, as well as to the economic and public health impact that the disease may cause in sub‐Saharan Africa. However, emerging serological and virological evidence of swine influenza virus in some countries in the region underscores the importance of integrated surveillance to better understand the circulation and epidemiology of swine influenza, a disease of global economic and public health importance.
Control of a hydraulic system by means of a fuzzy approach
Authors: Ksantini Mohamed , Ellouze Ameni , Delmotte Francois
Published: July 2013

Non linear models can be represented conveniently by Takagi-Sugeno fuzzy models when nonlinearities are bounded. This approach uses a collection of linear models which are interpolated by non linear functions. Then the global control law is the interpolation by the same functions of each feedback associated to each linear model. A Lyapunov approach enables to compute these feedback gains. The number of linear models depends directly on the number of nonlinearities the system has. The more models there are, the more difficult it is to guarantee the stability of the closed loop. This paper proposes a method to reduce the number of linear models by assuming a number of nonlinearities considered as uncertainties and to guarantee the global exponential stability of the system. This method is applied on a hydraulic system.
A multi-parametric programming algorithm for special classes of non-convex multilevel optimization problems
Authors: Kassa Abay Molla , Kassa Semu Mitiku
Published: July 2013

A global solution strategy for multilevel optimization problems with special non-convexityformulation in the objectives of the inner level problems is presented based on branch-and-bound andmulti-parametric programming approach. An algorithm to such problems is proposed by convexifyingthe inner level problem while the variables from upper level problems are considered as parameters.The resulting convex parametric under-estimator problem is solved using multi-parametric program-ming approach. A branch-and-bound procedure is employed until a pre-specied positive tolerance issatised. Moreover, a Ïµ-convergence proof is given for the algorithm.
Minimization over randomly selected lines
Authors: Sahin Ismet
Published: July 2013

This paper presents a population-based evolutionary optimization method for minimizing a given cost function. The mutation operator of this method selects randomly oriented lines in the cost function domain, constructs quadratic functions interpolating the cost function at three different points over each line, and uses extrema of the quadratics as mutated points. The crossover operator modifies each mutated point based on components of two points in population, instead of one point as is usually performed in other evolutionary algorithms. The stopping criterion of this method depends on the number of almost degenerate quadratics. We demonstrate that the proposed method with these mutation and crossover operations achieves faster and more robust convergence than the well-known Differential Evolution and Particle Swarm algorithms.
Surface Roughness Effects in the Region Between High Wave Number and High Bearing Number Limited Lubricant Flows
Authors: White James
Published: July 2013

The ability to predict surface roughness effects is now well established for gas bearings that satisfy the requirements for either high wave number–limited or high bearing number–limited conditions. However, depending on the parameters involved, a given bearing configuration may not satisfy either of these limited requirements for analysis of roughness effects. Well-established methods for the analysis of surface roughness effects on gas lubrication are not yet available outside of these two limited regions. With that as motivation, this paper then reports an analytical investigation of rough surface gas-bearing effects for the region bounded on one side by high wave number–limited conditions and on the other by high bearing number–limited effects. It emphasizes the gas-bearing region, where shear-driven flow rate and pressure-driven flow rate due to surface roughness are of the same order of magnitude. This paper makes use of the compressible continuum form of the Reynolds equation of lubrication together with multiple-scale analysis to formulate a governing lubrication equation appropriate for the analysis of striated roughness effects collectively subject to high bearing number (Λ→∞), high inverse roughness length scale (β→∞), and unity order of magnitude-modified bearing number based on roughness length scale (Λ2=Λ/β=O(1)). The resulting lubrication equation is applicable for both moving and stationary roughness and can be applied in either averaged or un-averaged form. Several numerical examples and comparisons are presented. Among them are results that illustrate an increased sensitivity of bearing force to modified bearing number for Λ2=O(1). With Λ2 in this range, bearings with either moving or stationary roughness exhibit increased force sensitivities, but the effects act in opposite ways. That is, while an increase in modified bearing number causes a decrease in force for stationary roughness, the same increase in modified bearing number causes an increase in force for moving roughness.
Ultrahigh Magnetoresistance at Room Temperature in Molecular Wires
Authors: Mahato R. N. , Lülf H. , Siekman M. H. , Kersten S. P. , Bobbert P. A. , de Jong M. P. , De Cola L. , van der Wiel W. G.
Published: July 2013

More Magnetoresistance

When data is read off your computer's hard drive, chances are that the read head is using the phenomenon of magnetoresistance (MR)—the dependence of electrical resistance on applied magnetic field—to interpret the magnetic signature of the data on the disk. Devices that have the large MR necessary for such tasks are usually made of layers of magnetic materials.

Mahato
et al.

(p.
257
, published online 4 July) observed a large MR effect in a nonmagnetic material—organic molecules squeezed into a zeolite crystal. Importantly for potential future applications, the effect was observed at room temperature and at low magnetic fields.
The Xist lncRNA Exploits Three-Dimensional Genome Architecture to Spread Across the X Chromosome
Authors: Engreitz Jesse M. , Pandya-Jones Amy , McDonel Patrick , Shishkin Alexander , Sirokman Klara , Surka Christine , Kadri Sabah , Xing Jeffrey , Goren Alon , Lander Eric S. , Plath Kathrin , Guttman Mitchell
Published: July 2013

Understanding Xist-ance

Large noncoding RNAs (lncRNAs) are increasingly appreciated to play important roles in the cell. A number of lncRNAs act to target chromatin regulatory complexes to their sites of action.

Engreitz
et al.

(p.
10.1126/science.1237973
, published online 4 July; see the Perspective by

Dimond and Fraser

) found that the mouse Xist lncRNA, which initiates X-chromosome inactivation, was transferred from its site of transcription to distant sites on the X chromosome purely through their close three-dimensional proximity to the
Xist
gene. Xist initially localized to the periphery of active genes on the X chromosome but gradually spread across them using its A-repeat domain, until the Xist RNA bound broadly across the inactive X chromosome in differentiated female cells.
Familial Mediterranean fever without fever as a cause of monoarthritis
Authors: Mattiassich Georg , Semlitsch Georg , Nadler Karin , Rainer Franz
Published: July 2013

Familial Mediterranean fever (FMF) is an autosomal recessive hereditary disease. FMF-related arthritis affects large joints, especially in the lower extremities. It starts with acute pain and swelling and affects one joint at a time. Fever is the most common symptom in FMF. Monoarthritis as the sole symptom is relatively rare and thus delayed diagnosis of the disease in a patient who had been suffering from monoarthritis for several years. Genetic analysis showing typical mutations in the patient eventually resulted in correct diagnosis, although classical clinical diagnostic criteria were not met. The patient received appropriate therapy with colchicine, which led to remission of the symptoms.
Intratracheal inflammatory myofibroblastic tumour mimicking severe acute asthma
Authors: Goussard Pierre , Gie Robert , Janson Jacques , Schubert Pawel
Published: July 2013

A 3-year-old boy presented with severe airway obstruction which was diagnosed as asthma. He improved but had repeated episodes of severe airway obstruction. On clinical examination, he had a tracheal cough and monophonic wheezing. Imaging revealed a large lesion in the distal part of the trachea which was confirmed by bronchoscopy. The lesion was surgically removed. Histology revealed features characteristic of an inflammatory myofibroblastic tumour. Following the resection there is no recurrence of the lesion.
Upper oesophageal foreign body with acute respiratory distress
Authors: Singh Amit , Panda Shasanka Shekhar , Panda Meely , Srinivas M
Published: July 2013

Foreign body (FB) ingestion, a common and serious problem in children can present with a wide variety of symptoms. Oesophageal FB leading to severe acute respiratory distress is uncommon and requires urgent surgical intervenetion. We report an 8-month-old female child who presented with severe respiratory distress to casualty and was found to have a FB in her upper oesophagus.
Reducing cardiac arrests in the acute admissions unit: a quality improvement journey
Authors: Beckett Daniel J , Inglis Monica , Oswald Sharon , Thomson Elaine , Harley Wilma , Wilson Jennifer , Lloyd Robert C , Rooney Kevin D
Published: July 2013

Background

In 2010, the acute admissions unit (AAU) at Stirling Royal Infirmary had the highest number of cardiac arrests of any ward. A quality improvement project was undertaken to reduce this to <1/1000 admissions by December 2011.

Methods

In January 2011, based on initial needs assessment, we selected three initiatives to improve cardiac arrest rate: (1) structured response to deteriorating patients; (2) analysis of adverse events; and (3) improved end-of-life decision-making. We performed a failure modes effects analysis to identify reasons for the failure of early recognition and response. Ward staff conducted weekly safety meetings to engage unit staff and promote a safety culture of continuous improvement. Additionally, in July 2011 the unit adopted a ward-based clinical team structure with twice daily consultant ward rounds. Our primary outcome measure, cardiac arrests per 1000 admissions, was measured from January 2011 to August 2012.

Results

Over 17 months, the number of cardiac arrests per 1000 admissions fell from a baseline of 2.8/1000 admissions to 0.8/1000 admissions (71% reduction), referrals to palliative care increased by 22 to 37/1000 admissions per month (68% increase) and the 30-day mortality of patients admitted to the AAU fell from 6.3% to 4.8% (24% relative reduction).

Conclusions

Through adoption of a shared goal, application of improvement methodology including the model for improvement to test new innovations, and promotion of a safety culture in the AAU, cardiac arrests were successfully reduced to <1/1000 admissions per month with an associated significant fall in mortality. This was achieved with negligible cost.
Assessing adverse events among home care clients in three Canadian provinces using chart review
Authors: Blais Régis , Sears Nancy A , Doran Diane , Baker G Ross , Macdonald Marilyn , Mitchell Lori , Thalès Stéphane
Published: July 2013

Objectives

The objectives of this study were to document the incidence rate and types of adverse events (AEs) among home care (HC) clients in Canada; identify factors contributing to these AEs; and determine to what extent evidence of completion of incident reports were documented in charts where AEs were found.

Methods

This was a retrospective cohort study based on expert chart review of a random sample of 1200 charts of clients discharged in fiscal year 2009–2010 from publicly funded HC programmes in Manitoba, Quebec and Nova Scotia, Canada.

Results

The results show that 4.2% (95% CI 3.0% to 5.4%) of HC patients discharged in a 12-month period experienced an AE. Adjusting to account for clients with lengths of stay in HC of less than 1 year, the AE incidence rate per client-year was 10.1% (95% CI 8.4% to 11.8%); 56% of AEs were judged preventable. The most frequent AEs were injuries from falls, wound infections, psychosocial, behavioural or mental health problems and adverse outcomes from medication errors. More comorbid conditions (OR 1.15; 95% CI 1.05 to 1.26) and a lower instrumental activities of daily living score (OR 1.54; 95% CI 1.16 to 2.04) were associated with a higher risk of experiencing an AE. Clients’ decisions or actions contributed to 48.4% of AEs, informal caregivers 20.4% of AEs, and healthcare personnel 46.2% of AEs. Only 17.3% of charts with an AE contained documentation that indicated an incident report was completed, while 4.8% of charts without an AE had such documentation.

Conclusions

Client safety is an important issue in HC, as it is in institutionalised care. HC includes the planned delivery of self-care by clients and care provision by family, friends and other individuals often described as ‘informal’ caregivers. As clients and these caregivers can contribute to the occurrence of AEs, their involvement in the delivery of healthcare interventions at home must be considered when planning strategies to improve HC safety.
Focus on: African horse sickness
Authors: Hopley Richard , Toth Balazs
Published: July 2013

Richard Hopley of Defra and Balazs Toth of the AHVLA discuss African horse sickness and how an outbreak would be dealt with in Great Britain
PRECISE MEASUREMENT OF THE W-BOSON MASS AT CDF
Authors: ZENG YU
Published: July 2013

This review presents the world's most precise measurement of the W-boson mass mW using data corresponding to ≈ 2.2 fb-1 integrated luminosity collected with the CDF II detector at Fermi National Accelerator Laboratory (Fermilab). With samples of 470,126 W → eν candidates and 624,708 W → μν candidates, mW is measured to be 80387±12 stat ± 15 syst = 80387 ± 19 MeV [Phys. Rev. Lett.108, 151803 (2012)]. This result significantly exceeds the precision of all previous measurements and improves the world averaged precision by 30%.
QUANTUM FIELD THEORY ON CURVED BACKGROUNDS — A PRIMER
Authors: BENINI MARCO , DAPPIAGGI CLAUDIO , HACK THOMAS-PAUL
Published: July 2013

Goal of this paper is to introduce the algebraic approach to quantum field theory on curved backgrounds. Based on a set of axioms, first written down by Haag and Kastler, this method consists of a two-step procedure. In the first one, it is assigned to a physical system a suitable algebra of observables, which is meant to encode all algebraic relations among observables, such as commutation relations. In the second step, one must select an algebraic state in order to recover the standard Hilbert space interpretation of a quantum system. As quantum field theories possess infinitely many degrees of freedom, many unitarily inequivalent Hilbert space representations exist and the power of such approach is the ability to treat them all in a coherent manner. We will discuss in detail the algebraic approach for free fields in order to give the reader all necessary information to deal with the recent literature, which focuses on the applications to specific problems, mostly in cosmology.
PRICING STEP OPTIONS UNDER THE CEV AND OTHER SOLVABLE DIFFUSION MODELS
Authors: CAMPOLIETI G. , MAKAROV R. , WOUTERLOOT K.
Published: July 2013

We consider a special family of occupation-time derivatives, namely proportional step options introduced by [18]. We develop new closed-form spectral expansions for pricing such options under a class of nonlinear volatility diffusion processes which includes the constant-elasticity-of-variance (CEV) model as an example. In particular, we derive a general analytically exact expression for the resolvent kernel (i.e. Green's function) of such processes with killing at an exponential stopping time (independent of the process) of occupation above or below a fixed level. Moreover, we succeed in Laplace inverting the resolvent kernel and thereby derive newly closed-form spectral expansion formulae for the transition probability density of such processes with killing. The spectral expansion formulae are rapidly convergent and easy-to-implement as they are based simply on knowledge of a pair of fundamental solutions for an underlying solvable diffusion process. We apply the spectral expansion formulae to the pricing of proportional step options for four specific families of solvable nonlinear diffusion asset price models that include the CEV diffusion model and three other multi-parameter state-dependent local volatility confluent hypergeometric diffusion processes.
Preparation and characterization of silver nanoparticle-porphyrazine composites
Authors: Sevim Altuğ Mert , Keskin Ayşe Selda , Gül Ahmet
Published: July 2013

A one step chemical reduction process was used for the preparation of hydrophilic silver nanoparticles ( AgNP ) using silver nitrate, sodiumborohydride and polyvinylpyrolidone as stabilizer. In the case of hydrophobic silver nanoparticles reduced silver ions were stabilized with cetyl trimethylammonium bromide (CTAB). The resultant nano particles were characterized by absoption spectra and their interactions with cationic cobalt (QCoPz) and neutral magnesium (MgPz) porphyrazines in water and in organic medium were investigated by using UV-vis spectroscopy and zeta potential techniques. It is confirmed that both metalloporphyrazine molecules interact with silver nanoparticles in an effective manner. The possible arrangement of the porphyrazines on the surfaces of the hydrophilic and hydrophobic AgNPs has been also discussed according to obtained spectroscopic results. These well-characterized novel AgNP -metalloporphyrazine composites are expected to be useful in optical and catalytic applications.
Ablation of Arg1 in hematopoietic cells improves respiratory function of lung parenchyma, but not that of larger airways or inflammation in asthmatic mice
Authors: Cloots Roy H. E. , Sankaranarayanan Selvakumari , de Theije Chiel C. , Poynter Matthew E. , Terwindt Els , van Dijk Paul , Hakvoort Theodorus B. M. , Lamers Wouter H. , Köhler S. Eleonore
Published: July 2013

Asthma is a chronic inflammatory disease of the small airways, with airway hyperresponsiveness (AHR) and inflammation as hallmarks. Recent studies suggest a role for arginase in asthma pathogenesis, possibly because arginine is the substrate for both arginase and NO synthase and because NO modulates bronchial tone and inflammation. Our objective was to investigate the importance of increased pulmonary arginase 1 expression on methacholine-induced AHR and lung inflammation in a mouse model of allergic asthma. Arginase 1 expression in the lung was ablated by crossing Arg1 fl/fl with Tie2Cre tg/− mice. Mice were sensitized and then challenged with ovalbumin. Lung function was measured with the Flexivent. Adaptive changes in gene expression, chemokine and cytokine secretion, and lung histology were quantified with quantitative PCR, ELISA, and immunohistochemistry. Arg1 deficiency did not affect the allergic response in lungs and large-airway resistance, but it improved peripheral lung function (tissue elastance and resistance) and attenuated adaptive increases in mRNA expression of arginine-catabolizing enzymes Arg2 and Nos2, arginine transporters Slc7a1 and Slc7a7, chemokines Ccl2 and Ccl11, cytokines Tnfa and Ifng, mucus-associated epithelial markers Clca3 and Muc5ac, and lung content of IL-13 and CCL11. However, expression of Il4, Il5, Il10, and Il13 mRNA; lung content of IL-4, IL-5, IL-10, TNF-α, and IFN-γ protein; and lung pathology were not affected. Correlation analysis showed that Arg1 ablation disturbed the coordinated pulmonary response to ovalbumin challenges, suggesting arginine (metabolite) dependence of this response. Arg1 ablation in the lung improved peripheral lung function and affected arginine metabolism but had little effect on airway inflammation.
Self-Perceived Stigmatization in Female Patients with Anorexia Nervosa - Results from an Explorative Retrospective Pilot Study of Adolescents
Authors: Maier A. , Ernst J.-P. , Müller S. , Gross D. , Zepf F.D. , Herpertz-Dahlmann B. , Hagenah U.
Published: July 2013

Background: The stigma of mental illness has been identified as an important barrier to treatment and recovery. Previous research reported the stigmatization of individuals with eating disorders by both health professionals and the general public. The aim of this pilot study was to empirically assess the previous stigmatization and discrimination experiences of young female patients with anorexia nervosa (AN) using a retrospective explorative approach. Methods: An in-house questionnaire that was developed to survey experiences of stigmatization was mailed to 75 former adolescent patients with AN. The mean time of assessment after discharge was 5.6 ± 1.2 years. The patients were asked to respond anonymously. The response rate was approximately 48% (n = 36). Results: Feelings that society held negative stereotypes of individuals with AN, concrete experiences of stigmatization and discrimination, and rejection by peers were reported. A remarkable degree of self-stigmatization, as indexed by high rates of agreement to stigmatizing statements, was detected. Approximately one third of the participants reported delayed initiation of treatment due to fear of stigmatization and discrimination. Conclusion: Stigmatization plays a decisive role in young patients with AN and impacts their motivation to seek professional help and engage in treatment. Clinicians should be aware of the stigmatization related to eating disorders and its burden for affected patients.
Predicting Patient-Reported Stroke Outcomes: A Validation of the Six Simple Variable Prognostic Model
Authors: Teale Elizabeth , Young John , Dennis Martin , Sheldon Trevor
Published: July 2013

Background: Case-mix represents the range of disease severity and baseline characteristics that may be the cause of variation in outcomes between individuals and populations. Adjustment for case-mix is therefore important to allow meaningful comparison of healthcare outcomes. The best available case-mix adjustment model for stroke (the Six Simple Variable [SSV] model) was developed to adjust the hard endpoints of independent survival, survival and alive and living at home. There is increasing interest in the measurement of patient-reported outcomes through self-completed questionnaires, though there are currently no robust adjustment models for any such outcome. We aimed to determine whether the SSV prognostic model derived to predict 6-month post-stroke independent survival has wider utility in case-mix adjustment of a patient-reported functional outcome measure, the Subjective Index of Physical and Social Outcome (SIPSO), collected by post 6 months after stroke onset. Methods: We examined data from 176 patients admitted following an acute stroke and recruited into a prospective cohort study in three participating acute hospitals in Yorkshire, UK. Patients in receipt of palliative care or with transient ischaemic attack were excluded. Using the beta coefficients from the published SSV model to predict independent survival, individual probabilities of ‘good' outcome as measured with the dichotomised SIPSO collected by post 6 months after stroke onset were calculated. The ability of the SSV case-mix adjustment model to discriminate patients with ‘good' over ‘poor' outcome was assessed through calculation of C statistics. Correct predictions were visualised with calibration plots. Results: The C statistics for the SSV model to predict the physical and social subscales of the SIPSO outcome measure were 0.73 (95% CI 0.65-0.79) and 0.66 (0.58-0.82), respectively. Inclusion of patients who died prior to follow-up and ascribing them a score of 0 improved the discrimination (0.76 [0.70-0.82] and 0.70 [0.64-0.76], respectively). Calibration plots demonstrated a tendency to over-optimistic predictions, although confidence limits were wide. Conclusions: The SSV model predicts adequately the physical component of the SIPSO patient-reported outcome measure and may be useful to adjust this outcome for case-mix following stroke in survivors to follow-up. This could be of benefit in observational studies, stratified randomisation for trials, and in comparison of between-institution clinical trials. Further exploration of the generalizability of the model to adjust other patient-reported stroke outcomes may be warranted.
Thyroid Surgery in the Elderly
Authors: Schwartz N. , Shpitzer T. , Feinmesser R. , Robenshtok E. , Bachar G.
Published: July 2013

Background: The increase in life expectancy combined with the relatively high incidence of thyroid disease requiring surgery in the elderly has raised questions concerning the appropriate management of the older patient. Aim: Evaluation of the surgical management and outcome of thyroid disease requiring surgery in elderly patients. Methods: We performed a retrospective cohort study, in which the medical charts of 2,239 patients who underwent total thyroidectomy or hemithyroidectomy between 1995 and 2011 in a tertiary medical center were reviewed for clinical, disease-related, operative and outcome measures. Findings were analyzed between the patients aged more than 75 years for whom complete information was available (n = 255) and a control group of 100 patients aged 40-60 years matched for sex and extent of surgery. Results: The prevalence of comorbidities was significantly higher in the elderly. Presenting symptoms were similar in the two groups; in approximately 25% of both groups thyroid cancer was an incidental finding. There were no between-group differences in surgery duration, time to anesthesia induction, recovery time from anesthesia, or rate of postoperative complications. Hospitalization was 3 days longer on average in the older group. Malignancy rates and distribution of histologic subtypes were similar in the two groups, although the older group presented with significantly higher rates of advanced disease stage and larger tumors. There were no differences in recurrence rate both locoregional and distant metastases. However, a higher proportion of older patients failed to achieve cure. Conclusion: Although older patients with thyroid disease have more comorbidities and advanced disease, there is no practical difference in their operative management and surgical outcome compared to younger patients. Surgery should not be deferred solely on the basis of age in the presence of compelling indications; rather, the decision should be based on individual risk-benefit analysis.
Fibrocalcific Aortic Valve Disease
Authors: Weiss Robert M. , Miller Jordan D. , Heistad Donald D.
Published: July 2013

Studies in vitro and in vivo continue to identify complex-regulated mechanisms leading to overt fibrocalcific aortic valve disease (FCAVD). Assessment of the functional impact of those processes requires careful studies of models of FCAVD in vivo. Although the genetic basis for FCAVD is unknown for most patients with FCAVD, several disease-associated genes have been identified in humans and mice. Some gene products which regulate valve development in utero also protect against fibrocalcific disease during postnatal aging. Valve calcification can occur via processes that resemble bone formation. But valve calcification can also occur by nonosteogenic mechanisms, such as formation of calcific apoptotic nodules. Anticalcific interventions might preferentially target either osteogenic or nonosteogenic calcification. Although FCAVD and atherosclerosis share several risk factors and mechanisms, there are fundamental differences between arteries and the aortic valve, with respect to disease mechanisms and responses to therapeutic interventions. Both innate and acquired immunity are likely to contribute to FCAVD. Angiogenesis is a feature of inflammation, but may also contribute independently to progression of FCAVD, possibly by actions of pericytes that are associated with new blood vessels. Several therapeutic interventions seem to be effective in attenuating the development of FCAVD in mice. Therapies which are effective early in the course of FCAVD, however, are not necessarily effective in established disease.
Introduction to Aortic Stenosis
Authors: Carabello Blase A.
Published: July 2013

Aortic stenosis is perhaps the most common of all valvular heart diseases in the developed nations of the world. Once primarily caused by rheumatic fever, the most common pathogenesis today is an active inflammatory process with some features that are similar to atherosclerosis. Because of this shift, the age at onset of severe obstruction has changed from the sixth decade 50 years ago to the eighth decade in most individuals today. The onset of symptoms remains a key determinant of outcome, although the later age at onset may make it difficult to discern if aortic stenosis or other age-related comorbidities is the cause of the symptoms. Once symptoms of aortic stenosis develop, life expectancy is shortened to ≈3 years unless the mechanical obstruction to left ventricular outflow is relieved by aortic valve replacement. Traditionally performed during cardiac surgery, aortic valve replacement now may be performed safely and effectively using transcatheter techniques, potentially revolutionizing the approach to this potentially fatal disease.
The Subject’s Life and the Life of Manifestation: Towards a Privative Biology
Authors: Barbaras Renaud
Published: July 2013

Abstract

The universal a priori of the correlation between transcendental being and its subjective modes of givenness constitutes the minimal framework for any phenomenological approach. The proper object of phenomenology is then to characterize both the exact nature of the correlation and the sense of being of the terms in relation, that is to say, of subject and world. It involves demonstrating that a rigorous analysis of the correlation unfolds necessarily on three levels and that phenomenology is thus destined to move beyond itself towards a cosmology and metaphysics. The phenomenological correlation that we will establish is essentially a relation between a subject that is desire and a world that is pure transcendence and assumes their common belonging to a φύσίς whose description stems from a cosmology. But the difference of the subject, without which there is no correlation, refers itself to a more originary split that affects the very process of the manifestation and opens the space of metaphysics.