bluuebunny/crossref_metadata_2025 huggingface dataset:
Identity transformation and a changed lifestyle following dramatic weight loss and body-contouring surgery: An exploratory study
Authors: Gilmartin Jo , Long Andrew , Soldin Mark
Published: December 2013

This article reports on two major quality-of-life perception changes for patients who had undergone plastic surgery following dramatic weight loss. The exploratory, qualitative study was undertaken with 20 patients from one teaching hospital. In-depth interviews were conducted, and a thematic analysis of the data was undertaken. The results provide unique glimpses of surgical consumption empowering and facilitating ‘identity transformation’, embracing improved physical function and enhanced self-esteem, confidence and quality of life, and a ‘changed lifestyle’. For a minority, identity transformation was sometimes interrupted by ‘identity lag’, posing the need for additional health-care support throughout the adjustment process. The study provides additional insight into existing quantitative studies, adding to the body of knowledge in this area.
How do environmental factors influence walking in groups? A walk-along study
Authors: Kassavou Aikaterini , French David P , Chamberlain Kerry
Published: December 2013

Insufficient attention has been given to the influence of context on health-related behaviour change. This article reports on walk-along interviews conducted with 10 leaders of walking groups while leading their groups to investigate the influence of contextual factors on walking behaviours in groups. Data analysis used ideas from thematic analysis and grounded theory, approaching the data inductively. We identified that characteristics of place influenced the type of walking that people do in groups and the processes used by walkers to make sense of their behaviours in the places they walk. This research provides insight into how place influences walking in groups. It also suggests recommendations for co-ordinators and policymakers that could be used to facilitate behaviour change, when designing interventions targeting public health within the community.
Using Rasch analysis to evaluate the validity of the diabetes-specific version of the Illness Perception Questionnaire–Revised
Authors: Rees Gwyneth , Lamoureux Ecosse L , Xie Jing , Sturrock Bonnie A , Fenwick Eva K
Published: December 2013

This study used Rasch analysis to examine the psychometric validity of the Illness Perception Questionnaire–Revised to assess beliefs about diabetes in 470 participants with Type 2 diabetes and 71 participants with Type 1 diabetes. All Illness Perception Questionnaire–Revised scales had psychometric issues, which included poorly utilised response categories, poor scale precision and multidimensionality. Following re-engineering, only four of the eight scales (Consequences, Illness coherence, Timeline cyclical and Emotional representations) were psychometrically adequate according to the Rasch model. The diabetes-specific version of the Illness Perception Questionnaire–Revised provides suboptimal assessment of beliefs held by patients with diabetes.
Predicting safe sex: Assessment of autoregressive and cross-lagged effects within the Theory of Planned Behavior
Authors: Eggers Sander M , Taylor Myra , Sathiparsad Reshma , Bos Arjan ER , de Vries Hein
Published: December 2013

Despite its popularity, few studies have assessed the temporal stability and cross-lagged effects of the Theory of Planned Behavior factors: Attitude, subjective norms and self-efficacy. For this study, 298 adolescent learners from KwaZulu-Natal, South Africa, filled out a Theory of Planned Behavior questionnaire on teenage pregnancy at baseline and after 6 months. Structural equation modeling showed that there were considerable cross-lagged effects between attitude and subjective norms. Temporal stability was moderate with test–retest correlations ranging from 0.37 to 0.51 and the model was able to predict intentions to have safe sex ( R2 = 0.69) Implications for practice and future research are discussed.
Use and effectiveness of lapse prevention strategies among pregnant smokers
Authors: Naughton Felix , McEwen Andy , Sutton Stephen
Published: December 2013

Little is known about the use of lapse prevention strategies to help smokers manage situation-triggered urges to smoke. Pregnant smokers ( N = 174) participating in an intervention trial reported use of cognitive–behavioural lapse prevention strategies and smoking abstinence (biochemically verified). Participants typically enacted few strategies. Distraction strategies were most commonly used. Total number of strategies used did not predict abstinence. However, using ‘self-talk’ (odds ratio (OR) = 3.44, 95% confidence interval = 1.14–10.40) or ‘avoiding spending time with other smokers’ (OR = 4.01, 95% confidence interval = 1.34–11.95) independently increased the odds of abstinence. The promotion of these and other under-utilised evidence-based strategies warrants further attention.
Managing parental groups during early childhood
Authors: Lefèvre Åsa , Pia Lundqvist , Eva Drevenhorn , Inger Hallström
Published: December 2013

The purpose of this study was to describe child health centre (CHC) nurses’ views of managing parental groups during early childhood. All 311 CHC nurses working within the Swedish CHC system in one county were asked to complete a web-based questionnaire. Findings showed that although the CHC nurses were experienced, several found group leadership challenging and difficult. The need for specialized groups for young parents, single parents and parents whose first language was not Swedish was identified by 57% of the nurses. The CHC nurses found the participation of fathers in their parental groups to be low (an estimate of 10–20%), and 30% of the nurses made special efforts to make the fathers participate. Education in group dynamics and group leadership can strengthen CHC nurses in managing parental groups. It is recommended that specialized parental groups are organized by a few family centres so CHC nurses can develop their skill in managing such groups.
A discontinuous surface reflector for high-power integrated LEDs
Authors: Liu F , Chen L , Tang B , Hu Y , Lin Q , Lei L
Published: December 2013

High-power integrated LEDs usually have a bright square surface. When the rays emitted from them are collected to project a round spot at a very short distance using a rotationally symmetrical reflector, there will be a dark spot in the centre. This problem can be avoided in advanced lighting systems. A discontinuous surface reflector is designed by a simple method based on the three-dimensional form of compound parabolic concentrators. The dark spot is removed, and the uniformity is better.
Altered Resting-State Functional and White Matter Tract Connectivity in Stroke Patients With Dysphagia
Authors: Li Shasha , Ma Zhenxing , Tu Shipeng , Zhou Muke , Chen Sihan , Guo Zhiwei , Gong Qiyong , He Li , Huang Xiaoqi , Yao Dezhong , Lui Su , Yu Bo , Wang Xiaotong , Zhou Dong , He Chengqi
Published: December 2013

Background. Swallowing dysfunction is intractable after acute stroke. Our understanding of the alterations in neural networks of patients with neurogenic dysphagia is still developing. Objective. The aim was to investigate cerebral cortical functional connectivity and subcortical structural connectivity related to swallowing in unilateral hemispheric stroke patients with dysphagia. Methods. We combined a resting-state functional connectivity with a white matter tract connectivity approach, recording 12 hemispheric stroke patients with dysphagia, 12 hemispheric stroke patients without dysphagia, and 12 healthy controls. Comparisons of the patterns in swallowing-related functional connectivity maps between patient groups and control subjects included ( a) seed-based functional connectivity maps calculated from the primary motor cortex (M1) and the supplementary motor area (SMA) to the entire brain, ( b) a swallowing-related functional connectivity network calculated among 20 specific regions of interest (ROIs), and ( c) structural connectivity described by the mean fractional anisotropy of fibers bound through the SMA and M1. Results. Stroke patients with dysphagia exhibited dysfunctional connectivity mainly in the sensorimotor-insula-putamen circuits based on seed-based analysis of the left and right M1 and SMA and decreased connectivity in the bilateral swallowing-related ROIs functional connectivity network. Additionally, white matter tract connectivity analysis revealed that the mean fractional anisotropy of the white matter tract was significantly reduced, especially in the left-to-right SMA and in the corticospinal tract. Conclusions. Our results indicate that dysphagia secondary to stroke is associated with disruptive functional and structural integrity in the large-scale brain networks involved in motor control, thus providing new insights into the neural remodeling associated with this disorder.
Robotic Therapy Provides a Stimulus for Upper Limb Motor Recovery After Stroke That Is Complementary to and Distinct From Conventional Therapy
Authors: Brokaw Elizabeth B. , Nichols Diane , Holley Rahsaan J. , Lum Peter S.
Published: December 2013

Background. Individuals with chronic stroke often have long-lasting upper extremity impairments that impede function during activities of daily living. Rehabilitation robotics have shown promise in improving arm function, but current systems do not allow realistic training of activities of daily living. We have incorporated the ARMin III and HandSOME device into a novel robotic therapy modality that provides functional training of reach and grasp tasks. Objective. To compare the effects of equal doses of robotic and conventional therapy in individuals with chronic stroke. Methods. Subjects were randomized to 12 hours of robotic or conventional therapy and then crossed over to the other therapy type after a 1-month washout period. Twelve moderate to severely impaired individuals with chronic stroke were enrolled, and 10 completed the study. Results. Across the 3-month study period, subjects showed significant improvements in the Fugl-Meyer ( P = .013) and Box and Blocks tests ( P = .028). The robotic intervention produced significantly greater improvements in the Action Research Arm Test than conventional therapy ( P = .033). Gains in the Box and Blocks test from conventional therapy were larger than from robotic therapy in subjects who received conventional therapy after robotic therapy ( P = .044). Conclusions. Data suggest that robotic therapy can elicit improvements in arm function that are distinct from conventional therapy and supplements conventional methods to improve outcomes. Results from this pilot study should be confirmed in a larger study.
Ischemic Stroke as a Complication of Varicella Zoster Encephalitis
Authors: Venhovens Jeroen , Stelten Bianca , Feyen Bart F. E. , van Dijk Gert , Meulstee Jan
Published: December 2013

A 72-year-old man with varicella zoster virus (VZV) encephalitis complicated by an ischemic stroke in the right internal capsule, possibly due to secondary small-vessel vasculopathy, is described in this case report. The focus of this article is on the electroencephalogram (EEG) description of varicella zoster encephalitis and secondary vasculopathy because EEG descriptions are scarce in the literature and detailed descriptions are lacking. In this patient’s EEG, right temporal theta waves were found in combination with a mild slowing of the background rhythm to 7.5 to 8 Hz in the acute stage with an amplitude asymmetry (right temporal lobe amplitudes were significantly higher compared with the left side). The theta waves were thought to originate from the ischemic lacunar stroke, the slowing of the background rhythm from early encephalitis, and the amplitude asymmetry was presumed to be of physiologic origin. A follow-up EEG 6 days after initiation of treatment with acyclovir showed a normal symmetrical background rhythm of 8 to 8.5 Hz, wherein the theta waves were significantly reduced in abundance, and the amplitude asymmetry was unchanged. In conclusion, the EEG may localize focal abnormalities possibly due to cortical or lacunar ischemia, which could be explained by early small and/or large vessel vasculopathy in patients with suspected VZV encephalitis.
An Analysis of Skills Acquisition During a Training Program for Experienced Laparoscopists in Laparoendoscopic Single-Site Surgery
Authors: Sánchez-Margallo Francisco M. , Pérez Francisco J. , Azevedo Ana M. , Sánchez-Margallo Juan A. , Sánchez Miguel A. , Díaz-Güemes Idoia
Published: December 2013

Background. Laparoendoscopic single-site surgery has been presented in the past few years as an innovative minimally invasive approach, one which despite its advantages is also challenging and requires specific training. We propose to analyze the performance of attendants in a specific LESS training course. Methods. Following the LESSCAR 2010 guidelines, we focused on level 1 hands-on simulator tasks and level 2 hands-on training on animal model for skills acquisition during a LESS-specific training course. Each attendant completed coordination and cut tasks on simulator, followed by a cholecystectomy on an ex vivo porcine liver. Hands-on animal model each trainee performed 1 cholecystectomy and at least 2 nephrectomies (N1, N2). Performance was analyzed through video recording and reviewed by 3 independent observers. Each result was registered according to a modified objective structured assessment of technical skills. Total task or procedure completion time was also determined. Results. Regarding coordination and cut tasks, attendants improved on their performance from first to third attempts with an accompanying decrease in completion time. Surgeons completed the cholecystectomy on animal model significantly faster than on simulator, although with lower performance quality. Regarding N1 and N2, attendants showed improvement both in quality and total completion time. Conclusions. A gradual and positive evolution of attendants was observed throughout the training course. Thus, we believe a structured program for the acquisition of basic skills in new minimally invasive surgical approaches should be recommended. Considering that this is a small study, it would be advisable to increase the number of study subjects on future opportunities.
Biomechanics–Machine Learning System for Surgical Gesture Analysis and Development of Technologies for Minimal Access Surgery
Authors: Cavallo Filippo , Sinigaglia Stefano , Megali Giuseppe , Pietrabissa Andrea , Dario Paolo , Mosca Franco , Cuschieri Alfred
Published: December 2013

Background. The uptake of minimal access surgery (MAS) has by virtue of its clinical benefits become widespread across the surgical specialties. However, despite its advantages in reducing traumatic insult to the patient, it imposes significant ergonomic restriction on the operating surgeons who require training for the safe execution. Recent progress in manipulator technologies (robotic or mechanical) have certainly reduced the level of difficulty, however it requires information for a complete gesture analysis of surgical performance. This article reports on the development and evaluation of such a system capable of full biomechanical and machine learning. Methods. The system for gesture analysis comprises 5 principal modules, which permit synchronous acquisition of multimodal surgical gesture signals from different sources and settings. The acquired signals are used to perform a biomechanical analysis for investigation of kinematics, dynamics, and muscle parameters of surgical gestures and a machine learning model for segmentation and recognition of principal phases of surgical gesture. Results. The biomechanical system is able to estimate the level of expertise of subjects and the ergonomics in using different instruments. The machine learning approach is able to ascertain the level of expertise of subjects and has the potential for automatic recognition of surgical gesture for surgeon–robot interactions. Conclusions. Preliminary tests have confirmed the efficacy of the system for surgical gesture analysis, providing an objective evaluation of progress during training of surgeons in their acquisition of proficiency in MAS approach and highlighting useful information for the design and evaluation of master–slave manipulator systems.
Understanding and retention of trial-related information among participants in a clinical trial after completing the informed consent process
Authors: Mexas Fernanda , Efron Anne , Luiz Ronir Raggio , Cailleaux-Cezar Michelle , Chaisson Richard E , Conde Marcus B
Published: December 2013

Background

Methods for assessing the level of understanding of trial-related information during the informed consent (IC) process in developing countries are lacking.

Purpose

To assess the understanding and retention of trial-related information presented in the IC process by administering an informed consent assessment instrument (ICAI) to participants in a clinical trial for a new tuberculosis (TB) regimen being conducted in Rio de Janeiro (Brazil).

Methods

The format of the ICAI was based on the language and structure of the United States National Cancer Institute’s IC comprehension checklist. The ICAI was designed to assess points of the RioMAR study IC process that addressed the principles of research ethics requested by Brazilian Regulatory Authority: autonomy, beneficence, non-maleficence, and justice. Briefly, (1) Is the respondent participating in a clinical trial? (2) Are two different treatments being evaluated? (3) Is the treatment arm chosen by chance? (4) Is an HIV test required? (5) Are liver function tests required? (6) Can participants leave the study at any time? (7) Are the risks and benefits of taking part in the study clear? (8) May pregnant women participate in the study? (9) Can one of the study drugs reduce the effectiveness of contraceptives? (10) Are patients paid to participate in the study? The ICAI was applied at two time points: immediately after enrollment in the clinical trial and 2 months later.

Results

A total of 61 patients who enrolled in the RioMAR study participated in this study. The percentage of correct answers to all questions was 82% at the time of the first ICAI; 31 participants (51%) did not recall that an HIV test was required (question 4) and 43 (70%) did not know that they could leave the study (question 6). Other individual questions were answered correctly by at least 76% of participants. There was no association between incorrect answers and age, gender, monthly family income, neighborhood, or level of education (p > 0.07). When the responses to the first and the second ICAI questions were compared, 15% or more of participants had conflicting answers to 5 of the 10 questions.

Limitations

The ICAI uses dichotomous responses, leading to a 50% chance of guessing the correct answers. Two questions were asked only of women. Finally, only 6 of the 10 questions on the current version of the ICAI apply to most trials; others are trial-specific.

Conclusions

The ICAI may be adapted to an individual trial and may prove to be a useful tool following a consent discussion to identify issues not fully understood by the research participants, thus prompting study staff to re-explain topics, possibly in a more elementary manner.
A proposed new clinical assessment framework for diagnostic medical ultrasound students
Authors: Gibbs Vivien
Published: December 2013

Current financial pressures within higher education institutions (HEIs) are driving new ways of delivering education and assessment. New technological developments are facilitating opportunities to rethink traditional educational methods and explore more innovative, effective approaches. Set against a background of increasing pressures to integrate technology to enhance learning, both in higher education and the NHS, education is moving towards greater integration of technology. Ultrasound education is an area which is currently being reviewed in many HEIs, as these programmes are expensive to administer for the relatively low numbers of students involved. Within ultrasound education, rigorous assessment of clinical competence is an area which is particularly expensive to undertake, and methods used in many training programmes are potentially unsustainable for HEIs in the current economic climate. In addition, clinical assessment methods used are often criticised for the difficulties encountered in trying to exclude subjectivity from the process, and ensure equity across all assessments. A new framework is therefore proposed, which has recently been accredited within a HEI ultrasound training programme by the Consortium for the Accreditation of Sonographic Education (CASE), and has been piloted during 2013. One of the components of this approach is the incorporation of an ultrasound simulator, which will help to standardise assessments and ensure students are assessed over a range of pathologies, rather than only those randomly presenting on the day of assessment. This paper discusses details of the newly accredited assessment process.
WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations
Authors: Hu Teh-Wei , Lee Anita H. , Mao Zhengzhong
Published: December 2013

Aim:

The aim of this study was to analyze the barriers in the implementation of the Framework Convention on Tobacco Control (FCTC) in China and present recommendations on ways to address these challenges in tobacco control in China.

Methods:

We review the available literature on progress and explore the barriers and challenges that impede a speedier pace in the adoption of the effective tobacco control measures, and present recommendations based on in-depth knowledge of decision-making process on the implementation of FCTC in China.

Results:

The pace of progress in China is too slow. China faces intractable political, structural, economic and social barriers in tobacco control, which make the whole-hearted implementation of FCTC measures a painstaking process.

Discussion:

The authors recommend a comprehensive approach to speed up the implementation of tobacco control measures. This includes strong political leadership from the top, structural changes to the tobacco industry and government oversight of the tobacco industry, as well as advocacy and support for tobacco control from civil society at the grassroots level.
Clinically Relevant Subregions of Articular Cartilage of the Hip for Analysis and Reporting Quantitative Magnetic Resonance Imaging
Authors: Surowiec Rachel K. , Lucas Erin P. , Wilson Katharine J. , Saroki Adriana J. , Ho Charles P.
Published: December 2013

Objective:

Before quantitative imaging techniques can become clinically valuable, the method, and more specifically, the regions of locating and reporting these values should be standardized toward reproducibility comparisons across centers and longitudinal follow-up of individual patients. The purpose of this technical note is to describe a rigorous and reproducible method of locating, analyzing, and reporting quantitative MRI values in hip articular cartilage with an approach that is consistent with current orthopedic literature.

Design:

To demonstrate this localization and documentation, 3 patients (age, 23 ± 5.1 years; 2 males, 1 female) who presented with symptomatic mixed-type femoroacetabular impingement (α angle, 63.3° ± 2.1°; center edge angle, 39° ± 4.2°) were evaluated with T2-mapping at 3 T MRI prior to hip arthroscopy. Manual segmentation was performed and cartilage of the acetabulum and femur was divided into 12 subregions adapted from the geographic zone method. Bone landmarks in the acetabulum and femur, identifiable both in arthroscopy and MR images, were manually selected and the coordinates exported for division of cartilage.

Results:

Mean T2 values in each zone are presented.

Conclusions:

The current work outlines a standardized system to locate and describe quantitative mapping values that could aid in surgical decision making, planning, and the noninvasive longitudinal follow-up of implemented cartilage preservation and restoration techniques.
Development of a Comprehensive Osteochondral Allograft MRI Scoring System (OCAMRISS) With Histopathologic, Micro–Computed Tomography, and Biomechanical Validation
Authors: Chang Eric Y. , Pallante-Kichura Andrea L. , Bae Won C. , Du Jiang , Statum Sheronda , Wolfson Tanya , Gamst Anthony C. , Cory Esther , Amiel David , Bugbee William D. , Sah Robert L. , Chung Christine B.
Published: December 2013

Objective:

To describe and apply a semiquantitative MRI scoring system for multifeature analysis of cartilage defect repair in the knee by osteochondral allografts and to correlate this scoring system with histopathologic, micro–computed tomography (µCT), and biomechanical reference standards using a goat repair model.

Design:

Fourteen adult goats had 2 osteochondral allografts implanted into each knee: one in the medial femoral condyle and one in the lateral trochlea. At 12 months, goats were euthanized and MRI was performed. Two blinded radiologists independently rated 9 primary features for each graft, including cartilage signal, fill, edge integration, surface congruity, calcified cartilage integrity, subchondral bone plate congruity, subchondral bone marrow signal, osseous integration, and presence of cystic changes. Four ancillary features of the joint were also evaluated, including opposing cartilage, meniscal tears, synovitis, and fat-pad scarring. Comparison was made with histologic and µCT reference standards as well as biomechanical measures. Interobserver agreement and agreement with reference standards was assessed. Cohen’s κ, Spearman’s correlation, and Kruskal-Wallis tests were used as appropriate.

Results:

There was substantial agreement (κ > 0.6, P < 0.001) for each MRI feature and with comparison against reference standards, except for cartilage edge integration (κ = 0.6). There was a strong positive correlation between MRI and reference standard scores (ρ = 0.86, P < 0.01). Osteochondral allograft MRI scoring system was sensitive to differences in outcomes between the types of allografts.

Conclusions:

We have described a comprehensive MRI scoring system for osteochondral allografts and have validated this scoring system with histopathologic and µCT reference standards as well as biomechanical indentation testing.
Severe inflammatory response and vasculitis leading to quadruple limb amputations
Authors: Brinkler Rebecca , Zhang Xiaoxi , Ratnasingam Sinthuja , Dawson Jeremy , Palamaras Ioulios
Published: December 2013

Lesson

A systemic inflammatory response causing multi-organ failure and requiring multiple amputations was refractory to all treatments except Anakinra, and the cause remains unclear.
Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions
Authors: Reeve Joanne , Dowrick Christopher F , Freeman George K , Gunn Jane , Mair Frances , May Carl , Mercer Stewart , Palmer Victoria , Howe Amanda , Irving Greg , Shiner Alice , Watson Jessica
Published: December 2013

Objectives

Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role.

Design

Qualitative study in General Practice.

Setting

UK primary care.

Main outcome measures

A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory.

Design and setting

Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory.

Participants

UK based GPs (interview and surveys); European GP trainees (focus groups).

Results

Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP.

Conclusions

We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role.
Obesity hypoventilation syndrome in obstructive sleep apnea patients in the United Arab Emirates: a retrospective cross-sectional study
Authors: Alzaabi Ashraf , Fizal Salahudeen , Moilothkandy Rafeek , Mahboub Bassam , Nagelkerke Nico
Published: December 2013

Objectives

To estimate the frequency of symptoms of obesity hypoventilation syndrome (OHS) in patients with obstructive sleep apnoea (OSA) and to evaluate comorbidities associated with OHS.

Design

Retrospective study based on patients' medical records and on further sleep tests performed in the study centre during the inclusion visit.

Setting

Respiratory Care Unit and Sleep Disorder Centre of the Zayed Military Hospital United Arab Emirates.

Participants

All patients referred to the study centre for a suspicion of sleep-disordered breathing.

Main outcome measures

Prevalence of OSA and OSA + OHS and comorbidities in patients with OSA and OHS.

Results

A total of 212 adult patients participated in the study. Of these, 107 patients (50.5% [43.8–57.1% CI 95%]) fulfilled diagnostic criteria for OSA, and the majority were men (79.4%). Among patients with OSA, 18 patients (16.8% [10.8–25.1% CI 95%]) fulfilled diagnostic criteria for OHS. In this group, women were more frequently affected than men (31.8% [7/22] vs. 12.9% [11/85], respectively; p = 0.03) and tended to be older than affected men, with a mean age of 55 ± 10.6 years versus 46 ± 13 for men. After adjustment for gender, OHS was significantly associated with hypertension (OR = 3.5; p = 0.03), diabetes mellitus (OR = 4.6; p = 0.02), ischaemic heart disease (OR = 5.1; p = 0.04) and pulmonary hypertension (OR = 16.1; p = 0.001).

Conclusion

OHS is a common condition in obese patients in the UAE and is associated with an increased risk of cardiovascular comorbidities and diabetes.
Performance of the 10-item Center for Epidemiologic Studies Depression scale for caregiving research
Authors: Andresen Elena M , Byers Katherine , Friary John , Kosloski Karl , Montgomery Rhonda
Published: December 2013

Objectives:

The Center for Epidemiologic Studies Depression (CESD) scale has been useful in a broad spectrum of health research on patient and population outcomes. A brief version is used when depressive symptoms are not the primary focus. Rasch (item response) analysis previously demonstrated potential problems with positively worded items. We tested the 10-item CESD (CESD-10) scale and considered an 8-item version with both psychometric and Rasch analyses.

Methods:

This was a special sample of 2067 caregivers from three existing US databases. We describe item response patterns and internal constancy in addition to Rasch scale results.

Results:

There were few problems with missing data, and internal consistency was high (alpha = 0.86–0.88) for both CESD versions. Rasch analysis indicated that one of the positive items (“hopeful about future”) could be dropped.

Conclusions:

We partly confirmed prior work that suggested dropping positive items for the CESD-10. Among caregivers, item-level problems and scaling problems seem minimal. At present, there is not a strong rationale for dropping the CESD-10 positive items: the one poorly performing positive item might be explained by the special caregiver sample.
Management of Simultaneous Bilateral Neck of Femur Fractures in an Elderly Patient
Authors: McGoldrick Niall P. , Dodds Michael K. , Green Connor , Synnott Keith
Published: December 2013

Simultaneous bilateral neck of femur fracture is rare. There have been few reports of such a condition in the literature. This uncommon pattern of injury has been associated with high-energy trauma, underlying bone disease, and seizure disorders. We describe our experience of such a condition involving an elderly patient with significant cardiovascular comorbidity. The operative approach involved single-stage repair of both the involved joints. Bilateral uncemented hemi-arthroplasty was performed using a single tray of sterile surgical instruments and 2 sterile drapes. We report a satisfactory outcome. Uncemented arthroplasty should be considered in such a case so as to minimize the risk of a possible bone cement implantation syndrome.
Discussion in Postsecondary Classrooms
Authors: Dudley-Marling Curt
Published: December 2013

Spoken language is, arguably, the primary means by which teachers teach and students learn. Much of the literature on language in classrooms has focused on discussion that is seen as both a method of instruction and a curricular outcome. While much of the research on discussion has focused on K-12 classrooms, there is also a body of research examining the efficacy of discussion in postsecondary settings. This article provides a review of this literature in order to consider the effect of discussion on student learning in college and university classrooms, the prevalence of discussion in postsecondary settings, and the quality of discussion in these settings. In general, the results of research on the efficacy of discussion in postsecondary settings are mixed. More seriously, researchers have not been explicit about the meaning of discussion and much of what is called discussion in this body of research is merely recitation with minimal levels of student participation. Although the research on discussion in college and university classrooms is inconclusive, some implications can be drawn from this review of the research including the need for future researchers to clearly define what they mean by “discussion.”
Emerging Adults With Type 1 Diabetes During the First Year Post-High School
Authors: Hanna Kathleen M. , Weaver Michael T. , Stump Timothy E. , Guthrie Diana , Oruche Ukamaka M.
Published: December 2013

Among 182 emerging adults with type 1 diabetes (93% White and 57% female), changes during the year post-high school were examined in perceptions of diabetes-specific conflict with parents, parent–youth shared responsibility, parental tangible aid, and parental autonomy support, as well as the moderating effects of living situation, gender, years with diabetes, and glycemic control. A linear mixed effects model, controlling for baseline values, tested the changes in and relationships among these variables over time. Changes over time in parent–youth conflict were moderated by living independently of parents; autonomy support and shared responsibility were moderated by years with diabetes; and tangible aid was moderated by glycemic control. Future longitudinal research needs to examine whether changes in parental behaviors lead to positive or negative diabetes outcomes among these emerging adults with diabetes.
Prevalence and Treatment of Mental Health and Substance Use Problems in the Early Emerging Adult Years in the United States
Authors: Adams Sally H. , Knopf David K. , Park M. Jane
Published: December 2013

Onset of most mental disorders occurs by the mid-20s, yet studies of mental health (MH) status are limited for younger adults (YAs) aged 18–25. The objectives were to determine YAs’ rates of MH and substance use (SU) disorders, treatment, and sociodemographic disparities. To determine relative vulnerability and unmet need, overall rates were compared between ages 18–25 and 26–34. Using the 2010 National Survey on Drug Use and Health ( n = 25,216), we estimated past-year serious psychological distress, major depressive episode, alcohol and drug abuse/dependence, and treatment for both age groups and examined YA subgroup differences (gender, race/ethnicity, income, education, and insurance). YAs had higher prevalence of MH and SU disorders, but lower treatment rates than older adults. YA females had higher MH but lower SU disorder rates than males. Other sociodemographic disparities were noted. Efforts to improve YAs’ MH status are necessary to foster a successful transition to adulthood.
Altered expression of platelet proteins and calpain activity mediate hypoxia-induced prothrombotic phenotype
Authors: Tyagi Tarun , Ahmad Shadab , Gupta Neha , Sahu Anita , Ahmad Yasmin , Nair Velu , Chatterjee Tathagat , Bajaj Nitin , Sengupta Shantanu , Ganju Lilly , Singh Shashi Bala , Ashraf Mohammad Z.
Published: December 2013

Key Points

Hypoxia induces altered platelet proteome/reactivity, which correlates with a prothrombotic phenotype. CAPNS1-dependent calpain activity in platelet activation cascade is associated with hypoxia-induced thrombogenesis.
Oxidative stress in angiogenesis and vascular disease
Authors: Kim Young-Woong , Byzova Tatiana V.
Published: December 2013

Despite the damaging effect on tissues at a high concentration, it has been gradually established that oxidative stress plays a positive role during angiogenesis. In adults, physiological or pathological angiogenesis is initiated by tissue demands for oxygen and nutrients, resulting in a hypoxia/reoxygenation cycle, which, in turn promotes the formation of reactive oxygen species (ROS). The ROS can be generated either endogenously, through mitochondrial electron transport chain reactions and nicotinamide adenine dinucleotide phosphate oxidase, or exogenously, resulting from exposure to environmental agents, such as ultraviolet or ionizing radiation. In many conditions, ROS promotes angiogenesis, either directly or via the generation of active oxidation products, including peroxidized lipids. The latter lipid metabolites are generated in excess during atherosclerosis, thereby linking atherogenic processes and pathological angiogenesis. Although the main mechanism of oxidative stress-induced angiogenesis involves hypoxia-inducible factor/vascular endothelial growth factor (VEGF) signaling, recent studies have identified several pathways that are VEGF-independent. This review aims to provide a summary of the past and present views on the role of oxidative stress as a mediator and modulator of angiogenesis, and to highlight newly identified mechanisms.
MosaicIA: an ImageJ/Fiji plugin for spatial pattern and interaction analysis
Authors: Shivanandan Arun , Radenovic Aleksandra , Sbalzarini Ivo F
Published: December 2013

Background

Analyzing spatial distributions of objects in images is a fundamental task in many biological studies. The relative arrangement of a set of objects with respect to another set of objects contains information about potential interactions between the two sets of objects. If they do not “feel” each other’s presence, their spatial distributions are expected to be independent of one another. Spatial correlations in their distributions are indicative of interactions and can be modeled by an effective interaction potential acting between the points of the two sets. This can be used to generalize co-localization analysis to spatial interaction analysis. However, no user-friendly software for this type of analysis was available so far.

Results

We present an ImageJ/Fiji plugin that implements the complete workflow of spatial pattern and interaction analysis for spot-like objects. The plugin detects objects in images, infers the interaction potential that is most likely to explain the observed pattern, and provides statistical tests for whether an inferred interaction is significant given the number of objects detected in the images and the size of the space within which they can distribute. We benchmark and demonstrate the present software using examples from confocal and PALM single-molecule microscopy.

Conclusions

The present software greatly simplifies spatial interaction analysis for point patterns, and makes it available to the large user community of ImageJ and Fiji. The presented showcases illustrate the usage of the software.
Transcriptome analysis of the filamentous fungus Aspergillus nidulans directed to the global identification of promoters
Authors: Sibthorp Christopher , Wu Huihai , Cowley Gwendolyn , Wong Prudence W H , Palaima Paulius , Morozov Igor Y , Weedall Gareth D , Caddick Mark X
Published: December 2013

Background

The filamentous fungus Aspergillus nidulans has been a tractable model organism for cell biology and genetics for over 60 years. It is among a large number of Aspergilli whose genomes have been sequenced since 2005, including medically and industrially important species. In order to advance our knowledge of its biology and increase its utility as a genetic model by improving gene annotation we sequenced the transcriptome of A. nidulans with a focus on 5′ end analysis.

Results

Strand-specific whole transcriptome sequencing showed that 80-95% of annotated genes appear to be expressed across the conditions tested. We estimate that the total gene number should be increased by approximately 1000, to 11,800. With respect to splicing 8.3% of genes had multiple alternative transcripts, but alternative splicing by exon-skipping was very rare. 75% of annotated genes showed some level of antisense transcription and for one gene, meaB, we demonstrated the antisense transcript has a regulatory role. Specific sequencing of the 5’ ends of transcripts was used for genome wide mapping of transcription start sites, allowing us to interrogate over 7000 promoters and 5′ untranslated regions.

Conclusions

Our data has revealed the complexity of the A. nidulans transcriptome and contributed to improved genome annotation. The data can be viewed on the AspGD genome browser.
Chagas disease-specific antigens: characterization of epitopes in CRA/FRA by synthetic peptide mapping and evaluation by ELISA-peptide assay
Authors: Bottino Carolina G , Gomes Luciano P , Pereira José B , Coura José R , Provance David William , De-Simone Salvatore G
Published: December 2013

Background

The identification of epitopes in proteins recognized by medically relevant antibodies is useful for the development of peptide-based diagnostics and vaccines. In this study, epitopes in the cytoplasmic repetitive antigen (CRA) and flagellar repetitive antigen (FRA) proteins from Trypanosoma cruzi were identified using synthetic peptide techniques and pooled sera from Chagasic patients. The epitopes were further assayed with an ELISA assay based on synthetic peptides.

Methods

Twenty-two overlapping synthetic peptides representing the coding sequence of the T. cruzi CRA and FRA proteins were assessed by a Spot-synthesis array analysis using sera donated by patients with Chagas disease. Shorter peptides were selected that represented the determined epitopes and synthesized by solid phase synthesis to evaluate the patterns of cross-reactivities and discrimination through an ELISA-diagnostic assay.

Results

The peptide Spot-synthesis array successfully identified two IgG antigenic determinants in the CRA protein and four in FRA. Bioinformatics suggested that the CRA antigens were unique to T. cruzi while the FRA antigen showed similarity with sequences present within various proteins from Leishmania sp. Subsequently, shorter peptides representing the CRA-1, CRA-2 and FRA-1 epitopes were synthesized by solid phase synthesis and assayed by an ELISA-diagnostic assay. The CRA antigens gave a high discrimination between Chagasic, Leishmaniasis and T. cruzi-uninfected serum. A sensitivity and specificity of 100% was calculated for CRA. While the FRA antigen showed a slightly lower sensitivity (91.6%), its specificity was only 60%.

Conclusions

The epitopes recognized by human anti-T. cruzi antibodies have been precisely located in two biomarkers of T. cruzi, CRA and FRA. The results from screening a panel of patient sera through an ELISA assay based on peptides representing these epitopes strongly suggest that the sequences from CRA would be useful for the development of diagnostic reagents that could improve upon the sensitivity and specificity of currently available diagnostic tests. Overall, the results provide further evidence of the usefulness of identifying specific linear B-cell epitopes for improving diagnostic tools.
Is human immunodeficiency virus (HIV) stage an independent risk factor for altering the periodontal status of HIV-positive patients? A South African study
Authors: John Cathy Nisha , Stephen Lawrence Xavier , Joyce Africa Charlene Wilma
Published: December 2013

Background

The immunosuppresion in HIV patients makes them highly susceptible to microbial infections. The aim of the study was to establish whether HIV stage (as depicted by CD4+ T lymphocyte counts) could independently be associated with periodontal status (as revealed by the measurement of clinical indices).

Methods

One hundred and twenty HIV-infected patients attending an infectious diseases clinic in the Western Cape, South Africa were included in the study. The periodontal clinical indices such as plaque index, gingival index, pocket probing depth and clinical attachment levels were measured on the mesial aspect of the six Ramfjord teeth. The CD4 + T cell counts were taken from the patients’ medical records and patients’ HIV stage determined and grouped according to their CD4+ T cell counts into A (<200 cells /mm3), B (200–500 cells /mm3) and C (>500 cells /mm3).

Results

The mean age of 120 HIV-positive patients was 33.25 years and the mean CD4 + T cell count was 293.43 cells/mm3. The probing depth and clinical attachment loss were found to be significantly associated with the total CD4 + T cell counts but not with HIV stage. Significant correlations were found between age and all clinical indices except for clinical attachment loss. No correlation was found between age and HIV stage of the patients. The use of antiretroviral therapy was significantly associated with probing depth and clinical attachment loss, but not with plaque nor gingival index. Significant associations were observed between smoking and all of the clinical indices except for the gingival index. A significant association was observed between the use of interdental aids and all the clinical indices except for probing depth, while brushing was significantly associated with plaque index only. CD4 + T cell counts were significantly associated with brushing frequency (p = 0.0190) and the use of interdental aids (p = 0.0170).

Conclusion

The findings of this study conclude that HIV stage, ART and age are not independent risk factors for changes in the periodontal status of HIV-positive subjects but rather that smoking and oral hygiene habits determine their susceptibility to disease.