bluuebunny/crossref_metadata_2025 huggingface dataset:
Rethinking consumer culture theory from the postmodern to the communist horizon
Authors: Cova Bernard , Maclaran Pauline , Bradshaw Alan
Published: March 2013

We explore the slow disappearance of the postmodern critique that challenged mainstream marketing and emphasised the importance of locating phenomena in their wider social, political and historic contexts to expose embedded power relationships and ideologies. After an initial overview of how postmodernism impacted on theorising in consumer research, we highlight how it reached saturation point, with many of its ideas accepted into mainstream marketing. Following this claimed demise of the postmodern critique, we review the proliferation of post-postmodern proposals and speculate from where the next theoretical direction will originate. As part of this analysis, we focus on a group of theorists who are giving communism a renaissance and consider how these ideas can help us critique and reimagine consumer culture theory.
Can just war theory delegitimate terrorism?
Authors: Sussmann Naomi
Published: March 2013

The rapidly expanding literature on terrorism can be seen to respond to the growing incidence of violent political conflict. Most of the relevant discussion is conducted within the framework of just war theory – a theory in which armed conflicts are considered legitimate only when they are explicitly announced and justified; when they take place between states and their armies; and when they are strictly exclusive of non-combatants. This article argues that framing the discussion in these terms is unhelpful: rather than help us to properly consider and delegitimize terrorism, it tends to expose the inadequacy of just war theory itself under conditions of modern violence. The purpose of this article is thus to establish that the framework of just war theory is inadequate to the delegitimation of terrorism. The article concludes by arguing, on these grounds, for the replacement of the theory of just war with a theory of justified political violence.
The Validity and Reliability of the Comprehensive Home Environment Survey (CHES)
Authors: Pinard Courtney A. , Yaroch Amy L. , Hart Michael H. , Serrano Elena L. , McFerren Mary M. , Estabrooks Paul A.
Published: March 2013

Few comprehensive measures exist to assess contributors to childhood obesity within the home, specifically among low-income populations. The current study describes the modification and psychometric testing of the Comprehensive Home Environment Survey (CHES), an inclusive measure of the home food, physical activity, and media environment related to childhood obesity. The items were tested for content relevance by an expert panel and piloted in the priority population. The CHES was administered to low-income parents of children 5 to 17 years ( N = 150), including a subsample of parents a second time and additional caregivers to establish test–retest and interrater reliabilities. Children older than 9 years ( n = 95), as well as parents ( N = 150) completed concurrent assessments of diet and physical activity behaviors (predictive validity). Analyses and item trimming resulted in 18 subscales and a total score, which displayed adequate internal consistency (α = .74-.92) and high test–retest reliability ( r ≥ .73, ps < .01) and interrater reliability ( r ≥ .42, ps < .01). The CHES score and a validated screener for the home environment were correlated ( r = .37, p < .01; concurrent validity). CHES subscales were significantly correlated with behavioral measures ( r = −.20-.55, p < .05; predictive validity). The CHES shows promise as a valid/reliable assessment of the home environment related to childhood obesity, including healthy diet and physical activity.
Innovations in Times of Austerity
Authors: Dryden Joe
Published: March 2013

This case represents a multitude of leadership dilemmas created by financial exigencies and the difficult decisions that must be made during times of economic austerity. Under the best of circumstances, deciding between programmatic elimination and/or employee termination is agonizing, onerous, and filled with political and social ramifications. When high-ranking state officials and local political activists undermine administrative efforts to mitigate a financial crisis, the political and social ramifications are magnified exponentially. The facts and circumstances outlined in this narrative are based on real-life events and describe how officials in a well-respected and successful Texas school district strategically addressed potentially divisive and politically charged decisions. The rich context associated with these events provides a platform on which best practices in educational leadership can be identified and examined, a platform on which individual core principles and values can be evaluated, and a platform on which students and practicing educational leaders can build leadership capacity.
Analysis of Average Daily Fiber Intake Among Ready-to-Eat Cereal Consumers
Authors: Williams Christine L. , Felt-Gunderson Patricia
Published: March 2013

There is no minimum fiber requirement for on-pack whole-grain claims, yet consumers perceive products made with whole grains to provide at least a good source of fiber. To understand how this misperception may be fueling Americans’ fiber intake shortfall, this study investigated the impact on fiber intakes of ready-to-eat (RTE) cereal products with whole-grain claims. A 14-day eating frequency diary was collected from US free-living households over 3 years in the NPD Group’s National Eating Trends (NET) panel (n=10,708). Average daily fiber intake and sources were calculated from the types and frequency of food and beverages consumed at meals. T-tests were conducted on mean fiber intake at breakfast and daily to identify significant differences between all adults, adults consuming whole-grain RTE cereals with <3 g of fiber per serving, and adults consuming whole-grain RTE cereals with ≥3 g of fiber per serving. Adults eating whole-grain RTE cereals with ≥3 g of fiber per serving consumed 42% more fiber at breakfast and 14% more daily fiber than typical adults. Individuals choosing whole-grain RTE cereal with ≥3 g of fiber per serving consume significantly more fiber at breakfast and throughout the day relative to all adults and to adults eating whole-grain RTE cereals with <3 g of fiber per serving.
Enthusiasm and the Metaphor of Revolution
Authors: Poe Andrew
Published: March 2013

This article explores the metaphoric content latent in modern conceptions of revolution. Originary theories of modern revolutions relied explicitly on Copernicus’ rethinking of the movements of celestial bodies. There, spectators were significant in characterizing the logic of revolutions despite the appearances of things, revealing a new center of the universe distinct from their own location. Contemporary political theories of revolution obscure this metaphor. My aim here is to highlight tensions implicit in recent democratic theorizing on the role of spectators in legitimizing political revolutions. Recent accounts of revolution have too often presumed that revolutionaries aspire merely to “join” spectators in an already-existing democratic revolution. Here, spectators understand themselves as the center of things, and thus risk mistaking a new political history for their own. Following Kant’s observations on political enthusiasm, I show how spectators can offer legitimation through their own enthusiasm for revolution as historical event, rather than historical norm. Read this way, revolutions become progressive, uncovering new histories and their own requisite normative orders, and reminding spectators of the limits and possibilities of their own politics.
Pancreatic cancer: why is it so hard to treat?
Authors: Oberstein Paul E. , Olive Kenneth P.
Published: March 2013

No common malignancy is as rapidly and inevitably fatal as pancreatic ductal adenocarcinoma (PDA). This grim fact has driven substantial research efforts into this disease in recent decades. Unfortunately, the investment has yet to result in a meaningful increase in 5-year survival. This has prompted many pancreatic cancer researchers and advocates to redouble their efforts, but also requires one to step back and ask why the previous efforts were lacking and to consider why pancreatic cancer is so difficult to treat. The difficulties are legion. PDA is characterized by an insidious clinical syndrome, but is rarely diagnosed at a time when surgical resection is feasible. We lack markers of early detection and screening programs remain unproven even in high risk populations. The location of the tumor in the retroperitoneum, the advanced age of patients, and the systemic effects of disease limit the options for local therapy. Chemotherapy may provide a small benefit, but most efforts to improve on the current regimens consistently and stubbornly fail in advanced clinical trials. The molecular and cellular features of ductal pancreatic tumors are aggressive and underlay multiple levels of therapeutic resistance. Non-cell-autonomous features including stromal proliferation, reduced vascular density and immune suppression also contribute to therapeutic resistance. Growing awareness of these the fundamental features of PDA has begun to guide ongoing research efforts. Clinical trials are now specifically targeting these tumor properties and actively focusing on the therapeutic implications of tumor stroma. As reviewed here, reflecting on the fundamental question of why pancreatic cancer is so difficult to treat is a necessary and informative exercise that will aid our efforts to improve patient outcomes. These efforts will lead to improvements in clinical trial design, expand our focus to include the molecular and histologic implications of novel treatment paradigms, and ultimately change the lives of our patients.
Comprehensive review: antitumor necrosis factor agents in inflammatory bowel disease and factors implicated in treatment response
Authors: Lichtenstein Gary R.
Published: March 2013

Antitumor necrosis factor α (anti-TNF) agents have dramatically influenced management of refractory inflammatory bowel disease (IBD). However, not all patients respond to treatment and some lose response or become intolerant over time. Immunogenicity, a well established phenomenon with anti-TNF agents, may have important clinical implications in patients with IBD. A comprehensive review of available evidence demonstrating how drug concentrations, immunogenicity, and other factors influence outcomes with anti-TNF agents was performed. PubMed, EMBASE, Biosis, Dialog, and Conference Papers Index were searched from 1 January 1995 to 7 April 2012 to identify clinical trials in adult and pediatric patients with IBD treated with anti-TNF agents for Crohn’s disease or ulcerative colitis. Data on serum drug levels and immunogenicity and their relationship with clinical efficacy and safety outcomes were extracted and examined. Serum infliximab concentrations correlated with clinical efficacy and treatment outcomes in patients with IBD; this relationship is less well characterized with adalimumab and certolizumab pegol concentrations. In multiple studies, the presence and level of antibodies to infliximab correlated with loss of clinical efficacy and increased risk of infusion reactions. The incidence and clinical impact of antibody formation with adalimumab or certolizumab in IBD is becoming evident as more data become available. Current, enzyme-linked immunosorbent assay based anti-TNF antibody assays are suboptimal in that results are often inconclusive and comparisons between agents cannot be made. Measurement of anti-TNF agent drug concentrations and assessment of immunogenicity has the potential to positively impact clinical decision making during anti-TNF therapy for IBD. As assays are optimized, it is expected that the clinical impact of these determinations will be better characterized.
Malignant Hyperthermia or Not Malignant Hyperthermia
Authors: Bautista Alexander F. , Tongprasert Sujittra
Published: March 2013

In an acute event, the diagnosis of malignant hyperthermia (MH) in patients in the ICU can be challenging. Initial presentation may be attributed to a gamut of causes, making the diagnosis complicated. This example is the case of a 46-year-old African American man who was admitted to the Stroke Service and intubated for respiratory distress. To facilitate intubation, he was given etomidate and succinylcholine. Within an hour, a sustained increase in arterial carbon dioxide concentration, rhabdomyolysis, and later on, hyperthermia, developed. He was started on broad-spectrum antibiotics, aggressive fluid hydration, and mechanical ventilation. He had had one previous uneventful anesthesia exposure and he denied having any family member having anesthesia complications. With a very convoluted presentation, a high degree of suspicion for MH warranted appropriate treatment to avoid significant morbidity and/or mortality. Moreover, until the diagnosis is confirmed, education regarding the disease process to patients and their family members is as vital as the treatment itself. The main objective of this case is to present a diagnostic dilemma in a probable MH patient who is in a state of shock in the ICU.
The Transient Chondrocyte Phenotype in Human Osteophytic Cartilage
Authors: Klinger Patricia , Beyer Christian , Ekici Arif B. , Carl Hans-Dieter , Schett Georg , Swoboda Bernd , Hennig Friedrich F. , Gelse Kolja
Published: March 2013

Objective:

To identify factors that are responsible for the phenotypic differences between transient chondrocytes within human osteophytes prone to endochondral ossification and permanent chondrocytes within articular cartilage persisting for decades.

Methods:

Differential gene expression of chondrocytes from human osteophytes or from articular cartilage was detected by cDNA microarray analysis. The expression of pigment epithelium-derived factor (PEDF), one of the most impressively differentially expressed genes, was validated by quantitative reverse transcriptase polymerase chain reaction as well as immunohistochemistry. The mode of action of PEDF was explored by cell viability assays and by detecting target genes.

Results:

PEDF mRNA expression was upregulated by 118.5-fold ( P = 0.01) in human osteophytic cartilage compared with articular cartilage, which was reflected by strong immunostaining for PEDF in the cartilaginous layer of osteophytes but largely negative staining in articular cartilage. Elevated levels of PEDF in osteophytes were associated with enhanced apoptosis. PEDF increased the expression of the proapoptotic factor FasL and induced cell death in cell culture. Osteochondral progenitor cells were more responsive to PEDF than differentiated articular chondrocytes.

Conclusions:

The induction of the proapoptotic factor PEDF within the osteophyte cartilage suggests a molecular concept for the transient chondrocyte phenotype that arises from progenitor cells and is prone to terminal differentiation and cell death.
Exercise training in chronic heart failure
Authors: De Maeyer Catherine , Beckers Paul , Vrints Christiaan J. , Conraads Viviane M.
Published: March 2013

The syndrome of heart failure (HF) is a growing epidemic that causes a significant socio-economic burden. Despite considerable progress in the management of patients with HF, mortality and morbidity remain a major healthcare concern and frequent hospital admissions jeopardize daily life and social activities. Exercise training is an important adjunct nonpharmacological treatment modality for patients with HF that has proven positive effects on mortality, morbidity, exercise capacity and quality of life. Different training modalities are available to target the problems with which HF patients are faced. It is essential to tailor the prescribed exercise regimen, so that both efficiency and safety are guaranteed. Electrical implanted devices and mechanical support should not exclude patients from exercise training; however, particular precautions and a specialized approach are advised. At least 50% of patients with HF, older than 65 years of age, present with HF with preserved ejection fraction (HFPEF). Although the study populations included in studies evaluating the effect of exercise training in this population are small, the results are promising and seem to support the idea that exercise training is beneficial for HFPEF patients. Both the short- and especially long-term adherence to exercise training remain a major challenge that can only be tackled by a multidisciplinary approach. Efforts should be directed towards closing the gap between recommendations and the actual implementation of training programmes.
Adult experience of local anaesthetic circumcision defies consultant beliefs in Scotland
Authors: Crosbie Robin , Dunn Ian
Published: March 2013

Objective:

In the United Kingdom, adult circumcision is often performed using general anaesthesia. Our aim was to assess our patients’ experiences of local anaesthetic (LA) circumcision and also the attitudes and practices of urologists in Scotland towards this procedure.

Patients and methods:

All adult patients undergoing LA circumcision over a 21-month period were asked to complete an anonymous post-operative questionnaire assessing domains such as pre-operative anxiety, anaesthetic discomfort and intra-operative pain. Postal questionnaires were sent to consultant urologists in central Scotland to determine current practice and attitudes for circumcision.

Results:

Seventy-four patients were included, all of whom were happy with their choice of anaesthesia and would recommend the procedure to a friend. Discomfort during anaesthetic infiltration was low, although approximately a quarter of patients reported feeling relatively mild pain intra-operatively. Just over half of the urologists replied to the questionnaire (53%), with the majority not offering LA circumcision routinely, believing it causes severe discomfort and that patients want a general anaesthesia.

Conclusion:

LA circumcision is acceptable to patients, avoids the need for pre-assessment, and offers potential cost savings. Our results challenge the beliefs of a number of urologists that LA circumcision is unacceptable to patients.
Timing of Premarital Intercourse in Bandjoun (West Cameroon)
Authors: Tsala Dimbuene Zacharie , Defo Barthelemy Kuate
Published: March 2013

This article examined the effects of family environment on the risks of premarital intercourse for male and female youth. Previous research in sub-Saharan Africa (SSA) on the linkages between family structures and sexual debut mainly utilized cross-sectional data. In a sample drawn from Cameroon Family and Health Survey ( N = 2,166), descriptive and multivariate results showed that youth who resided in nuclear two-parent families, those who reported higher levels of parental monitoring and higher quality of parent–child relationships during childhood and/or adolescence, had significantly lower rates of premarital intercourse. Polygynous families, parent–child communication, orphanhood, and change in family structure were significantly associated with higher rates of premarital intercourse. Programmatic implications for reproductive health interventions in SSA are discussed.
Universal Design for Learning Principles in a Hybrid Course
Authors: Elder Hinshaw Rebecca , Sakalli Gumus Suad
Published: March 2013

Universal Design for Learning (UDL) is a promising approach of differentiating instruction to meet the needs of all students. While differentiation is not unique to special educators, it is an expectation of the profession that special educators know ways to differentiate instruction to meet the needs of diverse learners. Furthermore, as more practicing educators seek out online education opportunities offered by teacher education programs, it is beneficial that instructors understand how these participants interpret what they learn and translate it into practice. This article focuses on a case study of the experiences of five special educators who participated in a hybrid graduate course using UDL concepts. The case study design utilized interviews, observation, and course products. Inductive data analysis uncovered three emerging themes that corresponded to the participants’ perception and practice of UDL.
International Trade, Environment and Market Imperfection: A Computable General Equilibrium Analysis for India
Authors: Das Koushik , Chakraborti Pinaki
Published: March 2013

The purpose of this article is to understand general equilibrium impacts of international trade and globalization on social welfare and environmental emission caused on account of energy consumption by industries and households. We applied Computable General Equilibrium (CGE) modelling as the relevant methodology following Shoven and Whalley (1984). By constructing an energy/environmental Social Accounting Matrix (SAM), this article attempts to measure the effects of trade liberalization on different macroeconomic variables, energy consumption and green house gas (GHG) emission. We simulate various trade related policies like import liberalization, foreign capital inflow and use of energy saving technologies under both perfect and monopolistic competition.
Does Poor Quality of Institutions Attract Cross-Border Mergers and Acquisitions?
Authors: Singh Poonam
Published: March 2013

Quality of institutions has been found to positively affect Foreign Direct Investment (FDI) flows. This, however, fails to explain the flow of FDI into countries with poor quality of institutions like India and China. This article shows that FDI flows in the form of cross-border mergers and acquisitions (CBMAs) in India share a negative relationship with the gap in quality of institutions between the host and home countries after controlling for market size and market opportunity in the home and host country and infrastructural facilities in the host country. This suggests that apart from market size and opportunity, CBMAs in India are attracted by poor quality of institutions, particularly corruption and poor governance in the country.
Debating Contribution vis-à-vis Equity Principle in Tax Sharing: A Review of Recommendations of the Finance Commission of India
Authors: Datta Polly
Published: March 2013

This article discusses the objectives of the Finance Commission of India since inception, within the ambit of critical issues in public finance. Amidst increasing political tensions between the central and state governments in India and waning trends in single party majority at the Centre, the evolution of tax sharing arrangements are critical indi- cators of a functional federal structure. The article compares various objectives put forth by the Finance Commission and evaluates observed conditions in four important states in the country. We carefully evaluate if the recommendations of the Finance Commission have influenced the degree of industrialization in these states.
Seasonality and Site Function in Chalcolithic Cyprus
Authors: Frankel David , Webb Jennifer M. , Pike-Tay Anne
Published: March 2013

Excavations at the small Chalcolithic site of Politiko-Kokkinorotsos in central Cyprus show that it was occupied around 2880–2670 cal BC. Fallow deer(Dama mesopotamica)form the major component of the substantial faunal assemblage. The structure of the animal population suggests a seasonal hunting site, an interpretation consistent with the lack of formal architecture and the range of stone tools. In this study, independent odontochronological analyses of deer and caprine are used to test and confirm the model of seasonal culling in spring and summer based on more general indicators. The results suggest a pattern of varied, specialized site-types and activities in different parts of the island and in different ecological zones, and add considerably to our understanding of cultural systems on the island in the early third millennium BC.
Severity of obstructive sleep apnoea predicts coronary artery plaque burden: a coronary computed tomographic angiography study
Authors: Kent Brian D. , Garvey John F. , Ryan Silke , Nolan Geraldine , Dodd Jonathan D. , McNicholas Walter T.
Published: March 2013

Obstructive sleep apnoea (OSA) is associated with significantly increased risk of cardiovascular disease. Carotid ultrasonography and retrospective, uncontrolled, coronary imaging studies have suggested an association of OSA with subclinical atherosclerosis, but there is a lack of prospective, controlled studies directly evaluating the relationship of OSA with occult coronary artery disease.

We performed coronary computed tomographic angiography and inpatient-attended sleep studies on a cohort of otherwise healthy males attending our sleep laboratory, and compared coronary artery plaque volume between subjects with low and high apnoea/hypopnoea index (AHI) scores.

29 subjects participated. The median AHI was 15.5 events·h−1, with subjects who scored above this classified as high AHI. No significant differences were observed in demographic, anthropometric and clinical variables between the high- and low-AHI groups. Coronary plaque volume was significantly greater in the high-AHI group (mean plaque volume 2.6±0.7 mm2versus0.8±0.2 mm2; p=0.017) and, furthermore, correlated significantly with AHI (Spearman’s r=0.433; p=0.019). Following adjustment for dyslipidaemia and fasting plasma glucose levels, AHI remained a significant predictor of plaque volume (standardised β=0.424; p=0.027).

In this prospective case–control study, we found that severity of OSA may predict occult coronary atherosclerosis in otherwise healthy overweight or obese male subjects.
Fine-scale mapping of meiotic recombination in Asians
Authors: Bleazard Thomas , Ju Young Seok , Sung Joohon , Seo Jeong-Sun
Published: March 2013

Background

Meiotic recombination causes a shuffling of homologous chromosomes as they are passed from parents to children. Finding the genomic locations where these crossovers occur is important for genetic association studies, understanding population genetic variation, and predicting disease-causing structural rearrangements. There have been several reports that recombination hotspot usage differs between human populations. But while fine-scale genetic maps exist for European and African populations, none have been constructed for Asians.

Results

Here we present the first Asian genetic map with resolution high enough to reveal hotspot usage. We constructed this map by applying a hidden Markov model to genotype data for over 500,000 single nucleotide polymorphism markers from Korean and Mongolian pedigrees which include 980 meioses. We identified 32,922 crossovers with a precision rate of 99%, 97% sensitivity, and a median resolution of 105,949 bp. For direct comparison of genetic maps between ethnic groups, we also constructed a map for CEPH families using identical methods. We found high levels of concordance with known hotspots, with approximately 72% of recombination occurring in these regions. We investigated the hypothesized contribution of recombination problems to age-related aneuploidy. Our large sample size allowed us to detect a weak but significant negative effect of maternal age on recombination rate.

Conclusions

We have constructed the first fine-scale Asian genetic map. This fills an important gap in the understanding of recombination pattern variation and will be a valuable resource for future research in population genetics. Our map will improve the accuracy of linkage studies and inform the design of genome-wide association studies in the Asian population.
Skin injury model classification based on shape vector analysis
Authors: Röhrich Emil , Thali Michael , Schweitzer Wolf
Published: March 2013

Background: Skin injuries can be crucial in judicial decision making. Forensic experts base their classification on subjective opinions. This study investigates whether known classes of simulated skin injuries are correctly classified statistically based on 3D surface models and derived numerical shape descriptors.

Methods: Skin injury surface characteristics are simulated with plasticine. Six injury classes – abrasions, incised wounds, gunshot entry wounds, smooth and textured strangulation marks as well as patterned injuries - with 18 instances each are used for a k-fold cross validation with six partitions. Deformed plasticine models are captured with a 3D surface scanner. Mean curvature is estimated for each polygon surface vertex. Subsequently, distance distributions and derived aspect ratios, convex hulls, concentric spheres, hyperbolic points and Fourier transforms are used to generate 1284-dimensional shape vectors. Subsequent descriptor reduction maximizing SNR (signal-to-noise ratio) result in an average of 41 descriptors (varying across k-folds). With non-normal multivariate distribution of heteroskedastic data, requirements for LDA (linear discriminant analysis) are not met. Thus, shrinkage parameters of RDA (regularized discriminant analysis) are optimized yielding a best performance with λ = 0.99 and γ = 0.001.

Results: Receiver Operating Characteristic of a descriptive RDA yields an ideal Area Under the Curve of 1.0for all six categories. Predictive RDA results in an average CRR (correct recognition rate) of 97,22% under a 6 partition k-fold. Adding uniform noise within the range of one standard deviation degrades the average CRR to 71,3%.

Conclusions: Digitized 3D surface shape data can be used to automatically classify idealized shape models of simulated skin injuries. Deriving some well established descriptors such as histograms, saddle shape of hyperbolic points or convex hulls with subsequent reduction of dimensionality while maximizing SNR seem to work well for the data at hand, as predictive RDA results in CRR of 97,22%. Objective basis for discrimination of non-overlapping hypotheses or categories are a major issue in medicolegal skin injury analysis and that is where this method appears to be strong. Technical surface quality is important in that adding noise clearly degrades CRR.

Trial registration: This study does not cover the results of a controlled health care intervention as only plasticine was used. Thus, there was no trial registration.
The effectiveness of fermented turmeric powder in subjects with elevated alanine transaminase levels: a randomised controlled study
Authors: Kim Sang-Wook , Ha Ki-Chan , Choi Eun-Kyung , Jung Su-Young , Kim Min-Gul , Kwon Dae-Young , Yang Hye-Jung , Kim Min-Jung , Kang Hee-Joo , Back Hyang-Im , Kim Sun-Young , Park Soo-Hyun , Baek Hum-Young , Kim Yong-Jae , Lee Joon-Yeol , Chae Soo-Wan
Published: March 2013

Background

Previous animal studies have shown that Curcuma longa (turmeric) improves liver function. Turmeric may thus be a promising ingredient in functional foods aimed at improving liver function. The purpose of the study is to investigate the hepatoprotective effect of fermented turmeric powder (FTP) on liver function in subjects with elevated alanine transaminase (ALT) levels.

Methods

A randomised, double-blind, placebo-controlled trial was conducted between November 2010 and April 2012 at the clinical trial center for functional foods of the Chonbuk National University Hospital. The trial included 60 subjects, 20 years old and above, who were diagnosed mild to moderate elevated ALT levels between 40 IU/L and 200 IU/L. Sixty subjects were randomised to receive FTP 3.0 g per day or placebo 3.0 g per day for 12 weeks. The treatment group received two capsules of FTP three times a day after meals, for 12 weeks. The primary efficacy endpoint was change in the ALT levels in the two groups. The secondary efficacy endpoints included its effect on aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (TB), and lipid profiles. Safety was assessed throughout the study using ongoing laboratory tests. Adverse events (AEs) were also recorded.

Results

Sixty subjects were randomised in the study (30 into the FTP group, 30 into the placebo group), and among them, twelve subjects were excluded from the analysis for protocol violation, adverse events or consent withdrawal. The two groups did not differ in baseline characteristics. After 12 weeks of treatment, 48 subjects were evaluated. Of the 48 subjects, 26 randomly received FTP capsules and 22 received placebo. The FTP group showed a significant reduction in ALT levels after 12 weeks of treatment compared with the placebo group (p = 0.019). There was also observed that the serum AST levels were significantly reduce in the FTP group than placebo group (p = 0.02). The GGT levels showed a tendency to decrease, while the serum alkaline phosphatase (ALP), TB, and lipids levels were not modified. There were no reported severe AEs during this study, or abnormalities observed on blood glucose, total protein, albumin, blood urea nitrogen (BUN), and creatinine levels.

Conclusion

The data of this trial indicate that FTP is effective and safe, generally well-tolerated without severe AEs, in the treatment of subjects with elevated ALT levels over a 12 weeks period.

Trial registration

ClinicalTrials.gov: http://NCT01634256
Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care
Authors: Edwards Helen , Finlayson Kathleen , Courtney Mary , Graves Nick , Gibb Michelle , Parker Christina
Published: March 2013

Background

Chronic leg ulcers cause long term ill-health for older adults and the condition places a significant burden on health service resources. Although evidence on effective management of the condition is available, a significant evidence-practice gap is known to exist, with many suggested reasons e.g. multiple care providers, costs of care and treatments. This study aimed to identify effective health service pathways of care which facilitated evidence-based management of chronic leg ulcers.

Methods

A sample of 70 patients presenting with a lower limb leg or foot ulcer at specialist wound clinics in Queensland, Australia were recruited for an observational study and survey. Retrospective data were collected on demographics, health, medical history, treatments, costs and health service pathways in the previous 12 months. Prospective data were collected on health service pathways, pain, functional ability, quality of life, treatments, wound healing and recurrence outcomes for 24 weeks from admission.

Results

Retrospective data indicated that evidence based guidelines were poorly implemented prior to admission to the study, e.g. only 31% of participants with a lower limb ulcer had an ABPI or duplex assessment in the previous 12 months. On average, participants accessed care 2–3 times/week for 17 weeks from multiple health service providers in the twelve months before admission to the study clinics. Following admission to specialist wound clinics, participants accessed care on average once per week for 12 weeks from a smaller range of providers. The median ulcer duration on admission to the study was 22 weeks (range 2–728 weeks). Following admission to wound clinics, implementation of key indicators of evidence based care increased (p < 0.001) and Kaplan-Meier survival analysis found the median time to healing was 12 weeks (95% CI 9.3–14.7). Implementation of evidence based care was significantly related to improved healing outcomes (p < 0.001).

Conclusions

This study highlights the complexities involved in accessing expertise and evidence based wound care for adults with chronic leg or foot ulcers. Results demonstrate that access to wound management expertise can promote streamlined health services and evidence based wound care, leading to efficient use of health resources and improved health.
The rural - urban divide in ambulatory care of gastrointestinal diseases in Taiwan
Authors: Lin Yi-Hsuan , Tseng Yen-Han , Chen Yi-Chun , Lin Ming-Hwai , Chou Li-Fang , Chen Tzeng-Ji , Hwang Shinn-Jang
Published: March 2013

Background

The utilization of medical care for gastrointestinal diseases increased over the past decade worldwide. The aim of the study was to investigate the difference between rural and urban patients in seeking medical service for gastrointestinal diseases at ambulatory sector in Taiwan.

Methods

From the one-million-people cohort datasets of the National Health Insurance Research Database, the utilization of ambulatory visits for gastrointestinal diseases in 2009 was analyzed. Rural patients were compared with urban and suburban patients as to diagnosis, locality of visits and choice of specialists.

Results

Among 295,056 patients who had ambulatory visits for gastrointestinal diseases in 2009, rural patients sought medical care for gastrointestinal diseases more frequently than urban and suburban patients (1.60 ± 3.90 vs. 1.17 ± 3.02 and 1.39 ± 3.47). 83.4% of rural patients with gastrointestinal diseases were treated by non-gastroenterologists in rural areas. Rural people had lower accessibility of specialist care, especially for hepatitis, esophageal disorders and gastroduodenal ulcer.

Conclusion

The rural–urban disparity of medical care for gastrointestinal diseases in Taiwan highlighted the importance of the well communication between rural physicians and gastroenterologists. Besides the establishment of the referral system, the medical teleconsultation system and the arrangement of specialist outreach clinics in rural areas might be helpful.
An investigation of 125I seed permanent implantation for recurrent carcinoma in the head and neck after surgery and external beam radiotherapy
Authors: Zhu Lihong , Jiang Yuliang , Wang Junjie , Ran Weiqiang , Yuan Huishu , Liu Chen , Qu Ang , Yang Ruijie
Published: March 2013

Background

A preliminary assessment was conducted of the feasibility, efficacy, and morbidity of 125I seed implantation for recurrent head and neck carcinoma after surgery and external beam radiotherapy.

Methods

Nineteen patients with recurrent head and neck carcinomas underwent 125I seed implantation under ultrasound or computed tomography guidance. The actuarial D90 of 125I seed implantation ranged from 90 to 160 Gy (median, 131 Gy). The follow-up period ranged from 3 to 44 months (median, 11 months).

Results

The median local control was 24 months (95% confidence interval, 10.2 to 37.8). The one- year, two-year and three-year local controls were 73.3%, 27.5% and 27.5%, respectively, whereas the one-year, two-year and three-year survival rates were 53.0%, 18.2% and 18.2%, respectively, and the median survival was 13 months (95% confidence interval, 6.6 to 19.4). A total of 26.3% of patients (5/19) died of local recurrence and 21.1% of patients (4/19) died of metastases. One suffered from a grade 1 skin reaction.

Conclusions

125I seed implantation is feasible and safe as a salvage treatment for patients with recurrent head and neck cancers. The high local control results and low morbidity merits further investigation.
Cancer patient perceptions on the ethical and legal issues related to biobanking
Authors: Master Zubin , Claudio Jaime O , Rachul Christen , Wang Jean CY , Minden Mark D , Caulfield Timothy
Published: March 2013

Background

Understanding the perception of patients on research ethics issues related to biobanking is important to enrich ethical discourse and help inform policy.

Methods

We examined the views of leukemia patients undergoing treatment in clinics located in the Princess Margaret Hospital in Toronto, Ontario, Canada. An initial written survey was provided to 100 patients (64.1% response rate) followed by a follow-up survey (62.5% response rate) covering the topics of informed consent, withdrawal, anonymity, incidental findings and the return of results, ownership, and trust.

Results

The majority (59.6%) preferred one-time consent, 30.3% desired a tiered consent approach that provides multiple options, and 10.1% preferred re-consent for future research. When asked different questions on re-consent, most (58%) reported that re-consent was a waste of time and money, but 51.7% indicated they would feel respected and involved if asked to re-consent. The majority of patients (62.2%) stated they had a right to withdraw their consent, but many changed their mind in the follow-up survey explaining that they should not have the right to withdraw consent. Nearly all of the patients (98%) desired being informed of incidental health findings and explained that the information was useful. Of these, 67.3% of patients preferred that researchers inform them and their doctors of the results. The majority of patients (62.2%) stated that the research institution owns the samples whereas 19.4% stated that the participants owned their samples. Patients had a great deal of trust in doctors, hospitals and government-funded university researchers, moderate levels of trust for provincial governments and industry-funded university researchers, and low levels of trust towards industry and insurance companies.

Conclusions

Many cancer patients surveyed preferred a one-time consent although others desired some form of control. The majority of participants wanted a continuing right to withdraw consent and nearly all wanted to be informed of incidental findings related to their health. Patients had a great deal of trust in their medical professionals and publically-funded researchers as opposed to profit-based industries and insurance companies.
Production of soluble eukaryotic recombinant proteins in E. coli is favoured in early log-phase cultures induced at low temperature
Authors: San-Miguel Teresa , Pérez-Bermúdez Pedro , Gavidia Isabel
Published: March 2013

Background

Producing recombinant plant proteins expressed in Escherichia coli produce in high yields and in a soluble and functional form can be difficult. Under overexpression conditions, proteins frequently accumulate as insoluble aggregates (inclusion bodies) within the producing bacteria. We evaluated how the initial culture density, temperature and duration of the expression stage affect the production of some eukaryotic enzymes in E. coli.

Findings

A high yield of active soluble proteins was obtained by combining early-log phase cultures and low temperatures for protein induction. When IPTG was added at OD600 = 0.1 and cultures were maintained at 4°C for 48-72 h, the soluble protein yield was 3 fold higher than that obtained in the mid-log phase (OD600 = 0.6). Besides, the target protein expression increased and the endogenous bacterial proteins reduced, thus making the protein purification process easier and more efficient.

Conclusions

The protocol can be widely applied to proteins with a heterologous expression which was limited by loss of activity at high temperatures or by low soluble recombinant protein yield.
Collagen catabolism through Coll2-1 and Coll2-1NO2 and myeloperoxidase activity in marathon runners
Authors: Henrotin Yves , Labasse Alain , Franck Thierry , Bosseloir Alain , Bury Thierry , Deberg Michelle
Published: March 2013

To determine the influence of marathon on the serum levels of two markers of cartilage degradation, Coll2-1 and its nitrated form, Coll2-1NO2, and of a marker of neutrophils activation, the myeloperoxidase (MPO).

Coll2-1, Coll2-1NO2, total and active MPO were measured in 98 marathon runners without joint pain and with an average age of 47 years. Sera were taken at rest right before the departure and within 30 min after the marathon. The subjects were submitted to a questionnaire concerning their physical activity and their life style.

The levels of Coll2-1, Coll2-1NO2 and active MPO were not affected by age, body mass index, sex or performance. The levels of total MPO were higher in female than in male (p < 0.05), but were not affected by the other parameters. After the marathon, Coll2-1 and Coll2-1NO2 concentrations were slightly but systematically decreased. The total and active MPO concentrations were increased by 2 to 3-fold in comparison to the pre-marathon values (p < 0.001 for total and active MPO). The active MPO/total MPO ratio was significantly enhanced after the marathon (p < 0.001). The variation of total MPO during the marathon was negatively correlated with the training time per week (r = −0.34; p = 0.009).

The serum levels of Coll2-1 and Coll2-1NO2 were slightly decreased by marathon, indicating that intensive running could reduce cartilage catabolism. Furthermore, Coll2-1NO2 was not correlated with the total and active MPO indicating that Coll2-1 nitration did not result of a systemic oxidative phenomenon but reflects local changes.
Technical note: proteomic approaches to fundamental questions about neutrophil biology
Authors: McLeish Kenneth R , Merchant Michael L , Klein Jon B , Ward Richard A
Published: March 2013

Proteomics is one of a group of technologies that generates high-throughput, large-scale datasets that can be used to understand cell or organ functions at a systems level. This review will focus on the application of proteomics to the understanding of neutrophil biology. The strengths and weaknesses of common proteomic methods and their application to neutrophils are reviewed, with the goal of evaluating whether the technology is ready to advance our understanding of neutrophil biology.
Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis
Authors: Fone David , Greene Giles , Farewell Daniel , White James , Kelly Mark , Dunstan Frank
Published: March 2013

Background

Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known.

Aims

To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health.

Method

Multilevel analysis of population data from the Welsh Health Survey, 2003/04-2010. A total of 88623 respondents aged 18-74 years were nested within 50587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a ‘case’ of common mental disorder.

Results

High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. =0.33), P=0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88-0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate −1.35 (s.e.=0.54), P=0.012; OR=1.13, 95% CI 1.04-1.22).

Conclusions

The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level.