bluuebunny/crossref_metadata_2025 huggingface dataset:
Political organizations’ use of websites and Facebook
Authors: Nitschke Paula , Donges Patrick , Schade Henriette
Published: August 2014

The Internet offers internal and external communication opportunities to political organizations but also adds new costs and social pressure to use it in an appropriate way. This study examines whether and which political and organizational context factors explain the usage of online media by political organizations. We content-analyzed the websites and Facebook pages of 116 German-based political organizations in the policy sectors environment and health and distinguished between different aspects of “ usage”; we investigated whether an organization was present on the World Wide Web and Facebook and then scrutinized the actual level of activity on both platforms—the overall activity and the activity in different communication dimensions. By drawing this distinction, the current study sheds light on relationships that have thus far not been the focus of political organizational Internet research. While there are no clear-cut differences regarding the overall activity, there are differences in terms of linking and mobilization behavior.
Pricing climate change
Authors: Dasgupta Partha
Published: August 2014

In developing the basis on which climate change should be priced, I do five things. First, I review the ethical foundations for valuing future consumption relative to present consumption (i.e. social discount rates). Second, I report that the criterion for both assessing and prescribing economic policies should not be an economy's GDP, but an inclusive measure of an economy's wealth adjusted for the distribution of wealth. Third, I apply the resulting analysis to the problem of pricing carbon concentration in the atmosphere. I give prominence to future uncertainties. Fourth, I show that the existing models of human behaviour on the basis of which these questions have been analysed by economists have serious deficiencies, in as much as the idea of personhood embodied in them has been built on the psychology of confirmed egotists. Fifth, I sketch the motivations of a social being and show how the altered specification of the human person affects the social price of climate change.
Engaging in community conversation: A means to improving the paramedicine student clinical placement experience
Authors: Hickson Helen , O'Meara Peter , Huggins Chris
Published: August 2014

Community conversations are structured, inclusive conversations that bring together a group of people to engage in meaningful conversation, share knowledge and ideas, and discuss solutions to complex problems. This article focuses on the methodological aspects of using community conversations as a research approach. Participants included paramedics, ambulance service managers, paramedicine students and paramedicine educators, who gathered at La Trobe University in Bendigo in February 2013 to attend a conference titled ‘Paramedic Education and Leadership. Conversations took place over three days, with participants spending around five hours discussing the key issues related to paramedicine student clinical placements. Three stages of community conversations are described, along with the participants’ evaluation of the process, leading to the conclusion that community conversations are a valuable and effective way to bring together groups of people to discuss ideas and solutions to complex social problems.
Implementation of transcatheter aortic valve insertion (TAVI) in clinical practice: An ethical analysis
Authors: Ohldieck Annabel Eide , Nordrehaug Jan Erik , Vandvik Per Olav , Schaufel Margrethe , Norheim Ole Frithjof
Published: August 2014

Objective

The objective of this article is to provide an ethical analysis of a high-risk, advanced treatment case where the patient received transcatheter aortic valve insertion (TAVI), for aortic valve stenosis. Particular emphasis will be placed upon the significance of evidence and the implications for priority setting.

Method

One paradigmatic case involving a TAVI patient from a large university hospital in Norway is described and analysed. The method used was ethical case analysis modified after Kymlicka by Miljeteig et al. Perioperative mortality risk was estimated using the Euroscore risk-logarithm and the Society of Thoracic Surgeons’ risk model, STS. These predict the risk of operative mortality and morbidity associated with adult cardiac surgery. GRADE, the Grading of Recommendations Assessment, Development and Evaluation, was used to evaluate the evidence.

Results

In the case analysis, we found that it would be ethically justifiable not to recommend TAVI treatment for this patient. Although the patient had a severe condition in need of treatment, the expected improvement was marginal, the quality of evidence was low and the opportunity costs for other patients and society were higher than usually deemed appropriate.

Conclusions

Decision-making in the absence of high quality evidence from randomized trials is a complex process involving difficult ethical judgments. Novel high-risk devices often enter the European market with limited clinical evidence. Transparency and improved clinical evaluation are required so patient safety is not jeopardized. We argue that implementation of high risk, high cost interventions should be better regulated at a national level.

Background

All clinical decisions imply priority setting and therefore indirectly affect other patients and other patient groups. The use of expensive, innovative health technologies has an affect on individual patients as well as on other patient groups competing for the same resources.
Measuring moral thinking from a neo-Kohlbergian perspective
Authors: Thoma Stephen J.
Published: August 2014

The neo-Kohlbergian model revises and extends Lawrence Kohlberg’s model of moral reasoning development to better reflect advances in research and theory. In moving from Kohlberg’s global stage model to a multi-process description of moral functioning, these modifications are most evident in the ways in which moral thinking is described, measured, and interpreted. This article highlights the two primary measurement systems of moral thinking associated with the neo-Kohlbergian perspective: measures of moral judgment development and the more recently identified intermediate concepts measures. In describing both systems, attention is given to the nature of the information supplied and evidence used to support them.
Masking Political Engagement
Authors: Castelló Enric
Published: August 2014

This article analyzes how statewide and regional public television in Spain handled the demonstration held on September 11, 2012 (the National Day of Catalonia), in Barcelona under the slogan “Catalonia, a New European State.” The author performed a content analysis of fifty-eight news programs and a narrative analysis of eighty-nine stories. The results indicate that the majority of the channels offered limited coverage of the demonstration. The television narratives also minimized the role of citizen agency in the achievement of goals through democratic participation and displayed a depoliticized account. The author argues that the coverage of the march and its consequences resulted in a masking of citizens’ political engagement; far from promoting an understanding of why the march was so massively supported, it instead presented a story on politicians’ strategy. The author relates this case to a wider trend of media coverage of citizens’ protests in a Western, post-democratic context.
Correlates of Pain Intensity in Community-Dwelling Individuals With Mild to Moderate Dementia
Authors: Breland Jessica Y. , Barrera Terri L. , Snow A. Lynn , Sansgiry Shubhada , Stanley Melinda A. , Wilson Nancy , Amspoker Amber B. , Kunik Mark E.
Published: August 2014

Objectives:

To identify correlates of participant-reported pain in community-dwelling individuals with mild to moderate dementia.

Methodology:

Associations among participant-reported pain intensity and depressive symptoms, mental health diagnoses, pain diagnoses, pain medications, level of functional ability, and cognitive impairment were assessed in 136 community-dwelling veterans with mild to moderate dementia and pain. Univariate and multiple regressions were used to assess relationships among the independent variables and participant-reported pain.

Results:

Pain diagnoses (β = .23, t132 = 2.65, P < .01) and pain medications (β = .21, t132 = 2.48, P < .05) were correlated with participant-reported pain intensity in univariate regression models. Only pain diagnoses (β = .20, t132 = 2.17, P < .05) remained a significant predictor in adjusted models.

Conclusion:

Participant-reported pain in individuals with dementia appears to be a unique construct for which other psychosocial indicators cannot be substituted. Therefore, directly asking community-dwelling individuals with mild to moderate dementia about their pain is a critical component of assessment.
Using Virtual Reality for Cognitive Training of the Elderly
Authors: García-Betances Rebeca I. , Jiménez-Mixco Viveca , Arredondo María T. , Cabrera-Umpiérrez María F.
Published: August 2014

There is a pressing demand for improving the quality and efficacy of health care and social support services needed by the world’s growing elderly population, especially by those affected by mild cognitive impairment (MCI) and Alzheimer’s disease (AD)-type early-stage dementia. Meeting that demand can significantly benefit from the deployment of innovative, computer-based applications capable of addressing specific needs, particularly in the area of cognitive impairment mitigation and rehabilitation. In that context, we present here our perspective viewpoint on the use of virtual reality (VR) tools for cognitive rehabilitation training, intended to assist medical personnel, health care workers, and other caregivers in improving the quality of daily life activities of people with MCI and AD. We discuss some effective design criteria and developmental strategies and suggest some possibly useful protocols and procedures. The particular innovative supportive advantages offered by the immersive interactive characteristics inherent to VR technology are discussed.
High Matrix Metalloproteinase Levels Are Associated With Dermal Graft Failure in Diabetic Foot Ulcers
Authors: Izzo Valentina , Meloni Marco , Vainieri Erika , Giurato Laura , Ruotolo Valeria , Uccioli Luigi
Published: August 2014

The aim of our study is to analyze factors, including matrix metalloproteinase (MMP) levels, that could influence the integration of dermal grafts in diabetic foot ulcers. From September 2012 to September 2013, 35 diabetic patients with IIA lesion (Texas Wound Classification) and an extensive foot tissue loss were considered suitable for dermal graft. Before the enrollment we ensured the best local conditions: adequate blood supply, control of infection, and offloading. The MMP level of each lesion was evaluated blindly before the application of dermal substitutes. At 1-month follow-up, we analyzed the correlation between clinical patient characteristics, local wound features including MMP levels, dermal substitute applied, and the outcome expressed in terms of dermal graft integration. We observed dermal graft integration in 28/35 patients (80% of our population). In multivariate analysis high MMP level was the only negative predictor for dermal graft integration ( P < .0007). In addition, we divided the patients into 2 groups according to MMP levels: group 1 with low protease activity (24 patients) and group 2 with elevated protease activity (11 patients). The integration of the dermal graft was 100% in group 1 (n = 24 patients) and 36.4% in group 2 (n = 4patients), P < .0001. According to our data, the evaluation of MMP levels may be useful to choose the right strategy to get the best results in terms of clinical success and cost saving. However, further studies are necessary to confirm these findings.
Gender Differences of Lower Extremity Amputation Risk in Patients With Diabetic Foot
Authors: Tang Zhu-Qi , Chen Hong-Lin , Zhao Fang-Fang
Published: August 2014

In this meta-analysis, we aim to evaluate gender differences of lower extremity amputation risk in patients with diabetic foot. Systematic computerized searches of PubMed and Web of Knowledge were performed. The pooled odds ratio (OR) and 95% confidence interval (CI) for amputation risk were calculated. Twenty studies with 15 385 case (present amputation) and 438 760 control (absent amputation) patients were included in the meta-analysis. The pooled crude OR was 1.676 (95% CI 1.307-2.149; Z = 4.07, P = .000). In the retrospective study subgroup, the pooled OR was 1.708 (95% CI = 1.235-2.363; Z = 3.24, P = .001); in the prospective study subgroup, the pooled OR was 1.478 (95% CI = 1.189-1.838; Z = 3.51, P = .000). The pooled adjusted OR was 1.439 (95% CI = 1.238-1.671; Z = 4.76, P = .000). In retrospective study subgroup, the pooled OR was 1.440 (95% CI = 1.208-1.717; Z = 4.07, P = .000); in prospective study subgroup, the pooled OR was 1.478 (95% CI = 1.080-2.024; Z = 2.44, P = .015). No significant publication bias was found. Sensitivity analyses by omitting a heterogeneity study showed the results were robust. In conclusion, our meta-analysis indicates that men with diabetic foot have about one half increased amputation risk than women with diabetic foot. Men with diabetes should receive more complete follow-up and more adequate health education.
Clinical Outcomes of Multidrug Resistant Pseudomonas aeruginosa Infection and the Relationship With Type III Secretion System in Patients With Diabetic Foot
Authors: Zhang Jinghang , Chu Yuejie , Wang Penghua , Ji Xiaoyan , Li Xiwen , Wang Chao , Peng Yue
Published: August 2014

The objective was to analyze the clinical outcomes of multidrug resistant Pseudomonas aeruginosa (MDRPA) infection and determine the relationship between type III secretion system (TTSS) and MDRPA in diabetic foot (DF) patients. A total of 117 patients infected with P aeruginosa were recruited and grouped into MDRPA and non-MDRPA group according to antimicrobial susceptibility testing. TTSS genes were detected by polymerase chain reaction (PCR). Potential risk factors for MDRPA infection were examined using univariate and multivariate analyses. Clinical outcomes were compared on the basis of MDRPA or TTSS virulence gene. Previous antibiotic therapy, previous hospitalization and osteomyelitis were associated with MDRPA infection. MDRPA group had a higher amputation/toe rate (32.6% vs 16.2%) and lower healing rate (20.9% vs 41.9%) than non-MDRPA group ( P = .032). A significantly higher proportion of exoU was present in MDRPA group (75.0% vs 25.0%, P < .05) than non-MDRPA group. Patients infected with exoU isolates had a lower healing rate and higher amputation/toe rate (25.0% vs 65.2%, 33.3% vs 8.7%, P < .05) than infected with exoS isolates. The exoU gene was predominance among MDRPA strains. The poor clinical outcomes of MDRPA infection in patients with DF were attributable to exoU gene.
Notch signaling regulates col1α1 and col1α2 expression in airway fibroblasts
Authors: Hu Mei , Ou-Yang Hai-Feng , Wu Chang-Gui , Qu Shuo-Yao , Xu Xin-Ting , Wang Ping
Published: August 2014

Subepithelial fibrosis is one of the common pathological features of asthmatic airway remodeling. During subepithelial fibrosis, type I collagen becomes the most abundant extracellular protein component. Studies have shown that Notch signaling participates in the progression of fibrosis; however, whether Notch signaling is involved in regulating type I collagen expression in airway fibroblasts remains unclear. The aim of the present study was to examine whether Notch signaling can regulate type I collagen expression in airway fibroblasts and to explore the underlying molecular mechanisms. Here, the expression of Notch signaling components was examined in mouse L929 cells and human MRC-5 cells. After upregulating or downregulating Notch signaling in these cell lines, col1α1 and col1α2 expression was examined. Using gene reporter assays, site-directed mutagenesis, and ChIP assays, the role of Hes1 binding sites in both the mouse and human COL1A1 and COL1A2 promoters was investigated. This study revealed that Notch signaling-related molecules (including Notch1, Hes1, and others) are expressed in L929 and MRC-5 cells and that Notch signaling regulates the expression of col1α1 and col1α2 in both cell lines. Additionally, over-expression of the Notch intracellular domain resulted in activation of the COL1A1 and COL1A2 promoters, and site-directed mutagenesis reporter assays revealed that Hes1 proteins might augment both mouse and human COL1A1 and COL1A2 promoter activity. Furthermore, ChIP assays confirmed that Hes1 binds to the COL1A1 and COL1A2 promoters in both L929 and MRC-5 cells. Therefore, it is reasonable to assume that Notch signaling can directly upregulate COL1A1 and COL1A2 promoter activity through a Hes1-dependent mechanism, which could serve as a possible target for pharmacotherapy of airway subepithelial fibrosis.
Vascular endothelial growth factor recovers suppressed cytochrome c oxidase activity by restoring copper availability in hypertrophic cardiomyocytes
Authors: Sun Miao , Zuo Xiao , Li Rui , Wang Tao , Kang Y James
Published: August 2014

Cardiomyocyte hypertrophy induced by phenylepherine (PE) is accompanied by depression of cytochrome c oxidase (COX) activity. Vascular endothelial growth factor (VEGF) recovers the suppressed COX activity and reverses cardiomyocyte hypertrophy. Because PE causes intracellular copper (Cu) depletion and COX activity is Cu-dependent, the present study was undertaken to test the hypothesis that VEGF recovers suppressed COX activity by restoring Cu availability. Primary cultures of neonatal rat cardiomyocytes were treated with PE at a final concentration of 100 µmol/L in cultures for 48 h to induce cell hypertrophy. The hypertrophic cardiomyocytes were exposed to VEGF at a final concentration of 20 ng/mL in cultures for 24 h. Atomic absorption spectrometry analysis revealed that VEGF restored PE-depleted Cu concentrations in hypertrophic cardiomyocytes along with the recovery of COX activity. Western blot analysis showed that protein contents of COX subunit COX-IV and Cu chaperones for COX (COX17, COX11, and SCO2) were decreased in response to PE treatment, and recovered after VEGF treatment. In addition, VEGF treatment suppressed PE-induced accumulation of reactive oxygen species (ROS) and the relevant elevation of homocysteine, which has been shown to form complexes with Cu to restrict Cu availability. This study thus demonstrates that VEGF recovers PE-suppressed COX activity by restoring Cu availability and VEGF suppression of ROS accumulation and homocysteine elevation would contribute to the increased Cu availability.
A Training Program for Improving the Informed Consent Discussion Between Clinical Researchers and Their Subjects
Authors: Cadman Mary Ellen , Murphy Jean H. , Brintnall-Karabelas Julie , Squires Carol , Whorton Katherine , Pao Maryland
Published: August 2014

Although there are many training programs on informed consent, they seldom model the contextual factors that support the vital elements of communication, including presentation style, body language, providing a comfortable environment, utilizing clear language, and establishing overall rapport with the subject. A team of clinicians at the National Institute of Mental Health (NIMH) created a pilot program that consists of a video ( http://www.youtube.com/watch?v=l26hdCD9g2I ) and didactic presentation to train investigators to conduct informed consent discussions. Thirty-four physicians and eighty nurses were tested on the training content including these contextual factors. Both groups showed an increase in content knowledge after the training. An informed consent training program such as this is feasible and may improve both the knowledge and communication skills necessary for this important process.
Masculinity and Fatherhood
Authors: Kwon Jae-Yung , Oliffe John L. , Bottorff Joan L. , Kelly Mary T.
Published: August 2014

Health promotion initiatives to reduce smoking among parents have focused almost exclusively on women to support their cessation during pregnancy and postpartum, while overlooking the importance of fathers’ smoking cessation. This study was a secondary analysis of in-depth interviews with 20 new and expectant fathers to identify how they perceived their female partners’ efforts to assist them to reduce or quit smoking. Social constructionist gender frameworks were used to theorize and develop the findings. Three key themes were identified: support and autonomy in men’s smoking cessation, perception of challenging men’s freedom to smoke, and contempt for men’s continued smoking. The findings suggest that shifts in masculinities as men take up fathering should be considered in designing smoking cessation interventions for fathers.
Early results with LifeStent implantation in RESILIENT and non-RESILIENT inclusion criteria patients
Authors: Stone Patrick A , Campbell John E , Fischer Rashi , Phang David , Thompson Stephanie N , Dippel Neil , Mousa Albeir
Published: August 2014

The purpose of our study was to determine outcomes of patients receiving the LifeStent (Bard Peripheral Vascular, Tempe, AZ) for femoropopliteal peripheral arterial disease in real-world academic practice outside the limitations of an industry supported trial. All patients from 2009 to 2012 at our institution who received a LifeStent during endovascular interventions and had follow-up were included. Outcomes evaluated included patency and freedom from limb loss. A total of 166 limbs in 151 patients had the LifeStent implanted in de novo vessels (54% male; 68 ± 12 years). Eighty-percent of limbs did not meet RESILIENT criteria due to Rutherford category >3 (51%), TransAtlantic Inter-Society Consensus II classifications C/ D (51%), zero runoff vessels (6%), or stent location (17%). Primary patency rates were 81% at 6 months and 58% at 12 months with predictors for primary patency loss at 1 year including Rutherford category >3 (HR: 1.8 (95% CI: 1.0–3.1), p = 0.04), tobacco use (HR: 1.8 (95% CI: 1.0–3.3), p = 0.04), and no clopidogrel at discharge (HR: 3.2 (95% CI: 1.6–6.7), p < 0.01). A preintervention Rutherford category >3 predicted 24-month limb loss (HR, 16.0 (95% CI: 2.0–122.0), p < 0.01). The LifeStent is a viable option regardless of the TransAtlantic Inter-Society Consensus II classification; however, critical limb ischemia, current tobacco use, and absence of clopidogrel on discharge predict decreased patency on follow-up.
Heat, air and moisture transport modelling in ventilated cavity walls
Authors: Van Belleghem Marnix , Steeman Marijke , Janssens Arnold , De Paepe Michel
Published: August 2014

Cavity walls are a widely used external wall type in north-western Europe with a good moisture tolerance in cool humid climates. In this work, a cavity wall configuration with a brick veneer outside leaf and a wood fibre board inside leaf is analysed with a newly developed coupled computational fluid dynamics–heat, air and moisture model. Drying of the outside or inside cavity leaf, both for summer and winter conditions was analysed. The new model was compared with a widely used simulation tool for building envelope analysis (WUFI®) that uses a simplified modelling approach for the convection in the cavity. The study showed that the simplified model overestimated the drying and moistening rates of the cavity wall compared to the detailed model. For both models the drying of the outer leaf was mainly determined by the outside conditions, and the outside leaf dried out mainly to the outside and not to the cavity. For the inside leaf, however the cavity ventilation was of major importance in drying. The study revealed that the simplified model could not be used to evaluate the drying potential of a ventilated cavity because it overestimated the ventilation effect systematically. The simplified model would in such case indicate lower moisture contents than in reality and consequently lower risk for mould growth, wood rot or other structural damage. Only detailed modelling of the convection in the cavity, as in the new model, leads to a correct evaluation of ventilated cavity walls.
Advance directives in dementia research: The opinions and arguments of clinical researchers − an empirical study
Authors: Jongsma Karin , van de Vathorst Suzanne
Published: August 2014

In order to discover an effective treatment for dementia it is necessary to include dementia patients in clinical research trials. Dementia patients face an increased risk to lose the capacity to consent to research participation, and research possibilities with incompetent participants are legally strictly limited. One solution is for patients to consent to research through an advance research directive (ARD) whilst still competent. In order to explore whether such a directive would be useful and valuable in practice we conducted a qualitative study (13 interviews). We explored the opinions and arguments of researchers in the field of dementia, aiming to map the possibilities and constraints of ARDs. It was argued that a positive ARD could be valuable to discuss research participation with proxies, and patients with a negative ARD will be excluded from research trials. However, it is argued that an ARD cannot replace the informed consent procedure, and in practice proxy dissent will overrule written consent. The practical use of these directives is thus limited, as most researchers will not comply with positive directives.
The effectiveness of student-run organizations within global health promotion initiatives
Authors: Byron Yoni , West Henry , Wood Benjamin , Murray Linda , Cooling Nick
Published: August 2014

Introduction:

This commentary describes a student-led project that distributed long-lasting insecticide-treated nets in Masaka, Uganda. The role of student-led initiatives in global health promotion projects is also discussed.

Methods:

A survey of 213 net recipients was conducted after a 12-month period to evaluate malaria prevention knowledge, and net use and maintenance.

Results:

Only 4.7% of recipients could not recall any malaria prevention methods. Seventy percent of pregnant women and 86.5% of children under five slept under a net the previous night. Only two households (0.9%) no longer possessed a net, and nets were not used in 2.3% of houses. Household observation revealed 17.4% of nets had at least one problem that would compromise effectiveness.

Conclusions:

Student-led projects can play an important role in effectively preventing malaria. However coordination with existing programs, targeting hard-to-access groups, and training of students overcomes some common limitations of such student-led initiatives.
Clinical assessment of the glenoid labrum
Authors: Arnander Magnus , Tennent Duncan
Published: August 2014

Background

The glenoid labrum is integral to shoulder stability and can be difficult to assess clinically. Whilst it is a single anatomical structure, damage to different regions results in very different clinical manifestations. A large number of provocative tests have been described, all of which initially purport to have excellent diagnostic accuracy. Clinical experience suggests that this is not the case and decision making can be difficult for the non-expert. The purpose of this study is to review the current evidence for the most commonly used tests and to provide suggestions for tests which have the most evidence for efficacy.

Methods

The glenoid labrum was divided into anterior, superior and posterior regions. The English language literature describing labral tests was reviewed. The evidence provided by the authors and any subsequent studies was analysed.

Results

Whilst a large number if tests have been described with the primary authors reporting excellent results the evidence for most is poor when later tested critically.

Discussion

No single test will accurately diagnose labral pathology. The clinician must use evidence from the clinical history combined with selective use and interpretation of tests with which they are familiar.
Prevalence and Nutritional Status of Infants With Cystic Fibrosis and Pseudo-Bartter Syndrome During the First Year of Life
Authors: Del Ciampo Ieda Regina Lopes , Martins Natalia , Sawamura Regina , Facincani Inalda , Del Ciampo Luiz Antonio , Fernandes Maria Inez Machado
Published: August 2014

Background. Cystic fibrosis (CF) is an autosomal recessive disease more commonly occurring among Caucasians. An electrolyte derangement, pseudo-Bartter syndrome (PBS) is a complication leading to failure to thrive. Objectives. To describe the prevalence of PBS and related nutritional status in infants with CF detected after a newborn screening test who were treated in a Brazilian town with a very warm climate. Methods. This was a retrospective study with data collected from medical records. The diagnosis of PBS was based on hypokalemia (K+ < 3.5 mEq/L), hyponatremia (Na++ < 135 mEq/L), low urinary sodium (Na++ < 20 mEq/L), and metabolic alkalosis (pH > 7.45; bicarbonate >28 mEq/L). The anthropometric data assessed were weight and length at the following: birth, diagnosis of CF, diagnosis of PBS, and discharge from hospital after correction of PBS and at 12 months of age. The nutritional indicators were weight/height, weight/age, length/age, and body mass index/age ratios. The cutoff point was z-score < p −2 (World Health Organization reference). Data were analyzed using the Anthro (World Health Organization) and Epi-info 2007 programs. Results. Twelve infants with CF were included, and 41.6% (5) had PBS. There was progressive improvement of nutritional status after CF management and after an early diagnosis and management of PBS. Conclusions. The prevalence of PBS was high. There were mild clinical manifestations of PBS accompanied by compromised nutritional status, identified in patients from a region of hot weather.
Mentoring Marginality
Authors: Sykes Bryan L. , Gioviano Jason , Piquero Alex R.
Published: August 2014

Educational attainment is a key predictor of potential contact with the criminal justice system. A growing body of literature implicates social background and parental incarceration as factors that affect the educational, emotional, and behavioral development of children. Wilson argues that the social isolation of the underclass in urban cities prevents youth from being exposed to mainstream individuals who serve as positive role models, thereby solidifying inequality among the socially disadvantaged. This article draws upon a new, nationally representative data set to assess racial differences in informal mentorship among adolescents. We investigate how mentoring affects academic engagement and self-control among disadvantaged youth who have experienced parental incarceration. Using propensity score-matching methods, findings indicate persistent racial differences in the likelihood of having an informal mentor after controlling for measures of neighborhood disorder, social institutions, and social cohesion. Results show that informal mentoring is associated with increased self-control for non-White children who have never had a parent incarcerated but not for Latino youth who have had a parent behind bars. However, informal mentoring has no measurable effect on the academic engagement of adolescents exposed and unexposed to parental incarceration.
Exploring Student, Family, and School Predictors of Self-Determination Using NLTS2 Data
Authors: Shogren Karrie A. , Garnier Villarreal Mauricio , Dowsett Chantelle , Little Todd D.
Published: August 2014

This study conducted secondary analysis of data from the National Longitudinal Transition Study-2 (NLTS2) to examine the degree to which student, family, and school constructs predicted self-determination outcomes. Multi-group structural equation modeling was used to examine predictive relationships between 5 student, 4 family, and 7 school constructs developed from NLTS2 data and self-determination outcomes (autonomy, psychological empowerment, and self-realization) across disability groups. The pattern of predictive relationship between the constructs and self-determination outcomes across disability groups was complex. Only one construct—self-concept—showed a positive predictive relationship with all three self-determination constructs across most disability groups. Implications of the complex pattern of findings for research and practice are discussed.
Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation
Authors: Mackay Nicola D. , Smith Nicholas A. , Parsons Nick , Spalding Tim , Thompson Peter , Sprowson Andrew P.
Published: August 2014

Background:

With improved understanding of the biomechanical importance of the medial patellofemoral ligament (MPFL), its reconstruction for patellar dislocation has become increasingly popular. The aim of this systematic review was to critically determine the effectiveness of MPFL reconstruction for patellar dislocation.

Hypothesis:

MPFL reconstruction for patellar dislocation leads to a low redislocation rate with improved Kujala scores.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search was performed using Embase and Medline (Ovid) databases. Inclusion criteria included first-time and recurrent patellar dislocation, subluxation, or persistent instability with a minimum follow-up of 12 months and documentation of postoperative redislocation rate or Kujala score. The studies were systematically appraised, and a meta-analysis was performed.

Results:

Twenty-two studies were included: 2 randomized controlled trials, 3 parallel case series, and 17 case series. There were a total of 655 knees in the review, with an age range at time of surgery from 11 to 52 years. The pooled postoperative redislocation rate from all 17 case series showed a mean of 2.44%. The pooled preoperative Kujala scores from 12 case series showed a mean of 51.6 (95% CI, 46.71-56.49). The pooled postoperative Kujala scores from 16 case series showed a mean of 87.77 (95% CI, 85.15-90.39).

Conclusion:

Although the studies were of low quality, the meta-analysis of 17 case series shows that MPFL reconstruction for recurrent patellar dislocation results in a significant improvement in Kujala scores, a low redislocation rate, and acceptable complication rate. Randomized trials would be needed to draw influences on the superiority of MPFL reconstruction compared with other treatments.
High On-Treatment Platelet Reactivity Associated With Prasugrel
Authors: Cahoon William D. , Kroll Amanda L. , Lowe Denise K.
Published: August 2014

Objective: To report a case of high on-treatment platelet reactivity (HTPR) with prasugrel maintenance therapy despite adequate initial platelet response to a loading dose. Case Summary: A 51-year-old woman presented to the emergency department complaining of chest pain. She was diagnosed with acute-on-chronic systolic heart failure and non-ST-elevated myocardial infarction (MI). She had a previous MI with bare metal stent placement and was taking aspirin and prasugrel 10 mg daily. Once admitted, a P2Y12 assay revealed HTPR (331 PRU); therefore, prasugrel was reloaded (60 mg). The next day a P2Y12 assay showed adequate platelet reactivity inhibition (118 PRU), so prasugrel 10 mg daily was continued in the hospital and on discharge. Seventeen days after discharge she was readmitted for possible ischemia. On day 3 of admission, a P2Y12 assay revealed HTPR (278 PRU); subsequently, prasugrel was discontinued and ticagrelor started. After 3 doses of ticagrelor, a P2Y12 assay was 97 PRU, so ticagrelor was continued. Five months have passed since discharge. The patient continues to take ticagrelor and has had no further cardiac events. Discussion: HTPR indicates hypo- or nonresponsiveness for antiplatelet agents and may result in serious adverse events. HTPR has rarely been reported with prasugrel or ticagrelor. An objective causality assessment of our case revealed a probable association between HTPR and prasugrel. Conclusion: Patient education and recognition of signs and symptoms associated with prasugrel HTPR may prevent morbidity and mortality from treatment failure. Additional research may determine incidence, risk factors, and optimal management of HTPR with prasugrel.
Incidental Finding of Cor Triatriatum Sinistrum in an Adult
Authors: Lindauer Stephanie R.
Published: August 2014

Cor triatriatum is a congenital heart defect often diagnosed in infancy or childhood. This case study presents an adult with metastatic breast cancer, anemia, and an incidental finding of cor triatriatum sinistrum. On the basis of clinical presentation, the patient was treated conservatively and discharged. Sonographic findings of cor triatriatum sinistrum, along with clinical signs, the significance of other imaging modalities, and potential treatments, are presented.
The Breast Cancer Epidemic: 10 Facts
Authors: Schneider A. Patrick , Zainer Christine M. , Kubat Christopher Kevin , Mullen Nancy K. , Windisch Amberly K.
Published: August 2014

Breast cancer, affecting one in eight American women, is a modern epidemic. The increasing frequency of breast cancer is widely recognized. However, the wealth of compelling epidemiological data on its prevention is generally not available, and as a consequence, is largely unknown to the public. The purpose of this report is to review the epidemiological evidence of preventable causes of breast cancer.
Dietary guideline adherence for gastroesophageal reflux disease
Authors: Kubo Ai , Block Gladys , Quesenberry Charles P , Buffler Patricia , Corley Douglas A
Published: August 2014

Background

Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Recently described side effects of long-term acid suppression have increased the interest in nonpharmacologic methods for alleviating GERD symptoms. We aimed to examine whether GERD patients follow recommended dietary guidelines, and if adherence is associated with the severity and frequency of reflux symptoms.

Methods

We conducted a population-based cross-sectional study within the Kaiser Permanente Northern California population, comparing 317 GERD patients to 182 asymptomatic population controls. All analyses adjusted for smoking and education.

Results

GERD patients, even those with moderate to severe symptoms or frequent symptoms, were as likely to consume tomato products and large portion meals as GERD-free controls and were even more likely to consume soft drinks and tea [odds ratio (OR) = 2.01 95% confidence interval (CI) 1.12-3.61; OR = 2.63 95% CI 1.24-5.59, respectively] and eat fried foods and high fat diet. The only reflux-triggering foods GERD patients were less likely to consume were citrus and alcohol [OR = 0.59; 95% CI: 0.35-0.97 for citrus; OR = 0.41 95% CI 0.19-0.87 for 1 + drink/day of alcohol]. The associations were similar when we excluded users of proton pump inhibitors.

Conclusions

GERD patients consume many putative GERD causing foods as frequently or even more frequently than asymptomatic patients despite reporting symptoms. These findings suggest that, if dietary modification is effective in reducing GERD, substantial opportunities for nonpharmacologic interventions exist for many GERD patients.
Sociodemographic correlates of 25-hydroxyvitamin D test utilization in Calgary, Alberta
Authors: de Koning Lawrence , Henne Dan , Woods Paul , Hemmelgarn Brenda R , Naugler Christopher
Published: August 2014

Background

Increasing laboratory test utilization is a major challenge facing clinical laboratories.

However, in most instances we lack population level information on the patient groups to which increased testing is directed. Much recent work has been published on the sociodemographic correlates of 25-hydroxyvitamin D deficiency. An unanswered question, however, is whether testing is preferentially directed towards individuals with a higher likelihood of deficiency. In this paper we examine this question by combining laboratory information system data on testing rates with Census Canada data.

Methods

We examined 1,436 census dissemination areas within the city of Calgary, Alberta, Canada. For each census dissemination area we determined age and sex-specific 25-hydroxyvitamin D testing rates over a one year period. We then compared these testing rates with the following sociodemographic variables obtained from Census Canada: first nations status, education level, household income, visible minority status, and recent immigrant status.

Results

Overall, 6.9% of males in the city of Calgary were tested during the study period. Females were 1.7 times more likely to be tested than males. Testing rate increased with increasing age, with 16.8% of individuals 66 years and over tested during the one-year study period.

Individuals having at least some university education were less likely to be tested (RR = 0.60;

p < 0.0001). Interestingly, although visible minorities were over twice as likely to be tested as compared to non-visual minorities (RR = 2.25; p < 0.0001), recent immigrants, a group known to exhibit low 25 hydroxyvitamin D levels, were significantly less likely to be tested than non-recent immigrants (RR = 0.72; p = 0.0174). While median household income was modestly associated with increased testing (RR = 1.02; p < 0.0001), First Nations status and non-English speaking were not significant predictors of 25-hydroxyvitamin D testing.

Conclusions

Testing for 25-hydroxyvitamin D is in part directed toward populations at higher risk of deficiency (visible minorities) and at higher risk of osteoporosis (older females), but a particularly high risk group (recent immigrants) is being tested at a lower rate than other patient groups.
Itch-Associated Peptides: RNA-Seq and Bioinformatic Analysis of Natriuretic Precursor Peptide B and Gastrin Releasing Peptide in Dorsal Root and Trigeminal Ganglia, and the Spinal Cord
Authors: Goswami Samridhi C , Thierry-Mieg Danielle , Thierry-Mieg Jean , Mishra Santosh , Hoon Mark A , Mannes Andrew J , Iadarola Michael J
Published: August 2014

Background:

Three neuropeptides, gastrin releasing peptide (GRP), natriuritic precursor peptide B (NPPB), and neuromedin B (NMB) have been proposed to play roles in itch sensation. However, the tissues in which these peptides are expressed and their positions in the itch circuit has recently become the subject of debate. Here we used next-gen RNA-Seq to examine the expression of transcripts coding for GRP, NPPB, NMB, and other peptides in DRG, trigeminal ganglion, and the spinal cord as well as expression levels for their cognate receptors in these tissues.

Results:

RNA-Seq demonstrates that GRP is not transcribed in mouse, rat, or human sensory ganglia. NPPB, which activates natriuretic peptide receptor 1 (NPR1), is well expressed in mouse DRG and less so in rat and human, whereas NPPA, which also acts on the NPR1 receptor, is expressed in all three species. Analysis of transcripts expressed in the spinal cord of mouse, rat, and human reveals no expression of Nppb, but unambiguously detects expression of Grp and the GRP-receptor ( Grpr). The transcripts coding for NMB and tachykinin peptides are among the most highly expressed in DRG. Bioinformatics comparisons using the sequence of the peptides used to produce GRP-antibodies with proteome databases revealed that the C-terminal primary sequence of NMB and Substance P can potentially account for results from previous studies which showed GRP-immunostaining in the DRG.

Conclusions:

RNA-Seq corroborates a primary itch afferent role for NPPB in mouse and potentially NPPB and NPPA in rats and humans, but does not support GRP as a primary itch neurotransmitter in mouse, rat, or humans. As such, our results are at odds with the initial proposal of Sun and Chen (2007) that GRP is expressed in DRG. By contrast, our data strongly support an itch pathway where the itch-inducing actions of GRP are exerted through its release from spinal cord neurons.
Altered immune status of circulating T lymphocytes during sepsis: children also
Authors: Cavaillon Jean-Marc
Published: August 2014

Altered immune status of blood leukocytes is a general phenomenon observed in adult patients with sepsis or septic shock. This is also the case in children with septic shock for both T helper 1 and T helper 2 lymphocytes, as demonstrated by their reduced ex vivo cytokine production upon activation by phytohemagglutinin.
Deep sequencing reveals clonal evolution patterns and mutation events associated with relapse in B-cell lymphomas
Authors: Jiang Yanwen , Redmond David , Nie Kui , Eng Ken W , Clozel Thomas , Martin Peter , Tan Leonard HC , Melnick Ari M , Tam Wayne , Elemento Olivier
Published: August 2014

Background

Molecular mechanisms associated with frequent relapse of diffuse large B-cell lymphoma (DLBCL) are poorly defined. It is especially unclear how primary tumor clonal heterogeneity contributes to relapse. Here, we explore unique features of B-cell lymphomas - VDJ recombination and somatic hypermutation - to address this question.

Results

We performed high-throughput sequencing of rearranged VDJ junctions in 14 pairs of matched diagnosis-relapse tumors, among which 7 pairs were further characterized by exome sequencing. We identify two distinctive modes of clonal evolution of DLBCL relapse: an early-divergent mode in which clonally related diagnosis and relapse tumors diverged early and developed in parallel; and a late-divergent mode in which relapse tumors developed directly from diagnosis tumors with minor divergence. By examining mutation patterns in the context of phylogenetic information provided by VDJ junctions, we identified mutations in epigenetic modifiers such as KMT2D as potential early driving events in lymphomagenesis and immune escape alterations as relapse-associated events.

Conclusions

Altogether, our study for the first time provides important evidence that DLBCL relapse may result from multiple, distinct tumor evolutionary mechanisms, providing rationale for therapies for each mechanism. Moreover, this study highlights the urgent need to understand the driving roles of epigenetic modifier mutations in lymphomagenesis, and immune surveillance factor genetic lesions in relapse.
Layered double hydroxide nanocomposite for drug delivery systems; bio-distribution, toxicity and drug activity enhancement
Authors: Kura Aminu Umar , Hussein Mohd Zobir , Fakurazi Sharida , Arulselvan Palanisamy
Published: August 2014

The production of layered double hydroxide(LDH) nanocomposite as an alternative drug delivery system against various ailments is on the increase. Their toxicity potential is usually dose and time dependent with particle sizes, shapes and surface charge playing some role both in the in vitro and in vivo studies. The reticular endothelial system of especially the liver and spleen were shown to sequestrate most of these nanocomposite, especially those with sizes greater than 50 nm. The intracellular drug delivery by these particles is mainly via endocytotic pathways aided by the surface charges in most cases. However, structural modification of these nanocomposite via coating using different types of material may lower the toxicity where present. More importantly, the coating may serve as targeting ligand hence, directing drug distribution and leading to proper drug delivery to specific area of need; it equally decreases the unwanted nanocomposite accumulation in especially the liver and spleen. These nanocomposite have the advantage of wider bio-distribution irrespective of route of administration, excellent targeted delivery potential with ease of synthetic modification including coating.