bluuebunny/crossref_metadata_2025 huggingface dataset:
Antioxidant and cytoprotective properties of infusions from leaves and inflorescences of Achillea collina Becker ex Rchb.
Authors: Giorgi Annamaria , Bombelli Raffaella , Luini Alessandra , Speranza Giovanna , Cosentino Marco , Lecchini Sergio , Cocucci Maurizio
Published: December 2008

Plants are the main source of molecules with antioxidant and radical scavenging properties that aid the natural defence systems of cells and may be involved in the preservation of human health, particularly preventing all the physiopathological conditions where oxidative damage is a hallmark. Achillea collina Becker ex Rchb. is a medicinal plant of the Achillea millefolium aggregate (yarrow) traditionally used, particularly in mountain areas, as an infusion or alcohol extract for its digestive, antiinflammatory, analgesic, antipyretic and wound healing properties. The aim of this study was to investigate the antioxidant capacity and cytoprotective activity against oxidative stress of infusions obtained from the leaves and inflorescences of Achillea collina Becker ex Rchb., assessed by chemical (free radical scavenging activity by DPPH and Folin Ciocalteu assay) and biological assays (in vitro model of cytotoxicity and lipid peroxidation in PC12 cells line). Infusions of leaves had the highest antioxidant properties and cytoprotective activity. The antioxidant capacity was significantly correlated with the total phenolic content but not with the cytoprotective profile. Achillea collina Becker ex Rchb. has good antioxidant and cytoprotective properties, suggesting further investigations on its chemical composition and potential health value, particularly for traditionally prepared infusions of leaves. Copyright © 2008 John Wiley & Sons, Ltd.
Cyclooxygenase‐2 inhibitory and antioxidant compounds from the truffle Elaphomyces granulatus
Authors: Stanikunaite Rita , Khan Shabana I. , Trappe James M. , Ross Samir A.
Published: December 2008

The ethanol extract of fruiting bodies of Elaphomyces granulatus, a truffle‐like fungus, was evaluated for cyclooxygenase‐2 (COX‐2) enzyme inhibitory and antioxidant activities. Inhibition of COX‐2 activity was evaluated in mouse macrophages (RAW 264.7). The extract of E. granulatus caused a 68% inhibition of COX‐2 activity at 50 µg/mL. Bioassay‐guided investigation led to the isolation and identification of two active compounds, syringaldehyde and syringic acid. Syringaldehyde moderately inhibited COX‐2 activity with an IC50 of 3.5 µg/mL, while syringic acid strongly inhibited COX‐2 activity with an IC50 of 0.4 µg/mL. The antioxidant activity of the extract and isolated compounds was evaluated in HL‐60 cells by the DCFH‐DA method. The extract of E. granulatus showed a potent antioxidant effect, with an IC50 of 41 µg/mL. Of the pure compounds, syringic acid displayed a strong antioxidant activity, with an IC50 of 0.7 µg/mL, while syringaldehyde showed no activity in the assay. Copyright © 2008 John Wiley & Sons, Ltd.
A numerical investigation of entrainment and transport within a stratocumulus‐topped boundary layer
Authors: J. Kurowski Marcin , P. Malinowski Szymon , W. Grabowski Wojciech
Published: December 2008

Entrainment into the stratocumulus‐topped boundary layer (STBL) is investigated by means of large‐eddy simulations. Set‐up of the numerical experiment is based on the research flight RF‐01 in the DYCOMS‐II field campaign. We focus on the stability of the flow in the cloud‐top region known as the Entrainment Interface Layer (EIL). We calculate the local gradient Richardson number, Ri, at the surface of maximum static stability and at the material top of the STBL defined by a threshold of the total water content. We found that regions in which updraughts impinge upon the inversion and diverge horizontally are characterized by small values of Ri. Resulting turbulence is responsible for entrainment and formation of the EIL. Volumes of the STBL air and the free‐tropospheric air from above it, mixed in proportion resulting in negative buoyancy and typically void of cloud water, form ‘cloud holes’ ‐‐ trenches of descending cloud‐free air which surround updraught areas.

The entrainment process is further analyzed using a passive scalar introduced after three hours of the simulation above the layer of maximum static stability. The mixing fraction of this scalar in the air within the cloud holes falls within the range corresponding to the buoyancy reversal. Some of the negatively buoyant mixtures sinking through the cloud holes are wrapped around the edge of cloudy regions and recirculated into the cloud, which causes a local increase of the cloud‐base height. The rest of the entrained free‐tropospheric air sinks slowly into the STBL and leads to its gradual dilution. Copyright © 2008 Royal Meteorological Society
Design strategies for response surface models for the study of supersonic combustion
Authors: Johnson Rachel T. , Parker Peter A. , Montgomery Douglas C. , Cutler Andrew D. , Danehy Paul M. , Rhew Ray D.
Published: December 2008

An application of a classical design approach to an experiment involving the study of supersonic combustion is described in this paper. The case study described is that of an experiment whose objective is to create response surfaces of the mean and variance of several flow parameters as a function of location within a supersonic jet flow field. The approach demonstrated in this paper involves the use of a classic response surface methodology design in a unique manner. Additionally a unique application involving the sub‐sampling and replication strategies is developed in a similar manner to those of robust parameter design. The sub‐sampling and replication techniques allow for the ability to systematically account for the precision in mean and variance models of the output response variables. The final design prescribed met the experimental objectives of the project by creating the ability to fit response surfaces and allowing for the experimenters to understand the relative precision of their estimates based on the final sub‐sampling and replication techniques. Results from one section of the region of interest are used to illustrate two different modeling approaches. The performance of both modeling approaches in prediction of new data is illustrated. The conclusions also include a discussion of the future work that will follow. Copyright © 2008 John Wiley & Sons, Ltd.
Obesity‐associated stigma and physiological markers of stress: evidence from the Dominican Republic
Authors: Muennig Peter , Bench Kara Keating
Published: December 2008

Social stigma is increasingly recognized as a cause of stress‐induced pathophysiology. We tested the hypothesis that stigma is associated with obesity‐related morbidity, using a cohort of subjects from the Dominican Republic who value fat bodies over thin ones. We surveyed 87 subjects from Batey Algodón—a small region in the Dominican Republic where obesity is not stigmatized. We obtained information on ideal body norms, perceptions of one's own body and self‐rated health. We also measured height, weight, waist circumference and blood pressure. We then performed linear regression analyses to ascertain the extent to which body mass index (BMI) and body norm perceptions were related to self‐rated health and blood pressure. Self‐rated health was strongly associated with one's satisfaction with his or her physical appearance (p < 0.001) and weight (p < 0.001). As expected, self‐rated health was not independently associated with BMI in this community, which does not stigmatize obesity. However, BMI was nevertheless associated with both systolic and diastolic blood pressure (p < 0.05). While de‐stigmatizing obesity may improve perceptions of health, it might not significantly reduce the incidence of hypertension among heavier persons. Copyright © 2008 John Wiley & Sons, Ltd.
Job stress, job satisfaction and stress‐related illnesses among South African educators
Authors: Peltzer Karl , Shisana Olive , Zuma Khangelani , Van Wyk Brian , Zungu‐Dirwayi Nompumelelo
Published: December 2008

The aim of this study was to explore the relationship between self‐reported job stress and job satisfaction, and the prevalence of stress‐related illnesses and risk factors among educators. A cross‐sectional survey was conducted in a representative sample of 21,307 educators from public schools in South Africa. Results indicate that the prevalence of stress‐related illnesses were 15.6 per cent for hypertension, 9.1 per cent stomach ulcer, 4.5 per cent diabetes, 3.3 per cent minor mental distress, 3.1 per cent major mental distress and 3.5 per cent asthma. The study found considerably high stress levels among educators. Job stress and lack of job satisfaction were associated with most stress‐related illnesses (hypertension, heart disease, stomach ulcer, asthma, mental distress, tobacco and alcohol misuse). From three components of the demand‐control model, two, namely work stress from teaching methods and low peer support, were related to hypertension but not to heart disease. The components of the effort‐reward model of low socio‐economic status and lack of career advancement were both not related to heart disease, and only lack of career advancement was inversely related to hypertension. Most components assessed here of the demand‐control model (including stress with teaching methods and educational system and low peer support) and effort‐reward model (including job insecurity and lack of career advancement) were related to stomach ulcer and mental distress. Copyright © 2008 John Wiley & Sons, Ltd.
Postnatal development and resistance to Plasmodium yoelii infection of mice prenatally exposed to triphenyltin hydroxide
Authors: Delgado Isabella F. , Viana Vanilda G. , Sarpa Marcia , Paumgartten Francisco J. R.
Published: December 2008

In this study, we evaluated the effects of prenatal exposure to triphenyltin hydroxide (TPTH) on the postnatal development of Swiss Webster mice. Females were treated by gavage (0, 7.5 15 and 30 mg TPTH/kg/day) on days 6–17 of gestation. After birth, the progeny was examined for deaths, body weight gain and appearance of developmental landmarks. On postnatal day 50, one male and one female of each litter were inoculated with Plasmodium yoelii and the time‐course of infection was monitored. TPTH was embryolethal at doses ≥15 mg/kg/day. Body weight at birth was decreased, but no alteration of pup body weight was observed after postnatal day 5. Except for an advancement of incisor eruption in the group treated with 15 mg/kg/day, no alteration of somatic development was noted. A shorter latency to peak parasitemia and a reduced malaria‐induced spleen enlargement were observed in mice prenatally exposed to TPTH. In conclusion, prenatal exposure to TPTH at doses ≥15 mg/kg enhanced neonatal lethality, reduced pup birth weight and interfered with the response to infection with P. yoelii in adulthood. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2009.
Business process management with group features in pervasive environments
Authors: He Wei , Wang Haiyang
Published: December 2008

The interaction modality constrained to desktop PC between users and workflow management system is one of the main factors obstructing the wide application of business processes in pervasive computing environments. In addition, the increasingly complicated and flexible group activities have been a salient feature of current business processes. Traditional workflow management systems have difficulties in supporting such features. With the introduction of new modeling methods and the improvement of executing mechanism of traditional workflow model, a group‐enabled workflow management system capable of interacting with users in multiple modalities is designed and implemented. Compared with the traditional workflow modeling methods, this method has more capabilities in describing group activities and makes modeling simpler. This paper introduces the new modeling method for multifold group activities as well as the mechanism supporting interaction between users and systems with multiple modalities. Then some outcomes and findings in the applications of the system are discussed. Copyright © 2008 John Wiley & Sons, Ltd.
Early administration of enzyme replacement therapy for Pompe disease: Short‐term follow‐up results
Authors: Hamdan M. A. , Almalik M. H. , Mirghani H. M.
Published: December 2008

Pompe disease (glycogen storage disease II, OMIM # 232300), is a hereditary lysosomal disorder. It is characterized by deficiency of acid alpha‐glucosidase enzyme (acid maltase, GAA, OMIM *606800, EC 3.1.26.2), secondary to mutations in the GAA gene (HGNC:4065) on chromosome 17q25.2‐q25.3. Absent enzyme activity in the infantile form of Pompe disease results in abnormal glycogen deposition in the skeletal, cardiac, and smooth muscles, leading to hypertrophic cardiomyopathy, feeding abnormalities, hypotonia, weakness, respiratory insufficiency, and ultimately death. Prenatal diagnosis is accomplished by enzyme assay, mutation analysis or electron microscopy of amniotic fluid cells or chorionic villus sample. However, these techniques may not always be available, and can result in perinatal morbidity and fetal loss. Early diagnosis of Pompe disease results in early institution of enzyme replacement therapy (ERT), which minimizes morbidity and prolongs survival. We report the case of a 35‐week part‐of‐twin neonate, whose older sibling died earlier because of infantile Pompe disease. At 32 weeks of gestation, fetal echocardiography showed hypertrophic cardiomyopathy in twin 1, which persisted until birth at 35 weeks of gestation. Diagnosis was confirmed after birth by enzyme assay, and mutation analysis showing homozygosity for the sequence change 1327–2A>G (GAA intr 8). Administration of ERT at 18 h of age, resulted in normalization of cardiac abnormalities within 21 weeks of therapy, and normal neurodevelopmental assessment at 46 weeks, using Griffiths Mental Development Scales. To our knowledge, this is the youngest patient reported to receive ERT for Pompe disease, and the first report of prenatal diagnosis of Pompe disease by fetal echocardiography.
Environmentally Friendly Vegetable Oil Microemulsions Using Extended Surfactants and Linkers
Authors: Do Linh D. , Withayyapayanon Anuradee , Harwell Jeffrey H. , Sabatini David A.
Published: December 2008

Microemulsion formation of triglyceride oils at ambient conditions (temperature and pressure) and without the addition of co‐oil and/or alcohols is challenging at best. Undesirable phases, such as macroemulsions, liquid crystals and sponge phases, are often encountered when formulating triglyceride microemulsions. The purpose of this study is to investigate the use of extended surfactants, lipophilic linkers, and hydrophilic linkers in enhancing triglyceride solubilization and interfacial tension reduction. We have studied two classes of extended surfactants, linear alkyl polypropoxylated sulfate (LAPS) surfactants and linear alkyl polypropoxylated ethoxylated sulfate (LAPES) surfactants. Linkers evaluated were oleyl alcohol (lipophilic linker), sodium mono and dimethyl naphthalene sulfonate (SMDNS), and polyglucoside (hydrophilic linkers). Oils studied include olive, peanut, soybean, canola and sunflower oils. The effect of electrolyte concentration on microemulsion phase behavior was studied. The microemulsion “fish” diagram was obtained by plotting the total surfactant and linker concentrations versus the electrolyte concentration. We were able to form Winsor Type I, II, III and IV microemulsions at ambient conditions and without co‐oil or short and medium chain length alcohol addition. Winsor Type III and IV triglyceride microemulsions are particularly useful in numerous applications such as cosmetics, vegetable oil extraction and soil remediation.
Random Mating amongAnastrepha ludens(Diptera: Tephritidae) Adults of Geographically Distant and Ecologically Distinct Populations in Mexico
Authors: Aluja M. , Rull J. , Pérez-Staples D. , Díaz-Fleischer F. , Sivinski J.
Published: December 2008

The Mexican fruit flyAnastrepha ludens(Loew) (Diptera: Tephritidae) is a polyphagous pestiferous insect with a geographical range encompassing highly variable environmental conditions. Considering that cryptic species have been recently found among South American representatives of the same taxonomic group asA. ludens, we tested whether or not some populations ofA. ludenshave evolved assortative mating as an isolating mechanism that maintains intrapopulation genetic differences and behavioral adaptations to local conditions. Males and females stemming from widely separated locations with similar environmental conditions and males and females stemming from populations within individual-flight range, but collected in different hosts (a native and an exotic one), mated randomly amongst themselves when placed in a field cage. Despite the fact that sibling males and females from two distinct populations also mated randomly amongst themselves, siblings engaged in significantly longer copulations than non-siblings, indicating that perhaps adults discriminated mates with similar genetic compositions. Our results have important practical implications asA. ludensis the most devastating pest of citrus in Mexico and Central America, and large-scale releases of sterile flies are used to control it.
Diversity, distribution and role of wild crucifers in major cabbage and kale growing areas of Kenya
Authors: Kahuthia-Gathu R. , Löhr B. , Poehling H.M. , Mbugua P.K.
Published: December 2008

An investigation of the diversity and distribution of wild crucifer species and their importance for cultivated crucifers was conducted during 2005 and 2006 in the highland and mid-altitude semi-arid areas of Kenya. Thirteen species of wild crucifers in nine genera were recorded:Raphanus raphanistrum,Erucastrum arabicum,Sisymbrium officinale,Crambe kilimandscharica,Capsella bursa-pastoris,Rorippa nudiuscula,Ro. micrantha,Ro. microphylla,Lepidium bonariense,Coronopus didymus,Brassica rapa,B. junceaand an unidentifiedBrassicaspecies. Highland areas had significantly higher species diversity and species richness than mid-altitude semi-arid areas. Species richness, diversity and evenness varied with season and location.Raphanus raphanistrumwas the dominant non-cultivated species in the highlands followed byE. arabicum, which was also present and dominant in the semi-arid study sites. Diamondback moth (DBM) was recorded from ten wild crucifer species andR. raphanistrumandE. arabicumwere the preferred host plant species. Overall, four larval, one larval-pupal and one pupal parasitoid of DBM were recorded:Diadegma semiclausum,D. mollipla, Apanteles sp.,Cotesia plutellae, Oomyzus sokolowskiiandBrachymeriaspecies, respectively.Diadegma semiclausumwas the most dominant species on all crucifers. We conclude that wild crucifers act as alternative hosts for DBM and provide refugia for DBM parasitoids, which risk local extinction through pesticide application or competition from introduced exotic parasitoid species. The wild crucifers also act as recolonization sites for DBM parasitoids.
Factors limiting the species richness of bees in Saharan Africa
Authors: Patiny S. , Michez D. , Kuhlmann M. , Pauly A. , Barbier Y.
Published: December 2008

There is a severe shortage of knowledge of bee biogeography. Some former studies have highlighted a link between bee diversity and xeric ecosystems, but we know practically nothing of the macro-ecological factors driving bee diversity. The present study aims to analyse the main macro-ecological factors driving bee species-richness in the Saharan region. Our dataset includes 25,000+ records for localities in Africa, between 37° and 10°N. Maps and GIS were used to get a first overview of the distribution of the studied taxa. Partial least squares analysis (PLS) was used to study the impact of a set of ecological factors on the bee species richness (SR). The mapping highlighted the clustering of the highest bee SR values in some parts of the Saharan area (e.g. Maghreb, western Africa). In Central Sahara, there is an obvious topological coincidence of the high SR, the local mountain chains and the inland waters. The PLS helped to quantify the relationships between bee SR and a set of eco-climatic variables. It also highlighted a residual variance not explained by the considered descriptors. Our results recover the tight link between bee SR and xeric ecosystems. They also suggest that, within these ecosystems, bee SR is driven by an optimum of the energy-water balance (on which adjustment is allowed by the above gradients).
Diagnostic accuracy of different urine dipsticks to detect urinary schistosomiasis: a comparative study in five endemic communities in Osun and Ogun States, Nigeria
Authors: Ugbomoiko U.S. , Obiezue R.N.N. , Ogunniyi T.A.B. , Ofoezie I.E.
Published: December 2008

The diagnostic accuracy of urine dipsticks was investigated using two different brands in five endemic communities of south-western Nigeria. The BM-5L test was used in 1992 to screen 566 subjects in two communities in Ogun State, while 1457 subjects in three other communities in Osun State were screened with the Combur-9 test in 2006. Haematuria gave a higher prevalence of infection than proteinuria irrespective of which strip brand was used (e.g. BM-5L test: 58.3 and 36.2%; Combur-9 test: 46.5 and 41.9%, respectively). Compared with egg microscopy (gold standard), haematuria identified over 90% of egg-positive samples using either the BM-5L test in 1992 or the Combur-9 test in 2006. The corresponding values for proteinuria were 58% using the BM-5L test and 82% using the Combur-9 test. Sensitivity of haematuria to infection was higher using the BM-5L test (92.4–93.5%) than Combur-9 (58.6–73.3%), while sensitivity of proteinuria to infection was higher using Combur-9 (55.5–80.4%) than BM-5L test (26.0–58.3%). However, both strip brands have comparable specificity for haematuria (BM-5L test, 88.3–99.5%; Combur-9, 88.9–100%) and proteinuria (BM-5L test, 94.4–100%; Combur-9, 98.7–100%) to infection. Based on these results we conclude that neither brand nor manufacturer has a significance effect on the performance of chemical reagent strips. However, the diagnostic value of both haematuria and proteinuria varied according to the positivity level adopted, intensity of infection and age, but was not affected by sex and village of residence.
Impact of antidepressants on the risk of suicide in patients with depression in real-life conditions: a decision analysis model
Authors: Cougnard A. , Verdoux H. , Grolleau A. , Moride Y. , Begaud B. , Tournier M.
Published: December 2008

Background

The impact of antidepressant drug treatment (ADT) on the risk of suicide is uncertain. The aim of this study was to determine in a real-life setting whether ADT is associated with an increased or a reduced risk of suicide compared to absence of ADT (no-ADT) in patients with depression.

Method

A decision analysis method was used to estimate the number of suicides prevented or induced by ADT in children and adolescents (10–19 years old), adults (20–64 years old) and the elderly (⩾65 years) diagnosed with major depression. The impact of gender and parasuicide history on the findings was explored within each age group. Sensitivity analyses were used to assess the robustness of the models.

Results

Prescribing ADT to all patients diagnosed with depression would prevent more than one out of three suicide deaths compared to the no-ADT strategy, irrespective of age, gender or parasuicide history. Sensitivity analyses showed that persistence in taking ADT would be the main characteristic influencing the effectiveness of ADT on suicide risk.

Conclusions

Public health decisions that contribute directly or indirectly to reducing the number of patients with depression who are effectively administered ADT may paradoxically induce a rise in the number of suicides.
A direct proof of the tail variational principle and its extension to maps
Authors: BURGUET DAVID
Published: December 2008

Downarowicz [Entropy structure. J. Anal.96 (2005), 57–116] stated a variational principle for the tail entropy for invertible continuous dynamical systems of a compact metric space. We give here an elementary proof of this variational principle. Furthermore, we extend the result to the non-invertible case.
The Lyapunov spectrum of some parabolic systems
Authors: GELFERT KATRIN , RAMS MICHAŁ
Published: December 2008

We study the Hausdorff dimension for Lyapunov exponents for a class of interval maps which includes several non-hyperbolic situations. We also analyze the level sets of points with given lower and upper Lyapunov exponents and, in particular, with zero lower Lyapunov exponent. We prove that the level set of points with zero exponent has full Hausdorff dimension, but carries no topological entropy.
Databases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease – a comparison of administrative and clinical data
Authors: Welke Karl F. , Karamlou Tara , Diggs Brian S.
Published: December 2008

The introduction of the reporting of medical and surgical outcomes to the public and the potential implementation of initiatives involving pay-for-performance have invigorated debates about the relative benefits of administrative and clinical databases for comparing rates of mortality at the level of the hospital and surgeon. While general agreement exists that public performance report cards must use the highest quality data available, debate continues regarding whether administrative or clinical data should be utilized for this purpose. Clinical databases may contain information more relevant to risk-adjustment, but the currently available clinical databases are voluntary and suffer from validity concerns. Administrative data, however, suffer from inaccuracies of coding and a lack of potentially informative covariates. Particularly problematic to congenital heart surgery is the non-uniform application of coding algorithms to define complex reconstructive procedures for which there is no unique code assignment. The purposes of this manuscript are; therefore, to discuss the relative advantages and limitations of both clinical and administrative data, and to provide a brief introduction to currently available databases germane to the study of congenital cardiac disease.
Making sense of congenital cardiac disease with a research database: The Congenital Heart Surgeons’ Society Data Center
Authors: Hickey Edward J. , McCrindle Brian W. , Caldarone Christopher A. , Williams William G. , Blackstone Eugene H.
Published: December 2008

Background

Challenges inherent in researching rare congenital cardiac lesions led to creation of the Congenital Heart Surgeons’ Society Data Center (Data Center) two decades ago. The Data Center pools experiences from up to 60 institutions, and over 4,700 children have been prospectively recruited within nine diagnostic inception cohorts. This report describes the operations of our research database, with particular focus on analytic strategies employed.

Methods and results

A procedural log is created of all investigations and interventions, and reports from enrolling institutions are subsequently obtained. Cross-sectional follow-up is undertaken annually by the Data Center. All data are linked to the individual child, and quality control mechanisms ensure that completeness and accuracy are maximised. Specific advantages of Data Center analytic approaches include multi-phase parametric hazard analysis, re-sampling techniques for reliable risk factor identification, competing risks methodology, and propensity-adjusted comparisons. Virtues of applying these techniques to a research database are illustrated by clinically pertinent questions that have been addressed in place of what would be difficult through randomised trials.

Conclusions

The Data Center is a cost-effective, versatile tool for researching congenital cardiac surgical outcomes. Research databases are ideally suited to in-depth investigations of survival and functional outcomes. Multi-center propensity-adjusted analyses represent efficient surrogates for randomised trials. Well-designed observational prospective studies should remain a principle mode of researching congenital cardiac disease.
Empowering a database with national long-term data about mortality: the use of national death registries
Authors: Morales David L.S. , McClellan Andrew J. , Jacobs Jeffrey P.
Published: December 2008

The interest of professional medical societies in research about outcomes, mixed with the recent accessibility to management of data on the internet, has moved many societies to create national databases or registries for their specialty. In societies with procedure-based specialties such as surgery, these databases will help with the care of patients by predicting prognosis, defining risk-factors, and aiding with the selection of patients who are the best candidates for these procedures. These databases eventually will also help to establish standards of care. The latter is rapidly growing in importance as governments attempt to create “pay-for-performance” programs in many of the surgical specialties. It is essential to create a database from which a specialty can provide accurate data and standards to its members, its patients, and third parties, such as regulatory bodies and agencies of re-numeration. Unfortunately, surgeons often only care for their patients in the short-term peri-operative period, typically lasting weeks to months; and therefore, the ability of surgeons to create databases with long-term follow-up has been limited. The introduction of “personal health information” into a surgical database, with the intention of linking with other societies or national databases that have long-term follow-up, can remedy this weakness. This article describes the investigation by one surgical society into the available national registries of death and examines their accuracy, accessibility, cost, and their suitability in respect to the goals of that society. The information gathered, the comparisons outlined, and the processes used to determine the best combination of indices of death for this society should be translatable and hopefully useful for other societies and registries who wish to empower their databases with long-term national data about mortality.
Endocrinal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease
Authors: Dickerson Heather , Cooper David S. , Checchia Paul A. , Nelson David P.
Published: December 2008

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the endocrine system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.

As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of endocrinal complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.
Congenital cardiac surgical complications of the integument, vascular system, vascular-line(s), and wounds: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease
Authors: Walters Henry L. , Jeffries Howard E. , Cohen Gordon A. , Klitzner Thomas
Published: December 2008

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to a collection of loosely related topics that include the following groups of complications: 1) Complications of the Integument, 2) Complications of the Vascular System, 3) Complications of the Vascular-Line(s), 4) Complications of Wounds. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.

As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.
The nomenclature of safety and quality of care for patients with congenital cardiac disease: a report of the Society of Thoracic Surgeons Congenital Database Taskforce Subcommittee on Patient Safety
Authors: Jacobs Jeffrey Phillip , Benavidez Oscar J. , Bacha Emile A. , Walters Henry L. , Jacobs Marshall Lewis
Published: December 2008

A large body of literature devoted to “patient safety” and error prevention exists and utilizes a nomenclature that can be applied specifically to the field of congenital cardiac disease and aid in the goals of increasing the safety of patients, decreasing medical error, minimizing mortality and morbidity, and evaluating quality of care. The purpose of this manuscript is to suggest and document a quality of health care taxonomy and the appropriate application of this nomenclature of “patient safety” to the specialty of congenital cardiac disease, with special emphasis on the following ten terms: morbidity, complication, medical error, adverse event, harm, near miss, iatrogenesis, iatrogenic complication, medical injury, and sentinel event. Each of these terms is commonly utilized in the medical literature without universal agreement on their meaning and relationship. It is our hope that the standardization of the definitions of these terms, as they are applied to the analysis of outcomes of the treatments applied to patients with congenital and paediatric cardiac disease, will facilitate improved methodologies to assess and improve quality of care in our profession.
The Ra Mo Che Temple, Lhasa, and the Image of Mi bsKyod rDo rJe: The Narrative of Ri ‘Bur sPrul sKu
Authors: GONKATSANG TSERING , WILLIS MICHAEL
Published: December 2008

Although practicing Buddhists and historians of Tibet are well aware of the Ra Mo Che Temple in Lhasa, very little about the building and its history has been published. Situated a short distance north-west of the more-famous Ra Sa gTsug Lag Khang or Jo Khang, the temple received, according to the dBa' bZhed, the Buddha image brought to Tibet in the time of the Tang princess Ong Jo. Early in the reign of Khri Srong lDe bTsan, while the king was still in his minority, anti-Buddhist factions led by Zhang Ma Zham Khrom Pa sKyes circumscribed royal power and murdered the pro-Buddhist minister Zhang sNa Nam Khri Thong rJe Thang la ‘Bar. They also arranged for the image at Ra Mo Che to be removed from the temple. The plan was to return the Buddha to China, along with the head priest and his entourage. The statue's great weight, however, thwarted the scheme. After being dragged a short distance, the Buddha was left half-buried in the earth. The state of affairs in those days is indicated by dBa' bZhed which reports that the Lhasa vihāra was turned into a workshop with sheep carcasses hung from the arms of the principal holy images and entrails wound round their necks! After Buddhism was reinstated, the Ra Mo Che was returned to worship. Subject to campaigns of refurbishment and additions through the centuries, it was the centre of a number of important developments, notably becoming the seat of the upper Tantric college (rGyud sTod) established by rJe bTsun Kun dGa' Don Drub in 1474.
Iron intake does not significantly correlate with iron deficiency among young Japanese women: a cross-sectional study
Authors: Asakura Keiko , Sasaki Satoshi , Murakami Kentaro , Takahashi Yoshiko , Uenishi Kazuhiro , Yamakawa Miki , Nishiwaki Yuji , Kikuchi Yuriko , Takebayashi Toru ,   the Japan Dietetic Students’ Study for Nutrition and Biomarkers Group
Published: December 2008

Objectives

We evaluated the association of nutrient intake with Fe deficiency with regard to lifestyle factors and health condition in young Japanese women. Uniquely among developed countries, dietary habits render Japanese populations vulnerable to Fe deficiency, owing to their relatively low intake of Fe and high intake of Fe absorption inhibitors, such as green tea and soyabeans.

Design

A cross-sectional study.

Setting and subjects

The subjects were 1019 female Japanese dietetic students aged 18–25 years. Dietary habits during the preceding month were assessed using a previously validated, self-administered, diet history questionnaire. Blood analysis was performed to assess body Fe status. Subjects were categorized with Fe deficiency when their serum ferritin levels were <12 ng/ml. Twenty-nine dietary variables, i.e. intakes of energy, sixteen nutrients including Fe and twelve food groups, were analysed using multivariate logistic regression models adjusted for possible confounders.

Results

Of the subjects, 24·5 % were categorized with Fe deficiency. However, no dietary factors assessed were significantly associated with Fe deficiency. The risk of Fe deficiency was significantly lower in women with infrequent or no menstrual cycles than in those with regular cycles (OR = 0·58; 95 % CI 0·34, 1·00) and significantly higher in women with heavy menstrual flow than in women with average flow, albeit that these were self-reported (OR = 1·83; 95 % CI 1·35, 2·48).

Conclusions

These results suggest that dietary habits, including Fe intake, do not significantly correlate with Fe deficiency among young Japanese women.
Evaluation von Psychotherapien aus der Perspektive von Qualitätssicherung und Qualitätsmanagement
Authors: Hiller Wolfgang , Bleichhardt Gaby , Schindler Amrei
Published: December 2008

Dieser Beitrag befasst sich mit methodischen Fragen, die sich aus den Prämissen des Qualitätsmanagements (QM) für die Evaluation von Psychotherapien unter Routinebedingungen ergeben. Am Beispiel der Poliklinischen Institutsambulanz der Universität Mainz wird aufgezeigt, welche Anforderungen an den Datenerhebungsprozess zu stellen sind und nach welchen Kennwerten die Therapieergebnisse bewertet werden können. Es werden Qualitätskriterien für Datenqualität und Erfolgsmaße vorgeschlagen. Die Ergebnisqualität sollte sowohl mit Hilfe von Mittelwertsveränderungen (und dazugehörigen Effektstärken) als auch durch Response- und Remissionsanalysen (Beurteilung des individuellen Ansprechens auf die Therapie) gemessen werden. Entsprechend des Vorgehens in kontrollierten Therapiestudien wird vorgeschlagen, zwischen Intention-to-Treat- und Completer-Analysen zu unterscheiden. Hierfür sind Kriterien erforderlich, nach denen Therapieabschlüsse als Abbruch oder reguläre Beendigung klassifiziert werden können. Anhand eines Datensatzes von 493 abgeschlossenen Routinetherapien wird demonstriert, dass reine Completer-Analysen tendenziell zu einer Überschätzung der Therapieergebnisse führen. Eine QM-bezogene Evaluation eröffnet die Chance, über langjährige vergleichende Bewertungsprozesse ein realistisches Bild der Therapiequalität zu erhalten und daraus kontinuierliche Verbesserung abzuleiten.
An investigation of internal mixing in a seasonally stratified shelf sea
Authors: Palmer Matthew R. , Rippeth Tom P. , Simpson John H.
Published: December 2008

The shelf sea seasonal thermocline is a critical interface within the marine environment, separating the euphotic zone from nutrient‐rich deep water. Fluxes across the thermocline therefore represent a key biogeochemical pathway. In this paper we quantify the rate of mixing across the seasonal thermocline for a location in the Celtic Sea and investigate the processes responsible for driving thermocline fluxes. Profiles of the rate of dissipation of turbulent kinetic energy (ɛ) show enhanced dissipation within the thermocline region (∼6 × 10−5 W m−3). The diffusivity implied by these measurements is ∼0.5 cm2 s−1, similar to previous shelf sea studies, and is sufficient to explain the observed warming of the deep water, suggesting that vertical mixing is the dominant control on water column structure. Two potential sources of mixing energy are identified, the internal tide and near‐inertial waves. The mechanism of energy transfer from the candidate mixing mechanisms to turbulence is not clear. Thermocline dissipation rates were found to have no Richardson number dependence, but scaled positively with N2 and S2, in agreement with a previous turbulence parameterization. Application of this model to our data does a good job of capturing the mean characteristics of the observed heating flux across the thermocline, although none of the short‐term fluctuations in mixing were reproduced.
Plasma temperature distributions in the heliosheath
Authors: Richardson J. D.
Published: December 2008

Voyager 2 crossed the termination shock (TS) in August 2007 and began observations of the heliosheath. We present the first 400 days of heliosheath plasma data and propose a consistent picture of the energy flow across the TS. Roughly 15% of the plasma flow energy lost at the shock heats the thermal ions and most of the rest of this energy heats the pickup ions. The pickup ions make up roughly 20% of the sheath plasma and have energies of about 6 keV in the heliosheath, consistent with STEREO observations. Relative standard deviations of the proton temperature in the upstream solar wind and in the heliosheath are similar, but this similarity is probably accidental since the temperatures are strongly modified at the termination shock. The temperature fluctuations in the heliosheath may be derived from changes in the TS speed and/or temporal changes in the TS structure.
Combining remote and in situ observations of coronal mass ejections to better constrain magnetic cloud reconstruction
Authors: Owens M. J.
Published: December 2008

Determination of the nonradial extent of magnetic clouds (MCs) is vital for two key reasons. First, it affects the amount of “drag” a fast MC experiences and therefore controls the travel time from the Sun to 1‐AU, a critical parameter for space‐weather prediction. Second, it is vital to estimating the flux content of MCs, which in turn is important for understanding both the formation and eruption of the magnetic flux rope and for determining the role of coronal mass ejections in the heliospheric flux budget and the evolution of heliospheric flux over the solar cycle. In this study, it is demonstrated that the cross‐sectional elongation of MCs is poorly constrained by in situ observations of the magnetic field alone. A method for combining remote and in situ observations of ejecta to better determine MC cross‐sectional elongation is then outlined and applied to a previously studied event which occurred during the SOHO‐Ulysses quadrature of late 1996. The new technique reveals an axial magnetic flux content ∼4 times higher than that inferred by a force‐free flux rope model fit to the same in situ observations of the magnetic cloud. This event also shows evidence of axial distortion by the structured ambient solar wind.
Experimental observations of water‐like behavior of initially fluidized, dam break granular flows and their relevance for the propagation of ash‐rich pyroclastic flows
Authors: Roche O. , Montserrat S. , Niño Y. , Tamburrino A.
Published: December 2008

The physics of ash‐rich pyroclastic flows were investigated through laboratory dam break experiments using both granular material and water. Flows of glass beads of 60–90 μm in diameter generated from the release of initially fluidized, slightly expanded (2.5–4.5%) columns behave as their inertial water counterparts for most of their emplacement. For a range of initial column height to length ratios of 0.5–3, both types of flows propagate in three stages, controlled by the time scale of column free fall ∼(h0/g)1/2, where h0 denotes column height and g denotes gravitational acceleration. Flows first accelerate as the column collapses. Transition to a second, constant velocity phase occurs at a time t/(h0/g)1/2 ∼ 1.5. The flow velocity is then U ∼ (gh0)1/2, larger than that for dry (initially nonfluidized) granular flows. Transition to a last, third phase occurs at t/(h0/g)1/2 ∼ 4. Granular flow behavior then departs from that of water flows as the former steadily decelerates and the front position varies as t1/3, as in dry flows. Motion ceases at t/(h0/g)1/2 ∼ 6.5 with normalized runout x/h0 ∼ 5.5–6. The equivalent behavior of water and highly concentrated granular flows up to the end of the second phase indicates a similar overall bulk resistance, although mechanisms of energy dissipation in both cases would be different. Interstitial air‐particle viscous interactions can be dominant and generate pore fluid pressure sufficient to confer a fluid‐inertial behavior to the dense granular flows before they enter a granular‐frictional regime at late stages. Efficient gas‐particle interactions in dense, ash‐rich pyroclastic flows may promote a water‐like behavior during most of their propagation.