bluuebunny/crossref_metadata_2025 huggingface dataset:
Deviations between observed and RothC‐simulated Δ14C values despite improved IOM initialization
Authors: Shirato Y. , Jomura M. , Wagai R. , Kondo M. , Tanabe K. , Uchida M.
Published: August 2013

The 14C contents and the carbon (C) pool sizes for Rothamsted Carbon (RothC) model pools and soil fractions determined by physical separation and subsequent chemical oxidation were directly compared for an agricultural topsoil (Dystric Cambisol) from a long‐term experimental field in central Japan. The RothC model was run from 1975 to 2009 and the C concentration and Δ14C value of each pool and for the bulk soil were compared with the physical fractions that have been, according to literature, suggested as corresponding with model pools. When compared with the default estimate of the inert organic matter (IOM) pool size derived from an exponential dependency on total organic carbon (TOC), direct estimation of IOM pool size determined from the C remaining after chemical oxidation of the silt plus clay (< 63 µm) fraction improved the model performance for TOC changes over the 34‐year experimental period. The size of each model pool matched that of the physical fractions well, whereas the Δ14C values clearly differed between modelled pools and corresponding physical fractions. The physical fractions showed more negative Δ14C values with 50–190‰ (indicating slower turnover rates) compared with the active pools in RothC, whereas using the oxidation residue generated more positive Δ14C values with 700‰ (faster turnover) than the original RothC IOM pool. These results suggest that (i) the proposed physical fractionation scheme improves the model performance in simulating TOC changes at the temporal scale of decades under the current climate and (ii) long‐term predictions should be interpreted carefully because of the large discrepancy in 14C‐based turnover rate between the physical fractions and RothC model pools.
Psychogenic nonepileptic seizures in children: A review
Authors: Reilly Colin , Menlove Leanne , Fenton Virginia , Das Krishna B.
Published: August 2013

One of the considerations when a child presents with paroxysmal events is psychogenic nonepileptic seizures (PNES). PNES are discernible changes in behavior or consciousness that resemble epileptic seizures but are not accompanied by electrophysiologic changes. They are usually understood as the manifestation of a conversion disorder that reflects underlying psychological distress. There is a lack of population‐based data on the prevalence or incidence of PNES in pediatric populations. The prevalence of PNES in children would appear to be lower than that in the adult population, but the prevalence of PNES seems to increase with age, and nonepileptic paroxysmal events are more likely to be PNES in adolescence than earlier in childhood. In terms of manifestation, PNES in childhood have been described using various categorizations and terminology, making comparisons across studies difficult. There is some evidence that events are more likely to involve unresponsiveness in younger children and prominent motor symptoms in older children. The most common precipitating factors would appear to be school‐related difficulties and interpersonal conflict within the child's family. In terms of psychopathology, children with PNES are at high risk for symptoms of depression and anxiety. Accurate diagnosis of PNES in children is likely to involve taking a comprehensive description of the episodes, garnering the child's medical/developmental history, video‐electroencephalography (video‐EEG) to rule out epileptic seizures, and an evaluation of family functioning. The importance of effective and sensitive communication of the diagnosis of PNES has been emphasized and management approaches will typically involve multidisciplinary efforts to safely manage the events at home and at school. Interventions to reduce the effect of precipitating psychosocial stressors and the involvement of a mental health professional to treat comorbid psychopathology will also form part of an effective management plan. Outcome at follow‐up is reported to be largely positive, although studies have not been able to follow all children, and few studies have focused on predictors of a good outcome. Future controlled intervention studies using a range of outcome measures are needed to identify efficacious approaches and predictors of best outcome.
When local isn't best
Authors: Jones Thomas A.
Published: August 2013

This paper attempts to explain circumstances under which local may be or may not be best. Natural selection may lead to local adaptation (LA), or it may be constrained by gene flow, founder effects, small population size, genetic drift, and archetype. ‘Specialist’ species display greater LA than ‘generalist’ species. Local genotypes are to a certain extent transient, being a consequence of past historical genetic patterns. Two recent meta‐analyses found that while local performance exceeded the performance of a randomly chosen nonlocal population in 71% of comparisons, general adaptation across environments was as frequent as LA. Genotypes for restoration are most likely to be effective if they are adapted to current site conditions. As environmental change accelerates, both globally and locally, exceptions to ‘local is best’ may increase. For these reasons, ‘local is best’ may be better thought of as a testable hypothesis rather than as a general assumption. While either local or nonlocal plant material may be most effective for restoration practice depending on individual circumstances, local material will continue to be the first choice for restoration practitioners whenever this option is feasible and effective.
Isotopic biosignatures in carbonate‐rich, cyanobacteria‐dominated microbial mats of the Cariboo Plateau, B.C.
Authors: Brady A. L. , Druschel G. , Leoni L. , Lim D. S. S. , Slater G. F.
Published: August 2013

Photosynthetic activity in carbonate‐rich benthic microbial mats located in saline, alkaline lakes on the Cariboo Plateau, B.C. resulted in pCO2 below equilibrium and δ13CDIC values up to +6.0‰ above predicted carbon dioxide (CO2) equilibrium values, representing a biosignature of photosynthesis. Mat‐associated δ13Ccarb values ranged from ~4 to 8‰ within any individual lake, with observations of both enrichments (up to 3.8‰) and depletions (up to 11.6‰) relative to the concurrent dissolved inorganic carbon (DIC). Seasonal and annual variations in δ13C values reflected the balance between photosynthetic 13C‐enrichment and heterotrophic inputs of 13C‐depleted DIC. Mat microelectrode profiles identified oxic zones where δ13Ccarb was within 0.2‰ of surface DIC overlying anoxic zones associated with sulphate reduction where δ13Ccarb was depleted by up to 5‰ relative to surface DIC reflecting inputs of 13C‐depleted DIC. δ13C values of sulphate reducing bacteria biomarker phospholipid fatty acids (PLFA) were depleted relative to the bulk organic matter by ~4‰, consistent with heterotrophic synthesis, while the majority of PLFA had larger offsets consistent with autotrophy. Mean δ13Corg values ranged from −18.7 ± 0.1 to −25.3 ± 1.0‰ with mean Δ13Cinorg‐org values ranging from 21.1 to 24.2‰, consistent with non‐CO2‐limited photosynthesis, suggesting that Precambrian δ13Corg values of ~−26‰ do not necessitate higher atmospheric CO2 concentrations. Rather, it is likely that the high DIC and carbonate content of these systems provide a non‐limiting carbon source allowing for expression of large photosynthetic offsets, in contrast to the smaller offsets observed in saline, organic‐rich and hot spring microbial mats.
Potential role of catalase in mice with lipopolysaccharide/D‐galactosamine‐induced fulminant liver injury
Authors: Jia Mengying , Jing Yuping , Ai Qing , Jiang Rong , Wan Jingyuan , Lin Ling , Zhou Dan , Che Qian , Li Longjiang , Tang Li , Shen Yi , Zhang Li
Published: August 2013

Aim

Lipopolysaccharide (LPS)‐induced liver injury in D‐galactosamine (D‐Gal)‐sensitized mice is a well‐established animal model widely used in exploring the pathogenesis of fulminant hepatitis. Increasing evidence has indicated that reactive oxygen species (ROS)‐induced oxidative injury may be involved in LPS/D‐Gal‐induced hepatitis. Catalase (CAT) is a major antioxidant enzyme while aminotriazole (ATZ) is commonly used as a CAT inhibitor. In the present study, the effects of ATZ on LPS/D‐Gal‐induced liver injury were investigated.

Methods

Fuliminant liver injury was induced by intraperitoneal injection of LPS combined with D‐Gal, ATZ was administrated 0.5 h prior to LPS/D‐Gal challenge. The degree of liver injury, the level of hepatic oxidative stress, the grade of hepatic apoptosis and the survival of experimental animals were determined.

Results

Our experimental data showed that treatment with ATZ significantly enhanced LPS/D‐Gal‐induced elevation of serum aspartate transaminase (AST) and alanine transaminase (ALT), exacerbated the hepatic histopathological abnormality and decreased the survival rate of experimental animals. ATZ inhibited the activity of CAT, increased the content of H2O2 and the levels of malondialdehyde (MDA) in liver tissues. In addition, treatment with ATZ also enhanced LPS/D‐Gal‐induced hepatic apoptosis as evidenced by increased caspases activities in liver tissues and increased number of terminal deoxynucleotidyl transferase dUTP nick end labeling positive cells in liver sections.

Conclusion

These findings suggested that CAT might be involved in the progression of LPS/D‐Gal‐induced fulminant liver injury.
Conversion to Islam: A Case Study for the Use of Legal Sources
Authors: Simonsohn Uriel
Published: August 2013

The past few decades have witnessed increasing calls in modern scholarship for revisions of the portrayal of early Islamic rule history. Such calls not only challenge older historiographic paradigms but also encourage historians to seek answers in sources hitherto neglected. Accordingly, in recent years there has been a dramatic proliferation of studies offering new historical conceptions, many of which are indebted to new kinds of source material, including coinage, official documents, inscriptions, and material artifacts, alongside more conventional forms of data like historiographic treatises, biographical dictionaries, apologetic literature, theological essays, and scriptural texts. Assembled together, new and older historical materials were now being processed, synthesized, and analyzed through the lenses of fresh paradigms and often in collaboration with other disciplines, especially the social sciences and comparative literature.

The present contribution offers further support of this latter approach by highlighting the utility of legal sources for discussing the process of conversion to Islam in the early Islamic period. Following a brief historical survey, the discussion turns to address one of the central, yet highly elusive, episodes in early Islamic history – the process of conversion to Islam. The goal of this sample analysis of legal sources is twofold – to provide new historiographic insights, but also, from a methodological perspective, to underscore the remarkable utility of these sources for historians.
Opaque Proliferation: The Historiography of Australia's Cold War Nuclear Weapons Option
Authors: Auton Luke
Published: August 2013

This article looks at Australia's Cold War Interest in Manufacturing or Otherwise Acquiring nuclear weapons. It will examine the development of the historiography and highlight views from the field, including perspectives from disciplines other than history. Its key objective will be to show how these views have informed contemporary observations about nuclear issues in Australia, and question why it is that discussion of such issues invites allusions to everything from previous nuclear weapon ‘ambitions’, to a genuine Australian nuclear weapon programme. This paper will contend that such allusions reflect divergent views in the field, as well as the poor collective capacity of the historiography for depicting the complexity – and denoting the dynamics – of proliferation. The final goal of this paper will be to survey how the historiography is evolving to increasingly bring together the various approaches and judgments on Australia's Cold War nuclear weapons option.
Histological features associated with occult lymph node metastasis in FIGO clinical stage I, grade I endometrioid carcinoma
Authors: Han Guangming , Lim Diana , Leitao Mario M , Abu‐Rustum Nadeem R , Soslow Robert A
Published: August 2013

Aims

Lymph node involvement affects prognosis/treatment in endometrial carcinoma patients. We assessed various histological features associated with nodal metastasis in patients with grade I, stage I endometrial endometrioid carcinoma (EEC).

Methods and results

Eighteen stage I EECs with occult positive lymph nodes and 36 controls were assessed for depth of myoinvasion; microcystic, elongated and fragmented (MELF) pattern of myometrial invasion; lymphovascular invasion (LVI); and epithelial metaplasia. Nodal metastases were subclassified as isolated tumour cells (ITCs; ≤0.2 mm), micrometastasis (>0.2 mm and <2 mm), or macrometastasis (≥2 mm). Node‐positive cases had significantly higher rates of LVI (P < 0.001) and MELF invasion (P = 0.003) on univariate analysis. Only LVI was associated significantly with nodal metastasis on multivariate analysis (P = 0.002). Tumours with MELF invasion demonstrated reduced E‐cadherin expression. Macrometastases were identified in seven cases (39%) with or without micrometastasis/ITCs. Eight (44%) contained only ITCs. Eleven (61%) had histiocyte‐like nodal metastases. Biopsy material from four of six (67%) and five of 17 (29%) cases with and without nodal metastasis showed detached eosinophilic tumour cell buds. Of the former, three were associated with histiocyte‐like nodal metastases – a feature absent in biopsies without tumour budding.

Conclusions

Lymph nodes from grade I EEC exhibiting cellular budding or LVI should be examined for occult metastases, especially in the form of histiocyte‐like cells.
LABORATORY DATABASE POPULATION SURVEILLANCE TO IMPROVE DETECTION OF PROGRESSIVE CHRONIC KIDNEY DISEASE
Authors: Kennedy David M. , Chatha Kamaljit , Rayner Hugh C.
Published: August 2013

Background

Some patients with chronic kidney disease are still referred late for specialist care despite the evidence that earlier detection and intervention can halt or delay progression to end‐stage kidney disease (ESKD).

Objectives

To develop a population surveillance system using existing laboratory data to enable early detection of patients at high risk of ESKD by reviewing cumulative graphs of estimated glomerular filtration rate (eGFR).

Methods

A database was developed, updated daily with data from the laboratory computer. Cumulative eGFR graphs containing up to five years of data are reviewed by clinical scientists for all primary care patients or out‐patients with a low eGFR for their age. For those with a declining trend, a report containing the eGFR graph is sent to the requesting doctor. A retrospective audit was performed using historical data to assess the predictive value of the graphs.

Results

In nine months, we reported 370,000 eGFR results, reviewing 12,000 eGFR graphs. On average 60 graphs per week were flagged as ‘high’ or ‘intermediate’ risk. Patients with graphs flagged as high risk had a significantly higher mortality after 3.5 years and a significantly greater chance of requiring renal replacement therapy after 4.5 years of follow‐up. Five patients (7%) with graphs flagged as high risk had a sustained >25% fall in eGFR without evidence of secondary care referral. Feedback about the service from requesting clinicians was 73% positive.

Conclusions

We have developed a system for laboratory staff to review cumulative eGFR graphs for a large population and identify patients at highest risk of developing ESKD. Further research is needed to measure the impact of this service on patient outcomes.
Ichthyophonus‐infected walleye pollock Theragra chalcogramma (Pallas) in the eastern Bering Sea: a potential reservoir of infections in the North Pacific
Authors: White V C , Morado J F , Friedman C S
Published: August 2013

In 2003, the Alaska walleye pollock industry reported product quality issues attributed to an unspecified parasite in fish muscle. Using molecular and histological methods, we identified the parasite in Bering Sea pollock as Ichthyophonus. Infected pollock were identified throughout the study area, and prevalence was greater in adults than in juveniles. This study not only provides the first documented report of Ichthyophonus in any fish species captured in the Bering Sea, but also reveals that the parasite has been present in this region for nearly 20 years and is not a recent introduction. Sequence analysis of 18S rDNA from Ichthyophonus in pollock revealed that consensus sequences were identical to published parasite sequences from Pacific herring and Yukon River Chinook salmon. Results from this study suggest potential for Ichthyophonus exposures from infected pollock via two trophic pathways; feeding on whole fish as prey and scavenging on industry‐discharged offal. Considering the notable Ichthyophonus levels in pollock, the low host specificity of the parasite and the role of this host as a central prey item in the Bering Sea, pollock likely serve as a key Ichthyophonus reservoir for other susceptible hosts in the North Pacific.
Impact of Interatrial Septum Anatomic Features on Short‐ and Long‐Term Outcomes After Transcatheter Closure of Patent Foramen Ovale: Single Device Type Versus Anatomic‐Driven Device Selection Strategy
Authors: RIGATELLI GIANLUCA , DELL'AVVOCATA FABIO , DAGGUBATI RAMESH , DUNG HO THUONG , NGHIA NGUYEN THUONG , NANJIUNDAPPA ARAVINDA , GIORDAN MASSIMO , CARDAIOLI PAOLO
Published: August 2013

Backgrounds

We reported the short‐ and long‐term results of our institutional single center registry Interatrial Septum Interventions Study (ISIS) about the impact of different anatomic characteristics and related device selection in patent foramen ovale (PFO) closure.

Methods

Over a 9 year period (September 2003–September 2012) we prospectively enrolled 340 consecutive patients (mean age 44 ± 15. 5 years, 198 females) who had been referred to our center for PFO catheter‐based closure. The first 105 patients received a single type of device independently from the anatomy (single device strategy). The remaining 235 patients received a different device based on intracardiac echocardiographic study of interatrial septum anatomy (anatomic strategy).

Results

Immediate success rate was 100% in both groups, whereas the rate of immediate complications was 10.4% and 2.5% (P < 0.01) in the single strategy group and anatomic strategy group, respectively. During a mean follow‐up of 59.3 ± 28.9 months, the occlusion rate was 86.6% and 94%, whereas the incidence of recurrences was 1.8% and 0% in the single device strategy group and anatomic strategy group, respectively.

Conclusion

The results from ISIS registry showed that anatomy of interatrial septum associated with PFO is quite complex leading to an increased rate of complications and a slightly lower closure rate if treated with a single device strategy.
Breastfeeding and maternal weight changes during 24 months post‐partum: a cohort study
Authors: da Silva Maria da Conceição M. , Oliveira Assis Ana Marlúcia , Pinheiro Sandra Maria C. , de Oliveira Lucivalda Pereira Magalhães , da Cruz Thomaz Rodrigues P.
Published: August 2013

The relationship between breastfeeding and the loss of weight gained during pregnancy remains unclear. This study aimed to investigate the association between breastfeeding and maternal weight changes during 24 months post‐partum. We studied a dynamic cohort comprising 315 women living in two cities in the state of Bahia, Brazil. The outcome variable was change in the post‐partum weight; the exposure variable was the duration and intensity of breastfeeding. Demographic, socio‐economic, environmental, reproductive and lifestyle factors were integrated in the analysis as covariates. The data were analysed using multiple linear regression and linear mixed‐effects models. The average cumulative weight loss at 6 months post‐partum was 2.561 kg (SD 4.585), increasing at 12 months (3.066 kg; SD 5.098) and decreasing at 18 months (1.993 kg; SD 5.340), being 1.353 kg (SD, 5.574) at 24 months post‐partum. After adjustment, the data indicated that for every 1‐point increase in breastfeeding score, the estimated average post‐partum weight loss observed was 0.191 kg at 6 months (P = 0.03), 0.090 kg at 12 months (P = 0.043), 0.123 kg at 18 months (P < 0.001) and 0.077 kg at 24 months (P = 0.001). Based on these results, we concluded that despite the low expressiveness, the intensity and duration of breastfeeding was associated with post‐partum weight loss at all stages of the study during the 24‐month follow‐up.
‘Sometimes they fail to keep their faith in us’: community health worker perceptions of structural barriers to quality of care and community utilisation of services in Bangladesh
Authors: Puett Chloe , Alderman Harold , Sadler Kate , Coates Jennifer
Published: August 2013

Community health workers (CHWs) have strong potential to extend health and nutrition services to underserved populations. However, CHWs face complex challenges when working within weak health systems and among communities with limited abilities to access and utilise CHW services. It is crucial to understand these challenges to improve programme support mechanisms. This study describes the results of qualitative investigations into CHW perceptions of barriers to quality of care among two groups of workers implementing community case management of acute respiratory infection, diarrhoea and severe acute malnutrition in southern Bangladesh. We explored systemic barriers to service delivery, pertaining to communities and health systems, which limited the usefulness and effectiveness of CHW services. Focus group discussions (n = 10) were conducted in March 2010. Discussions were analysed for themes related to CHWs' work challenges. Findings highlight several perceived barriers to effective service provision, including community poverty constraining uptake of recommended practices, irregular supplies of medicine from the health facility and poor quality of care for CHW referrals sent there. This study further documents interactions between demand‐side and supply‐side constraints including the influence of health system resource constraints on community trust in CHW services, and the influence of community resource constraints on the utilisation and effectiveness of CHW services. By documenting service delivery challenges from the perspective of the frontline workers themselves, this article contributes evidence to help identify appropriate support mechanisms for these workers, in order to develop scalable and sustainable CHW programmes in countries with under‐resourced public health care infrastructure.
Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review
Authors: Paulis W. D. , Silva S. , Koes B. W. , van Middelkoop M.
Published: August 2013

In order to examine (i) the association between weight status and musculoskeletal complaints (MSC) in children, and (ii) whether overweight and obese children have a higher risk of developing MSC than normal‐weight children Medline, Embase, Web of Science and Cochrane were searched (all years up to 2 January 2013) for observational studies studying direct associations between body mass index (or weight status) and MSC in children.

Forty studies, together studying over one million children, were included. There was moderate quality of evidence that being overweight in childhood is positively associated with musculoskeletal pain (risk ratio [RR] 1.26; 95% confidence interval [CI]: 1.09–1.45). In addition, low quality of evidence was found for a positive association between overweight and low back pain (RR 1.42; 95% CI: 1.03–1.97) and between overweight and injuries and fractures (RR 1.08; 95% CI: 1.03–1.14). Although the risk of developing an injury was significantly higher for overweight than for normal‐weight adolescents (RR: 2.41, 95% CI: 1.42 to 4.10), this evidence was of very low quality.

Overweight and obesity are associated with musculoskeletal pain, injuries and fractures as early as childhood. More high‐quality prospective cohort studies are needed to study the nature of this relationship.
Local application of periodontal ligament stromal cells promotes soft tissue regeneration
Authors: Baik H‐S , Park J , Lee K‐J , Chung C
Published: August 2013

Objectives

To test the potential stimulatory effect of local application of periodontal ligament (PDL) stromal cells on soft tissue regeneration.

Materials and Methods

Fluorescently labeled PDL cells outgrown from extracted human premolars or phosphate‐buffered saline were locally injected to the cutaneous wounds created on mice. Soft tissue regeneration was evaluated for 14 days using photographs and histomorphometry. PDL cell engraftment was tracked with confocal microscopy. To detect the paracrine effect of the PDL cells on soft tissue regeneration, PDL cell‐conditioned medium (CM) was evaluated for the concentration of secretory factors, transforming growth factor‐beta 1 (TGFβ1). The effect of PDL CM on the proliferation and migration of dermal fibroblast and keratinocyte was tested using MTT assay and migration assay.

Results

The application of PDL cells significantly promoted soft tissue regeneration compared with the application of PBS. Self‐replicating PDL cells were engrafted into the hair follicles of the host tissue. Dermal fibroblast proliferation and keratinocyte migration were significantly enhanced by the treatment with PDL CM. Physiologically significant amount of TGFβ1 was secreted from PDL cells into the CM.

Conclusion

Local injection of PDL cells promoted soft tissue regeneration in part by the enhancement of fibroblast proliferation and keratinocyte migration through a paracrine mechanism.
Study on post‐operative complications after outpatient treatments
Authors: van der Sleen J.M. , van Gool A.V. , de Lange J.
Published: August 2013

Aim

This study analyses the post‐operative telephone contacts and complications after minor surgery.

Material and methods

In a prospective study design, all patients who underwent oral surgery in the outpatient clinic were included, and post‐operative telephone contacts and complications were recorded. The surgical interventions were divided into four groups: removal of third molars, apicectomies, placement of implants and removal of teeth other than third molars. The following characteristics were registered for each patient: gender, age, smoking habit, medical status, duration of the surgery, location of the interventions (upper or lower jaw), surgical difficulty classification and the number of teeth extracted.

Results

In total, 1080 patients were included: 526 third molar extractions, 122 apicectomies, 123 implants and 309 extractions of other teeth. There were significantly more post‐operative telephone contacts and complications associated with longer surgeries (P = 0.025 and 0.014), treatment in the mandible (P = 0.024 and 0.041) and surgical complexity of third molar extractions (P = 0.013 and 0.005).

Conclusions

Overall, increasing age, gender, medical status and smoking habit were not identified as risk factors. In conclusion, there were significantly more telephone calls and post‐operative complications associated with difficult mandibular third molar extractions that required longer surgical times.
Epiduroscopy for Patients With Lumbosacral Radicular Pain
Authors: Kallewaard Jan Willem , Vanelderen Pascal , Richardson Jonathan , Van Zundert Jan , Heavner James , Groen Gerbrand Jan
Published: August 2013

Lumbosacral radicular pain is a pain in the distribution area of one of the nerves of the lumbosacral plexus, with or without sensory and/or motor impairment. A major source of lumbosacral radicular pain is failed back surgery, which is defined as persistent or recurrent pain, mainly in the region of the lower back and legs even after technically, anatomically successful spine surgeries. If lumbosacral radicular neuropathic pain fails to respond to conservative or interventional treatments, epiduroscopy can be performed as part of a multidisciplinary approach. Epiduroscopy aids in identifying painful structures in the epidural space, establishing a diagnosis and administering therapy. The novelty consists in the use of an epiduroscope to deliver therapies such as adhesiolysis and targeted administration of epidural medications. Clinical trials report favorable treatment outcomes in 30% to 50% of patients. Complications are rare and related to the rate or volume of epidural fluid infusion or inadvertent dural puncture. In patients with lumbosacral radicular pain, especially after back surgery, epiduroscopy with adhesiolysis may be considered (evidence rating 2 B+).
One‐year follow up after admission to an emergency department for drug overdose in Japan
Authors: Ando Shuntaro , Matsumoto Toshihiko , Kanata Sho , Hojo Aya , Yasugi Daisuke , Eto Nobuaki , Kawanishi Chiaki , Asukai Nozomu , Kasai Kiyoto
Published: August 2013

Aim

The aim of the study was to investigate the incidence of and risk factors for repetition of suicidal behavior within a year after admission for drug overdose in Japan.

Methods

Patients admitted to the emergency department of a general public hospital in Tokyo for drug overdose of prescribed medicine and/or over‐the‐counter drugs between March 2008 and February 2009 were followed up after 1 year. Demographic characteristics, previous suicide attempts, and mental health state were examined by self‐report questionnaire and interview at recovery from the initial attempt. Information about suicidal behavior during the follow‐up period was obtained from the outpatient psychiatrists by postal questionnaire 1 year after discharge.

Results

Of 190 patients admitted to the emergency department, 132 patients answered the questionnaire and had the interview. Information about thefollow‐up period for 66 patients was obtained. Of the 66 patients, 28 patients attempted suicide again and two patients committed suicide during the 1‐year follow‐up period. Psychiatric diagnosis of personality disorder and denial of suicidal intent at the time of recovery were associated with increased risk for another suicide attempt. Lethality levels of suicidal behaviors before and after admission were associated with each other.

Conclusion

The rate of fatal and non‐fatal suicide attempt within a year after admission for self‐poisoning was substantial. Psychiatric diagnosis of personality disorder was a risk factor for repetition of suicide attempt. Clinicians should pay attention to the means of previous suicide attempts even though the patient denies suicidal intent at recovery.
Toward a Social Theory of Resilience: Social Systems, Cultural Systems, and Collective Action in Transitioning Forest‐Based Communities
Authors: Lyon Christopher , Parkins John R.
Published: August 2013

Impacts from post‐Fordist and poststaples economic transition in theCanadian natural resource sector have resulted in dramatic challenges to the livelihoods of many rural residents and the viability of many rural communities. This study seeks to understand community response to economic transition through a lens of social ecological resilience. This article puts forwardArcher's theory of cultural morphogenesis as an analogous model of social ecological change that focuses attention on cultural systems, cultural elaboration, and collective action within an adaptive cycle of resilience. With case material from focused ethnographies of two forest‐dependent communities, we identify distinctive interactions between culture and agency over time that condition community response to change, and we make an analytical distinction between the social system and cultural system. These insights point to catalysts for collective action and adaptation within a resilient cultural realm that extend beyond institutional factors such as economic dependency or political opportunity. By integrating culture, we also deepen the social theory contribution to social‐ecological resilience.
The development of an integrated care model for patients with severe or very severe chronic obstructive pulmonary disease (COPD): the COPD–Home model
Authors: Sunde Synnøve , Walstad Rolf Aksel , Bentsen Signe Berit , Lunde Solfrid J. , Wangen Eva Marie , Rustøen Tone , Henriksen Anne Hildur
Published: August 2013

Background

Adherence to guidelines for managing stable chronic obstructive pulmonary disease (COPD) and its exacerbations is inadequate among healthcare workers and patients. An appropriate care model would meet patient needs, enhance their coping with COPD and improve their quality of life (QOL).

Aim

This study aims to present the ‘COPD–Home’ as an integrated care model for patients with severe or very severe COPD.

Model

One principle of the COPD–Home model is that hospital treatment should lead to follow up in the patient's home. The model also includes education, improved coordination of levels of care, improved accessibility and a management plan. One of the main elements of the COPD–Home model is the clear role of the home‐care nurse. Model development is based on earlier research and clinical experience. It comprises: (i) education provided through an education programme for patients and involved nurses, (ii) joint visits and telephone checks, (iii) a call centre for support and communication with a general practitioner and (iv) an individualised self‐management plan including home monitoring and a plan for pharmacological and nonpharmacological interventions.

Conclusion

The COPD–Home model attempts to cultivate competences and behaviours of patients and community nurses that better accord with guidelines for interventions. The next step in its development will be to evaluate its ability to assist both healthcare workers and planners to improve the management of COPD, reduce exacerbations and improve QOL and coping among patients with COPD.
Focused information criterion and model averaging based on weighted composite quantile regression
Authors: Xu Ganggang , Wang Suojin , Huang Jianhua Z.
Published: August 2013

We study the focused information criterion and frequentist model averaging and their application to post‐model‐selection inference for weighted composite quantile regression (WCQR) in the context of the additive partial linear models. With the non‐parametric functions approximated by polynomial splines, we show that, under certain conditions, the asymptotic distribution of the frequentist model averaging WCQR‐estimator of a focused parameter is a non‐linear mixture of normal distributions. This asymptotic distribution is used to construct confidence intervals that achieve the nominal coverage probability. With properly chosen weights, the focused information criterion based WCQR estimators are not only robust to outliers and non‐normal residuals but also can achieve efficiency close to the maximum likelihood estimator, without assuming the true error distribution. Simulation studies and a real data analysis are used to illustrate the effectiveness of the proposed procedure.
Eccentric/concentric training of ankle evertor and dorsiflexors in recreational athletes: Muscle latency and strength
Authors: Keles S. B. , Sekir U. , Gur H. , Akova B.
Published: August 2013

The aim of this study was to investigate the effects of a combined eccentric–concentric exercise program of the ankle evertors and dorsiflexors on the latency time of the peroneus longus and tibialis anterior muscles. Twenty‐four healthy male recreational athletes were admitted to this study and were randomly assigned to either the exercise group (n = 12) or the control group (n = 12). Subjects in the exercise group performed an isokinetic exercise program of the ankle evertors and dorsiflexors in a combined eccentric–concentric mode for 3 days per week for 6 weeks. Before and after the exercise program, muscle reaction times of the peroneus longus and tibialis anterior muscles to sudden supinating maneuvers on a tilting platform, and isokinetic strength of the ankle joint musculature were evaluated. The peroneus longus and tibialis anterior reaction times showed significant (P < 0.01–0.05) reductions following six weeks of intervention in the exercise group. Additionally, eccentric peak torques for the ankle evertor and dorsiflexors represented significant (P < 0.05) increases in the exercise group compared with the control group. The results of this study suggest that it is possible to reduce peroneal and anterior tibial reaction times following a six week eccentric/concentric isokinetic training program in healthy ankles.
Serum paraoxonase 1 activity in dogs: preanalytical and analytical factors and correlation with C‐reactive protein and alpha‐2‐globulin
Authors: Rossi Gabriele , Giordano Alessia , Pezzia Francesca , Kjelgaard‐Hansen Mads , Paltrinieri Saverio
Published: August 2013

Background

Serum activity of paraoxonase (PON1) decreases during inflammation in many species. Little information is available on paraoxon‐based tests and the possible role ofPON1 in dogs.

Objectives

The objectives of the study were to validate an automated paraoxon‐based assay to measurePON1 activity in canine serum, to determine its stability under different storage conditions, to determine a reference interval (RI) in healthy dogs, and to assess whetherPON1 is of comparable diagnostic value as C‐reactive protein (CRP) and α2‐globulins.

Methods

Intra‐assay and inter‐assay imprecision, linearity under dilution (LUD), interference, and storage artifacts were evaluated. APON1RIwas determined for healthy dogs, andPON1 activity, sensitivity, and specificity were compared withCRPand α2‐globulins.

Results

Intra‐ and inter‐assayCVs were below 1.6% and 7.8%, respectively. TheLUDtest fitted the linear model.PON1 activity measurements were increased after addition of hemolysates and lipids, and after storage for 12 hours at room temperature, 72 hours at 4°C, and 6 months at −20°C.PON1 activity andCRPor α2‐globulins did not correlate well.PON1 activity decreased significantly only in dogs with very highCRPconcentrations. In contrast toCRPand α2‐globulins,PON1 activity was not significantly different between dogs with and without inflammation.

Conclusions

The automated paraoxon‐based method to assess serum caninePON1 activity was accurate and precise, but it was influenced by hemolysis, lipemia, and standard storage conditions. In this study, contrarily toCRPand α2‐globulins,PON1 activity did not provide diagnostic value as a negative acute phase protein in dogs.
Design and Experimental Investigation of a Heat Pipe Supported External Cooling System for HT-PEFC Stacks
Authors: Supra Jen , Janßen Holger , Lehnert Werner , Stolten Detlef
Published: August 2013

A 10-cell high-temperature polymer electrolyte fuel cell (HT-PEFC) stack with an active cell area of 200 cm2 has been built up and tested with regard to the temperature distribution from cell to cell and over the active area since not every cell is cooled. Measurements with artificial reformate as a fuel show that the vertical temperature distribution over the active area is sufficiently small, with a maximum of 5.1 K at 550 mA cm−2. Additionally, the temperature gradient from cell to cell is sufficiently small with 10.7 K at 550 mA cm−2. As a result, it can be concluded that the heat pipe supported external cooling is well suited to cool HT-PEFC stacks with large active areas in reformate operation.
Measurements of Rotordynamic Response and Temperatures in a Rotor Supported on Metal Mesh Foil Bearings
Authors: Abraham Chirathadam Thomas , San Andrés Luis
Published: August 2013

Gas bearings in power generation microturbomachinery (MTM) and for automotive turbocharger applications must demonstrate adequate thermal management without performance degradation while operating in a harsh environment. The paper presents rotor surface temperatures and rotordynamic measurements of a rigid rotor supported on a pair of metal mesh foil bearings (MMFBs) (L = 38.1 mm, D = 36.6 mm). In the tests, to a maximum rotor speed of 50 krpm, an electric cartridge heats the hollow rotor over several hours while a steady inlet air flow rate at ∼160 L/min cools the bearings. In the tests with the heater set to a high temperature (max. 200 °C), the rotor and bearing OD temperatures increase by 70 °C and 25 °C, respectively. Most rotor dynamic responses do not show a marked difference for operation under cold (ambient temperature) or hot rotor conditions. A linear rotordynamics structural model with predicted MMFB force coefficients delivers rotor response amplitudes in agreement with the measured ones for operation with the rotor at ambient temperature. There are marked differences in the peak amplitudes when the rotor crosses its (rigid body) critical speeds. The test bearings provide lesser damping than predictions otherwise indicate. Waterfalls of rotor motion show no sub synchronous whirl frequency motions; the rotor-bearing system being stable for all operating conditions. The measurements demonstrate that MMFBs can survive operation with severe thermal gradients, radial and axial, and with little rotordynamic performance changes when the rotor is either cold or hot. The experimental results, accompanied by acceptable predictions of the bearings dynamic forced performance, promote further MMFBs as an inexpensive reliable technology for MTM.
Livestock Origin for a Human Pandemic Clone of Community-Associated Methicillin-Resistant Staphylococcus aureus
Authors: Spoor Laura E. , McAdam Paul R. , Weinert Lucy A. , Rambaut Andrew , Hasman Henrik , Aarestrup Frank M. , Kearns Angela M. , Larsen Anders R. , Skov Robert L. , Fitzgerald J. Ross
Published: August 2013

The importance of livestock as a source of bacterial pathogens with the potential for epidemic spread in human populations is unclear. In recent years, there has been a global increase in community-associated methicillin-resistant
Staphylococcus aureus
(CA-MRSA) infections of healthy humans, but an understanding of the different evolutionary origins of CA-MRSA clones and the basis for their recent expansion is lacking. Here, using a high-resolution phylogenetic approach, we report the discovery of two emergent clones of human epidemic CA-MRSA which resulted from independent livestock-to-human host jumps by the major bovine
S. aureus
complex, CC97. Of note, one of the new clones was isolated from human infections on four continents, demonstrating its global dissemination since the host jump occurred over 40 years ago. The emergence of both human
S. aureus
clones coincided with the independent acquisition of mobile genetic elements encoding antimicrobial resistance and human-specific mediators of immune evasion, consistent with an important role for these genetic events in the capacity to survive and transmit among human populations. In conclusion, we provide evidence that livestock represent a reservoir for the emergence of new human-pathogenic
S. aureus
clones with the capacity for pandemic spread. These findings have major public health implications highlighting the importance of surveillance for early identification of emergent clones and improved transmission control measures at the human-livestock interface.

IMPORTANCE
Animals are the major source of new pathogens affecting humans. However, the potential for pathogenic bacteria that originally were found in animals to switch hosts and become widely established in human populations is not clear. Here, we report the discovery of emergent clones of methicillin-resistant
Staphylococcus aureus
(MRSA) that originated in livestock and switched to humans, followed by host-adaptive evolution and epidemic spread in global human populations. Our findings demonstrate that livestock can act as a reservoir for the emergence of new human bacterial clones with potential for pandemic spread, highlighting the potential role of surveillance and biosecurity measures in the agricultural setting for preventing the emergence of new human pathogens.
Genomic Insights to Control the Emergence of Vancomycin-Resistant Enterococci
Authors: Howden Benjamin P. , Holt Kathryn E. , Lam Margaret M. C. , Seemann Torsten , Ballard Susan , Coombs Geoffrey W. , Tong Steven Y. C. , Grayson M. Lindsay , Johnson Paul D. R. , Stinear Timothy P.
Published: August 2013

Nosocomial outbreaks of vancomycin-resistant
Enterococcus faecium
(VREfm) are thought to occur by transmission of VREfm between patients, predicting that infection control interventions will limit cross-transmission. Despite implementation of such strategies, the incidence of VREfm infections continues to rise. We aimed to use genomics to better understand the epidemiology of
E. faecium
within a large hospital and investigate the reasons for failure of infection control strategies. Whole-genome sequencing was performed on 61
E. faecium
(36 VREfm) isolates, predominately from blood cultures collected at a single hospital between 1998 and 2009, and on five
vanB
-positive anaerobic commensal bacteria isolated from human feces. Phylogenomic analysis and precise mapping of the
vanB
gene, which contains the Tn
1549
transposon, showed that at least 18 of the 36 VREfm isolates had acquired the transposon via independent insertion events, indicating
de novo
generation of VREfm rather than cross-transmission. Furthermore, Tn
1549
sequences found in 15 of the 36 VREfm isolates were the same as the Tn
1549
sequence from one of the gut anaerobes. National and international comparator
E. faecium
isolates were phylogenetically interspersed with isolates from our hospital, suggesting that our findings might be globally representative. These data demonstrate that VREfm generation within a patient is common, presumably occurring in the human bowel during antibiotic therapy, and help explain our inability to reduce VREfm infections. A recommendation from our findings is that infection control practices should include screening patients for specific hospital clones of vancomycin-susceptible
E. faecium
rather than just VREfm.

IMPORTANCE
Enterococcus faecium
is an increasingly important human pathogen causing predominantly antibiotic-resistant infections in hospitalized patients. Large amounts of health care funding are spent trying to control antibiotic-resistant bacteria in hospitals globally, yet in many institutions around the world, vancomycin-resistant
E. faecium
(VREfm) infections continue to rise. The new findings from this study help explain the failures of our current approaches to controlling
vanB
VREfm in health care institutions. Given the importance of this bacterium as a cause of hospital-acquired infections and the difficulties faced by infection control units in trying to prevent colonization in their institutions, the novel findings from this study provide evidence that a new approach to controlling VREfm in hospitals is required. In particular, more attention should be given to understanding the epidemiology of hospital-adapted vancomycin-susceptible
E. faecium
, and patients at higher risk for
de novo
generation of VREfm need to be identified and optimally managed.