bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated screening for tuberculosis by multiparametric analysis of data obtained during routine complete blood count
Authors: Park J. , Lee H. , Kim Y.‐K. , Kim K. H. , Lee W. , Lee K.‐Y. , Park Y.‐J. , Kahng J. , Kwon H. J. , Kim Y. , Oh E.‐J. , Lim J. , Kim M. , Han K.
Published: September 2013

Introduction

The main goal of this study was to develop a multiparametric cell population data (CPD) model that combines information from several morphologic parameters generated by DxH800, in addition to the traditional parameters regularly reported in the CBC‐diff, and to test the performance of this model in screening the general population for primary tuberculosis (TB).

Methods

A total of 3741 study cases were divided into two groups, test and validation set at cut‐off value of 6000 WBCs/μL. We developed multiparametric model for primary TB screening (TB hemeprint), selected CPD, and calculated parameters which could discriminate primary TB from other non‐TB diseases and normal control in test set. We applied it to the validation set, which was a set of completely different samples, to test its reproducibility if applied to a routine laboratory test.

Results

After screening primary TB using TB hemeprint, sensitivity, specificity, PPV, and NPV were 85.4%, 89.6%, 31.1%, and 99.1%, respectively, in primary TB with lower than 6000 WBCs/μL of test set (test set‐L). In primary TB with higher than 6000 WBCs/μL of test set (test set‐H), those values were 83.1%, 85.6%, 29.7%, and 98.6%, respectively. There were only 0.4% (2/461) and 0.6% (2/326) of normal control samples included in test set‐L and ‐H, respectively. Diagnostic efficiencies except sensitivity in each validation set were very comparable with those in each test set.

Conclusion

Tuberculosis hemeprint may allow us to screen primary TB with acceptable sensitivity and specificity using combination of TB‐specific CPD and calculated parameters.
Australian caregivers’ management of childhood ailments
Authors: Hietbrink Elsa , Bakshi Ruchi , Moles Rebekah J
Published: September 2013

Aim

To profile medication dosing behaviour of caregivers of children aged 5 years and under in fever and cough/cold management.

Methods

Caregivers (n = 97), recruited from childcare centres in Sydney, Australia, were presented two scenarios in a face to face consultation with the researcher, requiring them to make decisions about the management of a child, including medicine dosing. Accuracy of doses and appropriateness of management were documented. Focus groups explored factors surrounding caregivers’ skills.

Results

In the fever scenario, 45% (44/97) chose to medicate when temperature was below 38°C. Many measured incorrect doses and stated inappropriate dosage intervals. Only 23% managed the scenario appropriately. In the cough/cold scenario, 43% (38/89) chose to medicate. Overall, only 35% (45/127) of dose measurements observed were accurate based on the child's weight. Focus groups revealed that caregivers are not aware of risks associated with children's medicines and when to medicate.

Conclusions

The ability of caregivers to accurately measure and administer doses is important. Determining the motivations to use medicines, as well as dosing behaviours is necessary to improve the quality use of medicines.
Intracluster Correlation Coefficients and Reliability of Randomized Multicenter Stroke Trials within VISTA
Authors: Frank Benedikt , Fulton Rachael L. , Goldie Fraser C. , Hacke Werner , Weimar Christian , Lees Kennedy R. ,   for the VISTA Collaborators
Published: September 2013

Background

Reliable estimates of intracluster correlation coefficients (ICCs) for specific outcome measures are crucial for sample size calculations of future cluster randomized trials. ICCs indicate the proportion of data variability that is explained by defined levels of clustering.

Aims

In this manuscript, we present potentially valuable and reliable estimates of ICCs for specific baseline and follow-up data.

Method

ICCs were estimated from linear and generalized linear mixed models using maximum likelihood estimation for common measures used in stroke research, including modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index (BI).

Results

Data were available for 11 841 patients with ischemic stroke from 11 randomized trials. After adjusting for age, thrombolysis, and baseline NIHSS, the median ICC for follow-up data, using center as the level of clustering, ranged from 0·007 to 0·041. The ICCs using trial, continent or year of enrollment as level of clustering were distinctly lower. Less than 1% of the variability of mRS, NIHSS, and BI was explained by any of these three cluster levels.

Conclusion

This compendium of relevant ICC estimates should assist trial planning. For example, the sample size for a cluster trial with 150 patients per center using ordinal analysis of mRS should be inflated by 2·0 due to the ICC of 0·007; whereas the ICC of 0·031 using mRS dichotomized above mRS 0–1, requires inflation by 5·6. The low contribution of trials, year or continent of enrollment to overall variation in outcome offers reassurance that analyses using pooled data from multiple trials in VISTA are unlikely to suffer from bias from these sources.
Volunteer unrelated donor experience after administration of filgrastim and apheresis for the collection of haemopoietic stem cells: the Australian perspective
Authors: Gordon S. V. , Nivison‐Smith I. , Szer J. , Chapman J. R.
Published: September 2013

Background

Voluntary donations of peripheral blood stem cells after administration of filgrastim (granulocyte‐colony stimulating factor, G‐CSF) are undertaken throughout the world by healthy individuals, but the short‐, medium‐ and long‐term adverse events during and after donation are not fully understood.

Aims

We document the experience of donors of peripheral blood stem cells mobilised by G‐CSF at Australian Bone Marrow Donor Registry collection centres.

Methods

When the Australian Bone Marrow Donor Registry commenced collecting mobilised peripheral blood stem cells, based on data used for registration of G‐CSF, all adverse reactions in donors were documented prospectively to determine the rate and severity of events. A total of 512 consecutive first‐time donors assessed between July 2001 and March 2010 were included in this study.

Results

The median age at work‐up was 40 years and 71% of donors were male. A large proportion of donors (91%) experienced bone pain during administration of G‐CSF, and in fewer numbers headache (61%) and fatigue (61%). Bone pain was associated with a body mass index of overweight/obese (P = 0.03). Headache (P = 0.03), muscle pain (P = 0.03) and fatigue (P = 0.001) were all significantly associated with female sex. More than a quarter (28%) of donations involved a range of complications at collection.

Conclusion

The incidence of short‐ and medium‐term symptoms and events observed provide support for the information provided to unrelated donors at counselling. Follow up of the consequences of unrelated voluntary donation remains important to provide accurate and relevant information to prospective donors.
Inactivated influenza virus vaccine is efficient and reduces IL‐4 and IL‐6 in allergic asthma mice
Authors: Jian You‐Ru , Chang Sui‐Yuan , Lin Pin‐Yi , Yang Yao‐Hsu , Chuang Ya‐Hui
Published: September 2013

Background

Allergic asthma is a globally respiratory inflammatory disease. Influenza virus is a respiratory pathogen that causes yearly epidemics and results in high rates of morbidity and mortality. Patients with allergic asthma had a more severe symptom and a higher mortality when they were infected with influenza virus. Hence, influenza vaccination is recommended for patients with asthma.

Objectives

We evaluated the efficacy and effects of influenza vaccination on allergic asthma in a mouse model.

Methods

Ovalbumin‐immunized mice were inoculated with inactivated influenza virus A/Puerto Rico/8/34 (PR8) as vaccines and morbidity or mortality and allergic asthma features of these mice were analyzed.

Results

Mice inoculated with inactivated PR8 induced high levels of anti‐PR8 IgG2a and upregulation of Toll‐like receptor (TLR) 7. Vaccinated allergic mice were healthy when they were challenged with live influenza virus while none of non‐vaccinated allergic mice survived. Furthermore, inactivated influenza virus vaccine induced neither extra airway inflammation nor asthma features such as IgE, airway hyper‐reactivity, and eosinophilia in allergic mice. Particularly, decreased frequency of immune cell infiltrated airways and Th2 cytokines IL‐4 and IL‐6 production in the bronchoalveolar lavage fluid were noted in vaccinated allergic mice. These results suggested that inactivated influenza virus vaccine is efficient to protect allergic mice from further influenza infection, and it does not exacerbate but reduces IL‐4 and IL‐6 of allergic asthma.

Conclusion

Influenza vaccination is essential and efficient for allergic subjects to protect influenza virus infection.
Pension Reform in Atlanta: Funding Past Promises in an Uncertain Future
Authors: GEHL SARAH BETH , WILLOUGHBY KATHERINE G. , BELL MICHAEL J.
Published: September 2013

This research assesses state and local pensions in the U.S. Concerns of locally administered pensions are addressed; actions taken and possible reforms to these plans are noted. Then, recent pension reform in Atlanta, Georgia is examined. In 2009, Atlanta had the 12th lowest funding ratio for its general employee fund compared to all other city plans in Georgia. Atlanta's story explains the depths of its pension problems, how the pension got into trouble and the changes necessary to advance fiscal sustainability. Such plans will require strict discipline by politicians, pension boards and financial managers, and tempering member expectations to reach sustainability.
The Impact of Budget Stabilization Funds on State Pension Contributions
Authors: ST.CLAIR TRAVIS
Published: September 2013

Despite the shortfalls in public employee pension funds, there is little known about the effect of fiscal institutions on pension funding. This paper focuses attention on the link between pension contributions and budget stabilization funds (BSFs) over the period 1997–2008. It employs the Blundell–Bond (1998) estimator in order to address the concern that the deposit and withdrawal rules that drive the management of BSFs may be endogenous to state pension contributions. Empirical results suggest that BSFs with strict deposit rules are associated with higher pension contributions, while strict withdrawal rules are associated with lower contributions.
The Management of Defined Contribution Pension Plans in Local Government
Authors: CHEN GANG , EBDON CAROL , KRIZ KENNETH A. , LAFORGE OLIVIER MAISONDIEU
Published: September 2013

Despite the growing importance of defined contribution pension plans in state and local governments, little research exists on how those plans are actually managed. Our study fills a gap in the literature through using a mixed‐methods approach on a sample of local governments in Nebraska. We employ a mail‐out survey to get broad‐based information on DC plan administration throughout the state, and use face‐to‐face interview techniques on a subsample of plans to investigate the details of plan management. We find several deviations from promulgated best practices, and substantial variation in administrators' knowledge of and role perception related to DC plans.
The Opportunity Cost of Public Funds: Concepts and Issues
Authors: MASSIANI JÉRÔME , PICCO GABRIELE
Published: September 2013

This paper reviews the main conceptual issues regarding the notion of Opportunity Cost of Public Funds (OCPF) and its use in normative economics. Despite the importance of the mechanisms it illustrates, the OCPF still has received too marginal attention in public economics literature and is often handled with some definitional ambiguity. Our review indicates that the core of the notion lies in the deadweight loss and, to a minor extent, in administrative costs, while other aspects like crowding out are more controversial. Moreover, we argue that the financing mechanisms of the public expenditures should be considered for a proper analysis and quantification of OCPF and suggest that public expenditures are generally financed through the displacement of funds from alternative uses. We conclude with a review of available quantifications.
Assessing the Relationship Between Objective and Subjective Measures of Fiscal Condition Using Government‐Wide Statements
Authors: MAHER CRAIG S. , DELLER STEVEN C.
Published: September 2013

Government Accounting Standards Board (GASB) Statement 34 has been in effect for a decade yet there is limited research examining government‐wide financial reporting data. This study builds on our ability to delve into the fiscal condition of Wisconsin counties during the Great Recession. The principal aims of the research are: (1) expand on works utilizing GASB 34 reporting requirements; (2) report on county administrators perceptions of fiscal condition; and (3) examine the relationship between subjective and objective measures of fiscal condition. We find little evidence that objective fiscal condition indices are related to subjective administrative assessments of fiscal condition.
Exploitation, Justice, and Parity in International Clinical Research
Authors: Panitch Vida
Published: September 2013

Consensus is lacking among research ethicists on the question of how broadly to understand the requirements of non‐exploitation in international clinical research. Two types of principles have been proposed, minimalist and non‐minimalist, grounded in two opposing conceptions of exploitation, transactional and systemic. Transactionalists have offered principles, which, it has been argued, are satisfied by minimal gains to vulnerable subjects measured against an unjust status quo. Systemicists have advanced principles with decidedly non‐minimal mandates but only by conflating the obligations of clinical research with those of First World citizenship. My aim here is to break this deadlock by offering grounds for a non‐minimal requirement of international research ethics grounded in a transactional conception of exploitation. I do this by arguing that a subject's gains must be measured not only within the transaction, relative to her own starting point and to the share of gains enjoyed by her co‐transactor, but also across transactions, so as to ensure parity of benefit to trial participants whenever, and wherever, parity of burden is assumed.
One Year Incidence of Iatrogenic Atrial Septal Defect After Cryoballoon Ablation for Atrial Fibrillation
Authors: SIEIRA JUAN , CHIERCHIA GIAN‐BATTISTA , DI GIOVANNI GIACOMO , CONTE GIULIO , DE ASMUNDIS CARLO , SARKOZY ANDREA , DROOGMANS STEVEN , BALTOGIANNIS GIANNIS , SAITOH YUKIO , CICONTE GIUSEPPE , LEVINSTEIN MOISES , BRUGADA PEDRO
Published: September 2013

Atrial Septal Defect After AF Cryoballoon Ablation

Introduction

Pulmonary vein (PV) isolation by means of cryoballoon (CB) technology is an effective treatment for symptomatic paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drug therapy. The CB requires a 15F transseptal sheath that may lead to the creation of a iatrogenic atrial septal defect (IASD).

Methods and Results

Individuals having undergone PV isolation by the means of CB ablation and a subsequent transesophageal echocardiography (TEE) examination during postablation follow‐up were consecutively included. Thirty‐nine patients formed the study group (31 male, 76.9%; mean age 57.4 ± 13.7 years). IASD was present in 8 (20%) of them after a mean follow‐up time of 11.7 months. Mean diameter of the defect was 0.57 cm × 0.48 cm; only left to right shunt was observed. No adverse events were recorded in these patients during the follow‐up.

Conclusion

IASD after CB ablation of AF is present in up to 20% of patients after 1 year. Although no adverse clinical events were recorded in patients with persistence of IASD, this complication should not be underestimated and systematic echocardiographic examinations might be advised at regular intervals in the follow‐up period after CB. Further studies with larger population and follow‐up might be required to confirm our findings.
Value of Serial Heart Rate Variability Measurement for Prediction of Appropriate ICD Discharge in Patients with Heart Failure
Authors: TEN SANDE JUDITH N. , DAMMAN PETER , TIJSSEN JAN G.P. , DE GROOT JORIS R. , KNOPS REINOUD E. , WILDE ARTHUR A.M. , VAN DESSEL PASCAL F.H.M.
Published: September 2013

HRV and Appropriate ICD Shock in Heart Failure

Introduction

Decreased heart rate variability (HRV) is associated with adverse outcomes in patients with heart failure. Our objective was to examine whether decreased HRV predicts appropriate implantable cardioverter defibrillator (ICD) shocks.

Methods and Results

In 105 patients with a Boston Scientific Contak Renewal, Cognis or Energen device implanted for either primary (73.3%) or secondary prevention (26.7%), time domain HRV variables standard deviation of averages of normal beat‐to‐beat interval (SDANN) and footprint percentage (FPP) were collected at baseline and during follow‐up. In case of appropriate shock, HRV before shock was assessed. Using time‐dependent Cox regression models, the relation between median‐based dichotomized SDANN or FFP and appropriate shock was investigated.

Baseline characteristics between patients with or without shocks were similar, with exception of secondary prevention patients using more often antiarrhythmic drugs. During follow‐up (median 451, IQR 202–1,460 days), appropriate shocks occurred in 20 (19%) patients. SDANN and FPP did not differ significantly at baseline between patients with or without shocks (respectively, P = 0.18 and P = 0.78). However, time‐dependent Cox regression analysis showed a trend that patients were at lower risk for appropriate shock (SDANN: HR 0.43, 95% CI [0.18–1.05], P = 0.06 and FPP: HR 0.49, 95% CI [0.20–1.20], P = 0.12) when HRV values were above median baseline value during follow‐up.

Conclusions

These results imply that HRV could be an independent predictor for appropriate shocks. Therefore, low HRV could be of additional use in predicting imminent appropriate shocks and could possibly guide concomitant medical therapy.
A Multicenter Study of Shock Pathways for Subcutaneous Implantable Defibrillators
Authors: KUSCHYK JÜRGEN , MILASINOVIC GORAN , KÜHLKAMP VOLKER , ROBERTS PAUL R. , ZABEL MARKUS , MOLIN FRANCK , SHOROFSKY STEPHEN , STROMBERG KURT D. , DEGROOT PAUL J. , MURGATROYD FRANCIS D.
Published: September 2013

Subcutaneous Defibrillation

Introduction

A purely subcutaneous implantable cardioverter defibrillator (ICD) requires higher energy but may be an effective alternative to transvenous ICDs to deliver lifesaving therapies.

Objective

To identify combinations of anteroposterior subcutaneous shock pathways and waveforms with defibrillation efficacy comparable to transvenous ICDs.

Methods

Defibrillation testing was performed in 141 patients temporarily implanted with an active can emulator and subcutaneous coil electrodes. The patients were subdivided into 5 groups within 2 study phases. In all groups, a posterior electrode was positioned with its tip close to the spine. In the first study phase, 2 different can locations were evaluated: (1) an inframammary pocket (IM‐1–750), or (2) a conventional infraclavicular pocket (IC‐1–750). In both cases, a 70 J biphasic shock was used (peak voltage 750 V; 270 μF capacitance). In the second phase, configuration IC‐1–750 was enhanced by the addition of a second (parasternal) subcutaneous electrode (IC‐2–750). Furthermore, the effects of a different 70 J shock waveform (1,000 V, 160 μF) were evaluated for configurations IM‐1–750 and IC‐2–750 (becoming IM‐1–1000 and IC‐2–1000).

Results

The proportion of patients satisfying a defibrillation safety margin test of 2 consecutive successes at ≤50 J was 74%, 11%, and 44%, respectively, for the IM‐1–750, IC‐1–750, and IC‐2–750 configurations, and 93% and 86% for the IM‐1–1000 and IC‐2–1000 configurations.

Conclusions

Defibrillation efficacy comparable to that of a transvenous system was achieved with an anteroposterior subcutaneous ICD configuration, with 160 μF capacitance, 1,000 V, and 70 J output. An infraclavicular pocket location becomes feasible if a parasternal subcutaneous coil is added.
Number of circulating pro‐angiogenic cells, growth factor and anti‐oxidative gene profiles might be altered in type 2 diabetes with and without diabetic foot syndrome
Authors: Nowak Witold N , Borys Sebastian , Kusińska Katarzyna , Bukowska‐Strakova Karolina , Witek Przemysław , Koblik Teresa , Józkowicz Alicja , Małecki Maciej Tadeusz , Dulak Józef
Published: September 2013

Aims/Introduction

Type 2 diabetes is often complicated by diabetic foot syndrome (DFS). We analyzed the circulating stem cells, growth factor and anti‐oxidant gene expression profiles in type 2 diabetes patients without or with different forms of DFS.

Materials and Methods

Healthy volunteers (n = 13) and type 2 diabetes patients: (i) without DFS (n = 10); or with (ii) Charcot osteoneuropathy (n = 10); (iii) non‐infected (n = 17); (iv) infected (n = 11); and (v) healed ulceration were examined (n = 12). Peripheral blood endothelial progenitor cells (EPC), mesenchymal stem cells (MSC), hematopoietic stem cells (HSC) and very small embryonic‐like (VSEL) cells were phenotyped using flow cytometry. Plasma cytokine concentrations and gene expressions in blood cells were measured by Luminex and quantitative real‐time polymerase chain reaction assays, respectively.

Results

Patients with non‐complicated type 2 diabetes showed reduced HMOX1 expression, accompanied by HMOX2 upregulation, and had less circulating EPC, MSC or HSC than healthy subjects. In contrast, VSEL cells were elevated in the type 2 diabetes group. However, subjects with DFS, even with healed ulceration, had fewer VSEL cells, more CD45‐CD29+CD90+MSC, and upregulated HMOX1 when compared with the type 2 diabetes group. Patients with Charcot osteopathy had lowered plasma fibroblast growth factor‐2. Elevated plasma tumor necrosis factor‐α and decreased catalase expression was found in all diabetic patients.

Conclusions

Patients with type 2 diabetes and different forms of DFS have an altered number of circulating stem cells. Type 2 diabetes might also be associated with a changed plasma growth factor and anti‐oxidant gene expression profile. Altogether, these factors could contribute to the pathogenesis of different forms of DFS.
From gelatinous to muscle food chain: rock cod Patagonotothen ramsayi recycles coelenterate and tunicate resources on the Patagonian Shelf
Authors: Arkhipkin A. , Laptikhovsky V.
Published: September 2013

Stomach contents of 4808 fishes of 20 species caught in the eastern part of the Patagonian Shelf between 1999 and 2012 were analysed to assess dietary contributions of gelatinous plankton resources. Gelatinous plankton occurred in diets of seven species with two species, Patagonotothen ramsayi and Squalus acanthias, having >10% ctenophores in their diet. Consumption of gelatinous plankton was important in P. ramsayi and was strikingly seasonal, with maximum occurrence (up to 46% of non‐empty stomachs) in late summer to autumn. Ctenophores were most abundant in P. ramsayi of 25–34 cm total length, LT, whereas salps were more frequent in larger >35 cm LT individuals. In winter to spring, occurrence of gelatinous plankton in diets was minimal, reflecting their overall seasonal abundance in the ocean. The recent increase in abundance of P. ramsayi has enabled the species to recycle a significant proportion of the ecosystem production from gelatinous dead end to the main muscular food chain via seasonal reliance on ctenophores, jellyfish and tunicates. This additional influx of production that has been diverted from the gelatinous food chain favours the increase in abundance of several piscivorous top predators and affects the trophic web structure of the Patagonian Shelf ecosystem.
Global fishmeal and fish‐oil supply: inputs, outputs and marketsa
Authors: Shepherd C. J. , Jackson A. J.
Published: September 2013

Recent data on fishmeal and fish‐oil supply are presented identifying key producer countries and raw material sources and distinguishing between whole fish and by‐products. The conversion of these raw materials into marine ingredients is discussed and global volumes presented. This is followed by a summary of the main countries using these marine ingredients over recent years. Uses of fishmeal and fish‐oil by market segment are then presented. From this, a global mass balance of inputs and outputs is derived which allows the calculation of the input‐to‐output ratios (fish in:fish out; FIFO) for the main aquaculture production types to be made. Current areas of focus by the industry include the need to demonstrate sustainable practice, more strategic use of marine ingredients, greater use of fishery and land‐animal by‐products as well as vegetable substitutes, and novel sources of essential omega‐3 fats, notably the long‐chain polyunsaturated fatty acids, eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. Implications are drawn for future supply prospects of fishmeal and fish‐oil and their future role in aquaculture, agriculture and human health.
Executive dysfunction in Parkinson's disease: A review
Authors: Dirnberger Georg , Jahanshahi Marjan
Published: September 2013

Executive dysfunction can be present from the early stages of Parkinson's disease (PD). It is characterized by deficits in internal control of attention, set shifting, planning, inhibitory control, dual task performance, and on a range of decision‐making and social cognition tasks. Treatment with dopaminergic medication has variable effects on executive deficits, improving some, leaving some unchanged, and worsening others. In this review, we start by defining the specific nature of executive dysfunction in PD and describe suitable neuropsychological tests. We then discuss how executive deficits relate to pathology in specific territories of the basal ganglia, consider the impact of dopaminergic treatment on executive function (EF) in this context, and review the changes in EFs with disease progression. In later sections, we summarize correlates of executive dysfunction in PD with motor performance (e.g., postural instability, freezing of gait) and a variety of psychiatric (e.g., depression, apathy) and other clinical symptoms, and finally discuss the implications of these for the patients’ daily life.
Comparing accuracy of the Yale swallow protocol when administered by registered nurses and speech‐language pathologists
Authors: Warner Heather L , Suiter Debra M , Nystrom Karin V , Poskus Kelly , Leder Steven B
Published: September 2013

Aims and objectives

(1) To describe the results of a web‐based teaching module used by registered nurses to identify patients at risk of aspiration and (2) to determine accuracy of the registered nurse‐administered 3‐ounce water swallow challenge protocol, that is, drinking three ounces of water, a basic cognitive screen and oral mechanism evaluation, when compared with blinded ratings from speech‐language pathology.

Background

Early identification of potential swallowing problems is important prior to ingestion of food, fluid and medications. Unfortunately, current nurse‐administered screens use a variety of non‐evidence‐based assessments. It would be beneficial to use a valid, reliable and evidence‐based screen, that is, the Yale swallow protocol.

Design

Prospective, blinded, referral‐based.

Methods

Fifty‐two registered nurses and 101 inpatients participated. First, each participant was administered the 3‐ounce water swallow challenge protocol by a speech‐language pathologist. Second, a nurse administered the protocol to the same patient within one hour and independently recorded results and diet recommendations. The nurse was blinded to the study's purpose and results of the speech‐language pathologist's initial screening. Out of view, but simultaneous with the nurse‐administered protocol, a speech‐language pathologist rerated the patient's challenge for comparison with initial results and determined the accuracy of the nurse‐administered protocol.

Results

Intra‐ and inter‐rater protocol agreements for the two speech‐language pathologists were 100%. Inter‐rater protocol agreement between registered nurses and speech‐language pathologists was 98·01%.

Conclusions

Results confirm the reliability and accuracy of a registered nurse–administered Yale swallow protocol. The consequence of 98% accuracy combined with previously reported 96·5% sensitivity, 97·9% negative predictive value and <2% false negative rate allowed for adoption of the protocol for the entire general hospital population.

Relevance to clinical practice

Avoidance of preventable prandial pulmonary aspiration as a cause of nosocomial infection is an important goal for all acute care hospitalised patients deemed at risk of aspiration.
Perceptions about family planning and contraceptive practice in a marital dyad
Authors: Lee Taewha , Lee Hyeonkyeong , Ahn Hyun Mi , Jang Younkyoung , Shin Hyejeong , Kim Myeong Seon
Published: September 2013

Aims and objectives

To examine couple interactions to predict wives' contraceptive use as well as that of their husbands in rural Ethiopia.

Background

Previous studies stated that men's power and their preferences regarding family planning have a significant role in the adoption of contraception, as well as women's general reproductive health. Spousal communication on reproductive matters helped couples to be aware of each other's perspectives and enhanced the usage of family planning through shared decision‐making.

Design

A cross‐sectional descriptive design was used to analyse the Actor and Partner effects within the marital dyad. The study sample included 389 married couples who were recruited from households in seven enumeration areas randomly selected from Hetosa Woreda in Ethiopia.

Methods

We used a face‐to‐face interview survey. Data were collected between 22 October and 21 November 2010 and analysed using descriptive statistics, chi‐squared test, t‐test, Pearson's correlation and the Actor–Partner interdependence model.

Results

There were significant differences in perceptions about family planning, contraceptive knowledge and contraceptive use between wives and husbands. Wives' perceptions about family planning affected theirs as well as that of their husbands' knowledge and use of contraceptive methods. However, husbands' perceptions about family planning did not affect their knowledge and use of contraceptive methods, but did influence their wives'.

Conclusions

The application of couple data enhanced our understanding of the complex interactions between wives and husbands, which may lead to novel dyadic‐based interventions to improve family planning practice.

Relevance to clinical practice

Couples must be educated and informed not only about the adoption of contraception, but also about reproductive rights and responsibilities through changes in educational and motivational strategies.
The Danish School of Interior Architecture: A Visionary Functionalist, a Visionary Aesthete, and their Women Students1
Authors: Lytken Malene
Published: September 2013

Recently there has been a growing international interest in the history of interior design. Danish design owes much of its international renown to a few prominent architects and their iconic products. One of them was Finn Juhl, who earned an international reputation mainly through his elegant furniture design. However, an important aspect of his work has received virtually no attention: his seminal work as a visionary teacher and leader at the school for professional interior design in Copenhagen in the 1940s and 1950s. Harald Willerup, architect as well, and Juhl's equally visionary predecessor, had initiated this work in 1934, but has remained largely unknown. This article offers a historiographical mapping of the professional education of Danish interior designers in the period from 1934 to 1955—a subject, which has so far remained unexposed. Despite the fact that the leading figures and pioneers of the education of interior design were men, the students were almost exclusively women. The article seeks to explain this and to explain the consequences for the general image of the profession. The research into the development of interior design education in Denmark shows how the change of leadership from Willerup to Juhl resulted in a shift in the educational focus from functional and social issues toward a greater focus on aesthetics. The fact remains, however, that this work was informed by prevalent functionalist ideas at the time. A particularly fascinating aspect of the Danish history of interior design education is the hard struggle its pioneers had to fight cultural prejudice and conventional thinking.
Not All Great Minds Think Alike: Systematic and Intuitive Cognitive Styles
Authors: Sagiv Lilach , Amit Adi , Ein‐Gar Danit , Arieli Sharon
Published: September 2013

Individuals process information and make decisions in different ways. Some plan carefully and analyze information systematically, whereas others follow their instincts and do what “feels right.” We aimed to deepen our understanding of the meaning of the intuitive versus systematic cognitive styles. Study 1 (N = 130, 39% female, Mage = 24) compared cognitive styles of arts, accounting, and mathematics students. Cognitive styles were associated with values (Study 2: N = 154, 123, 78; female = 59%, 49%, 85.9%; Mage = 22, 23, 27) and traits (Study 3: N = 77, 140, 151; female = 59%, 66%, 46%; Mage = 22, 25, 23), and they interacted with experience in predicting performance (Study 4: N = 63, 48% female, Mage = 23; Study 5: N = 44, 39% female, Mage = 23). All participants were Caucasian Israeli students. The systematic style was most frequent among accountants, and the intuitive style was most frequent among artists, validating the meaning of the styles. Systematic style was positively correlated with Conscientiousness and with security values and negatively correlated with stimulation values. The intuitive style had the opposite pattern and was also positively correlated with Extraversion. Experience improved rule‐based performance among systematic individuals but had no effect on intuitive ones. Cognitive style is consistent with other personal attributes (traits and values), with implications for decision making and task performance.
Cyclodextrins improve oral absorption of a novel factor Xa inhibitor by interfering with interaction between the drug and bile acids in rats
Authors: Fujii Yoshimine , Takahashi Masayuki , Ishiguro Takako , Sakuma Shinji , Uekama Kaneto , Irie Tetsumi
Published: September 2013

Objectives

Poor oral absorption of a factor Xa inhibitor, DX-9065, is partly due to the interaction with bile acids in the gastrointestinal tract. The aim of this study is to improve the oral bioavailability of DX-9065 by cyclodextrins (CyDs) capable of interfering with such interaction.

Methods

The abilities of the CyDs to interfere with the interaction between DX-9065 and sodium chenodeoxycholate were evaluated using equilibrium dialysis. The interaction between DX-9065 and the CyDs was studied spectroscopically. Effects of the CyDs on the oral absorption of DX-9065 were examined in rats.

Key findings

Hydroxypropyl-β-CyD and γ-CyD were effective in interfering with the interaction between DX-9065 and sodium chenodeoxycholate as a representative bile acid. Spectroscopic studies revealed that DX-9065 was included into the CyD cavity to form inclusion complexes in an acidic medium. With dissociation of the carboxyl group of DX-9065 in a neutral medium, the stability of the complexes was decreased to such an extent that DX-9065 in the cavity is replaced with co-existing bile acids. The average area under the plasma concentration-time curve value after oral administration of DX-9065 with hydroxypropyl-β-CyD was 2.5 times higher than that of DX-9065 alone with a statistical difference in rats.

Conclusions

We suggest that the CyDs are useful in designing oral formulations of DX-9065 with an improved bioavailability.
Potassium bromide‐associated panniculitis
Authors: Boynosky N. A. , Stokking L. B.
Published: September 2013

Two cases of panniculitis associated with administration of potassium bromide in dogs are reported. Both dogs were treated with potassium bromide for idiopathic epilepsy for over 1 year. Dose increases in both cases were associated with panniculitis, characterised by painful subcutaneous nodules in a generalised distribution over the trunk. Nodule eruption waxed and waned in one dog and was persistent in the other. In both cases, panniculitis was accompanied by lethargy and pyrexia. Panniculitis, lethargy and pyrexia resolved and failed to recur after discontinuation of potassium bromide. No other cause of panniculitis could be determined for either dog. Panniculitis has been reported after administration of potassium bromide in humans and may be a form of drug‐induced erythema nodosum. To the authors’ knowledge, these are the first reports of potassium bromide‐associated panniculitis in dogs.
Intervertebral Disk Degeneration in Dogs: Consequences, Diagnosis, Treatment, and Future Directions
Authors: Jeffery N.D. , Levine J.M. , Olby N.J. , Stein V.M.
Published: September 2013

Evidence of intervertebral disk degeneration (IVDD) is extremely common in dogs, and its prevalence increases with age. It has many important consequences because degeneration of the intervertebral disks often is a prelude to disk herniation, which can injure the spinal cord, spinal nerves, or both. This review summarizes the advances in diagnosis and treatment ofIVDDthat have been made since the 1950s when the first detailed description of the degenerative changes was published. It also discusses new approaches to treatment of the associated spinal cord injury and new methods by which to classify injury severity that are currently under development.
Reduction in absorption of gallium maltolate in adult horses following oral administration with food: chemistry and pharmacokinetics
Authors: Pollina G. F. , Pepe M. , Dean A. , Di Marco V. , Marton D.
Published: September 2013

Gallium (Ga) is under study for the treatment of osteolytic disorders in equines. Previous studies indicate that oral gallium maltolate (GaM) would provide a higher bioavailability than oral Ga salts. However, oral administration to adult horses of 2 mg/kg of GaM, in the form of a solution mixed with food, did not lead to detectable Ga levels in plasma. Therefore, a study was performed to model the chemical behaviour of GaM in the digestive tract. The equilibrium formation constants for Ga(III) and maltol were calculated by means of UV–visible measurements and validated by 1H‐NMR measurements at selected pH values. Data indicate that the dissociation of GaM in aqueous solutions is very rapid, while the re‐association is slower. Based on these results, poor Ga absorption seems to be due to the equilibrium dissociation of GaM in the stomach and to its slow formation rate in the intestine. The concomitant presence of high concentrations of phytates (strong charged metal chelating agents, which represent about 1% of dry matter in vegetables) might also explain the low absorption of GaM by the gastrointestinal tract. Methods of optimizing Ga absorption after oral administration of GaM require further investigation.
Association of a potential functional pre‐miR‐218 polymorphism and its interaction with hepatitis B virus mutations with hepatocellular carcinoma risk
Authors: Han Yifang , Pu Rui , Han Xue , Zhao Jun , Li Weiping , Yin Jianhua , Zhang Yuwei , Shen Qiuxia , Xie Jiaxin , Zhang Qi , Jiang Shuang , Li Juhong , Zhang Hongwei , Wang Hongyang , Cao Guangwen
Published: September 2013

Background & Aims

MicroRNA‐218 (miR‐218) can function as a tumour suppressor and inactivate cancer‐promoting inflammation. However, role of miR‐218 on hepatocellular carcinoma (HCC) remains unclear. To determine the contribution of miR‐218 genetic predisposition and its interaction with hepatitis B virus (HBV) mutations to HCC risk.

Methods

rs11134527 located at putative promoter region of pre‐miR‐218 was genotyped in 1012 healthy controls, 302 hepatitis B surface antigen (HBsAg) seroclearance subjects and 2011 subjects with chronic HBV infection (1021 with HCC) using quantitative PCR. HBV mutation was determined by sequencing.

Results

rs11134527 variant genotypes in dominant model was associated with HCC risk compared with all HCC‐free subjects [odds ratio (OR) = 1.22, 95% confidence interval (CI) = 1.04–1.43], HCC‐free HBsAg‐positive subjects (OR = 1.23, 95% CI = 1.02–1.50) and HBsAg seroclearance subjects (OR = 1.45, 95% CI = 1.08–1.96), adjusting for age and gender, and also associated with the generation of HBV preS deletion in men (adjusted OR = 1.85, 95% CI = 1.23–2.76). In multivariate regression analyses, rs11134527 in dominant model was associated with HCC risk (OR = 1.50, 95% CI = 1.05–2.13), whereas its multiplicative interaction with viral mutation T1674C/G was inversely associated with HCC risk (OR = 0.44, 95% CI = 0.21–0.96), adjusting for covariates including HBV mutations in the enhancer II‐precore region; its interaction with HBV preS1 start codon mutation was associated with HCC risk (OR = 4.44, 95% CI = 1.27–15.55), adjusting for covariates including HBV mutations in the preS region.

Conclusion

rs11134527 may be a novel genetic risk factor of HCC in HBV‐exposed subjects, can facilitate HBV preS deletion generation and predispose the host to the effect of T1674C/G and preS1 start codon mutation in hepatocarcinogenesis.
Toll‐like receptors and liver disease
Authors: Kesar Vivek , Odin Joseph A.
Published: September 2013

Toll‐like receptors (TLRs) are pattern recognition receptors that play an important role in host defence by recognizing pathogen‐associated molecular patterns (PAMP). Recent studies indicate that TLR signalling plays an important role in progression of chronic liver diseases. Ongoing clinical trials suggest that therapeutic manipulation of TLR pathways may offer novel means of reversing chronic liver diseases. Upon activation by their respective ligands, TLRs initiate an intracellular pro‐inflammatory/anti‐inflammatory signalling cascade via recruitment of various adaptor proteins. TLR associated signalling pathways are tightly regulated to keep a check on inappropriate production of pro‐inflammatory cytokines and interferons thereby preventing various autoimmune and inflammatory processes. Herein, we review the current state of knowledge of hepatic distribution, signalling pathways and therapeutic modulation of TLRs in chronic liver diseases.
Is Infrastructure Spending an Effective Fiscal Policy?
Authors: Yanushevsky Camilla , Yanushevsky Rafael
Published: September 2013

The impact of expansionary fiscal policy intended to increase economic growth by using infrastructure‐focused stimulus packages is analyzed by considering the debt to GDP ratio dynamics model. It is shown that for the data characterizing the current state of the US economy the government investment in infrastructure cannot decrease the debt to GDP ratio. The paper contributes to the ongoing fiscal policy debate whether government investment in infrastructure is an effective approach to boost the economy.
Evidence for phenotypic bistability resulting from transcriptional interference of bvgAS in Bordetella bronchiseptica
Authors: Mason Eliza , Henderson Michael W. , Scheller Erich V. , Byrd Matthew S. , Cotter Peggy A.
Published: September 2013

Bordetella species cause respiratory infections in mammals. Their master regulatory system BvgAS controls expression of at least three distinct phenotypic phases in response to environmental cues. The Bvg+ phase is necessary and sufficient for respiratory infection while the Bvg− phase is required for survival ex vivo. We obtained large colony variants (LCVs) from the lungs of mice infected with B. bronchiseptica strain RBX9, which contains an in‐frame deletion mutation in fhaB, encoding filamentous haemagglutinin. RBX9 also yielded LCVs when switched from Bvg− phase conditions to Bvg+ phase conditions in vitro. We determined that LCVs are composed of both Bvg+ and Bvg− phase bacteria and that they result from defective bvgAS positive autoregulation. The LCV phenotype was linked to the presence of a divergent promoter 5′ to bvgAS, suggesting a previously undescribed mechanism of transcriptional interference that, in this case, leads to feedback‐based bistability (FBM). Our results also indicate that a small proportion of RBX9 bacteria modulates to the Bvg− phase in vivo. In addition to providing insight into transcriptional interference and FBM, our data provide an example of an in‐frame deletion mutation exerting a ‘polar’ effect on nearby genes.
Ralstonia solanacearum type III secretion system effector Rip36 induces a hypersensitive response in the nonhost wild eggplant Solanum torvum
Authors: Nahar Kamrun , Matsumoto Iyo , Taguchi Fumiko , Inagaki Yoshishige , Yamamoto Mikihiro , Toyoda Kazuhiro , Shiraishi Tomonori , Ichinose Yuki , Mukaihara Takafumi
Published: September 2013

Ralstonia solanacearum is a Gram‐negative soil‐borne bacterium that causes bacterial wilt disease in more than 200 plant species, including economically important Solanaceae species. In R. solanacearum, the hypersensitive response and pathogenicity (Hrp) type III secretion system is required for both the ability to induce the hypersensitive response (HR) in nonhost plants and pathogenicity in host plants. Recently, 72 effector genes, called rip (Ralstonia protein injected into plant cells), have been identified in R. solanacearum RS1000. RS1002, a spontaneous nalixidic acid‐resistant derivative of RS1000, induced strong HR in the nonhost wild eggplant Solanum torvum in an Hrp‐dependent manner. An Agrobacterium‐mediated transient expression system revealed that Rip36, a putative Zn‐dependent protease effector of R. solanacearum, induced HR in S. torvum. A mutation in the putative Zn‐binding motif (E149A) completely abolished the ability to induce HR. In agreement with this result, the RS1002‐derived Δrip36 and rip36E149A mutants lost the ability to induce HR in S. torvum. An E149A mutation had no effect on the translocation of Rip36 into plant cells. These results indicate that Rip36 is an avirulent factor that induces HR in S. torvum and that a putative Zn‐dependent protease motif is essential for this activity.
The anagenetic world of spore‐producing land plants
Authors: Patiño Jairo , Carine Mark , Fernández‐Palacios José María , Otto Rüdiger , Schaefer Hanno , Vanderpoorten Alain
Published: September 2013

A fundamental challenge to our understanding of biodiversity is to explain why some groups of species diversify, whereas others do not. On islands, the gradual evolution of a new species from a founder event has been called ‘anagenetic speciation’. This process does not lead to rapid and extensive speciation within lineages and has received little attention.

Based on a survey of the endemic bryophyte, pteridophyte and spermatophyte floras of nine oceanic archipelagos, we show that anagenesis, as measured by the proportion of genera with single endemic species within a genus, is much higher in bryophytes (73%) and pteridophytes (65%) than in spermatophytes (55%).

Anagenesis contributed 49% of bryophyte and 40% of endemic pteridophyte species, but only 17% of spermatophytes. The vast majority of endemic bryophytes and pteridophytes are restricted to subtropical evergreen laurel forests and failed to diversify in more open environments, in contrast with the pattern exhibited by spermatophytes.

We propose that the dominance of anagenesis in island bryophytes and pteridophytes is a result of a mixture of intrinsic factors, notably their strong preference for (sub)tropical forest environments, and extrinsic factors, including the long‐term macro‐ecological stability of these habitats and the associated strong phylogenetic niche conservatism of their floras.