bluuebunny/crossref_metadata_2025 huggingface dataset:
North American Climate in CMIP5 Experiments. Part I: Evaluation of Historical Simulations of Continental and Regional Climatology
Authors: Sheffield Justin , Barrett Andrew P. , Colle Brian , Nelun Fernando D. , Fu Rong , Geil Kerrie L. , Hu Qi , Kinter Jim , Kumar Sanjiv , Langenbrunner Baird , Lombardo Kelly , Long Lindsey N. , Maloney Eric , Mariotti Annarita , Meyerson Joyce E. , Mo Kingtse C. , David Neelin J. , Nigam Sumant , Pan Zaitao , Ren Tong , Ruiz-Barradas Alfredo , Serra Yolande L. , Seth Anji , Thibeault Jeanne M. , Stroeve Julienne C. , Yang Ze , Yin Lei
Published: July 2013

This is the first part of a three-part paper on North American climate in phase 5 of the Coupled Model Intercomparison Project (CMIP5) that evaluates the historical simulations of continental and regional climatology with a focus on a core set of 17 models. The authors evaluate the models for a set of basic surface climate and hydrological variables and their extremes for the continent. This is supplemented by evaluations for selected regional climate processes relevant to North American climate, including cool season western Atlantic cyclones, the North American monsoon, the U.S. Great Plains low-level jet, and Arctic sea ice. In general, the multimodel ensemble mean represents the observed spatial patterns of basic climate and hydrological variables but with large variability across models and regions in the magnitude and sign of errors. No single model stands out as being particularly better or worse across all analyses, although some models consistently outperform the others for certain variables across most regions and seasons and higher-resolution models tend to perform better for regional processes. The CMIP5 multimodel ensemble shows a slight improvement relative to CMIP3 models in representing basic climate variables, in terms of the mean and spread, although performance has decreased for some models. Improvements in CMIP5 model performance are noticeable for some regional climate processes analyzed, such as the timing of the North American monsoon. The results of this paper have implications for the robustness of future projections of climate and its associated impacts, which are examined in the third part of the paper.
Linearization of Microphysical Parameterization Uncertainty Using Multiplicative Process Perturbation Parameters
Authors: van Lier-Walqui Marcus , Vukicevic Tomislava , Posselt Derek J.
Published: July 2013

Recent studies have shown the importance of accounting for model physics uncertainty within probabilistic forecasts. Attempts have been made at quantifying this uncertainty in terms of microphysical parameters such as fall speed coefficients, moments of hydrometeor particle size distributions, and hydrometeor densities. It has been found that uncertainty in terms of these “traditional” microphysical parameters is highly non-Gaussian, calling into question the possibility of estimating and propagating this error using Gaussian statistical techniques such as ensemble Kalman methods. Here, a new choice of uncertain control variables is proposed that instead considers uncertainty in individual modeled microphysical processes. These “process parameters” are multiplicative perturbations on contributions of individual modeled microphysical processes to hydrometeor time tendency. The new process parameters provide a natural and appealing choice for the quantification of aleatory microphysical parameterization uncertainty. Results of a nonlinear Monte Carlo parameter estimation experiment for these new process parameters are presented and compared with the results using traditional microphysical parameters as uncertain control variables. Both experiments occur within the context of an idealized one-dimensional simulation of moist convection, under the observational constraint of simulated radar reflectivity. Results indicate that the new process parameters have a more Gaussian character compared with traditional microphysical parameters, likely due to a more linear control on observable model evolution. In addition, posterior forecast distributions using the new control variables (process parameters) are shown to have less bias and variance. These results strongly recommend the use of the new process parameters for an ensemble Kalman-based estimation of microphysical parameterization uncertainty.
Observation Quality Control with a Robust Ensemble Kalman Filter
Authors: Roh Soojin , Genton Marc G. , Jun Mikyoung , Szunyogh Istvan , Hoteit Ibrahim
Published: July 2013

Current ensemble-based Kalman filter (EnKF) algorithms are not robust to gross observation errors caused by technical or human errors during the data collection process. In this paper, the authors consider two types of gross observational errors, additive statistical outliers and innovation outliers, and introduce a method to make EnKF robust to gross observation errors. Using both a one-dimensional linear system of dynamics and a 40-variable Lorenz model, the performance of the proposed robust ensemble Kalman filter (REnKF) was tested and it was found that the new approach greatly improves the performance of the filter in the presence of gross observation errors and leads to only a modest loss of accuracy with clean, outlier-free, observations.
Mean Platelet Volume in Patients With Carbon Monoxide Poisoning
Authors: Karabacak Mustafa , Varol Ercan , Türkdogan Kenan Ahmet , Duman Ali , Akpinar Orhan , Karabacak Pinar
Published: July 2013

Carbon monoxide (CO) poisoning is frequent and can lead to high morbidity and mortality. Some studies have indicated increased platelet activation and aggregation in CO poisoning. Thus, we investigated mean platelet volume (MPV), an indicator of platelet activation, in patients with CO poisoning. We included 193 (117 women) patients who presented with a diagnosis of CO poisoning between June 2011 and March 2013. Control group was composed of 39 (15 women) patients. Troponin and creatine kinase MB levels were significantly higher in the CO poisoning group. Platelet counts were significantly higher in patients with CO poisoning (281 ± 76 vs 248 ± 65 × 109, respectively; P = .01). Similarly, MPV was significantly higher in the CO poisoning group (8.9 ± 0.8 vs 7.9 ± 0.9 fL, respectively; P < .001). Elevated MPV values may indicate that patients with CO poisoning have a higher risk of thromboembolic and cardiovascular complications due to platelet activation.
Diagnostic applications of newborn screening for α-thalassaemias, haemoglobins E and H disorders using isoelectric focusing on dry blood spots
Authors: Jindatanmanusan Punyanuch , Riolueang Suchada , Glomglao Waraporn , Sukontharangsri Yaowapa , Chamnanvanakij Sangkae , Torcharus Kitti , Viprakasit Vip
Published: July 2013

Background

Neonatal screening for haemoglobin (Hb) disorders is a standard of care in several developed countries with the main objective to detect Hb S. Such practice has not been established in Thailand where α-thalassaemia and haemoglobin E (Hb E) are highly prevalent. Early identification of thalassaemias could be helpful and strengthen the programme for prevention and control for severe thalassaemias.

Methods

Data from isoelectric focusing (IEF) and Isoscan® for detecting types and amount (%) of each haemoglobin in 350 newborn’s dried blood spots were analysed and compared with the comprehensive genotype analysis by DNA studies as a gold standard.

Results

Based on genetic profiles, there were 10 different categories: (1) normal ( n = 227), (2) α+-thalassaemia trait ( n = 14), (3) α0-thalassaemia trait ( n = 13), (4) β0-thalassaemia trait ( n = 7), (5) Hb E trait ( n = 72), (6) Hb E trait with α0-thalassaemia or homozygous α+-thalassaemia ( n = 5), (7) Hb E trait with α+-thalassaemia trait ( n = 5), (8) homozygous Hb E ( n = 3), (9) homozygous Hb E with α0-thalassaemia trait ( n = 1) and (10) Hb H disease ( n = 3). The presence of Hb Bart’s and Hb E were used to identify cases with α-thalassaemia and Hb E, respectively. We set 0.25% of Hb Bart’s and 1.5% of Hb E as a cut-off level to detect α+-thalassaemia trait (sensitivity 92.86% and specificity 74.0%) and Hb E trait with 100% of both sensitivity and specificity for IEF diagnosis.

Conclusion

Although molecular diagnosis seems to be better for definitive diagnosis of thalassaemia syndromes at birth, however, using our reference range described herein, IEF can be applied in a resource-limiting setting with acceptable reliability.
A Phenomenological Case Study of Communication Between Clinicians About Attention-Deficit/Hyperactivity Disorder Assessment
Authors: Lynch Sean E. , Cho Jennifer , Ogle Stacy , Sellman Heather , dosReis Susan
Published: July 2013

Introduction. Communication between clinicians related to attention-deficit/hyperactivity disorder (ADHD) assessment is challenging because it involves a number of individuals. While the communication process might be more efficient if these individuals worked together, research on ADHD-specific collaborative care models is scarce. The purpose of this qualitative study was to investigate the parties with whom prescribers communicate and how they collaborate. Methods. Providers were interviewed, and the data were analyzed using a phenomenological case study approach. Results. The results suggested that there were communication breakdowns between providers and teachers that hindered the assessment process. Discussion. Communication related to ADHD assessment may be more complex than theoretical models may conceptualize.
Seattle to Spokane
Authors: Evans Betsy E.
Published: July 2013

This research explores perceptions of linguistic variation in English in Washington state (WA). Respondents marked on a map of WA the places where they believe people’s English sounds “different” and provided a label for that type of English. The analysis of the results used digital tools to create composite maps consisting of (1) respondents’ spatial perceptions of English in WA, (2) spatial perceptions of English in WA according to different demographic groups, and (3) affective values associated with regions identified by respondents. The results suggest that Washingtonians perceive that urban areas and eastern WA are places where English is different. The results also demonstrate that when respondents are surveyed about variation within their own state rather than variation across the country, local types of organizational categories, such as an urban/rural dichotomy or belief in a regional standard, can emerge.
Perilous Patches and Pitstaches
Authors: Fahs Breanne
Published: July 2013

Although some research has examined men and women’s general attitudes toward women growing body hair, little research has engaged in a side-by-side examination of women’s imagined experiences of growing body hair with an experiential component of growing their own body hair. In the first of two studies, I asked a diverse community sample of women aged 18 to 59 to assess their impressions of women who grew body hair and to imagine their own, and others’, reactions to their hypothetical body hair growth. For the second study, I utilized response papers from 62 women from diverse backgrounds in an undergraduate women’s studies course, who grew their body hair for an assignment. Results showed overwhelming negativity toward women growing body hair in both studies, but they differed in perceptions of social control and individual agency. Women in Study 1, who merely imagined body hair growth, described it more nonchalantly and individualistically, citing personal choice and rarely acknowledging social pressures placed upon women even disgusted by other women’s body hair. Women in Study 2 regularly discussed unanticipated social pressures and norms, rarely discussed personal choice, and reported a constellation of difficulties, including homophobia, family and partner anger, and internalized disgust and “dirtiness.” These results on a seemingly “trivial” subject nuance the “rhetoric of choice” debate within feminist theories of the body while also illustrating a vivid experiential assignment that delves into women’s personal values, relationships, and social norms. Implications for assessing and changing attitudes about women’s bodies—particularly “abject” or “othered” bodies—are discussed.
“Potemkin Europeanisation”?
Authors: Mikulova Kristina
Published: July 2013

After the EU’s Eastern enlargement of 2004, it became clear that some of the reform in the former candidate countries resembled a Potemkin village: behind a gleaming façade lingered a grimmer reality. Party politics in Central Europe proved to be a case in point. The following article argues that party systems in the region only underwent “Potemkin Europeanisation”—essentially enjoying a “liberal consensus” thanks to a “camouflage effect” of the Europeanisation processes—in 1998–2004. Using case studies of party competition in Poland and Hungary in 1998–2004, it draws broader theoretical conclusions about the persistence of traditional cleavages as organizing principles of party systems in Central Europe, as well as the nature of EU influence on the modus operandi of party politics in candidate countries.
An investigation of the influence of the wheel spoke type on the convective cooling of the brake disc using the computational fluid dynamics method
Authors: Kang Ning , Zheng Weiqi , Liu Xiandong
Published: July 2013

Three-dimensional models of detailed wheel assemblies which have different spoke types are established. The effects of the number of spokes and the twist angle of the spokes on the air-flow field and the convective heat transfer of an automobile brake disc are investigated using the computational fluid dynamics method. To validate the numerical approach employed in this paper, two reference experiments were simulated and the calculation results agree with the experimental data well. It can be concluded from this study that the spoke type has a significant influence on the wheel flow field and the convective heat dissipation of the disc. When the twist angle of the spokes is kept at 0°, the convective cooling performance of the disc of a five-spoke wheel is better than that of the baseline and modified designs. When there is a constant number of spokes equal to six, the convective heat dissipation capacity of the disc improves as the twist angle of the spokes increases. An optimized spoke configuration is proposed and it has the best convective cooling performance of all the cases simulated in the present work.
Antiproliferation and anti-migration induced by gypenosides in human colon cancer SW620 and esophageal cancer Eca-109 cells
Authors: Yan H , Wang X , Wang Y , Wang P , Xiao Y
Published: July 2013

Gypenosides (Gyp), found in Gynostemma pentaphyllum Makino, has attracted more attention owing to its wide bioactivities. However, the effects of Gyp on esophageal cancer cells and colon cancer cells are still unknown. The present study was to investigate the possible anti-proliferative and anti-migration activity of Gyp on human colon cancer cells SW620 and esophageal cancer cells Eca-109. Cell viability was evaluated using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Cell membrane integrity was evaluated using flow cytometry following propidium iodide staining. Apoptotic cell death was determined by nuclear 4′-6-diamidino-2-phenylindole staining. Generation of intracellular reactive oxygen species (ROS) and changes in mitochondrial membrane potential (Δ ψm) was analyzed by flow cytometry using 2′,7′-dichlorofluorescein–diacetate and rhodamine 123 staining, respectively. Wound healing assay was carried out to investigate Gyp-inhibited migration of SW620 and Eca-109 cells. The results indicated that Gyp inhibited cell proliferation and migration in SW620 and Eca-109 cells in dose- and time-dependent manner. Gyp elevated intracellular ROS level, decreased the Δ ψm, and induced apoptotic morphology such as cell shrinkage and chromatin condensation, suggesting oxidative stress and mitochondria-dependent cell apoptosis that might be involved in Gyp-induced cell viability loss in SW620 and Eca-109 cells. The findings indicate Gyp may have valuable application in clinical colon cancer and esophageal cancer treatments.
Industry–academic links: A new phase in Ireland’s FDI-led industrialisation strategy
Authors: Ramirez Paulina , Love James H , Vahter Priit
Published: July 2013

We analyse industry–academic links in the context of a dual economy (or disarticulated industrial structure) in Ireland, as an example of a peripheral territory in the EU. The duality found in the Irish industrial structure is the result of a FDI-led industrialisation strategy which has resulted in two distinct economic sectors – foreign and indigenous, respectively – with weak interactions between the two. Through increased public funding of academic research, the Irish government aimed to attract and embed new waves of higher-value foreign direct investment and increase the dynamism of its indigenous enterprise base. Based on a combination of quantitative and qualitative data, the paper analyses a crucial aspect of Ireland’s recent emphasis on STI policy – industry-academic linkages – and finds that the measures introduced reproduce in the public research system the uneven development found in Ireland’s productive system between indigenous industry and the foreign-owned industrial base.
From Redistribution to Ownership
Authors: Imbroscio David
Published: July 2013

Equity is a crucial goal of American urban policy. The means by which it is pursued via the liberal approach to urban policy—augmented redistribution—is problematic, however. What is needed, therefore, is an alternative means to advance equity. Broadening ownership (of productive assets) can be the basis of such an alternative. I discuss how the liberal approach to American urban policy can be transcended by supplanting its Redistributive Paradigm with an Ownership Paradigm.
Ultrasonographic thickening of the muscularis propria in feline small intestinal small cell T-cell lymphoma and inflammatory bowel disease
Authors: Daniaux Lise A , Laurenson Michele P , Marks Stanley L , Moore Peter F , Taylor Sandra L , Chen Rachel X , Zwingenberger Allison L
Published: July 2013

Gastrointestinal lymphoma is the most common form of lymphoma in the cat. More recently, an ultrasonographic pattern associated with feline small cell T-cell gastrointestinal lymphoma has been recognized as a diffuse thickening of the muscularis propria of the small intestine. This pattern is also described with feline inflammatory bowel disease. To evaluate the similarities between the diseases, we quantified the thickness of the muscularis propria layer in the duodenum, jejunum and ileum of 14 cats affected by small cell T-cell lymphoma and inflammatory bowel disease (IBD) and 19 healthy cats. We found a significantly increased thickness of the muscularis propria in cats with lymphoma and IBD compared with healthy cats. The mean thickness of the muscularis propria in cats with lymphoma or IBD was twice the thickness of that of healthy cats, and was the major contributor to significant overall bowel wall thickening in the duodenum and jejunum. A muscularis to submucosa ratio >1 is indicative of an abnormal bowel segment. Colic lymph nodes in cats with lymphoma were increased in size compared with healthy cats. In cats with gastrointestinal lymphoma and histologic transmural infiltration of the small intestines, colic or jejunal lymph nodes were rounded, increased in size and hypoechoic.
Risk factors for bullying among children with autism spectrum disorders
Authors: Zablotsky Benjamin , Bradshaw Catherine P , Anderson Connie M , Law Paul
Published: July 2013

Although children with disabilities have been found to be at an increased risk of bullying, there are limited studies investigating predictors of bullying involvement in children with autism spectrum disorders. The current study presents findings from 1221 parents of children diagnosed with autism spectrum disorder who were selected from a national web-based registry. Parents completed a survey dedicated to the school and bullying experiences of their child, and multivariate logistic regression analyses were conducted to identify child and school risk factors for involvement as victim, bully, or bully–victim. Additional analyses examined the risk of bullying involvement based on the amount of time spent in general education classrooms. Children diagnosed with Asperger’s disorder, attending a public school or a school with a general education population, were at the greatest risk of being victimized in the past month. Children with comorbid conditions and a high level of autistic traits were the most likely to be victims, bullies, and bully–victims. Finally, children in full inclusion classrooms were more likely to be victimized than those who spend the majority of their time in special education settings. Future research studies should be invested in finding appropriate supports for children with autism spectrum disorder placed in inclusive settings.
How Italian politics goes popular: Evidence from an empirical analysis of gossip magazines and TV shows
Authors: Mazzoni Marco , Ciaglia Antonio
Published: July 2013

It is widely acknowledged that present-day politicians are becoming celebrities. This causes significant effects on the way printed and audiovisual media outlets have started covering them. In fact, political leaders’ private lives are increasingly scanned by gossip magazines and entertainment TV programmes, whose coverage contributes to feed people’s interest over political leaders’ personal sphere. However, as is shown in this case study, in Italy this phenomenon seems to develop in a peculiar way. First, in spite of the fact that both media share the same goal, which is to entertain their public, gossip magazines and TV shows seem to follow very different coverage strategies. Second, and more importantly, only those politicians who belong to the centre-right political area receive a considerable coverage. In the authors’ view, this is due to a greater openness to the use of unconventional political communication forms, as well as a more marked inclination to being affected by political scandals.
The grammar of political obligation
Authors: Fossen Thomas
Published: July 2013

This essay presents a new way of conceptualizing the problem of political obligation. On the traditional ‘normativist’ framing of the issue, the primary task for theory is to secure the content and justification of political obligations, providing practically applicable moral knowledge. This paper develops an alternative, ‘pragmatist’ framing of the issue, by rehabilitating a frequently misunderstood essay by Hanna Pitkin and by recasting her argument in terms of the ‘pragmatic turn’ in recent philosophy, as articulated by Robert Brandom. From this perspective, the content and justification of political obligations cannot be determined in a way that is in principle separable from their application. This casts ‘political obligation’ not as a problem to be philosophically resolved, but as a political predicament that calls for a kind of practical engagement. The merit of this perspective is to draw our attention toward the conditions under which the problem appears as a lived predicament.
Analyzing the effect of yarn and fabrics parameters on electromagnetic shielding of metalized fabrics coated with polyaniline
Authors: Manesh Fatemeh Yousefi , Hasani Hossein , Mortazavi Sayed Majid
Published: July 2013

In this article, the effect of various yarn and fabric parameters on the electromagnetic shielding of metalized fabrics coated with polyaniline has been investigated. Copper wires with diameters of 0.06, 0.08 and 0.1 mm were chosen as conductive ﬁllers for producing the metalized core-spun yarn. To investigate the effect of sheath material, cotton, viscose and polyester fibers supplied in a roving form were used to produce different core-spun yarn on a ring spinning frame. From the produced core yarn, woven fabrics were produced in three different pick densities: 12, 16 and 20 picks per cm. Polyaniline was synthesized in two chemical polymerization methods to achieve different surface conductivity. Taguchi’s experimental design was used to estimate the optimum process conditions and to examine the individual effects of each of the controllable factors on a particular response. The fabric parameters considered in this article were: copper wire thickness, sheath material type, fabric pick density and the coating compound chemical polymerization method. The electromagnetic effectiveness was measured at the frequency range of 1.7–2.7 GHz, using a waveguide. According to the level average analysis, fabric density factor shows the strongest effect on electromagnetic shielding, factor thickness of copper wire is the second and is followed by the factor coating compound chemical polymerization method and the sheath material type. The findings revealed that the samples at the frequency range 2.4–2.45 GHz show the highest shielding.
A Statewide Comparison of Gang and Non-Gang Youth in Public High Schools
Authors: Gebo Erika , Sullivan Christopher J.
Published: July 2013

Gang and non-gang youth are often considered distinct for the purposes of prevention and intervention; yet, research shows there are areas of overlap in their risk profiles. This study examines areas of overlap and differences using a statewide representative sample of high school youth from the Youth Risk Behavior Survey. Gang membership is treated as a predictor variable rather than as an outcome. Results from a latent class analysis show that gang members do not form their own group in the school setting. These findings are discussed in relation to prevention and intervention strategies in the school realm and beyond.
“€14,875?!”: Precision Boosts the Anchoring Potency of First Offers
Authors: Loschelder David D. , Stuppi Johannes , Trötschel Roman
Published: July 2013

In negotiations, higher first offers from sellers drive up sale prices—reversely, buyers benefit from lower first offers. Whereas abundant research has replicated this robust anchoring effect of opening offers, little is known about the impact of anchors’ precision or the interplay of extremity and precision. We propose that precision moderates the effect of anchor extremity, in that precise anchors gain in plausibility and thereby magnify the first-mover advantage. Two experiments tested this assumption. Study 1 shows that increasing precision strengthens the anchoring potency of first offers—sellers assimilate more to strong and precise anchors, which ultimately results in a particularly pronounced first-mover advantage. Study 2 replicates this moderating effect for buyers and indicates that an increased plausibility of precise anchors accounts for the findings. Implications for anchor theorizing, negotiation research, and the first minutes at a bargaining table are discussed.
Evidence and ideology as a rationale for light-therapy in Russia: from the Soviet Union to the present day
Authors: Kühlbrandt Charlotte , McKee Martin
Published: July 2013

Light therapy is still used to treat a number of common diseases in Russia. The practice is firmly anchored in history: Soviet clinical practice was divorced from the emerging field of evidence-based medicine. Medical researchers were cut off from international medical research and scientific literature, with much Soviet scientific activity based on a particular socialist ideology. In this study, the use of light therapy serves as a case study to explore tensions between international evidence-based medicine and practices developed in isolation under the Soviet Union, the legacy of which is to the detriment of many patients today. We used four different search methods to uncover scientific and grey literature, both historical and contemporary. We assessed the changing frequency of publications over time and contrasted the volume of literature on light therapy with more orthodox treatments such as statins and painkillers. Our search found an increasing number and comparatively large body of scientific publications on light therapy in the Russian language, and many publications emanating from prestigious Russian institutions. Combined with our analysis of the historical literature and our appraisal of 22 full text articles, this leads us to suggest that light therapy entered mainstream Soviet medical practice before the Stalinist period and still occupies an important position in contemporary Russian clinical practice. We propose that this outdated treatment survives in Russia in part due to the political, economic and social forces that helped to popularize it during Soviet times, and by the seeming justification offered by poorly executed studies.
How do online patient support communities affect the experience of inflammatory bowel disease? An online survey
Authors: Coulson Neil S
Published: July 2013

Objective

To explore how participation in an online support community may impact upon the experience of inflammatory bowel disease (IBD).

Design

An online survey.

Setting

Study participants recruited through 35 IBD online communities.

Participants

A total of 249 males and females aged 16–69 years, living with either Crohn’s disease (65.9%) or ulcerative colitis (26.1%) or awaiting formal diagnosis (8%).

Results

Patients reported being members for an average of two years, with the majority accessing the community on a daily (46.9%) or weekly (40%) basis. Spending on average four hours per week online, approximately two-thirds of members posted between one and five messages per week. Members joined to find others in a similar situation and to obtain and share information and emotional support. Through participation members accessed a wealth of knowledge about all aspects of living with IBD and this was helpful in terms of accepting their illness and learning to manage it. The community also helped members see their illness more positively as well as contributing to an improvement in subjective wellbeing. However, some negatives aspects were noted.

Conclusions

Online support communities may provide a useful shared space through which IBD patients may seek and provide both informational and emotional support. Many of these benefits may not be available through traditional healthcare. Whilst online support communities may be beneficial for those who choose to participate in them, they are not without limitations. Health professionals should be aware of the potential benefits and limitations of online communities.
Inappropriate use of proton pump inhibitors among medical inpatients: a questionnaire-based observational study
Authors: Haroon Muhammad , Yasin Faiza , Gardezi Syed K M , Adeeb Fahd , Walker Frank
Published: July 2013

Objectives

To evaluate the appropriateness of proton pump inhibitor (PPI) prescribing by conducting an audit of medical inpatients against recommended guidelines.

Design

Questionnaire-based study. All medical wards were audited and different information was documented by patients' medical records review (both hospital visit notes and general practitioner's letters) and short interview, where we asked them to name the clinical reason for using PPI.

Setting

This study was carried out in the setting of a regional hospital (537-bed, secondary care referral centre) in Ireland.

Participants

The study participants were all consecutive medical patients admitted to the medical wards at Waterford Regional Hospital, Waterford.

Main outcome measures

The appropriateness of PPI usage in our regional hospital by assessing the level of its prescribing against published guidelines (NICE, 2000).

Results

During the audit period, 205 consecutive medical inpatients were assessed. Seventy-nine percent (162 out of 205) of the studied patients were found to be using PPI. For 45% ( n = 73) of patients, there was no documentation of valid indication for being on PPI. Overall, 64% of patients were prescribed PPI by hospital doctors, either during their current or previous admissions. We noted that 31% ( n = 51) of patients were taking PPI for ≥2 years and another 25% of patients were using PPI for about one year. Only 12% ( n = 20) of patients had undergone endoscopy procedures.

Conclusion

Inappropriate use of PPI remains common in hospital practice. The risks of using long-term PPI must be weighed against the benefits.
Evaluation of WHO criteria for diagnosis of polycythemia vera: a prospective analysis
Authors: Silver Richard T. , Chow William , Orazi Attilio , Arles Stephen P. , Goldsmith Stanley J.
Published: July 2013

Key Points

Current WHO criteria are inadequate for diagnosing “early-stage” PV. Hemoglobin and hematocrit values are inadequate surrogate markers for erythrocytosis.
Endobronchial ultrasound-guided cryobiopsies in peripheral pulmonary lesions: a feasibility study
Authors: Schuhmann Maren , Bostanci Korkut , Bugalho António , Warth Arne , Schnabel Philipp A. , Herth Felix J.F. , Eberhardt Ralf
Published: July 2013

Peripheral lung lesions are sometimes difficult to reach even with endobronchial ultrasound (EBUS) and insufficient material is often obtained by transbronchial forceps biopsy. Cryoprobes can be used for performing tissue biopsies. We evaluated the safety and feasibility of the cryoprobe in combination with EBUS for the diagnosis of peripheral lung lesion.

Patients with peripheral lung lesions of up to 4 cm were enrolled. After identifying the lung lesion by radial EBUS, forceps biopsies and cryobiopsies were performed in a randomised order. We evaluated safety and feasibility, and compared diagnostic yield and sample size.

39 patients were randomised and the peripheral lung lesion was reached in 31. The overall diagnostic yield was 60.5% and, in the lesions reached by EBUS, it was 74.2%. In 19 cases, the diagnosis was made with forceps as well as cryobiopsy and, in four cases, only with cryobiopsy. Cryobiopsies were significantly larger than forceps biopsies (11.17 mm2versus4.69 mm2, p<0.001). We observed one case of moderate bleeding.

Transbronchial cryobiopsy with EBUS guidance is safe and useful to obtain histological samples. Larger tissue samples can be obtained by cryoprobe.
Gene expression analysis of a Helicobacter pylori-infected and high-salt diet-treated mouse gastric tumor model: identification of CD177 as a novel prognostic factor in patients with gastric cancer
Authors: Toyoda Takeshi , Tsukamoto Tetsuya , Yamamoto Masami , Ban Hisayo , Saito Noriko , Takasu Shinji , Shi Liang , Saito Ayumi , Ito Seiji , Yamamura Yoshitaka , Nishikawa Akiyoshi , Ogawa Kumiko , Tanaka Takuji , Tatematsu Masae
Published: July 2013

Background

Helicobacter pylori (H. pylori) infection and excessive salt intake are known as important risk factors for stomach cancer in humans. However, interactions of these two factors with gene expression profiles during gastric carcinogenesis remain unclear. In the present study, we investigated the global gene expression associated with stomach carcinogenesis and prognosis of human gastric cancer using a mouse model.

Methods

To find candidate genes involved in stomach carcinogenesis, we firstly constructed a carcinogen-induced mouse gastric tumor model combined with H. pylori infection and high-salt diet. C57BL/6J mice were given N-methyl-N-nitrosourea in their drinking water and sacrificed after 40 weeks. Animals of a combination group were inoculated with H. pylori and fed a high-salt diet. Gene expression profiles in glandular stomach of the mice were investigated by oligonucleotide microarray. Second, we examined an availability of the candidate gene as prognostic factor for human patients. Immunohistochemical analysis of CD177, one of the up-regulated genes, was performed in human advanced gastric cancer specimens to evaluate the association with prognosis.

Results

The multiplicity of gastric tumor in carcinogen-treated mice was significantly increased by combination of H. pylori infection and high-salt diet. In the microarray analysis, 35 and 31 more than two-fold up-regulated and down-regulated genes, respectively, were detected in the H. pylori-infection and high-salt diet combined group compared with the other groups. Quantitative RT-PCR confirmed significant over-expression of two candidate genes including Cd177 and Reg3g. On immunohistochemical analysis of CD177 in human advanced gastric cancer specimens, over-expression was evident in 33 (60.0%) of 55 cases, significantly correlating with a favorable prognosis (P = 0.0294). Multivariate analysis including clinicopathological factors as covariates revealed high expression of CD177 to be an independent prognostic factor for overall survival.

Conclusions

These results suggest that our mouse model combined with H. pylori infection and high-salt diet is useful for gene expression profiling in gastric carcinogenesis, providing evidence that CD177 is a novel prognostic factor for stomach cancer. This is the first report showing a prognostic correlation between CD177 expression and solid tumor behavior.
Functional characterization of cinnamyl alcohol dehydrogenase and caffeic acid O-methyltransferase in Brachypodium distachyon
Authors: Trabucco Gina M , Matos Dominick A , Lee Scott J , Saathoff Aaron J , Priest Henry D , Mockler Todd C , Sarath Gautam , Hazen Samuel P
Published: July 2013

Background

Lignin is a significant barrier in the conversion of plant biomass to bioethanol. Cinnamyl alcohol dehydrogenase (CAD) and caffeic acid O-methyltransferase (COMT) catalyze key steps in the pathway of lignin monomer biosynthesis. Brown midrib mutants in Zea mays and Sorghum bicolor with impaired CAD or COMT activity have attracted considerable agronomic interest for their altered lignin composition and improved digestibility. Here, we identified and functionally characterized candidate genes encoding CAD and COMT enzymes in the grass model species Brachypodium distachyon with the aim of improving crops for efficient biofuel production.

Results

We developed transgenic plants overexpressing artificial microRNA designed to silence BdCAD1 or BdCOMT4. Both transgenes caused altered flowering time and increased stem count and weight. Downregulation of BdCAD1 caused a leaf brown midrib phenotype, the first time this phenotype has been observed in a C3 plant. While acetyl bromide soluble lignin measurements were equivalent in BdCAD1 downregulated and control plants, histochemical staining and thioacidolysis indicated a decrease in lignin syringyl units and reduced syringyl/guaiacyl ratio in the transgenic plants. BdCOMT4 downregulated plants exhibited a reduction in total lignin content and decreased Maule staining of syringyl units in stem. Ethanol yield by microbial fermentation was enhanced in amiR-cad1-8 plants.

Conclusion

These results have elucidated two key genes in the lignin biosynthetic pathway in B. distachyon that, when perturbed, may result in greater stem biomass yield and bioconversion efficiency.
Increased detection of Plasmodium knowlesi in Sandakan division, Sabah as revealed by PlasmoNex™
Authors: Goh Xiang Ting , Lim Yvonne AL , Vythilingam Indra , Chew Ching Hoong , Lee Ping Chin , Ngui Romano , Tan Tian Chye , Yap Nan Jiun , Nissapatorn Veeranoot , Chua Kek Heng
Published: July 2013

Background

Plasmodium knowlesi is a simian malaria parasite that is widespread in humans in Malaysian Borneo. However, little is known about the incidence and distribution of this parasite in the Sandakan division, Malaysian Borneo. Therefore, the aim of the present epidemiological study was to investigate the incidence and distribution of P. knowlesi as well as other Plasmodium species in this division based on a most recent developed hexaplex PCR system (PlasmoNex™).

Methods

A total of 189 whole blood samples were collected from Telupid Health Clinic, Sabah, Malaysia, from 2008 to 2011. All patients who participated in the study were microscopically malaria positive before recruitment. Complete demographic details and haematological profiles were obtained from 85 patients (13 females and 72 males). Identification of Plasmodium species was conducted using PlasmoNex™ targeting the 18S ssu rRNA gene.

Results

A total of 178 samples were positive for Plasmodium species by using PlasmoNex™. Plasmodium falciparum was identified in 68 samples (38.2%) followed by 64 cases (36.0%) of Plasmodium vivax, 42 (23.6%) cases of P. knowlesi, two (1.1%) cases of Plasmodium malariae and two (1.1%) mixed-species infections (i e, P. vivax/P. falciparum). Thirty-five PlasmoNex™ positive P. knowlesi samples were misdiagnosed as P. malariae by microscopy. Plasmodium knowlesi was detected in all four districts of Sandakan division with the highest incidence in the Kinabatangan district. Thrombocytopaenia and anaemia showed to be the most frequent malaria-associated haematological complications in this study.

Conclusions

The discovery of P. knowlesi in Sandakan division showed that prospective studies on the epidemiological risk factors and transmission dynamics of P. knowlesi in these areas are crucial in order to develop strategies for effective malaria control. The availability of advanced diagnostic tool PlasmoNex™ enhanced the accuracy and accelerated the speed in the diagnosis of malaria.
The use of non-prescribed anti-malarial drugs for the treatment of malaria in the Bolgatanga municipality, northern Ghana
Authors: Aborah Samuel , Akweongo Patricia , Adjuik Martin , Atinga Roger A , Welaga Paul , Adongo Philip B
Published: July 2013

Background

The use of non-prescribed anti-malarial drugs can lead to treatment failure and development of drug-resistant parasites. This study investigated the use of non-prescribed anti-malarial drugs for the treatment of malaria in the Bolgatanga Municipality of northern Ghana.

Methods

This was a cross-sectional survey of a random sample of 392 adults and children with episodes of malaria in the last four weeks prior to the study.

Results

Majority of survey respondents 96.9% (380) knew the symptoms of malaria, 75% (294) knew the causes of malaria and 93.1% (365) were aware of mode of transmission of malaria. The use of non-prescribed anti-malarial drugs was 16.8% (95% CI: 13.3-21.0) among the respondents. About 56% (95% CI: 43.3-68.3) of the respondents who took non-prescribed anti-malaria drugs took non-artemisinin-based combination therapy (chloroquine, artemether, amodiaquine and sulphadoxine-pyrimethamine). Respondents above five years of age were more likely to use non-prescribed anti-malarial drugs than those below five years of age [P < 0.001]; respondents who knew the right source of malaria treatment were less likely to use non-prescribed anti-malarial drugs than those who did not [P = 0.002]. Respondents using non-prescribed anti-malarials were influenced by people around them who used non-prescribed anti-malarials. Thus, these respondents were more likely to use non-prescribed anti-malarials than those who were not influenced [P = 0.004].

Conclusions

Respondents’ knowledge of malaria treatment and the influence of people using non-prescribed anti-malarials are factors affecting use of non-prescribed anti-malarials. The study concludes that there is high use of non-prescribed anti-malarial drugs in the municipality and most of the non-prescribed anti-malarias were non-artemisinin-based combination therapy. The study recommends education of the general public and chemical sellers to reduce the use of non-prescribe anti-malaria drugs.
Frequency of D222G haemagglutinin mutant of pandemic (H1N1) pdm09 influenza virus in Tunisia between 2009 and 2011
Authors: Moussi Awatef El , Kacem Mohamed Ali Ben Hadj , Pozo Francisco , Ledesma Juan , Cuevas Maria Teresa , Casas Inmaculada , Slim Amine
Published: July 2013

Background

The novel pandemic A (H1N1) pdm09 virus was first identified in Mexico in April 2009 and since then it spread worldwide over a short period of time. Although the virus infection is generally associated with mild disease and a relatively low mortality, it is projected that mutations in specific regions of the viral genome, especially within the receptor binding domain of the haemagglutinin (HA) protein could result in more virulent virus stains, leading to a more severe pathogenicity.

Methods

To monitor the genetic polymorphisms at position 222 of Haemagglutinin of influenza A(H1N1)pdm09 viruses from both outpatients with mild influenza and individuals with severe disease requiring hospitalization, during 2009–2010 and 2010–2011 seasons, a sequence-based genotypic assessment of viral populations to understand the prevalence of D222G mutation.

Results

The D222G was identified in clinical specimens from 3 out of 42 cases analyzed in Tunisia with severe outcome (7%). Interestingly, in one fatal case out of four viruses taken from fatal cases studied (25%). Also this mutation was found in one mild case out of 8 mild cases studied (0.1%). D222E substitution was found in virus taken from one patient with severe clinical syndrome (2%) out of 42 severe cases analyzed and E374K substitution was found in two severe cases (4%) out of 42 severe cases studied.

Conclusions

A specific mutation in the viral haemagglutinin (D222G) was found in fatal, severe and mild case. Further virological, clinical and epidemiological investigations are needed to ascertain the role of this and other mutations that may alter the virulence and transmissibility of the pandemic influenza A (H1N1)pdm09.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1027334947811255
Prognosis of patients without perfusion defects with and without rest study in myocardial perfusion scintigraphy
Authors: Edenbrandt Lars , Ohlsson Mattias , Trägårdh Elin
Published: July 2013

Background

Stress myocardial perfusion scintigraphy (MPS) is widely regarded as a useful imaging modality for diagnosing patients with suspected ischemic heart disease. Current European guidelines recommend stress study to be performed first since rest study can be omitted if stress study is interpreted as normal. Thus, a rest study should only be performed in patients with equivocal or abnormal studies. The aim of the present study was to investigate the prognosis of a normal stress-only MPS compared to a normal stress-rest MPS in a retrospective manner and also with regard to normal/abnormal left ventricular function data.

Methods

All 4,820 patients who underwent 99mTc MPS at Skåne University Hospital in Malmö, Sweden, in 2004 to 2007, for suspected or management of known ischemic heart disease were considered. The physician in clinical charge of the investigation decided whether a rest study was necessary or not. Based on the final report according to clinical routine, only patients with a normal perfusion study (no infarction or inducible ischemia) were included. The endpoints were non-fatal acute coronary syndrome or death from ischemic cardiac origin.

Results

A total of 3,426 patients with a normal perfusion study were included. Of these, 2,215 patients had a stress-only study and 1,211 patients had both stress and rest studies. Mean follow-up was 6.2 years. The lowest event rate was found in the normal stress-only group (0.56% for normal stress-only patients vs. 1.42% for normal stress-rest patients; p < 0.0001). When dividing patients according to sex and stress type, the best prognosis was also found in the normal stress-only group (p < 0.0001 for all comparisons). Regarding left ventricular function data, we did not find any significant difference in event rate between normal vs. abnormal ejection fraction (EF), normal vs. abnormal end-diastolic volume (EDV) or normal EF, and EDV vs. abnormal EF or EDV for either the normal stress-only patients or the normal stress-rest patients.

Conclusions

Patients with a normal stress-only study had an excellent prognosis over a mean follow-up time of 6 years. Thus, omitting the rest study if the stress study is normal is a safe procedure.