bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidental White Matter Lesions in Children Presentıng With Headache
Authors: Bayram Erhan , Topcu Yasemin , Karaoglu Pakize , Yis Uluc , Guleryuz Handan Cakmakci , Kurul Semra Hiz
Published: April 2013

Aim

We aimed to describe the prevalence and significance of white matter lesions detected on magnetic resonance imaging (MRI) in children with headache.

Material and Methods

Children who were admitted with the complaint of headache and had neuroimaging between December 2007 and June 2012 were included in the study. The clinical and neuroimaging data of the patients were retrospectively evaluated. MRI results of the patients were documented in detail. The patients with non‐specific white matter lesions were called for a control visit, and current status of headache and neurological findings were determined.

Results

A total of 941 patients were included in the study. Sixty‐one percent of the patients received cranial neuroimaging. 8.2% had only cranial computed tomography (CT), 7.5% had cranial CT and cranial MRI, and 84.3% had only cranial MRI. 22.1% of the patients had abnormal cranial MRI findings. The rate of incidental non‐specific white matter changes detected in our study group was 23/527 (4.4%). Among the 23 patients, 12 (52.2%) were male and 11 (47.8%) were female. Fourteen (60.9%) had migraine without aura, 8 (34.8%) had tension‐type headache, and 1 (4.3%) had migraine with aura. Mean age of patients at the time of imaging was 12.1 ± 3.4 years (range 4.0‐16.0 years). All patients with non‐specific white matter changes on MRI showed normal psychomotor development, and there was no history of seizures or head trauma. The physical and neurological examinations of all patients were normal. The mean clinical follow‐up period of the patients was 16.8 ± 17.3 months (range 6‐80 months). No patients showed neurological deterioration during the follow up. The white matter lesions were supratentorial in all patients. The mean size of the lesions was 5.1 ± 4.5 mm (minimum, 2 mm; maximum, 24 mm). Repeated radiological evaluations were performed in 11 (47.8%) of the patients. No new white matter lesions were detected in control MRI during follow up.

Conclusion

Non‐specific incidental white matter changes may be seen in children with headache. For normal clinical follow up, in the absence of evident benefits from repeated imaging studies, we suggest that repeated imaging studies are not warranted in every patient and should be tailored according to clinical course.
MicroRNA‐520c‐3p inhibits hepatocellular carcinoma cell proliferation and invasion through induction of cell apoptosis by targeting glypican‐3
Authors: Miao Hui‐Lai , Lei Chang‐Jiang , Qiu Zhi‐Dong , Liu Zhong‐Kao , Li Ran , Bao Shi‐Ting , Li Ming‐Yi
Published: April 2013

Aim

Glypican‐3 (GPC3) is a membrane‐associated heparan sulfate proteoglycan involved in regulation of cell proliferation, cell survival, cell migration and differentiation process. MicroRNAs (miRNAs) are single‐stranded, non‐coding functional RNAs that are important in many biological processes. GPC3 and miRNAs have been found to play essential roles in the development and progression of hepatocellular carcinoma (HCC). However, little information about the relationship between GPC3 and miRNAs is available nowadays. Therefore, this study aims to examine the relationship between GPC3 and miRNAs.

Methods

Dual‐luciferase reporter assay was used to validate the direct target of GPC3. Fluorescence quantitative PCR and Western blotting were used to examined the gene expression at mRNA and protein levels. Cell apoptosis was evaluated by flow cytometric analysis and Annexin V‐FITC staining. Invasion of cells was evaluated by Transwell matrigel assay.

Results

The results showed that miR‐520c‐3p could specifically target GPC3 in HCC cells. GPC3 protein levels decreased with unchanged transcription efficiency after miRNA transfection, and there was negative correlation of miR‐520c‐3p expression in HCC in relate to GPC3 protein levels. Moreover, miR‐520c‐3p not only induced HCC cell apoptosis, but also inhibited the growth and invasion of the cells. Interestingly, overexpression of GPC3 could effectively reverse apoptosis induced by miR‐520c‐3p transfection in HCC.

Conclusions

Taken together, these results supported that miR‐520c‐3p may decrease GPC3 protein levels to inhibit proliferation of HCC cells. Therefore, GPC3 could be a new target for genetic diagnosis and treatment of HCC.
FX enzyme and GDP‐L‐Fuc transporter expression in colorectal cancer
Authors: Villar‐Portela Susana , Muinelo‐Romay Laura , Cuevas Elisa , Gil‐Martín Emilio , Fernández‐Briera Almudena
Published: April 2013

Aims

Fucosylation is regulated by fucosyltransferases, the guanosine diphosphate‐L‐fucose (GDP‐L‐Fuc) synthetic pathway, and the GDP‐L‐fucose transporter (GDP‐L‐Fuc Tr). We have reported previously an increased level of α(1,6)fucosyltransferase activity and expression in colorectal cancer (CRC). The present study aimed to analyse the expression profiles of the FX enzyme and GDP‐L‐Fuc Tr in a cohort of operated CRC patients to elucidate their role in α(1,6)fucosylation in this neoplasm.

Methods and results

We assessed the immunohistochemical expression of FX and GDP‐L‐Fuc Tr in a series of tumour samples and healthy tissues from CRC specimens. FX expression was observed in 58 of 91 (63.7%) tumours and 23 of 28 (82.1%) corresponding healthy samples. GDP‐L‐Fuc Tr expression was detected in 86 of 102 (84.3%) colorectal tumours, and 13 of 27 (48.1%) healthy tissue specimens. The expression of GDP‐L‐Fuc Tr was statistically higher in tumours than in healthy tissues (P < 0.001). A correlation was found between FX and GDP‐L‐Fuc Tr expression in tumour samples (P = 0.003).

Conclusion

GDP‐L‐Fuc Tr overexpression in the tumour tissue of CRC patients suggests that GDP‐L‐Fuc transport to the Golgi apparatus may be an important factor associated with increased α(1,6)fucosylation in CRC.
Contrast‐enhanced transrectal ultrasonography: Measurement of prostate cancer tumor size and correlation with radical prostatectomy specimens
Authors: Qi Ting Yue , Chen Ya Qing , Jiang Jun , Zhu Yun Kai , Yao Xiao Hong , Qi Jun
Published: April 2013

Objectives

To determine the accuracy of contrast‐enhanced transrectal ultrasonography for tumor size measurements of hypoechoic prostate cancer foci located in the peripheral zone.

Methods

A total of 55 men scheduled for radical prostatectomy, with biopsy‐proven cancer in hypoechoic foci located in the peripheral zone, were consecutively enrolled in the present prospective study. Each patient underwent grayscale ultrasound and contrast‐enhanced transrectal ultrasonography of the prostate according to a standardized protocol. The maximum tumor diameter on grayscale imaging and contrast‐enhanced transrectal ultrasonography was compared with that determined using histopathology.

Results

A mean underestimation was documented to be approximately 3.9 mm and 0.6 mm for grayscale and contrast‐enhanced transrectal ultrasonography imaging, respectively. Grayscale and contrast‐enhanced transrectal ultrasonography imaging underestimated measurements by 76.67% (46 of 60) and 48.33% (29 of 60), whereas overestimated measurements were 20% (12 of 60) and 26.67% (16 of 60), respectively. A strong correlation was observed between contrast‐enhanced transrectal ultrasonography and histopathological measurements (r = 0.91, P < 0.0001). A weak linear correlation was found between grayscale and histopathological measurements (r = 0.59, P < 0.0001). Bland–Altman analysis results were in complete accordance with correlation analysis results. For cases with maximum histopathological tumor diameters ≤10 mm and >10 mm, 40% (6 of 15) and 86.67% (39 of 45) were index tumors, respectively (P < 0.0001).

Conclusions

Contrast‐enhanced transrectal ultrasonography is significantly more accurate than conventional grayscale imaging for measuring prostate tumor size, especially for tumors with a diameter >10 mm, and it might have a role in preoperative assessment of prostatic index tumor sizes.
Novel mutation in the TMEM127 gene associated with phaeochromocytoma
Authors: Elston M. S. , Meyer‐Rochow G. Y. , Prosser D. , Love D. R. , Conaglen J. V.
Published: April 2013

Phaeochromocytomas and paragangliomas are rare neuroendocrine tumours that arise from the adrenal glands or paraganglia (paragangliomas) within the abdomen, thorax and neck. Although it was originally suggested that approximately 10% of these tumours were inherited, it is now recognised that up to approximately 30% of these tumours are associated with a germline mutation in one of the phaeochromocytoma/paraganglioma susceptibility genes. Of the 12 currently known genes predisposing to these tumours, the TMEM127 gene is one of the more recently identified and appears to be present in approximately 2% of apparently sporadic phaeochromocytomas. We report a 33‐year‐old man who presented with an apparently sporadic adrenal phaeochromocytoma and was identified as carrying a novel TMEM127 germline mutation, p.Gln139X. Patients harbouring a germline TMEM127 mutation most commonly present with an apparently sporadic solitary adrenal phaeochromocytoma. Testing patients who present with a phaeochromocytoma or paraganglioma for an underlying germline mutation needs to be considered in all patients due to implications for family members, but a strategy based on clinical and immunohistochemical findings would be prudent to limit costs.
Marijuana ‘bong’ smoking and tuberculosis
Authors: Thu K. , Hayes M. , Miles S. , Tierney L. , Foy A.
Published: April 2013

The incidence of tuberculosis in the non‐indigenous Australian population is low. However, in this paper we report on three cases of cavitating disease, which seem to be associated with a common illicit drug habit namely smoking marijuana using a makeshift pipe or bong. There was a total of 34 positive contacts of these cases and among the contacts sharing a bong with an index case was associated with a sixfold risk of transmission (odds ratio 6.5, confidence interval 1.4–30.4, P = 0.016). When cavitating tuberculosis is detected in a young non‐indigenous native born Australian, marijuana use should be considered as a possible risk factor.
Thyrotoxic psychosis in an elderly woman and haloperidol use: a case report
Authors: EMUL Murat , SAKALLI Ayse , EROL Turgut Can , ERTAN Turan
Published: April 2013

Thyrotoxic patients may occasionally present with affective disorders. Here, we discuss a case of a 61‐year‐old woman with misidentification and persecutory delusions, olfactory hallucinations, and apathy associated with thyrotoxicosis. After definitive antithyroid and antipsychotic agent haloperidol treatments, the patient was released within 4 weeks. Thyrotoxic psychosis with apathy is a rare entity that can be misdiagnosed as affective psychosis. Haloperidol may be an alternative treatment in resolving psychotic features beside the treatment of hyperthyroid state.
Intelligence or years of education: which is better correlated with memory function in normal elderly Japanese subjects?
Authors: MURAYAMA Norio , ISEKI Eizo , TAGAYA Hirokuni , OTA Kazumi , KASANUKI Koji , FUJISHIRO Hiroshige , ARAI Heii , SATO Kiyoshi
Published: April 2013

Background:  We compared differences in intelligence and memory function between normal elderly Japanese subjects with more years of education and those with fewer years of education. We also investigated clinical and neuropsychological factors that are strongly correlated with memory function.

Methods:  There were 118 normal elderly subjects who underwent the Mini‐Mental State Examination, Wechsler Adult Intelligence Scale, 3rd edition (WAIS‐III), and Wechsler Memory Scale Revised. Subjects with at least 13 years of education were categorized as the H group, and those with 12 years of education or less were categorized as the L group.

Results:  Age and Mini‐Mental State Examination scores were not significantly different between the two groups. On the WAIS‐III, there were significant differences between the two groups in Verbal IQ and Full Scale IQ. On the Wechsler Memory Scale Revised, there were significant differences between the two groups in Visual Memory, General Memory, and Delayed Recall. Correlation coefficients between memory function and the other factors demonstrated significant but weak correlations between years of education and General Memory (R = 0.22) and between years of education and Delayed Recall (R = 0.20). Strong correlations were found between Verbal IQ and Verbal Memory (R = 0.45), between Verbal IQ and General Memory (R = 0.49), between Full Scale IQ and General Memory (R = 0.50) and between Full Scale IQ and Delayed Recall (R = 0.48).

Conclusions:  In normal elderly Japanese subjects, years of education weakly correlated with memory function while Verbal IQ, Full Scale IQ and Verbal Comprehension on WAIS‐III had stronger correlations with memory function. Verbal IQ and Verbal Comprehension on WAIS‐III were found to be insusceptible to the cognitive decline characteristic of Alzheimer's disease or amnestic mild cognitive impairment. Therefore, verbal intelligence, as measured by Verbal IQ and Verbal Comprehension, may be the most useful factor for inferring premorbid memory function in Alzheimer's disease or amnestic mild cognitive impairment patients.
Cognitive effects of quetiapine in a patient with dementia with Lewy bodies
Authors: RICE Timothy , DOBRY Yuriy , WANG Eugene , NOVAKOVIC Vladan , SHER Leo
Published: April 2013

A recent large‐scale randomized controlled clinical trial, the Clinical Antipsychotic Trials of Intervention Effectiveness‐Alzheimer's Disease study, found a significant worsening of cognitive functioning in a sample of patients with Alzheimer's disease. To date there have been no equally powered studies examining the cognitive effects of atypical antipsychotics in patients with dementia with Lewy bodies, the second most prevalent neurodegenerative disorder. This case report describes a significant cognitive improvement observed through the use of an atypical antipsychotic in a patient with dementia with Lewy bodies. The observed divergence in cognitive responsiveness is discussed mechanistically on both the clinical and neuromolecular level. Limitations to this case study design are presented and discussed. The prudence of caution in importing the results of the Clinical Antipsychotic Trials of Intervention Effectiveness‐Alzheimer's Disease study to the dementia with Lewy bodies population is summarized and presented for psychiatrists, neurologists and primary care providers, with an intent to stimulate discussion and further research.
Effects of Yangxue Qingnao Granules on chronic cerebral circulation insufficiency: a randomized, double‐blind, double‐dummy, controlled multicentre trial
Authors: WU Chenghan , LIAO Lianming , YAN Xiaohua , LI Meide , WU Songying , WANG Jinmin , LIN Jushan , LI Shiju , GAO Lili , DU Jian , YANG Renmin ,   The Yangxue Qingnao Granule CHRONIC CEREBRAL HYPOPERFUSION STUDY GROUP
Published: April 2013

Background:  There is a great deal of interest in traditional Chinese medicine as a treatment for chronic cerebral circulation insufficiency (CCCI). In the present study, we evaluated the efficacy and safety of Yangxue Qingnao Granules (YXQNG) as a monotherapy in patients with CCCI.

Methods:  From July 2007 to May 2010, 273 patients with CCCI at nine centres in China were randomly assigned to receive either YXQNG with nimodipine placebo (n= 140, 12 g/day) or nimodipine with YXQNG placebo (n= 133, 30 mg/day) for 8 weeks. The primary end points after 8 weeks of treatment were changes from baseline in severity of headache, heavy‐headed feeling, dizziness and sleep disorder.

Results:  The mean baseline levels of headache, heavy‐headed feeling, dizziness and sleep disorder were comparable between the two groups. Both therapies significantly improved these symptoms after 8 weeks of treatment (P < 0.001). Compared with nimodipine therapy, YXQNG resulted in similar reductions in these symptoms. No adverse effects were observed in the YXQNG group.

Conclusions:  These data demonstrate that YXQNG as a monotherapy were as effective as nimodipine monotherapy in improving the symptoms of CCCI. It is well‐tolerated and may have an important place in the management of this condition. Whether a combination of these two medicines will increase therapeutic efficacy deserves further clinical investigation.
Using hypernatraemic events to predict reduced renal function in elderly lithium patients: a brief report
Authors: Rej Soham , Senouci Soumia I. , Looper Karl , Segal Marilyn
Published: April 2013

Background

Diabetes insipidus (DI) is a recognized adverse effect of lithium use, and studies have shown an association between decreased renal function and DI in patients using lithium. We hypothesize that hypernatraemic events that occur in DI predict decreased renal function in elderly patients on lithium.

Methods

We conducted a retrospective cohort study involving 55 geriatric psychiatry patients using lithium between 1985 and 2010. Patients who always had sodium levels ≤146 mmol/L were compared to patients with one or more episodes of hypernatraemia (serum sodium level ≥147 mmol/L) for estimated glomerular filtration rate (eGFR) levels and prevalence of severe chronic renal failure (eGFR ≤30 mL/min/1.73 m2).

Results

eGFR was found to be less in the hypernatraemic group than in the non‐hypernatraemic controls (41 vs 56 mL/min/1.73 m2; P = 0.0074). Severe chronic renal failure appeared more prevalent in hypernatraemic patients (4/14 (28.6%) vs. 3/41 (7.3%)), but this did not achieve statistical significance (P = 0.061). The two groups did not differ for age, sex, medical comorbidities or other clinical variables, except antidepressant use. Hypernatraemic patients appeared less likely to use antidepressants than non‐hypernatraemic patients, odds ratio = 0.69 (P = 0.020). However, in multivariate analysis, hypernatraemia correlated with decreased eGFR (β = −0.39, P = 0.004), while antidepressant use did not (P = 0.81).

Conclusions

These results suggest that hypernatraemic events may predict reduced renal function in geriatric patients using lithium. The role of hypernatraemia and DI in renal failure in this population requires further study. Health professionals should be aware of the risks of renal failure in older patients treated with lithium, especially in the context of sodium level abnormalities.
Synthesis of Germanium–Gallium–Tellurium (Ge–Ga–Te) Ceramics by Ball‐Milling and Sintering
Authors: Hubert Mathieu , Petracovschi Elena , Zhang Xiang‐Hua , Calvez Laurent
Published: April 2013

In this study, we present the preparation of a bulk material with a composition of 80GeTe2–20Ga2Te3 by combining mechanosynthesis and sintering. This composition cannot be prepared by conventional melt/quenching technique. The progressive evolution of the powder during ball‐milling is followed by X‐ray Diffraction (XRD) and Differential Scanning Calorimetry analysis. The final powder obtained is highly crystalline, but a glass transition temperature (Tg) is observed, indicating the presence of some amorphous phase remaining, allowing for its efficient sintering. By hot‐pressing, a dense bulk material with a fine microstructure and a high electrical conductivity is obtained. The synthesis method described represents a simple and cost‐effective way to produce tellurium‐based materials of desired dimension with potential applications for optical storage or thermoelectric devices.
Phase Evolution of SiO2–Al2O3–ZnO–CaO–ZrO2–TiO2‐Based Glass with Added Y‐PSZ Particles
Authors: Wang Xin , Chen Minghui , Zhu Shenglong , Wang Fuhui
Published: April 2013

Yttria partially stabilized zirconia Y‐PSZ/glass‐ceramic composites were prepared by reaction sintering using powder mixtures of a SiO2–Al2O3–ZnO–CaO–ZrO2–TiO2‐based glass and yttria partially stabilized zirconia (Y‐PSZ). The glass crystallized during sintering at temperatures of 1173, 1273, and 1373 K to give a glass‐ceramic matrix for high‐temperature protecting coatings. With the increasing firing time, the added zirconia reacted with the base glass and a glass‐ceramic material with dispersed zircon particles was prepared in situ. Furthermore, the added zirconia changed the crystallization behavior of the base glass, affecting the shape, amount, and distribution of zircon in the microstructure. The bipyramid‐like zircon grains with imbedded residual zirconia particles turned out to have two growth mechanisms: the inward growth and the outward growth, and its rapid growth was mainly dominated by the later one. For comparison, the referenced glass‐ceramic was prepared by sintering using exclusive glass granules and its crystallization behavior at 1173–1373 K was examined as well. Scanning electron microscopy (SEM), energy dispersive X‐ray spectroscopy (EDS), transmission electron microscopy (TEM), and X‐ray diffraction (XRD) were used to characterize the crystallization behavior of the base glass and the phase evolution of the Y‐PSZ/glass‐ceramic composites.
What explains the distribution of doctors and nurses in different countries, and does it matter for health outcomes?
Authors: Carr‐Hill Roy , Currie Elizabeth
Published: April 2013

Aims

To re‐examine the form of the relationships between the global distribution of health professionals (physicians and nurses), gross national product per capita, female literacy, and infant and under‐5 mortality rates reported in three papers by Robinson and Wharrad using more recent data. The secondary aim was to explore prior assumptions about the quality of the data, the homogeneity of the sample, and the form of the relationship.

Background

The analyses by Robinson and Wharrad did not take account of differences between developing and developed countries. Furthermore, the intervening years have seen changes in healthcare professional roles and their global distribution. Re‐examination of these relationships is therefore timely.

Design

A secondary analysis of routinely collected data from international databases.

Methods

A database was constructed from Organisation for Economic Co‐operation and Development, United Nations and World Bank sources on 177 countries for around 2005. Regression analyses were performed first with number of physicians and of nurses per 1000 population as dependent variables and gross national product per capita, female literacy rates, and the Gini coefficient as independent variables; and second with all those variables as independent variables and infant mortality, under‐5 mortality rates, and maternal mortality rates as dependent variables.

Results

There were clear and interesting differences between richer (Organisation for Economic Co‐operation and Development) countries and developing countries in the coefficients and in the power of the equations.

Conclusions

The importance of understanding the implications of carrying out cross‐country analysis and the urgent need for standardization of definitions in datasets are emphasized.
Discussion: “America's Rivers and the American Experiment” by Martin W. Doyle
Authors: Auerbach Daniel A.
Published: April 2013

Doyle cogently describes advantages and concerns related to the system of United States river management in the context of its historical and political development. He rightly asserts the need for flexible, adaptable institutions in order to address changing societal demands. However, river management also requires certain inflexible standards in order to discern and prevent practices that undermine future human needs. Where modern scientific evidence converges with cultural traditions of stewardship, river managers can comfortably assert limits to specific patterns of use and to the malleability of restrictions.
Spatial Considerations in Wet and Dry Periods for Phosphorus in Streams of the Fort Cobb Watershed, United States
Authors: Franklin Dorcas H. , Steiner Jean L. , Duke Sara E. , Moriasi Daniel N. , Starks Patrick J.
Published: April 2013

The Fort Cobb Watershed in Oklahoma has diverse biogeophysical settings and provides an opportunity to explore the association of water quality with a diverse set of landscapes during both wet (April 2007‐December 2009) and dry (January 2005‐March 2007) periods. The objective of this work was to identify spatial patterns in phosphorus (P) (soluble reactive P [SRP] and bioavailable P [BAP]) associated with landscape metrics for two distinct streamflow regimes. Spatial autocorrelation of P was evaluated using contiguous (side‐by‐side) and upstream (upstream:downstream) connectivity matrices. Biogeophysical metrics were compiled for each contributing area, and were partitioned based on association to P concentrations. Results for both SRP and BAP indicated that spatial autocorrelation was present (p < 0.05). There was more spatial autocorrelation and stream P concentrations were three to five times higher in the Wet phase than in the Dry phase (p < 0.05). Analysis with recursive partitioning resulted in higher R2 with spatial autocorrelation than without spatial autocorrelation and indicated that lateral metrics (topography, soil, geology, management) were better predictors for SRP than instream metrics. During Wet phase, lateral metrics indicative of rapid surface and subsurface water movement were associated with higher P stream concentrations. This research demonstrated that we can detect landscapes more vulnerable to P losses and/or contaminations in either drought or very wet periods.
Natural, practical and social contexts of e‐learning: a critical realist account for learning and technology
Authors: Li Z.
Published: April 2013

Much of the research in educational technology with a primary concern over how technology enhances learning has been criticized as privileging the immediate learning settings over the other dimensions of learners’ social life and the wider social and economic contexts in which learning and technology are located. The ability to develop a rich understanding of learning and technology in various contexts requires careful use of theory that might enable ‘looking beyond learning’. To meet this need, this paper proposes the use of a critical realistic account of learning and technology, in particular Margaret Archer's ‘three orders of reality’ and ‘personal Identity’. Drawing on an empirical case study for illustration, the paper argues that such an approach offers a ‘way out’ to unpack the relationship between learning and technology through a deep exploration of the interrelationship between individual practices of learning, with or without technology, and the bigger picture of how learning intervenes in other dimensions of social life and how other contexts come into play in learning settings.
Similar Blood Pressure Values Across Racial and Economic Groups: Baseline Data from a Group Randomized Clinical Trial
Authors: Carter Barry L. , Coffey Christopher S. , Uribe Liz , James Paul A. , Egan Brent M. , Ardery Gail , Chrischilles Elizabeth A. , Ecklund Dixie , Vander Weg Mark , Vaughn Thomas ,   Collaboration Among Pharmacists and Physicians to Improve Outcomes Now (CAPTION) trial investigators
Published: April 2013

This paper examines baseline characteristics from a prospective, cluster‐randomized trial in 32 primary care offices. Offices were first stratified by percentage of minorities and level of clinical pharmacy services and then randomized into 1 of 3 study groups. The only differences between randomized arms were for marital status (P=.03) and type of insurance coverage (P<.001). Blood pressures (BPs) were similar in Caucasians and minority patients, primarily blacks, who were hypertensive at baseline. On multivariate analyses, patients who were 65 years and older had higher systolic BP (152.4±14.3 mm Hg), but lower diastolic BP (77.3±11.8 mm Hg) compared with those younger than 65 years (147.4±15.0/88.6±10.6 mm Hg, P<.001 for both systolic and diastolic BP). Other factors significantly associated with higher systolic BP were a longer duration of hypertension (P=.04) and lower basal metabolic index (P=.011). Patients with diabetes or chronic kidney disease had a lower systolic BP than those without these conditions (P<.0001). BP was similar across racial and socioeconomic groups for patients with uncontrolled hypertension in primary care, suggesting that patients with uncontrolled hypertension and an established primary care relationship likely have different reasons for poor BP control than other patient populations.
Finite Element Analysis of an Implant‐Assisted Removable Partial Denture
Authors: Shahmiri Reza , Aarts John M. , Bennani Vincent , Atieh Momen A. , Swain Michael V.
Published: April 2013

Purpose

This study analyzes the effects of loading a Kennedy class I implant‐assisted removable partial denture (IARPD) using finite element analysis (FEA). Standard RPDs are not originally designed to accommodate a posterior implant load point. The null hypothesis is that the introduction of posteriorly placed implants into an RPD has no effect on the load distribution.

Materials and Methods

A Faro Arm scan was used to extract the geometrical data of a human partially edentulous mandible. A standard plus regular neck (4.8 × 12 mm) Straumann® implant and titanium matrix, tooth roots, and periodontal ligaments were modeled using a combination of reverse engineering in Rapidform XOR2 and solid modeling in Solidworks 2008 FEA program. The model incorporated an RPD and was loaded with a bilateral force of 120 N. ANSYS Workbench 11.0 was used to analyze deformation in the IARPD and elastic strain in the metal framework.

Results

FEA identified that the metal framework developed high strain patterns on the major and minor connectors, and the acrylic was subjected to deformation, which could lead to acrylic fractures. The ideal position of the neutral axis was calculated to be 0.75 mm above the ridge.

Conclusion

A potentially destructive mismatch of strain distribution was identified between the acrylic and metal framework, which could be a factor in the failure of the acrylic. The metal framework showed high strain patterns on the major and minor connectors around the teeth, while the implant components transferred the load directly to the acrylic.
Prosthodontic and Surgical Management of a Completely Edentulous Patient with a Severe Class III Skeletal Maxillomandibular Relationship: A Clinical Report
Authors: Ashy Linah M. , Sukotjo Cortino
Published: April 2013

This article describes a multidisciplinary approach combining surgical and prosthodontic treatment of a completely edentulous patient who presented with a severe skeletal class III relationship and was diagnosed as American College of Prosthodontists Prosthodontic Diagnostic Index (ACP PDI) class IV. The use of a complete denture serving as diagnostic tool, surgical guide, and definitive restoration is presented. Computer‐aided surgical simulation was used to achieve an accurate diagnostic and surgical plan. Maxillary Lefort class I and mandibular sagittal split osteotomy surgical treatment was performed to correct arch discrepancy. The surgical procedure demonstrated a clinically acceptable maxillomandibular relationship and stability. The patient was satisfied with the esthetics and demonstrated improved oral function following prosthesis insertion.
Implant‐Supported Oral Rehabilitation of a Patient with Pemphigus Vulgaris: A Clinical Report
Authors: Altin Nazlı , Ergun Sertan , Katz Joseph , Sancakli Erkan , Koray Meltem , Tanyeri Hakkı
Published: April 2013

Pemphigus vulgaris (PV) is a rare mucocutaneous vesiculobullous disease characterized by the development of autoantibodies against the desmosomal proteins. Current treatment is largely based on systemic immunosuppression using systemic corticosteroids. Immunosuppressive drugs used in the treatment of the disease may increase the risk of infection and delayed healing, which are of concern in dental treatment procedures in this group of patients. The clinical outcomes of implants in PV have not been investigated. We present a case of PV rehabilitated with an implant‐supported prosthesis with a 32‐month follow‐up and discuss the important points in the surgical and prosthodontic phases.
‘We have got the tools’: Qualitative evaluation of a mental health Wellness Recovery Action Planning (WRAP) education programme in Ireland
Authors: Keogh B. , Higgins A. , DeVries J. , Morrissey J. , Callaghan P. , Ryan D. , Gijbels H. , Nash M.
Published: April 2013

Accessible summary

Because Recovery is an important idea, an educational course was run to help service users and professionals to introduce Wellness Recovery Action Planning (WRAP) to interested parties in their communities.

The evaluation of this course made use of group interviews in which participants were asked about their experiences on the course.

Although they enjoyed the course and were positive about Recovery and WRAP, they felt that they still lacked confidence in the presentation skills that they felt they required.

In recent years, there has been a consistent drive to incorporate Recovery principles into the Irish mental health services. A group of Irish mental health service providers came together and delivered a 5‐day Wellness Recovery Action Planning (WRAP) facilitator's programme. The programme was developed and delivered by key stakeholders including people with self‐experience of mental health problem. This paper presents the qualitative findings from an evaluation of these facilitator's programmes. Three focus groups were held with 22 people, the majority of who described themselves as mental health professionals and/or people with self‐experience of mental health problems. Data were analysed using a thematic approach and yielded four themes. Although the participants were positive about the programme and felt that their knowledge of Recovery and WRAP had improved, they felt that they still lacked confidence in terms of the presentation skills required for facilitating Recovery and WRAP programmes. The findings suggest that mental health service providers who wish to develop service users and clinicians as WRAP facilitators need to put more emphasis on the provision of facilitation and presentation skills in the programmes they develop.
New Developments in Education and Training in Sexual Medicine
Authors: Reisman Yacov , Eardley Ian , Porst Hartmut , Multidisciplinary Joint Committee on Sexual Medicine (MJCSM)
Published: April 2013

Introduction

The past 12 months have been historic ones for the field of Sexual Medicine in that we have seen the creation of the European Board examination in Sexual Medicine with the title of “Fellow of the European Committee on Sexual Medicine” (FECSM) offered to successful candidates.

Aim

The study aims to promote a high standard of care in Sexual Medicine.

Methods

An important way of promoting high standards of care is by the development of training, regulation, and assessment framework. The background to these developments and the recent educational activities of the European Society for Sexual Medicine (ESSM) are described in this article.

Results

The creation of the Multidisciplinary Joint Committee on Sexual Medicine (MJCSM) under the auspices of the European Union of Medical Specialists, with the primary purpose to develop the highest possible standards of training in Sexual Medicine in Europe, made it possible to create a process for qualification in Sexual Medicine. The ESSM educational activities created opportunities to support trainees in Sexual Medicine and the first MJCSM exam was held in Amsterdam with a high overall success rate.

Conclusion

These activities are intended to improve quality. The FECSM examination is the first of its type and provides a real opportunity for Sexual Medicine physicians to demonstrate and document their knowledge.
Critical Realism and the Process Account of Emergence
Authors: Pratten Stephen
Published: April 2013

For advocates of critical realism emergence is a central theme. Critical realists typically ground their defence of the relative disciplinary autonomy of various sciences by arguing that emergent phenomena exist in a robust non‐ontologically, non‐causally reductionist sense. Despite the importance they attach to it critical realists have only recently begun to elaborate on emergence at length and systematically compare their own account with those developed by others. This paper clarifies what is distinctive about the critical realist account of emergence by comparing it with an alternative. Critical realism and interactivism are shown to independently converge on the same general process (or constraint) view of emergence and develop complementary accounts of particular emergents.
Nations, National Cultures, and Natural Languages: A Contribution to the Sociology of Nations
Authors: Pickel Andreas
Published: April 2013

This paper seeks to contribute to the sociology of nations, a literature that is only starting to carve out its place in the social sciences. The paper offers a reconceptualization of “nations” as “national cultures”, employing an evolutionary perspective and a systemic framework in which “nations” are understood as cultural systems of a special kind. National cultures are intimately tied to natural languages, and the acquisition of a national culture occurs as part and parcel of the acquisition of a natural language. Acquiring a natural language is a prerequisite for learning other cultural systems (artefactual languages as well as other natural languages). National cultures function as metacultures. They are also the reference cultures for modern states and their citizens, a political dimension of nations that is of paramount importance, though it will only be touched on in this paper. National cultures should be considered as the most fundamental type of cultural system today.
All‐oral therapy with nucleotide inhibitors sofosbuvir and GS‐0938 for 14 days in treatment‐naive genotype 1 hepatitis C (NUCLEAR)
Authors: Lawitz E. J. , Rodriguez‐Torres M. , Denning J. , Mathias A. , Mo H. , Gao B. , Cornpropst M. T. , Berrey M. M. , Symonds W. T.
Published: April 2013

Sofosbuvir and GS‐0938 are distinct nucleotide analogues with activity against hepatitis C virus (HCV) in vitro. We evaluated the antiviral activity and safety of sofosbuvir and GS‐0938 alone and in combination in HCV genotype 1 patients. In this double‐blind study, 40 treatment‐naïve patients were randomly assigned to 4 treatment cohorts: (i) GS‐0938 for 14 days, (ii) GS‐0938 for 7 days followed by GS‐0938 plus sofosbuvir for 7 days, (iii) sofosbuvir for 7 days followed by GS‐0938 plus sofosbuvir for 7 days and (iv) GS‐0938 plus sofosbuvir for 14 days. In each arm, 8 patients received active drug and 2 placebo. After 7 days of dosing, patients in all 4 dose groups experienced substantial reductions in HCV RNA, with median declines (Q1, Q3) of −4.50 (−4.66, −4.24) in Cohort 1, −4.55 (−4.97, −4.13) in Cohort 2, −4.65 (−4.78, −4.17) in Cohort 3 and −4.43 (−4.81, −4.13) in Cohort 4; patients receiving placebo had essentially no change in HCV RNA (+0.07 log10 IU/mL). Seven days after the end of treatment, the proportions of patients with HCV RNA <15 IU/mL were 4 (50%), 8 (100%), 7 (88%) and 5 (63%) for Cohorts 1–4, respectively, vs 0 for placebo. No viral breakthrough or resistance mutations were observed. No serious adverse events or Grade 3 or 4 adverse events were reported. Sofosbuvir and GS‐0938—alone and in combination—were well tolerated and led to substantial reductions in viral load. Sofosbuvir is undergoing further investigation as a possible backbone of an all‐oral regimen for chronic HCV.
Coke, the statute, wives and lovers: routes to a harsher interpretation of the Statute of Westminster II c. 34 on dower and adultery
Authors: Seabourne Gwen
Published: March 2013

In the Statute of Westminster II (1285) c. 34, it was enacted that a widow could lose her action of dower, and the possibility of claiming the usual proportion of her deceased husband's real property, if, while he was alive, she had left him for a lover, and the married couple had not been reconciled during the husband's life. This new exception to the action of dower represented an important change in the balance between a widow and her husband's heir, or others with an interest in lands she might claim as her dower, and is therefore of great significance to the history of women, law and property in the common law world. The exception remained part of the law of England until dower itself was abolished in 1925, but, although the early years of the exception have been explored, its later history is less well known. As this paper will show, there was a slow and contested move away from the early literal and relatively ‘widow-friendly’ interpretation of c. 34 to a purposive, more moralising and much more ‘widow-unfriendly’ view, influenced by the opinion of Sir Edward Coke (1552–1634), and encouraged by a number of other legal and social factors.
Biliary cast syndrome post–liver transplantation: risk factors and outcome
Authors: Voigtländer Torsten , Negm Ahmed A. , Strassburg Christian P. , Lehner Frank , Manns Michael P. , Lankisch Tim O.
Published: April 2013

Background

Biliary cast syndrome (BCS) is characterized by the retention of lithogenic material leading to obstructive cholangitis and subsequent liver damage. BCS after orthotopic liver transplantation (OLT) can lead to retransplantation or death.

Aim

Evaluation of aetiology, risk factors and outcome of BCS after OLT.

Methods

In a retrospective single centre analysis between 2002 and 2011, all OLT patients with BCS diagnosed by endoscopic retrograde cholangiography were identified and compared with a matched control group at a 2:1 ratio.

Results

Thirty patients with BCS after OLT were identified (30/887, 3.4%). Seventy per cent of those patients (21/30) underwent transplantation in the Model for Endstage Liver Disease (MELD) score era. Median time to diagnosis after OLT was 255 days (IQR 107–621). Intensive care unit treatment after OLT was significantly longer in BCS patients [16 days (IQR 8–42) vs. 9 (IQR 7–17) days; P = 0.039]. In a multivariate analysis, hepatic artery stenosis (P = 0.04), biliary strictures (P = 0.032) and need for renal replacement therapy (P = 0.002) were significantly associated with BCS. Immunosuppressant regimen, operation time, cold or warm ischaemia time, graft size, acute cellular rejection and cytomegalovirus infections were not significantly different between both groups. Retransplantation rate and 12‐month mortality were significantly higher with BCS (9/30, 30% vs. 4/60, 7%, P = 0.003).

Conclusions

BCS is a rare, but severe complication after OLT. Patients with hepatic artery stenosis, biliary strictures or renal replacement therapy have the highest risk to develop BCS and should therefore be monitored carefully.
Depression, Anxiety and the Bladder
Authors: SAKAKIBARA Ryuji , ITO Takashi , YAMAMOTO Tatsuya , UCHIYAMA Tomoyuki , YAMANISHI Tomonori , KISHI Masahiko , TSUYUSAKI Yohei , TATENO Fuyuki , KATSURAGAWA Shuichi , KUROKI Nobuo
Published: April 2013

Depression and anxiety are common mental illnesses. It is recognized that depression/anxiety causes physical changes, including insomnia, anorexia, and bladder dysfunction. We aimed to delineate bladder dysfunction in patients with depression/anxiety by reviewing the literature. We performed a systematic review of the literature to identify the frequency, lower urinary tract symptoms (LUTS), urodynamic findings, putative underlying pathology, and management of bladder dysfunction in patients with depression/anxiety. From a recent survey of a depression cohort (at a psychiatry clinic), the frequency of bladder dysfunction in depression is lower (up to 25.9%) than that in Parkinson's disease (up to 75%) and stroke (up to 55%), whereas it is significantly higher than that in age‐matched controls (around 10%). In both the depression cohort and the psychogenic bladder dysfunction cohort (at a urology clinic), the most common LUTS was overactive bladder (OAB), followed by difficult urination and infrequent voiding. Compared with severe LUTS, urodynamic findings were dissociated; i.e. urodynamic findings were normal except for increased bladder sensation without detrusor overactivity for OAB (50% of all patients), followed by underactive detrusor without post‐void residual for difficult urination. The effectiveness of serotonergic or anti‐cholinergic medication for ameliorating OAB in the patients awaits further study. In conclusion, although the frequency of LUTS among the depression cohort is not elevated, depression/anxiety is obviously a risk factor for OAB. This finding presumably reflects that the bladder is under emotional control. Amelioration of bladder dysfunction is an important target in treating patients with depression/anxiety.
A petrogenetic model for the comagmatic origin of chassignites and nakhlites: Inferences from chlorine‐rich minerals, petrology, and geochemistry
Authors: McCubbin Francis M. , Elardo Stephen M. , Shearer Charles K. , Smirnov Alexander , Hauri Erik H. , Draper David S.
Published: April 2013

Twelve samples belonging to the chassignite and nakhlite subgroups of Martian meteorites were investigated using a variety of micro‐beam analytical techniques to gain insight into the petrogenesis of these two meteorite classes. There are a striking number of geochemical similarities between the chassignites and nakhlites, including mineralogy and petrology, crystallization age, cosmic‐ray exposure age, and radiogenic isotopic compositions. However, there are also geochemical differences, namely in trace element systematics of pyroxenes, that have led some authors to conclude that the nakhlites are comagmatic with each other, but not comagmatic with the chassignites. On the basis of data presented here, we propose a model in which these differences can be reconciled by the addition of an exogenous Cl‐rich fluid to the chassignite‐nakhlite magma body shortly after the formation of the cumulate horizon that was sampled by the Chassigny meteorite. This model is supported by the textural and chemical associations of the volatile‐bearing minerals apatite, amphibole, and biotite, which record a history starting with the addition of a Cl‐ andLREE‐enriched fluid to the magma body. As the magma continued to crystallize, it eventually reached chloride saturation and degassed a Cl‐rich fluid phase. Depending on the provenance of the Cl‐rich fluid, this model could explain how the chassignites and nakhlites originated from anLREE‐depleted source, yet all exhibitLREE‐enriched bulk‐rock patterns. Additionally, the model explains the range in oxygen fugacity that is recorded by the chassignites and nakhlites because eventual exsolution and loss of Cl‐rich fluid phases near the end of crystallization of the nakhlite sequence leads to auto‐oxidation of the magma body due to the preferential partitioning of Fe2+into the fluid phase.
Mindreading in Infancy
Authors: Carruthers Peter
Published: April 2013

Various dichotomies have been proposed to characterize the nature and development of human mindreading capacities, especially in light of recent evidence of mindreading in infants aged 7 to 18 months. This article will examine these suggestions, arguing that none is currently supported by the evidence. Rather, the data support a modular account of the domain‐specific component of basic mindreading capacities. This core component is present in infants from a very young age and does not alter fundamentally thereafter. What alters with development are the interactions between core mindreading and other systems, including executive systems, and forms of learning that do not require radical conceptual change.
Protagonist Projection
Authors: Stokke Andreas
Published: April 2013

This article provides a semantic analysis of Protagonist Projection, the phenomenon by which things are described from a point of view different from that of the speaker. Against what has been argued by some, the account vindicates the intuitive idea that Protagonist Projection does not give rise to counterexamples to factivity, and similar plausible principles. A pragmatics is sketched that explains the attitude attributions generated by Protagonist Projection. Further, the phenomenon is compared to Free Indirect Discourse, and the proposed account is seen to preserve the relation between them.