bluuebunny/crossref_metadata_2025 huggingface dataset:
Distance from care predicts in-hospital mortality in HIV-infected patients with severe sepsis from rural and semi-rural Virginia, USA
Authors: Evans Emily E , Wang Xin-Qun , Moore Christopher C
Published: May 2015

There are few data regarding outcomes from severe sepsis for HIV-infected patients living in rural or semi-rural settings. We aim to describe the characteristics and predictors of mortality in HIV-infected patients admitted with severe sepsis to the University of Virginia located in semi-rural Charlottesville, Virginia, USA. We queried the University of Virginia Clinical Data Repository for cases with ICD-9 codes that included: (1) infection, (2) acute organ dysfunction, and (3) HIV infection. We reviewed each case to confirm the presence of HIV infection and severe sepsis. We recorded socio-demographic, clinical, and laboratory data. We used a generalised linear mixed-effects model to assess pre-specified predictors of mortality. We identified 74 cases of severe sepsis in HIV-infected patients admitted to University of Virginia since 2001. The median (IQR) age was 44 (36–49), 32 (43%) were women, and 56 (76%) were from ethnic minorities. The median (IQR) CD4+ T-cell count was 81 (7–281) cells/µL. In-hospital mortality was 20%. When adjusted for severity of illness and respiratory failure, patients who lived >40 miles away from care or had a CD4+ T cell count <50 cells/µL had > four-fold increased risk of death compared to the rest of the study population (AOR = 4.18, 95% CI: 1.09-16.07, p = 0.037; AOR = 4.33, 95% CI: 1.15–16.29, p = 0.03). In HIV-infected patients from rural and semi-rural Virginia with severe sepsis, mortality was increased in those that lived far from University of Virginia or had a low CD4+ T cell counts. Our data suggest that rural HIV-infected patients may have limited access to care, which predisposes them to critical illness and a high associated mortality.
Atlas Labs: Gearing for Growth
Authors: Bhaskaran Bala
Published: May 2015

The case is structured around the infancy problems being faced by the firm Atlas Labs. As a start-up initiated by technocrats with limited financial resources, the firm is struggling to find the financial resources necessary to create adequate facilities to meet quality standards demanded by a sophisticated customer segment. The professional background and expertise of the promoters are impeccable; their goodwill with domestic customers is also very good. They have managed the firm with meager resources, high dedication and great personal sacrifices. The firm has no debt but its volume of operations is constrained by facilities. If the firm fails to find a way out of this situation quickly, it would drift and would become unviable; or it would be grabbed by outsiders with the promoters not getting due return. The firm’s constitution is not ideally suited for the growth that is possible in the business sector. The challenge before the firm is about re-constitution, about finding the optimal financial structure to cater to long-term growth and about coming out of the current crisis. The firm needs to develop an action plan that builds in all these elements.
Business Portfolio Planning at Roland Construction Company Limited
Authors: Phadtare Milind T.
Published: May 2015

This case is developed in the context of infrastructure construction business in India and provides an insight into different sectors of infrastructure. It involves appraising the business environment, SWOT analysis and development of Environmental Threat Opportunity Profile. It also involves application of the BCG growth-share matrix and GE 9 Cell Matrix models for project portfolio management and decision regarding the entry into a new infrastructure construction business. It also brings out the differences between the two models vis-à-vis subjectivity, simplicity, holistic view and their applicability.
KoldKraft Pakistan: An Entrepreneurial Journey
Authors: Qureshi Shahid , Aftab Ebraheem
Published: May 2015

The case describes the entrepreneurial journey of Tariq Siraj. He is a mechanical engineering graduate from UET Lahore and started his entrepreneurial journey right after his graduation. The sequence of events enabled him to discover his entrepreneurial mindset. The case starts with the opportunity recognition, evaluation and refinement process followed by the resource acquisition process for the new start-up. The case discusses the various influencers who helped Tariq to plunge into an entrepreneurial journey. This case is well suited to apply the Opportunity + People + Resources = Fit (Timmons model) to the case analysis. KoldKraft continued growth by diversifying its product and services portfolio and taking the business to wherever there was need for cooling and refrigeration solutions. The current economic circumstances however, left the business quite stagnant. The case further discusses the management dilemmas being faced by Tariq.

This case adds value towards the entrepreneurship literature in Pakistan as it describes the pursuit of entrepreneurial opportunities in the much ignored agriculture sector of the country. The use of technology to add value in the agriculture business in a creative and resourceful manner is a key lesson of the case.
GIKI MEMS Lab—Architects of Tiny Machines
Authors: Chatha Kamran A. , Omar Aziz
Published: May 2015

The case describes the dynamics faced by Dr Shafaat Bazaz, a foreign faculty member hired by the Higher Education Commission (HEC) of Pakistan, in establishing a state-of-the-art research lab at Ghulam Ishaq Khan Institute (GIKI), a premier engineering institute in Pakistan. The lab specialized in designing tiny micro electro-mechanical systems (MEMS). During five years of untiring efforts, the lab produced both skilled human resources in MEMS technologies and a number of cutting-edge technologies (devices) comparable to, and even surpassing, specifications of similar products developed in other countries. The efforts contributed significantly in the introduction and launch of a new industry in Pakistan. The case also highlights the numerous entities that Shafaat interacted with while producing a continuous stream of funding for meeting bare-minimum operational needs of the lab, amidst other challenges, while bearing a perpetual opportunity cost himself. At the time of writing this case, MEMS lab had acquired the capability of offering commercial design services to companies in the Americas and Europe. At the same time, it was engaged in research collaborations with various international institutions for development of new technologies. The potential of producing revenues through commercial activity could be utilized for further development of the MEMS lab and its research potential and resources. However, any future decision on commercializing activity was dependent on Shafaat’s own future, which was uncertain due to possible devolution of HEC in 2011 (as he was an HEC-hired foreign faculty working at GIKI). Shafaat had to decide what the future held for MEMS lab and for himself.
Punish and perish?
Authors: Antoci Angelo , Zarri Luca
Published: May 2015

The evolution of large-scale cooperation among strangers is a fundamental unanswered question in the social sciences. Behavioral economics has persuasively shown that the so-called strong reciprocity plays a key role in accounting for the endogenous enforcement of cooperation. Insofar as strongly reciprocal players are willing to costly sanction defectors, cooperation flourishes. However, experimental evidence unambiguously indicates that not only defection and strong reciprocity, but also unconditional cooperation without punishment is a quantitatively important behavioral attitude. By referring to a prisoner’s dilemma framework where punishment (“stick”) and rewarding (“carrot”) options are available, here we show analytically that the presence of cooperators who don’t punish in the population makes altruistic punishment evolutionarily weak. We show that cooperation breaks down and strong reciprocity is maladaptive if costly punishment means “punishing defectors” and, even more so, if it is coupled with costly rewarding of cooperators. In contrast, punishers do not perish if cooperators, far from being rewarded, are sanctioned. These results, based on an extended notion of strong reciprocity, challenge evolutionary explanations of cooperation that overlook the “dark side” of altruistic behavior.
The Impact of Interpersonal Style and Interpersonal Complementarity on the Therapeutic Alliance Between Therapists and Offenders in Sex Offender Treatment
Authors: Watson Rachael , Daffern Michael , Thomas Stuart
Published: May 2015

Therapist and treatment process variables affect the effectiveness of offender rehabilitation programs. This study examined the influence of therapists’ and offenders’ interpersonal styles (IPSs) and interpersonal complementarity on therapeutic alliance (TA). Seventy-five sex offenders and their therapists evaluated each other’s IPSs and the TA after 3 weeks of treatment. Offenders evaluated the TA more positively than therapists. Regarding the impact of IPS, therapist affiliation was positively correlated and therapist control was negatively correlated with offenders’ ratings of the TA; in other words, offenders evaluated the TA more strongly when therapists were perceived as affiliative, and weaker when therapists were viewed as controlling. Offender affiliation was positively correlated with therapists’ ratings of TA; in other words, therapists evaluated the TA more strongly when offenders were viewed as more affiliative; perceptions of offender control were unrelated to offenders’ ratings of TA. Complementarity in IPS between offenders and therapists did not affect TA.
Brand Attachment, Tour Leader Attachment, and Behavioral Intentions of Tourists
Authors: Yen Chang-Hua , Chen Chien-Yu , Cheng Jui-Chang , Teng Hsiu-Yu
Published: May 2015

The brand of a travel agency and the tour leader play critical roles in travel decision making. Attachment theory has recently been extended to the domain of travel behavior. However, little academic attention has been paid to travel agency brand and tour leader attachment. The purpose of this study is to examine the effect of brand attachment and tour leader attachment on tourists’ behavioral intentions and to clarify the roles of perceived value and customer trust. The results indicate that brand attachment has an indirect effect on behavioral intentions through perceived value. Tour leader attachment also has both direct and indirect positive influences on tourists’ behavioral intentions. Finally, the influences of brand attachment and tour leader attachment on perceived value are stronger among customers with a high level of trust than among those with a low level of trust. The implications of these findings and future research are subsequently discussed.
Analytical solution for vibration and buckling of functionally graded sandwich beams using various quasi-3D theories
Authors: Osofero Adelaja I , Vo Thuc P , Nguyen Trung-Kien , Lee Jaehong
Published: May 2015

This paper presents an analytical solution for vibration and buckling of functionally graded (FG) sandwich beams using various quasi-3D theories, which consider effects of both shear and normal deformation. Sandwich beams with FG skins–homogeneous core and homogeneous skins–FG core are considered. By using the Hamilton’s principle, governing equations of motion are derived. An analytical solution is presented, and the obtained results by various quasi-3D theories are compared with each other and with the available solutions in the literature. The effects of normal strain, power-law indexes, skin–core–skin thickness and slenderness ratios on vibration and buckling behaviour of sandwich beams are investigated.
Identification of alcohol abuse and transition from long-term unemployment to disability pension
Authors: Nurmela Kirsti , Heikkinen Virpi , Hokkanen Risto , Ylinen Aarne , Uitti Jukka , Mattila Aino , Joukamaa Matti , Virtanen Pekka
Published: May 2015

Aims: The aim of the study was to reveal potential gaps and inconsistencies in the identification of alcohol abuse in health care and in employment services and to analyse the granting of disability pensions with respect to the alcohol abuse identification pattern. Methods: The material consisted of documentary information on 505 long-term unemployed subjects with low employability sent to the development project entitled ‘Eligibility for a Disability Pension’ in 2001–2006 in Finland. The dichotomous variables ‘Alcohol abuse identified in employment services’ and ‘Alcohol abuse identified in health care’ were cross-tabulated to obtain a four-class variable ‘Alcohol abuse identification pattern’. Logistic regression analyses were conducted to ascertain the association of alcohol abuse identification pattern with the granting of disability pensions. Results: Alcohol abuse was detected by both health care and employment services in 47% of those identified as abusers (41% of examinees). Each service systems also identified cases that the other did not. When alcohol abuse was identified in health care only, the OR for a disability pension being granted was 2.8 (95% CI 1.5–5.2) compared with applicants without identified alcohol abuse. The result remained the same and statistically significant after adjusting for confounders. Conclusions: Alcohol abuse identified in health care was positively associated with the granting of a disability pension. Closer co-operation between employment services and health care could help to identify those long-term unemployed individuals with impaired work ability in need of thorough medical examination.
Optimization of process parameters for plasma arc welding of austenitic stainless steel (304 L) with low carbon steel (A-36)
Authors: Fatima Shane , Khan Mushtaq , Jaffery Syed Husain Imran , Ali Liaqat , Mujahid Mohammad , Butt Shahid I
Published: May 2015

This research aims to optimize the process parameters of plasma arc welding for welding of dissimilar metals: austenitic stainless steel SS-304 L and low carbon steel A-36. It investigates the effect of welding current and welding speed on the quality of the welded joints. The quality characteristics like bead geometry, microstructure, hardness, ferrite measurement and tensile test are considered for qualification of the welded samples. Welded specimens were prepared both with and without filler material. These specimens were mechanically tested and analyzed using metallographic techniques. Based on the results, suitable welding parameters were found to be 45 A and 2 mm/s for samples prepared with and without filler wire. An all-martensitic weld zone structure was obtained for direct fusion. However, a complex heterogeneous microstructure was obtained by using austenitic stainless steel filler wire E 309 L. Hardness of directly fused sample was observed to be significantly higher compared to filler wire sample.
Sixty years of research on leadership in Africa: A review of the literature
Authors: Fourie Willem , van der Merwe Suzanne C , van der Merwe Ben
Published: May 2015

This paper reviews peer-reviewed research on leadership in Africa published from 1950 to 2009. The review has a dual purpose. On the one hand, it provides scholars with an entry point to the relatively large body of historical literature by means of a descriptive diachronic analysis of the literature. On the other hand, it also applies a synchronic analysis, and concludes with four interpretative statements on the scholarship on leadership in Africa. These statements are: (i) Scholarship on leadership in Africa has changed, and the change is lopsided; (ii) Female scholars are increasing, and they work on different themes from male scholars; (iii) Legitimacy remains a key issue, and continues to evolve; (iv) Authenticity has become a key issue and is now closely related to reclaiming African values.
Rapid palliative discharge home
Authors: Warwick Ian , Watson Max
Published: May 2015

When it comes to patients who are in the last days of life most healthcare professionals will make a special effort to ensure that care is delivered as well as possible, and, ‘walk the extra mile to do so’. Unfortunately, in an NHS that is under increasing pressure, and in which staff are feeling the effects of financial cutbacks and professional burnout, the community resources available to manage and support patients and families will vary greatly from area to area. Given these difficulties, how can we optimise our chances of a good outcome? The key to successful discharge to the community for imminently dying patients is good communication and good forward planning. This article aims to outline an approach to the dying patient who is rapidly discharged without prior involvement of the GP.
Hypo- and Hyperglycemic Alarms
Authors: Howsmon Daniel , Bequette B. Wayne
Published: May 2015

Soon after the discovery that insulin regulates blood glucose by Banting and Best in 1922, the symptoms and risks associated with hypoglycemia became widely recognized. This article reviews devices to warn individuals of impending hypo- and hyperglycemia; biosignals used by these devices include electroencephalography, electrocardiography, skin galvanic resistance, diabetes alert dogs, and continuous glucose monitors (CGMs). While systems based on other technology are increasing in performance and decreasing in size, CGM technology remains the best method for both reactive and predictive alarming of hypo- or hyperglycemia.
Functional outcomes and recanalization rates of stent retrievers in acute ischaemic stroke: A systematic review and meta-analysis
Authors: Grech Reuben , Mizzi Adrian , Pullicino Richard , Thornton John , Downer Jonathan
Published: May 2015

Background and purpose

Intra-arterial therapy for acute ischaemic stroke has evolved rapidly in the last few years. Stent retrievers have now replaced ‘first-generation’ devices, which have been the principle devices tested in stroke trials. Our aims were to determine the rates of successful recanalization and functional independence in acute stroke patients treated with stent retrievers. We also sought to assess the safety outcomes of stent retrievers by assessing the rates of mortality and intra-cranial haemorrhage.

Materials and methods

We conducted a systematic review and meta-analysis of studies which utilized stent retrievers as sole treatment or as part of a multi-modal approach in acute ischaemic stroke.

Results

We identified 20 eligible studies: 17 on Solitaire (ev3/Covidien, Irvine, California, USA) ( n = 762) and three on Trevo (Stryker, Kalamazoo, Michigan, USA) ( n = 210). The mean age of participants was 66.8 (range 62.1–73.0) years and the M:F ratio was 1.1:1. The average stroke severity score (National Institutes of Health Stroke Scale (NIHSS)) at presentation was 17.2. The weighted mean symptom onset to arterial puncture and procedural duration were 265.4 minutes and 54.8 minutes, respectively. Successful recanalization was achieved in 84.5% of patients with a weighted mean of 2.0 stent retriever passes. Independent functional outcome was achieved in 51.2% and the mortality rate was 16.8%.

Conclusion

Stent retrievers have the potential to achieve a high rate of recanalization and functional independence whilst being relatively safe. They should be assessed in well-designed randomized controlled trials to determine their efficacy and assess whether they compare favourably with ‘standard treatment’ in stroke.
Advances and challenges in the management of essential thrombocythemia
Authors: Birgegård Gunnar
Published: May 2015

The new World Health Organization (WHO) diagnostic criteria for essential thrombocythemia (ET) issued in 2008 made an important distinction between true ET and early myelofibrosis (MF), which has helped to identify a more homogenous population for the diagnosis with longer survival and much less transformation to overt MF. The recent finding of a new mutation ( CALR), which is mutually exclusive with JAK2 and MPL mutations, adds to the characterization of ET patients, since there are important phenotypic differences between the mutation types. CALR patients are younger, have lower white blood cell counts (WBC) and a lower thrombosis incidence. A growing field of interest is the state of hypercoagulation due to dysfunction of hemostatic systems, cell–cell interaction and hereditary prothrombotic traits. Activation of platelets, WBC and endothelial cells has been found, making the whole intravascular milieu prothrombotic. Several risk score models, based on retrospective studies, have been developed lately, distinguishing patient groups with graded risk for complications and death. Even if these may be helpful in evaluating patients, they have not been validated in prospective studies and there are not enough data to support their use as a basis for treatment algorithms. The traditional risk factors age, previous thrombosis and platelets >1500 × 109/l are still recommended for the distinction between high risk and low risk ET and the decision to give cytoreductive therapy. However, cardiovascular (CV) risk factors add to thrombosis risk and should be considered both for specific treatment in any risk group and for upgrading low risk patients with high CV risk to an intermediary group where active therapy with aspirin and cytoreduction may be considered. First-line cytoreductive therapy differs with age; in younger patients interferon (IFN) or anagrelide are preferable, in older patients hydroxycarbamide (HC). Second-line therapy for younger patients is HC, for older patients IFN or anagrelide (ANA). JAK2 inhibitors may be suitable in rare cases with symptoms not responding to other therapy.
How brand gives employees meaning: Towards an extended view of brand equity
Authors: Berger-Remy Fabienne , Michel Géraldine
Published: May 2015

Brand is a corporate equity often examined today from the marketing and financial points of view. The present research tries to show that brand value can also be seen in terms of the added meaning it gives employees. Based on a case study of four organizations, we show that brand creates a triad of qualities – signification, direction and sensation – for employees, distinct from those that consumers feel and understand. Accordingly, we revisit the concept of brand equity from the employee point of view, or Employee-Based Brand Equity (EBBE).
Metacognitions mediate HIV stigma and depression/anxiety in men who have sex with men living with HIV
Authors: Strodl Esben , Stewart Lauren , Mullens Amy B , Deb Sibnath
Published: May 2015

The study examined whether the relationships between HIV stigma and depression and anxiety would be mediated by metacognitive beliefs and thought control strategies in men who have sex with men living with HIV. Men who have sex with men living with HIV completed an online survey that measured 30-item Metacognitions Questionnaire, thought control strategies (Thought Control Questionnaire), as well as symptoms of depression (Patient Health Questionnaire-9) and anxiety (generalized anxiety disorder-7). The relationships between internalised and anticipated HIV stigma with depressive symptoms were mediated by Negative Metacognitive Beliefs and the use of Worry and Social thought control strategies. Negative Metacognitive Beliefs mediated the association between internalised HIV stigma and anxiety symptoms.
Conceptualizing and Implementing a Professional Development Pilot Program for Public School Teachers to Strengthen Sexuality Education
Authors: Wilson Kelly L. , Wiley David C. , Housman Jeff , McNeill Elisa Beth , Rosen Brittany L.
Published: May 2015

Professional development and training efforts are essential components of effective and evidence-based approaches for educators to teach sexuality education. Public school teachers, with and without health professional preparation, are often assigned to teach sexuality units with limited training. Although sexuality-based curriculum trainings have been available to educators, they are rarely implemented for school teachers at the local, regional, or state levels. This article presents a framework for planning and implementing a professional development opportunity for public school teachers occurring outside the school setting. The authors describe a professional training, called the Sexuality Education Academy, developed to assist Texas school health professionals working with students in grades kindergarten through 12 to understand the importance of using evidence-based tools, resources, and practices in their classroom regarding sexuality education. The Sexuality Education Academy approach holds promise for professional development efforts in sexuality education, in addition to evaluating interventions to ensure accurate implementation of evidence-based sexuality education.
Practice Makes Perfect
Authors: Oberne Alison B.
Published: May 2015

Background. A majority of undergraduate students lack opportunities to engage in research. Often, students must seek research opportunities with faculty members, and these opportunities are generally difficult to acquire. These research experiences increase student satisfaction and success in graduate school. Objectives. Undergraduate public health and health promotion faculty can integrate research skill building into traditional courses through didactic instruction, course assignments, and group discussion. Teaching method. This teaching method includes four key components: (1) didactic instruction, (2) skill development, (3) data collection and analysis, and (4) class discussion. First, students learn the importance of research and free listing as a qualitative research method. Second, the class participates in a free listing exercise to learn how to collect, format, analyze, and synthesize free listing data. Third, students apply skills learned in the class session by collecting data, formatting data for analysis, analyzing data, and preparing a results section describing their findings. Fourth, the instructor aggregates the data to facilitate a class discussion. By completing these assignments, students learn about the research process and enhance their skills in qualitative research methods. Results/outcomes. This activity supports the development of research skills in public health and health promotion courses. This method can be suited for courses of any size or format (lecture-based, online, or blended format). Faculty can be confident that students can understand and apply research methods, as well as analyze data, thus supporting students’ transitions into the workforce or graduate education programs.
Polyethylene terephthalate graft copolymers acting as an interfacial modifier in rubber modified polyethylene terephthalate compounds
Authors: Bourland Larry G
Published: May 2015

Compounding rubbery materials into polyethylene terephthalate (PET) alone is not sufficient to absorb and dissipate impact energy at sub-ambient temperatures. A PET-graft-rubber additive made by reactive extrusion acts as an interfacial modifier providing a mechanism for stress transfer from the PET matrix component to the dispersed rubbery component. The chemical structure verification of the graft copolymer and its effect on properties were established. Improvements in low temperature toughness and impact strengths are presented for containers thermoformed from extruded sheet.
Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes
Authors: Steensma David P. , Bejar Rafael , Jaiswal Siddhartha , Lindsley R. Coleman , Sekeres Mikkael A. , Hasserjian Robert P. , Ebert Benjamin L.
Published: May 2015

Recent genetic analyses of large populations have revealed that somatic mutations in hematopoietic cells leading to clonal expansion are commonly acquired during human aging. Clonally restricted hematopoiesis is associated with an increased risk of subsequent diagnosis of myeloid or lymphoid neoplasia and increased all-cause mortality. Although myelodysplastic syndromes (MDS) are defined by cytopenias, dysplastic morphology of blood and marrow cells, and clonal hematopoiesis, most individuals who acquire clonal hematopoiesis during aging will never develop MDS. Therefore, acquisition of somatic mutations that drive clonal expansion in the absence of cytopenias and dysplastic hematopoiesis can be considered clonal hematopoiesis of indeterminate potential (CHIP), analogous to monoclonal gammopathy of undetermined significance and monoclonal B-cell lymphocytosis, which are precursor states for hematologic neoplasms but are usually benign and do not progress. Because mutations are frequently observed in healthy older persons, detection of an MDS-associated somatic mutation in a cytopenic patient without other evidence of MDS may cause diagnostic uncertainty. Here we discuss the nature and prevalence of CHIP, distinction of this state from MDS, and current areas of uncertainty regarding diagnostic criteria for myeloid malignancies.
Minocycline does Not Affect Long-Term Potentiation in the Anterior Cingulate Cortex of Normal Adult Mice
Authors: Song Qian , Liu Ming-Gang , Zhuo Min
Published: May 2015

It has been reported that activated microglia plays important roles in chronic pain-related sensory signaling at the spinal cord dorsal horn. Less is known about the possible contribution of microglia to cortical plasticity that has been found to be important for chronic pain. In the present study, we used a 64-channel multi-electrode array recording system to investigate the role of microglia in cortical plasticity of the anterior cingulate cortex (ACC) in normal adult mice. We found that bath application of minocycline, an inhibitor of microglial activation, had no effect on postsynaptic LTP (post-LTP) induced by theta burst stimulation in the ACC. Furthermore, presynaptic LTP (pre-LTP) induced by the combination of low-frequency stimulation with a GluK1-containing kainate receptor agonist was also not affected. The spatial distribution of post-LTP or pre-LTP among the cingulate network is also unaltered by minocycline. Our results suggest that minocycline does not affect cingulate plasticity and neurons are the major player in pain-related cortical plasticity.
Associations between toe grip strength and hallux valgus, toe curl ability, and foot arch height in Japanese adults aged 20 to 79 years: a cross‐sectional study
Authors: Uritani Daisuke , Fukumoto Takahiko , Matsumoto Daisuke , Shima Masayuki
Published: May 2015

Background

The associations between toe grip strength (TGS) and foot structure are not well known, although foot structure is inferred to affect TGS. This study investigated the associations between TGS and hallux valgus angle (HVA), toe curl ability, and foot arch height (FAH).

Methods

This study analysed 227, 20 to 79‐year‐old, community‐dwelling participants. TGS, HVA formed by the first metatarsal bone and the proximal phalanx of the hallux, toe curl ability (percentage) calculated as (foot length–flexed foot length)/foot length, and FAH (percentage) calculated as navicular height/truncated foot length were measured. To elucidate associations between TGS and foot structure, a correlation analysis and stepwise multivariate linear regression analyses were performed, based on the participant's sex. Pearson's correlation coefficients for TGS with age, height, weight, HVA, toe curl ability, and FAH were also calculated. In the stepwise, multivariate linear regression analyses, the independent variable was TGS and the dependent variables were those that significantly correlated with TGS, as shown by the Pearson's correlation coefficients. The significance level was set at 5%.

Results

According to the Pearson's correlation coefficients, in men, TGS was significantly correlated with age, height, toe curl ability, and FAH. According to the stepwise multiple regression analysis, TGS correlated with age and toe curl ability (adjusted R2=0.22). In women, TGS was significantly correlated with age, height, and toe curl ability (adjusted R2=0.40).

Conclusions

TGS was associated with toe curl ability in both men and women. However, TGS was not associated with HVA and FAH in men or women. The results of this study may lead to the development of effective interventions to improve TGS. However, factors other than structure of the foot require more detailed investigation to clarify the factors contributing to TGS.
Cognitive screening among acute respiratory failure survivors: a cross-sectional evaluation of the Mini-Mental State Examination
Authors: Pfoh Elizabeth R , Chan Kitty S , Dinglas Victor D , Girard Timothy D , Jackson James C , Morris Peter E , Hough Catherine L , Mendez-Tellez Pedro A , Ely E Wesley , Huang Minxuan , Needham Dale M , Hopkins Ramona O ,   with the NIH NHLBI ARDS Network
Published: May 2015

Introduction

The Mini-Mental State Examination (MMSE) is a common cognitive screening test, but its utility in identifying impairments in survivors of acute respiratory failure is unclear. The purpose of this study was to evaluate MMSE performance versus a concurrently administered detailed neuropsychological test battery in survivors of acute respiratory failure.

Methods

This cross-sectional analysis used data from the ARDSNet Long Term Outcomes Study (ALTOS) and Awakening and Breathing Controlled Trial (ABC). Participants were 242 survivors of acute respiratory failure. The MMSE and detailed neuropsychological tests were administered at 6 and 12 months post-hospital discharge for the ALTOS study, and at hospital discharge, 3 and 12 months for the ABC study. Overall cognitive impairment identified by the MMSE (score <24) was compared to impairments identified by the neuropsychological tests. We also matched orientation, registration, attention, memory and language domains on the MMSE to the corresponding neuropsychological test. Pairwise correlations, sensitivity, specificity, positive and negative predictive values, and agreement were assessed.

Results

Agreement between MMSE and neuropsychological tests for overall cognitive impairment was fair (42 to 80%). Specificity was excellent (≥93%), but sensitivity was poor (19 to 37%). Correlations between MMSE domains and corresponding neuropsychological tests were weak to moderate (6 months: r = 0.11 to 0.28; 12 months: r = 0.09 to 0.34). The highest correlation between the MMSE and neuropsychological domains was for attention at 6 months (r = 0.28) and language at 12 months (r = 0.34).

Conclusions

In acute respiratory failure survivors, the MMSE has poor sensitivity in detecting cognitive impairment compared with concurrently administered detailed neuropsychological tests. MMSE results in this population should be interpreted with caution.
Insights in agricultural practices and management systems linked to microbiological contamination of lettuce in conventional production systems in Southern Brazil
Authors: Bartz Sabrina , Hessel Claudia Titze , Rodrigues Rochele de Quadros , Possamai Anelise , Perini Fabiana Oliveira , Jacxsens Liesbeth , Uyttendaele Mieke , Bender Renar João , Tondo Eduardo César
Published: May 2015

Background

Three conventional lettuce farms were evaluated in Southern Brazil using a standardized self-assessment questionnaire with 69 indicators and a microbiological sampling plan in order to assess the status of current agricultural practices and management systems. The use of both tools aimed to identify the foremost contamination sources and control measures during the crop production. A total of 128 samples were taken (manure, soil, water, workers’ hands and equipment, lettuce seedlings and lettuce heads) in four visits during the growth cycle of lettuces. Samples were analysed for hygiene indicators (E. coli) and presence of pathogens (Salmonella spp. and E. coli O157).

Results

Microbiological results indicated that E. coli counts were very low in all analysed samples and no pathogens were detected. These results could be explained partially because all farms had toilets near to the fields, they did not raise animals near the crops, fields were located in areas where flooding was not possible, they used organic fertilizers adequately composted, and irrigation water demonstrated good microbiological quality. The microbial results for manure and soil indicated that the composting time was of utmost importance to maintain minimal contamination levels for the duration of the cultivation period, as long as the quality of irrigation water was very important to prevent further contamination of the crop. On the other hand, the self-assessment questionnaire identified a moderate to high risk level concerning microbiological contamination in all evaluated farms, because they had no formal good agricultural practices implemented, technical support, water control, inspections, food safety registers or sampling plan for microbiological or chemical analyses.

Conclusion

These different results are important in order to provide information about the actual status of contamination (microbial sampling plan) and possible food safety problems in the future based on the results given by the questionnaire. Furthermore, the results of this study also highlighted the necessity to provide more safety during the fresh produce cultivation, being formal good agricultural practices implementation an important start to the fresh produce farms in Brazil, as well as to adopt a higher level of control activities in order to achieve lower risk levels.
Obsessive–compulsive disorder in young people
Authors: Williams Tim I. , Shafran Roz
Published: May 2015

Obsessive–compulsive disorder (OCD) is one of the most debilitating psychiatric conditions in young people. In DSM-5 it is no longer characterised as an anxiety disorder, but instead is part of a group of ‘obsessive–compulsive and related disorders'. In the past 10 years, cognitive—behavioural therapy (CBT) has become well established as the first-choice treatment. This article explains some of the elements of CBT and describes new directions in research which might improve interventions.
Immune abnormalities across psychiatric disorders: clinical relevance
Authors: Mondelli Valeria , Dazzan Paola , Pariante Carmine M.
Published: May 2015

It is well established that the immune system can modulate brain functioning and influence behavioural processes. Awareness of communication between the immune and nervous systems has, over the years, progressively heightened interest in the relationship between psychiatric disorders and immune function. By reviewing findings from studies investigating inflammation in the periphery and in the central nervous systems, we summarise here the evidence linking inflammation to the development of depression, schizophrenia and bipolar disorder. We discuss how a pathophysiological role for inflammation has now been recognised across different psychiatric disorders, at least in a significant subpopulation of patients. Finally, we discuss a possible role for these findings in the development of future diagnostic classifications of psychiatric disorders as well as of new treatment strategies.
The use of internet-mediated cross-sectional studies in mental health research
Authors: Pitman Alexandra , Osborn David P. J. , King Michael B.
Published: May 2015

This article summarises internet-mediated approaches to conducting quantitative and qualitative cross-sectional mental health research, and describes aspects of research design to consider for optimising scientific rigour and validity as well as response. Rapid adoption of internet-mediated approaches risks compromising the quality of the methods used. Not only can it cause distress to participants, but methodological problems may lead to inappropriate inferences being made from research findings. In this article the advantages of using internet communication for research purposes are balanced against the disadvantages, using examples of recent internet-mediated research (IMR) studies to illustrate good practice.
The role of attachment in medically unexplained symptoms and long-term illness
Authors: Adshead Gwen , Guthrie Elspeth
Published: May 2015

In this article, we explore the role of attachment in the development of medically unexplained symptoms (MUS) and response to physical illness. We review the evidence that attachment insecurity is common in people with different forms of MUS and certain long-term physical conditions. We discuss a possible developmental model for understanding how MUS develop. We conclude with discussion of potential therapies and implications for services.
Quetiapine immediate release v. placebo for schizophrenia: systematic review, meta-analysis and reappraisal
Authors: Hutton Paul , Taylor Peter J. , Mulligan Lee , Tully Sarah , Moncrieff Joanna
Published: May 2015

Background

Immediate-release (IR) quetiapine has been used to treat schizophrenia since 1997, although all the principal placebo-controlled trials have >50% missing outcome data. New studies with relatively lower rates of participant withdrawal have since been published.

Aims

To assess the efficacy and adverse effects of quetiapine IR for schizophrenia, with consideration of outcome quality and clinical meaningfulness of results, and to examine the potential impact of missing data on the main efficacy findings.

Method

We conducted a systematic review and meta-analysis of randomised controlled trials comparing quetiapine IR and placebo (or subtherapeutic dose in relapse prevention trials) for the treatment of schizophrenia (PROSPERO registration CRD4201100165). Primary outcomes were change in overall symptoms and response rates. We also examined whether high rates of participant withdrawal (⩾50%) attenuated effect sizes, and assessed the impact of making different assumptions about these people's outcomes.

Results

We identified 15 relevant trials (including 2 unpublished), providing the first 12-week data for this drug and the first data on self-reported quality of life. We found quetiapine IR to have a weighted mean difference (WMD) of 6.5 points (95% CI −8.9 to −4) on Positive and Negative Syndrome Scale (PANSS) total scores, which corresponds to a standardised mean difference (SMD) of −0.33 (95% CI −0.46 to −0.21). Longer trials reported larger mean differences favouring quetiapine IR, but the overall estimate was smaller if more conservative assumptions about the outcomes of people who left the trial early were made. Approximately 21 people needed to take quetiapine IR for 1 person to experience at least a 50% improvement in PANSS score. No difference in quality of life was observed (two RCTs), although small to moderate improvements in social functioning were found (three RCTs). Quetiapine IR caused sedation and increased rates of clinically significant weight gain, but no extrapyramidal effects were observed.

Conclusions

Quetiapine IR has a small beneficial effect on overall psychotic symptoms over 2–12 weeks, but also leads to weight gain and sedation.
Diagnostic neglect: The potential impact of losing a separate axis for personality disorder
Authors: Newton-Howes Giles , Mulder Roger , Tyrer Peter
Published: May 2015

Both major classifications in psychiatry have now moved away from the multi-axial nosological model. This is clinically understandable as the specific categorical diagnoses, other than borderline personality disorder and personality disorder ‘NOS' (not otherwise specified) were so seldom used and empirical evidence would not support the polythetic categorical system. As a consequence, those with personality disorders, frequently referred to as Axis II disorders, now have to compete with all other mental disorders for clinical attention.
NICE CG178 Psychosis and Schizophrenia in Adults: Treatment and Management – an evidence-based guideline?
Authors: Taylor Mark , Perera Udayanga
Published: May 2015

National Institute for Health and Care Excellence (NICE) clinical guideline (CG)178 was published in 2014. NICE guidelines occupy an important international position. We argue that CG178 overemphasises the use of cognitive–behavioural therapy for schizophrenia and those ‘at risk’ of psychosis, with recommendations that do not always reflect the evidence base. The CG178 recommendations on medications are limited.
Religious Authority, Gendered Recognition, and Instrumentalization of Nusrat Amin in Life and After Death
Authors: Rutner Maryam
Published: May 2015

This article sheds light on the most influential woman religious scholar in twentieth-century Iran, Nusrat Amin (1886–1983). Contemporaneous prominent men religious scholars recognized Amin’s religious authority and expertise in Islamic sciences despite her gender. Amin’s influence was nevertheless circumscribed to some degree by gendered resistance among male ulema and a system of granting religious authority and positions that advantaged men scholars. Amin has elicited renewed interest in Iran since the 1990s, although this attention is selective. It highlights and reproduces Amin as a modern pious role model for Iranian women, a conservative in her viewpoints on gender relations, and an advocate of the veil. This selective attention worked to recuperate the traditional gender viewpoints of the Islamic Republic while facilitating demands to expand religious education opportunities for women. Primary sources include major Persian-language biographies that have appeared in Iran over the last thirty years and research from two fieldwork trips.
The Life of a Text: A Brief History of the Liji 禮記 (Rites Records) and Its Transmission
Authors: Liu Yucai , Habberstad Luke
Published: May 2015

This article surveys the compilation and transmission of the Liji (Rites Records), one of the San li 三禮 (Three Rites texts) and a key source for classical ritual practice and theory. Drawing upon accounts in early texts and the latest secondary scholarship, the article traces the emergence of the Liji from the world of ritual specialists during Warring States, Qin, and Han times, as well as the complicated manuscript culture of early China. The article emphasizes that no single author composed the Liji, nor does the text offer a unified vision of ritual. This composite nature of the text suggests that its compilers drew upon a wide range of sources, which only enhances the value of the Liji as a source for early ritual. The article then moves on to trace the history of the Liji's transmission through written versions on bamboo and silk, carved stelae, paper, and finally printed editions. As with all early texts, the advent of printing signified a major rupture in the transmission of the Liji. The article traces in some detail the sources that printers drew upon when they produced the first printed versions of the Liji, starting from the Song period. Finally, the article concludes with an appendix listing the major commentaries, studies, and translations of the Liji.