bluuebunny/crossref_metadata_2025 huggingface dataset:
Implications of Holding Ideas of Evidence-Based Practice in Nursing
Authors: Mitchell Gail J.
Published: April 2013

The author of this paper examines emerging implications of holding ideas about evidence and evidence-based practice. Evidence has a very specific role in the delivery of safe clinical care, but it is creating a serious problematic for the practice of nursing. It is proposed that: evidence-based practice be re-situated or reconstructed as a collective and organizational responsibility and not the responsibility of individual nurses in practice; nurses re-focus on articulating a more ethical foundation for praxis, one that emerges from nursing philosophy and one that is co-constituted with persons/families/groups; and nurse leaders and educators establish teaching-learning and practice environments that enable a peer-to-peer process of critical review and curious inquiry of available evidence in the contexts of shared work.
Historical Perspectives on Evidence-Based Nursing
Authors: Beyea Suzanne C. , Slattery Mary Jo
Published: April 2013

The authors of this article offer a review and historical perspective on research utilization and evidence-based practice in nursing. They present the evolution of research utilization to the more contemporary framework of evidence-based nursing practice. The authors address the role of qualitative research in the context of evidence-based practice. Finally, some approaches and resources for learning more about the fundamentals of evidence-based healthcare are provided.
Thoughts About Conceptual Models and Measurement Validity
Authors: Fawcett Jacqueline
Published: April 2013

This essay focuses on measurement validity, with an emphasis on the connections among the conceptual, theoretical, and empirical components of nursing research and nursing practice. Although attention typically is given to the connection between the concepts of a middle-range theory and the research instruments or practice tools that are used to measure those concepts, more attention needs to be given to the congruence between conceptual model concepts and research instruments or practice tools.
Quality of Life
Authors: Poradzisz Michele , Florczak Kristine L.
Published: April 2013

The focus of this column is to provide a brief overview of several conceptual analyses of quality of life along with their resulting definitions. A discussion of the more specific construct of health-related quality of life in terms of chronic illness is considered followed by an in-depth review of health-related quality of life measurement instruments. Finally, the idea of health-related quality of life considered as input to decision-making instead of designated as an outcome measure is proposed.
Tolerance analysis of systems in motion taking into account interactions between deviations
Authors: Walter Michael , Sprügel Tobias , Wartzack Sandro
Published: April 2013

A product’s functionality depends largely on the interaction of its components and their geometries. Hence, tolerance analyses are used to determine the effects of deviations on functional key characteristics of mechanisms. However, possible interactions between the different deviations and the resulting effects on themselves as well as on the functional key characteristics have not yet been considered.

This article considers the extension of the existing “integrated tolerance analysis of systems in motion” approach. By means of the methodology, the interactions between appearing deviations can be identified and integrated into a tolerance analysis functional relation. Therefore, the appearing interactions are represented by meta-models that can be easily integrated into the functional relation. Consequently, the product developer is able to gain information about the effects of deviations on functional key characteristics, as well as the effects of the deviations among themselves. In order to show the methodology’s practical use, the interactions between deviations of a nonideal crank mechanism inside a four-stroke combustion engine are considered. For this purpose, two different meta-modeling techniques are used: response surface methodology and artificial neural networks.
Evaluating the form errors of spheres, cylinders and cones using the primal–dual interior point method
Authors: Zhang Xiangchao , Jiang Xiangqian , Forbes Alistair B , Minh Hoang D , Scott Paul J
Published: April 2013

In precision metrology, the form errors between the measured data and reference nominal surfaces are usually evaluated in four approaches: least squares elements, minimum zone elements, maximum inscribed elements and minimum circumscribed elements. The calculation of minimum zone element, maximum inscribed element and minimum circumscribed element is not smoothly differentiable, thus very difficult to be solved. In this article, a unified method is presented to evaluate the form errors of spheres, cylinders and cones in the sense of minimum zone element, maximum inscribed element and minimum circumscribed element. The primal–dual interior point method is adopted to solve this non-linearly constrained optimisation problem. The solution is recursively updated by arc search until the Karush–Kuhn–Tucker conditions are satisfied. Some benchmark data are employed to demonstrate the validity and superiority of this method. Numerical experiments show that this optimisation algorithm is computationally efficient and its global convergence can be guaranteed.
Optimal design of magnetorheological fluid-based dampers for front-loaded washing machines
Authors: Nguyen QH , Choi SB , Woo JK
Published: April 2013

In this research, a magnetorheological fluid-based damper to attenuate vibration due to unbalanced laundry mass from a front-loaded washing machine is proposed and optimally designed with experimental validation. First, rigid vibration mode of the washing machine due to an unbalanced mass is analyzed, and an optimal positioning of the suppression system for the washing machine is figured out. In order to attenuate vibration from the washing machine, several configurations of magnetorheological damper are proposed considering available space and the required damping force of the system. Based on the Bingham rheological model of magnetorheological fluid, damping force of the proposed magnetorheological dampers is then derived. An optimal design problem for the proposed magnetorheological damper is constructed considering its zero-field friction force and the maximum damping force. The optimization objective is to minimize the zero-field friction force of the magnetorheological damper while the maximum value of damping force is kept being greater than a required value. An optimization procedure based on finite element analysis integrated with an optimization tool is employed to obtain optimal geometric dimensions of the magnetorheological dampers featuring different types of magnetorheological fluid. Optimal solutions of the magnetorheological dampers are then presented and the optimized damper is figured out. In addition, performance characteristics of the optimized magnetorheological damper are presented and discussed.
Playing “Duck Duck Goose” With Neurons
Authors: Tian Xing , Huber David E.
Published: April 2013

Reduced connectivity between sending and receiving neurons (i.e., synaptic depression) may facilitate change detection by reducing responses for recently viewed objects so new objects can be highlighted. In the experiment reported here, we investigated high-level change detection following semantic satiation, which is the loss of meaning following repetition of a word. A computer simulation of a word-reading neural network with synaptic depression identified key predictions of connectivity reduction. A dynamic-causal-modeling analysis of magnetoencephalography (MEG) responses collected during a category-matching task identified connectivity reduction between a cortical region related to orthography and a cortical region related to semantics as the cause of the reduced MEG response to a repeated word. As predicted, prior repetitions of a category-matching word presented immediately after the repeated word enhanced semantic novelty, as measured with the M400 component. These results demonstrate that a combination of neural-network modeling and connectivity analyses can reveal the manner in which connectivity fluctuations underlie cognitive functions.
Dynamics of Agricultural Marginalization in Emergent Rural Economy: A Study in South Bihar
Authors: Singh Shashibhushan
Published: April 2013

To a large extent, present rural crisis in different parts of India is an outcome of stagnation in agriculture. Based upon an intensive study of a large multi-caste village in south Bihar, the article argues that four factors, the spatial organization of agricultural land at the micro-level in the rain-fed area, whereas only a fourth arable land of a village has certainty of agricultural production; breaking off traditional social and technological arrangements in agriculture, which has led to cash-induced agricultural activities; the differentiation of farmers between the rich and poor, making it difficult for small farmers to compete with big farmers for limited natural and human resources required in agriculture; and lastly but perhaps most importantly, non-agricultural activities becoming more and more profitable and risk free, thus tilting the balance against agricultural sector in overall economic landscape, are responsible for marginalization of agriculture. In rain-fed areas where agriculture to a large extent is dependent upon natural rainfall, and good harvest is more an exception than the rule; only those farmers who own substantial landholding and are capable to cope with exigencies in agriculture can engage in farming. The medium and small farmers without any non-agricultural income have very little chance to absorb the losses occurring due to even one year of crop failure. As agriculture is becoming less attractive as an enterprise and people are migrating to urban centres, more and more land is coming into forced tenancy. But neither the landlords nor the tenants are willing to invest in agriculture as they can earn more by working somewhere else in non-agricultural sector. The forced exodus from agriculture has brought people in contact with other economic activities and the nature of non-agricultural economic activities is such that they are better off economically. For the state what matters is the Gross Domestic Product (GDP) and for the people what matters is money. Both seem to be happy with the present economic arrangement. However, this development has come at the heavy cost of physical, metal and moral deterioration and has sociologically led to distress in family and community life. Any planning or strategy to solve agricultural crisis must take into account these factors.
Experiences Undergone While Researching Survival Strategies of the Changpas of Eastern Ladakh
Authors: Chaudhuri Ajit
Published: April 2013

The article chronicles the experiences of a research team that undertook five field exercises over the course of a year, including three in winter, in the high-altitude Changthang region of Ladakh in 1997–98. It outlines the challenges that field research must address to work with a sparse, scattered and peripatetic community in a geographically remote and climatically harsh cold-desert region. It describes the practicalities of working under difficult conditions, the compromises made between pragmatism and rigour, the continuous innovation required in research tools and techniques, and the many wonderful surprises that situations kept throwing up. It also looks at the mistakes made, and stresses the importance of preparation, teamwork, humility and openness to other cultures for successful fieldwork. The author hopes that this article provides useful information to others planning research exercises in remote and harsh regions.
Effect of Passive Smoking on Female Breast Cancer in China
Authors: Chen Zhenghong , Shao Jing , Gao Xiaohong , Li Xiaofeng
Published: April 2013

The objective is to explore the relationship between passive smoking and female breast cancer using meta-analysis. Literature on risk factors for female breast cancer published from January 2001 to December 2011 was collected from CBM, CAJD, VIP, WanFangData, and MEDLINE databases. The meta-analysis was performed using Review Manager 5.0.24. A total of 8 studies were included according to inclusion and exclusion standards. The results of the meta-analysis indicated that the combined odds ratio (OR) estimate for those who had been exposed to passive smoke from tobacco was 1.67 (95% confidence interval [CI] = 1.27-2.21). Results of the subgroup analysis were consistent with an OR = 1.98 (95% CI = 1.63-2.42) for 1:1 paired design research and 1.60 (95% CI = 1.08-2.37) for the group design research. Results suggest a possible association between passive tobacco smoke and female breast cancer in China.
Diagnosing clostridial enteric disease in poultry
Authors: Cooper Kerry K. , Songer J. Glenn , Uzal Francisco A.
Published: April 2013

The world’s poultry industry has grown into a multibillion-dollar business, the success of which hinges on healthy intestinal tracts, which result in effective feed conversion. Enteric disease in poultry can have devastating economic effects on producers, due to high mortality rates and poor feed efficiency. Clostridia are considered to be among the most important agents of enteric disease in poultry. Diagnosis of enteric diseases produced by clostridia is usually challenging, mainly because many clostridial species can be normal inhabitants of the gut, making it difficult to determine their role in virulence. The most common clostridial enteric disease in poultry is necrotic enteritis, caused by Clostridium perfringens, which typically occurs in broiler chickens but has also been diagnosed in various avian species including turkeys, waterfowl, and ostriches. Diagnosis is based on clinical and pathological findings. Negative culture and toxin detection results may be used to rule out this disease, but isolation of C. perfringens and/or detection of its alpha toxin are of little value to confirm the disease because both are often found in the intestine of healthy birds. Ulcerative enteritis, caused by Clostridium colinum, is the other major clostridial enteric disease of poultry. Diagnosis of ulcerative enteritis is by documentation of typical pathological findings, coupled with isolation of C. colinum from the intestine of affected birds. Other clostridial enteric diseases include infections produced by Clostridium difficile, Clostridium fallax, and Clostridium baratii.
Epizootic hemorrhagic disease in yaks (Bos grunniens)
Authors: Van Campen Hana , Davis Charlie , Flinchum John D. , Bishop Jeanette V. , Schiebel Anita , Duncan Colleen , Spraker Terry
Published: April 2013

An epizootic of hemorrhagic disease associated with Epizootic hemorrhagic disease virus serotype 2 (EHDV-2) infections in yaks from 5 herds occurred in Colorado between August 21 and October 3, 2012. Affected yaks presented with fever, lethargy, anorexia, dyspnea, and swollen conjunctivae. Ulcerated dental pads, mucoid sanguineous nasal discharge, petechial hemorrhages in multiple organs, pulmonary edema, and serosanguinous fluid in the thorax, abdomen, and pericardial sac were observed at necropsy. Blood and tissue samples from 8 yaks with similar clinical signs and necropsy findings were positive for EHDV-2 by reverse transcription polymerase chain reaction and 5 yaks were seropositive for EHDV. Tests for malignant catarrhal fever ( Ovine herpesvirus 2), Bovine viral diarrhea virus, Bovine herpesvirus 1, Foot-and-mouth disease virus, and Vesicular stomatitis virus were negative. The findings indicate that yaks are susceptible to infection with EHDV-2 and exhibit the clinical signs, and gross and histologic lesions of hemorrhagic disease observed in other ruminant species.
Come One, Come All into the Newsroom? Student Publications after Christian Legal Society v. Martinez
Authors: Pritchard Andrew D.
Published: April 2013

The Supreme Court’s ruling in Christian Legal Society v. Martinez allows a public university to institute a “take-all-comers” nondiscrimination policy for student organizations. In doing do, the Court adds new perils and expands existing hazards for student publications. First, the Christian Legal Society majority overlooks the possibility that safeguards for the rights of student organizations generally may not adequately protect the unique interests of student publications. In addition, the ruling creates a misleading impression of the degree of deference courts owe the pedagogical judgments of public university administrators.
Playing with News
Authors: Aayeshah Wajeehah
Published: April 2013

The idea of incorporating digital games in journalism education provides the convenience of experiencing real-time happenings in a virtual world and opens up a new possibility for teaching journalism students. These games have the flexibility of offering different perspectives to students, providing them with a bigger picture and required skill sets. They can assist students in acquiring required analytical reasoning and train students to compile and edit news stories, learn about interview techniques and support the development of empathy and cultural sensitivity, crucial for journalistic expertise. Despite these attributes and their existence for over a decade, digital games have yet to be incorporated as a frequently used pedagogical tool in journalism education. This study explores the existing shape of digital games relevant to journalism, and the reason for their rare use as an educational and training resource.
Tertiary Education
Authors: Hwa Ang Peng
Published: April 2013

While the research culture is slowly but surely being strengthened, undergraduate teaching continues to be troubling. Employers said that they would not hire first-degree graduates because of the poor quality of their training. Many Indians therefore go on to obtain a master’s degree.Grinding poverty, corruption, the political culture and the caste system are four critical reasons for the current state of affairs. School fees are kept low as low as US$200 a year so as to be affordable; attempts to raise the fees are met with protests, with support from politicians.

 Quoting the BBC broadcaster Mark Tulley, the author concludes that because of the Indian form of bad governance, where ideas sound excellent on paper but fail on implementation, the peculiarly Indian problems faced by the tertiary media education will require a peculiarly Indian solution.
Conceptualising Risk and Need: The Rise of Actuarialism and the Death of Welfare? Practitioner Assessment and Intervention in the Youth Offending Service
Authors: Briggs Damon B.
Published: April 2013

This article is concerned with the assessment and intervention strategies and processes employed by practitioners working within the Youth Offending Service (YOS) in England and Wales. It draws on interview data with YOS practitioners to investigate assessment and intervention rationales and conceptions of both ‘risk’ and ‘need’ against a backdrop of shifting ideologies and modes of governance in youth justice. The article revisits macro theories of risk and the ‘risk society’, explores theories of modern penality and how conceptions of risk have permeated contemporary youth justice policy and practice through actuarial frameworks of assessment. It is argued that competing rationales in YOT practitioners’ assessments and interventions reveal an active struggle where, despite a managerial/actuarial milieu, some practitioners continue to hold the welfare needs of young people as paramount. The article then reflects on current youth justice policy under the Conservative–Liberal Democrat Coalition Government and the effect that their proposed changes may have on practice.
Chest Wall Reconstruction after Oncological Resections
Authors: Tukiainen E.
Published: April 2013

Most chest wall defects requiring reconstruction result from tumor resection. Bone and soft tissue sarcomas and recurrent mammary cancer are the most common tumors. Careful preoperative evaluation, meticulous surgical technique and active postoperative treatment are important. The selection of reconstruction is based on the nature, size and location of the defect as well as on the general health and prognosis of the patient. The goals of the reconstruction are adequate stability, water- and airtight closure of the chest cavity, and acceptable cosmetic appearance. The pedicled muscular or musculocutaneous flaps are usually the first choice for tissue coverage. These include flaps such as latissimus dorsi, vertical or transverse rectus abdominis and pectoralis. In certain cases also the breast flap or omental flap can be used. In selected cases, a free flap reconstruction is indicated if the local options for reconstruction have been used, or if they are unreliable due to earlier scars or radiotherapy. The free flaps to be used for chest wall can be harvested from the thigh (tensor fascia latae flap, anterolateral thigh flap), from the abdomen (transverse rectus abdominis flaps, deep epigastric perforator flaps) or from the chest wall (latissimus dorsi flap and other flaps based on the subscapular artery). Sometimes a fillet forearm can be used as a flap to cover a defect after extended forequarter amputation. Artificial meshes are commonly used to give stability in the defect and to give a platform for the flap. Methylmethacrylate embedded between the two layers of a mesh, or one or two rib grafts fixed to the mesh, can be used to give additional stability in extensive defects to prevent paradoxical movement.
Plasmin induces intercellular adhesion molecule 1 expression in human endothelial cells via nuclear factor-κB/mitogen-activated protein kinases-dependent pathways
Authors: Li Qun , Syrovets Tatiana , Simmet Thomas , Ding Jiazeng , Xu Jianzhong , Chen Wendong , Zhu Dingliang , Gao Pingjin
Published: April 2013

Activation of endothelial cells (ECs) by proinflammatory stimuli triggers expression of cellular adhesion molecules including intercellular adhesion molecule 1 (ICAM-1) on the cell surface. Such molecules mediate the transendothelial migration of inflammatory cells, which is an early key step of atherogenesis. We have previously demonstrated that plasmin activates human inflammatory cells via the annexin A2 heterotetramer (A2t). Here we show that human umbilical vein endothelial cells (HUVECs) and human microvascular endothelial cells express high amounts of A2t, as shown by Western blotting, fluorescence microscopy and flow cytometry. Activation of HUVEC by plasmin led to cleavage of the annexin A2 subunit of the receptor complex, followed by the activation of Akt/nuclear factor (NF)-kB signaling, and phosphorylation of MAP kinases p38 and ERK1/2. Further, plasmin stimulates the NF-kB/p38-dependent expression of ICAM-1 by HUVEC. The plasmin-induced activation of cells was abolished when annexin A2 was down-regulated by small-interfering RNA. In vivo, we show co-localization of the ECs marker CD31 with the plasmin receptor A2t and ICAM-1 in human atherosclerotic plaques of human femoral arteries, which also exhibit activated NF-κB signaling as revealed by immunofluorescence staining for phosphorylated Iκbα. In addition, plasma of patients with advanced atherosclerosis exhibited enhanced plasmin activity and up-regulated levels of plasmin-α2-antiplasmin. These data point to a previously unrecognized functional role of plasmin in EC biology, which could be of particular relevance in the development of atherosclerosis.
Congenital dyserythropoietic anemia type III (CDA III) is caused by a mutation in kinesin family member, KIF23
Authors: Liljeholm Maria , Irvine Andrew F. , Vikberg Ann-Louise , Norberg Anna , Month Stacy , Sandström Herbert , Wahlin Anders , Mishima Masanori , Golovleva Irina
Published: April 2013

Key Points

KIF23/MKLP1 mutation found in the CDA III patients causes cytokinesis failure.
Acquired copy-neutral loss of heterozygosity of chromosome 1p as a molecular event associated with marrow fibrosis in MPL-mutated myeloproliferative neoplasms
Authors: Rumi Elisa , Pietra Daniela , Guglielmelli Paola , Bordoni Roberta , Casetti Ilaria , Milanesi Chiara , Sant’Antonio Emanuela , Ferretti Virginia , Pancrazzi Alessandro , Rotunno Giada , Severgnini Marco , Pietrelli Alessandro , Astori Cesare , Fugazza Elena , Pascutto Cristiana , Boveri Emanuela , Passamonti Francesco , De Bellis Gianluca , Vannucchi Alessandro , Cazzola Mario
Published: April 2013

Key Points

In MPL exon 10–mutated myeloproliferative neoplasms, the MPL-mutant allele burden varies considerably from about 1% to almost 100%. High mutation burdens originate from acquired copy-neutral loss of heterozygosity of chromosome 1p and are associated with marrow fibrosis.
Gene prediction in metagenomic fragments based on the SVM algorithm
Authors: Liu Yongchu , Guo Jiangtao , Hu Gangqing , Zhu Huaiqiu
Published: April 2013

Background

Metagenomic sequencing is becoming a powerful technology for exploring micro-ogranisms from various environments, such as human body, without isolation and cultivation. Accurately identifying genes from metagenomic fragments is one of the most fundamental issues.

Results

In this article, we present a novel gene prediction method named MetaGUN for metagenomic fragments based on a machine learning approach of SVM. It implements in a three-stage strategy to predict genes. Firstly, it classifies input fragments into phylogenetic groups by a k-mer based sequence binning method. Then, protein-coding sequences are identified for each group independently with SVM classifiers that integrate entropy density profiles (EDP) of codon usage, translation initiation site (TIS) scores and open reading frame (ORF) length as input patterns. Finally, the TISs are adjusted by employing a modified version of MetaTISA. To identify protein-coding sequences, MetaGun builds the universal module and the novel module. The former is based on a set of representative species, while the latter is designed to find potential functionary DNA sequences with conserved domains.

Conclusions

Comparisons on artificial shotgun fragments with multiple current metagenomic gene finders show that MetaGUN predicts better results on both 3' and 5' ends of genes with fragments of various lengths. Especially, it makes the most reliable predictions among these methods. As an application, MetaGUN was used to predict genes for two samples of human gut microbiome. It identifies thousands of additional genes with significant evidences. Further analysis indicates that MetaGUN tends to predict more potential novel genes than other current metagenomic gene finders.
Genome-wide identification, classification and expression profiling of nicotianamine synthase (NAS) gene family in maize
Authors: Zhou Xiaojin , Li Suzhen , Zhao Qianqian , Liu Xiaoqing , Zhang Shaojun , Sun Cheng , Fan Yunliu , Zhang Chunyi , Chen Rumei
Published: April 2013

Background

Nicotianamine (NA), a ubiquitous molecule in plants, is an important metal ion chelator and the main precursor for phytosiderophores biosynthesis. Considerable progress has been achieved in cloning and characterizing the functions of nicotianamine synthase (NAS) in plants including barley, Arabidopsis and rice. Maize is not only an important cereal crop, but also a model plant for genetics and evolutionary study. The genome sequencing of maize was completed, and many gene families were identified. Although three NAS genes have been characterized in maize, there is still no systematic identification of maize NAS family by genomic mining.

Results

In this study, nine NAS genes in maize were identified and their expression patterns in different organs including developing seeds were determined. According to the evolutionary relationship and tissue specific expression profiles of ZmNAS genes, they can be subgrouped into two classes. Moreover, the expression patterns of ZmNAS genes in response to fluctuating metal status were analysed. The class I ZmNAS genes were induced under Fe deficiency and were suppressed under Fe excessive conditions, while the expression pattern of class II genes were opposite to class I. The complementary expression patterns of class I and class II ZmNAS genes confirmed the classification of this family. Furthermore, the histochemical localization of ZmNAS1;1/1;2 and ZmNAS3 were determined using in situ hybridization. It was revealed that ZmNAS1;1/1;2, representing the class I genes, mainly expressed in cortex and stele of roots with sufficient Fe, and its expression can expanded in epidermis, as well as shoot apices under Fe deficient conditions. On the contrary, ZmNAS3, one of the class II genes, was accumulated in axillary meristems, leaf primordia and mesophyll cells. These results suggest that the two classes of ZmNAS genes may be regulated on transcriptional level when responds to various demands for iron uptake, translocation and homeostasis.

Conclusion

These results provide significant insights into the molecular bases of ZmNAS in balancing iron uptake, translocation and homeostasis in response to fluctuating environmental Fe status.
Use of electronic health record data to identify skin and soft tissue infections in primary care settings: a validation study
Authors: Levine Pamela J , Elman Miriam R , Kullar Ravina , Townes John M , Bearden David T , Vilches-Tran Rowena , McClellan Ian , McGregor Jessina C
Published: April 2013

Background

Epidemiologic studies of skin and soft tissue infections (SSTIs) depend upon accurate case identification. Our objective was to evaluate the positive predictive value (PPV) of electronic medical record data for identification of SSTIs in a primary care setting.

Methods

A validation study was conducted among primary care outpatients in an academic healthcare system. Encounters during four non-consecutive months in 2010 were included if any of the following were present in the electronic health record: International Classification of Diseases, Ninth Revision (ICD-9) code for an SSTI, Current Procedural Terminology (CPT) code for incision and drainage, or a positive wound culture. Detailed chart review was performed to establish presence and type of SSTI. PPVs and 95% confidence intervals (CI) were calculated among all encounters, initial encounters, and cellulitis/abscess cases.

Results

Of the 731 encounters included, 514 (70.3%) were initial encounters and 448 (61.3%) were cellulitis/abscess cases. When the presence of an ICD-9 code, CPT code, or positive culture was used to identify SSTIs, 617 encounters were true positives, yielding a PPV of 84.4% [95% CI: 81.8–87.0%]. The PPV for using ICD-9 codes alone to identify SSTIs was 90.7% [95 % CI: 88.5–92.9%]. For encounters with cellulitis/abscess codes, the PPV was 91.5% [95% CI: 88.9–94.1%].

Conclusions

ICD-9 codes may be used to retrospectively identify SSTIs with a high PPV. Broadening SSTI case identification with microbiology data and CPT codes attenuates the PPV. Further work is needed to estimate the sensitivity of this method.
Chronic back problems and labor force participation in a national population survey: impact of comorbid arthritis
Authors: Churcher Lauren , Chan Christina H , Badley Elizabeth M
Published: April 2013

Background

Back problems and arthritis are common chronic conditions, while having back problems is a frequent reason for lost work time. The objective of this study was to investigate employment status amongst individuals who report having both back problems and arthritis, compared to having either condition alone.

Methods

We analyzed data from the 2007/2008 Canadian Community Health Survey (ages 25–64, n = 79,719). Respondents who reported neither having worked in the past 12 months nor the past week were coded as not currently employed. Those reported being permanently unable to work were considered to be out of the labor force. Log-Poisson regressions, adjusting for socio-demographic and lifestyle factors, were used to estimate risks for being not currently employed or being out of the labor force for 5 mutually exclusive groups of chronic conditions: arthritis and back problems, back problems, arthritis, any other chronic conditions, and no chronic conditions.

Results

12.7% of respondents reported being not currently employed and 2.9% being out of the labor force. 5.8% of respondents reported both arthritis and back problems, while 16.1% reported back problems and 7.3% arthritis. The back problems and arthritis group had the highest risk of not being currently employed. The risk was higher for men (PR = 1.90; 95% CI = 1.58, 2.29) than for women (PR = 1.31; 95% CI = 1.18, 1.46). Risks of being permanently unable to work were also the greatest for those with comorbid back problems and arthritis.

Conclusions

There is a need for a reappraisal of back problems as a cause of work disability to account for the possibility of co-occurring arthritis.
Microtechnologies to fuel neurobiological research with nanometer precision
Authors: Brunello Cecilia A , Jokinen Ville , Sakha Prasanna , Terazono Hideyuki , Nomura Fumimasa , Kaneko Tomoyuki , Lauri Sari E , Franssila Sami , Rivera Claudio , Yasuda Kenji , Huttunen Henri J
Published: April 2013

The interface between engineering and molecular life sciences has been fertile ground for advancing our understanding of complex biological systems. Engineered microstructures offer a diverse toolbox for cellular and molecular biologists to direct the placement of cells and small organisms, and to recreate biological functions in vitro: cells can be positioned and connected in a designed fashion, and connectivity and community effects of cells studied. Because of the highly polar morphology and finely compartmentalized functions of neurons, microfabricated cell culture systems and related on-chip technologies have become an important enabling platform for studying development, function and degeneration of the nervous system at the molecular and cellular level. Here we review some of the compartmentalization techniques developed so far to highlight how high-precision control of neuronal connectivity allows new approaches for studying axonal and synaptic biology.
Damped wave equation and dissipative wave equation in fractal strings within the local fractional variational iteration method
Authors: Su Wei-Hua , Baleanu Dumitru , Yang Xiao-Jun , Jafari Hossein
Published: April 2013

In this paper, the local fractional variational iteration method is given to handle the damped wave equation and dissipative wave equation in fractal strings. The approximation solutions show that the methodology of local fractional variational iteration method is an efficient and simple tool for solving mathematical problems arising in fractal wave motions.

MSC:74H10, 35L05, 28A80.
Hecke operators type and generalized Apostol-Bernoulli polynomials
Authors: Aygunes Aykut Ahmet , Bayad Abdelmejid , Simsek Yilmaz
Published: April 2013

In this paper, we construct some Hecke-type operators acting on the complex polynomials space, and we prove their commutativity. By means of this commutativity, we find a new approach to establish the generating function of the Apostol-Bernoulli type polynomials which are eigenfunctions of these Hecke-type operators. Moreover, we derive many useful identities related to these operators and polynomials.

MSC:11M35, 30B40, 30B50.
Blood alcohol concentration and self-reported alcohol ingestion in acute poisoned patients who visited an emergency department
Authors: Woo Seon Hee , Lee Woon Jeong , Jeong Won Jung , Kyong Yeon Young , Choi Se Min
Published: April 2013

Background

Many acute poisoned patients have co-ingested alcohol in the emergency department (ED). This study aimed to estimate the blood alcohol concentration (BAC) of acute poisoned patients who visited an ED by age and gender distribution and to determine whether it is possible to obtain self-reports of alcohol ingestion among poisoned patients.

Method

A retrospective medical chart review was conducted for all patients who visited the ED with acute poisoning between January 2004 and February 2008. Data regarding the patient’s age, gender, BAC, self-reported alcohol ingestion, poison ingested, time elapsed since poison exposure, presence of suicide attempts, and self-reported alcohol ingestion were collected. Patients were classified into two groups based on serum alcohol levels (≤10 mg/dl, >10 mg/dl).

Results

Of the 255 subjects, 88 subjects (34.5%) were included in the non-alcohol group and 167 subjects (65.5%) were included in the alcohol group. 227 subjects (89.0%) showed suicide intention. Using the 201 subjects who completed the self-report of alcohol ingestion, self-report resulted in 96.6% sensitivity and 86.7% specificity for the assessment of alcohol ingestion. The positive and negative predictive values for self-report were 91.2% and 94.7%, respectively. The median (interquartile range) BAC of the 97 males in the sample was 85.0 (10.0-173.5) mg/dl, and that of the 158 females was 32.0 (4.0-137.5) mg/dl (p = 0.010). The distribution of age in the groups was significantly different between the alcohol and non-alcohol groups (p = 0.035), and there was a significant difference in the mean BAC with respect to age for males (p = 0.003).

Conclusion

This study showed that over two-thirds of patients presenting with acute poisoning had a BAC > 10 mg/dl. Most of patients visited by suicide attempt. Males had a higher BAC than did females. Self-reported alcohol ingestion in acute poisoned patients showed high sensitivity and specificity.
Scoring systems for outcome prediction in patients with perforated peptic ulcer
Authors: Thorsen Kenneth , Søreide Jon Arne , Søreide Kjetil
Published: April 2013

Background

Patients with perforated peptic ulcer (PPU) often present with acute, severe illness that carries a high risk for morbidity and mortality. Mortality ranges from 3-40% and several prognostic scoring systems have been suggested. The aim of this study was to review the available scoring systems for PPU patients, and to assert if there is evidence to prefer one to the other.

Material and methods

We searched PubMed for the mesh terms “perforated peptic ulcer”, “scoring systems”, “risk factors”, ”outcome prediction”, “mortality”, ”morbidity” and the combinations of these terms. In addition to relevant scores introduced in the past (e.g. Boey score), we included recent studies published between January 2000 and December 2012) that reported on scoring systems for prediction of morbidity and mortality in PPU patients.

Results

A total of ten different scoring systems used to predict outcome in PPU patients were identified; the Boey score, the Hacettepe score, the Jabalpur score the peptic ulcer perforation (PULP) score, the ASA score, the Charlson comorbidity index, the sepsis score, the Mannheim Peritonitis Index (MPI), the Acute physiology and chronic health evaluation II (APACHE II), the simplified acute physiology score II (SAPS II), the Mortality probability models II (MPM II), the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity physical sub-score (POSSUM-phys score). Only four of the scores were specifically constructed for PPU patients. In five studies the accuracy of outcome prediction of different scoring systems was evaluated by receiver operating characteristics curve (ROC) analysis, and the corresponding area under the curve (AUC) among studies compared. Considerable variation in performance both between different scores and between different studies was found, with the lowest and highest AUC reported between 0.63 and 0.98, respectively.

Conclusion

While the Boey score and the ASA score are most commonly used to predict outcome for PPU patients, considerable variations in accuracy for outcome prediction were shown. Other scoring systems are hampered by a lack of validation or by their complexity that precludes routine clinical use. While the PULP score seems promising it needs external validation before widespread use.
Rab35 establishes the EHD1-association site by coordinating two distinct effectors during neurite outgrowth
Authors: Kobayashi Hotaka , Fukuda Mitsunori
Published: April 2013

Endocytic recycling is a process in which molecules have been internalized are recycled back to the plasma membrane, and although it is crucial for regulating various cellular events, the molecular nexus underlying this process remains poorly understood. Here we report a well-orchestrated molecular link between two gatekeepers for endocytic recycling, the molecular switch Rab35 and the molecular scissors EHD1, that is mediated by two distinct Rab35 effectors during neurite outgrowth of PC12 cells. Rab35 forms a tripartite complex with MICAL-L1 and centaurin-β2/ACAP2 and recruits them to perinuclear Arf6-positive endosomes in response to nerve growth factor stimulation. MICAL-L1 and centaurin-β2 then cooperatively recruit EHD1 to the same compartment by functioning as a scaffold for EHD1 and as an inactivator of Arf6, respectively. We propose that Rab35 regulates the formation of an EHD1-association site on Arf6-positive endosomes by integrating the functions of two distinct Rab35 effectors for successful neurite outgrowth.
Medium chain triglycerides dose-dependently prevent liver pathology in a rat model of non-alcoholic fatty liver disease
Authors: Ronis Martin J J , Baumgardner January N , Sharma Neha , Vantrease Jamie , Ferguson Matthew , Tong Yudong , Wu Xianli , Cleves Mario A , Badger Thomas M
Published: April 2013

Metabolic syndrome is often accompanied by development of hepatic steatosis and less frequently by non-alcoholic fatty liver disease (NAFLD) leading to non-alcoholic steatohepatitis (NASH). Replacement of corn oil with medium chain triacylglycerols (MCT) in the diets of alcohol-fed rats has been shown to protect against steatosis and alcoholic liver injury. The current study was designed to determine if a similar beneficial effect of MCT occurs in a rat model of NAFLD. Groups of male rats were isocalorically overfed diets containing 10%, 35% or 70% total energy as corn oil or a 70% fat diet in which corn oil was replaced with increasing concentrations of saturated fat (18:82, beef tallow: MCT oil) from 20% to 65% for 21 days using total enteral nutrition (TEN). As dietary content of corn oil increased, hepatic steatosis and serum alanine amino transferases were elevated ( P < 0.05). This was accompanied by greater expression of cytochrome P450 enzyme CYP2E1 ( P < 0.05) and higher concentrations of polyunsaturated 18:2 and 20:4 fatty acids (FA) in the hepatic lipid fractions ( P < 0.05). Keeping the total dietary fat at 70%, but increasing the proportion of MCT-enriched saturated fat resulted in a dose-dependent reduction in steatosis and necrosis without affecting CYP2E1 induction. There was no incorporation of C8-C10 FAs into liver lipids, but increasing the ratio of MCT to corn oil: reduced liver lipid 18:2 and 20:4 concentrations; reduced membrane susceptibility to radical attack; stimulated FA β- and ω-oxidation as a result of activation of peroxisomal proliferator activated receptor (PPAR)a, and appeared to increase mitochondrial respiration through complex III. These data suggest that replacing unsaturated fats like corn oil with MCT oil in the diet could be utilized as a potential treatment for NAFLD.
Unusual Findings in Persistent Hyperplastic Primary Vitreous: Two Cases
Authors: Onkar Prashant Madhukar , Mitra Kajal
Published: April 2013

Persistent hyperplastic primary vitreous is a result of failure of regression of the embryonic hyaloid artery and presents commonly as leucocoria in the first few weeks of life. It leads to abnormal lenticular development and secondary changes in the retina and orbit. We discuss two cases of persistent hyperplastic primary vitreous with unusual findings. The first case is an example of unilateral involvement, and on high frequency ultrasound, the commonly associated retrolental mass was absent. The hyaloid artery was well visualized on colour and spectral Doppler. The second case had bilateral retrolenticular masses. The hyaloid artery could be demonstrated in one side on colour Doppler. Thickening of the choroido-retinal layer was noted in both sides. Retinal detachment or vitreous haemorrhages, which are commonly associated findings with persistent hyperplastic primary vitreous, were not seen in either case.
Surveillance of Endovascular Aneurysm Repair: An Audit of Sonographer-Led Ultrasound and Radiologist-Led Computed Tomography Services
Authors: Wolstenhulme S , Froggett Js , Nicholls Mj
Published: April 2013

Objectives

Postoperative complications associated with endovascular aneurysm repair (EVAR) mandate the need for lifelong surveillance. The aim of this audit was to compare the detection rates of endoleaks during the first 10 months of a combined sonographer-led colour Doppler ultrasound (CDUS) and radiologist-led contrast-enhanced computed tomography (CECT), postoperative EVAR surveillance programme, within a single National Health Service Hospital.

Methods

A prospective audit was carried out of all patients with EVAR, who had same-day CECT and CDUS surveillance examinations between March 2010 and January 2011. CECT examinations were reported by three consultant vascular radiologists. Of 66 CDUS examinations, 64 (97%) were performed and reported by four certified vascular sonographers. The reports of dual-modality, same-day scans were compared, to establish agreement on the presence and classification of the type, or absence of endoleaks. CECT was used as the gold standard, against which the sensitivity and specificity of CDUS in endoleak detection was determined.

Results

Sixty-six paired same-day CECT and CDUS reports were compared. Ten endoleaks were identified by CECT (15% incidence) and eight (80%) of 10 were type II. The number of observed agreements was 58 (88%) of 66; CDUS missed six endoleaks (five type II) and suggested two false-positives. CDUS had a sensitivity of 40% and a specificity of 96%. Conclusions: In our study, CDUS demonstrated an excellent specificity but had a low sensitivity for endoleak detection. We agree CDUS cannot effectively replace CECT as the sole imaging modality. Research to determine an international consensus for an effective and efficient postoperative EVAR surveillance patient pathway is required.
Şed Makam mı Şed İcra mı?
Authors: Harmancı Başak İlhan
Published: April 2013

Arel-Ezgi-Uzdilek nazari sisteminin makam tasnifinde yer alan şed makam terimi, günümüzde halen tartışmalı bir kavram olmayı sürdürmektedir. Şed kavramı Safiyüddin tarafından makam manasında kullanılmış ise de, kendisinden sonra tabakat kavramının yerini alarak aktarım (transposition) anlamında kullanılmıştır. Edvârlar incelendiğinde şed makam adı altında bir sınıflandırma mevcut olmadığı görülmektedir. Gerek Şed olduğu iddia edilen makamlarda bestelenmiş eserler üzerinde Türk Mûsikîsi repertuarında yapılan incelemeler, gerekse edvarlarda yapılan makam incelemeleri Türk mûsikîsinde “şed (aktarılmış) makam” diye bir kavramın olmadığını, şed icrânın söz konusu olduğunu ortaya koymaktadır. Makalemizin amacı da halen sürmekte olan şed makam tartışmasına açıklık getirerek, şed olduğu iddia edilen makamların –makam akrabalıklarını da ortaya koyarak- başlı başına farklı seyir özellikleri olan makamlar olduğunu gözler önüne sermektir.