bluuebunny/crossref_metadata_2025 huggingface dataset:
Local Mineralocorticoid Receptor Activation and the Role of Rac1 in Obesity-Related Diabetic Kidney Disease
Authors: Yoshida Shigetaka , Ishizawa Kenichi , Ayuzawa Nobuhiro , Ueda Kohei , Takeuchi Maki , Kawarazaki Wakako , Fujita Toshiro , Nagase Miki
Published: February 2014

Background/Aims: Obesity and diabetes are intimately interrelated, and are independent risk factors for kidney disease. Overactivation of mineralocorticoid receptor (MR) is implicated in end organ damage of both pathologies. But the underlying mechanism of MR activation in kidney remains uncertain. We explored the involvement of Rac1, which we previously identified as a ligand-independent MR activator, in renal MR activation in vitro and in vivo. Methods: We evaluated the MR activity and Rac1 activity under high-glucose stimulation using luciferase reporter system and glutathione S-transferase pull-down assay in cultured mesangial cells. To elucidate the role of Rac1 in vivo, we employed KKAy, a mouse model of obesity-related type 2 diabetes, which spontaneously developed massive albuminuria and distinct glomerular lesions accompanied by increased plasma aldosterone concentration. Results: High-glucose stimulation increased Rac1 activity and MR transcriptional activity in cultured mesangial cells. Overexpression of constitutively active Rac1 activated MR, and glucose-induced MR activation was suppressed by overexpression of dominant negative Rac1 or Rac inhibitor EHT1864. In KKAy, renal Rac1 was activated, and nuclear MR was increased. EHT1864 treatment suppressed renal Rac1 and MR activity and mitigated renal pathology of KKAy without changing plasma aldosterone concentration. Conclusion: Our results suggest that MR activation plays an important role in the nephropathy of KKAy mice, and that glucose-induced Rac1 activation, in addition to hyperaldosteronemia, contributes to their renal MR activation. Along with MR blockade, Rac inhibition may potentially be a preferred option in the treatment of nephropathy in obesity-related diabetic patients.
Long-Term Anatomical and Functional Outcome of Three Intravitreal Bevacizumab Injections for Persistent Macular Edema after Idiopathic Macular Epiretinal Membrane Peeling
Authors: Chang Yo-Chen , Lin Chia-Ching , Wu Wen-Chuan
Published: February 2014

Purpose: The aim of this study was to investigate the effect of three consecutive intravitreal bevacizumab injections (IVB) on long-term outcome for patients with macular edema after epiretinal membrane (ERM) removal. Methods: All patients in both the treatment and control groups had persistent macular edema 3 months after ERM removal. The patients in the treatment group received three consecutive IVB in an interval of approximately 4 weeks. The main outcome measures included logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) and central foveal thickness (CFT) determined by optical coherence tomography. Results: Two weeks after the first IVB, CFT decreased significantly by 24.1 ± 4.2 μm in the treatment group versus 4.2 ± 2.1 μm in the control group (p < 0.001). However, the mean reduction in CFT after 12 months did not differ significantly between the two groups (35.2 ± 4.9 vs. 33.7 ± 4.6 μm, p = 0.824). No significant differences were found for logMAR BCVA between the two groups at each follow-up. Conclusion: IVB could significantly decrease macular edema 2 months after the initial injection but failed to make significant differences in final CFT and logMAR BCVA.
Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation
Authors: Larsen Torben Bjerregaard , Rasmussen Lars Hvilsted , Lip Gregory Y. H. , Skjøth Flemming
Published: February 2014

Large Phase 3 clinical trials for stroke prevention in atrial fibrillation (AF) have compared non-vitamin K antagonist oral anticoagulants (NOACs) against warfarin, with the edoxaban trial only recently reported. In the absence of head to head trials directly comparing these NOACs against each other, we compared the efficacy and safety of edoxaban to other agents by an indirect comparison analysis. We performed an indirect comparison analysis of edoxaban (2 dose strategies) against apixaban (1 dose), dabigatran etexilate (2 doses) and rivaroxaban (1 dose), for their relative efficacy and safety against each other. For high-dose edoxaban vs apixaban, there were no significant differences in efficacy endpoints, mortality, myocardial infarction and major bleeding. Apixaban was associated with less major or clinically relevant non-major bleeding (hazard ratio [HR] 0.79; 95% confidence interval [CI] 0.70–0.90) and gastrointestinal bleeding (HR 0.72; 95% CI 0.53–0.99). For dabigatran 110 mg twice daily, there were no significant differences in the main efficacy or safety endpoints. Dabigatran 150 mg bid was associated with lower stroke/systemic embolism (SE) (HR 0.75; 95% CI 0.56–0.99), stroke (HR 0.73; 95% CI 0.55–0.96) and haemorrhagic stroke (HR 0.48; 95% CI 0.23–0.99). There were no significant differences between high-dose edoxaban vs rivaroxaban for efficacy endpoints or mortality, but rivaroxaban had more major and/or clinically relevant non-major bleeding. When compared to low-dose edoxaban, apixaban was associated with lower stroke/SE (HR 0.70; 95% CI 0.55–0.89), stroke (HR 0.70; 95% CI 0.55–0.92) and ischaemic stroke (HR 0.65; 95% CI 0.50–0.89), but more major bleeding (HR 1.47; 95% CI 1.20–1.80). For dabigatran 110 mg bid, there were no significant differences in the efficacy endpoints, but dabigatran 110 mg bid had higher major (and gastrointestinal) bleeding. Dabigatran 150 mg bid and rivaroxaban were associated with lower stroke/SE and ischaemic stroke, but higher bleeding rates. In the present analysis, we have provided for the first time, comparisons of efficacy and safety of edoxaban against other NOACs. Notwithstanding the significant limitations of an indirect comparison analysis, some differential effects are evident with the NOACs for stroke prevention, allowing us to allow the prescriber a ‘choice’ to be able to fit the drug to the patient clinical profile (and vice versa).

Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.
Mitogen-Activated Protein Kinase Phosphatase-1 Promotes Neovascularization and Angiogenic Gene Expression
Authors: Boerckel Joel D. , Chandrasekharan Unnikrishnan M. , Waitkus Matthew S. , Tillmaand Emily G. , Bartlett Rebecca , DiCorleto Paul E.
Published: February 2014

Objective—

Angiogenesis is the formation of new blood vessels through endothelial cell sprouting. This process requires the mitogen-activated protein kinases, signaling molecules that are negatively regulated by the mitogen-activated protein kinase phosphatase-1 (MKP-1). The purpose of this study was to evaluate the role of MKP-1 in neovascularization in vivo and identify associated mechanisms in endothelial cells.

Approach and Results—

We used murine hindlimb ischemia as a model system to evaluate the role of MKP-1 in angiogenic growth, remodeling, and arteriogenesis in vivo. Genomic deletion of MKP-1 blunted angiogenesis in the distal hindlimb and microvascular arteriogenesis in the proximal hindlimb. In vitro, endothelial MKP-1 depletion/deletion abrogated vascular endothelial growth factor–induced migration and tube formation, and reduced proliferation. These observations establish MKP-1 as a positive mediator of angiogenesis and contrast with the canonical function of MKP-1 as a mitogen-activated protein kinase phosphatase, implying an alternative mechanism for MKP-1–mediated angiogenesis. Cloning and sequencing of MKP-1–bound chromatin identified localization of MKP-1 to exonic DNA of the angiogenic chemokine fractalkine, and MKP-1 depletion reduced histone H3 serine 10 dephosphorylation on this DNA locus and blocked fractalkine expression. In vivo, MKP-1 deletion abrogated ischemia-induced fractalkine expression and macrophage and T-lymphocyte infiltration in distal hindlimbs, whereas fractalkine delivery to ischemic hindlimbs rescued the effect of MKP-1 deletion on neovascular hindlimb recovery.

Conclusions—

MKP-1 promoted angiogenic and arteriogenic neovascular growth, potentially through dephosphorylation of histone H3 serine 10 on coding-region DNA to control transcription of angiogenic genes, such as fractalkine. These observations reveal a novel function for MKP-1 and identify MKP-1 as a potential therapeutic target.
The ‘4Project’, Suning County, Hebei: Enabling Rural People to Come Together and Re-Organize
Authors: Ruoting Zheng
Published: February 2014

Abstract

Faced with the countless problems of rural society, in 2008 Suning County began to ponder and explore ways to solve these rural problems right at the root. Suning spent time and effort putting thought into the practicalities of working in the countryside, and combined this with the frame of reference gleaned through useful experiences of solving the ‘Three Rurals’ (the state’s term for three major issues troubling rural China). On this basis, Suning County devised the 4Project – a four-fold approach – to bring rural people back together, encouraging them once again to organize. Through development of grassroots Party organizations, grassroots democracy organizations, comprehensive stability maintenance organizations, and economic cooperatives, the local people, who had been scattered and lacking unity, were brought into these organizations.
Major Topics of Research on Chinese Foundations over the Last Decade: An Exploration Drawing on Co-Word Analysis
Authors: Xuqing Chen , Zhenhua Tian
Published: February 2014

Abstract

This paper adopts a co-word analysis approach and uses EXCEL and SPSS as tools to assist the authors in undertaking content analysis and mining of research on Chinese foundations between 2003-2012. In this way, the authors attempt to develop an understanding of the current state of research on Chinese foundations and to grasp the major areas within this research that has commanded the most attention. Our study reveals that the four main sub-divisions of this field that have been main focal points of scholarly interest are: the institutional environment within which foundations exist; internal governance; systems for foundation evaluation; and foundations linked to institutes of higher education.
Students as Consumers: Commodifying or Democratising Learning?
Authors: Naidoo Rajani , Whitty Geoff
Published: February 2014

The positioning of students as ‘consumers’ of education is becoming a global phenomenon. This paper begins by drawing on insights from both the marketing and education literatures to assess the impact of this development on the processes and outcomes of education, on the professional practices of faculty and on widening participation. Pierre Bourdieu’s conceptual framework is then applied to analyse how consumer mechanisms are mediated by the organisational cultures and practices within universities. These theoretical insights are combined with data from different national contexts to identify both positive and negative aspects of this trend. The paper goes on to consider the critique of consumerism as something that promotes commodification and passive learning. Some other ways of empowering students more actively in their learning, including ‘student voice’ and ‘co-production’ initiatives that are currently fashionable in Western policy contexts, are then discussed. While these are seen by some commentators as examples of ‘pre-figurative democratic practice’, others have identified them as having the potential to alienate students through tokenistic provision or as serving a neo-liberal policy agenda through the ‘responsibilisation’ of students. The paper concludes by suggesting that such initiatives may have the potential to challenge academic complacency without undermining core academic values.
Trends towards Global Excellence in Undergraduate Education: Taking the Liberal Arts Experience into the 21st Century
Authors: van der Wende Marijk
Published: February 2014

Dissatisfaction over undergraduate education seems to be persistent and has been jeopardized by the boost in research performance as fuelled by global rankings. Yet it will continue to be the cornerstone and a key mission of higher education. Hence the tide is shifting and the global debate on “the world-class university” is increasingly inclusive towards excellence in teaching and learning. A renewed focus on liberal arts education is part of this global debate on redefining excellence. This article aims to explain why liberal arts education, as it is (re)emerging in different regions, seems to be an adequate response to the search for excellence in the 21st century. It explores the drivers for liberal arts education from an epistemological, economic and a social-moral point of view. The role of interdisciplinarity, generic skills, and citizenship in different regional context are discussed, and also an admission that a liberal arts education is no panacea—that various limitations should be overcome and a truly global perspective is needed.
Resin Canals in Pinus Taeda: Longitudinal Canal Lengths and Interconnections Between Longitudinal and Radial Canals
Authors: LaPasha C.A. , Wheeler E.A.
Published: February 2014

Lengths of longitudinal resin canals in Pinus taeda (loblolly pine) wood were determined by 1) peeling offthe bark and measuring the canals, visible as white lines along the surface, to the nearest mm, and 2) photographing aseries ofcross sections (4000) ofknown thickness with a movie camera, and sub sequently using a film editor and frame counter to ca1culate lengths. The values yielded by the. two methods were not significantly different and indicate that the less time-consuming method of peeling and measuring lengths is as reliable as the cinematographic technique.
Scanning Electron Microscope Aided Wood Identification of a Bronze Age Wooden Diptych
Authors: Pendleton Michael , Warnock Peter
Published: February 2014

A broken wooden diptych was found in 1986 on the 14th century B.C. Ulu Burun, Turkey, shipwreck, with only minute fragments available for anatomical study using scanning electron microscopy. Previously, the earliest known diptychs, considered the oldest books in existence, had been found at Assyrian Nimrud and were constructed of walnut. Using observed features from the wood fragments a computerised wood identification program generated Buxus as a probable candidate. Boxwood (Buxus) is frequently mentioned in historical references, including Assyrian texts, as a wood used for small, durable objects. Comparison of the diptych wood features with those of Buxus sempervirens convinces us that the diptych was constructed from boxwood (Buxus sp.).
Wound-Induced Periderm Tubes in the Bark of Melia Azedarach, Ficus Sycomorus and Platanus Acerifolia
Authors: Lev-Yadun Simcha , Aloni Roni
Published: February 2014

Tubes of periderm were induced experimentally by wounding stems of Melia azedarach L., Ficus sycomorus L. and Platanus acerifolia Willd. This wounding stimulated the formation of periderm tubes around those strands of phloem fibres which were exposed to the outside atmosphere. The differentiation of periderm tubes inside the bark is a defence reaction by which the wound-exposed fibres are isolated from the living cells of the bark. The regulating factors of wound-induced periderm tubes are probably ethylene and atmospheric air.
Comparative Anatomy of the Secondary Phloem of Ten Species of Rosaceae
Authors: Donghua Liu , Xinzeng Gao
Published: February 2014

The anatomy of the secondary phloem of species belonging to four genera in Rosaceae is described. The three genera of the Maloideae studied are more or less similar in their phloem anatomy; tangential bands of fibresclereids alternate with bands of sieve elements, companion cells and parenchyma cells; superficially, the nonconducting and conducting phloem are not distinct from one another; sieve plates are compound and there are conspicuous sieve areas on lateral walls; rays are uniseriate and multiseriate, and homocellular. In the five species of Prunus (Prunoideae) studied, there are no fibre-sclereids in the conducting phloem, end walls bearing simple sieve plates are oblique to nearly horizontal; and rays are uniseriate and multiseriate, homocellular.
Aggregate Rays of Thujopsis Dolabrata Var. Hondai (Cupressaceae)
Authors: Sugawa Toyonobu , Fujii Tomoyuki
Published: February 2014

Aggregate rays of Thujopsis dolabrata Sieb. et Zucc. var. hondai are described in detail. These rays occur sporadically in Thujopsis stemwood and are composed mainly of multiseriate rays, with thin-walled ray parenchyma cells, and ray tracheids of irregular shape and widely varying size. Ray tracheids have Iignified three-layered secondary walls, but their S3 layer is very thin as in the secondary walls of axial tracheids.
A new species of Malayopotamon Bott, 1968 (Crustacea: Decapoda: Brachyura: Potamidae), a freshwater crab from northern Sumatra, Indonesia
Authors: NG Peter K.L.
Published: February 2014

A new species of potamid freshwater crab, Malayopotamon weh sp. nov., is described from the island of Pulau Weh off northern Sumatra, Indonesia. The species superficially resembles three Sumatran species: M. batak Ng & Wowor, 1991, M. tobaense (Bott, 1968), and M. turgeo Ng & Tan, 1999, but can easily be distinguished by various carapace as well as gonopod characters.
Carotid Intimal Thickness and Plaque Predict Prevalence and Severity of Coronary Atherosclerosis
Authors: Jeevarethinam Anand , Venuraju Shreenidhi , Weymouth Michelle , Atwal Satvir , Lahiri Avijit
Published: February 2014

We determined whether increased carotid intima–media thickness (cIMT) and prevalence of carotid plaque (CP) are predictive of prevalence and severity of coronary atherosclerosis. Consecutive patients (n = 150) with no history of coronary artery disease (CAD), who underwent both carotid ultrasound and computed tomographic coronary angiography, were included in the analysis. The mean cIMT was higher in patients with CAD than in those without CAD (0.76 vs 0.66 mm, P < .003). In a logistic regression analysis, diabetes ( P = .03) and CP ( P = .02) were associated with significant coronary plaque. Backward selection analysis (after removing nonsignificant variables) showed higher mean cIMT measurement correlated well with prevalence of any coronary plaque ( P = .03) and obstructive coronary plaque disease ( P = .05), whereas presence of CP was a good predictor of both obstructive (>50% stenosis P = .003) and any coronary plaque ( P = .003). In conclusion, CP and cIMT can be useful predictors of prevalence of CAD and its severity.
Client Perspectives About Religion and Spirituality in Group Counseling
Authors: Post Brian C. , Wade Nathaniel G.
Published: February 2014

The main purpose of this study was to examine client-rated appropriateness and preferences regarding the discussion of religious and spiritual concerns in group counseling. Participants were 164 group clients at nine university counseling centers nationwide. Clients volunteered to complete an online questionnaire about their experiences and opinions regarding religion and spirituality in group counseling. The majority of clients indicated that religious concerns are an appropriate topic for group counseling and reported a preference to discuss religious and spiritual concerns with their groups. Regression analyses examined predictors of client-rated (a) appropriateness of discussing religious concerns in group, (b) appropriateness of group leaders using religious or spiritual interventions, and (c) preferences for discussing religious and spiritual issues in group. The most consistent predictors of these ratings were client spirituality, client religious commitment, degree of spiritual struggles, and the frequency with which religion had already been discussed in the clients’ specific groups.
Home, Car Use, and Vacation
Authors: Bratt Christopher , Stern Paul C. , Matthies Ellen , Nenseth Vibeke
Published: February 2014

Strategies to promote environmentally friendly behavior among consumers require an understanding of how such behaviors are interrelated. We examined 29 different environmentally significant behaviors, using data from surveys in Germany ( n = 967) and in Norway ( n = 880). A priori models derived from previous research assuming either environmental behavior as a single factor or as organized by behavioral sectors, degrees of constraint, or frequencies of occurrence did not fit the data. In contrast, a model developed via a bottom-up approach with the German data was supported by the independent, Norwegian sample. This model can integrate several theoretical perspectives and suggests three distinct behavioral fields, with little or no correlation: home-based actions, car use, and air travel for vacation. The factor home-based actions encompasses several behaviors and correlates with the New Ecological Paradigm scale but also with a measure of impression management. Implications for understanding and influencing environmentally significant behaviors are discussed.
UK Nuclear Industry First Wireless Applications
Authors: Nobes Tom S , Murphy Chris
Published: February 2014

Magnox Ltd® and Sellafield Sites Ltd® have both installed modern wireless instruments. This paper discusses the challenges and benefits.
Prevalence of depressive disorders and related factors in women in the first trimester of their pregnancies in Erzurum, Turkey
Authors: Akçalı Aslan Puren , Aydın Nazan , Yazıcı Esra , Aksoy Ayse Nur , Kirkan Tulay Sati , Daloglu Gokhan Ali
Published: February 2014

Introduction:

Depression is the most frequently seen mental disease in the pregnancy period. The first trimester of pregnancy is important in terms of its effects on both the fetus and on the mother. This study has researched the prevalence of depression in women in the first trimester of their pregnancies in Erzurum, which is a large province in the Eastern region of Turkey.

Method:

The study participants were 463 pregnant women who were in the first trimester of their pregnancy. Screening was primarily carried out using the Edinburgh Postnatal Depression Scale (EPDS), and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition ( DSM-IV)–Clinical Version (SCID-I) was applied to those participants with a score of 12 points and higher. To assess the risk factors, a sociodemographic data form was completed by the authors.

Results:

The total depressive disorder rate was 16.8% in women in the first trimester of their pregnancies (12.3% major depressive disorder, 1.5% double depression, 2.6% minor depressive disorder and 0.4% dysthymia). A history of mental disease, mental disease suffered during a previous pregnancy, exposure to violence in the present pregnancy, an unplanned pregnancy and spouse’s unemployment were predictors for depressive disorders.

Conclusion:

It is important to identify the risk groups for the early recognition of depression in pregnancy. Developing depression screening programs can be useful for early diagnosis and therapy.
Bororo Fulani Pastoralists and Yoruba Farmers’ Conflicts in the Upper Ogun River, Oyo State Nigeria, 1986–2004
Authors: Olaniyi Rasheed Oyewole
Published: February 2014

This article, based on in-depth oral interviews, focuses on the conflicts between Bororo Fulani pastoralists and Yoruba farmers in Saki and Iseyin towns of the Upper Ogun River ( Oke-Ogun), Oyo State Nigeria to show the power disparity and competition over land resources. The conflicts that occurred between Bororo Fulani pastoralists and Yoruba farmers are classified as: economic (crop destruction and cattle killing); social (murder, rape, armed banditry, molestation on both sides of the conflict); and communal (large-scale destruction of villages, pastoral settlements and markets). Other conflicts involved access to grazing and water resources and access to markets. These conflicts were products of resource scarcity and broader challenges of power relations between indigenes and settlers/migrants in Nigeria. Ethnicity became more conspicuous among local people as these conflicts intensified. This article discusses the intervention of Yoruba traditional rulers ( Oba) and Fulani headman ( Ardo) in the formation of peace committees in Iseyin and Saki towns.
On the importance of telemetric temperature sensor location during intraperitoneal implantation in rats
Authors: Chapon PA , Bulla J , Gauthier A , Moussay S
Published: February 2014

This study aims to assess the thermal homogeneity of the intraperitoneal (IP) cavity and the relevance of using a fixed telemetric temperature sensor at a given location in studying rodents. Ten rats were intraperitoneally implanted with three Jonah® capsules each; after assessing the accuracy and reliability of the sensors. Two capsules were attached, one to the right iliac fossa (RIF) and the other to the left hypochondrium (LH), and another was placed between the intestines but not attached (Free). In the ex vivo condition, the differences between sensors and reference values remained in the range of ±0.1℃. In the in vivo condition, each sensor enabled the observation of temperature patterns. However, sensor location affected mean and median temperature values while the rats were moving freely. Indeed, temperature data collected in the LH were 0.1℃ significantly higher than those collected in the RIF and temperature data collected in the LH were 0.11℃ significantly higher than those collected with the Free capsules. In in vivo conditions, intra-sensor variability of temperature data was not affected by sensor location. Taking into account sensor accuracy, similar intra-sensor variability, and mean differences observed between the three locations, the impact of sensor location within the IP cavity could be considered negligible. In in vivo conditions, temperature differences between locations regularly exceeded ±0.2℃ and reached up to 2.5℃. These extreme values could be explained by behavioral factors such as food or water intake. Finally, considering the good thermal homogeneity of the IP cavity and possible adverse consequences of sensor attachment, it seems better to let sensors range free within the cavity.
Prognostic indicators for children and young people at the end of life: A Delphi study
Authors: Shaw Karen L , Brook Lynda , Cuddeford Lisa , Fitzmaurice Nicki , Thomas Claire , Thompson Angela , Wallis Maybelle
Published: February 2014

Background:

Recognizing transitions in end of life care for children is difficult and hinders communication and care planning.

Aim:

To identify the signs and symptoms that are most useful in signalling which children may have end of life care needs.

Methods:

A Delphi study was undertaken with palliative care professionals who rated the extent to which 75 symptoms alerted them that a child/young person may have moved into his or her last (a) weeks/days, (b) 6–12 months of life using a 7-point response scale. Level of support for items was indicated by the median, and consensus was shown by the mean absolute deviation from the median. The impact of the Delphi on final agreement and consensus was also assessed.

Results:

Second-round questionnaires were completed by 49 (89%) individuals. It was easier to identify prognostic items in the last weeks/days than earlier in the end of life trajectory. Items most indicative included failure of physiological systems, deteriorating level of consciousness, loss of autonomic control (e.g. breathing and peripheral circulation), together with a feeling of the professional that life is ending and an agreement that resuscitation would be futile. Items most indicative of last 6/12 months suggest a progressive decline in disease trajectory, increased chest infections or other complications from which the child has difficulty in making a full recovery and which may require high dependency or critical care.

Conclusion:

This study provides important insight into which signs and symptoms are considered most valuable in identifying children approaching the end of the life.
Postanesthetic Death in a Cat With Myopathy
Authors: Remmers G. , Hayden D. W. , Jaeger M. A. , Ervasti J. M. , Valberg S. J.
Published: February 2014

There are few reports of naturally occurring muscular dystrophy in domestic animals. Herein, we describe a case of muscular dystrophy in a 4-year-old neutered male American domestic shorthair cat that died unexpectedly following anesthesia for an elective surgical procedure. Macroscopic muscular hypertrophy and histologic evidence of myofiber size variation, mineralization, myofiber degeneration, and necrosis were compatible with a diagnosis of muscular dystrophy. Extensive endomysial fibrosis was noted histologically in the diaphragm. A complete absence of dystrophin protein in Western blot confirmed the diagnosis of Duchenne muscular dystrophy. Immunofluorescence microscopy revealed reduced levels of dystrophin-associated proteins and an upregulation of utrophin at the sarcolemma. Anesthetic deaths can occur in dystrophin-deficient cats, and therefore muscular dystrophy and the associated cardiomyopathy should be considered in the differential diagnoses for perianesthetic death in cats.
Body dirt or liquid gold? How the ‘safety’ of donated breastmilk is constructed for use in neonatal intensive care
Authors: Carroll Katherine
Published: February 2014

When mothers of preterm infants are unable to produce sufficient volumes of breastmilk, neonatologists in many Western countries prescribe pasteurized donor breastmilk. Breastmilk has a paradoxical presence in the neonatal intensive care unit: while it has therapeutic properties, it also has the potential to transmit disease. National health authorities and local neonatal intensive care unit policies each delimit the safety of donor milk by focusing on the presence or absence of pathogens. It is in this light that breastmilk from the human milk bank is both sought and legitimated to minimize safety concerns. This research uses data arising from an ethnographic study of two human milk banks and two neonatal intensive care units in the United States, and 73 interviews with milk donors, neonatal intensive care unit parents and clinicians. The primary research question framing the study was ‘What are the underlying processes and practices that have enabled donor milk to be endorsed as a safe and legitimate feeding option in neonatal intensive care units?’ This study is framed using three key principles of Latour’s ‘new critique’, namely, adding to reality rather than debunking it, getting closer to data rather than turning away from fact and creating arenas in which to assemble. As a result, conceptions of donor milk’s safety are expanded. This case study of donor milk demonstrates how Latour’s new critique can inform science and technology studies approaches to the study of safety in health care.
Comparisons of Retear Patterns for 3 Arthroscopic Rotator Cuff Repair Methods
Authors: Kim Kyung Cheon , Shin Hyun Dae , Cha Soo Min , Park Jun Yeong
Published: February 2014

Background:

Only a few studies have reported an unusual retear pattern after arthroscopic rotator cuff repair based on the repair method.

Purpose:

To compare the retear pattern of the arthroscopic single-row technique (SRT), conventional suture-bridge technique (SBT), and knotless suture-bridge technique (K-SBT) for rotator cuff tears.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This study evaluated 65 shoulders with retears revealed on magnetic resonance imaging at least 6 months after arthroscopic repair for a full-thickness rotator cuff tear. A retear was revealed in 21, 22, and 22 shoulders after the SRT, SBT, and K-SBT, respectively. Retears were classified as type 1 (unhealed tendons), type 2 (medially ruptured tendons with a healed footprint), or type 3 (unable to classify). Retear patterns were classified as full- or partial-thickness lesions; partial-thickness retears were further classified as articular- or bursal-side lesions.

Results:

A type 1 retear was observed in 71.4%, 40.9%, and 54.5% and a type 2 retear in 23.8%, 59.0%, and 40.9% of patients in the SRT, SBT, and K-SBT groups, respectively. No significant differences were observed among the 3 groups together ( P = .195); however, a significant difference was observed between the SRT and SBT groups alone ( P = .049). No significant differences were observed for either type 1 ( P = .121) or type 2 (including both full- and partial-thickness) retears ( P = .064) among the 3 groups together. When respective pairs of groups were compared, a significant difference was noted in both type 1 ( P = .044) and type 2 retears ( P = .019) between the SRT and SBT groups alone. No significant differences were observed in type 1 ( P = .281) or type 2 full-thickness retears ( P = .117) among the 3 groups together. When pairs of groups were compared, a significant difference in type 2 full-thickness retears was detected between the SRT and SBT groups alone ( P = .037).

Conclusion:

The SBT has a different retear pattern than that of the SRT. However, the K-SBT retear pattern was not different from that of the SRT.
Funnel Tenotomy Versus Intracuff Tenodesis for Lesions of the Long Head of the Biceps Tendon Associated With Rotator Cuff Tears
Authors: Cho Nam Su , Cha Sang Won , Rhee Yong Girl
Published: February 2014

Background:

There is no clear consensus regarding optimal management of lesions of the long head of the biceps tendon (LHBT) associated with rotator cuff tears.

Purpose:

To compare clinical outcome and cosmetic deformity of a funnel tenotomy versus intracuff tenodesis for concomitant LHBT lesion in patients with rotator cuff tears.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent surgical treatment for rotator cuff tears associated with LHBT lesions between March 2005 and February 2011 were enrolled in the study (N = 83). Forty-one underwent a funnel tenotomy (group A), and 42 underwent an intracuff tenodesis (group B). The mean age at the time of operation was 63.8 years in group A (range, 44-68 years) and 58.6 years in group B (range, 45-70 years).

Results:

At the most recent follow-up, the mean University of California at Los Angeles (UCLA) score in group A improved from a preoperative mean of 16.9 ± 3.6 to 30.6 ± 4.1 ( P < .001), and the Constant score improved from 58.7 ± 14.2 to 73.8 ± 11.2 ( P < .001). In group B, these scores improved from 18.1 ± 4.0 to 31.3 ± 3.0 ( P < .001) and 53.6 ± 13.4 to 74.8 ± 11.9 ( P < .001), respectively. There were no statistically significant differences between the 2 groups ( P = .43 for UCLA, P = .81 for Constant score). Popeye deformity was detected in 11 cases of group A (26.8%) and in 7 cases of group B (16.7%) ( P = .06).

Conclusion:

For the treatment of concomitant LHBT lesions in patients with rotator cuff tears, both a funnel tenotomy and an intracuff tenodesis showed good clinical outcomes. Even though the incidence of Popeye deformity in the funnel tenotomy group tended to be higher, there was no significant difference in the overall incidence of cosmetic deformity between the 2 groups.
Economic Policy without Politics
Authors: Peacock Mark S.
Published: February 2014

Commentators on market-oriented policy reform, e.g. John Williamson and Naomi Klein, have observed that radical policy change is often enacted in the wake of a “crisis” which is perceived to necessitate and justify the change. In section 2, I critically examine Williamson’s work and his analysis of the enabling conditions of policy changes based on the “Washington Consensus.” I also consider Klein’s work, and use, as a case study, the economic reforms in Chile in the 1970s. Whilst Williamson and Klein provide insights into the introduction of policy change, they do not offer plausible accounts of its persistence after a crisis has passed. Drawing on insights from behavioral economics, an explanation of persistence is offered (section 3). In section 4, the notion of “politics” contained in the work of proponents of market-oriented policy reform is scrutinized. I conclude with remarks on strategies for resisting market-oriented policy change.
Coefficient of Variation of Coarsely Sampled Heart Rate is Associated With Early Vasopressor Independence in Severe Sepsis and Septic Shock
Authors: Brown Samuel M. , Tate M. Quinn , Jones Jason P. , Kuttler Kathryn G. , Lanspa Michael J. , Rondina Matthew T. , Grissom Colin K. , Mathews V. J.
Published: February 2014

Purpose:

To determine whether variability of coarsely sampled heart rate and blood pressure early in the course of severe sepsis and septic shock predicts successful resuscitation, defined as vasopressor independence at 24 hours after admission.

Methods:

In an observational study of patients admitted with severe sepsis or septic shock from 2009 to 2011 to either of 2 intensive care units (ICUs) at a tertiary-care hospital, in whom blood pressure was measured via an arterial catheter, we sampled heart rate and blood pressure every 30 seconds over the first 6 hours of ICU admission and calculated the coefficient of variability of those measurements. Primary outcome was vasopressor independence at 24 hours; and secondary outcome was 28-day mortality.

Results:

We studied 165 patients, of which 97 (59%) achieved vasopressor independence at 24 hours. Overall, 28-day mortality was 15%. Significant predictors of vasopressor independence at 24 hours included the coefficient of variation of heart rate, age, Acute Physiology and Chronic Health Evaluation II, the number of increases in vasopressor dose, mean vasopressin dose, mean blood pressure, and time–pressure integral of mean blood pressure less than 60 mm Hg. Lower sampling frequencies (up to once every 5 minutes) did not affect the findings.

Conclusions:

Increased variability of coarsely sampled heart rate was associated with vasopressor independence at 24 hours after controlling for possible confounders. Sampling frequencies of once in 5 minutes may be similar to once in 30 seconds.
Long-Term Mortality After Pneumonia in Cardiac Surgery Patients
Authors: Ibañez J. , Riera M. , Amezaga R. , Herrero J. , Colomar A. , Campillo-Artero C. , de Ibarra J. I. Saez , Bonnin O.
Published: February 2014

Background:

The role that intensive care unit (ICU)-acquired pneumonia plays in the long-term outcomes of cardiac surgery patients is not well known. This study examined the association of pneumonia with in-hospital mortality and long-term mortality after adult cardiac surgery.

Methods:

A total of 2750 patients admitted to our ICU after cardiac surgery from January 2003 to December 2009 are the basis for this observational study. Patients who developed ICU-acquired pneumonia were matched with patients without it in a 1:2 ratio. The matching criteria were age, urgent or scheduled surgery, surgical procedure, and the propensity score for pneumonia. Multiple regression analysis was used to find predictors of hospital mortality. The relationship between pneumonia and long-term survival was analyzed with Kaplan-Meier survival estimates and a risk-adjusted Cox proportional regression model for patients discharged alive from hospital.

Results:

Pneumonia was diagnosed in 32 (1.2%) patients and there were 19 cases per 1000 days of mechanical ventilation. Patients with pneumonia had a significantly higher hospital mortality rate (28% vs 6.2%, P = .003) and a higher mortality at the end of follow-up (53% vs 19%, P < .0001) than those without it. Regression analysis showed that pneumonia was a strong predictor of hospital mortality. Five-year survival was as follows: pneumonia, 62%; control, 81%; and cohort patients, 91%. The Cox model showed that, after adjusting for confounding factors, patients with pneumonia (hazard ratio = 3.96, 95% confidence interval [CI]: 1.41-11.14) had poorer long-term survival.

Conclusion:

Pneumonia remains a serious complication in patients operated for cardiac surgery and is associated with increased hospital mortality and reduced long-term survival.
Exploring Employee Satisfaction With Performance Management and the Challenges Faced in Context of IT Industry
Authors: Mishra Geeta , Farooqi Rahela
Published: February 2014

Performance management is considered to be a most significant HR process and has gained significant attention from both researchers and practitioners owing to its complexities and perceived problems. This research focuses on the satisfaction of employees with their employer’s performance management system in the context of the IT industry of India. IT companies represent a challenge for managers and employees, as knowledge workers are often asked to address multiple goals and projects simultaneously. Since managing the performance of knowledge workers has unique complexities, this research work is intended to shed light on the satisfaction of IT professionals related to the major dimensions of the performance management process: performance planning, feedback and coaching, performance review and outcomes (or consequences). Also, the article aims to explore the challenges faced by employees during the implementation of a performance management system. The findings of this study have implications for the working of IT organizations to improve the effectiveness of efforts to manage knowledge workers.
Screening for Mild Cognitive Impairment Using the Dementia Rating Scale-2
Authors: Springate Beth A. , Tremont Geoffrey , Papandonatos George , Ott Brian R.
Published: February 2014

This study examined the sensitivity and specificity of the Dementia Rating Scale-2 (DRS-2) to distinguish individuals with mild cognitive impairment (MCI) from both patients with Alzheimer’s disease (AD) and healthy controls (HCs). A total of 50 HCs, 98 patients with MCI, and 49 patients with AD completed a neurological examination and battery of neuropsychological tests that included the DRS-2. Across almost all subscales of the DRS-2, patients with AD scored significantly worse than patients with MCI who in turn performed more poorly than the HCs. The only exception was the construction subscale where no significant difference was found between patients with MCI and the HCs. At a cutoff of 136, the sensitivity was 71% and specificity was 86% for distinguishing between patients with MCI and the HCs. Sensitivity was 82% and specificity was 78% for distinguishing between patients with MCI and patients with AD (cutoff score <124). For distinguishing between patients (with MCI and AD) and the HCs, sensitivity was 81% and specificity was 86% at a cutoff of 136. Our findings suggest the DRS-2 is a brief, easily administered cognitive test that appears to be useful in assisting with the detection of MCI.
Obsessive–Compulsive Disorder
Authors: Bokor Gyula , Anderson Peter D.
Published: February 2014

Obsessive–compulsive disorder (OCD) is a common heterogeneous psychiatric disorder manifesting with obsessions and compulsions. Obsessions are intrusive, recurrent, and persistent unwanted thoughts. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to the obsessions. The heterogeneity of OCD includes themes of obsessions, types of rituals, presence or absence of tics, etiology, genetics, and response to pharmacotherapy. Complications of OCD include interpersonal difficulties, unemployment, substance abuse, criminal justice issues, and physical injuries. Areas of the brain involved in the pathophysiology include the orbitofrontal cortex, anterior cingulate gyrus, and basal ganglia. Overall, OCD may be due to a malfunction in the cortico–striato–thalamo–cortical circuit in the brain. Neurotransmitters implicated in OCD include serotonin, dopamine, and glutamate. Numerous drugs such as atypical antipsychotics and dopaminergic agents can cause or exacerbate OCD symptoms. The etiology includes genetics and neurological insults. Treatment of OCD includes psychotherapy, pharmacotherapy, electroconvulsive therapy, transcranial magnetic simulation, and in extreme cases surgery. Exposure and response prevention is the most effective form of psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) are the preferred pharmacotherapy. Higher doses than listed in the package insert and a longer trial are often needed for SSRIs than compared to other psychiatric disorders. Alternatives to SSRIs include clomipramine and serotonin/norepinephrine reuptake inhibitors. Treatment of resistant cases includes augmentation with atypical antipsychotics, pindolol, buspirone, and glutamate-blocking agents.
Hospital characteristics affecting potentially avoidable emergency admissions: National ecological study
Authors: O’Cathain A , Knowles E , Maheswaran R , Turner J , Hirst E , Goodacre S , Pearson T , Nicholl J
Published: February 2014

Some emergency admissions can be avoided if acute exacerbations of health problems are managed by emergency and urgent care services without resorting to admission to a hospital bed. In England, these services include hospitals, emergency ambulance, and a range of primary and community services. The aim was to identify whether characteristics of hospitals affect potentially avoidable emergency admission rates. An age-sex adjusted rate of admission for 14 conditions rich in avoidable emergency admissions was calculated for 129 hospitals in England for 2008–2011. Twenty-two per cent (3,273,395/14,998,773) of emergency admissions were classed as potentially avoidable, with threefold variation between hospitals. Explanatory factors of this variation included those which hospital managers could not control (demand for hospital emergency departments) and those which they could control (supply in terms of numbers of acute beds in the hospital, and management of non-emergency and emergency patients within the hospital). Avoidable admission rates were higher for hospitals with higher emergency department attendance rates, higher numbers of acute beds per 1000 catchment population and higher conversion rates from emergency department attendance to admission. Hospital managers may be able to reduce avoidable emergency admissions by reducing supply of acute beds and conversion rates from emergency department attendance.
Stator conditioning effects on steam turbine rotating instability
Authors: Zhang LY , He L , Stüer H
Published: February 2014

Rotating stall and rotating instability (as it is often called) have been extensively studied in compressors and fan stages. Though less known, they are relevant to steam turbines operated at very low mass flow conditions. In the present work, flow under various flow rate conditions in the last stage of steam turbine configurations is investigated. The objective of this study is to identify the main physical dependent parameters of rotating instability for turbine configurations and to see if they can be used to explore the potential of delaying rotating instability by blading design or by control. The computational results clearly show that the onset and development of the flow instability in the rotor row are subject to the intra-row gap distance and in particular can be influenced by the upstream stator flow conditioning. Further 3D calculations with a re-staggered stator row are carried out to examine the effect on a 3D steam turbine blading configuration. Under the flow conditions considered in this study, rotating instability is consistently shown to be suppressed for the 3D stage configuration with a re-staggered stator row, compared to the original configuration. The flow pattern responsible for this effect is also examined.