bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvements in Health Status after Massachusetts Health Care Reform
Authors: VAN DER WEES PHILIP J. , ZASLAVSKY ALAN M. , AYANIAN JOHN Z.
Published: December 2013

Context

Massachusetts enacted health care reform in 2006 to expand insurance coverage and improve access to health care. The objective of our study was to compare trends in health status and the use of ambulatory health services before and after the implementation of health reform in Massachusetts relative to that in other New England states.

Methods

We used a quasi‐experimental design with data from the Behavioral Risk Factor Surveillance System from 2001 to 2011 to compare trends associated with health reform in Massachusetts relative to that in other New England states. We compared self‐reported health and the use of preventive services using multivariate logistic regression with difference‐in‐differences analysis to account for temporal trends. We estimated predicted probabilities and changes in these probabilities to gauge the differential effects between Massachusetts and other New England states. Finally, we conducted subgroup analysis to assess the differential changes by income and race/ethnicity.

Findings

The sample included 345,211 adults aged eighteen to sixty‐four. In comparing the periods before and after health care reform relative to those in other New England states, we found that Massachusetts residents reported greater improvements in general health (1.7%), physical health (1.3%), and mental health (1.5%). Massachusetts residents also reported significant relative increases in rates of Pap screening (2.3%), colonoscopy (5.5%), and cholesterol testing (1.4%). Adults in Massachusetts households that earned up to 300% of the federal poverty level gained more in health status than did those above that level, with differential changes ranging from 0.2% to 1.3%. Relative gains in health status were comparable among white, black, and Hispanic residents in Massachusetts.

Conclusions

Health care reform in Massachusetts was associated with improved health status and the greater use of some preventive services relative to those in other New England states, particularly among low‐income households. These findings may stem from expanded insurance coverage as well as innovations in health care delivery that accelerated after health reform.
Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices
Authors: HOFF TIMOTHY
Published: December 2013

Context

The patient‐centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care.

Methods

I used a multicase, comparative study design that relied on a sensemaking approach and fifty‐one in‐depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care.

Findings

I found two distinct taxonomies of implementation best practices, which I labeled “hard” and “soft” because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices.

Conclusions

The results suggest that there may be no standardized, one‐size‐fits‐all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted.
Self, Career and Nationhood: The contrasting aspirations of British and French elite graduates
Authors: Power Sally , Brown Phillip , Allouch Annabelle , Tholen Gerbrand
Published: December 2013

There is increasing interest in the emergence of a ‘global middle class’ in which high achieving young graduates increasingly look to develop careers that transcend national boundaries. This paper explores this issue through comparing and contrasting the aspirations and orientations of two ‘elite’ cohorts of graduates. Interviews with students at the University of Oxford, England, and Sciences‐Po, France, reveal very different ambitions and allegiances. Our Oxford respondents portray their futures as projects of self‐fulfilment as they build portfolio careers by moving from job to job and from country to country with limited social allegiances – epitomizing the nomadic worker of the transnational elite. Our Parisian respondents, on the other hand, display strong allegiances to the nation, state and civic duty. Their projects of the self involve reconciling their personal aspirations with strong allegiances to France. The paper concludes by discussing the significance of these differences. It argues that the enduring role of education in the formation of national identities should not be overlooked and that more detailed research is needed on the contextual specifity of transnationalism and the (re)production of elites.
A comparison of the physicochemical characteristics of the regional cheese Oscypek and the traditional cheese Gazdowski from the Polish Podhale
Authors: Kędzierska‐Matysek Monika , Florek Mariusz , Skałecki Piotr , Litwińczuk Anna , Chruścicki Adam
Published: December 2013

The quality of two types of traditional cheese manufactured in Podhale (southernmost region of Poland), that is, Oscypek (regional PDO) and Gazdowski (native traditional product ‐ NTP), was compared. The appearance, sensory qualities, proximate composition and intrinsic traits were evaluated. Oscypek manufactured from mixed (sheep and cow) milk received higher sensory scores for texture, taste and aroma than the traditional Gazdowski cheese made from cow's milk. Furthermore, the Oscypek cheese contained significantly more total solids and protein, but less salt. Composition could be responsible for its more cohesive texture which was defined by significantly greater cohesiveness, greater hardness, springiness, shear force and shear energy.
Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
Authors: Doumouchtsis SK , Nikolopoulos K , Talaulikar VS , Krishna A , Arulkumaran S
Published: December 2013

Background

Uterine‐sparing surgical interventions have long been practiced as an alternative to hysterectomy in the management of severe postpartum haemorrhage (PPH); however, the risks of impairment of subsequent fertility from such procedures are unclear.

Objective

To evaluate the menstrual and fertility outcomes following radiological or conservative surgical interventions for severe PPH.

Search strategy

A systematic review of English and non‐English articles using the Cochrane Library 2012, PubMed (1950–2012), Embase (1980–2012), and the National Research Register. The keywords used for our search included ‘fertility’, ‘reproductive outcome’, ‘postpartum haemorrhage’, ‘embolisation’, ‘hypogastric artery ligation’, ‘B‐Lynch suture’, ‘stepwise uterine devascularisation’, ‘tamponade’, and ‘uterine compression sutures’.

Selection criteria

Studies including human female subjects with at least five cases.

Data collection and analysis

Independent extraction of articles by two authors using predefined data fields, including study quality indicators.

Main results

We identified 402 publications and after exclusions, 28 studies were included in the systematic review. Seventeen studies (675 women) reported on the fertility outcomes after uterine artery embolisation, five studies (195 women) reported on the fertility outcomes after uterine devascularisation, and six studies (125 women) reported on the fertility outcomes following uterine compression sutures. Overall, 553 out of 606 (91.25%) women resumed menstruation within 6 months of delivery. One hundred and eighty‐three out of 235 (77.87%) women who desired another pregnancy achieved conception.

Author's conclusions

Uterine‐sparing radiological and surgical techniques for the management of severe PPH do not appear to adversely affect the menstrual and fertility outcomes in most women; however, the number of studies and the quality of the available evidence is of concern.
Search costs, demand‐side economies, and the incentives to merge under Bertrand competition
Authors: Moraga‐González José L. , Petrikaitė Vaiva
Published: December 2013

We study the incentives to merge and the aggregate implications of mergers in a Bertrand competition model where firms sell differentiated products and consumers search sequentially for satisfactory deals. When search frictions are substantial, firms have an incentive to merge and to retail their products within a single store, which induces consumers to begin their search there. Such a merger lowers the profits of the outsiders and may benefit consumers due to more efficient search. Overall welfare may even increase. If the merged entity limits itself to coordinating the prices of the constituent firms, merging may not be profitable.
A selective sweep in a microsporidian parasite Nosema‐tolerant honeybee population, Apis mellifera
Authors: Huang Q. , Lattorff H. M. G. , Kryger P. , Le Conte Y. , Moritz R. F. A.
Published: December 2013

Nosema is a microsporidian parasite of the honeybee, which infects the epithelial cells of the gut. In Denmark, honeybee colonies have been selectively bred for the absence of Nosema over decades, resulting in a breeding line that is tolerant toward Nosema infections. As the tolerance toward the Nosema infection is a result of artificial selection, we screened chromosome 14 for a selective sweep with microsatellite markers, where a major quantitative trait locus (QTL) had been identified to be involved in the reduction in Nosema spores in the honeybees. By comparing the genetic variability of 10 colonies of the selected honeybee strain with a population sample from 22 unselected colonies, a selective sweep was revealed within the previously identified QTL region. The genetic variability of the swept loci was not only reduced in relation to the flanking markers on chromosome 14 within the selected strain but also significantly reduced compared with the same region in the unselected honeybees. This confirmed the results of the previous QTL mapping for reduced Nosema infections. The success of the selective breeding may have driven the selective sweep found in our study.
Children under the age of seven with diabetes are increasing their cardiovascular risk by their food choices
Authors: Sundberg F. , Augustsson M , Forsander G , Cederholm U , Axelsen M
Published: December 2013

Aim

Early‐onset diabetes increases the risk of cardiovascular disease. This study examined the eating habits of children under 7 years of age with diabetes to see whether their diet increased that risk even further.

Methods

A total of 24 children with type 1 diabetes (mean age 4.5 years) and 27 healthy controls (mean age 4.6 years) participated in this cross‐sectional study. Food intake was assessed by two 4‐day food records.

Results

Children with type 1 diabetes had a higher energy intake from protein (18 vs 15%, p < 0.05) and fat (35 vs 31%, p < 0.05) but lower intake from carbohydrates (47 vs 54%, p < 0.05), than the healthy control group. Intake of saturated fat was higher than recommended in both groups, and consumption of fruit and vegetables was lower than recommended, but similar, in both the diabetes and control groups (191 vs 207 g per day). Total intake of fat was negatively correlated with intake of fruit and vegetables (r = −0.74 p < 0.05) in children with type 1 diabetes.

Conclusion

Children under 7 years of age with type 1 diabetes eat too much saturated fat and not enough fruit and vegetables. Their diet should be improved to reduce their cardiovascular risk.
Procedure for microbial identification based on Matrix‐Assisted Laser Desorption/Ionization‐Time of Flight Mass Spectrometry from screening‐positive urine samples
Authors: March Rosselló Gabriel A. , Gutiérrez Rodríguez María P. , de Lejarazu Leonardo Raúl Ortiz , Orduña Domingo Antonio , Bratos Pérez Miguel A.
Published: December 2013

Matrix‐Assisted Laser Desorption/Ionization‐Time of Flight Mass Spectrometry is a widely used proteomic technique in clinical microbiology laboratories, and enables microbial identification directly from clinical samples. This study seeks to establish a protocol for bacterial identification from monomicrobial urine samples that have tested positive in the screening with Sysmex UF‐1000i (Sysmex Corporation, Kobe, Japan). Sysmex UF‐1000i counts ≥1 × 107 bacteria/mL indicate a sufficient bacterial concentration to allow direct identification from urine, with 87.5% sensitivity. Microbial identification from urine with Sysmex UF‐1000i counts between 1 × 105 and 1 × 107 bacteria/ml requires preincubation to obtain the adequate amount of bacteria needed for analysis, and 91.7% sensitivity thus being achieved.
Antibody therapy for acute myeloid leukaemia
Authors: Gasiorowski Robin E. , Clark Georgina J. , Bradstock Kenneth , Hart Derek N. J.
Published: December 2013

Novel therapies with increased efficacy and decreased toxicity are desperately needed for the treatment of acute myeloid leukaemia (AML). The anti CD33 immunoconjugate, gemtuzumab ozogamicin (GO), was withdrawn with concerns over induction mortality and lack of efficacy. However a number of recent trials suggest that, particularly in AML with favourable cytogenetics, GO may improve overall survival. This data and the development of alternative novel monoclonal antibodies (mAb) have renewed interest in the area. Leukaemic stem cells (LSC) are identified as the subset of AML blasts that reproduces the leukaemic phenotype upon transplantation into immunosuppressed mice. AML relapse may be caused by chemoresistant LSC and this has refocused interest on identifying and targeting antigens specific for LSC. Several mAb have been developed that target LSC effectively in xenogeneic models but only a few have begun clinical evaluation. Antibody engineering may improve the activity of potential new therapeutics for AML. The encouraging results seen with bispecific T cell‐engaging mAb‐based molecules against CD19 in the treatment of B‐cell acute lymphobalstic leukaemia, highlight the potential efficacy of engineered antibodies in the treatment of acute leukaemia. Potent engineered mAb, possibly targeting novel LSC antigens, offer hope for improving the current poor prognosis for AML.
Role of urinary cations in the aetiology of bladder symptoms and interstitial cystitis
Authors: Parsons C. Lowell , Shaw Timothy , Berecz Zoltan , Su Yongxuan , Zupkas Paul , Argade Sulabha
Published: December 2013

Objectives

To identify and characterise urinary cationic metabolites, defined as toxic factors, in patients with interstitial cystitis (IC) and in control subjects. To evaluate the cytotoxicity of the urinary cationic metabolite fraction of patients with IC vs control subjects and of individual metabolites in cultured urothelial cells.

Subjects and Methods

Cationic fractions (CFs) were isolated from the urine specimens of 62 patients with IC and 33 control subjects by solid‐phase extraction. CF metabolites were profiled using C18 reverse‐phase high performance liquid chromatography (RP‐HPLC) with UV detection, quantified by area‐under‐the‐peaks using known standards, and normalized to creatinine. RP‐HPLC and liquid chromatography (LC)‐mass spectrometry (MS)/tandem MS (MS/MS) were used to identify major CF peaks. HTB‐4 urothelial cells were used to determine the cytotoxicity of CFs and of individual metabolites with and without Tamm–Horsfall protein (THP).

Results

RP‐HPLC analysis showed that metabolite quantity was twofold higher in patients with IC compared with control subjects. The mean (sem) for control subjects vs patients was 3.1 (0.2) vs 6.3 (0.5) mAU*min/μg creatinine (P < 0.001). LC‐MS identified 20 metabolites. Patients with IC had higher levels of modified nucleosides, amino acids and tryptophan derivatives compared with control subjects. The CF cytotoxicity was higher for patients with IC compared with control subjects. The mean (sem) for control subjects vs patients was −2.3 (2.0)% vs 36.7 (2.7)% (P < 0.001). A total of 17 individual metabolites were tested for their cytotoxicity. Cytotoxicity data for major metabolites were all significant (P < 0.001): 1‐methyladenosine (51%), 5‐methylcytidine (36%), 1‐methyl guanine (31%), N4‐acetylcytidine (24%), N7‐methylguanosine (20%) and L‐Tryptophan (16%). These metabolites were responsible for higher toxicity in patients with IC. The toxicity of all metabolites was significantly lower in the presence of control THP (P < 0.001).

Conclusions

Major urinary cationic metabolites were characterised and found to be present in higher amounts in patients with IC compared with control subjects. The cytotoxicity of cationic metabolites in patients with IC was significantly higher than in control subjects, and control THP effectively lowered the cytotoxicity of these metabolites. These data provide new insights into toxic factor composition as well as a framework in which to develop new therapeutic strategies to sequester their harmful activity, which may help relieve the bladder symptoms associated with IC.
Active surveillance for renal angiomyolipoma: outcomes and factors predictive of delayed intervention
Authors: Ouzaid Idir , Autorino Riccardo , Fatica Richard , Herts Brian R. , McLennan Gordon , Remer Erick M. , Haber Georges‐Pascal
Published: December 2013

Objective

To present the outcomes of active surveillance (AS) for renal angiomyolipomas (AMLs) and to assess the clinical features predicting delayed intervention of this treatment option.

Patients and Methods

We retrospectively reviewed the outcomes of patients diagnosed with AMLs on computed tomography (CT) who were managed with AS at our institution. The AS protocol consisted of 6‐ and 12‐month, then annual follow‐up visits, each one including a physical examination and CT imaging. Discontinuation of AS was defined as the need or decision for an active procedure during the follow‐up period. Causes of delayed intervention, as well as the type of active treatment (AT), were recorded. Clinical features at presentation of patients failing AS were compared with those who remained under AS at the time of the last follow‐up. Predictive factors of delayed intervention were analysed using univariate and multivariate Cox regression models.

Results

Overall, 130 patients were included in the analysis, of whom 102 (78.5%) were incidentally diagnosed, while 15 (11.5%) and 13 patients (10%) presented with flank pain and haematuria, respectively. After a mean (sd) follow‐up of 49 (40) months, 17 patients (13%) discontinued AS and underwent AT. Patients who underwent delayed intervention were more likely to present with a higher body mass index, larger tumours and symptomatic disease. Angioembolization represented the first‐line AT after AS (64.7%), whereas partial nephrectomy was adopted in 29.4% of patients. On the univariate analysis, risk factors for delayed intervention included tumour size ≥4 cm, symptoms at diagnosis, and history of concomitant or contralateral kidney disease. On the multivariate analysis, only tumour size and symptoms remained independently associated with discontinuation of AS.

Conclusions

Tumour size and symptoms at initial presentation were highly predictive of discontinuation of AS in the management of AMLs. Selective angioembolization was the first‐line option used for AT after AS was discontinued.
Novel Central Nervous System Drug Delivery Systems
Authors: Stockwell Jocelyn , Abdi Nabiha , Lu Xiaofan , Maheshwari Oshin , Taghibiglou Changiz
Published: December 2013

For decades, biomedical and pharmaceutical researchers have worked to devise new and more effective therapeutics to treat diseases affecting the central nervous system. The blood–brain barrier effectively protects the brain, but poses a profound challenge to drug delivery across this barrier. Many traditional drugs cannot cross the blood–brain barrier in appreciable concentrations, with less than 1% of most drugs reaching the central nervous system, leading to a lack of available treatments for many central nervous system diseases, such as stroke, neurodegenerative disorders, and brain tumors. Due to the ineffective nature of most treatments for central nervous system disorders, the development of novel drug delivery systems is an area of great interest and active research. Multiple novel strategies show promise for effective central nervous system drug delivery, giving potential for more effective and safer therapies in the future. This review outlines several novel drug delivery techniques, including intranasal drug delivery, nanoparticles, drug modifications, convection‐enhanced infusion, and ultrasound‐mediated drug delivery. It also assesses possible clinical applications, limitations, and examples of current clinical and preclinical research for each of these drug delivery approaches. Improved central nervous system drug delivery is extremely important and will allow for improved treatment of central nervous system diseases, causing improved therapies for those who are affected by central nervous system diseases.
Preparation, Optimization and Characterization of Bovine Lactoferrin‐loaded Liposomes and Solid Lipid Particles Modified by Hydrophilic Polymers Using Factorial Design
Authors: Yao Xudong , Bunt Craig , Cornish Jillian , Quek Siew‐Young , Wen Jingyuan
Published: December 2013

Bioadhesive liposomes and solid lipid particles (SLPs) modified by pectin and chitosan for oral administration of bovine lactoferrin (bLf) were prepared using a 24 full‐factorial design to identify the key formulation variables influencing particle size and drug entrapment efficiency (EE). Netlike structures of the polymer–particle mixture consisting of a polymeric network in which multiple particles were imbedded were observed by scanning electron microscopy (SEM). Chemical stability of bLf after encapsulation into pectin‐ and chitosan‐modified liposomes and SLPs was confirmed by Fourier transform infrared spectra (FTIR). Bovine lactoferrin was located within phospholipid bilayer, whereas in SLPs bLf was within the matrix. The crystalline nature of bLf after encapsulation was investigated by differential scanning calorimetry (DSC) of drug‐loaded particles, indicating amorphous dispersion of bLf in the polymer–lipid matrix of pectin‐ and chitosan‐modified liposomes and SLPs. In vivo pharmacokinetic investigation of bLf in pectin‐ and chitosan‐modified liposomes and SLPs showed prolonged mean residence time (MRT) of bLf in rat blood and increased the relative bioavailability (Fbio%) by 1.95‐ to 2.69‐fold compared with free bLf. The developed carrier systems are considered to be promising vehicles for oral delivery.
Comparison of Binding Characterization of Two Antiviral Drugs to Human Serum Albumin
Authors: Li Mei , McAuley Erin , Zhang Yao , Kong LinLin , Yang Feng , Zhou ZuPing , Wu XiaoYang , Liang Hong
Published: December 2013

Ribavirin and lamivudine are representatives of antiviral drugs that are widely used to treat viral infections, especially chronic liver disease. To compare binding mechanism and behavior of antiviral drugs with human serum albumin (HSA), we performed fluorescence spectroscopy and X‐ray crystallography to investigate the interactions of ribavirin and lamivudine with HSA. Fluorescence spectroscopy showed ribavirin and lamivudine inhibit binding affinity each other. Our results further demonstrated that ribavirin and lamivdudine interaction with HSA could be affected by the presence of other compounds, including the non‐steroidal anti‐inflammatory drugs, indometacin. X‐ray structures revealed that ribavirin and lamivudine bind in IIA subdomain of HSA mainly by forming hydrogen bond and hydrophobic interactions forces. The carboxamido of ribavirin forms hydrogen bonds with Arg222; Hydroxyl group (6) of ribavirin forms hydrogen bond with Arg257. Hydroxyl group (15) of lamivudine forms hydrogen bond with Arg222; amino group (4) of lamivudine forms hydrogen bond with carbonyl of Arg257. Our results reveal the key biochemical and structural characteristics of the HSA interaction with ribavirin and lamivudine, providing guidance for future development of ribavirin‐ and lamivudine‐based compounds and a drug‐HSA delivery system.
Planning Across Freshwater and Terrestrial Realms: Cobenefits and Tradeoffs Between Conservation Actions
Authors: Adams Vanessa M. , Álvarez‐Romero Jorge G. , Carwardine Josie , Cattarino Lorenzo , Hermoso Virgilio , Kennard Mark J. , Linke Simon , Pressey Robert L. , Stoeckl Natalie
Published: December 2013

Conservation planning has historically been restricted to planning within single realms (i.e., marine, terrestrial, or freshwater). Recently progress has been made in approaches for cross‐realm planning which may enhance the ability to effectively manage processes that sustain biodiversity and ecosystem functions (e.g., connectivity) and thus minimize threats more efficiently. Current advances, however, have not optimally accounted for the fact that individual conservation management actions often have impacts across realms. We advance the existing cross‐realm planning literature by presenting a conceptual framework for considering both co‐benefits and tradeoffs between multiple realms (specifically freshwater and terrestrial). This conceptual framework is founded on a review of 1) the shared threats and management actions across realms and 2) existing literature on cross‐realm planning to highlight recent research achievements and gaps. We identify current challenges and opportunities associated with the application of our framework and consider the more general prospects for cross‐realm planning.
Socio‐spatial patterning of off‐sale and on‐sale alcohol outlets in aTexas city
Authors: Han Daikwon , Gorman Dennis M.
Published: December 2013

Introduction and Aims

To examine the socio‐spatial patterning of off‐sale and on‐sale alcohol outlets following a policy change that ended prohibition of off‐sale outlets inLubbock,Texas.

Design and Methods

The spatial patterning of alcohol outlets by licensing type was examined using the k‐function difference (Dstatistic) to compare the relative degree of spatial aggregation of the two types of alcohol outlets and by the spatial scan statistic to identify statistically significant geographic clusters of outlets. The sociodemographic characteristics of the areas containing clusters of outlets were compared with the rest of the city. In addition, the socioeconomic characteristics of census block groups with and without existing on‐sale outlets were compared, as were the socioeconomic characteristics of census block groups with and without the newly issued off‐sale licenses.

Results

The existing on‐sale premises inLubbock and the newly established off‐sale premises introduced as a result of the 2009 policy change displayed different spatial patterns, with the latter being more spatially dispersed. A large cluster of on‐sale outlets identified in the north‐east of the city was located in a socially and economically disadvantaged area of the city.

Discussion and Conclusion

The findings support the view that it is important to understand the local context of deprivation within a city when examining the location of alcohol outlets and add to the existing research by drawing attention to the importance of geographic scale in assessing such relationships.[Han D, Gorman DM. Socio-spatial patterning of off-sale and on-sale alcohol outlets in a Texas City.Drug Alcohol Rev2014;33:152–160]
Ash as a phosphorus fertilizer to reed canary grass: effects of nutrient and heavy metal composition on plant and soil
Authors: Lindvall Eva , Gustavsson Anne‐Maj , Samuelsson Robert , Magnusson Tord , Palmborg Cecilia
Published: December 2013

Fertilization effects and risks of heavy metal enrichment were studied in a field experiment, in which plots of reed canary grass (RCG) were treated annually with three different fertilizers: Ash from co‐combustion of RCG and municipal wastes (mixed ash), pure RCG ash, and commercial fertilizer (control). RCG ash is a waste product that is currently expensive to dispose of. The amounts of nutrients applied annually were 100 kg ha−1 N, 15 kg ha−1 P, and 80 kg ha−1 K in all treatments. In the ash treatments, all P derived from ash, whereas N and part of the K were supplemented by fertilizers. The amount of heavy metals exceeded the limits set by the Swedish Environmental Protection Agency for all elements analyzed in the mixed ash and for Ni and Cr in the RCG ash. There were no significant differences between treatments in terms of RCG dry matter yield obtained at harvest in spring, or in heavy metal concentrations in the biomass.

Soil samples from 0–5 cm, 5–10 cm, and 10–20 cm below the surface showed significant differences between treatments for the concentration of Cd, Cr, Cu, Pb, and Zn, with higher concentrations in plots fertilized with mixed ash than in the control. Neither spring yield nor soil available P was reduced by using ash instead of mineral P fertilizer, suggesting that pure RCG ash can be used to complement commercial fertilizer, albeit less frequently than here. However, ash derived from co‐combusting RCG with different waste materials (mixed ash treatment) should not be used in RCG production due to the high heavy metal content.
Prevalence of periradicular periodontitis in a Scottish subpopulation found on CBCT images
Authors: Dutta A. , Smith‐Jack F. , Saunders W. P.
Published: December 2013

Aim

To investigate the prevalence of periradicular periodontitis (PRP) using cone‐beam computed tomography (CBCT) scans in a retrospective cross‐sectional epidemiological study in a Scottish subpopulation.

Methodology

Of the 319 CBCT scans performed at Dundee Dental Hospital between November 2009 and July 2012, 245 dentate scans of patients over 18 years of age were included and 3595 teeth examined. Odds ratios were calculated, and the association between root filling and posts with PRP was determined.

Results

Radiological signs of PRP were detected in 209 teeth (5.8%) in 96 patients (male = 53, female = 43) of which 145 (69.4%) were measurable and 64 (30.6%) appeared as periapical widening. Most lesions were seen in the 46–55‐year age group and in maxillary anterior teeth (35.4%); 47.4% (n = 81) of the total root filled teeth (n = 171) had PRP. Of the root filled teeth with lesions, approximately half (50.6%) had an inadequate root filling. Teeth with crowns, but not root filled, accounted for 17.7% of PRP. Periapical changes were detected on a high proportion of teeth with post‐retained crowns (70.7%). The presence of a root filling was significantly associated with PRP (z = 17.689 P < 0.0001; odds ratio 16.36 < 23.17 < 32.83, 95% CI) and the presence of a post (z = 10.901 P < 0.0001; odds ratio 21.36 < 41.8021 < 81.78, 95% CI).

Conclusions

The prevalence of PRP in a Scottish subpopulation was 5.8%. The presence of a root filling or a post‐retained crown was significantly associated with the presence of PRP as determined by CBCT scans. The prevalence of periradicular disease in root filled teeth remains high in the Scottish population.
Relationship between local neuroimmune impairment and diabetic foot: the immunocompromised district theory
Authors: Baroni Adone , Russo Teresa , Piccolo Vincenzo
Published: December 2013

Background

Diabetic foot (DF) can be defined as an infection and/or an ulceration with or without destruction of deep tissues associated with neurological abnormalities and varying degrees of peripheral vascular disease of the lower limb in patients with diabetes. Both neuropathy and vascular disease, along with the well‐known impairment of immune function in patients with diabetes, contribute to polymicrobial foot infections, which further aggravate the already severe clinical manifestations of diabetes.

Discussion

The immunocompromised district (ICD) is a novel pathogenic concept referring to a site in which there is an obstacle to the normal trafficking of immunocompetent cells through lymphatic channels, and/or interference with the signals that neuropeptides and neurotransmitters, released by peripheral nerves, send to cell membrane receptors of immunocompetent cells. These loci minoris resistentiae have the propensity to develop a secondary disease, which may occur after an extremely variable length of time.

Conclusions

In this work, we provide an overview of etiopathogenetic mechanisms of DF and propose a unifying view of this topic based on the concept of the ICD.
Health status, late effects and long‐term survivorship of allogeneic bone marrow transplantation: a retrospective study
Authors: Gifford G. , Sim J. , Horne A. , Ma D.
Published: December 2013

Background

Survival after allogeneic haemopoietic stem cell transplantation (allo‐HSCT) has improved because of advancements in allo‐HSCT. Allo‐HSCT has been performed in Australia since the late 1970s. However, there are few published data about health problems of allo‐HSCT survivors in Australia.

Aims

Identify health issues in long‐term survivors of allo‐HSCT in an Australian centre to manage better and prevent long‐term complications.

Methods

The health records of all patients of allo‐HSCT in a single centre from January 2000 to December 2007 and survived beyond 2 years were assessed.

Results

Ninety‐nine of the 200 allo‐HSCT patients survived beyond 2 years, and the median time from allo‐HSCT was 74 months. Twenty‐eight per cent died at a median of 37 months after allo‐HSCT because of relapsed malignancy (12%), stroke (1%), infection (3%), chronic graft versus host disease (9%), secondary malignancy (2%) and unknown cause (1%). Ninety‐one per cent reported one or more chronic health conditions. Health issues were chronic graft versus host disease (70%); respiratory (66%), ophthalmic (40%), bone (33%), and renal (26%) problems; and malignancies (14% skin, 3% solid organ). Seventy‐nine per cent resumed vocation at full or reduced capacity 2 years after allo‐HSCT. Clinicians identified 40% with quality of life (QOL) issues, but survivors’ self‐reported QOL was comparable with the general Australian population.

Conclusion

This study shows that allo‐HSCT patients are living with high burdens of chronic diseases that warrant lifelong surveillance and engagement with healthcare. Structured, multi‐disciplinary care as recommended by published guidelines for allo‐HSCT survivors may reduce long‐term effects and improve their outcomes.
Biology and pathogenesis of cytomegalovirus in periodontal disease
Authors: Contreras Adolfo , Botero Javier Enrique , Slots Jørgen
Published: December 2013

Human periodontitis is associated with a wide range of bacteria and viruses and with complex innate and adaptive immune responses. Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Treponema denticola, cytomegalovirus and other herpesviruses are major suspected pathogens of periodontitis, and a combined herpesvirus–bacterial periodontal infection can potentially explain major clinical features of the disease. Cytomegalovirus infects periodontal macrophages and T‐cells and elicits a release of interleukin‐1β and tumor necrosis factor‐α. These proinflammatory cytokines play an important role in the host defense against the virus, but they also have the potential to induce alveolar bone resorption and loss of periodontal ligament. Gingival fibroblasts infected with cytomegalovirus also exhibit diminished collagen production and release of an increased level of matrix metalloproteinases. This article reviews innate and adaptive immunity to cytomegalovirus and suggests that immune responses towards cytomegalovirus can play roles in controlling, as well as in exacerbating, destructive periodontal disease.
Composition and development of oral bacterial communities
Authors: Palmer Jr Robert J.
Published: December 2013

The oral bacterial microbiome encompasses approximately 700 commonly occurring phylotypes, approximately half of which can be present at any time in any individual. These bacteria are largely indigenous to the oral cavity; this limited habitat range suggests that interactions between the various phylotypes, and between the phylotypes and their environment, are crucial for their existence. Molecular cataloging has confirmed many basic observations on the composition of the oral microbiome that were formulated well before ribosomal RNA‐based systematics, but the power and the scope of molecular taxonomy have resulted in the discovery of new phylotypes and, more importantly, have made possible a level of bacterial community analysis that was unachievable with classical methods. Bacterial community structure varies with location within the mouth, and changes in community structure are related to disease initiation and disease progression. Factors that influence the formation and the evolution of communities include selective adherence to epithelial or tooth surfaces, specific cell‐to‐cell binding as a driver of early community composition, and interorganismal interaction leading to alteration of the local environment, which represents the first step on the road to oral disease. A comprehensive understanding of how these factors interact to drive changes in the composition of the oral microbial community can lead to new strategies for the inhibition of periodontal diseases and dental caries.
Pulsed Electrical Stimulation and Surface Charge Induced Cell Growth on Multistage Spark Plasma Sintered Hydroxyapatite‐Barium Titanate Piezobiocomposite
Authors: Dubey Ashutosh K. , Basu Bikramjit
Published: December 2013

The primary purpose of the present work was to illustrate whether cell proliferation can be enhanced on electroactive bioceramic composite, when the cells are cultured in the presence of external electrical stimulation. The two different aspects of the influence of electric field (E‐field) application toward stimulating the growth/proliferation of bone/connective tissue cells in vitro, (a) intermittent delivery of extremely low strength pulsed electrical stimulation (0.5–4 V/cm, 400 μs DC pulse) and (b) surface charge generated by electrical poling (10 kV/cm) of hydroxyapatite (HA)‐BaTiO3 piezobiocomposite have been demonstrated. The experimental results establish that the cell growth can be enhanced using the new culture protocol of the intermittent delivery of electrical pulses within a narrow range of stimulation parameters. The optimal E‐field strength for enhanced cellular response for mouse fibroblast L929 and osteogenic cells is in the range of 0.5–1 V/cm. The MTT [3‐(4, 5‐dimethylthiazol‐2‐yl)‐2, 5‐diphenyl tetrazolium bromide] assay results suggested the increased viability of E‐field treated cells over 7 d in culture, implicating the positive impact of electrical pulses on proliferation behavior. The alizarin red assay results showed noticeable increase in Ca‐deposition on the E‐field treated samples in comparison to their untreated counterparts. The negatively charged surfaces of developed piezocomposite stimulated the cell growth in a statistically noticeable manner as compared with the uncharged or positively charged surfaces of similar composition.
Self‐regulatory deficits associated with unpracticed mindfulness strategies for coping with acute pain
Authors: Evans Daniel R. , Eisenlohr‐Moul Tory A. , Button Daniel F. , Baer Ruth A. , Segerstrom Suzanne C.
Published: December 2013

Training in mindfulness is a well‐supported therapeutic strategy for pain conditions, though short‐term mindfulness training for acute pain is not always effective. To explore the possibility that initial attempts at mindfulness in people without previous training may drain self‐regulatory resources, the current study used a student sample (N = 63) to test the hypothesis that brief instruction in mindfulness would lead to reduced pain tolerance on a cold pressor task, compared to more familiar strategies for coping with acute pain. We also investigated whether high heart rate variability (HRV), a physiological indicator of self‐regulatory capacity, would predict pain tolerance. Higher HRV predicted greater pain tolerance only in the control group, suggesting that applying unfamiliar mindfulness strategies while attempting to tolerate pain more rapidly sapped self‐regulatory strength.
True ectopic ovary in the right iliac fossa mimicking acute appendicitis and associated with ipsilateral renal agenesis
Authors: Kollia Paraskevi , Kounoudes Christos , Veloudis George , Giannakou Nikoletta , Gourgiotis Stavros
Published: December 2013

Ectopic ovarian tissue is a rare gynecologic condition. The presence of ectopic ovary may be accompanied by maldevelopments of the genital and urinary tract. We report an extremely rare case of a 39‐year‐old woman presenting with abdominal pain localized in the right lower quadrant. During the preoperative investigation and the exploratory laparotomy, an ectopic ovary in contact with the appendix accompanied by a single left kidney was found. The present report also includes a review of the related published work. To the best of our knowledge, this is one of the very few cases reported describing the co‐occurrence of true ovarian ectopia and ipsilateral renal agenesis.
Surf, sand, scrapes and stings: First aid incidents involving children at New Zealand beaches, 2007–2012
Authors: Moran Kevin , Webber Jonathon
Published: December 2013

Aims

In spite of the popularity of beaches for family recreation, little is known about childhood injuries sustained at beaches. It is the purpose of this study to analyse data from incidents necessitating first aid treatment from reports compiled by surf lifeguards on New Zealand beaches.

Method

A retrospective analysis of first aid incidents involving children (<16 years) was conducted using data obtained from Surf Life Saving New Zealand incident report forms during five summer seasons from 2007 to 2012. In addition to demographic data, the incident reports included such detail as the type of injury, the activity and location prior to injury, the injury outcome, and the first aid equipment used.

Results

Children (n = 4407) accounted for one‐half (52%) of all injuries; of these, 55% were male, and incidence peaked in the 11‐ to 15‐year age group (24%). Most incidents (90%) required minor treatment, with lacerations (44%) the most common injury. Marine stings accounted for one‐quarter (24%) of injuries and were most frequent among younger children (<10 years). Injuries to the extremities were frequently noted in the incident reports, the feet (33%) and hands (8%) being common sites.

Conclusions

Although most (90%) injury incidents were minor in nature, their frequency (880 cases per season) suggests that greater emphasis on prevention rather than cure would be efficacious. Ways of promoting child beach safety via greater care giver awareness, the use of protective clothing and footwear, and child safety promotion via health professionals and safety organisations are discussed.
Preventing Mobility Barriers to Inclusion for People With Intellectual Disabilities
Authors: Sherman Jean , Sherman Sarah
Published: December 2013

Many disability advocates and professionals believe they will recognize community inclusion when they see it, yet “inclusion” is a nuanced subjective construct that may hold a somewhat different meaning for each person. A comparison of the disability movement and accessibility laws and policies reveals community inclusion to be an ideal repeatedly sought by individuals with disabilities and advocates alike. This article recounts national and international efforts toward inclusion and suggests some reasons why these have fallen short. Research has revealed that limited financial resources, inadequate social supports and transportation, and unwelcoming or negative reciprocal attitudes are important community barriers to inclusion. These barriers are significant to all individuals with disabilities but especially to persons with intellectual disabilities (ID). Regarding ID in the context of person–environment interactions, the authors suggest that other significant barriers to community inclusion may be found in the built environment and result from negative attitudes of the professionals responsible for its creation. Because the built environment plays a substantial role in community inclusion for individuals with ID, it is important to ensure the congruency of designers' attitudes with the philosophies that underlie accessible design and inclusion. The authors suggest that the negative attitudes of the creators of the built environment may be amenable to change through education. The authors highlight the need for an integrated and preventive interdisciplinary educational approach, particularly targeting design professionals, as one meaningful step toward creating truly inclusive and disability‐friendly communities.
Emotional and Tangible Reciprocity in Middle‐ and Older‐Aged Carers of Adults With Intellectual Disabilities
Authors: Perkins Elizabeth A. , Haley William E.
Published: December 2013

Reciprocal benefits may exist in relationships between carers and their adult sons/daughters with intellectual disabilities, but the topic has not been widely studied. The present study investigated whether older carers of adult children with intellectual disabilities perceive emotional and tangible reciprocity in their relationships and the association between perceived reciprocity with quality of life. The authors surveyed 91 parental carers (aged 50+ years, mean = 60.8). Bivariate correlations and hierarchical regression analyses assessed the relationship between tangible and emotional reciprocity and carer quality of life variables (physical and mental health, depressive symptomatology, life satisfaction) and carers' desire for an alternative residential situation of their son/daughter. Overall, more tangible and emotional support was given than received from their adult children. However, despite varying levels of intellectual disability and functional impairments of their care recipient, carers did report receiving considerable support. Relative disadvantage (i.e., giving more than received) in tangible reciprocity was associated with increased depressive symptomatology and poorer mental health but also reduced desire for seeking an alternative residential situation for the person for whom they are caring. These relationships were attenuated after covariance analyses. Emotional reciprocity was not associated with any of the outcome measures. The results suggest that perceptions of reciprocity are relevant in caregiving for intellectual disability and may be an underappreciated asset in coping with caregiving.