bluuebunny/crossref_metadata_2025 huggingface dataset:
The social negotiation of fitness for work: Tensions in doctor–patient relationships over medical certification of chronic pain
Authors: Wainwright Elaine , Wainwright David , Keogh Edmund , Eccleston Christopher
Published: May 2014

The UK government is promoting the health benefits of work, in order to change doctors’ and patients’ behaviour and reduce sickness absence. The rationale is that many people ‘off sick’ would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the ‘sick note’ with the ‘fit note’ and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor–patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note’s focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing.
From ‘Madonna’ to ‘Whore’: Sexuality, pregnancy, and popular culture
Authors: Musial Jennifer
Published: May 2014

Pregnant bodies are often perceived to be sites of reproductive beauty in American popular culture; however, the intersection of pregnancy and sexuality elicits reactions ranging from cultural disgust to fetishization. Using Foucauldian discourse theory, I look at how cultural ambivalence about pregnant women who have sex manifests in varied popular culture texts. Ambivalence, I argue, appears through the medicalization of pregnant sexuality (asexualizing), compulsory heterosexuality and pregnancy pornography (hypersexualizing). I also include feminist responses that disrupt the asexual/hypersexual binary.
Queer youth suicide and the psychopolitics of “It Gets Better”
Authors: Grzanka Patrick R , Mann Emily S
Published: May 2014

This article investigates a mass-mediated campaign against a perceived increase in suicides among gay (or presumed-to-be-gay) youth in the USA since September 2010. “It Gets Better” (IGB) became a rallying cry for “anti-bullying” activists, politicians, celebrities and ordinary people who created YouTube videos addressed to gay, lesbian, bisexual and transgender (LGBT) youth who might be considering suicide. A critical discourse analysis of a sample of IGB videos reveals a neoliberal frame that places the burden of a “better” life onto the emotional lives of LGBT youth, who are instructed to endure suffering in the interest of inevitable happiness. Drawing on Foucault and Orr's work on the construction and management of mental illness, we use the concept of “psychopower” to explore how these IGB videos render queer youth suicide both a psychological disorder and a sociological crisis for which the only viable solution is “homonormative” subjectivity.
Imagining community: Visibility, bonding, and L Word audiences
Authors: Kern Rebecca
Published: May 2014

This essay examines the ways in which L Word audiences engaged with each other, and used the text as a way to build community and find acceptance in hetero-normative privileged society. This is particularly apparent among marginalized sexual minorities: bisexual, transgender, older lesbians, and lesbians of color. Viewers found connection through representations, shared narratives, and discourse. The resulting imagined communities provided cultural visibility and worked to make all sexual and gender identifications accepted, visible, and safe.
Queer time in global city Singapore: Neoliberal futures and the ‘freedom to love’
Authors: Oswin Natalie
Published: May 2014

In the Southeast Asian city-state of Singapore, efforts to shake off an authoritarian image and foster a creative economy have led to significant changes in sexual citizenship since the early 2000s. Most remarked upon has been the government’s new liberalized approach to public expressions of homosexuality while it simultaneously upholds legislation and policies that discriminate against gays and lesbians. Critical scholarly and activist responses to this state of affairs abound, with many pressing for the ‘freedom to love’ for sexual minorities. In this article, I extend this emergent queer critique by arguing for the need to move laterally away from a single-issue, sexual identity-based project in order to launch other lines of critique and highlight additional avenues for political struggle. I situate this ostensible contest between heterosexuality and homosexuality as just one facet of a much larger story about the ways in which heteronormativity works through teleological narratives of progress and social reproduction in Singapore. Specifically, I highlight the family’s function as a regulative governing fiction in the city-state, setting out the ways in which the ‘proper family’ has been carefully cultivated throughout Singapore’s colonial and postcolonial history to produce both a stable population of ‘quality’ citizens as well as multiple ‘queered’ others who fall outside the very particular heterosexual family norm upon which Singapore’s developmental aims have come to rest.
The (not so) straight story: Queering migration narratives of sexual orientation and gendered identity refugee claimants
Authors: Murray David AB
Published: May 2014

Canadian media coverage of sexual orientation and gendered identity (SOGI) refugees presents a relatively uniform story of these queer newcomers. While LGBT media have identified problems in some Canadian Immigration and Refugee Board (IRB) decisions, the hegemonic narrative remains one of ‘migration to liberation nation’. In this article I argue that this hegemonic narrative is produced in relation to particular socio-cultural and juridical-legal categories which are themselves historically produced in and through the bureaucratic machinery of the state, human rights organizations, and some legal scholarship. The effect of this model narrative is to reinscribe what Ahmed (2010) calls the ‘happy migrant’, that is, someone who espouses national ideals which are couched in terms of empire, the new twist being that sexual diversity is now held aloft as justification of empire’s liberation from abjection. Based on interviews with SOGI refugee claimants in Toronto.
A burden of knowledge
Authors: Green Janet , Darbyshire Philip , Adams Anne , Jackson Debra
Published: May 2014

Improved life-sustaining technology in the neonatal intensive care has resulted in an increased probability of survival for extremely premature babies. In the neonatal intensive care, the condition of a baby can deteriorate rapidly. Nurses and parents are together for long periods at the bedside and so form close and trusting relationships. Neonatal nurses as the constant caregivers may be presented with contradictory demands in attempting to meet the baby’s needs and being a patient and family advocate. This article aims to explore the issues arising for neonatal nurses when holding information about changes to a condition of a baby that they are unable to share with parents. Data were collected via interviews with 24 neonatal nurses in New South Wales, Australia. A qualitative approach was used to analyse the data. The theme ‘keeping secrets’ was identified and comprised of three sub-themes ‘coping with potentially catastrophic news’, ‘fear of inadvertent disclosure’ and ‘a burden that could damage trust’. Keeping secrets and withholding information creates internal conflict in the nurses as they balance the principle of confidentiality with the parent’s right to know information. The neonatal nurses experienced guilt and shame when they were felt forced by circumstances to keep secrets or withhold information from the parents of extremely premature babies.
Adaptation to low levels of chemical exposure in individuals with multiple chemical sensitivity in a controlled indoor environment
Authors: Fox R. A. , Sampalli T.
Published: May 2014

Environmental sensitivity or multiple chemical sensitivity (MCS) is a debilitating condition and increasingly prevalent in the recent years. MCS is a multisystem disorder with lack of standardized treatment strategies and clinical practice guidelines. Consequently, there are significant costs associated with disability and treating individuals with an increasing percentage of the population experiencing challenges in indoor environments from exposure to everyday chemicals such as personal care products. MCS remains a poorly understood condition with many challenges in establishing evidence to support the reactivity to the indoor environment experienced in individuals. This research attempts to validate the physiological reactivity and adaptation to everyday chemicals in a controlled environment in a sample of individuals ( n = 90) with MCS. Sixty percent of the female and 40% of the male subjects demonstrated confirmed physiological reactivity to the test substance. The results from this study indicate that the multifaceted nature of this condition possibly goes beyond the reactivity to chemicals in the environment. Further research is essential to understand the implications of hypersensitivity to help individuals optimally manage their health.
From organizational crisis to multi-platform salvation? Creative destruction and the recomposition of news media
Authors: Schlesinger Philip , Doyle Gillian
Published: May 2014

Schumpeter’s trope of ‘creative destruction’ aptly describes current transformations of news media whose business models are adjusting to the twin challenges of digitization and the Internet. While most production studies focus on the journalistic labour process, based on current empirical research in the UK press and access to key decision-makers, this article presents case studies of the strategies pursued by the Financial Times and The Telegraph in migrating from print to digital. It shows how new conceptions of the news business are being articulated by managements and how production is being reshaped and increasingly driven by data analytics, and poses questions about the impact of these changes on journalistic practices.
An evaluation of cetane sensitivity in low-temperature combustion and options to compensate for market cetane variation
Authors: Kurtz Eric M , Kuhel Douglas G
Published: May 2014

A single-cylinder engine was used to assess the sensitivity of emissions, noise and fuel consumption to variation in cetane number when operated in low temperature combustion both with and without the application of compensation strategies. Without compensation, changes in cetane caused greater variability in all of the parameters studied when operated in low temperature combustion as compared to conventional diesel combustion. Correcting combustion phasing was explored by adjusting three different parameters: start of injection timing, burnt gas fraction and intake manifold temperature. None of these methods were able to achieve substantially equivalent combustion and emissions across all fuels evaluated. Large variations in hydrocarbon and particulate emissions were observed when start of injection was adjusted to correct combustion phasing. Adjusting the burnt gas fraction caused large differences in nitrogen oxides and noise, particularly with low cetane fuels. Finally, intake manifold temperatures low enough to reach the target combustion phasing with the higher cetane fuel were unachievable, suggesting that this method would not be viable as a production solution. It was concluded that the most effective way to ensure robust combustion and emissions in low temperature combustion is to reduce ignition delay variability by refining the fuel specification, either through tighter control over the cetane number range or by shifting the fuel specification toward higher cetane number, where ignition delay is less sensitive to changes in cetane rating.
Barium sulfate/regenerated cellulose composite fiber with X-ray radiation resistance
Authors: Qu Lijun , Tian Mingwei , Zhang Xiansheng , Guo Xiaoqing , Zhu Shifeng , Han Guangting , Li Changlei
Published: May 2014

In this article, submicron barium sulfate particles, as the radiation-resistant component, were incorporated into regenerated cellulose spinning solution. Then a series of X-ray radiation-resistant fibers were fabricated via a primarily industrialized wet-spinning trail, and the resultant fibers were knitted into fabrics by knitting loom. The morphology and structure of the fibers were studied with the aid of scanning electron micrography, Fourier-transform infrared spectroscopy, and X-ray diffraction. The composite fibers exhibited reasonably good properties, which met the criteria of mechanical requirements of commercial textiles—dry breaking strength and elongation (>1.5 cN/dtex and 26%) and wet breaking strength and elongation (>1.4 cN/dtex and 22%) and permanent laundry-resistant abilities even after being washed 20 times. An effective and feasible X-ray radiation-resistant method, the medical digital X-ray photography system, was proposed to evaluate the radiation resistance of the composite fiber and its fabric. The X-ray attenuation ratio of the sample tended to increase with increasing barium sulfate content and finally reached a dose of a 0.1 mmPb lead equivalent. Therefore, these fibers and fabrics can be utilized as the base materials for X-ray radiation-resistant lightweight apparel and detective surgical yarn.
Optimization of the parameters involved in fabrication of solid state polymerized polyamide (SSP PA66) nanofibers via an enhanced electro-centrifuge spinning
Authors: Valipouri Afsaneh , Ravandi Seyed Abdolkarim Hosseini , Pishevar Ahmadreza
Published: May 2014

The Taguchi method was adopted to optimize the fabrication condition of solid state polymerized polyamide (SSP PA66) nanofibers with respect to minimizing nanofiber diameter. A novel fabrication system called air-sealed centrifuge electrospinning was used for preparing high-quality nanofibers. In this study, solution concentration, rotational speed, syringe content, and applied voltage were selected as key parameters affecting the diameter of the fabricated nanofibers. The morphology of the electrospun nanofibers was analyzed by using the field-emission scanning electron microscope. Nanofiber diameters ranging from 20 to 250 nm were successfully controlled by the Taguchi method, and the statistical data based on experimental results indicated that the syringe content and rotational speed had greater influences (35.76% and 23.93%, respectively) on nanofiber diameter than did solution concentration and voltage (21.36% and 11.49%, respectively). Lower syringe content as well as higher rotational speed decreased the nanofiber diameter. The minimum concentration and applied voltage decreased the diameter of SSP PA66 nanofibers. Additionally, altering rotational speed and syringe content had no influence on crystalline behavior of nanofibers.
The restructuring of schooling in England
Authors: Coldron John , Crawford Megan , Jones Steve , Simkins Tim
Published: May 2014

Research to date about the English government’s policy to make schools independent of local authorities (LAs) has looked at the ‘macro’ level of national policy and at the ‘micro’ level of the institution. The study of which this article is a part, explores changes at the ‘meso’ level – the locality. The article analyses interviews in three LAs with 15 headteachers whose schools were well positioned locally. We sought to understand how and why they responded to the changing policy environment. We applied Bourdieu’s concepts of forms of capital to model the relationships between schools and to ground explanations of their responses as positioning themselves in the local field. The article develops this general approach by identifying the varieties of capital available and actually possessed. The most important was categorization as a result of the inspection process. Many of the headteachers felt impelled to lead their schools into various associations with other schools. Some individuals were becoming notably more powerful in their competition arenas. The power of these elite schools to further accumulate advantage and the withdrawal of the LA role as an arbiter of conflict between schools in the interests of the whole community are discussed.
Local responses to national policy
Authors: Smith Penny , Abbott Ian
Published: May 2014

Drawing on data from a series of semi-structured interviews this article reports on findings from a research project focusing on the responses of two local authorities and their secondary schools to the Academies Act 2010. The article considers the background and the development of the education system in both localities. It goes on to focus on issues relating to collaboration, competition, independence and the re-structuring of school governance. For the purposes of the analysis, our theoretical underpinnings drew upon path dependence and Michel Foucault’s theories of discourse and power. This framework helped us to illuminate how local conditions had a significant impact on responses to the national policy agenda.
‘Who owns our schools?’ An analysis of the governance of free schools in England
Authors: Higham Rob
Published: May 2014

The legal basis of free schools, provided for in the Academies Act 2010, allows the Secretary of State for Education ‘to enter into Academy arrangements with any person’. A range of debate has ensued over who will govern free schools. This article develops an analysis of the individuals and organizations that have had free school proposals accepted by government. The article progresses, first, by locating free schools in the existing policy trajectories towards privatization and self-governing schools. Second, it draws on a mapping exercise and interviews with a sample of 58 free school proposers, sponsors and suppliers to explore the processes through which free schools are established. The main categories of free school proposers are identified as: local civil society groups; sponsoring organizations; existing educational institutions. Third, the article considers the wider implications for school governance. It is argued free school policy allows governance to become an additional and direct lever through which those with the capacity to do so are able to mould state education in their own interests.
On the practice architectures of instructional leadership
Authors: Salo Petri , Nylund Jan , Stjernstrøm Else
Published: May 2014

This paper explores the concept of instructional leadership and principals’ perceptions of the practices of instructional leadership. Despite the emphasis on the effects of school leadership regarding teaching practices and learning outcomes, research on direct instructional leadership is scarce. It is focused either on identifying overall leadership practices or on measuring the effect of various intangible school level variables, such as school climate, on student learning. The concepts related to instructional leadership are ambiguous and vague, and challenged by contemporary understandings of school leadership (transformative and distributed leadership). The data consists of narratives written by principals from Norway, Sweden and Finland on successful and unsuccessful efforts of guiding teachers’ work in the classroom. These narratives are used for enabling principals to communicate their experiences of the complexity of interacting with teachers in instructional matters. A theoretical framework of practice architectures is used to elucidate the material, discursive and relational aspects of instructional leadership. A three-step analysis of the data suggests that successful instructional leadership is characterized by solidity, co-production and direction. Interestingly, principals’ narratives on instructional leadership lack an explicit vocabulary of didactics, examples of face-to-face guidance of teaching as well as direct professional relationships for strengthening teaching practices.
Health literacy
Authors: Benyon Kay
Published: May 2014

Health literacy is the ability to absorb and use information relating to health. Low levels of health literacy are associated with higher levels of hospital admissions, emergency department attendances and reduced up-take of screening and vaccinations. Additionally, low health literacy is linked to poorer general health and increased mortality. All doctors, but especially GPs, need a clear and sensitive approach to assess and adapt for low health literacy in the consultation. As GPs play a vital role in health promotion, a good understanding of health literacy is essential. This article aims to improve knowledge, awareness and understanding of health literacy and suggests ideas for everyday practice.
Physical space and its impact on waste management in the neonatal care setting
Authors: Nichols Andrew , Manzi Sean
Published: May 2014

This paper reports an investigation intended to obtain some understanding of how the working environment might influence the practice and knowledge of those involved in the management of healthcare waste. The National Health Service (NHS) has a continuing waste problem, and the way it manages waste harms the environment and consumes resources. It has been estimated that the carbon footprint of the NHS in England is approximately 20 million tons of CO2e. It has been suggested that better waste segregation could lead to more effective recycling, saving up to 42,000 tonnes of CO2. This qualitative study employed non-participant observation and semi-structured interviews. The interviews were carried out with the key informants within the participating neonatal intensive care unit. Findings from this study indicate that space and the physical arrangement of the environment are significant and influential factors in clinical practice. Where the clinical environment is not supportive, poor infection control and waste management practice is likely to occur. However, proximity of staff caused by a lack of physical space might facilitate situated learning and a collective development of knowledge in practice. The implementation of sustainable waste management practices would be more likely to succeed in an environment that facilitates correct waste segregation.
Point prevalence survey of urinary catheterisation in care homes and where they were inserted, 2012
Authors: McNulty CAM , Verlander NQ , Turner K , Fry C
Published: May 2014

The extent to which the use of catheter care bundles and other interventions has led to a reduction in urinary catheterisation rates is unknown. We aimed to determine current urinary catheterisation rates in care homes with residents over 65 years old, and determine the extent to which residents are discharged from the hospital setting with urinary catheters. A point prevalence questionnaire survey was used in care homes that looked after residents over 65 years in six UK health boards or primary care trusts, to determine urinary catheterisation rates, and where these catheters were inserted. Questionnaires for 445 of 461 care homes (96.5%) were completed, 425 of 445 care homes cared for residents over 65 years; 888 (6.9%) of 12,827 residents had a urethral (82.5%) or supra-pubic (17.5%) urinary catheter. Over half of all catheters (both urethral and suprapubic, 57.4%, 509 of 888 catheters), and 3.1% of all residents had a catheter inserted while the residents were hospital inpatients, and then discharged back to the care home still catheterised. There was a significant variation in urinary catheterisation rates in the care homes surveyed, and rates remain similar to previous English surveys in 2003 and 2009. More still needs to be done to understand the variation in urinary catheterisation rates in care homes and reduce these rates, including the numbers of residents that are discharged from hospital with a urinary catheter.
Tumor regression of multiple bone metastases from breast cancer after administration of strontium-89 chloride (Metastron)
Authors: Heianna Joichi , Miyauchi Takaharu , Endo Wataru , Miura Naoki , Terui Kazuyuki , Kamata Syuichi , Hashimoto Manabu
Published: May 2014

We report a case of tumor regression of multiple bone metastases from breast carcinoma after administration of strontium-89 chloride. This case suggests that strontium-89 chloride can not only relieve bone metastases pain not responsive to analgesics, but may also have a tumoricidal effect on bone metastases.
Vertebral metastases from intracranial meningioma
Authors: Zaghouani H , Yahyaoui S , Chabchoub I , Mallat N , Majdoub S , Amara H , Bakir D , Badreddine S , Kraiem C
Published: May 2014

Meningioma rarely gives rise to metastases outside the brain and meninges. We report here a case of a patient who was treated for anaplastic brain meningioma with surgery and fractionated radiation therapy without any recurrence until 5 years after the operation, when she developed vertebral metastases.
Gerrymandering or geography? How Democrats won the popular vote but lost the Congress in 2012
Authors: Goedert Nicholas
Published: May 2014

This article assesses whether the antimajoritarian outcome in the 2012 US congressional elections was due more to deliberate partisan gerrymandering or asymmetric geographic distribution of partisans. The article first estimates an expected seats–votes slope by fitting past election results to a probit curve, and then measures how well parties performed in 2012 compared to this expectation in each state under various redistricting institutions. I find that while both parties exceeded expectations when controlling the redistricting process, a persistent pro-Republican bias is also present even when maps are drawn by courts or bipartisan agreement. This persistent bias is a greater factor in the nationwide disparity between seats and votes than intentional gerrymandering.
Relationship Between Tightness of the Hip Joint and Elbow Pain in Adolescent Baseball Players
Authors: Saito Manabu , Kenmoku Tomonori , Kameyama Kentaro , Murata Ryo , Yusa Takashi , Ochiai Nobuyasu , Kijima Takehiro , Takahira Naonobu , Fukushima Kensuke , Ishige Noriyuki , Takaso Masashi
Published: May 2014

Background:

Repetitive tensile stresses from valgus torque can induce elbow injury in adolescent baseball players. Insufficient hip range of motion (ROM) can change throwing mechanics, reducing the transfer of energy from the lower to the upper extremities. Thus, hip ROM limitations may force the upper extremities to bear the burden of a strong throw. Improper pitching mechanics caused by insufficient hip ROM are thought to increase valgus torque on the elbow when throwing, increasing the risk of elbow injury.

Purpose:

To investigate the relationship between elbow pain and hip ROM in adolescent baseball players.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 122 adolescent baseball players with a mean age of 12.0 years (range, 6-14 years) participated in this study. Elbow pain, hip flexion angle, and the internal rotation angles of the hip at 0° and 90° of flexion were assessed. Participants were divided into a pain group and a normal group based on the pain assessment, and each hip angle was compared between groups using Student t tests. P values <.05 were considered statistically significant.

Results:

Thirty-one of 122 players had elbow pain. The hip flexion angle of the trail leg was 121.9° ± 12.3° for the normal group and 111.2° ± 11.3° for the pain group ( P = .0001). The plant leg hip flexion angles were 122.0° ± 12.4° and 113.6° ± 11.3° ( P = .0014) for the normal and pain groups, respectively. The internal rotation angle at 0° of hip flexion of the trail leg was 49.4° ± 12.6° and 45.6° ± 8.8° (not significant), and of the plant leg was 49.1° ± 12.5° and 48.7° ± 11.5° (not significant), for the normal and pain groups, respectively. The internal rotation of the trail leg at 90° of hip flexion was 46.9° ± 13.3° in the normal group and 36.1° ± 15.7° in the pain group ( P = .0005). In the plant leg, the internal rotation angle at 90° of hip flexion was 46.9° ± 12.2° and 36.4° ± 18.1° for the normal and pain groups, respectively ( P = .0013).

Conclusion:

Limitations to hip flexion and internal rotation at 90° of hip flexion were risk factors for elbow injury. Differences in internal rotation angles between 0° and 90° of hip flexion may be important criteria for identifying adolescent baseball players at risk of elbow pain.
Single-Leg Balance Impairments Persist in Fully Operational Military Special Forces Operators With a Previous History of Low Back Pain
Authors: Sell Timothy C. , Clark Nicholas C. , Wood Dallas , Abt John P. , Lovalekar Mita , Lephart Scott M.
Published: May 2014

Background:

Single-leg balance (SLB) can be chronically impaired after low back pain (LBP). Impaired SLB is a risk factor for recurrent LBP and lower extremity injury. In the United States military, the special forces operator (SFO) deploys on high-risk missions under extreme conditions, and impaired SLB can potentially threaten SFO safety and mission success.

Purpose:

To compare SLB in fully operational SFOs with and without a history of LBP. The hypothesis was that SLB deficits would be present in SFOs with a history of LBP.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 226 SFOs were included in this analysis. Comparisons were made between SFOs with and without medical chart documented history of LBP (LBP group [n = 43]: mean age = 31.2 ± 10.3 years, mean height = 177.3 ± 7.2 cm, mean mass = 87.3 ± 11.8 kg; healthy group [n = 183]: mean age = 28.0 ± 6.0 years, mean height = 177.9 ± 6.0 cm, mean mass = 84.9 ± 8.8 kg). Bilateral SLB was tested (eyes open and eyes closed) in both groups using a force plate. The variability in the ground-reaction forces was averaged across 3 trials for each leg for both conditions. Comparisons were made between legs in the LBP and between the LBP and healthy group (α = .05).

Results:

There were significant between-group differences for each leg for both conditions, with the healthy group demonstrating better SLB compared with the LBP group. P values ranged from .01 to .03.

Conclusion:

Impaired SLB persists in SFOs with previously reported LBP. Balance assessments of individuals who report LBP may assist with designing targeted interventions to address potential deficits that may increase the risk of future injury.

Clinical Relevance:

SFOs with a known history of LBP would benefit from examination of SLB and may benefit from balance training to resolve any deficits that may be present to lower the potential risk for future injury.
Field testing the alternative criteria for tension-type headache proposed in the third beta edition of the international classification of headache disorders: results from the Korean headache-sleep study
Authors: Chu Min Kyung , Cho Soo-Jin , Kim Jae-Moon , Hwang Sung-Hee
Published: May 2014

Background

According to the third beta edition of the International Classification of Headache Disorder (ICHD-3 beta), the diagnostic criteria for tension-type headache (TTH) might lead to the inclusion of individuals with headaches showing migrainous features. To better define TTH, the alternative diagnostic criteria were proposed in the appendix of ICHD-3 beta. This study attempted to test the alternative criteria for diagnosis of TTH proposed in ICHD-3 beta in a population-based sample from Korea.

Methods

We selected participants from the Korean population aged 19–69 years using stratified random sampling and evaluated them by interview using a questionnaire designed to identify headache type, headache characteristics, and psychiatric comorbidities.

Results

Of the 2,762 participants, 586 (21.3%) were diagnosed as having TTH using the standard criteria. Among these, 238 (40.6%) were also classified as having TTH using the alternative criteria. All 238 TTH subjects first diagnosed as having TTH by the alternative criteria were also classified as having TTH by the standard criteria. If the standard criteria were not applied, the remaining 348 patients were subclassified as having probable migraine (115, 19.6%) and unclassified headache (233, 39.7%). Compared with subjects diagnosed with TTH using the standard criteria, those diagnosed using the alternative criteria were less likely to demonstrate unilateral, pulsating headache, which is aggravated by movement, photophobia, phonophobia, and osmophobia.

Conclusion

Using the alternative criteria, less than half of the subjects with TTH according to the standard criteria were classified as having TTH. All the subjects with TTH by the alternative criteria were classified as having TTH by the standard criteria. This study also demonstrated that subjects diagnosed with TTH using the standard criteria could include people with headaches showing migrainous features.
Robust stability analysis for Lur’e systems with interval time-varying delays via Wirtinger-based inequality
Authors: Park Myeongjin , Kwon Ohmin , Park Juhyun , Lee Sangmoon , Cha Eunjong
Published: May 2014

This paper considers the problem of robust stability for Lur’e systems with interval time-varying delays and parameter uncertainties. It is assumed that the parameter uncertainties are norm bounded. By constructing a newly augmented Lyapunov-Krasovskii functional, less conservative sufficient stability conditions of the concerned systems are introduced within the framework of linear matrix inequalities (LMIs). Three numerical examples are given to show the improvements over the existing ones and the effectiveness of the proposed methods.
Upper bounds for the decay rate in a nonlocal p-Laplacian evolution problem
Authors: Esteve Carlos , Rossi Julio D , San Antolin Angel
Published: May 2014

We obtain upper bounds for the decay rate for solutions to the nonlocal problem

∂
t

u
(
x
,
t
)
=

∫

R
n

J
(
x
,
y
)

|
u
(
y
,
t
)
−
u
(
x
,
t
)
|

p
−
2

(
u
(
y
,
t
)
−
u
(
x
,
t
)
)

d
y

with an initial condition

u
0

∈

L
1

(

R
n

)
∩

L
∞

(

R
n

)

and a fixed

p
>
2

. We assume that the kernel J is symmetric, bounded (and therefore there is no regularizing effect) but with polynomial tails, that is, we assume a lower bounds of the form

J
(
x
,
y
)
≥

c
1

|
x
−
y
|

−
(
n
+
2
σ
)

, for

|
x
−
y
|
>

c
2

and

J
(
x
,
y
)
≥

c
1

, for

|
x
−
y
|
≤

c
2

. We prove that

∥
u
(
⋅
,
t
)
∥

L
q

(

R
n

)

≤
C

t

−

n

(
p
−
2
)
n
+
2
σ

(
1
−

1
q

)

for

q
≥
1

and t large.

MSC: 35K05, 45P05, 35B40.
Comparison of enzymatic reactivity of corn stover solids prepared by dilute acid, AFEX™, and ionic liquid pretreatments
Authors: Gao Xiadi , Kumar Rajeev , Singh Seema , Simmons Blake A , Balan Venkatesh , Dale Bruce E , Wyman Charles E
Published: May 2014

Background

Pretreatment is essential to realize high product yields from biological conversion of naturally recalcitrant cellulosic biomass, with thermochemical pretreatments often favored for cost and performance. In this study, enzymatic digestion of solids from dilute sulfuric acid (DA), ammonia fiber expansion (AFEX™), and ionic liquid (IL) thermochemical pretreatments of corn stover were followed over time for the same range of total enzyme protein loadings to provide comparative data on glucose and xylose yields of monomers and oligomers from the pretreated solids. The composition of pretreated solids and enzyme adsorption on each substrate were also measured to determine. The extent glucose release could be related to these features.

Results

Corn stover solids from pretreatment by DA, AFEX, and IL were enzymatically digested over a range of low to moderate loadings of commercial cellulase, xylanase, and pectinase enzyme mixtures, the proportions of which had been previously optimized for each pretreatment. Avicel® cellulose, regenerated amorphous cellulose (RAC), and beechwood xylan were also subjected to enzymatic hydrolysis as controls. Yields of glucose and xylose and their oligomers were followed for times up to 120 hours, and enzyme adsorption was measured. IL pretreated corn stover displayed the highest initial glucose yields at all enzyme loadings and the highest final yield for a low enzyme loading of 3 mg protein/g glucan in the raw material. However, increasing the enzyme loading to 12 mg/g glucan or more resulted in DA pretreated corn stover attaining the highest longer-term glucose yields. Hydrolyzate from AFEX pretreated corn stover had the highest proportion of xylooligomers, while IL produced the most glucooligomers. However, the amounts of both oligomers dropped with increasing enzyme loadings and hydrolysis times. IL pretreated corn stover had the highest enzyme adsorption capacity.

Conclusions

Initial hydrolysis yields were highest for substrates with greater lignin removal, a greater degree of change in cellulose crystallinity, and high enzyme accessibility. Final glucose yields could not be clearly related to concentrations of xylooligomers released from xylan during hydrolysis. Overall, none of these factors could completely account for differences in enzymatic digestion performance of solids produced by AFEX, DA, and IL pretreatments.
Neoadjuvant Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin With Pegfilgrastim Support in Muscle-Invasive Urothelial Cancer: Pathologic, Radiologic, and Biomarker Correlates
Authors: Choueiri Toni K. , Jacobus Susanna , Bellmunt Joaquim , Qu Angela , Appleman Leonard J. , Tretter Christopher , Bubley Glenn J. , Stack Edward C. , Signoretti Sabina , Walsh Meghara , Steele Graeme , Hirsch Michelle , Sweeney Christopher J. , Taplin Mary-Ellen , Kibel Adam S. , Krajewski Katherine M. , Kantoff Philip W. , Ross Robert W. , Rosenberg Jonathan E.
Published: May 2014

Purpose

In advanced urothelial cancer, treatment with dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) results in a high response rate, less toxicity, and few dosing delays. We explored the efficacy and safety of neoadjuvant ddMVAC with pegfilgrastim support in muscle-invasive urothelial cancer (MIUC).

Patients and Methods

Patients with cT2-cT4, N0-1, M0 MIUC were enrolled. Four cycles of ddMVAC were administered, followed by radical cystectomy. The primary end point was pathologic response (PaR) defined by pathologic downstaging to ≤ pT1N0M0. The study used Simon's optimal two-stage design to evaluate null and alternative hypotheses of PaR rate of 35% versus 55%. Secondary end points included toxicity, disease-free survival (DFS), radiologic response (RaR), and biomarker correlates, including ERCC1.

Results

Between December 2008 and April 2012, 39 patients (cT2N0, 33%; cT3N0, 18%; cT4N0, 3%; cT2-4N1, 43%; unspecified, 3%) were enrolled. Median follow-up was 2 years. Overall, 49% (80% CI, 38 to 61) achieved PaR of ≤ pT1N0M0, and we concluded this regimen was effective. High-grade (grade ≥ 3) toxicities were observed in 10% of patients, with no neutropenic fevers or treatment-related death. One-year DFS was 89% versus 67% for patients who achieved PaR compared with those who did not (hazard ratio [HR], 2.6; 95% CI, 0.8 to 8.1; P = .08) and 86% versus 62% for patients who achieved RaR compared with those who did not (HR, 4.1; 95% CI, 1.3 to 12.5; P = .009). We found no association between serum tumor markers or ERCC1 expression with response or survival.

Conclusion

In patients with MIUC, neoadjuvant ddMVAC was well tolerated and resulted in significant pathologic and radiologic downstaging.
Triple Intrathecal Therapy Alone With Omission of Cranial Radiation in Children With Acute Lymphoblastic Leukemia
Authors: Liu Hsi-Che , Yeh Ting-Chi , Hou Jen-Yin , Chen Kuan-Hao , Huang Ting-Huan , Chang Ching-Yi , Liang Der-Cherng
Published: May 2014

Purpose

To eliminate the toxicities and sequelae of cranial irradiation (CrRT) and to minimize the adverse impact of traumatic lumbar puncture (TLP) with blasts, a prospective study of a modified CNS-directed therapy was conducted in children with acute lymphoblastic leukemia (ALL).

Patients and Methods

Since June 1999, children with newly diagnosed ALL have been treated with triple intrathecal therapy (TIT) alone without CrRT. The first TIT was delayed until the disappearance of blasts from peripheral blood (PB) for up to 10 days of multidrug induction, and CrRT was omitted in all patients. If PB blasts persisted on treatment day 10 (d10), the TIT was then performed.

Results

Of a total of 156 patients, 152 were eligible. Seventeen patients did not have PB blasts at diagnosis. Three fourths of the remaining patients achieved complete clearance of PB blasts by d10. Only hyperleukocytosis at diagnosis showed a significantly lower clearance rate. Six standard-risk patients were upgraded to high risk because of detectable PB blasts on d10. TLPs were encountered in four patients (2.6%), but none were contaminated with lymphoblasts. Neither CNS-2 (less than 5 WBCs/μL with blasts in a nontraumatic sample) nor CNS-3 (≥ 5 WBCs/μL with blasts in a nontraumatic sample or the presence of cranial nerve palsy) was present. The 5-year event-free survival and overall survival rates ± SE were 84.2% ± 3.0% and 90.6% ± 2.4%, respectively. No isolated CNS relapse occurred, but two patients experienced combined CNS relapses. The 7-year cumulative risk of any CNS relapse was 1.4% ± 1.0%.

Conclusion

Delaying first TIT until circulating blasts have cleared may improve CNS control in children with newly diagnosed ALL and preclude the need for CrRT.
Physiological Roles of Gonadotropin-Inhibitory Hormone Signaling in the Control of Mammalian Reproductive Axis: Studies in the NPFF1 Receptor Null Mouse
Authors: León Silvia , García-Galiano David , Ruiz-Pino Francisco , Barroso Alexia , Manfredi-Lozano María , Romero-Ruiz Antonio , Roa Juan , Vázquez María J. , Gaytan Francisco , Blomenrohr Marion , van Duin Marcel , Pinilla Leonor , Tena-Sempere Manuel
Published: May 2014

RF-amide-related peptide-3 (RFRP-3), the mammalian ortholog of the avian gonadotropin-inhibiting hormone (GnIH), operates via the NPFF1 receptor (NPFF1R) to repress the reproductive axis, therefore acting as counterpart of the excitatory RF-amide peptide, kisspeptin (ligand of Gpr54). In addition, RFRP-3 modulates feeding and might contribute to the integrative control of energy homeostasis and reproduction. Yet, the experimental evidence supporting these putative functions is mostly indirect, and the physiological roles of RFRP-3 remain debatable and obscured by the lack of proper analytical tools and models. To circumvent these limitations, we characterize herein the first mouse line with constitutive inactivation of NPFF1R. Ablation of NPFF1R did not compromise fertility; rather, litters from NPFF1R null mice were larger than those from wild-type animals. Pubertal timing was not altered in NPFF1R deficient mice; yet, pre-pubertal knockout (KO) males displayed elevated LH levels, which normalized after puberty. Adult NPFF1R null male mice showed increased Kiss1 expression in the hypothalamic arcuate nucleus, higher serum FSH levels, and enhanced LH responses to GnRH. However, genetic elimination of NPFF1R was unable to reverse the state of hypogonadism caused by the lack of kisspeptin signaling, as revealed by double NPFF1R/Gpr54 KO mice. NPFF1R null mice displayed altered feedback responses to gonadal hormone withdrawal. In addition, metabolic challenges causing gonadotropin suppression, such as short-term fasting and high-fat diet, were less effective in dampening LH secretion in NPFF1R-deficient male mice, suggesting that absence of this inhibitory pathway partially prevented gonadotropin suppression by metabolic stress. Our data are the first to document the impact of elimination of GnIH signaling on reproductive parameters and their modulation by metabolic challenges. Whereas, in keeping with its inhibitory role, the NPFF1R pathway seems dispensable for preserved puberty and fertility, our results surface different alterations due to the lack of GnIH signaling that prominently include changes in the sensitivity to fasting- and obesity-associated hypogonadotropism.
Lactoferrin-iCre: A New Mouse Line to Study Uterine Epithelial Gene Function
Authors: Daikoku Takiko , Ogawa Yuya , Terakawa Jumpei , Ogawa Akiyo , DeFalco Tony , Dey Sudhansu K.
Published: May 2014

Transgenic animal models are valuable for studying gene function in various tissue compartments. Mice with conditional deletion of genes in the uterus using the Cre-loxP system serve as powerful tools to study uterine biology. The uterus is comprised of 3 major tissue types: myometrium, stroma, and epithelium. Proliferation and differentiation in each uterine cell type are differentially regulated by ovarian hormones, resulting in spatiotemporal control of gene expression. Therefore, examining gene function in each uterine tissue type will provide more meaningful information regarding uterine biology during pregnancy and disease states. Although currently available Cre mouse lines have been very useful in exploring functions of specific genes in uterine biology, overlapping expression of these Cre lines in more than 1 tissue type and in other reproductive organs sometimes makes interpretation of results difficult. In this article, we report the generation of a new iCre knock-in mouse line, in which iCre is expressed from endogenous lactoferrin (Ltf) promoter. Ltf-iCre mice primarily direct recombination in the uterine epithelium in adult females and in immature females after estrogen treatment. These mice will allow for specific interrogation of gene function in the mature uterine epithelium, providing a helpful tool to uncover important aspects of uterine biology.