bluuebunny/crossref_metadata_2025 huggingface dataset:
State space analysis of forest fires
Authors: Lopes António M , Tenreiro Machado José A
Published: January 2015

This paper studies forest fires from the perspective of dynamical systems. Burnt area, precipitation and atmospheric temperatures are interpreted as state variables of a complex system and the correlations between them are investigated by means of different mathematical tools. First, we use mutual information to reveal potential relationships in the data. Second, we adopt the state space portrait to characterize the system’s behavior. Third, we compare the annual state space curves and we apply clustering and visualization tools to unveil long-range patterns. We use forest fire data for Portugal, covering the years 1980–2003. The territory is divided into two regions (North and South), characterized by different climates and vegetation. The adopted methodology represents a new viewpoint in the context of forest fires, shedding light on a complex phenomenon that needs to be better understood in order to mitigate its devastating consequences, at both economical and environmental levels.
Impact of Fruit Smoothies on Adolescent Fruit Consumption at School
Authors: Bates Dylan , Price Joseph
Published: January 2015

We examine the impact of serving fruit smoothies during school breakfast on fruit consumption among middle school and high school students. We draw on observational plate-waste data over a 10-week period during which fruit smoothies were introduced for breakfast at two Utah schools. Our total sample includes 2,760 student-day observations. We find that the fraction of students eating a full serving of whole fruit increased from 4.3% to 45.1%. As such, school districts should consider offering fruit smoothies as part of a set of interventions designed to increase fruit consumption at school.
The U.S. National Tips From Former Smokers Antismoking Campaign
Authors: Huang Li-Ling , Thrasher James F. , Abad Erika Nayeli , Cummings K. Michael , Bansal-Travers Maansi , Brown Abraham , Nagelhout Gera E.
Published: January 2015

Objective. Evaluate the second flight of the U.S. Tips From Former Smokers (Tips) campaign. Method. Data were analyzed from an online consumer panel of U.S. adult smokers before ( n = 1,404) and after ( n = 1,401) the 2013 Tips campaign launch. Generalized estimating equation models assessed whether the Tips advertisement recall was associated with knowledge about smoking-related risks in the Tips advertisements, awareness and use of a toll-free quitline and cessation websites, and quit attempts. Results. Seventy-one percent of participants at Wave 2 reported that they recalled seeing at least one Tips advertisement. Smokers who recalled seeing a Tips advertisement were more likely to (a) show increases over baseline in knowledge of health risks such as amputation: 65% versus 34%, p < .001; blindness: 27% versus 12%, p < .001; and (b) to be aware of a quitline (41% vs. 30%, p < .001) and cessation website (28% vs. 20%, p < .001). Recall of Tips advertisements was also associated with greater likelihood of reporting having visited cessation websites (odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.27-2.06), having called a quitline (OR = 2.28, 95% CI = 1.61-3.24), and having made a quit attempt (OR = 1.18, 95% CI = 1.00-1.39), although these results were only statistically significant in the unadjusted models. Conclusions. The 2013 Tips campaign was successful in increasing knowledge of health risks and awareness of tobacco cessation resources.
Oral Toxicity of 3-Nitro-1,2,4-triazol-5-one in Rats
Authors: Crouse Lee C. B. , Lent Emily May , Leach Glenn J.
Published: January 2015

3-Nitro-1,2,4-triazol-5-one (NTO), an insensitive explosive, was evaluated to assess potential environmental and human health effects. A 14-day oral toxicity study in Sprague-Dawley rats was conducted with NTO in polyethylene glycol -200 by gavage at doses of 0, 250, 500, 1000, 1500, or 2000 mg/kg-d. Body mass and food consumption decreased in males (2000 mg/kg-d), and testes mass was reduced at doses of 500 mg/kg-d and greater. Based on the findings in the 14-day study, a 90-day study was conducted at doses of 0, 30, 100, 315, or 1000 mg/kg-d NTO. There was no effect on food consumption, body mass, or neurobehavioral parameters. Males in the 315 and 1000 mg/kg-d groups had reduced testes mass with associated tubular degeneration and atrophy. The testicular effects were the most sensitive adverse effect and were used to derive a benchmark dose (BMD) of 70 mg/kg-d with a 10% effect level (BMDL10) of 40 mg/kg-d.
Influence of thermomechanical interaction effects on the failure behaviour of polymer foam cored sandwich panels
Authors: Palleti HNKT , Zhang S , Fruehmann RK , Dulieu-Barton JM , Thomsen OT
Published: January 2015

The paper presents an experimentally based and numerically supported investigation of the collapse behaviour of polymer foam cored sandwich beams subjected to combined mechanical and thermal loading. Recent analytical and numerical modelling results available in the literature have ascertained that collapse may be due to loss of stability induced by nonlinear interactions between mechanical loads and thermally induced deformations, when accounting for the reduction of the polymer foam core mechanical properties with increasing temperature. In the paper, experiments are devised whereby a thermal gradient is introduced into a sandwich beam specimen loaded in three-point bending. The experiments cover a range of temperatures where one face sheet is heated from room temperature (25℃) to just below the glass transition temperature of the polymer foam core (70℃) and the other face sheet remains at room temperature. Digital image correlation (DIC) is used to obtain the local displacement field of the sandwich beam and its temperature is monitored using an infrared detector and thermocouples. The experimental results are compared with the predictions of both a generally nonlinear finite element model and an analytical so-called high-order sandwich panel theory (HSAPT) model. It is important to note that the HSAPT model has clear limitations as it takes into account only the geometric nonlinearity and thermal degradation of the foam core elastic properties, and it further assumes that the sandwich constituents are linear elastic with infinite straining capability. The HSAPT model predicts the occurrence of a strongly nonlinear load response leading to loss of stability (limit point behaviour). However, the experiments show that for the investigated sandwich beam configuration, it is necessary to include the nonlinear material properties in the modelling, as the nonlinear beam response leading to failure and collapse is significantly influenced by plastic deformations in the constituent materials. Thus, core indentation and extensive plasticity precede the transition to loss of stability driven by geometric nonlinearity and thermomechanical interaction effects. Finite element analyses that include both geometric and material nonlinearities provide results that correlate closely with the experimental observations. The work presented lays the foundation of a methodology for validating complex thermomechanical behaviour in sandwich structures using non-contact full-field measurement systems, and it demonstrates that analytical or numerical models based on the assumption of linear elastic material behaviour (such as the HSAPT model referenced in the paper) generally cannot adequately describe the thermomechanical behaviour of foam-cored sandwich structures.
Four Measures of Change in Physiologic State During the Feeding Period of Very Premature Infants
Authors: Park Jinhee , Thoyre Suzanne , Knafl George J.
Published: January 2015

Precise assessment of infants’ ability to regulate feeding challenges requires modeling of physiologic values across intervals of the feeding period without smoothing too much of the data stream. Using a subset of data from a study of physiologic stability and feeding performance in very preterm (≤30 weeks’ gestational age) infants fed in two different feeding positions, this exploratory study compared mean heart rate (HR) and its coefficient of variation sampled during the feeding period using four methods: (1) dividing the feeding period into three equal intervals; (2) extracting 2-min intervals from the initial, middle, and final third of the feeding period; (3) using successive 2-min intervals during the first 6 min of feeding; and (4) using successive 2-min intervals during the entire feeding period. Power analysis simulation was conducted with varying numbers of subjects to determine the method that requires the least number of subjects to detect a position effect for change in HR across time with 80% power. Different patterns of HR change across the feeding period were observed across the methods, which suggest potential advantages and disadvantages of each method. Among the four methods, using the first 6 min of the feeding period required the fewest subjects to detect significant differences in changes in HR across time between the feeding positions.
Free gifts and positional gifts
Authors: Elder-Vass Dave
Published: January 2015

Social theories of giving have often been shaped by anthropological accounts that present it as a form of pre-market reciprocal exchange, yet this exchangist discourse obscures important contemporary giving practices. This article discusses two types of giving that confound the exchangist model: (1) sharing practices within the family; and (2) free gifts to strangers. Once we reject understandings of giving derived from analyses of non-modern economies, it is possible to see that the gift economy is not a rare survival but rather is a central element of contemporary society and indeed the contemporary economy. The task for social theory is not to anachronize giving but to make sense of the variety and complexity of actual contemporary giving practices. This article offers the categories of free and positional gifts as a contribution to this analysis.
Effects of infographics on news elaboration, acquisition, and evaluation: Prior knowledge and issue involvement as moderators
Authors: Lee Eun-Ju , Kim Ye Weon
Published: January 2015

This study investigated how infographics may affect individuals’ news processing, focusing on multimodality and interactivity as its signature characteristics. News readers’ prior knowledge and issue involvement, which affect their ability and motivation to process information, were considered as potential moderators. In a 3 (text vs graphic vs text + graphic) × 2 (hyperlinks vs no hyperlinks) between-subjects experiment ( N = 360), participants read a news article concerning economic issues. Adding graphics to the news heightened the extent to which they engaged in news elaboration, albeit only among those with higher issue involvement. However, in-text hyperlinks hindered information recall among those with less prior knowledge, creating an information acquisition gap between more and less resourceful individuals. The graphical representation of news appeared to have heuristic appeals to those less involved in and less knowledgeable about the news topic, leading to more favorable news evaluation.
Hacktivism and the male-only stereotype
Authors: Tanczer Leonie Maria
Published: January 2015

This research explores hacktivism as a new form of online political activism. It uses qualitative interviews with a gender-equal sample of 10 self-defined hacktivists to address issues of gender and the discursive strategies used by males and females to handle the hacktivist community’s male-only stereotype. The semi-structured interviews are analysed using Foucauldian discourse analysis (FDA). The analysis indicates that male hacktivists relate to this dominant male-only representation through discursive techniques such as the suppression of gender (Male Oblivious Discourse) or mechanisms of vindication (Male Justification Discourse). Female hacktivists use the accentuation of gender and sexism to counteract male-dominant discourses and establish Female Discourses of Resistance (Emphasis Discourse; Negation Discourse). These gender-related argumentative positions and rhetorical mechanisms demonstrate how the male-only stereotype is created and maintained and how it affects not only hacktivists’ talk and sense-making but also their identity and the hacktivist actions they perform.
Flow-pattern switching in a motored spark ignition engine
Authors: Abraham Preeti S , Yang Xiaofeng , Gupta Saurabh , Kuo Tang-Wei , Reuss David L , Sick Volker
Published: January 2015

Cycle-to-cycle variability of intake-jet flow in an optical engine was measured using particle image velocimetry, revealing the possibility of two different flow patterns. A phase-dependent proper orthogonal decomposition analysis showed that one or the other flow pattern would appear in the average flow, sampled from test to test or sub-sampled within a single test; each data set contained individual cycles showing one flow pattern or the other. Three-dimensional velocity data from a large-eddy simulation of the engine showed that the particle image velocimetry plane cuts through a region of high shear between the intake jet and another large flow structure. Rotating the measurement plane ±10° revealed one or the other flow structure observed in the particle image velocimetry measurements. Thus, it was hypothesized that cycle-to-cycle variations in the swirl ratio result in the two different flow patterns in the particle image velocimetry plane. Having an unambiguous metric to reveal large-scale flow cycle-to-cycle variability, causes for this variability were examined within the possible sources present in the available testing. In particular, variations in intake-port and cylinder pressure, lateral valve oscillations, and engine RPM were examined as potential causes for the cycle-to-cycle flow variations using the phase-dependent proper orthogonal decomposition coefficients. No direct correlation was seen between the intake-port pressure, or the pressure drop across the intake valve, and the in-cylinder flow pattern. A correlation was observed between dominant flow pattern and cycle-to-cycle variations in intake-valve horizontal position. RPM values and in-cylinder flow patterns did not correlate directly. However, a shift in flow pattern was observed between early and late cycles in a 2900-cycle test after an approximately 5 r/min engine speed perturbation.
Evangelical released time for religious education in South Carolina: A normative case study
Authors: Bindewald Benjamin J
Published: January 2015

Released time is an arrangement through which students are excused from public schools during regular hours to participate in devotional lessons. South Carolina has become the center of operations for a movement of evangelical Christians to expand proselytizing released time programs throughout the United States. As a result of the movement’s lobbying efforts, in 2006 South Carolina became the first state to enact legislation allowing public schools to award graduation credits for participation in released time courses. Ohio recently adopted legislation modeled after South Carolina’s, and other states are presently considering similar bills. In response to these developments, this normative case study evaluates the appropriateness of granting public school credits for released time courses in a pluralist, democratic society.
More Equal than We Thought? Using Vote Validation to Better Understand Participation Inequality in the States
Authors: Franko William W.
Published: January 2015

Inequality in political participation is a well-known and often studied feature of American politics. An important study examining misreporting of voter turnout in opinion surveys, however, calls into question the true extent of participation inequality. Ansolabehere and Hersh's first-ever 50-state vote validation project shows that those with more political resources are more likely to misreport turnout. That is, those with higher incomes are more likely than others to report that they had voted when in fact they did not. These findings suggest that income disparities in participation are not as large as opinion surveys have led us to believe. Moreover, studies using differences between voters and nonvoters as a key political indicator may also be biased. This article presents the first assessment of whether vote misreporting creates systematic bias in measures of state participation inequality. An index of economic inequality in participation for the 50 states is developed using the Ansolabehere and Hersh validated vote data and compares the measure of political inequality with a similar measure using traditional (i.e., nonvalidated) survey data. These state indices are used to determine the extent of bias produced by misreporting and whether this bias has implications for studies using these measures of participation inequality. The latter is assessed by examining the influence of the self-reported and validated inequality measures on state welfare programs and minimum wage policy.
Validation of AD-CSF-Index in Chinese Patients With Alzheimer’s Disease and Nondemented Controls
Authors: Chu Leung-Wing , Shea Yat Fung , Ha Joyce
Published: January 2015

Cerebrospinal fluid (CSF) biomarkers of Alzheimer’s disease (AD), especially Aβ42/t-tau and Aβ42/p-tau, showed high diagnostic sensitivities and specificities. But significant interassay and interlaboratory variabilities hinder the widespread clinical applications of CSF biomarkers. The objective of this study was to validate the diagnostic accuracy of AD-CSF-Index in our local Chinese patients with AD compared to nondemented controls. A total of 36 patients, which included 24 patients with AD and 12 nondemented controls, were recruited. Chinese patients with AD showed higher mean AD-CSF-Indices than nondemented controls (AD = 1.25-1.3, normal = 0.62-0.63; P < .001). The AD-CSF-indices have a high sensitivity and specificity of 86.4% to 90.9% and 83.3%, respectively, in differentiating patients with AD from nondemented controls. After selecting the patients with “pure AD” and “pure normal” controls, the AD-CSF-indices have a high sensitivity and specificity of 94.1% and 90%, respectively, in differentiating patients with AD from nondemented controls. Most importantly, our AD-CSF-indices cutoff was highly similar to that reported in Western studies.
Spatial and Temporal Control Contribute to Step Length Asymmetry During Split-Belt Adaptation and Hemiparetic Gait
Authors: Finley James M. , Long Andrew , Bastian Amy J. , Torres-Oviedo Gelsy
Published: January 2015

Background. Step length asymmetry (SLA) is a common hallmark of gait poststroke. Though conventionally viewed as a spatial deficit, SLA can result from differences in where the feet are placed relative to the body (step position strategy), the timing between foot strikes (step time strategy), or the velocity of the body relative to the feet (step velocity strategy). Objective. The goal of this study was to characterize the relative contributions of each of these strategies to SLA. Methods. We developed an analytical model that parses SLA into independent step position, step time, and step velocity contributions. This model was validated by reproducing SLA values for 25 healthy participants when their natural symmetric gait was perturbed on a split-belt treadmill moving at either a 2:1 or 3:1 belt-speed ratio. We then applied the validated model to quantify step position, step time, and step velocity contributions to SLA in 15 stroke survivors while walking at their self-selected speed. Results. SLA was predicted precisely by summing the derived contributions, regardless of the belt-speed ratio. Although the contributions to SLA varied considerably across our sample of stroke survivors, the step position contribution tended to oppose the other 2—possibly as an attempt to minimize overall SLA. Conclusions. Our results suggest that changes in where the feet are placed or changes in interlimb timing could be used as compensatory strategies to reduce overall SLA in stroke survivors. These results may allow clinicians and researchers to identify patient-specific gait abnormalities and personalize their therapeutic approaches accordingly.
Predicting Video Game Behavior
Authors: Seok Soonhwa , DaCosta Boaventura
Published: January 2015

A study ( N = 1,995) is presented that investigated whether the Big Five Inventory personality types—agreeableness, conscientiousness, extroversion, neuroticism, and openness—can be used in explaining mobile game play. The study is predicated on research suggesting that relationships exist between certain personality types and willingness to embrace technology and mobile phone ownership. The same might be argued between personality and certain mobile apps, to include games. Little research, however, has examined personality and mobile games. This is unfortunate, as these games lend themselves naturally to problem-solving challenges and are believed to aid with learning. Findings revealed that agreeableness was the most significant personality type in predicting frequency and number of hours spent playing mobile games, while openness was the most consistent predictor of mobile gaming as a whole. However, overall strength of associations was weak, suggesting care in using personality, as it may be a poor predictor.
Arterial vessels behind the right internal jugular vein with relevance to central venous catheterisation
Authors: Chandra Manik , Start Sarah , Roberts David , Bodenham Andrew
Published: January 2015

During right internal jugular vein cannulation, complications can arise due to transfixion of the posterior wall and damage to other vessels. The risks to the subclavian artery and its branches are less well appreciated than the carotid artery. Example images are lacking in the literature. Using ultrasound and cadaveric studies, we aim to provide clinically relevant images of at-risk vessels posterior to the right internal jugular vein to emphasise their close proximity, and provide strategies to avoid potential complications.

Using ultrasound in 24 patients, we found the presence of numerous arterial vessels (excluding the carotid) within 8.0 mm of the posterior wall of the right internal jugular vein at the levels of the mastoid, cricoid and supraclavicular region. Cadaveric dissections further highlighted the close proximity of numerous branches of the subclavian artery.

Vulnerable branches of the subclavian artery include the thyrocervical trunk, inferior thyroid and vertebral arteries. More inferior approaches to right internal jugular vein cannulation are likely to put more arterial branches at risk. Higher resolution ultrasound enables visualisation of these arteries prior to cannulation. If identified, measures should be taken to avoid vein transfixion and arterial damage.
Arm versus forearm tourniquet for carpal tunnel decompression – Which is better? A randomized controlled trial
Authors: Cousins G. R. , Gill S. L. , Tinning C. G. , Johnson S. M. , Rickhuss P. K.
Published: January 2015

Tourniquet pain is a common source of complaint for patients undergoing carpal tunnel decompression and practice varies as to the tourniquet position used. There is little evidence to suggest benefit of one position over another. Our aim was to compare patient and surgeon experience of forearm and arm tourniquets. Following a power calculation, 100 patients undergoing open carpal tunnel decompression under local anaesthetic were randomized to either an arm or a forearm tourniquet. Measurements of blood pressure, heart rate and pain were taken at 2.5 min intervals. The operating surgeon also provided a visual analogue scale rating for the extent of bloodless field achieved and for any obstruction caused by the tourniquet. There was no statistically significant inter-group difference in patient pain or physiological response, tourniquet time, bloodless field or length of procedure. The degree of obstruction caused by the tourniquet was significantly higher in the forearm group.

Level of Evidence: I. Prospective Randomized Controlled Trial
Surgical adhesive BioGlue™ does not benefit tendon repair strength: an ex vivo study
Authors: Jordan M. C. , Schmitt V. , Dannigkeit S. , Schmidt K. , Meffert R. H. , Hoelscher-Doht S.
Published: January 2015

Surgical adhesives are useful supplements in surgery, but their benefit in tendon repair is uncertain. The purpose of this study was to evaluate the effect of BioGlue™ on strength of flexor tendon repair. A total of 60 porcine flexor tendons were divided into three groups. In group one, a conventional core and peripheral suture repair was used. In group two, a core suture and BioGlue™ were used. In group three, a conventional core and peripheral suture repair and BioGlue™ were used. We performed static and cyclic axial load testing and measured diameter of the repair site. We found that BioGlue™ did not improve the tensile strength when added to a core and peripheral suture and that there was an increase in bulk at the repair site. We conclude that BioGlue™ application cannot replace a peripheral suture as tensile strength significantly decreases without a peripheral suture, and it does not benefit a tendon already repaired with a core and peripheral suture.

Level of evidence: n/a
Opinions Toward Breastfeeding in Public and Appropriate Duration
Authors: Roche Andrea T. , Owen Kimberly B. , Fung Teresa T.
Published: January 2015

Objective. To examine the attitudes toward breastfeeding in public and perceptions toward appropriate durations. Methods. A total of 1036 adults completed an online survey on comfort levels toward themselves/partner or others breastfeeding in various locations, and perceived appropriate durations of breastfeeding from 3 months to over 2 years. We used multivariable ordered logistic regression to examine the association between demographic characteristics and comfort levels of one’s breastfeeding and appropriate duration. Results. The sample was 68% female, 87% non-Hispanic white, 84% with college degree or higher, and 68% residing in the northeastern United States. After adjusting for demographic factors, men had significantly lower odds of being comfortable with having their partner (odds ratio [OR] range = 0.58-0.69, P < .05) or other women (OR range = 0.49-0.60, P < .05) breastfeed in malls, parks, restaurants, health clubs, and open spaces in general. Men had half the odds than women toward comfort with 2 or more years of breastfeeding (OR = 0.50, 95% confidence interval = 0.32-0.77). Ethnicity, residential setting, age, and education were not independently associated with comfort in breastfeeding in public or breastfeeding duration. Conclusions. In this mostly white, well-educated sample, women were significantly more comfortable with others and themselves/partner breastfeeding in public than males. The same was true regarding approval of longer durations of breastfeeding.
Losing the Wind Beneath Your Wings
Authors: Gomillion Sarah , Murray Sandra L. , Lamarche Veronica M.
Published: January 2015

Support from romantic partners can have tremendous benefits for people’s personal goal pursuits. However, when relationships end in breakup, this goal support is lost. Thus, breakup may have important consequences for goal progress. A longitudinal study found that breaking up with goal instrumental partners predicted poorer subsequent goal progress. Breaking up with noninstrumental partners did not impair goal progress. In contrast, breakup did not predict changes in goal importance, suggesting that people still valued goals associated with their former partners. These findings are the first to reveal a hidden potential cost of breakup: losing the support people once relied on to achieve their valued personal goals. Thus, finding alternative sources of goal support may be essential to coping successfully with breakup.
Qigong program on insomnia and stress in cancer patients: A case series report
Authors: Kim Seungmo , Lee Sangnam , Kwon Osung , Park Seonghoon , Seo Jungchul , Kim Kyungsoon
Published: January 2015

Background:

In recent years, the interest in Qigong as an alternative therapy has grown following reports of its ability to regulate psychological factors in cancer patients. This is a case series to evaluate the outcome measures of Qigong when used as an adjunct to standard medical care to treat insomnia and stress in cancer patients.

Patients and methods:

The Qigong program was applied to four cancer patients with insomnia, stress, and anxiety. The program consisted of 30-min sessions involving exercise, patting of the 12 meridians, and spontaneous breathing exercises three times a week for a period of 4 weeks. The Pittsburgh Sleep Quality Index was measured as the primary outcome, while the Stress Scale, the State–Trait Anxiety Inventory, and the Functional Assessment Cancer Therapy–General determined the secondary outcomes. Insomnia, stress, and anxiety levels were examined weekly, while quality of life was examined on the first visit and the last visit.

Results:

The Pittsburgh Sleep Quality Index and Stress Scale scores were reduced after conduct of the Qigong program.

Conclusion:

This study could provide a better understanding of Qigong’s influence on insomnia and stress in cancer patients. However, a larger controlled trial should be conducted to confirm these findings.
Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence
Authors: Wang Kenneth K , Carr-Locke David L , Singh Satish K , Neumann Helmut , Bertani Helga , Galmiche Jean-Paul , Arsenescu Razvan I , Caillol Fabrice , Chang Kenneth J , Chaussade Stanislas , Coron Emmanuel , Costamagna Guido , Dlugosz Aldona , Ian Gan S , Giovannini Marc , Gress Frank G , Haluszka Oleh , Ho Khek Y , Kahaleh Michel , Konda Vani J , Prat Frederic , Shah Raj J , Sharma Prateek , Slivka Adam , Wolfsen Herbert C , Zfass Alvin
Published: January 2015

Background

Probe‐based confocal laser endomicroscopy (pCLE) provides microscopic imaging during an endoscopic procedure. Its introduction as a standard modality in gastroenterology has brought significant progress in management strategies, affecting many aspects of clinical care and requiring standardisation of practice and training.

Objective

This study aimed to provide guidance on the standardisation of its practice and training in Barrett's oesophagus, biliary strictures, colorectal lesions and inflammatory bowel diseases.

Methods

Initial statements were developed by five group leaders, based on the available clinical evidence. These statements were then voted and edited by the 26 participants, using a modified Delphi approach. After two rounds of votes, statements were validated if the threshold of agreement was higher than 75%.

Results

Twenty‐six experts participated and, among a total of 77 statements, 61 were adopted (79%) and 16 were rejected (21%). The adoption of each statement was justified by the grade of evidence.

Conclusion

pCLE should be used to enhance the diagnostic arsenal in the evaluation of these indications, by providing microscopic information which improves the diagnostic performance of the physician. In order actually to implement this technology in the clinical routine, and to ensure good practice, standardised initial and continuing institutional training programmes should be established.
The human gastric microbiota: Is it time to rethink the pathogenesis of stomach diseases?
Authors: Nardone Gerardo , Compare Debora
Published: January 2015

Introduction

Although long thought to be a sterile organ, due to its acid production, the human stomach holds a core microbiome.

Aim

To provide an update of findings related to gastric microbiota and its link with gastric diseases.

Methods

We conducted a systematic review of the literature.

Results

The development of culture‐independent methods facilitated the identification of many bacteria. Five major phyla have been detected in the stomach: Firmicutes, Bacteroidites, Actinobacteria, Fusobacteria and Proteobacteria. At the genera level, the healthy human stomach is dominated by Prevotella, Streptococcus, Veillonella, Rothia and Haemophilus; however, the composition of the gastric microbiota is dynamic and affected by such factors as diet, drugs and diseases. The interaction between the pre‐existing gastric microbiota and Helicobacter pylori infection might influence an individual's risk of gastric disease, including gastric cancer.

Conclusions

The maintenance of bacterial homeostasis could be essential for the stomach's health and highlights the chance for therapeutic interventions targeting the gastric microbiota, even if gastric pH, peristalsis and the mucus layer may prevent bacteria colonization; and the definition of gastric microbiota of the healthy stomach is still an ongoing challenging task.
Can urodynamics distinguish between urethral strictures and Benign Prostatic Hyperplasia (BPH)?
Authors: Bishara Samuel , Foley Charlotte , Peters John , Philp Tim , Malone-Lee James
Published: January 2015

Objectives:

We tested whether pressure flow studies could distinguish between patients with Benign Prostatic Hyperplasia (BPH) and urethral strictures and hypothesised that urethral strictures were associated with a lower closure pressure and increased slope of the passive urethral relation compared to benign prostatic obstruction.

Patients and method:

Ninety patients who had Transurethral Resection of Prostate (TURP) and 45 male patients who had an optical urethrotomy or urethral dilatation for urethral stricture disease, who had a prior urodynamics study, were evaluated.

Results:

Patients with urethral stricture disease had lower closure pressures than those undergoing TURP (22.07 vs. 28.4 cmH2O, p=0.0039, r=0.61). However, the slope of the passive urethral relation was indistinguishable between the two groups. Only 60% of patients with symptomatic urethral strictures were categorised as unequivocally obstructed by the Abrams-Griffiths nomogram.

Conclusion:

Urethral strictures are associated with lower closure pressures than prostatic obstruction; however, there was no difference in the urethral resistance relation.
Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture
Authors: Jain Deepak , Sidhu Guraziz Singh , Selhi Harpal Singh , Mears Simon C. , Yamin Mohammad , Mahindra Pankaj , Pannu Harminder Singh
Published: January 2015

Geriatric hip fractures are a challenging clinical problem throughout the world. Hip fracture services have been shown to shorten time to surgery, decrease the cost of admissions, and improve the outcomes. We instituted a geriatric hip fracture program for comanagement of these injuries by orthopedic and internal medicine teams at our hospital in India. From January 2010 till December 2011, 119 patients with a femoral neck fracture were treated with cemented modular hemiarthroplasty under this program using a cost-effective Indian implant. The cohort included 63 males and 56 females with a mean age of 70.7 years (range 55-98 years). Hypertension (n = 42) and diabetes mellitus (n = 29) were the most common comorbidities. The follow-up period ranged from 12 to 37 months with an average of 24 months. The surgery was performed within 24 hours of admission in 60.5% (n = 72) patients. The use of antiplatelet drugs was the most common reason for delay of surgery. The mean length of hospital stay was 10.4 days (range 3-24 days) with 77% (n = 92) of patients discharged within 1 week of admission. On follow-up, good to excellent Harris hip scores were seen in 88% of patients with 76% of patients returning to the preinjury ambulatory status. The mortality rate was 6% at 6 months follow-up and 10.9% at 2 years. Our study shows that a hip fracture program can be instituted in India. The program helped us in achieving the goal of early surgery, mobilization, and discharge from hospital with decreased mortality.
Sharatchandra’s Caste and Gender Consciousness
Authors: Sil Narasingha
Published: January 2015

Sharatchandra Chattopadhyay’s attitude to the prevalent caste system and social ethos, especially concerning sex, love, and marriage and chastity of married as well as widowed women, shows a marked ambivalence. On one hand, his work demonstrates his progressive and liberal ideas emanating from Western contact and impact on late colonial India, and on Bengal in particular. On the other hand, and by the same token, his attitude to love, marriage, and sex shows marked affinity with the Victorian morality emanating from the society of colonial India’s metropolitan masters. The upshot of this historical and social context is that Sharatchandra was basically a caste conscious Hindu Brahmin and a firm believer in the patriarchal ethos of his contemporary society, his reputation as a compassionate ( daradī or maramī) writer exposing the ills of his society notwithstanding.
Estranged Wife, Other Man’s Beloved
Authors: Pizarro Jemimah Gaite , Gaspay-Fernandez Rowena
Published: January 2015

Amid societal constraints, difficult repercussions, and double-standard morality on sexuality that favors the male members of their society, eight Filipino women engaged in extramarital affairs. To answer the question “Why did they commit and endure the affair?” a phenomenological life-world approach explored their perspectives regarding the triggering and perpetuating factors of their extramarital relationships (EMR). The analysis revealed their standpoints that negatively perceived marital relationship quality, paternal neglect of children, increasing opportunities for EMR, that is, workplace and mobile technology, and positively perceived extramarital–alternative familial relationship quality emerged as the women’s reasons behind the decision to engage and endure in the affair.
Forty-two
Authors: Dumay John
Published: January 2015

This article explores the meaning and context of intellectual capital (IC) numbers to help break free from the domination of IC “accountingisation” . Offering a personal and reflective narrative about IC numbers, I first discuss what numbers mean by exploring the way we think about the number 42. This discussion is followed by two empirical sections examining the meaning and context of a common IC measure, employee turnover rates. Measuring any IC element is problematic from an IC accounting perspective because of the unique context in which each organization operates. The comparability of a number from one organization and one period with another is nearly impossible. The article is original because it takes a thought-provoking narrative journey into the use and meaning of applying IC numbers. It is a personal reflection on the implications of considering the meaning of numbers for IC practice, IC education and research, and IC’s future. It is particularly topical in light of the inclusion of IC in the recent Integrated Reporting () Guidelines.
Factors Associated with Late Engagement to HIV Care in Western Kenya
Authors: Kwobah Charles Meja , Braitstein Paula , Koech Julius K. , Simiyu Gilbert , Mwangi Ann W. , Wools-Kaloustian Kara , Siika Abraham M.
Published: January 2015

Background:

Late presentation of patients contributes significantly to the high mortality reported in HIV -care and treatment programs in sub-Saharan Africa.

Methods:

A cross-sectional study was conducted to assess factors associated with late engagement to HIV care at the Academic Model Providing Access to Healthcare in western Kenya. Late engagement was defined as baseline CD4 ≤100 cells/mm3.

Results:

Of the 10 533 participants included in the analysis, 67% were female and mean age was 36.7 years. Overall, 23% of the participants presented late. Factors associated with late engagement included male gender (adjusted odds ratio [AOR]: 1.54, 95% confidence interval [CI]: 1.35-1.75), older age (AOR: 1.62, 95% CI: 1.02-2.56), and longer travel time to clinic (AOR: 1.18, 95% CI: 1.04-1.34).

Conclusion:

Nearly one-quarter of HIV-infected patients in our setting present with advanced immune suppression at initial encounter. Being male, older age, and living further away from clinic are associated with late engagement to care.
Can Improving Knowledge of Antibiotic-Associated Adverse Drug Events Reduce Parent and Patient Demand for Antibiotics?
Authors: Roberts Rebecca M. , Albert Alison P. , Johnson Darcia D. , Hicks Lauri A.
Published: January 2015

Background:

According to the Centers for Disease Control and Prevention, at least 2 million people are infected and 23,000 die each year in the United States as a result of antibiotic-resistant bacterial infections. Antibiotic use is the most important factor contributing to antibiotic resistance and overuse is common, especially for upper respiratory tract infections. There is a perception among the public, as well as some health care providers, that antibiotics are harmless. We conducted formative research to explore patient and parent knowledge and attitudes relating to antibiotic use and adverse drug events (ADEs).

Methods:

Six computer-assisted telephone focus groups were conducted in October and November 2010 with adult patients and mothers of young children. The focus groups were developed to engage participants in discussion about their knowledge and attitudes regarding antibiotic resistance and ADEs associated with antibiotic use.

Results:

Nearly all mothers were familiar with the possibility of “side effects” with prescription medications, including antibiotics. However, very few mothers were familiar with severe antibiotic-associated ADEs and nearly all felt strongly that this information should be shared with parents at the time a prescription is recommended or written for their child. Adult participants did not believe that the potential for ADEs was a significant issue for adults and most reported never discussing the potential for adverse events with their provider.

Conclusions:

Parents were receptive to appropriate antibiotic use messaging around ADEs. We learned that ADE messages did not resonate with adults in the same way they did with mothers of young children.
Safety and Efficacy of Fondaparinux in Renal Impairment
Authors: Al-Shaer Mohammad H. , Ibrahim Tarek
Published: January 2015

Objective: To evaluate the cumulative evidence regarding the efficacy and safety of using fondaparinux in renal impairment, manifested by preventing new or recurrent thrombosis and the incidence of bleeding, respectively. Data Sources: We searched the MEDLINE and Cochrane databases for relevant studies from 1966 until November 2014, using the terms “fondaparinux” and “renal failure” or “dialysis.” Additional references were identified from review of literature citations. Study Selection and Data Extraction: Inclusion criteria were articles in English language and patients with creatinine clearance (CrCl) less than 50 mL/min. Exclusion criteria were using fondaparinux as an anticoagulant for dialyzer circuit patency, abstracts, case reports, case series, pediatrics (<18 years), and pharmacokinetic studies with no clinical efficacy and safety results. Data Synthesis: Our search retrieved 4 cohort studies, 1 clinical trial, and 1 randomized clinical trial (RCT) subgroup analysis. A total of 3237 patients received fondaparinux with a dose ranging from 1.25 mg to 2.5 mg daily. Three studies investigated fondaparinux as a prophylactic agent, 2 as a treatment agent, and 1 study investigated both. The only study with control group was the RCT subgroup analysis, which compared fondaparinux to enoxaparin. A total of 470 patients developed thromboembolic complications or death and 169 developed major bleeding. The composite outcome of safety and efficacy in the RCT subgroup analysis was significantly lower in fondaparinux group compared with the enoxaparin group ( P = .001). Conclusions: Current evidence regarding the safety and efficacy of fondaparinux in renally impaired patients is limited and does not support its use in such population.
An Orthodontic Bracket Embedded in the Medial Pterygoid Surface: A Case Report
Authors: Wilmott Sheryl E. , Ikeagwuani Okechukwu , McLeod Niall M. H.
Published: January 2015

There is a potential risk that orthodontic brackets can become dislodged into the aerodigestive tract. This case illustrates the management of an orthodontic bracket, which became embedded in the deep tissues of the oropharynx. We aim to highlight the potential risk misplaced dental instruments and materials pose, including that they may become embedded in the soft tissues of the throat and suggest that that this possibility should be considered when they cannot be localized.
Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality
Authors: Goel Ruchika , Ness Paul M. , Takemoto Clifford M. , Krishnamurti Lakshmanan , King Karen E. , Tobian Aaron A. R.
Published: January 2015

Key Points

Platelet transfusions are frequently administered to hospitalized patients with platelet consumptive/destructive disorders such as TTP, HIT, and ITP. Platelet transfusions are associated with higher odds of arterial thrombosis and mortality among TTP and HIT patients.
Anti-type II collagen immune complex-induced granulocyte reactivity is associated with joint erosions in RA patients with anti-collagen antibodies
Authors: Manivel Vivek Anand , Sohrabian Azita , Wick Marius C , Mullazehi Mohammed , Håkansson Lena Douhan , Rönnelid Johan
Published: January 2015

Introduction

Rheumatoid arthritis (RA) patients with autoantibodies against collagen type II (CII) are characterized by acute RA onset with elevated inflammatory measures and early joint erosions as well as increased production of tumor necrosis factor-α (ΤΝF-α) by peripheral blood mononuclear cells (PBMC) stimulated by anti-CII immune complexes (IC) in vitro. Polymorphonuclear granulocytes (PMN) are abundant in RA synovial fluids, where they might interact directly with anti-CII IC in the articular cartilage, but no studies have investigated PMN responses towards anti-CII IC. The aim was to investigate whether PMN react towards anti-CII IC, and to what extent such reactivity might relate to the clinical acute onset RA phenotype associated with elevated levels of anti-CII.

Methods

PMN and PBMC isolated from healthy donors were stimulated with IC made with a set of 72 baseline patient sera (24 anti-CII positive, 48 anti-CII negative) chosen from a clinically well-characterized RA cohort with two-year radiological follow-up with Larsen scoring. PMN expression of cluster of differentiation (CD)11b, CD66b, CD16 and CD32 was measured by flow cytometry, whereas PMN production of myeloperoxidase (MPO) and interleukin (IL)-17, and PBMC production of ΤΝF-α was measured with enzyme linked immunosorbent assay.

Results

PMN expression of CD11b, CD66b and MPO, and PBMC production of ΤΝF-α were upregulated whereas PMN expression of CD16 and CD32 were downregulated by anti-CII IC. CD16, CD66b, and MPO production correlated to serum anti-CII levels (Spearman’s ρ = 0.315, 0.675 and 0.253, respectively). CD16 was associated with early joint erosions (P = 0.024, 0.034, 0.046 at baseline, one and two years) and CD66b was associated with changes in joint erosions (P = 0.017 and 0.016, at one and two years compared to baseline, respectively). CD66b was associated with baseline C-reactive protein and PBMC production of ΤΝF-α was associated with baseline erythrocyte sedimentation rate, in accordance with our earlier findings. No clinical associations were observed for MPO or IL-17.

Conclusion

PMN responses against anti-CII IC are more closely associated with early joint erosions than are PBMC cytokine responses. PMN reactivity against anti-CII IC may contribute to joint destruction in newly diagnosed RA patients with high levels of anti-CII.