bluuebunny/crossref_metadata_2025 huggingface dataset:
Tracing aspects of the Greek crisis in Athens: Putting women in the picture
Authors: Vaiou Dina
Published: March 2014

In the political fluidity of our times, the dismal economic situation in Greece is perhaps extreme but indicative of a deepening crisis in Europe, which is expanding, both geographically and socially. Contrary to the dominant rhetoric, austerity measures and pacts imposed on Greece, Portugal, Spain – and later Cyprus – do not seem to provide effective remedies. On the contrary, they seem to plunge entire areas and groups of people into a vicious cycle of rising unemployment, shrinking incomes and deep impoverishment. In the context of this rhetoric, an almost exclusive emphasis on the macro-economic aspects of the crisis, seems to “expel” from public debate the fact that there are effects of austerity policies that are unevenly distributed, inscribed as they are on existing inequalities: inequalities among places, between women and men, locals and migrants, big and small employers, secure and precarious workers and, most importantly, intersections of these. This paper engages with some of the less debated aspects of the crisis in Athens, with a focus on the complex and usually invisible ways in which it impacts on women. It draws upon research in a low-income neighbourhood of Athens and focuses on changes in women’s everyday lives, which have to do with job precarity and job loss, destruction of social services and the re-shaping of care, as well as practices of coping with/resisting the crisis.
Influence of interface deformation on transmittable torque of disk-type magnetorheological clutch
Authors: Tian Zu-Zhi , Chen Fei , Wang Dao-Ming
Published: March 2014

The transmission interface deformation for a disk-type magnetorheological clutch appears unavoidably due to machining error, assembling error, and thermal stress. To study the transmittable torque variation due to interface deformation, the common deformation forms of a disk-type magnetorheological clutch are summarized. And then, an experimental test-bed is designed and established. After this, the experiments of transmittable torque due to deformed disks are carried out in the test-bed. The research results indicate that interface deformation has certain influence on the transmittable torque of magnetorheological clutch. For the skew deformation, the transmittable torque will increase approximately linearly with the increment of deformation value. For the warping deformation, when the deformation value is positive, the torque variation rule is the same as skew deformation. While the deformation value is negative, the torque decreases first as the absolute deformation value is smaller and then increases as the absolute deformation value becomes larger.
A new multiscale computational method for electromechanically coupled analysis of heterogeneous piezoelectric composites
Authors: Lv Jun , Zhang Hongwu , Gao Xiaowei , Huang Yi
Published: March 2014

This article is concerned with the electromechanically coupled multiscale behaviors of the heterogeneous piezoelectric materials, which consist of periodic or non-periodic distributed microstructures. A multiscale framework based on the extended multiscale finite element method is developed to capture the large-scale solutions on the coarse-scale mesh without resolving the entire small-scale features. In this method, the microscale fluctuations in the mechanical displacement and electrical potential are related to the macroscopic deformation and electrical fields through the multiscale base functions. To improve the accuracy of the multiscale method, the periodic boundary conditions are developed to calculate the multiscale base functions for those piezoelectric structures composed of periodic microstructures. Moreover, the oversampling techniques are introduced to derive the oscillatory boundary conditions to construct the base functions for those piezoelectric structures with non-periodic heterogeneous microscopic features. The efficiency and accuracy of the multiscale method proposed for the piezoelectric materials are validated through the examples where the structures consist of periodic or non-periodic heterogeneous microstructures. The results indicate that the multiscale method developed can effectively obtain the macroscale response of piezoelectric materials (displacement or electrical potential) as well as the response in the microscale (stress or electrical displacement).
Psychometric Comparison of the PROMIS Physical Function CAT With the FAAM and FFI for Measuring Patient-Reported Outcomes
Authors: Hung Man , Baumhauer Judith F. , Brodsky James W. , Cheng Christine , Ellis Scott J. , Franklin Jeremy D. , Hon Shirley D. , Ishikawa Susan N. , Latt L. Daniel , Phisitkul Phinit , Saltzman Charles L. , SooHoo Nelson F. , Hunt Kenneth J. ,   Orthopaedic Foot & Ankle Outcomes Research (OFAR) of the American Orthopaedic Foot & Ankle Society (AOFAS)
Published: March 2014

Background:

Selecting optimal patient-reported outcome (PRO) instruments is critical to improving the quality of health care. The purpose of this study was to compare the reliability, responsiveness, and efficiency of three PRO measures: the Foot and Ankle Ability Measure–Activity of Daily Living subscale (FAAM_ADL), the Foot Function Index 5-point verbal rating scale (FFI-5pt), and the PROMIS Physical Function computerized adaptive test (PF CAT).

Methods:

Data were aggregated from 10 clinical sites in the AOFAS’s National Orthopaedic Foot and Ankle Research (OFAR) Network from 311 patients who underwent elective surgery for a disorder of the foot or ankle. Patients were administered the FAAM_ADL, FFI-5pt, and PF CAT at their preoperative visit and at 6 months after surgery. Reliabilities were evaluated using a Rasch model. Responsiveness was calculated using paired samples t test and efficiency was recorded as number of seconds to complete the instrument.

Results:

Similar reliabilities were found for the three instruments. Item reliabilities for FAAM_ADL, FFI-5pt, and PF CAT were all .99. Pearson reliabilities for FAAM_ADL, FFI-5pt, and PF CAT were .95, .93, and .96, respectively. On average, patients completed the FAAM_ADL in 179 seconds, the FFI-5pt in 194 seconds, and the PF CAT in 44 seconds, ( P < .001). The PF CAT and FAAM_ADL showed significant improvement ( P = .01 and P = .001, respectively) in patients’ physical function after treatment; the FFI-5pt did not show improvement.

Conclusions:

Overall, the PF CAT performed best in terms of reliability, responsiveness, and efficiency in this broad sample of foot and ankle patients. It can be a potential replacement for the conventional PRO measures, but further validation is needed in conjunction with the PROMIS Pain instruments.

Level of Evidence:

Level I, prospective comparative outcome study.
Appearance of Subchondral Bone in Computed Tomography Is Related to Cartilage Damage in Osteochondral Lesions of the Talar Dome
Authors: Nakasa Tomoyuki , Adachi Nobuo , Kato Tomohiro , Ochi Mitsuo
Published: March 2014

Background:

Osteochondral lesions of the talar dome (OLT) involve the articular cartilage and/or subchondral bone. The subchondral bone plate plays an important role in cartilage metabolism. We hypothesized that the findings of subchondral bone on CT image would be related to the cartilage damage of OLT. The purpose of this study was to evaluate the relationship between the arthroscopic and CT findings focused on subchondral bone.

Methods:

Thirty-one ankles diagnosed as OLT were analyzed. All patients underwent CT, MRI, and arthroscopic surgery. The CT findings for both the cystic and fragment lesions were classified into 3 types. The 3 types for the cystic lesion ankles were irregular shape, round shape with sclerotic wall, and irregular shape with opening to an articular cavity. The 3 types for the fragment lesion were no bone absorption, bed absorption without fragment absorption, and bed sclerosis and fragment absorption. The subchondral bone findings on CT were compared with International Cartilage Repair Society (ICRS) grades and arthroscopic grading.

Results:

All round and sclerotic cystic lesions revealed cartilaginous flap lesions with a nearly normal cartilage surface. An irregular shape with opening revealed an unstable lesion with severely damaged cartilage. As for fragment lesions, no absorption revealed a stable lesion with a nearly normal cartilage surface. Bed absorption revealed an unstable lesion with a nearly normal cartilage surface. Fragment absorption with bed sclerosis showed an unstable lesion with severely damaged cartilage. There was a significant difference between CT findings and ICRS grade or arthroscopic findings (both P < .01), while there was no significant difference with MRI grading. The diagnosis of cartilage status by CT was better than MRI.

Conclusion:

CT findings for OLT based on subchondral bone related to cartilage damage. This study showed that CT was a useful tool for evaluating cartilage damage in OLT.

Level of Evidence:

Level III, comparative case series.
Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis
Authors: Lewis John S. , Adams Samuel B. , Queen Robin M. , DeOrio James K. , Nunley James A. , Easley Mark E.
Published: March 2014

Background:

Ipsilateral hindfoot arthrodesis in combination with total ankle replacement (TAR) may diminish functional outcome and prosthesis survivorship compared to isolated TAR. We compared the outcome of isolated TAR to outcomes of TAR with ipsilateral hindfoot arthrodesis.

Methods:

In a consecutive series of 404 primary TARs in 396 patients, 70 patients (17.3%) had a hindfoot fusion before, after, or at the time of TAR; the majority had either an isolated subtalar arthrodesis (n = 43, 62%) or triple arthrodesis (n = 15, 21%). The remaining 334 isolated TARs served as the control group. Mean patient follow-up was 3.2 years (range, 24-72 months).

Results:

The SF-36 total, AOFAS Hindfoot-Ankle pain subscale, Foot and Ankle Disability Index, and Short Musculoskeletal Function Assessment scores were significantly improved from preoperative measures, with no significant differences between the hindfoot arthrodesis and control groups. The AOFAS Hindfoot-Ankle total, function, and alignment scores were significantly improved for both groups, albeit the control group demonstrated significantly higher scores in all 3 scales. Furthermore, the control group demonstrated a significantly greater improvement in VAS pain score compared to the hindfoot arthrodesis group. Walking speed, sit-to-stand time, and 4-square step test time were significantly improved for both groups at each postoperative time point; however, the hindfoot arthrodesis group completed these tests significantly slower than the control group. There was no significant difference in terms of talar component subsidence between the fusion (2.6 mm) and control groups (2.0 mm). The failure rate in the hindfoot fusion group (10.0%) was significantly higher than that in the control group (2.4%; p < 0.05).

Conclusion:

To our knowledge, this study represents the first series evaluating the clinical outcome of TARs performed with and without hindfoot fusion using implants available in the United States. At follow-up of 3.2 years, TAR performed with ipsilateral hindfoot arthrodesis resulted in significant improvements in pain and functional outcome; in contrast to prior studies, however, overall outcome was inferior to that of isolated TAR.

Level of Evidence:

Level II, prospective comparative series.
Factors Influencing Discharge Disposition After Ankle Arthrodesis
Authors: Menendez Mariano E. , Bot Arjan G. J. , Neuhaus Valentin , Ring David , Johnson A. Holly
Published: March 2014

Background:

Although functional and morbidity outcomes following ankle arthrodesis have been widely studied, patterns of health care resource utilization remain unclear. The purpose of this study was to identify preoperative and postoperative risk factors for nonroutine discharge following ankle arthrodesis. A secondary study aim was to determine risk factors associated with prolonged hospital stay.

Methods:

Using the National Health Discharge Survey (NHDS) database for the years 2001 through 2007, an estimated 40 941 patients having undergone ankle arthrodesis were identified and separated into those who were discharged to home (routine discharge) and those who were discharged to rehabilitation facilities (nonroutine discharge). Factors influencing discharge disposition and hospital length of stay were determined using multivariable binary logistic regression analysis.

Results:

Risk factors for nonroutine discharge were increasing age, male sex, diabetes mellitus, atrial fibrillation, more than 1 general or surgery-related complication, additional days of care, and the 2005 to 2007 time period. Risk factors associated with prolonged hospital stay were advanced age, female sex, diabetes mellitus, more than 1 general or surgery-related complication, and the 2001 to 2004 time period.

Conclusion:

Early identification of these factors might prove useful for better allocation of resources and implementation of effective strategies aimed at preventing longer hospitalizations and nonroutine discharges in selected patients at risk.

Level of Evidence:

Level II, prognostic study.
Church-Based ESL Adult Programs
Authors: Chao Xia , Mantero Miguel
Published: March 2014

This multi-sited ethnographic study examines the ways in which Latino and Asian immigrant parents’ English learning through two church-based ESL programs in a Southeastern U.S. city affects their family literacy and home language practices. It demonstrates that the parents’ participation in the programs is an empowering experience promoting ESL acquisition and funds of knowledge, which in turn advances their family literacy. This study also finds that the programs do not promote linguistic assimilation, devalue or erase immigrant parents’ home language. Instead, they facilitate the parents to reclaim their home language and support children’s home language development. The “family literacy ecology of communities” framework is proposed in this study. It indicates that church-based ESL programs as social mediators for situating immigrant adult English learners within real-life communities, empowering their family literacy, accessing communities of power, and having a voice in the larger society. Implications for ESL adult programs and future studies are presented.
Composite end points to assess delay of disability progression by MS treatments
Authors: Zhang J , Waubant E , Cutter G , Wolinsky JS , Leppert D
Published: March 2014

Background:

The Expanded Disability Status Scale (EDSS) has low sensitivity and reliability for detecting sustained disability progression (SDP) in multiple sclerosis (MS) trials.

Objective:

This study evaluated composite disability end points as alternatives to EDSS alone.

Methods:

SDP rates were determined using 96-week data from the Olympus trial (rituximab in patients with primary progressive MS). SDP was analyzed using composite disability end points: SDP in EDSS, timed 25-foot walk test (T25FWT), or 9-hole peg test (9HPT) (composite A); SDP in T25FWT or 9HPT (composite B); SDP in EDSS and (T25FWT or 9HPT) (composite C); and SDP in any two (EDSS, T25FWT, and 9HPT) (composite D).

Results:

Overall agreements between EDSS and other disability measures in defining SDP were 66%−73%. Composite A showed similar treatment effect estimate versus EDSS alone with much higher SDP rates. Composite B, C, and D all showed larger treatment effect estimate with different or similar SDP rates versus EDSS alone. Using composite A (24-week confirmation only), B, C, or D could reduce sample sizes needed for MS trials.

Conclusion:

Composite end points including multiple accepted disability measures could be superior to EDSS alone in analyzing disability progression and should be considered in future MS trials.
Validation of remote mapping of cochlear implants
Authors: Eikelboom Robert H , Jayakody Dona MP , Swanepoel De Wet , Chang Samuel , Atlas Marcus D
Published: March 2014

Recipients of cochlear implants need to attend regular mapping sessions to adjust their speech processors. We developed a PC-based system for remote mapping, which employed voice, video and text communication. Eleven implant recipients had their implant electrodes programmed (mapped) both by conventional methods and remotely. Speech tests, conducted by a family member or research assistant, were used to test the outcome of the programming during the remote consultation. The recipient and audiologist were surveyed regarding aspects of the teleconsultation. There were no significant differences between conventionally and remotely programmed electrode settings. The speech test results were perfect in most cases. The average time to complete the conventional mapping session was 37 min and the average time for the remote mapping session was 42 min ( P = 0.034). Recipients and the audiologist reported favourably on most aspects of the consultations. Lack of synchronisation between voice and video was the most common problem, which disrupted communication. The assistant was important to overcome this problem. All but one participant indicated they would be willing to use tele-mapping in the future. Remote programming of cochlear implants can be conducted reliably with relatively simple equipment, potentially in the homes of remotely located patients assisted by a family member.
Hope and fatigue in chronic illness: The role of perceived stress
Authors: Hirsch Jameson K , Sirois Fuschia M
Published: March 2014

Fatigue is a debilitating symptom of chronic illness that is deleteriously affected by perceived stress, a process particularly relevant to inflammatory disease. Hopefulness, a goal-based motivational construct, may beneficially influence stress and fatigue, yet little research has examined these associations. We assessed the relation between hope and fatigue, and the mediating effect of stress, in individuals with fibromyalgia, arthritis, and inflammatory bowel disease. Covarying age, sex, and pain, stress partially mediated the association between hope and fatigue; those with greater hope reported less stress and consequent fatigue. Therapeutically, bolstering hope may allow proactive management of stressors, resulting in less fatigue.
International medical migration: A critical conceptual review of the global movements of doctors and nurses
Authors: Bradby Hannah
Published: March 2014

This paper critically appraises the discourse around international medical migration at the turn of the 21st century. A critical narrative review of a range of English-language sources, including grey literature, books and research reports, traces the development and spread of specific causative models. The attribution of causative relations between the movement of skilled medical workers, the provision of health care and population health outcomes illustrates how the global reach of biomedicine has to be understood in the context of local conditions. The need to understand migration as an aspect of uneven global development, rather than a delimited issue of manpower services management, is illustrated with reference to debates about ‘brain drain’ of Africa’s health-care professionals, task-shifting and the crisis in health-care human resources. The widespread presumed cause of shortages of skilled health-care staff in sub-Saharan Africa was overdetermined by a compelling narrative of rich countries stealing poor countries’ trained health-care professionals. This narrative promotes medical professional interests and ignores historical patterns of underinvestment in health-care systems and structures. Sociological theories of medicalization suggest that the international marketization of medical recruitment is a key site where the uneven global development of capital is at work. A radical reconfiguration of medical staffing along the lines of ‘task-shifting’ in rich and poor countries’ health-care systems alike offers one means of thinking about global equity in access to quality care.
Object drop in L3 acquisition
Authors: García Mayo María del Pilar , Slabakova Roumyana
Published: March 2014

The topic of cross-linguistic differences regarding the overt or null expression of arguments has been considered both in first (L1) and second language (L2) acquisition. There is abundant literature on both subject and object drop with different language pairings but the issue has not been considered in third language (L3) acquisition. The main goal of this article is to analyse the L3 interlanguage of Basque-Spanish bilinguals regarding the acceptability and interpretation of null objects. The three languages involved in the study display different semantic requirements for the target structure, with Basque allowing for a null object option across-the-board, Spanish only under certain semantic conditions, and English disallowing it in the standard variety. Two trilingual, one bilingual and a control group ( n = 119) rated experimental items embedded in context, presented in a written and aural format on a computer screen. Findings point to the successful acquisition of the target structure, as well as a clear influence of Spanish in the three experimental groups.
Unevenly mixed Romani languages
Authors: Adamou Evangelia , Granqvist Kimmo
Published: March 2014

This study reports on language mixing in two Romani communities, with a century-long presence in Finland and in Greece respectively. A quantitative analysis of free-speech data shows that verbs from the contact languages, Finnish and Turkish, are systematically inserted into a dominant Romani speech with their respective Finnish and Turkish tense, mood, aspect, and person morphology. The insertion in language A of non-integrated single words from language B is atypical for classic code-switching and borrowing, but is a well-known mechanism in the creation of mixed languages. Unlike mixed languages, however, where no single dominant language can be identified, Romani is the main component in the corpora under study. We suggest that this type of Romani language mixing illustrates an early stage of mixed language formation that did not develop into an independent mixed language, owing to changes in the sociopolitical settings.
Work to make simulation work: ‘Realism’, instructional correction and the body in training
Authors: Hindmarsh Jon , Hyland Lewis , Banerjee Avijit
Published: March 2014

This article explores the organization of instructional corrections in pre-clinical dental education. The students are practising manual skills using a simulator and tutors are inspecting and evaluating their progress. Simulators and simulation are critical to the organization of contemporary healthcare training, and the academic literature that explores forms of simulation in healthcare tends to consider the ‘fidelity’ (or ‘realism’) of systems and the extent to which they match the clinical situations that they are designed to mimic. In contrast, this article considers how tutors and students explicitly attend to matters of realism in the course of instructional sequences. We highlight the ways in which tutors routinely invoke ‘real life’ in instructional corrections and we discuss how these sequences reveal the work that tutors undertake to compensate for the ‘chronic insufficiency’ of the simulator. We show how tutors emphasize the reasoned character of manual bodily skills, reasons linked to the complexities and contingencies of clinical practice. To explore these issues and concerns, the article draws on the analysis of audio-visual data of everyday instruction.
Situated abstraction: From the particular to the general in second-order diagnostic work
Authors: Lymer Gustav , Ivarsson Jonas , Rystedt Hans , Johnsson Åse A , Asplund Sara , Båth Magnus
Published: March 2014

The present study examines the work of a group of medical scientists as they identify interpretative ‘pitfalls’ – recurrent sources of error – in the use of a new radiographic technique, formulate suggestions on how these pitfalls can be avoided and communicate their findings in the form of a scientific publication. The analysis focuses on a session in which previously diagnosed cases are discussed, and demonstrates the ways in which a certain source of diagnostic error gradually emerges as a taken-for-granted in the interaction. An increased sense of recognition, recurrence and typicality is discernible in the treatment of the cases. Talk characterized by expansions and elaborations, displays of understanding in the form of reformulations, understanding checks, and so on, leave room for brief typifications and reifications of interpretative difficulties in characteristics of the imaging technique. Topical treatment of perception and interpretation, as well as embodied engagement, become decreasingly salient. It is argued that the abstracted formulations in the published text rely on the case-by-case working up of generality from particularity; from individualized accounts of why ‘I’ interpreted the image in a certain way to proffered generalizations achieved through articulated perceptions of a generalized ‘one’. If these proffers are ratified, a potential ground is established for the consensual formulation of a pitfall. The formulation of novel instructions is consequently made relevant, projecting a re-instructed diagnostic practice.
‘Put your fingers right in here’: Learnability and instructed experience
Authors: Zemel Alan , Koschmann Timothy
Published: March 2014

Examining a fragment of interaction that occurred during a surgery at a teaching hospital, we explore how particular instructed experiences are produced for two trainees, a surgeon in the residency program and a medical student in a surgical clerkship. We are concerned with what is produced as learnable in each case. Stated slightly differently, we are interested in the ways in which the attending surgeon uses demonstrations as instruction and the ways in which recipients of that instruction, in this case the resident and the clerk, respond with enactments of those demonstrated actions. The recipients of this kind of instruction participate in a form of experiential learning in which they enact their own versions of the instructor’s demonstrated actions to be observed and assessed by the instructor. These enactments provide learners with experiential access to the instructor’s demonstrated actions. They are designed to be experiences that learners may draw upon to make experientially warranted claims at some later time.
Herculine Barbin and the omission of biopolitics from Judith Butler’s gender genealogy
Authors: Repo Jemima
Published: March 2014

This article argues that Judith Butler’s neglect of biopolitics in her reading of Michel Foucault’s work on sexuality leads her to propose a genealogy of gender ontology rather than conduct a genealogy of gender itself. Sex was not an effect of a cultural system for Foucault, but an apparatus of biopower that emerged in the eighteenth century for the administration of life. Butler, however, is interested in uncovering how something we call or identify as gender manifests itself in different times and contexts, rather than asking what relations of power made necessary the emergence of gender as a discourse. After examining the theoretical configurations underpinning Butler’s engagement with Foucault’s Herculine Barbin, I suggest a more biopolitically informed reading of how the material body becomes captured by the discourses of sexuality and sex. Finally, the article sets out preliminary questions with which a more strictly Foucauldian genealogy of gender might be conducted.
The times we’re in: Queer feminist criticism and the reparative ‘turn’
Authors: Wiegman Robyn
Published: March 2014

This article examines the reparative turn in current queer feminist scholarship by tracking its twin interest in the study of affect and time. By foregrounding Eve Kosofsky Sedgwick’s influential critique of what she called paranoid reading, I am interested in the ways that various critics – Ann Cvetkovich, Heather Love, and Elizabeth Freeman in particular – take up the call for reparative reading by using the temporal frameworks of the everyday, backward feeling, and queer time to reparative ends. In the process, I consider the reparative work being done to reclaim Sedgwick as a major thinker for queer feminist concerns, and speculate on the attraction, in a time of declining economic and cultural support for the interpretative humanities, of a critical practice that seeks to love and nurture its objects of study.
You are either with us or with us: Constructing a Samoan national identity through inclusion at the Samoa Observer
Authors: Kenix Linda Jean
Published: March 2014

Much research examining the mediated construction of national identity is qualitatively focused, exploring limited factors, asserting that exclusion/inclusion is essential for its formation, and based within the host country. This study creates a framework of micronarratives to quantitatively measure the constructed national identity of a small Pacific Island from three geographically distinct news outlets. This study suggests that the mediated creation of a national identity does not necessarily depend upon the exclusion of others and that future research should reconsider the mediated construction of national identity for cultures that celebrate different values.
Left Hemispheric Imbalance and Reward Mechanisms Affect Gambling Behavior
Authors: Balconi Michela , Finocchiaro Roberta , Canavesio Ylenia
Published: March 2014

The present research used the Iowa Gambling Task to test the effect of the reward-sensitivity Behavioral Activation System–Reward (BAS-Reward) construct on the ability to distinguish between high- and low-risk decisions. To elucidate the individual differences that influence the decisional processes, making the strategies more or less advantageous, we considered the impact of the BAS motivational system and the frontal left and right cortical activity on subjects’ decisions. More specifically, the lateralization effect, which is related to the increased activation of the left (BAS-Reward-related) hemisphere, was explored by using frequency band analysis. Specifically, behavioral responses (gain/loss options), metacognition, and delta, theta, alpha, and beta band modulation (asymmetry index) were considered. Thirty subjects were divided into high-BAS and low-BAS groups. In comparison with low-BAS, the high-BAS group showed an increased tendency to opt in favor of the immediate reward (losing strategy) instead of the long-term option (winning strategy), and members of this group were more impaired in metacognitive monitoring of their strategies and showed an increased left hemisphere activation when they responded to losing choices. A “reward bias” effect was hypothesized to act for high BAS, based on a left-hemisphere hyperactivation.
Lack of Prominent Cognitive Regression in the Long-term Outcome of Patients Having Electrical Status Epilepticus During Sleep With Different Types of Epilepsy Syndromes
Authors: Bebek Nerses , Gürses Candan , Baykan Betül , Gökyiğit Aysen
Published: March 2014

The purpose was to document 4 patients with different epilepsy syndromes, showing electrical status epilepticus during sleep (ESES), without marked cognitive and behavioral regression in the long-term follow-up. The mean age at onset of seizures was 8 years. Absences, myoclonic, focal motor, or generalized tonic - clonic seizures and drop attacks were the prominent seizure types. The neurological examination and neuroimaging findings revealed no abnormality. Focal epileptiform electroencephalographic (EEG) activity was seen in 3 cases, whereas generalized photosensitive epileptic discharges were detected in 1 patient with juvenile myoclonic epilepsy. Neuropsychological evaluations of all cases were within the normal range, and deterioration in mental status was not observed during their mean follow-up duration of 14 years. Our data support the view that ESES can emerge along with different types of childhood epilepsy syndromes, including idiopathic generalized epilepsies, and may not always be a poor prognostic factor.
Defensive Soccer Players’ Decision Making
Authors: Kermarrec Gilles , Bossard Cyril
Published: March 2014

The aim of this study was to describe the decision making of professional defensive football players according to the recognition-primed decision (RPD) model and to investigate relationships between their recognition processes and use of salient situational features in a naturalistic setting. Behavioral data were obtained from video recordings of four high-level football players in a top-level game, supplemented by verbal data collected during video-cued recall interviews, with the players watching the videotapes. Seven critical defensive stages in one game were studied. The data were analyzed using content analysis in relation to the RPD model in five steps. Considering the salient features the athletes used, 112 decisions were classified into three types of processes and eight typical decisions for defensive stages. These findings are discussed from three perspectives: the salient features the athletes used to assess the situation, the recognition processes of expert sport players’ decision making, and future directions for research and decision-making training.
Therapeutic efficacy of vacuum-assisted-closure therapy in the treatment of lymphatic complications following peripheral vascular interventions and surgeries
Authors: Aydin Ufuk , Gorur Alper , Findik Orhan , Yildirim Abdullah , Kocogullari Cevdet Ugur
Published: March 2014

Objectives

Lymphatic complications, lymphocele and lymphorrhea being the leading, are generally encountered after vascular interventions and surgeries. The present study aimed to evaluate the outcomes of vacuum-assisted-closure (VAC) therapy, which we frequently prefer as the first-choice treatment for such complications.

Materials and methods

Among patients undergoing peripheral vascular intervention or surgery between January 2008 and February 2012, the medical files of 21 patients who received VAC therapy or other treatment due to symptomatic lymphatic complications were retrospectively analyzed and the results were discussed.

Results

Group I consisted of 10 patients (three with lymphocele and seven with lymphorrhea) who underwent VAC therapy as the first-choice treatment, Group II consisted of 11 patients of which 7 patients received various therapies before VAC therapy and 4 patients received other treatments alone. The patients who received VAC therapy as the primary therapy demonstrated more rapid wound healing, early drainage control, and shorter hospital stay. The mean hospital medical cost was €1038 (range, €739–1826) for the patients who primarily underwent VAC therapy; it was calculated to be €2137 (range, €1610–3130) for the other patients ( p = 0.001).

Conclusion

In addition to its safety and good clinical outcomes, VAC therapy also has economic advantages and should be the primary method for the treatment of lymphatic complications.
Techniques to measure free-living energy expenditure during pregnancy – A guide for clinicians and researchers
Authors: Abeysekera Minoli V , Morris Jack A , O'Sullivan Anthony J
Published: March 2014

As maternal overweight and obesity increase in prevalence, the need to optimise gestational weight gain has entered the forefront due to the well-documented poor fetal and maternal outcomes associated with excess adipose tissue. Measurements of changes in energy expenditure form crucial components of effective weight management programmes, and they are also important for clarifying the energy requirements of pregnancy. This review evaluates the primary techniques for measuring free-living energy expenditure for use in pregnancy, with special consideration of the dynamic physiological changes that occur in this state. The methods that will be discussed include the doubly labelled water method, activity recall and activity logs, heart rate monitors and motion sensors. This article may be useful for clinicians seeking to implement active gestational weight management by enabling advice on increases in caloric intake linked to measured changes in energy expenditure, and for researchers studying energy metabolism in pregnancy.
Elobixibat and its potential role in chronic idiopathic constipation
Authors: Acosta Andres , Camilleri Michael
Published: March 2014

Chronic idiopathic constipation is highly prevalent among adults. Bile acids (BAs) and the enterohepatic BA circulation modulate colonic secretion and motility that affect transit. BAs in the colon have a dual action as osmotic and stimulant agents. Newer agents, such as elobixibat (A3309), an inhibitor of the ileal BA transporter, have the potential to improve significantly the management of chronic constipation, with minimal adverse effects. Elobixibat modulates the enterohepatic BA circulation, enhancing the delivery of BAs to the colon where they induce secretory and motor effects. Secondary effects of the inhibition of BA absorption are reduced activation of the farnesoid X receptor, decreased secretion of fibroblast growth factor-19 into the portal circulation, and increased BA synthesis. This review focuses on the role of BAs, the enterohepatic BA circulation, and an ileal BA transporter inhibitor (elobixibat) in chronic constipation.
Family practice in Turkey
Authors: Ozsahin Akatli Kursad
Published: March 2014

The national project ‘Transformation in Health’ was started in 2005 to provide expert primary care by family physicians, and decrease expenses in Turkey. The number of family physicians was far below the need, so public physicians were promoted to family physician status after a 10-day intensive course. The government declared some satisfactory results, but privately paid family physicians were not accepted into the system. Furthermore, the government stopped paying for their services from private settings. Some family physicians became unemployed as the major payer for all forms of medical care in Turkey denied their services.

The process showed it’s value in time. Nevertheless, family physicians should be the core of this transformation as family medicine is an academic and a scientific discipline and a primary care-oriented specialty with its own specific educational content, research and base of evidence, which cannot be achieved through standard medical education.
Faecal incontinence: A life-course approach
Authors: Maior Oana , Cumming Grant , Guerrero Karen
Published: March 2014

Faecal incontinence is under-reported and under-diagnosed. It is associated with negative social and psychological sequelae and reduced quality of life. Timely intervention potentially reduces its adverse impact throughout the life-course as most cases are potentially treatable. This review provides a summary of pre-disposing factors. It offers an overview of preventative and treatment options within the community setting, with signposting to further reading and a call to further research into this area of women’s health.
Complementary and Alternative Medicine for Posttraumatic Stress Disorder Symptoms: A Systematic Review
Authors: Wahbeh Helané , Senders Angela , Neuendorf Rachel , Cayton Julien
Published: March 2014

Objectives.

To (1) characterize complementary and alternative medicine studies for posttraumatic stress disorder symptoms, (2) evaluate the quality of these studies, and (3) systematically grade the scientific evidence for individual CAM modalities for posttraumatic stress disorder.

Design.

Systematic review. Eight data sources were searched. Selection criteria included any study design assessing posttraumatic stress disorder outcomes and any complementary and alternative medicine intervention. The body of evidence for each modality was assessed with the Natural Standard evidence-based, validated grading rationale.

Results and Conclusions.

Thirty-three studies (n = 1329) were reviewed. Scientific evidence of benefit for posttraumatic stress disorder was strong for repetitive transcranial magnetic stimulation and good for acupuncture, hypnotherapy, meditation, and visualization. Evidence was unclear or conflicting for biofeedback, relaxation, Emotional Freedom and Thought Field therapies, yoga, and natural products. Considerations for clinical applications and future research recommendations are discussed.
Identification and functional characterization of a flax UDP-glycosyltransferase glucosylating secoisolariciresinol (SECO) into secoisolariciresinol monoglucoside (SMG) and diglucoside (SDG)
Authors: Ghose Kaushik , Selvaraj Kumarakurubaran , McCallum Jason , Kirby Chris W , Sweeney-Nixon Marva , Cloutier Sylvie J , Deyholos Michael , Datla Raju , Fofana Bourlaye
Published: March 2014

Background

Lignans are a class of diphenolic nonsteroidal phytoestrogens often found glycosylated in planta. Flax seeds are a rich source of secoisolariciresinol diglucoside (SDG) lignans. Glycosylation is a process by which a glycosyl group is covalently attached to an aglycone substrate and is catalyzed by uridine diphosphate glycosyltransferases (UGTs). Until now, very little information was available on UGT genes that may play a role in flax SDG biosynthesis. Here we report on the identification, structural and functional characterization of 5 putative UGTs potentially involved in secoisolariciresinol (SECO) glucosylation in flax.

Results

Five UGT genes belonging to the glycosyltransferases’ family 1 (EC 2.4.x.y) were cloned and characterized. They fall under four UGT families corresponding to five sub-families referred to as UGT74S1, UGT74T1, UGT89B3, UGT94H1, UGT712B1 that all display the characteristic plant secondary product glycosyltransferase (PSPG) conserved motif. However, diversity was observed within this 44 amino acid sequence, especially in the two peptide sequences WAPQV and HCGWNS known to play a key role in the recognition and binding of diverse aglycone substrates and in the sugar donor specificity. In developing flax seeds, UGT74S1 and UGT94H1 showed a coordinated gene expression with that of pinoresinol-lariciresinol reductase (PLR) and their gene expression patterns correlated with SDG biosynthesis. Enzyme assays of the five heterologously expressed UGTs identified UGT74S1 as the only one using SECO as substrate, forming SECO monoglucoside (SMG) and then SDG in a sequential manner.

Conclusion

We have cloned and characterized five flax UGTs and provided evidence that UGT74S1 uses SECO as substrate to form SDG in vitro. This study allowed us to propose a model for the missing step in SDG lignan biosynthesis.
Addressing the needs of traumatic brain injury with clinical proteomics
Authors: Shen Sean , Loo Rachel R Ogorzalek , Wanner Ina-Beate , Loo Joseph A
Published: March 2014

Background

Neurotrauma or injuries to the central nervous system (CNS) are a serious public health problem worldwide. Approximately 75% of all traumatic brain injuries (TBIs) are concussions or other mild TBI (mTBI) forms. Evaluation of concussion injury today is limited to an assessment of behavioral symptoms, often with delay and subject to motivation. Hence, there is an urgent need for an accurate chemical measure in biofluids to serve as a diagnostic tool for invisible brain wounds, to monitor severe patient trajectories, and to predict survival chances. Although a number of neurotrauma marker candidates have been reported, the broad spectrum of TBI limits the significance of small cohort studies. Specificity and sensitivity issues compound the development of a conclusive diagnostic assay, especially for concussion patients. Thus, the neurotrauma field currently has no diagnostic biofluid test in clinical use.

Content

We discuss the challenges of discovering new and validating identified neurotrauma marker candidates using proteomics-based strategies, including targeting, selection strategies and the application of mass spectrometry (MS) technologies and their potential impact to the neurotrauma field.

Many studies use TBI marker candidates based on literature reports, yet progress in genomics and proteomics have started to provide neurotrauma protein profiles. Choosing meaningful marker candidates from such ‘long lists’ is still pending, as only few can be taken through the process of preclinical verification and large scale translational validation. Quantitative mass spectrometry targeting specific molecules rather than random sampling of the whole proteome, e.g., multiple reaction monitoring (MRM), offers an efficient and effective means to multiplex the measurement of several candidates in patient samples, thereby omitting the need for antibodies prior to clinical assay design. Sample preparation challenges specific to TBI are addressed. A tailored selection strategy combined with a multiplex screening approach is helping to arrive at diagnostically suitable candidates for clinical assay development. A surrogate marker test will be instrumental for critical decisions of TBI patient care and protection of concussion victims from repeated exposures that could result in lasting neurological deficits.
Evaluation of the efficacy of DDT indoor residual spraying and long-lasting insecticidal nets against insecticide resistant populations of Anopheles arabiensis Patton (Diptera: Culicidae) from Ethiopia using experimental huts
Authors: Asale Abebe , Getachew Yehenew , Hailesilassie Weriessaw , Speybroeck Niko , Duchateau Luc , Yewhalaw Delenasaw
Published: March 2014

Background

Indoor Residual Spraying (IRS) and Long-Lasting Insecticidal nets (LLINs) are major malaria vector control tools in Ethiopia. However, recent reports from different parts of the country showed that populations of Anopheles arabiensis, the principal malaria vector, have developed resistance to most families of insecticides recommended for public health use which may compromise the efficacy of both of these key vector control interventions. Thus, this study evaluated the efficacy of DDT IRS and LLINs against resistant populations of An. arabiensis using experimental huts in Asendabo area, southwestern Ethiopia.

Methods

The susceptibility status of populations of An. arabiensis was assessed using WHO test kits to DDT, deltamethrin, malathion, lambda-cyhalothrin, fenitrothion and bendiocarb. The efficacy of LLIN (PermaNet® 2.0), was evaluated using the WHO cone bioassay. Moreover, the effect of the observed resistance against malaria vector control interventions (DDT IRS and LLINs) were assessed using experimental huts.

Results

The findings of this study revealed that populations of An. arabiensis were resistant to DDT, deltamethrin, lambda-cyhalothrin and malathion with mortality rates of 1.3%, 18.8%, 36.3% and 72.5%, respectively but susceptible to fenitrothion and bendiocarb with mortality rates of 98.81% and 97.5%, respectively. The bio-efficacy test of LLIN (PermaNet® 2.0) against An. arabiensis revealed that the mosquito population showed moderate knockdown (64%) and mortality (78%). Moreover, mosquito mortalities in DDT sprayed huts and in huts with LLINs were not significantly different (p > 0.05) from their respective controls.

Conclusion

The evaluation of the efficacy of DDT IRS and LLINs using experimental huts showed that both vector control tools had only low to moderate efficacy against An. arabiensis populations from Ethiopia. Despite DDT being replaced by carbamates for IRS, the low efficacy of LLINs against the resistant population of An. arabiensis is still a problem. Thus, there is a need for alternative vector control tools and implementation of appropriate insecticide resistance management strategies as part of integrated vector management by the national malaria control program.