bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensitivity and specificity of histology for diagnoses of four common pathogens and detection of nontarget pathogens in adult Chinook salmon (Oncorhynchus tshawytscha) in fresh water
Authors: Kent Michael L. , Benda Susan , St-Hilaire Sophie , Schreck Carl B.
Published: March 2013

Histology is often underutilized in aquatic animal disease screening and diagnostics. The agreement between histological classifications of infection and results using diagnostic testing from the American Fisheries Society’s Blue Book was conducted with 4 common salmon pathogens: Aeromonas salmonicida, Renibacterium salmoninarum, Ceratomyxa shasta, and Nanophyetus salmincola. Adult Chinook salmon ( Oncorhynchus tshawytscha) in Oregon were evaluated, and agreement between tests was calculated. Live and dead (both pre- and postspawning) salmon were collected from the Willamette River, Oregon, its tributaries, the Willamette Hatchery, and after holding in cool, pathogen-free water during maturation at Oregon State University. Sensitivity and specificity of histology compared to Blue Book methods for all fish, live fish only, and dead (pre- and postspawned combined) fish only were, respectively, as follows: A. salmonicida ( n = 105): specificity 87.5%, 87.5%, 87.5% and sensitivity 38.6%, 14.8%, 60.0%; R. salmoninarum ( n = 111): specificity 91.9%, 85.7%, 97.7% and sensitivity 16.0%, 7.1%, 27.2%; C. shasta ( n = 136): specificity 56.0%, 63.3%, 28.6% and sensitivity 83.3%, 86.2%, 71.4%; N. salmincola ( n = 228): specificity 68.2%, 66.7%, not possible to calculate for dead fish and sensitivity 83.5%, 80.5%, 87.3%. The specificity was good for bacterial pathogens. This was not the case for C. shasta, likely due to detection of presporogenic forms only by histology. Sensitivity of histology for bacterial pathogens was low with the exception of dead fish with A. salmonicida. Kappa analysis for agreement between Blue Book and histology methods was poor to moderate. However, histological observations revealed the presence of other pathogens that would not be detected by other methods.
Measuring the Impact of Health Education Modules in Cameroon, West Africa
Authors: Chaponniere Paulette A. , Cherup Susan M. , Lodge Lillie
Published: March 2013

Each year, more than two million people die from diarrhea-associated diseases. Although there is a global need for safe drinking water, culturally appropriate health teaching is essential to behavior change. This study evaluated the impact of a health education program in a small rural community in Cameroon. Flash cards and a modified version of the CDC-KPC 2000 survey were used to collect data in 57 homes. Children who lived in households with working Manz BioSand filters were less likely to have had diarrhea in the 2 weeks prior to the evaluation. There remained a gap between health knowledge and healthy behaviors for hand hygiene and malaria prevention. This gap was significant in the diarrheal treatment (McNemar’s test, p < .000). The interdisciplinary program and 7-year time frame were crucial to sustainability. Faculty and students learned the importance of pairing service learning and research that respect local cultures in fostering a healthier global community.
Evaluation of a Multicomponent Online Communication Professional Development Program for Early Interventionists
Authors: Brown Jennifer A. , Woods Juliann J.
Published: March 2013

Collaborative early intervention (EI) service delivery is enhanced by professional development focused on knowledge and skills in the content and process of delivering services. This article describes a multicomponent online professional development course designed to build infant toddler specialists’ capacity to support children with communication needs and their families. A preliminary program evaluation approach was used to examine the impact, feasibility, and provider satisfaction of the initial implementation of the course. Findings indicated that providers enhanced their knowledge and skills in communication development and intervention and applied those skills within family-centered services in natural environments. Specifically, they demonstrated course competencies in identifying communication acts, developing intervention targets, and planning communication-promoting strategies within the context of coaching caregivers in activities and routines. Implications of professional development designed within the framework of adult learning principles, evidence-based content, and empirically supported instructional methods are presented in relation to the effectiveness of EI.
Nonlinear Frequency Compression
Authors: Parsa Vijay , Scollie Susan , Glista Danielle , Seelisch Andreas
Published: March 2013

Frequency lowering technologies offer an alternative amplification solution for severe to profound high frequency hearing losses. While frequency lowering technologies may improve audibility of high frequency sounds, the very nature of this processing can affect the perceived sound quality. This article reports the results from two studies that investigated the impact of a nonlinear frequency compression (NFC) algorithm on perceived sound quality. In the first study, the cutoff frequency and compression ratio parameters of the NFC algorithm were varied, and their effect on the speech quality was measured subjectively with 12 normal hearing adults, 12 normal hearing children, 13 hearing impaired adults, and 9 hearing impaired children. In the second study, 12 normal hearing and 8 hearing impaired adult listeners rated the quality of speech in quiet, speech in noise, and music after processing with a different set of NFC parameters. Results showed that the cutoff frequency parameter had more impact on sound quality ratings than the compression ratio, and that the hearing impaired adults were more tolerant to increased frequency compression than normal hearing adults. No statistically significant differences were found in the sound quality ratings of speech-in-noise and music stimuli processed through various NFC settings by hearing impaired listeners. These findings suggest that there may be an acceptable range of NFC settings for hearing impaired individuals where sound quality is not adversely affected. These results may assist an Audiologist in clinical NFC hearing aid fittings for achieving a balance between high frequency audibility and sound quality.
A Systematic Review of Electric-Acoustic Stimulation
Authors: Incerti Paola V. , Ching Teresa Y. C. , Cowan Robert
Published: March 2013

Cochlear implant systems that combine electric and acoustic stimulation in the same ear are now commercially available and the number of patients using these devices is steadily increasing. In particular, electric-acoustic stimulation is an option for patients with severe, high frequency sensorineural hearing impairment. There have been a range of approaches to combining electric stimulation and acoustic hearing in the same ear. To develop a better understanding of fitting practices for devices that combine electric and acoustic stimulation, we conducted a systematic review addressing three clinical questions: what is the range of acoustic hearing in the implanted ear that can be effectively preserved for an electric-acoustic fitting?; what benefits are provided by combining acoustic stimulation with electric stimulation?; and what clinical fitting practices have been developed for devices that combine electric and acoustic stimulation? A search of the literature was conducted and 27 articles that met the strict evaluation criteria adopted for the review were identified for detailed analysis. The range of auditory thresholds in the implanted ear that can be successfully used for an electric-acoustic application is quite broad. The effectiveness of combined electric and acoustic stimulation as compared with electric stimulation alone was consistently demonstrated, highlighting the potential value of preservation and utilization of low frequency hearing in the implanted ear. However, clinical procedures for best fitting of electric-acoustic devices were varied. This clearly identified a need for further investigation of fitting procedures aimed at maximizing outcomes for recipients of electric-acoustic devices.
Young People’s Uses and Understandings of Online Social Networks in Their Everyday Lives
Authors: Awan Fatimah , Gauntlett David
Published: March 2013

This article examines young people’s uses and understandings of social networking sites and instant messaging tools within the context of their everyday lives. It draws upon data from the Arts and Humanities Research Council (AHRC)-funded qualitative study, ‘Young people’s creative understanding of their mediaworlds’ (2008–10), in which young people aged 14–15 from six locations across England created ‘identity boxes’ which were meant to reflect their identities and the place of media in their lives. The results demonstrate that young people considered and negotiated their online practices in relation to three primary areas: ‘Connecting and convenience’, ‘Openness and control’ and ‘Privacy and authenticity’. In doing so the article reveals nuanced insights into young people’s online media use and communication, and contributes empirically to knowledge about young people’s online practices within their everyday lives.
Does Working Hard in School Explain Performance Differences between Girls and Boys? A Questionnaire-based Study Comparing Pakistani Students with Majority Group Students in the City of Oslo
Authors: Borg Elin
Published: March 2013

This study examines how working hard in school contributes to explaining gender differences in academic achievement between students of Norwegian ( n = 8,002) and Pakistani ( n = 862) descent in secondary schools in Oslo, Norway. Path analyses show that reported school effort explains a significant part of the gender differences in school achievement for the Pakistani sample, but not as much of the gender variation in the ethnic Norwegian sample. Working hard in school is characteristic for the Pakistani sample, especially the girls. Explanations that may account for the differences in the two samples are discussed, with particular emphasis on cultural distinctions in such areas as being native within a culture, expectations and pressure from home, social control and self-reporting.
Joining in on Different Terms—Dealing with Poverty in School and among ‘Peers’
Authors: Fernqvist Stina
Published: March 2013

The aim of this article is to discuss how economic hardship is experienced in school and among same-aged groups, and to explore how children and youth affected by poverty manage their situation in the school setting. In relation to this, I problematize the relevance of the stigma concept and the ‘peer group’ concept. The article takes its starting point in childhood sociology, and is based on an interview study involving 17 children and young people, between the ages of 6 and 18, who live in economic hardship. I argue that the accounts of experiencing and dealing with poverty in school show the complexity of this issue, which leads to a re-exanimation of how economic hardship among children and young people is understood.
Quality Spirals and Vicious Circles among Children of Immigrant Entrepreneurs: How Immigrant Entrepreneurs’ Resources are Remoulded by the Second Generation
Authors: Gudmundsson Gestur
Published: March 2013

This article investigates educational aspirations and attainments among children of immigrant entrepreneurs in the food business. It reports some of the results of the European research project Ethnogeneration, which conducted biographical, problem-centred interviews with 101 families in five European cities. The overarching research question of the project addresses the consequences of self-employment for the well-being of the second generation. This article examines the sub-question concerning the relation between educational trajectories of second generation immigrants and their upbringing in the immigrant families running food businesses. An inductive analysis of the interviews reveals that this relation can be both ‘virtuous’ and ‘vicious’ and identifies elements and mechanisms that contribute to both outcomes and to a couple of mixtures. The analysis evokes theoretical explanation, involving mainly theories of situated learning, social capital, cultural capital and transmission/transformation.
Physical activity intensity and cardiovascular risk by ankle–brachial index
Authors: Hawkins Marquis S , Gabriel Kelley Pettee , Conroy Molly B , Cooper Jennifer , Sutton-Tyrrell Kim
Published: March 2013

A low ankle–brachial index (ABI) is associated with increased risk for cardiovascular events and mortality. Physical inactivity in individuals with a low ABI may further increase their risk for cardiovascular events. The purpose of this paper is to examine the relationship between the intensity of free-living physical activity and cardiovascular disease (CVD) risk by ABI status. During 2003–2004, the National Health and Nutrition Examination Survey included an accelerometer module and collected ABI data. Individuals were classified as having a normal (1–1.4) or low (< 1) ABI. The Framingham risk score (FRS) was used to determine CVD risk. Multiple linear regression was used to determine the association of total accelerometer counts and time spent at various physical activity intensity levels with FRS by ABI groups. Individuals with a low ABI spent less time engaging in moderate-to-vigorous intensity physical activity (MVPA) (9.1 min/day vs 13.2 min/day; p = 0.06) when compared to those with a normal ABI. There were no differences in light intensity physical activity (LPA) or sedentary behavior between ABI groups. Total accelerometer counts were inversely related to FRS. MVPA, but not LPA, was inversely related to FRS in both normal and low ABI groups ( p < 0.001 and p = 0.001, respectively). In conclusion, these findings suggest that even modestly higher levels of physical activity may be beneficial for secondary risk prevention in this high-risk group.
Management of schizophrenia: clinical experience with asenapine
Authors: Cortese Leonardo , Bressan Rodrigo A , Castle David J , Mosolov Sergey N
Published: March 2013

Schizophrenia is a chronic brain disorder comprising a range of clinical features, including positive and negative symptoms, cognitive dysfunction and mood symptoms (particularly depression and anxiety). The management of schizophrenia requires effective short- and long-term treatment with antipsychotic medication that is effective across these symptom domains, while being well tolerated over the long term. Asenapine is the first tetracyclic atypical antipsychotic to be licensed in the USA and several other countries outside Europe for the acute and maintenance treatment of schizophrenia in adults. It has a unique receptor-binding profile and a broad range of therapeutic effects. Since clinical trials are conducted under strict conditions in tightly defined patient populations, evidence of an agent’s efficacy and tolerability under ‘real-world’ clinical practice conditions is also required. As in clinical trials, real-life case reports demonstrate that asenapine is effective in treating the positive symptoms of schizophrenia, both in the acute setting and for relapse prevention. It is also effective in treating negative symptoms and shows promise in the treatment of depressive symptoms associated with schizophrenia. Asenapine has a favourable tolerability profile, having a minimal impact on weight and metabolic parameters. As such, asenapine is valuable option for the treatment of schizophrenia in adults.
Use of asenapine in clinical practice for the management of bipolar mania
Authors: Young Allan H , Altamura Alfredo Carlo , González-Pinto Ana M , Millet Bruno , Wiedemann Klaus
Published: March 2013

Bipolar disorder is a chronic mental illness associated with high levels of somatic morbidity, comorbidity and mortality. Treatment guidelines for bipolar mania generally recommend initiating first-line therapy with a second-generation antipsychotic or mood stabiliser, either alone or in combination. Asenapine is a second-generation antipsychotic with a unique receptor binding profile, licensed for the treatment of manic episodes in adults with bipolar I disorder. ‘Real-world’ data are needed to complement evidence from clinical trials, in order to provide clinicians with pragmatic information regarding the likely risks and benefits of using a new agent in clinical practice. Evidence from real-world case reports demonstrates that – as in clinical trials – asenapine is effective in treating mania and mixed episodes associated with bipolar I disorder, whether used as monotherapy or in combination with a mood stabiliser. It has a rapid onset of antimanic effect and an early improvement is associated with treatment outcome. Asenapine also shows promise in controlling depressive symptoms and clinically challenging mixed states. Asenapine has a favourable tolerability profile, compared with other first-line agents, having a minimal impact on weight and metabolic parameters. Asenapine should be considered a first-line treatment option for adults with bipolar I disorder.
Adaptation of the “ten questions” to screen for autism and other neurodevelopmental disorders in Uganda
Authors: Kakooza-Mwesige Angelina , Ssebyala Keron , Karamagi Charles , Kiguli Sarah , Smith Karen , Anderson Meredith C , Croen Lisa A , Trevathan Edwin , Hansen Robin , Smith Daniel , Grether Judith K
Published: March 2013

Neurodevelopmental disorders are recognized to be relatively common in developing countries but little data exist for planning effective prevention and intervention strategies. In particular, data on autism spectrum disorders are lacking. For application in Uganda, we developed a 23-question screener (23Q) that includes the Ten Questions screener and additional questions on autism spectrum disorder behaviors. We then conducted household screening of 1169 children, 2–9 years of age, followed by clinical assessment of children who screened positive and a sample of those who screened negative to evaluate the validity of the screener. We found that 320 children (27% of the total) screened positive and 68 children received a clinical diagnosis of one or more moderate to severe neurodevelopmental disorders (autism spectrum disorder; cerebral palsy; epilepsy; cognitive, speech and language, hearing, or vision impairment), including 8 children with autism spectrum disorders. Prevalence and validity of the screener were evaluated under different statistical assumptions. Sensitivity of the 23Q ranged from 0.55 to 0.80 and prevalence for ≥1 neurodevelopmental disorders from 7.7/100 children to 12.8/100 children depending on which assumptions were used. The combination of screening positive on both autism spectrum disorders and Ten Questions items was modestly successful in identifying a subgroup of children at especially high risk of autism spectrum disorders. We recommend that autism spectrum disorders and related behavioral disorders be included in studies of neurodevelopmental disorders in low-resource settings to obtain essential data for planning local and global public health responses.
Penal optimism and second chances: The legacies of American Protestantism and the prospects for penal reform
Authors: Green David A
Published: March 2013

This article first makes the case that optimism in the reform potential of criminal offenders has recently increased among American policymakers, as evidenced by the bipartisan passage of the Second Chance Act of 2007, which encourages prisoner reentry and sets ambitious targets for recidivism reduction. It then sets this apparent renewal of ‘penal optimism’ in historical context by drawing on American evangelical Protestant traditions and examining how these affect contemporary perceptions of the redeemability of criminal offenders. One aim is to acquaint criminologists with the discourse of evangelical Protestantism, a significant and driving force in contemporary penal reform efforts – particularly in the realm of prisoner reentry – by outlining key religious concepts and their implications for penal discourse and policy.
Early desistance narratives: A qualitative analysis of probationers’ transitions towards desistance
Authors: King Sam
Published: March 2013

The importance of life scripts and identity change in the desistance process has been well documented in recent years. Such scripts involve the construction of a narrative which leads the would-be desister towards a new non-offending identity. Accounts of these subjective changes are frequently regarded in the existent literature as being the culmination of the desistance process – the final phase in the journey away from crime. This article examines the role of narrative and identity change from the perspective of individuals who might be considered to be in the primary desistance phase of the journey away from crime. The article presents findings from a qualitative study of early transitions towards desistance, among a group of males under probation supervision. It is argued that identity reconstruction begins during the early phases of desistance, and recommendations are made in relation to policy and practice.
Beyond criminocentric dogmatism: Mapping institutional forms of punishment in contemporary societies
Authors: Velloso João Gustavo Vieira
Published: March 2013

This article aims to question the role criminal justice and criminal law play in structuring the set of dominant conditioning questions in criminology. Based on socio-legal approaches and past fieldwork in immigration control, I argue that the punitive use of non-criminal-based normative systems (such as immigration law) is not a new trend and that, therefore, we are not assisting a ‘criminal contamination’ of other justice systems, but the re-emergence and consolidation of different punitive logics. In that sense, I suggest that criminal justice acts as an epistemological obstacle, being a major barrier to perceive such nuances. Instead, I propose a wider conception of the penal field which operates as a mobile (kinetic sculpture) and includes the criminal law realm, but also other institutional normative systems that configure ‘less’ prominent locations of punishment, such as: regulatory criminal law, civil courts, immigration law, military law, parole boards and other administrative legal systems that play an increasing role in social reaction. I ultimately argue that criminologists should also focus on such administrative-based justice systems in order to better address and resist punitiveness.
Numerical analysis on dynamic properties of tripod sliding universal joints
Authors: Wang Xuefeng , Hu Rufu , Wang Mingjun , Cui Hairong
Published: March 2013

In order to understand the dynamics of the tripod sliding universal joint, its dynamic equations were established and then the effects of the joint angle, the rotating radius and mass of the slide rods, the lengths of the input and output shafts and the frequency of the input shaft on its dynamics were investigated. The increase in the mass or rotating radius of the slide rods enhances the amplitudes of all dynamic curves and so does the frequency of the input shaft. Increasing length of the output shaft weakens the amplitudes of the forces and torques at the revolute and spherical pairs as well as the amplitude of the load torque but this length hardly affects the amplitudes of the forces at the tripod arm and the holes of the input shaft. The forces at the holes of the input shaft hardly depend on the joint angle whereas the amplitudes of the remaining dynamic curves increase with the increase of the joint angle. The amplitudes of two torques of the revolute pair increase with increasing length of the input shaft but the remaining forces (torques) are almost independent of its length.
Impact of electrocardiographic findings for diagnosis of left ventricular hypertrophy in patients with primary aldosteronism
Authors: Kurisu Satoshi , Iwasaki Toshitaka , Mitsuba Naoya , Ishibashi Ken , Dohi Yoshihiro , Kihara Yasuki
Published: March 2013

Background:

Compared to patients with similar levels of hypertension, patients with primary aldosteronism have a greater left ventricular hypertrophy (LVH). The presence of LVH should be detected as early as possible to prevent cardiovascular complications associated with the condition. We evaluated comparative diagnostic value of electrocardiographic (ECG) indexes for LVH in patients with primary aldosteronism.

Methods:

ECG and echocardiographic data were obtained in 88 patients with primary aldosteronism. We analyzed the four most commonly used ECG indexes, including Sokolow-Lyon index, Cornell voltage index, Cornell product index, and Gubner index.

Results:

Echocardiographic LVH was found in 35 patients (40%). Sensitivity ranged from 0% for Gubner index to 49% for Cornell product index. Specificity ranged from 81% for Sokolow-Lyon index to 100% for Gubner index. Sokolow-Lyon index ( r=0.43, p<0.001), Cornell voltage index ( r=0.55, p<0.001) and Cornell product index ( r=0.52, p<0.001) correlated significantly with left ventricular mass (LVM) index. No significant correlation was found between Gubner index and LVM index.

Conclusions:

ECG indexes had a reasonably high specificity, but a low sensitivity for LVH in patients with primary aldosteronism. Cornell voltage index and Cornell product index had a better diagnostic value of LVH, and had a better correlation with LVM index in these patients.
Subclinical Rhythmic Electroencephalogram Discharge of Adults Occurring During Sleep
Authors: Brigo Francesco , Ausserer Harald , Nardone Raffaele , Tezzon Frediano , Manganotti Paolo , Bongiovanni Luigi Giuseppe
Published: March 2013

Subclinical rhythmic electroencephalogram discharge of adults (SREDA) is an electroencephalogram (EEG) pattern of uncertain significance, which occurs without any correlation with epilepsy. It resembles epileptiform activity, and is therefore likely to be misinterpreted as an authentic epileptiform pattern. We describe the occurrence of SREDA during stage II nonrapid eye movement (NREM) sleep and discuss the diagnostic difficulties that may arise when such a pattern is encountered during sleep EEG recordings. SREDA may occur during sleep, leading to difficulties in correct identification of this pattern, as the patient is unconscious and unable to report any symptoms. Although there are rather distinctive EEG features, the lack of changes in electrocardiogram rhythm and the absence of ocular/muscular artifacts suggest a nonepileptic phenomenon. The ultimate diagnosis, and the correct identification of SREDA, may be achieved by a comparison of EEG features between the pattern occurring during sleep and that recorded in the awake state.
Tongue Somatosensory-Evoked Potentials
Authors: Gabelić Tereza , Skorić Magdalena Krbot , Adamec Ivan , Mayer Dijana , Habek Mario
Published: March 2013

The aim of this study was to determine the efficacy of tongue somatosensory-evoked potentials (tSSEPs) in evaluation of afferent trigeminal pathway in patients with early multiple sclerosis (MS). The tSSEP was performed on 10 healthy volunteers and 10 patients with the first symptom of MS. Data were compared between the groups, and tSSEP findings of patients with MS were correlated with clinical and magnetic resonance imaging (MRI) data. Among 10 patients, 2 (20%) had clinically evident involvement of the brainstem, 5 (50%) had brainstem lesions on brain MRI, while 9 (90%) had prolonged latencies on tSSEP. Of the 8 patients with no clinical evidence of brainstem pathology, 7 (88%) had prolonged latencies/conduction block on tSSEP. Patients had statistically significant prolongation of N1, P1, and N2 latencies for stimulation of the right side and N2 latency for stimulation of the left side compared to healthy controls. The tSSEP is an efficient method for evaluating the afferent trigeminal pathway in patients with early MS. This study provides evidence that lesions of the afferent trigeminal pathway are more frequently found by tSSEP than by clinical examination or MRI.
Clinical Advantages of Quantitative Electroencephalogram (QEEG)–Electrical Neuroimaging Application in General Neurology Practice
Authors: Koberda J. Lucas , Moses Andrew , Koberda Paula , Koberda Laura
Published: March 2013

QEEG-electrical neuroimaging has been underutilized in general neurology practice for uncertain reasons. Recent advances in computer technology have made this electrophysiological testing relatively inexpensive. Therefore, this study was conducted to evaluate the clinical usefulness of QEEG/electrical neuroimaging in neurological practice. Over the period of approximately 6 months, 100 consecutive QEEG recordings were analyzed for potential clinical benefits. The patients who completed QEEG were divided into 5 groups based on their initial clinical presentation. The main groups included patients with seizures, headaches, post-concussion syndrome, cognitive problems, and behavioral dysfunctions. Subsequently, cases were reviewed and a decision was made as to whether QEEG analysis contributed to the diagnosis and/or furthered patient’s treatment. Selected and representative cases from each group are presented in more detail, including electrical neuroimaging with additional low-resolution electromagnetic tomography analysis or using computerized cognitive testing. Statistical analysis showed that QEEG analysis contributed to 95% of neurological cases, which indicates great potential for wider application of this modality in general neurology. Many patients also began neurotherapy, depending on the patient’s desire to be involved in this treatment modality.
Neurofeedback Training Induces Changes in White and Gray Matter
Authors: Ghaziri Jimmy , Tucholka Alan , Larue Vanessa , Blanchette-Sylvestre Myriam , Reyburn Gabrielle , Gilbert Guillaume , Lévesque Johanne , Beauregard Mario
Published: March 2013

The main objective of this structural magnetic resonance imaging (MRI) study was to investigate, using diffusion tensor imaging, whether a neurofeedback training (NFT) protocol designed to improve sustained attention might induce structural changes in white matter (WM) pathways, purportedly implicated in this cognitive ability. Another goal was to examine whether gray matter (GM) volume (GMV) might be altered following NFT in frontal and parietal cortical areas connected by these WM fiber pathways. Healthy university students were randomly assigned to an experimental group (EXP), a sham group, or a control group. Participants in the EXP group were trained to enhance the amplitude of their β1 waves at F4 and P4. Measures of attentional performance and MRI data were acquired one week before (Time 1) and one week after (Time 2) NFT. Higher scores on visual and auditory sustained attention were noted in the EXP group at Time 2 (relative to Time 1). As for structural MRI data, increased fractional anisotropy was measured in WM pathways implicated in sustained attention, and GMV increases were detected in cerebral structures involved in this type of attention. After 50 years of research in the field of neurofeedback, our study constitutes the first empirical demonstration that NFT can lead to microstructural changes in white and gray matter.
Embedded Grey Relation Theory in Hopfield Neural Network
Authors: Hsu Wei-Yen
Published: March 2013

In this study, grey-based Hopfield neural network (GHNN), is proposed for the unsupervised analysis of motor imagery (MI) electroencephalogram (EEG) data. Combined with segment selection and feature extraction, GHNN is used for the recognition of left and right MI data. A Gaussian-like filter is proposed to reduce noise, to further enhance performance of active segment selection. Features are extracted by coherence from wavelet data, and then discriminated by GHNN, which is an unsupervised approach suitable for the online classification of nonstationary biomedical signals. Compared to EEG data without segment selection, several usual features, and classifiers, the proposed system is potentially an analytic approach in brain–computer interface (BCI) applications.
The use and reporting of patient-reported outcomes in phase III breast cancer trials
Authors: Brim Remy L , Pearson Steven D
Published: March 2013

Background

Public and government attention to patient-centered research outcomes has been increasing, evidenced by the recent formation of the Patient Centered Outcomes Research Institute. Drug development clinical trials can be made more patient-centered by collecting patient-reported outcome measures that can inform decision making by patients and their health-care providers. Patient-reported outcomes are important to collect in trials of breast cancer therapeutics, which encompass a wide range of treatment regimens and side effects.

Purpose

We sought to determine recent trends in the use of patient-reported outcomes in drug trials for the treatment of breast cancer and evaluate the reporting of these data in study publications.

Methods

We searched ClinicalTrials.gov for phase III breast cancer drug trials, recording information on start date, primary completion date, primary outcome measure, primary sponsor, stage of cancer, and patient-reported outcome use. To assess the reporting of patient-reported outcome data, Google.com and PubMed.gov were searched for all publications resulting from included trials.

Results

We found 236 eligible trials, starting between May 1989 and December 2011. Of these trials, 83 (35%) stipulated patient-reported outcome use. The rate of patient-reported outcome use in recent years has shown no increase over earlier time periods: 37% (1989–2000) versus 36% (2004–2007) versus 30% (2008–2011) ( p = 0.8). Trials with sponsorship led by the pharmaceutical industry and trials including patients with locally advanced or metastatic disease had the highest rates of patient-reported outcome use (40/87 (46%) and 44/102 (43%), respectively). Among the 83 trials that collected patient-reported outcome measures, 36 were completed a minimum of 2 years before our analysis; of these 36 studies, 19 (53%) had published patient-reported outcome data.

Limitations

Data were limited to self-reported descriptions of trials listed on the ClinicalTrial.gov database, which is the best compendium of trial information available, but it is neither a complete nor a fully accurate record of all trials.

Conclusions

Patient-reported outcome use and reporting in breast cancer drug trials has remained relatively low despite calls for more patient-centered research. Increasing the collection and availability of patient-reported outcome data to guide clinical decisions will require aligned support from trial sponsors, researchers, journal editors, regulators and patient advocacy groups, who can all play important roles in implementing change.
Topiramate: Effects on cognition in patients with epilepsy, migraine headache and obesity
Authors: Sommer Barbara R. , Mitchell Erica L. , Wroolie Tonita E.
Published: March 2013

This paper reviews the clinical implications of topiramate (TPM)-induced cognitive deficits in patients with epilepsy, migraine headache, obesity, and in normal populations, followed by reviews of the literature describing the reversal of such deficits upon medication discontinuation. It also discusses animal investigations of TPM’s role of neuroprotection in brain injury. TPM’s most intolerable adverse effects (AEs) are on verbal fluency and reaction time, resulting in high discontinuation rates in patients taking it for epilepsy and migraine headache. However, because TPM is so effective in the treatment of epilepsy and migraine headache, its use is expected to continue. There appears to be greater tolerance of TPM’s cognitive AEs when it is used in the treatment of obesity, perhaps because of the lower doses required. Research attempting to predict the populations most vulnerable to the cognitive effects caused by TPM is ongoing. Studies suggest that one such population may include patients with a past psychiatric history. Slow titration and administration of the lowest possible doses may decrease risk of cognitive deficits.
Case Report
Authors: Shelkey Julia , Huang Christina , Karpa Kelly , Singh Harjit , Silvis Matthew
Published: March 2013

Context:

The past 2 decades have shown a dramatic increase in the number of pelvic and hip injuries in female athletes. Accurate diagnosis of hip pain in active women has proven to be a challenge, as there is an extensive differential including both musculoskeletal and visceral problems. While the incidence of pelvic congestion syndrome (PCS) is not known, this condition may manifest as chronic hip pain in this patient population.

Evidence Acquisition:

A PubMed search was undertaken for articles published in English from 1980 to 2012. Additional references were accrued from reference lists of research articles.

Study Design:

Case series.

Level of Evidence:

Level 3.

Results:

Diagnosis was established using magnetic resonance imaging. Both women were evaluated and treated by interventional radiology with gonadal vein embolization. Initial evaluation and subsequent follow-up was completed in the Sports Medicine Clinic to monitor chronic hip pain symptoms. Both patients experienced significant alleviation of chronic hip pain symptoms within several months after gonadal vein embolization, allowing for a return to the previous level of activity.

Conclusion:

Although PCS most commonly presents as pelvic pain, it is important to consider this condition in athletes with persistent hip pain. PCS may also present with the primary symptom of hip pain as in the 2 case reports described. With more awareness of this condition and appropriate diagnosis, PCS as an unusual etiology of chronic hip pain may be effectively treated with gonadal vein embolization.
A Rare Cause of Foot Pain With Golf Swing
Authors: Petrera Massimo , Dwyer Tim , Ogilvie-Harris Darrell J.
Published: March 2013

The os vesalianum is an uncommon accessory bone of the foot, located proximally to the base of the fifth metatarsal. It is usually asymptomatic and detected incidentally on radiographs. This is a case of bilateral os vesalianum, symptomatic only in the right foot, in a golf player. After a failed nonoperative treatment, the os vesalianum in the symptomatic foot was excised and the peroneus brevis tendon reattached using a suture anchor. The functional outcome was excellent, and the patient returned to golf 8 weeks after surgery.
Voriconazole and its clinical potential in the prophylaxis of systemic fungal infection in patients with hematologic malignancies: a perspective review
Authors: Zabalza Amaya , Gorosquieta Ana , Equiza Encarnación Pérez , Olavarria Eduardo
Published: March 2013

Invasive fungal infections (IFIs) have become high prevalence in patients with hematologic malignancies. Drug-based strategies for IFIs include various approaches such as prophylactic, empiric, preemptive, and directed treatment. Prophylaxis is an attractive strategy in high-risk patients, given the lack of reliable diagnostics and the high mortality rate associated with IFIs. Prophylaxis includes the use of antifungal drugs in all patients at risk. An ideal antifungal compound for prophylaxis should have a potent and broad activity, be available both orally and intravenously, and have a low toxicity profile. Voriconazole fulfills all these criteria. The clinical efficacy of voriconazole against the majority of fungal pathogens makes it potentially very useful for the prevention of IFIs in patients with hematologic malignancies. Voriconazole appears to be very effective for the primary and secondary prevention of IFIs in these patients and recipients of allogeneic hematopoietic stem-cell transplantation. Randomized controlled trials evaluating voriconazole as primary antifungal prophylaxis in patients with neutropenia treated for a variety of hematologic malignancies have been performed, confirming its value as a prophylactic agent. Voriconazole is generally safe and well tolerated; however, its use is also associated with a number of concerns. In most patients with hematologic malignancies there is the potential for pharmacokinetic drug–drug interactions given that voriconazole is metabolized through the P450 cytochrome system.
Asthma Control and Asthma Triggers
Authors: Vernon Margaret K. , Bell Jill A. , Wiklund Ingela , Dale Peter , Chapman Kenneth R.
Published: March 2013

Objective. Little is known about the lifestyle adjustments made by patients with asthma to reduce symptoms and maintain control when exposed to environmental triggers. The objectives of this study were to understand patient perspectives on asthma control, the triggers they identify in their lives, and any lifestyle adjustments they make to control their asthma by avoiding or managing known or perceived triggers. Methods. Focus groups were conducted with patients in the United States who had clinically documented persistent asthma. Participants completed a sociodemographic form and the Asthma Control Test (ACT), on which a score of 19 or lower indicates that asthma may not be well controlled. Results. A total of 19 participants participated in 1 of 2 focus groups. Most participants (n = 14; 74%) reported moderate asthma; 3 (16%) reported mild, and 2 (10%) severe. Mean ACT total score was 16 ± 4; 15 (79%) participants had a score of ≤19, and 4 (21%) participants had a score of ≥20. The most common asthma triggers affecting patients included indoor/outdoor allergens (n = 14; 74%), environmental pollutants/irritants (n = 6; 32%), foods (n = 6; 32%), strong odors (n = 5; 26%), and weather (n = 5; 26%). Additional triggers reported by some patients included exercise, stress, sinusitis/respiratory infections, medications, and strong emotions. Patient-reported behaviors used to maintain asthma control included use of controller medication, use of rescue medication, avoidance of asthma triggers, and relaxation or breathing exercises. Conclusions. Participants perceived themselves to experience symptoms or exacerbations when encountering triggers and to make frequent lifestyle adjustments to cope with triggers encountered.
The Continuing Challenge of Reducing HIV Risk among Haitian Youth
Authors: Dévieux Jessy G. , Rosenberg Rhonda , Saint-Jean Gilbert , Bryant Vaughn E. , Malow Robert M.
Published: March 2013

There is a dire need for interventions that will address the multiple factors—poverty, substance use, early sexual debut, and violence—that influence Haitian youth’s engagement in risky behaviors. The deteriorating socioeconomic and political state of the country has had a deleterious effect on the sociocultural milieu and on the boundaries that have heretofore kept risky behaviors in check. Historically, the lakou system, a community-based approach that supports the family unit, has disintegrated, leading to the disruption of traditional parenting patterns. The unstable economic system has also led to the increasing use of children from poor families, who through the restavek system, are sent to work as servants in other households. The breakdown of traditional systems, coupled with the increasing economic and political instability, has had a significant effect on Haitian adolescents. Among boys, increased levels of substance use have been associated with multiple sex partnerships and very early sexual debut. Among girls, extremely high rates of sexual abuse and forced sex have led to relatively high levels of HIV. While the majority of them have been exposed to behavior change messages, behavior change itself has lagged because many adolescents do not accurately perceive their risk exposure. This review explores the risks of HIV transmission among Haitian youth, with a focus on vulnerability factors, including substance use, culture, and the socioeconomic context, and provides recommendations for intervention. An ecosystemic approach, designed specifically for Haitian youth and that takes environmental context and culture into account, is needed.
MRD-directed risk stratification treatment may improve outcomes of t(8;21) AML in the first complete remission: results from the AML05 multicenter trial
Authors: Zhu Hong-Hu , Zhang Xiao-Hui , Qin Ya-Zhen , Liu Dai-Hong , Jiang Hao , Chen Huan , Jiang Qian , Xu Lan-Ping , Lu Jin , Han Wei , Bao Li , Wang Yu , Chen Yu-Hong , Wang Jing-Zhi , Wang Feng-Rong , Lai Yue-Yun , Chai Jun-Yue , Wang Li-Ru , Liu Yan-Rong , Liu Kai-Yan , Jiang Bin , Huang Xiao-Jun
Published: March 2013

Key Points

Risk stratification treatment of t(8;21) acute myeloid leukemia may decrease relapse and improve long-term survival. Allo-HSCT benefited high-risk patients, but impaired the survival of low-risk patients.
Development and use of a polarized equine upper respiratory tract mucosal explant system to study the early phase of pathogenesis of a European strain of equine arteritis virus
Authors: Vairo Sabrina , Van den Broeck Wim , Favoreel Herman , Scagliarini Alessandra , Nauwynck Hans
Published: March 2013

The upper respiratory tract mucosa represents the first line of defense, which has to be overcome by pathogens before invading the host. Considering the economic and ethical aspects involved in using experimental animals for pathogenesis studies, respiratory mucosal explants, in which the tissue’s three-dimensional architecture is preserved, may be ideal alternatives. Different respiratory mucosal explant cultures have been developed. However, none of them could be inoculated with pathogens solely at the epithelium side. In the present study, equine nasal and nasopharyngeal explants were embedded in agarose (3%), leaving the epithelium side exposed to allow apical inoculation. Morphometric analysis did not show degenerative changes during 72 h of cultivation. The number of apoptotic cells in the mucosa slightly increased over time. After validation, the system was used for apical infection with a European strain (08P178) of equine arteritis virus (EAV) (107.6TCID50/mL per explant). Impermeability of agarose to virus particles was demonstrated by the absence of labeled microspheres (40nm) and a lack of EAV-antigens in RK13 cells seeded underneath the agarose layer in which inoculated explants were embedded. At 72 hpi, 27% of the EAV-positive cells were CD172a+and 19% were CD3+in nasal explants and 45% of the EAV-positive cells were CD172a+and 15% were CD3+in nasopharyngeal explants. Only a small percentage of EAV-positive cells were IgM+. This study validates the usefulness of a polarized mucosal explant system and shows that CD172a+myeloid cells and CD3+T lymphocytes represent important EAV-target cells in the respiratory mucosa.