bluuebunny/crossref_metadata_2025 huggingface dataset:
The Youngest Vegetarians
Authors: Mangels Reed , Driggers Julia
Published: December 2011

As the popularity of vegetarian diets increases, practitioners are likely to encounter vegetarian infants and toddlers. Vegetarian and vegan diets can be developed to meet nutrient needs and support growth of infants and toddlers. Key nutrients whose adequacy should be monitored in vegetarian/vegan diets include vitamin B12, calcium, vitamin D, iron, omega-3 fatty acids, and zinc. As for all infants, for the first 4 to 6 months, vegetarian infants should solely receive breast milk or a commercial infant formula. Fortified infant cereal or firm tofu is an appropriate first complementary food. Either of these, along with breast milk or formula, can meet needs for protein, iron, and zinc. Additional foods are introduced with timing similar to that for nonvegetarians. A variety of nutrient-dense foods should be introduced by 1 year of age. Fortified soy or cow’s milk should be the primary beverage postweaning. Growth should be monitored, and toddlers should be served a diet that includes high-calorie, low-fiber foods if growth appears to be faltering. Practitioners can play important roles in assessing the growth of vegetarian infants and toddlers, helping families make appropriate feeding choices, evaluating the need for supplements, and assisting with planning meals that will meet the needs of infants and toddlers.
Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients
Authors: Martin-Loeches Ignacio , Díaz Emili , Vidaur Loreto , Torres Antoni , Laborda Cesar , Granada Rosa , Bonastre Juan , Martín Mar , Insausti Josu , Arenzana Angel , Guerrero Jose Eugenio , Navarrete Ines , Bermejo-Martin Jesus , Suarez David , Rodriguez Alejandro ,   the H1N1 SEMICYUC/REIPI/CIBERES Working group
Published: December 2011

Background

There is a vast amount of information published regarding the impact of 2009 pandemic Influenza A (pH1N1) virus infection. However, a comparison of risk factors and outcome during the 2010-2011 post-pandemic period has not been described.

Methods

A prospective, observational, multi-center study was carried out to evaluate the clinical characteristics and demographics of patients with positive RT-PCR for H1N1 admitted to 148 Spanish intensive care units (ICUs). Data were obtained from the 2009 pandemic and compared to the 2010-2011 post-pandemic period.

Results

Nine hundred and ninety-seven patients with confirmed An/H1N1 infection were included. Six hundred and forty-eight patients affected by 2009 (pH1N1) virus infection and 349 patients affected by the post-pandemic Influenza (H1N1)v infection period were analyzed. Patients during the post-pandemic period were older, had more chronic comorbid conditions and presented with higher severity scores (Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA)) on ICU admission. Patients from the post-pandemic Influenza (H1N1)v infection period received empiric antiviral treatment less frequently and with delayed administration. Mortality was significantly higher in the post-pandemic period. Multivariate analysis confirmed that haematological disease, invasive mechanical ventilation and continuous renal replacement therapy were factors independently associated with worse outcome in the two periods. HIV was the only new variable independently associated with higher ICU mortality during the post-pandemic Influenza (H1N1)v infection period.

Conclusion

Patients from the post-pandemic Influenza (H1N1)v infection period had an unexpectedly higher mortality rate and showed a trend towards affecting a more vulnerable population, in keeping with more typical seasonal viral infection.
A Survey of Damages to Bridges in Pakistan after the Major Earthquake of 8 October 2005
Authors: Ali Syed M. , Khan Akhtar N. , Rahman Shahzad , Reinhorn Andrei M.
Published: December 2011

An earthquake measuring Mw 7.6 struck the Pakistan-administered part of Kashmir on 8 October 2005. The epicenter of the earthquake was located 22 km from the city of Muzaffarabad. The earthquake resulted in the loss of more than 80,000 lives and caused extensive damage to property and infrastructure. A survey of an approximately 400-km road network was carried out, in which 90 bridges were inspected for earthquake-associated damage, out of which 14 bridges (16%) experienced damage of varying degrees, of which nine bridges (10%) either failed or became nonfunctional. The survey revealed some of the deficiencies of the construction practices in Pakistan and also highlighted the need for improvement to the country's current bridge design practices. This paper reports the prominent types of failures observed and discusses the deficiencies in current design practices. Based on the findings of the survey, various recommendations are made, with the objective of minimizing earthquake-associated damages to new and existing bridges in areas with a high seismic risk.
Experimental Evaluation of the In-Plane Seismic Behavior of Storefront Window Systems
Authors: Eva Charles , Hutchinson Tara C.
Published: December 2011

Storefront window systems have been shown to suffer significant damage during earthquake loading, resulting in the potential for human injuries and significant economic losses. Despite the potential for film-coated windows to minimize seismic-induced damage to window systems, limited study has been undertaken. Furthermore, no thorough study of the effects of loading histories on window system performance has been performed to-date. Finally, previous studies have been limited in terms of their variation of window system geometry. In this work, three variables of interest were studied through in-plane seismic racking experiments of storefront window systems, namely: (i) loading protocol, (ii) window film type and attachment, and (iii) aspect ratio. This paper presents the overall experimental program, the identified damage modes and associated drift limits, and trends associated with variation of the window film and aspect ratio. A companion paper in this issue (Hutchinson et. al. 2011) summarizes studies of the effects of load protocol.
Study of Loading Protocols in Light-Gauge Stud Partition Walls
Authors: Restrepo JoséI. , Lang Anna F.
Published: December 2011

This paper examines the influence of two reversed cyclic loading protocols on the response of gypsum light-gauge metal-stud partition walls, which are common in office, hotel, and laboratory buildings. Two identical full-scale three-dimensional specimens were constructed to represent a typical room in an office building. The specimens were tested quasi-statically along two axes using different loading protocols. The loading protocols were applied to observe the sensitivity of loading protocol on damage progression. The loading protocols were developed for the Applied Technology Council ATC-58 project published in FEMA 461, which, among others, addresses the racking protocol of nonstructural building components for use within a performance-based earthquake engineering framework. Details are given about the damage progression of the specimens to the loading protocols and their lateral force-displacement response characteristics.
Identification of an Enhancer in the Ad4BP/SF-1 Gene Specific for Fetal Leydig Cells
Authors: Shima Yuichi , Miyabayashi Kanako , Baba Takashi , Otake Hiroyuki , Oka Sanae , Zubair Mohamad , Morohashi Ken-ichirou
Published: December 2011

Adrenal 4 binding protein/steroidogenic factor 1 (Ad4BP/SF-1) (Nr5a1) is a nuclear receptor essential for reproductive tissue development and endocrine regulation. This factor is expressed in steroidogenic tissues (e.g. adrenal glands and gonads), and expression of this factor is tightly regulated in a tissue and cell type-specific manner. Our previous studies have identified tissue and cell type-specific enhancers in the introns of the Ad4BP/SF-1 gene in fetal adrenal glands, ventromedial hypothalamus, and pituitary gonadotrope. Characterization of the enhancers had provided new insights into tissue and cell development. However, these studies have failed to identify any gonad-specific enhancer. Here, we identified a fetal Leydig cell-specific enhancer in the upstream region of the mouse Ad4BP/SF-1 gene using transgenic mouse assays. Alignment of the upstream regions among vertebrate animal species demonstrated that the enhancer consisted of three conserved regions, whereby the most highly conserved region contained an Ad4BP/SF-1 binding sequence and an E-box. Mutation of each sequence abolished the enhancer activity and led to a loss of reporter gene expression. These results suggested that Ad4BP/SF-1 gene expression in the fetal Leydig cell is regulated by a yet unidentified E-box binding protein(s) and by an autoregulatory loop formed by Ad4BP/SF-1. Although fetal Leydig cells have been thought to play crucial roles for masculinization of various fetal tissues through androgen production, other functions have remained elusive. Our identification of a fetal Leydig cell-specific enhancer in the Ad4BP/SF-1 gene would be a powerful tool to address these gaps in the knowledge base.
Protection from Palmitate-Induced Mitochondrial DNA Damage Prevents from Mitochondrial Oxidative Stress, Mitochondrial Dysfunction, Apoptosis, and Impaired Insulin Signaling in Rat L6 Skeletal Muscle Cells
Authors: Yuzefovych Larysa V. , Solodushko Viktoriya A. , Wilson Glenn L. , Rachek Lyudmila I.
Published: December 2011

Saturated free fatty acids have been implicated in the increase of oxidative stress, mitochondrial dysfunction, apoptosis, and insulin resistance seen in type 2 diabetes. The purpose of this study was to determine whether palmitate-induced mitochondrial DNA (mtDNA) damage contributed to increased oxidative stress, mitochondrial dysfunction, apoptosis, impaired insulin signaling, and reduced glucose uptake in skeletal muscle cells. Adenoviral vectors were used to deliver the DNA repair enzyme human 8-oxoguanine DNA glycosylase/(apurinic/apyrimidinic) lyase (hOGG1) to mitochondria in L6 myotubes. After palmitate exposure, we evaluated mtDNA damage, mitochondrial function, production of mitochondrial reactive oxygen species, apoptosis, insulin signaling pathways, and glucose uptake. Protection of mtDNA from palmitate-induced damage by overexpression of hOGG1 targeted to mitochondria significantly diminished palmitate-induced mitochondrial superoxide production, restored the decline in ATP levels, reduced activation of c-Jun N-terminal kinase (JNK) kinase, prevented cells from entering apoptosis, increased insulin-stimulated phosphorylation of serine-threonine kinase (Akt) (Ser473) and tyrosine phosphorylation of insulin receptor substrate-1, and thereby enhanced glucose transporter 4 translocation to plasma membrane, and restored insulin signaling. Addition of a specific inhibitor of JNK mimicked the effect of mitochondrial overexpression of hOGG1 and partially restored insulin sensitivity, thus confirming the involvement of mtDNA damage and subsequent increase of oxidative stress and JNK activation in insulin signaling in L6 myotubes. Our results are the first to report that mtDNA damage is the proximal cause in palmitate-induced mitochondrial dysfunction and impaired insulin signaling and provide strong evidence that targeting DNA repair enzymes into mitochondria in skeletal muscles could be a potential therapeutic treatment for insulin resistance.
Intranasal Leptin Reduces Appetite and Induces Weight Loss in Rats with Diet-Induced Obesity (DIO)
Authors: Schulz Carla , Paulus Kerstin , Jöhren Olaf , Lehnert Hendrik
Published: December 2011

Resistance to brain-mediated effects of leptin is a characteristic feature of obesity, resulting from alterations in leptin receptor signaling in hypothalamic neurons and/or transport across the blood-brain-barrier. We have shown previously, that the latter can be circumvented by intranasal (i.n.) application of leptin in lean rats. This prompted us to test i.n. leptin in animals with diet-induced obesity (DIO) as a basis for future human administration. DIO was induced in male Wistar rats by feeding a cafeteria diet for 25 or 32 wk, respectively. Consecutively, these DIO animals (seven to eight per treatment) and standard diet rats (lean) (14–15 per treatment, matched for age and diet duration) were treated with 0.1, 0.2 mg/kg leptin, or control solution i.n. daily for 4 wk before onset of dark period. Energy intake and body weight were measured daily; blood glucose, serum insulin, and leptin were measured before and after treatment. Expression of hypothalamic neuropeptides was assessed by quantitative real-time PCR. We demonstrate, for the first time, that i.n. leptin reduces appetite and induces weight loss in DIO to the same extent as in lean rats. Our findings are supported accordingly by an altered expression pattern of anorexigenic and orexigenic neuropeptides in the hypothalamus, e.g. proopiomelanocortin, cocaine and amphetamine-related transcript, neuropeptide Y, agouti-related protein. It now appears clear that i.n. leptin is effectively acting in obese animals in the same fashion as in their lean counterparts. These findings now clearly warrant studies in humans and may open new perspectives in the treatment of obesity.
Topical oxytocin reverses vaginal atrophy in postmenopausal women: a double-blind randomized pilot study
Authors: Jonasson Aino Fianu , Edwall Lena , Uvnäs-Moberg Kerstin
Published: December 2011

Introduction

Oxytocin is a peptide hormone produced in the hypothalamus and it is best known for its role in labour and lactation. This double-blind, randomized study was performed at Huddinge Hospital of Karolinska Institutet, Stockholm in order to test the effectiveness of topical oxytocin gel in women with postmenopausal vaginal atrophy.

Methods

Twenty postmenopausal women (at least two years after menopause) with symptoms of vaginal atrophy such as vaginal dryness, pain, itching, discomfort and bleeding during intercourse were enrolled in the study when visual inspection of the vagina had confirmed that their mucosa was atrophic. The participants were randomized to intravaginal treatment with either oxytocin or placebo gel for seven days. Before and after treatment, a gynaecological examination and a visual and colposcopic inspection of the vagina were performed, biopsies from the vaginal mucosa were taken and blood samples were collected for analysis of circulating levels of estradiol and oxytocin.

Results

Prior to treatment, visual and colposcopic inspection showed that all of the 20 participants had an atrophic vaginal mucosa. After treatment with the oxytocin gel, the examination showed that the vaginal epithelium of seven of the 10 participants in the oxytocin group had become healthier and normalized. No change in these parameters was observed among the 10 participants in the placebo group. This difference between the oxytocin and placebo groups was significant ( P= 0.003). Seven participants in the active group and four in the placebo group reported relief of symptoms of vaginal atrophy after seven days of applying the gel. The effect of oxytocin to normalize the morphological appearance of the vaginal mucosa was almost significant when compared with the placebo group ( P= 0.07). There was no significant difference between the circulating levels of estradiol and oxytocin in both the oxytocin and placebo groups before and after treatment. None of the participants reported any side-effects.

Conclusion

Topical treatment with oxytocin appears to improve vaginal atrophy in postmenopausal women. A limitation of this pilot study is that it was based on a small study population hence the results should be regarded with caution. Larger studies are in progress to establish the possibility of using oxytocin as a clinical treatment for vaginal atrophy.
B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement
Authors: Goetze Jens P
Published: December 2011

BACKGROUND

Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has revealed new plasma peptide forms of potential clinical use.

CONTENT

Natriuretic propeptide structures undergo variable degrees of endo- and exoproteolytic cleavages as well as amino acid modifications, which leave the plasma phase of the peptides highly heterogeneous and dependent on cardiac pathophysiology and capacity. An ongoing characterization of the molecular heterogeneity may not only help us to appreciate the biosynthetic capacity of the endocrine heart but may also lead to the discovery of new and more disease-specific targets for future molecular diagnosis.

Peptides derived from pro–atrial natriuretic peptide and pro–B-type natriuretic peptide are useful plasma markers in heart failure. New data have defined cardiac myocytes as competent endocrine cells in posttranslational processing and cellular secretion.
The effects of docosahexaenoic acid supplementation and exercise on growth hormone and insulin-like growth factor I serum levels during chronic hypoxia in rats
Authors: Turgut Sebahat , Erken Haydar Ali , Erken Gülten , Ayada Ceylan , Genc Osman , Turgut Günfer
Published: December 2011

Background: In this study we examined the effects of docosahexaenoic acid (DHA) on growth hormone (GH), insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) in response to chronic hypoxia and exercise training in hypoxic conditions.

Methods: Thirty-five rats were divided into five groups; control group (C), hypoxia group (H), hypoxia-exercise group (HE), hypoxia-docosahexaenoic acid group (HD), hypoxia-exercise-docosahexaenoic acid group (HED). A treadmill exercise was performed as 30 m/min for 20 min/day, 5 days per week for 28 days at level grade for the exercising groups (HE and HED). DHA was given to the HD and HED groups every day orally (36 mg/kg). The animals, except for the C group, were exposed to hypoxia for 28 days.

Results: Serum levels of GH and IGF-I in the H group decreased after chronic hypoxia (p<0.001). GH and IGF-I in the HD group also decreased compared with the C group (p<0.05, p<0.01, respectively). GH in C group did not show significant difference compared with the HE and HED groups. Decreased serum level of IGF-I was observed for the HED group (p<0.05).

Conclusions: According to our findings, chronic hypoxia exposure decreases serum levels of GH, and IGF-I and exercise training have a slightly positive effect on GH/IGF-I axis during hypoxia. In addition, DHA supplementation slightly increases GH and IGF-I serum levels in hypoxic conditions. However, this effect on GH/IGF-I axis during hypoxia is not strong compared with exercise. Therefore, we concluded that exercise and/or DHA supplementation does not have additional positive effect on these hormones in hypoxic conditions.
Kinematic Stability Evaluation of Spinal Fusion Devices by Synthetic FSU Model
Authors: Hansen Thomas
Published: December 2011

The purpose of the paper is to open discussion for an alternative methodology for stability testing of spinal fusion devices that does not require cadaveric tissue. A simulated single level functional spinal unit (FSU) model was used to evaluate spinal fusion devices as an alternative to using cadaveric human tissue models. Initially, this study was proposed as a feasibility investigation prior to investing in a cadaveric study, but was then developed into an alternative, stand-alone method that eliminates variabilities associated with cadaveric tissue testing for providing comparison testing between spinal devices. The objective of this paper is to present the development of the synthetic FSU model and the apparatus for providing kinematic stability testing on lumbar interbody spinal devices. The synthetic model geometry was based on morphological parameters for the lumbar spine using rigid foam per ASTM F1839. A universal servo-controlled test frame provided the pure moment loading through a system of cables and pulleys for the application of flexion-extension, lateral bending, and axial rotation. Comparable testing was performed using short cyclical, fully reversing runs up to 50 cycles where the last ten cycles were evaluated.
Past, Present, and Future of Model-Based User Interface Development
Authors: Meixner Gerrit , Paternò Fabio , Vanderdonckt Jean
Published: December 2011

This article presents the past, present and future of model-based user interface development. After 30 years of research there has been significant success in modeling user interfaces. This article aims to give a comprehensive overview of the history, describes important aspects and current approaches, lists actual challenges of model-based user interface development and gives implications for the next generation.
Serum high-mobility group box-1 levels are positively associated with micro- and macroalbuminuria but not with cardiovascular disease in type 1 diabetes: the EURODIAB Prospective Complications Study
Authors: Nin Johanna W M , Ferreira Isabel , Schalkwijk Casper G , Prins Martin H , Chaturvedi Nish , Fuller John H , Stehouwer Coen D A , _ _
Published: December 2011

Context and objective

High-mobility group box-1 (HMGB1) is a pro-inflammatory cytokine that may contribute to the pathogenesis of micro- and macrovascular complications commonly observed in diabetes. We investigated whether HMGB1 is associated with: i) markers of low-grade inflammation (LGI) and endothelial dysfunction (ED) and pulse pressure (PP, a marker of arterial stiffness); ii) prevalent nephropathy, retinopathy and cardiovascular disease (CVD) in type 1 diabetes; and iii) the potential mediating roles of LGI, ED and PP therein.

Design and methods

This was a cross-sectional nested case–control study of 463 patients (226 women; mean age 40±10 years) with type 1 diabetes from the EURODIAB Prospective Complications Study. We used linear and binary or multinomial logistic regression analyses adjusted for traditional risk factors.

Results

Serum Ln-HMGB1 levels were positively associated with LGI and ED (standardisedβ=0.07 (95% confidence interval (CI): 0.02–0.12) andβ=0.08 (95% CI: 0.02–0.14) respectively), but not with PP. Higher Ln-HMGB1 (per unit) was associated with greater odds of micro- and macroalbuminuria: odds ratio (OR)=1.24 (95% CI: 0.90–1.71) and OR=1.61 (95% CI: 1.15–2.25) respectively,Pfor trend=0.004. Further adjustments for LGI or ED did not attenuate these associations. No such associations were found between Ln-HMGB1 and estimated glomerular filtration rate (eGFR), retinopathy or CVD, however.

Conclusions

In type 1 diabetes, higher serum HMGB1 levels are associated with greater prevalence and severity of albuminuria, though not with eGFR, retinopathy and CVD. Prospective studies are needed to clarify the causal role of HMGB1, if any, in the pathogenesis of vascular complications in type 1 diabetes.
Locally advanced colorectal cancer: results of surgical treatment and prognostic factors
Authors: Campos Fábio Guilherme , Calijuri-Hamra Maria Célia , Imperiale Antonio Rocco , Kiss Desidério Roberto , Nahas Sergio Carlos , Cecconello Ivan
Published: December 2011

OBJECTIVES: To evaluate the incidence surgical results and prognostic factors of locally advanced colorectal cancer. METHODS: Cohort study including 679 colorectal cancer patients treated from 1997 to 2007. Clinical, surgical and histological data were analyzed. RESULTS: Ninety patients (females 61%; median age 59 years) were treated for locally advanced carcinomas (13.2%), either in the colon (66%) or rectum (34%). Extended resections most commonly involved the small bowel (19.8%), bladder (16.4%), uterus (12.9%) and ovaries (11.2%). Postoperative morbidity and mortality occurred in 23 (25.6%) and 3 (3.3%) patients, respectively. Survival and recurrence analysis among 76 R0 (84.4%) procedures revealed a 60% 5-year survival and 34% local recurrence rates. Survival curves demonstrated reduced rates for rectal location (45% vs 65%), tumor depth (50% for T4 vs 75% for T3), vascular/ lymphatic/perineural invasion (35% vs 80%) and lymph node metastasis (35% vs 80%). CONCLUSIONS: Locally advanced carcinomas were found in 13.2% of patients. Survival rates were negatively affected by rectal location and adverse histological features. Number of involved organs and neoplastic adhesions did not influenced chances of survival. A radical R0 extended resection was achieved in a high proportion of cases, resulting in a 60% cancer-free survival under acceptable operative risks.
"Construindo a 'ordem anárquica'": algumas considerações em torno da doutrina social de Proudhon e Bakunin
Authors: Piozzi Patrícia
Published: December 2011

Este artigo pretende examinar alguns aspectos da doutrina social de Proudhon e de Bakunin, procurando relacioná-los com suas propostas de transformação social.
Assessment of sand fly (Diptera, Psychodidae) control using cypermethrin in an endemic area for visceral leishmaniasis, Montes Claros, Minas Gerais State, Brazil
Authors: Barata Ricardo Andrade , Michalsky Erika Monteiro , Fujiwara Ricardo Toshio , França-Silva João Carlos , Rocha Marília Fonseca , Dias Edelberto Santos
Published: December 2011

Montes Claros in Minas Gerais State, Brazil, was considered an intense transmission area for visceral leishmaniasis. This study evaluated sand fly fauna after insecticide application. Captures were performed in 10 districts from September 2005 to August 2006 with CDC light traps inside and outside each residence. Cypermethrin was sprayed in two cycles during November/2005 and May/2006. The 636 specimens collected, belonging to 10 species, were predominantly Lutzomyia longipalpis (79%), and most frequently males (70%). The highest percentage of specimens were captured in areas surrounding domiciles (85.8%). The main species were observed to be sensitive to treatment with the insecticide. The results showed a reduction in the number of sand flies collected after use of cypermethrin in homes and annexes, and with residual effect lasting from two to four months.
A liberdade em obras do jovem Marx: referências para reflexões sobre ética
Authors: Guedes Olegna de Souza
Published: December 2011

Este artigo, elaborado através de revisão bibliográfica, apresenta uma análise da categoria liberdade nos escritos de Karl Marx, no período de 1841 a 1844. Situa a necessidade da análise da liberdade para a reflexão ética e mostra a importância da crítica marxiana para desconstrução de um ideário liberal que a vincula à propriedade privada e à defesa de interesses individuais. Ao evidenciar esse aspecto, remonta à vinculação entre liberdade e trabalho não alienado, o que remete ao horizonte uma nova sociabilidade. Reflete sobre a necessária reposição dessa perspectiva crítica para a interpretação do primeiro princípio do código de ética profissional dos assistentes sociais, no sentido de afirmar os propósitos do projeto ético-político do Serviço Social no Brasil.
Diet and food consumption of the pearl cichlid Geophagus brasiliensis (Teleostei: Cichlidae): relationships with gender and sexual maturity
Authors: Bastos Rodrigo F. , Condini Mário V. , Varela Junior Antonio S. , Garcia Alexandre M.
Published: December 2011

Despite the importance of the pearl cichlid Geophagus brasiliensis for the aquarium fish trade worldwide and its wide distribution, many aspects of its biology, such as the relationships between its feeding ecology and reproductive behavior, are not fully understood in natural conditions on its native habitat. In this paper, we investigated its diet focusing on how differences in diet and food consumption are related to differences in gender and sexual maturity. The digestive tract of each individual was dissected and had its content analyzed, whereas each gonad was microscopically analyzed to determine gender (male/female) and sexual maturity (immature/mature). A total of 28 females and 31 males were analyzed. Mature individuals were more common than immature specimens both for males (64.50%) and females (64.30%). The analysis of 52 individuals with non-empty digestive tracts revealed a diet comprised of 27 items. According to the Index of Alimentary importance (%IAi), the most important food items in the diet were Gastropoda (37.30%), fragments of vascular plants (15.16%), detritus (10.14%), Amphipoda (9.24%), and fish scales (6.29%). Mature males had more empty stomachs (65.00%) when compared to immature males (27.27%) and immature (55.56%) and mature females (40.00%). Also, mature females seemed to have more food consumption (greater mean values of total volume) in their digestive tracts than mature males. Some hypotheses are proposed in order to distinguish if this gender-based difference in food consumption in mature individuals of the pearl cichlid could be associated with the development of primary and secondary sexual characteristics or with asymmetrical time invested in parental care activities.
An eclectic approach to quality control in fee-for-service health care: The New York City Medicaid Experience.
Authors: Rosenberg S N , Gunston C , Berenson L , Klein A
Published: December 2011

A computer-based system for evaluating the quality of fee-for-service health care in the New York City Medicaid Program is described. Specific information is sought for use in educational, enforcement and managerial activities to improve health care quality. The gathering of this information necessitates coordinated assessment of the structure, process and outcome of health care, through inspection of offices, computerized analysis of patterns of practice as revealed by billing forms, and reexamination of patients. The program's focus on patterns of practice, its use of multiple assessment techniques, and its concentration on unequivocally substandard care circumvent several limitations on current evaluation technology. Implications for Professional Standards Review Organizations and national health insurance are explored.
Paramedic programs and out-of-hospital cardiac arrest: I. Factors associated with successful resuscitation.
Authors: Eisenberg M , Bergner L , Hallstrom A
Published: December 2011

As part of an evaluation of whether the addition of paramedic services can reduce mortality from out-of-hospital cardiac arrest compared to previously existing emergency medical technician (EMT) services, factors associated with successful resuscitation were studied. A surveillance system was established to identify cardiac arrest patients receiving emergency care and to collect pertinent information associated with the resuscitation. Outcomes (death, admission, and discharge) were compared in two areas with different types of prehospital emergency care (basic emergency medical technician services vs. paramedic services). During the period April 1976 through August 1977, 604 patients with out-of-hospital cardiac arrest received emergency resuscitation. Eighty-one per cent of these episodes were attributed to primary heart disease. Considered separately, four factors were found to have a significant association with higher admission and discharge rates :1) paramedic service, 2) rapid time to initiation of cardiopulmonary resuscitation (CPR), 3) rapid time to definitive care, and 4) bystander-initiated CPR. Using multivariate analysis, rapid time to initiation of CPA and rapid time to definitive care were most predictive of admission and discharge. Age was also weakly predictive of discharge. These findings suggest that if reduction in mortality is to be maximized, cardiac arrest patients must have CPR initiated within four minutes and definitive care provided within ten minutes.
Community structural characteristics and the adoption of fluoridation.
Authors: Smith R A
Published: December 2011

A study of community structural characteristics associated with fluoridation outcomes was conducted in 47 communities. A three-part outcome distinction was utilized: communities never having publicly considered the fluoridation issue, those rejecting it, and those accepting it. The independent variables reflect the complexity of the community social and economic structure, social integration, and the centralization of authority. Results of mean comparisons show statistically significant differences between the three outcome types on the independent variables. A series of discriminant analyses provides furtheor evidence of how the independent variables are associated with each outcome type. Non-considering communities are shown to be low in complexity, and high in social integration and the centralization of governmental authority. Rejecters are shown to be high in complexity, but low in social integration and centralized authority. Adopters are relatively high on all three sets of variables. Theretical reasoning is provided to support the hypothesis and why these results are expected. The utility of these results and structural explanations in general are discussed, especially for public/environmental health planning and political activities.
Isolation of N. meningitidis from patients in a gonorrhea screen program: a four-year survey in New York City.
Authors: Faur Y C , Wilson M E , May P S
Published: December 2011

In the course of the screening program for gonorrhea in New York City, a total of 964 N. meningitidis strains were recovered from the genitourinary tract and/or anal canal over a four-year period (April 1975-April 1979), the rate of such recoveries having tripled during that time. The majority of strains were isolated from anal canal cultures of male patients most of whom were seen in a clinic treating homosexuals. N. meningitidis and N. gonorrhoeae were cultured together from 41 patients: in 24 cases from different sites and in 17 instances from the same specimen. Evidence of clinically significant N. meningitidis involvement of genitourinary sites was obtained in a number of cases of urethritis and proctitis as well as in three instances of epidemiologically linked cases. The rising frequency of N. meningitidis isolations from these sites, with its potential clinical implications, should alert microbiologists, clinicians, and epidemiologists to the need for careful distinction of meningococcal from gonorrheal infection, particularly among homosexual men.
Who is being screened for cervical cancer?
Authors: Kleinman J C , Kopstein A
Published: December 2011

Data from the 1973 National Health Interview Survey, a probability sample of the United States population, are used to examine the relationship between Pap testing and four socioeconomic variables. It was found that women at highest risk of cervical cancer are least likely to have had Pap tests. The proportion of women who report never having had a Pap test is greater among Blacks, the poor, the elderly and nonmetropolitan residents. In particular, poor Black women in nonmetropolitan areas have extremely high proportions reporting no Pap test. However, high risk women are only slightly less likely to have visited a doctor in the two years preceding interview. These results suggest that improvement in Pap test coverage among high risk women could be attained by encouraging the use of the Pap test in regular ambulatory medical care.
High-risk young mothers: infant mortality and morbidity in four areas in the United States, 1973-1978.
Authors: McCormick M C , Shapiro S , Starfield B
Published: December 2011

An examination of the changes in infant mortality and morbidity in four regions in the United States has revealed high levels of health problems among the infants of two groups of mothers: those less than or equal to 17 years and 18-19 year-old multiparas, many of whom began their childbearing under age 18. Despite decreases over the period of observation, neonatal mortality rates remain over one and a half times as high for infants of these mothers as for other mothers, largely due to the relatively high proportion of low birthweight (LBW) infants born to these mothers. Post-neonatal mortality rates also remain high, and may be increasing; this change cannot be explained solely by differences in proportion of LBW infants between these and older mothers. Both the high post-neonatal mortality rates and the type of morbidity experienced by surviving infants is consistent with the socioeconomic disadvantage of young mothers. The data further indicate the limited resources available to these mothers to cope with their children's health needs, and their potential vulnerability to decreases in public programs supporting child health care.
Occupational health in the People's Republic of China.
Authors: Christiani D C
Published: December 2011

China's drive to modernize its economy will produce new occupational health problems even as it resolves earlier ones. Well aware of this, Chinese occupational health experts are intensifying efforts to improve workers' health and establish a modern occupational health program. Occupational lung disease, occupational cancer, heavy metal poisoning, industrial chemical poisoning, and physical factor-induced diseases (noise and heat) have all been targeted for expanded research which will serve as a basis for standard setting. Hazard control efforts include engineering controls, particularly in new construction, limited use of personal protective equipment, and expansion of environmental and medical monitoring. Worker education and professional activities have been expanded. International exchanges have been initiated and will prove occupational health a promising area of scientific cooperation.
Quality of life in childhood and adolescence: From concept to practice
Authors: Lakic Aneta
Published: December 2011

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Effects of a short-term differently dosed aerobic exercise on maximum aerobic capacity in breast cancer survivors: A pilot study
Authors: Brdareski Zorica , Djurovic Aleksandar , Susnjar Snezana , Zivotic-Vanovic Mirjana , Ristic Andjelka , Konstantinovic Ljubica , Vuckovic-Dekic Ljiljana , Tankosic Mirjana
Published: December 2011

Background/Aim. Regular physical activity and exercise improves quality of
life and possibly reduces risk of disease relapse and prolongs survival in
breast cancer survivors. The aim of this study was to evaluate the impact of
a 3-week moderate intensity aerobic training, on aerobic capacity (VO2max)
in breast cancer survivors. Methods. A prospective, randomized clinical
study included 18 female breast cancer survivors in stage I-IIIA, in which
the primary treatment was accomplished at least 3 months before the study
inclusion. In all the patients VO2max was estimated using the Astrand?s
protocol on a bicycle-ergometer (before and after 3 weeks of training),
while subjective assessment of exertion during training were estimated by
the Category-Ratio RPE Scale. Each workout lasted 21 minutes: 3 minutes for
warmup and cool-down each and 15 min of full training, 2 times a week. The
workload in the group E1 was predefined at the level of 45% to 65% of
individual VO2max, and in the group E2 it was based on subjective evaluation
of exertion, at the level marked 4-6. Data on the subjective feeling of
exertion were collected after each training course in both groups. Results.
We recorded a statistically significant improvement in VO2max in both groups
(E1 - 11.86%; E2 - 17.72%), with no significant differences between the
groups. The workload level, determined by the percent of VO2max, was
different between the groups E1 and E2 (50.47 ? 7.02% vs 55.58 ? 9.58%), as
well as subjective perception of exertion (in the groups E1 and E2, 11.6%
and 41.6% of training, respectively, was graded in the mark 6). Conclusion.
In our group of breast cancer survivors, a 3-week moderate intensity aerobic
training significantly improved the level of VO2max.
Evaluation of a Final-Year Module Using Online Asynchronous Discussion
Authors: Ward Tony , Dodd Lorna
Published: December 2011

This report evaluates the use of online asynchronous discussions as a main delivery strategy in a third (final) year undergraduate counselling psychology module. These discussions were student-facilitated and the discussion assessment criteria emphasised analysis, critique, application and originality. Students were assessed through the production of a written critique of one of the discussions, again using similar criteria. Students' judgments of their progress and attitudes to the online components were assessed, and both of these measures were significantly positively related to module outcomes. Students were asked for their comments about the module, and the results were analysed using thematic analysis. Overall the results suggest that whilst such a novel delivery strategy has much to commend it, many students perceive it negatively. This seems to be due to the novelty of the strategy, and a belief that traditional lectures and assignments are preferable.
Intestinal Parasitic Investigation in Temple Rhesus Monkeys of Kathmandu
Authors: Jha Anwita , Chalise Mukesh K , Shrestha Rebati M , Karki Kedar
Published: December 2011

The rhesus monkeys (Macaca mulatta) of Kathmandu come into frequent contact with humans and due to their habit of residing in the religious and parkland of human proximity, there is possibility of zoonotic and anthroponotic disease transmission between them. So, a prevalence survey of gastrointestinal parasites of these monkeys was conducted during April and May 2005 in three temples Pashupatinath, Swyombhunath and Tripureshwor. Total 121 fresh faecal samples, were collected randomly from these areas that were about fifteen percent of total monkey population. The faecal samples were analyzed by direct smear and concentration methods. The overall parasitization rate was 76.86% with the highest in Pashupatinath (86%) followed by Swyombhunath (74%) and Tripureshwor (61.9%). About 27.96% had single infection while 72.04% had mixed infection. This showed that the presence of one parasite reduced the immunity of the host as a result multiple infections existed. Parasite identifications were based upon the size and appearance of trophozoites, cysts, eggs and larvae of parasites. Both protozoan and helminthes parasites were observed in varying rates in three temples. Three species of protozoa and ten species of helminths were detected by microscopical examination of faecal samples. Human is always prone to be infected by most of these parasites so they are of zoonotic importance. The study will enrich the information on temple monkeys and will support their ecological management in human proximity. DOI: http://dx.doi.org/10.3126/init.v4i0.5530 The Initiation Vol.4 2011 1-7
Tourism: Boon for Forest Conservation, Livelihood, and Community Development in Ghandruk VDC, Western Nepal
Authors: Adhikari Yagya Prasad , Fischer Anton
Published: December 2011

This study investigates the socio-economic impact of tourism in two wards of Ghandruk VDC, western Nepal. The analyses are based on (i) primary data collected through household surveys using a random sample of 46 respondents and (ii) published and un-published secondary data, office records, informal and formal interviews and direct observation were the other sources of information. The results show that in Ghandruk both forest and tourism contribute to increase livelihood and sustainable development of the region. This is due to the good management practices of Ann apurna Conservation Area project and other local organizations. The community forest income is more important for the poor people and has a strong equalizing effect on local income distribution. Further more, alternative energy technologies should be promoted in future conservation programs. Sustainable tourism is able to enhance nature conservation by opening up new opportunities. The study suggests that there is a trade-off between economic benefits and environmental and social-cultural costs, which requires a good balance to implement the concept of ecotourism, which boons for forest conservation, livelihood, and community development.DOI: http://dx.doi.org/10.3126/init.v4i0.5535The Initiation Vol.4 2011 35-45
Status, Market, Opportunities and Challenges: Yarshagumba in Darchula
Authors: Yadav Kashi Ram
Published: December 2011

DOI: http://dx.doi.org/10.3126/init.v4i0.5549 The Initiation Vol.4 2011 138-151
Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management
Authors: Roy Anil K. , Slimack Nicholas P. , Ganju Aruna
Published: December 2011

Object

A syrinx is a fluid-filled cavity within the spinal cord that can be an incidental finding or it can be accompanied by symptoms of pain and temperature insensitivity. Although it is most commonly associated with Chiari malformation Type I, the advancement of imaging techniques has resulted in more incidental idiopathic syringes that are not associated with Chiari, tumor, trauma, or postinfectious causes. The authors present a comprehensive review and management strategies for the idiopathic variant of syringomyelia.

Methods

The authors retrospectively identified 8 idiopathic cases of syringomyelia at their institution during the last 6 years. A PubMed/Medline literature review yielded an additional 38 articles.

Results

Two of the authors' patients underwent surgical treatment that included a combination of laminectomy, lysis of adhesions, duraplasty, and syrinx fenestration. The remaining 6 patients were treated conservatively and had neurologically stable outcomes. Review of the literature suggests that an etiology-driven approach is essential in the diagnosis and management of syringomyelia, although conservative management suffices for most cases. In particular, it is important to look at disturbances in CSF flow, as well as structural abnormalities including arachnoid webs, cysts, scars, and a diminutive posterior fossa.

Conclusions

The precise etiology for idiopathic syringomyelia (IS) is still unclear, although conceptual advances have been made toward the overall understanding of the pathophysiology of IS. Various theories include the cerebellar piston theory, intramedullary pulse pressure theory, and increased spinal subarachnoid pressure. For most patients with IS, conservative management works well. Continued progression of symptoms, however, could be approached using decompressive strategies such as laminectomy, lysis of adhesions, and craniocervical decompression, depending on the level of pathology. Management for patients with progressive neurological dysfunction and the lack of flow disturbance is unclear, although syringosubarachnoid shunting can be considered.
Management of incidentally discovered intracranial vascular abnormalities
Authors: Chalouhi Nohra , Dumont Aaron S. , Randazzo Ciro , Tjoumakaris Stavropoula , Gonzalez L. Fernando , Rosenwasser Robert , Jabbour Pascal
Published: December 2011

With the widespread use of brain imaging studies, neurosurgeons have seen a marked increase in the number of incidental intracranial lesions, including vascular abnormalities. Specifically, the detection of incidentally discovered aneurysms, arteriovenous malformations, cavernous angiomas, developmental venous anomalies, and capillary telangiectasias has increased. The best management strategy for most of these lesions is controversial. Treatment options include observation, open surgery, endovascular procedures, and radiosurgery. Multiple factors should be taken into account when discussing treatment indications, including the natural history of the disease and the risk of the treatment. In this article, the authors focus on the natural history of these lesions and the risk of the treatment, and they give recommendations regarding the most appropriate management strategy based on the current evidence in the literature and their experience with intracranial vascular abnormalities.