bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study of New York City Obstetrics Units Demonstrates the Potential for Reducing Hospital Inpatient Capacity
Authors: Green Linda V. , Liu Nan
Published: February 2015

Hospitals are under significant pressure from payers to reduce costs. The single largest fixed cost for a hospital is inpatient beds, yet there is significant variation in hospital capacity utilization. We study bed capacity in New York City hospital obstetrics units and find that while many hospitals have an insufficient number of beds to provide timely access to care, overall there is significant excess capacity. Our findings, coupled with current demographic and clinical practice trends, indicate that a large fraction of obstetrics units nationwide could likely reduce their bed capacity while assuring timely access to care, resulting in large savings in capital and staffing costs. Given emerging health care delivery and payment models that will likely decrease demand for other types of hospital beds, our study suggests that data-based methodologies should be used by hospitals and policy makers to identify opportunities for reducing excess bed capacity in other inpatient units as well.
From Breaking Down Barriers to Breaking Up Communities
Authors: Goetz Edward G.
Published: February 2015

This article offers a critique of developments within fair housing thought in the United States that have brought it into conflict with community development approaches to high-poverty, segregated urban neighborhoods. I argue that the spatial strategies of Fair Housing have expanded from an initial orientation toward opening up the suburbs to nonwhite occupancy to efforts aimed at breaking up communities of color in central areas. The shifting gaze of Fair Housing toward neighborhoods of concentrated poverty has manifest itself in both a criticism of and opposition to affordable housing programs in central areas and support for what Chicago Fair Housing Attorney Alexander Polikoff calls the “radical surgery” of displacement and demolition of existing communities of color.
“What I Feel in My Heart”
Authors: Perry Kristen H. , Homan Annie
Published: February 2015

Through this international cross-case analysis of ethnographic literacy practices data, we investigated two questions: (1) In what literacy practices do adults with limited or no schooling engage for personal fulfillment? and (2) What do these practices reveal about the nature of literacy for individuals who are often characterized as illiterate? Data came from 92 participants across 13 case studies from Africa and the Americas in the Cultural Practices of Literacy Study database. We queried the database to identify (a) the social activity domains in which participants read or wrote, and (b) their purposes for doing so, then narrowed our analysis to practices related to personal fulfillment (i.e., practices that were clearly for themselves and/or for personal expression, self-understanding, and/or identity). We categorized purposes into themes, contextualized the practices within the original ethnographic data, identified participants representing “rich cases”, compiled participant portraits, and developed coding schemes to examine data for patterns. Participants across worldwide contexts read and wrote for a variety of personal purposes, including coping with life, facing problems, or escaping their daily realities, or for entertainment. Practices often connected with spiritual or religious life domains or with participants’ attempts to make sense of their lives. An important theme across practices and contexts was participants’ marginalized status, reflecting the ways in which practices connected with other aspects of context. Our findings challenge current understandings of the ways in which those assumed to be illiterate or low-literate practice literacy, suggesting implications for redefining functional literacy and for adult literacy instruction.
Successful Treatment of Myocardial Infarction in an Infant With Kawasaki Disease
Authors: Jone Pei-Ni , Tapia Daniel , Davidson Jesse , Fagan Thomas E. , Browne Lorna , Ing Richard John , Kay Joseph
Published: February 2015

Although early treatment with intravenous immunoglobulin reduces the risk of coronary artery aneurysms, in refractory cases of Kawasaki disease, myocardial infarction can result from thrombosis of coronary artery aneurysms. Early recognition of myocardial infarction from Kawasaki disease myocarditis can reduce morbidity and mortality. This report describes successful treatment of myocardial infarction from coronary thrombosis in an infant with Kawasaki disease using intravenous tissue plasminogen activator and abciximab.
DNA mutations of the cat
Authors: Lyons Leslie A
Published: February 2015

Practical relevance:

The health of the cat is a complex interaction between its environment (nurture) and its genetics (nature). Over 70 genetic mutations (variants) have been defined in the cat, many involving diseases, structural abnormalities and clinically relevant health concerns. As more of the cat’s genome is deciphered, less commonly will the term ‘idiopathic’ be used regarding the diagnosis of diseases and unique health conditions. State-of-the-art health care will include DNA profiling of the individual cat, and perhaps its tumor, to establish the best treatment approaches. Genetic testing and eventually whole genome sequencing should become routine diagnostics for feline health care.

Global importance:

Cat breeds have disseminated around the world. Thus, practitioners should be aware of the breeds common to their region and the mutations found in those regional populations. Specific random-bred populations can also have defined genetic characteristics and mutations.

Audience:

This review of ‘the good, the bad and the ugly’ DNA variants provides the current state of knowledge for genetic testing and genetic health management for cats. It is aimed at feline and general practitioners wanting to update and review the basics of genetics, what tests are available for cats and sources for genetic testing. The tables are intended to be used as references in the clinic. Practitioners with a high proportion of cat breeder clientele will especially benefit from the review.

Evidence base:

The data presented is extracted from peer-reviewed publications pertaining to mutation identification, and relevant articles concerning the heritable trait and/or disease. The author also draws upon personal experience and expertise in feline genetics.
Update in feline therapeutics
Authors: Whitehouse William , Viviano Katrina
Published: February 2015

Practical relevance:

The field of veterinary medicine is constantly evolving. New medications are being introduced into clinical practice, and novel uses for established medications are frequently being discovered as new information comes to light.

Clinical challenges:

Therapeutic options for our feline patients can be restricted based on inadequate clinical evidence, adverse effects and patient compliance concerns. Additionally, with the reduced availability of commonly used medications in some regions, clinicians are forced to utilize alternatives with which they may have limited experience.

Audience:

This review article is directed towards primary care veterinarians working with feline patients. The selection of medications discussed is based on many of the clinical challenges commonly encountered in practice.

Evidence base:

The evidence for use of some of these medications is limited due to their novelty. Known mechanisms of action, pharmacokinetic and pharmacodynamics data, adverse effects and clinical uses are reviewed where possible, with clinical recommendations made based on the evidence of data available.
ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats
Authors: Sparkes Andrew H , Cannon Martha , Church David , Fleeman Linda , Harvey Andrea , Hoenig Margarethe , Peterson Mark E , Reusch Claudia E , Taylor Samantha , Rosenberg Dan
Published: February 2015

Practical relevance:

Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats.

Clinical challenges:

Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently – unless hypoglycaemia is encountered.

Evidence base:

The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a consensus view on practical management of cats with DM based on available clinical data and experience. However, in many areas, substantial data are lacking and there is a need for better studies in the future to help inform and refine recommendations for the clinical management of this common disease.
2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats
Authors: Epstein Mark E , Rodanm Ilona , Griffenhagen Gregg , Kadrlik Jamie , Petty Michael C , Robertson Sheilah A , Simpson Wendy
Published: February 2015

Rationale:

The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge.

Relevance:

Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian–client–patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care.

Approaches:

The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals.

Evidence base:

The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.
‘Doing gender’ in the wild berry industry: Transforming the role of Thai women in rural Sweden 1980–2012
Authors: Hedberg Charlotta
Published: February 2015

‘Doing gender’ has often been used as the theoretical entrance for research on gender issues in the social sciences. However, research has been accused of using the concept in a ‘ceremonial’ way, treating gendered structures as static. In response to this claim, this article investigates the process of ‘hierarchization’, or how gendered and racial hierarchies occur through everyday practices and political and economic contexts in the rural, wild berry industry in contemporary Sweden. The industry has gone through a thorough transformation, from irregular and small-scale production to regularized and large-scale production, which has affected the intersection of gender and racial structures. In particular, Thai women have gone from being active participants both as entrepreneurs and as workers, to working under native men, or being passive receivers of men’s remittances. The mechanisms behind the intersection of gender and racial structures are a complex interplay of economic, social and institutional factors, which act on nested global, national and translocal scales.
Chitinase 3-like proteins as diagnostic and prognostic biomarkers of multiple sclerosis
Authors: Hinsinger G , Galéotti N , Nabholz N , Urbach S , Rigau V , Demattei C , Lehmann S , Camu W , Labauge P , Castelnovo G , Brassat D , Loussouarn D , Salou M , Laplaud D , Casez O , Bockaert J , Marin P , Thouvenot E
Published: February 2015

Background:

Despite sensitivity of MRI to diagnose multiple sclerosis (MS), prognostic biomarkers are still needed for optimized treatment.

Objective:

The objective of this paper is to identify cerebrospinal fluid (CSF) diagnostic biomarkers of MS using quantitative proteomics and to analyze their expression at different disease stages.

Methods:

We conducted differential analysis of the CSF proteome from control and relapsing–remitting MS (RRMS) patients followed by verification by ELISA of candidate biomarkers in CSF and serum in control, clinically isolated syndrome (CIS), RRMS and progressive MS (PMS) patients.

Results:

Twenty-two of the 527 quantified proteins exhibited different abundances in control and RRMS CSF. These include chitinase 3-like protein 1 (CHI3L1) and 2 (CHI3L2), which showed a strong expression in brain of MS patients, especially in astrocytes and microglial cells from white matter plaques. CSF and serum CHI3L1 levels increased with the disease stage and CIS patients with high CSF (>189 ng/ml) and serum (>33 ng/ml) CHI3L1 converted more rapidly to RRMS (log rank test, p < 0.05 and p < 0.001, respectively). In contrast, CSF CHI3L2 levels were lower in PMS than in RRMS patients. Accordingly, CSF CHI3L1/CHI3L2 ratio accurately discriminated PMS from RRMS.

Conclusions:

CSF CHI3L1 and CHI3L2 and serum CHI3L1 might help to define MS disease stage and have a prognostic value in CIS.
Trichuris suis ova therapy in relapsing multiple sclerosis is safe but without signals of beneficial effect
Authors: Voldsgaard A , Bager P , Garde E , Åkeson P , Leffers AM , Madsen CG , Kapel C , Roepstorff A , Thamsborg SM , Melbye M , Siebner H , Søndergaard HB , Sellebjerg F , Sørensen P Soelberg
Published: February 2015

Background:

An observational study has suggested that relapsing–remitting multiple sclerosis patients with helminth infections have lower disease activity and progression than uninfected multiple sclerosis patients.

Objective:

To evaluate the safety and efficacy on MRI activity of treatment with TSO in relapsing MS.

Methods:

The study was an open-label, magnetic resonance imaging assessor-blinded, baseline-to-treatment study including ten patients with relapsing forms of multiple sclerosis. Median (range) age was 41 (24–55) years, disease duration 9 (4–34) years, Expanded Disability Status Scale score 2.5 (1–5.0), and number of relapses within the last two years 3 (2–5). Four patients received no disease modifying therapy, while six patients received IFN-β. After an observational period of 8 weeks, patients received 2500 ova from the helminth Trichuris suis orally every second week for 12 weeks. Patients were followed with serial magnetic resonance imaging, neurological examinations, laboratory safety tests and expression of immunological biomarker genes.

Results:

Treatment with Trichuris suis orally was well-tolerated apart from some gastrointestinal symptoms. Magnetic resonance imaging revealed 6 new or enlarged T2 lesions in the run-in period, 7 lesions in the early period and 21 lesions in the late treatment period. Two patients suffered a relapse before treatment and two during treatment. Eight patients developed eosinophilia. The expression of cytokines and transcription factors did not change.

Conclusions:

In a small group of relapsing multiple sclerosis patients, Trichuris suis oral therapy was well tolerated but without beneficial effect.
Natalizumab discontinuation in patients with multiple sclerosis: Profiling risk and benefits at therapeutic crossroads
Authors: Prosperini Luca , Annovazzi Pietro , Capobianco Marco , Capra Ruggero , Buttari Fabio , Gasperini Claudio , Galgani Simonetta , Solaro Claudio , Centonze Diego , Bertolotto Antonio , Pozzilli Carlo , Ghezzi Angelo
Published: February 2015

Objective:

The objective of this paper is to estimate the risk of reaching well-established disability milestones after withdrawal of natalizumab (NTZ) due to concern about the risk of progressive multifocal leukoencephalopathy in patients with multiple sclerosis (MS).

Methods:

Data from 415 patients with MS followed-up for six years after starting NTZ were collected from seven tertiary MS centers. The risk of disability worsening, i.e. reaching Expanded Disability Status Scale (EDSS) scores of 4.0 or 6.0, and the likelihood of experiencing a disability reduction of one EDSS point (or more), were assessed by propensity score-adjusted analyses in patients who discontinued and in those still on treatment at the end of follow-up.

Results:

A total of 318 patients who received standard NTZ treatment without experiencing evidence of disability worsening in the first two years were included in the six-year follow-up analysis, with 196 (61.6%) still on treatment and 122 (38.4%) discontinuing after a median time of 3.5 years. Patients in the discontinuing group had a more than two-fold increased risk of disability worsening ( p = 0.007), and a 68% decreased likelihood of experiencing disability reduction ( p = 0.009) compared with the continuing group.

Conclusion:

While discussing the overall risk/benefit profile of NTZ, patients should be advised that, in case of treatment discontinuation, the risk of disability worsening is one in three, and increases to one in two if the EDSS score at NTZ start is above 3.0.
Cerebrospinal fluid levels of chitinase 3-like 1 and neurofilament light chain predict multiple sclerosis development and disability after optic neuritis
Authors: Modvig S , Degn M , Roed H , Sørensen TL , Larsson HBW , Langkilde AR , Frederiksen JL , Sellebjerg F
Published: February 2015

Background:

Cerebrospinal fluid (CSF) biomarkers have been suggested to predict multiple sclerosis (MS) after clinically isolated syndromes, but studies investigating long-term prognosis are needed.

Objective:

To assess the predictive ability of CSF biomarkers with regard to MS development and long-term disability after optic neuritis (ON).

Methods:

Eighty-six patients with ON as a first demyelinating event were included retrospectively. Magnetic resonance imaging (MRI), CSF leukocytes, immunoglobulin G index and oligoclonal bands were registered. CSF levels of chitinase-3-like-1, osteopontin, neurofilament light-chain, myelin basic protein, CCL2, CXCL10, CXCL13 and matrix metalloproteinase-9 were measured by enzyme-linked immunosorbent assay. Patients were followed up after 13.6 (range 9.6–19.4) years and 81.4% were examined, including Expanded Disability Status Scale and MS functional composite evaluation. 18.6% were interviewed by phone. Cox regression, multiple regression and Spearman correlation analyses were used.

Results:

Forty-six (53.5%) developed clinically definite MS (CDMS) during follow-up. In a multivariate model MRI ( p=0.0001), chitinase 3-like 1 ( p=0.0033) and age ( p=0.0194) combined predicted CDMS best. Neurofilament light-chain predicted long-term disability by the multiple sclerosis severity scale ( p=0.0111) and nine-hole-peg-test ( p=0.0202). Chitinase-3-like-1 predicted long-term cognitive impairment by the paced auditory serial addition test ( p=0.0150).

Conclusion:

Neurofilament light-chain and chitinase-3-like-1 were significant predictors of long-term physical and cognitive disability. Furthermore, chitinase-3-like-1 predicted CDMS development. Thus, these molecules hold promise as clinically valuable biomarkers after ON as a first demyelinating event.
A new model for airport passenger segmentation
Authors: Harrison Anna , Popovic Vesna , Kraal Ben
Published: February 2015

Recent changes in the aviation industry and in the expectations of travellers have begun to alter the way we approach our understanding, and thus the segmentation, of airport passengers. The key to successful segmentation of any population lies in the selection of the criteria on which the partitions are based. Increasingly, the basic criteria used to segment passengers (purpose of trip and frequency of travel) no longer provide adequate insights into the passenger experience. In this article, we propose a new model for passenger segmentation based on the passenger core value, time. The results are based on qualitative research conducted in situ at Brisbane International Terminal during 2012–2013.

Based on our research, a relationship between time sensitivity and degree of passenger engagement was identified. This relationship was used as the basis for a new passenger segmentation model, namely, airport enthusiast (engaged and non-time sensitive), time filler (non-engaged and non-time sensitive), efficiency lover (non-engaged and time sensitive) and efficient enthusiast (engaged and time sensitive).

The outcomes of this research extend the theoretical knowledge about passenger experience in the terminal environment. These new insights can ultimately be used to optimize the allocation of space for future terminal planning and design.
A model for the evaluation of data quality in health unit websites
Authors: Leite Patrícia , Gonçalves Joaquim , Teixeira Paulo , Rocha Álvaro
Published: February 2015

This article presents a research work, the goal of which was to achieve a model for the evaluation of data quality in institutional websites of health units in a broad and balanced way. We have carried out a literature review of the available approaches for the evaluation of website content quality, in order to identify the most recurrent dimensions and attributes, and we have also carried out a Delphi method process with experts in order to reach an adequate set of attributes and their respective weights for the measurement of content quality. The results obtained revealed a high level of consensus among the experts who participated in the Delphi process. In addition, the different statistical analysis and techniques implemented are robust and attach confidence to our results and consequent model obtained.
Electronic reporting of all reference laboratory results: An important step toward a truly all-encompassing, integrated health record
Authors: Kratz Alexander
Published: February 2015

Results from reference laboratories are often not easily available in electronic health records. This article describes a multi-pronged, long-term approach that includes bringing send-out tests in-house, upgrading the laboratory information system, interfacing more send-out tests and more reference laboratories, utilizing the “miscellaneous assay” option offered by some reference laboratories, and scanning all remaining paper reports from reference laboratories for display in the electronic health record. This allowed all laboratory results obtained in association with a patient visit, whether performed in-house or at a reference laboratory, to be available in the integrated electronic health record. This was achieved without manual data entry of reference laboratory results, thereby avoiding the risk of transcription errors. A fully integrated electronic health record that contains all laboratory results can be achieved by maximizing the number of interfaced reference laboratory assays and making all non-interfaced results available as scanned documents.
The Royal Malaysia Police has got its strategy wrong
Authors: Teh Yik Koon
Published: February 2015

The Malaysian police appealed to parliament to reinstate preventive detention without trial laws, such as the Emergency Ordinance and the Prevention of Crime Act 1959, to reduce crimes. These laws were abolished in 2012 because they violate the rights of ‘innocent until proven guilty’ and have been abused. Although the legal profession and civil society disagreed with their reinstatement, parliament amended the Prevention of Crime Act in 2013. This article shows that such laws alone have not been effective in crime prevention and that the crime rate declined between 2009 and 2012 because of the implementation of scientifically tested methods such as installing closed-circuit televisions, and the government’s mobilisation of the police to hot spots in order to meet the National Key Results Areas target of reducing crime. Lastly, the article stresses that effective crime prevention involves a judicious combination of both scientific research and strategy. The article believes that the concept of Total Defence mooted in 1986 by the Ministry of Defence should be revisited as a total strategy or comprehensive security strategy for the defence and security of the country.
Ritual power: Illuminating the blind spot of births, deaths and marriages in news media research
Authors: Hess Kristy
Published: February 2015

This article conceptualises the role and place of the newspaper births, deaths and marriages column in Western societies and its relationship to news media. It identifies the births, deaths and marriages notices as a ‘blind spot’ within journalism and media research generated by powerful cultural norms and conventions shaping the field. This is exemplified by the ‘mythical’ divide between political economy and culturalist approaches to media studies that has created a gap where people’s everyday practices or the social value of ‘commercial’ content tends to be overlooked in discussions about news media. Drawing more deeply from cultural studies and scholarship around media power and rituals, the births, deaths and marriages column provides a compelling unique illustration of the ways newspapers – especially at the local level – continue to be perceived as central to the social in this changing media world. A qualitative research project into the future of small commercial newspapers in Australia provides rich data for exploring these key ideas.
Cosmopolitan nuances in classical sociology: Reshaping conceptual frameworks
Authors: Pendenza Massimo
Published: February 2015

This article proposes to give voice to the argument that prospects a cosmopolitan vision of society by reading between the lines of classical sociological thought. This vision, neither manifest nor intentional, is, however, unequivocally present. In particular, the article analyses fragments of writings from Tönnies, Marx, Durkheim and Simmel, wherein each author’s underlying approach to cosmopolitanism clearly emerges: liberal (Marx and Tönnies), patriotic (Durkheim) and relational (Simmel). Contributing to the cosmopolitan historical narrative, the analysis shows that a classical sociology of cosmopolitanism effectively exists and that, if revisited, certain analytical categories of sociological tradition can be fruitfully adapted to contemporary society. This article does not envisage a rejection of the founding fathers of classical sociology; on the contrary, it endorses a more profound analysis of their works.
Fashioning the feminine self in “prosumer capitalism”: Women's work and the transnational reselling of Western luxury online
Authors: Zhang Lin
Published: February 2015

Through ethnography and interviews, this article examines the social media–based transnational reselling of Western luxury by Chinese women through the lens of gendered transnational prosumption. Linking prosumption to debates on the feminization of labor, it analyzes the paradoxical implications that neoliberal global capitalism's demand for more agentive and participatory prosuming female subjects have for international feminist politics. Disrupting the boundaries between the commercial or public and personal, virtual and physical, and work and consumption, transnational mobile middle-class Chinese women have “reinvented” prosumption as a cultural, technological, and economic solution to the contradictions that inhere in competing demands of different gender regimes. In their hands, prosumption becomes a gendered response to the tensions inherent to China's Post-Socialist modernity, allowing some women more choices, autonomy, flexibility, and mobility through the strategic performance of gendered identities and networks. But such freedom is often already contained by the biopolitical governmentality of both advanced capitalism and the patriarchal Chinese state, which divide women based on class, race, and nationality; render employment precarious and atomized; encourage consumer global citizenship; and foster a self-promotional, commoditized, and “always-on” interactive subjectivity. As such, this article seeks to complicate the current discussion of prosumption by highlighting the structuring imperatives of gender, class, race, and nation.
Reflections on a mobile train conference from Helsinki to Rovaniemi
Authors: Bissell Laura , Overend David
Published: February 2015

This is an account of Laura Bissell and David Overend’s experience of attending a ‘mobile train conference’, which explored ideas around theatre and nomadism en route from the Finnish capital, Helsinki, to the University of Lapland in Rovaniemi. The account of the journey, which took place on 8 April 2014, reflects on the opportunities, affordances and limitations of mobilising knowledge exchange in this way. Drawing on Michel De Certeau’s brief discussion of train travel, the account explores the relationship between the conference and the moving landscape.
Comparison of two ordinal prediction models: A cancer staging system example
Authors: Kattan Michael W , Gerds Thomas A
Published: February 2015

Background

Choosing to replace or maintain an existing cancer staging system is a difficult task. The system plays a critical role in patient counselling and treatment decision making because the staging system conveys prognosis.

Methods

Many issues may be considered when deciding the preferred system (i.e. old or new), such as the level of evidence for one or more factors included in the system or the general opinions of expert clinicians. However, given the major objective of estimating prognosis on an ordinal scale, we argue that the rival staging system candidates should be compared on their ability to predict outcome. We sought to outline an algorithm that would compare two rival ordinal systems on their predictive ability.

Results

We devised an algorithm based largely on the concordance index, which is appropriate for comparing two models in their ability to rank observations. We demonstrate our algorithm with a prostate cancer staging system example.

Conclusion

We have provided an algorithm for selecting the preferred staging system based on prognostic accuracy. It appears to be useful for the purpose of selecting between two ordinal prediction models.
d-Ribose aids heart failure patients with preserved ejection fraction and diastolic dysfunction: a pilot study
Authors: Bayram Melike , St. Cyr J.A. , Abraham William T.
Published: February 2015

Objectives:

The incidence of heart failure continues to escalate with >550,000 newly diagnosed patients annually worldwide. More than half of the patients with heart failure have preserved ejection fraction or isolated diastolic dysfunction, for which no current effective therapies for diastolic dysfunction exist. Every cell requires adequate levels of high energy phosphates to maintain integrity and function. Previous studies have demonstrated that diastolic function is energy dependent and supplemental d-ribose has shown to improve diastolic dysfunction. This study investigated what role d-ribose might play in congestive heart failure patients with preserved systolic function and diastolic dysfunction.

Methods:

A total of 11 patients, New York Heart Association class II–IV, with clinical symptoms, normal left ventricular systolic function and echocardiographic evidence of diastolic dysfunction were enrolled after meeting inclusion criteria. Each patient received oral d-ribose (5 g/dose) for 6 weeks. Echocardiographic evaluation, cardiopulmonary metabolic testing and subjective questionnaire assessment were performed at baseline, 6 weeks and at 9 weeks (3 weeks after discontinuing d-ribose).

Results:

An improvement in their tissue Doppler velocity (E′), which was maintained at 9 weeks, was demonstrated in 64% of the patients. Five patients showed an improvement in their ratio of early diastolic filling velocity (E) to early annulus relaxation velocity (E′). There was no appreciable difference in these measurements during valsalva or with leg raising and handgrip exercises. Four patients also had an improvement in their maximum predicted VO2 values; two demonstrated a worsening effect and no differences were noted in the remaining patients. Subjective assessment revealed a benefit in only one patient, worsening symptoms in one patient and no change in the remaining cohort.

Conclusions:

This pilot study revealed some beneficial trends with D-ribose even with this small cohort size. However, future investigations are necessary to further substantiate these observed benefits.
Prothrombotic risk factors and antithrombotic therapy in children with ischemic stroke
Authors: Eltayeb Azza A. , Askar Gamal A. , Abu Faddan Naglaa H. , Kamal Taghreed M.
Published: February 2015

Objective:

Congenital and acquired prothrombotic disorders have been highlighted in a recent series of cerebrovascular stroke (CVS), with a controversial role in pathogenesis. The aim is to study some prothrombotic risk factors [activated protein C (APC) resistance, von Willebrand factor (vWF), anticardiolpin (ACL) antibodies and plasma homocysteine] in children with ischemic stroke, and to evaluate the role of aspirin and low molecular weight heparin (LMWH) in its management in relation to outcome.

Methods:

A total of 37 cases aged from 1 month to 15 years ( mean ± standard deviation 26.2 ± 35.7 months), diagnosed as ischemic stroke (>24 hours) were recruited. Complete blood count, prothrombin time and concentration, partial thromboplastin time, serum electrolytes, random blood sugar, C-reactive protein, electrocardiogram and echocardiography were done. Levels of APC resistance, vWF, ACL antibodies [immunoglobulin G (IgG) and immunoglobulin M (IgM)] and plasma homocysteine were estimated. A total of 25 cases received aspirin 3–5 mg /kg/d and 12 patients received LMWH as initial dose at 75 international units (IU)/kg subcutaneously (SC) then 10–25 IU/kg/day for 15 days in a nonrandomized fashion.

Results:

The levels of APC resistance, vWF, ACL antibodies (IgG and IgM) and plasma homocysteine were significantly higher in stroke cases than in controls. There was no significant difference between cases treated with aspirin and those with LMWH in all prothrombotic factors. Significant positive correlations were found between vWF and ACL antibodies (IgG and IgM) levels before treatment. Significant decrease in cognitive function was detected between cases treated with LMWH and those treated with aspirin.

Conclusion:

Ischemic CVS in children is multifactorial. Thrombophilia testing should be performed in any child with CVS. Early use of aspirin improves the prognosis and has less effect on cognitive function.
Therapeutic strategy in unresectable metastatic colorectal cancer: an updated review
Authors: Chibaudel Benoist , Tournigand Christophe , Bonnetain Franck , Richa Hubert , Benetkiewicz Magdalena , André Thierry , de Gramont Aimery
Published: February 2015

Systemic therapy is the standard care for patients with unresectable advanced colorectal cancer (CRC), but salvage surgery of metastatic disease should be considered in the case of adequate tumor shrinkage. Several drugs and combinations are now available for use in treating patients with advanced CRC, but the optimal sequence of therapy remains unknown. Moreover, the administration of antitumor therapy can be modulated by periods of maintenance or treatment breaks rather than delivered as full therapy until disease progression or unacceptable toxicity, followed by reintroduction of prior full therapy when required, before switching to other drugs. Consequently, randomized strategy trials are needed to define the optimal treatment sequences. Molecular testing for Kirsten rat sarcoma viral oncogene homolog (KRAS) and neuroblastoma RAS viral oncogene homolog (NRAS) is mandatory but not sufficient to select appropriate patients for epidermal growth factor receptor (EGFR) monoclonal antibody (MoAb) therapy.
Investigating Impacts of Incorporating an Adjuvant Mind–Body Intervention Method Into Treatment as Usual at a Community-Based Substance Abuse Treatment Facility
Authors: Nakamura Yoshio , Lipschitz David L. , Kanarowski Elizabeth , McCormick Theresa , Sutherland Debbie , Melow-Murchie Melinda
Published: February 2015

Treatment of substance use/misuse (SUM) continues to pose a difficult challenge. This exploratory pilot study evaluated whether a novel mind–body intervention program called “Mind–Body Bridging” (MBB) could be an effective short-term adjuvant intervention for managing SUM and coexisting symptoms in women undergoing residential and outpatient substance use treatment in a community setting. Thirty-eight women attending a local substance abuse (SA) facility were recruited and randomly assigned to either (a) treatment as usual (TAU) or (b) MBB and TAU. The MBB program consisted of 20 sessions and lasted for 10 weeks. Participants were asked to complete a set of self-report questionnaires designed to assess drug/alcohol cravings, impact of past trauma, depression, sleep disturbance, mindfulness, self-compassion, and well-being. They completed the questionnaires at three time points: preintervention, midintervention (after the fifth week), and postintervention. MBB + TAU significantly reduced drug/alcohol cravings, trauma-related thinking, and disturbed sleep in comparison with TAU. Furthermore, MBB + TAU significantly increased mindfulness, self-compassion, and well-being in comparison with TAU. MBB for SUM appears promising as a complementary adjuvant intervention, warranting future larger scale randomized controlled trials of MBB for SUM populations. SUM is a difficult condition to treat and manage clinically, especially given the multiple comorbid conditions that frequently affect those with SUM. In the search to develop effective adjuvant interventions for SUM, the present pilot study suggested that adding MBB to standard SUM treatment in community-based settings could enhance therapeutic efficacy and quality of care.
The Relationship Between Cell Phone Use and Academic Performance in a Sample of U.S. College Students
Authors: Lepp Andrew , Barkley Jacob E. , Karpinski Aryn C.
Published: February 2015

The cell phone is ever-present on college campuses and is frequently used in settings where learning occurs. This study assessed the relationship between cell phone use and actual college grade point average (GPA) after controlling for known predictors. As such, 536 undergraduate students from 82 self-reported majors at a large, public university were sampled. A hierarchical regression ( R2 = .449) demonstrated that cell phone use was significantly ( p < .001) and negatively (β = −.164) related to actual college GPA after controlling for demographic variables, self-efficacy for self-regulated learning, self-efficacy for academic achievement, and actual high school GPA, which were all significant predictors ( p < .05). Thus, after controlling for other established predictors, increased cell phone use was associated with decreased academic performance. Although more research is needed to identify the underlying mechanisms, findings suggest a need to sensitize students and educators about the potential academic risks associated with high-frequency cell phone use.
Decomposing Change in Energy Consumption of the Agricultural Sector in Pakistan
Authors: Ahmed Vaqar , Zeshan Muhammad
Published: February 2015

The agricultural sector provides the majority of employment in Pakistan, especially among the poorest segments of the population. Energy provision affects production and livelihoods, especially with the advance of mechanization in agriculture.

Changes in gas and electricity prices affect the income of farmers significantly, thereby reducing the agricultural growth rate over time. Agriculture also has a positive impact on industrial sector exports. The dependence of agriculture on electricity consumption in Pakistan has increased over time, while power generation has not kept up with demand. This article decomposes energy consumption in Pakistan and analyzes the behaviour of change in agricultural production, energy intensity and structural changes over the time.
Book Review: Mahmood Mamdani (2012), Define and Rule: Native as Political Identity
Authors: de Mello Fabrício Cardoso
Published: February 2015

Mahmood Mamdani (2012), Define and Rule: Native as Political Identity, Cambridge, MA: Harvard University Press, ISBN 9780674050525, pp. 154, $29.95.
How Efficiently is Chemical Fertilizer Used in Indian Agriculture? Challenges and Alternatives
Authors: Ghosh Abhijit , Dey Saurav Kumar
Published: February 2015

Chemical fertilizer is one of the main inputs in Indian agriculture. The objective of the article is to study the efficiency of chemical fertilizer use in India over five decades (1962–65 to 2003–06). This period extends from the pre-green revolution to the post-reform era. Chemical fertilizer use is not uniform and efficient throughout the Indian states. For the purposes of this study, the districts of four states, Andhra Pradesh, Gujarat, Punjab and West Bengal, have been selected, representing the southern, western, northern and eastern regions, respectively. Data envelopment analysis technique is used to gauge the input-oriented technical efficiency. The results show that there is substantial scope for reducing the use of fertilizer.
Placental Mesenchymal Dysplasia (PMD) in Association With Beckwith-Wiedemann Syndrome Identified by First Trimester Sonography
Authors: Lindsley William , Haeri Sina
Published: February 2015

Placental mesenchymal dysplasia (PMD) has commonly been identified on second trimester ultrasound in association with Beckwith-Wiedemann syndrome (BWS). In this report, a case of PMD later confirmed as Beckwith-Wiedemann is presented, which was identified by sonography in the first trimester. When faced with a first trimester finding of an enlarged cystic placenta, it is suggested that BWS be considered as a possible diagnosis and accordingly, genetic testing with methylation studies offered to the parents.
Protective role for club cell secretory protein-16 (CC16) in the development of COPD
Authors: Laucho-Contreras Maria E. , Polverino Francesca , Gupta Kushagra , Taylor Katherine L. , Kelly Emer , Pinto-Plata Victor , Divo Miguel , Ashfaq Naveed , Petersen Hans , Stripp Barry , Pilon Aprile L. , Tesfaigzi Yohannes , Celli Bartolome R. , Owen Caroline A.
Published: February 2015

Club cell secretory protein-16 (CC16) is the major secreted product of airway club cells, but its role in the pathogenesis of chronic obstructive pulmonary disease (COPD) is unclear. We measured CC16 airway expression in humans with and without COPD and CC16 function in a cigarette smoke (CS)-induced COPD murine model.

Airway CC16 expression was measured in COPD patients, smokers without COPD and non-smokers. We exposed wildtype (WT) andCC16−/−mice to CS or air for up to 6 months, and measured airway CC16 expression, pulmonary inflammation, alveolar septal cell apoptosis, airspace enlargement, airway mucin 5AC (MUC5AC) expression, small airway remodelling and pulmonary function.

Smokers and COPD patients had reduced airway CC16 immunostaining that decreased with increasing COPD severity. Exposing mice to CS reduced airway CC16 expression.CC16−/−mice had greater CS-induced emphysema, airway remodelling, pulmonary inflammation, alveolar cell apoptosis, airway MUC5AC expression, and more compliant lungs than WT mice. These changes were associated with increased nuclear factor-κB (NF-κB) activation inCC16−/−lungs. CS-induced acute pulmonary changes were reversed by adenoviral-mediated over-expression of CC16.

CC16 protects lungs from CS-induced injury by reducing lung NF-κB activation. CS-induced airway CC16 deficiency increases CS-induced pulmonary inflammation and injury and likely contributes to the pathogenesis of COPD.
Incidence of occupational latent tuberculosis infection in South African healthcare workers
Authors: Adams Shahieda , Ehrlich Rodney , Baatjies Roslynn , van Zyl-Smit Richard N. , Said-Hartley Qonita , Dawson Rodney , Dheda Keertan
Published: February 2015

The test-specific incidence of latent tuberculosis infection (LTBI) in healthcare workers from sub-Saharan Africa is unknown.

505 healthcare workers from South Africa were screened at baseline, and after 12 months, with a questionnaire, the tuberculin skin test (TST), and two T-cell assays (T-SPOT.TB and QuantiFERON-TB Gold-In-Tube). Test-specific conversion rates were calculated.

The prevalence of presumed LTBI at baseline was 84, 69 and 62% using the TST, QuantiFERON-TB Gold-In-Tube and T-SPOT.TB, respectively. The annual test-specific conversion rate, depending on the cut-off point used, was as follows: TST 38%; QuantiFERON-TB Gold-In-Tube 13–22%; and T-SPOT.TB 18–22%. Annual reversion rates were 4, 7 and 16%, respectively. The annual TST conversion rate was significantly higher than that derived from published local community-based data (IRR 3.53, 95% CI 1.81–6.88). Factors associated with conversion (any test) included healthcare sector of employment, counselling of tuberculosis patients, and a baseline positive TST (for T-SPOT.TB).

The annual rate of tuberculosis infection in South African healthcare workers was very high, irrespective of the testing method used, and may be explained by occupational exposure, as the rate was considerably higher than non-healthcare workers from the same community. Collectively, these data support the need for implementation of tuberculosis-specific infection control measures in Africa.
The innate immune function of airway epithelial cells in inflammatory lung disease
Authors: Hiemstra Pieter S. , McCray Paul B. , Bals Robert
Published: February 2015

The airway epithelium is now considered to be central to the orchestration of pulmonary inflammatory and immune responses, and is also key to tissue remodelling. It acts as the first barrier in the defence against a wide range of inhaled challenges, and is critically involved in the regulation of both innate and adaptive immune responses to these challenges. Recent progress in our understanding of the developmental regulation of this tissue, the differentiation pathways, recognition of pathogens and antimicrobial responses is now exploited to help understand how epithelial cell function and dysfunction contributes to the pathogenesis of a variety of inflammatory lung diseases. Herein, advances in our knowledge of the biology of airway epithelium, as well as its role and (dys)function in asthma, chronic obstructive pulmonary fibrosis and cystic fibrosis will be discussed.