bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of genetic counseling among cystic fibrosis carriers, Michigan Newborn Screening
Authors: Kleyn Mary J. , Langbo Carrie , Abdulhamid Ibrahim , Adamski Craig R. , Allan Catherine , Carmany Erin P. , Gregoire‐Bottex M. Myrtha , Homnick Douglas , Schuen John , Nasr Samya Z.
Published: November 2012

Objective

A quality improvement (QI) strategy to improve the rate of genetic counseling (GC) services was initiated in cystic fibrosis (CF) care Center E in 2010. This statewide study was conducted to determine: (1) GC rates before and after implementation of the QI strategy at Center E; (2) characteristics associated with not receiving GC; and (3) topic areas addressed during GC.

Methods

The retrospective study included 1,097 CF carriers born from 2008 to 2011 identified through Michigan's Newborn Screening Program. Rate of GC services was determined for Center E and the other four CF centers before and after the QI change. Bivariate and multivariable logistic regression was used to determine associations between select characteristics and not receiving GC. Topic areas discussed during GC sessions were assessed using frequency tables.

Results

Rate of GC services in Center E increased from 23% in 2008–2010 to 91% in 2011, while at the other centers approximately 92% received GC services across those years. In 2008–2010, being seen at Center E and black race were significantly associated with increased likelihood of not receiving GC services in adjusted analyses. In 2011, neither characteristic was associated with receipt of GC. Of 16 target topic areas, all were discussed in 85% of GC sessions.

Conclusions

Implementing a QI strategy of providing sweat test results at the GC appointment within Center E resulted in more CF carriers receiving comprehensive GC services. Center‐specific procedure differences should be assessed to increase rate of GC services following a positive CF newborn screen. Pediatr Pulmonol. 2013; 48:123–129. © 2012 Wiley Periodicals, Inc.
Sea salt deliquescence and crystallization in atmosphere: an in situ investigation using x‐ray phase contrast imaging
Authors: Zeng Jianrong , Zhang Guilin , Long Shilei , Liu Ke , Cao Lingling , Bao Liangman , Li Yan
Published: November 2012

X‐ray phase contrast imaging (PCI) based on synchrotron radiation was introduced for the first time as an in situ imaging way to investigate sea salt phase change, i.e. deliquescence and crystallization in atmospheric environment. A performance on the deliquescence of pure NaCl, which is the dominant component in sea salt, demonstrated that this technique can directly observe the change of core particle and differentiate the outer water layer clearly in solid‐aqueous system of ~100 µm scale. The imaging results showed that sea salt particle deliquesced on a large scale of relative humidity (RH) between 34 and 97% RH as a solid–liquid drop, while no clear deliquescence RH was observed during the process. According to the drop size growth curve, sea salt deliquescence can be divided into three steps, namely water accumulating step (34–75% RH), bulk melting step (75–86% RH) and delay dissolving step (>86% RH), which are most probably dominated by grouped components as MgCl2/CaCl2/MgSO4, NaCl and Na2SO4/KCl/K2SO4, respectively. Instead at a sole RH, the crystallization of sea salt solution occurred at a range of 46–58% RH, which well agreed with the theory proposed by Ge et al. The aqueous‐solid condition provided by sea salt deliquescence and crystallization may greatly enhance the heterogeneous chemical reactions in atmosphere. Copyright © 2012 John Wiley & Sons, Ltd.
Performance analysis for buffer‐aided communication over block Rayleigh fading channels: queue length distribution, overflow probability, and ε‐overflow rate
Authors: Dong Yunquan , Fan Pingyi , Letaief Khaled Ben , Murch Ross D.
Published: November 2012

In this paper, we consider information transmission over a block Rayleigh fading channel, where a finite size buffer is employed to match the source traffic with the channel service capability. Given the buffer size, the transmission capability of a block fading Rayleigh channel is characterized from two aspects: (i) the buffer behavior when the input traffic rate is constant; and (ii) the traffic rate that can be supported by the channel for a given overflow probability constraint. For the first problem, the stationary distribution of the queue length in the buffer is derived by discretizing the queue length using a uniform quantization strategy. It is also shown that the overflow probability of the finite size buffer decreases exponentially with buffer size. An explicit upper bound on the overflow probability is also given. For the second one, a new concept of ε‐overflow rate is proposed to measure the transmission capability of a block fading channel under overflow probability constraints. It will be shown that the ε‐overflow rate is larger than the ε‐outage capacity under the same outage constraint and will meet the great gap between outage capacity and ergodic capacity as the overflow probability constraint varies. Copyright © 2012 John Wiley & Sons, Ltd.
Cooperative ad hoc networks for energy and delay efficient content distribution with fast channel variations
Authors: Atat Rachad , Yaacoub Elias , Alouini Mohamed‐Slim , Abu‐Dayya Adnan
Published: November 2012

Cooperative ad hoc networks for the efficient distribution of content of common interest are studied in the case of fast channel variations. Mobiles are grouped into cooperative clusters for the purpose of receiving the content with optimized energy efficiency. Data are sent to mobile terminals on a long range (LR) link, and then, the terminals exchange the content by using an appropriate short range wireless technology. When channel state information is available for the LR links, unicasting is used on the LR. When accurate channel state information is not available, threshold‐based multicasting is implemented on the LR. Energy minimization is formulated as an optimization problem for each scenario, and the optimal solutions are determined in closed form in scenarios with fast channel variations. Results show significant energy savings in the proposed schemes compared with the noncooperative case and other previous related work. Furthermore, the energy minimizing solutions are shown to lead to reduced delay in the content distribution process. Practical implementation aspects of the proposed methods are also discussed. Copyright © 2012 John Wiley & Sons, Ltd.
Psychosocial Benefits and Implications of Exercise
Authors: Gaz Daniel V. , Smith Aynsley M.
Published: November 2012

This review is based on a case report that concerns a young female athlete who experienced some of the negative aspects of exercise. Overtraining, a negative byproduct of excessive exercise, can turn the positive psychosocial and physiologic benefits of regular physical activity into an activity detrimental to one's health. With the proper psychological skills and appropriate exercise regimen, these negatives can be turned into positives. Once learned, the psychosocial benefits of exercise, as well as the positive implications, will become more prevalent, similar to the way in which proper physical training helps one become more fit over time.
The centralizer of a subgroup in a group algebra
Authors: Danz Susanne , Ellers Harald , Murray John
Published: November 2012

Let F be an algebraically closed field, G be a finite group and H be a subgroup of G. We answer several questions about the centralizer algebra FGH. Among these, we provide examples to show that

•

the centre Z(FGH) can be larger than the F-algebra generated by Z(FG) and Z(FH),

•

FGH can have primitive central idempotents that are not of the form ef, where e and f are primitive central idempotents of FG and FH respectively,

•

it is not always true that the simple FGH-modules are the same as the non-zero FGH-modules HomFH(S, T ↓ H), where S and T are simple FH and FG-modules, respectively.
REPRODUCTIVE PREFERENCES AND CONTRACEPTIVE USE: A COMPARISON OF MONOGAMOUS AND POLYGAMOUS COUPLES IN NORTHERN MALAWI
Authors: BASCHIERI A. , CLELAND J. , FLOYD S. , DUBE A. , MSONA A. , MOLESWORTH A. , GLYNN J. R. , FRENCH N.
Published: November 2012

There is now widespread agreement on the importance of men's role in reproductive decision-making. Several studies have argued that fertility preferences and their translation into behaviour differ between polygamous and monogamous unions. Studies investigating the dominance of men's preferences over women's preferences, in cases of couple disagreement, found mixed evidence of the effect of polygamy. However, an often cited limitation of these studies has been the inability to link husband's intention with each of his wives in a polygamous union. By adding fertility-intention questions to an on-going Demographic Surveillance Site in Karonga District in northern Malawi the fertility preferences and contraceptive use of husbands and wives were investigated. An analysis of the relationship between the level of agreement and disagreement between husbands' and wives' fertility preferences was then performed to gain insight into the reproductive decision-making process of polygamous couples.
Understanding the Energy Diplomacies of East Asian States
Authors: DENT CHRISTOPHER M.
Published: November 2012

Energy security is one of the major global challenges of the twenty-first century. Intensifying competition for ever scarcer forms of conventional energy resources is causing significant tensions in the international system. East Asia will have a more profound impact on global energy security than any other region as its burgeoning demand for energy fuels, spurred principally by China, is expected to continue growing at over twice the world average in the next few decades. This paper examines the reasons why we may expect the energy diplomacies of East Asian states to become an increasingly salient feature of East Asian states’ foreign policy and international relations in the foreseeable future, and thereby significantly shape the nature of the region's international political economy. It presents a framework of energy diplomacy analysis in order to better understand how East Asian states are formulating their energy diplomacy strategies and actions. The four prime elements of this framework comprise: empirical perspectives and generic task-oriented terms; agential influences on the formation and organization of energy diplomacy practice; the energy–development nexus; and transaction mechanisms of energy diplomacy. The main conclusions are first, mercantilist approaches to energy diplomacy will persist but continue to gradually give way to market institutionalism; second, energy diplomacy will become increasingly linked to other forms of diplomacy, such as trade, environment and development assistance; third, we may expect East Asian states to afford greater priority to multilateral energy co-operation both regionally and in a wider international or global sense as energy security interdependencies deepen; and fourth, East Asia's growing reliance on sourcing energy fuels from outside the region will make it more dependent on stable international energy markets—these markets are becoming increasingly internationalized and globalized, which will broaden the future options of East Asian states developing new international energy partnerships.
Prejudice is about politics: A collective action perspective
Authors: Drury John
Published: November 2012

In line with Dixon et al.'s argument, I contend that prejudice should be understood in broadly political rather than in narrowly psychological terms. First, whatcountsas prejudice is a political judgement. Second, studies of collective action demonstrate that it is in “political” struggles, where subordinate groups together oppose dominant groups, that prejudice can be overcome.
Statistical learning and prejudice
Authors: Madison Guy , Ullén Fredrik
Published: November 2012

Human behavior is guided by evolutionarily shaped brain mechanisms that make statistical predictions based on limited information. Such mechanisms are important for facilitating interpersonal relationships, avoiding dangers, and seizing opportunities in social interaction. We thus suggest that it is essential for analyses of prejudice and prejudice reduction to take the predictive accuracy and adaptivity of the studied prejudices into account.
Prejudicial behavior: More closely linked to homophilic peer preferences than to trait bigotry
Authors: Vigil Jacob M. , Venner Kamilla
Published: November 2012

We disagree with Dixon et al. by maintaining that prejudice is primarily rooted in aversive reactions toward out-group members. However, these reactions are not indicative of negative attributes, such as trait bigotry, but rather normative homophily for peers with similar perceived attributes. Cognitive biases such as stereotype threat perpetuate perceptions of inequipotential and subsequent discrimination, irrespective of individuals' personality characteristics.
Effects of News Frames on Recipients’ Information Processing in Disability Sports Communications
Authors: von Sikorski Christian , Schierl Thomas
Published: November 2012

The international media coverage of disability sports displays diverse quantitative and qualitative shortcomings and shows that disability sports issues are frequently framed in unfavorable and negative ways. This study explores the effects of (valenced) issue-specific news frames in a disability sports communication. In an experimental study (between-subjects design), 90 participants were randomly assigned to three groups. Participants read a sports news article about the situation in disability sports prior to the 2012 Paralympic Games with a frame that either saliently focused on the athletic performance in disability sports (Group 1), or the fate and (financial) dependency on public support of disability sports (Group 2), or both (mixed frame; Group 3). Participants’ importance considerations regarding specific aspects in disability sports, as well as their attitudes toward a portrayed athlete with a disability were measured. The findings showed a significant impact of the applied frames on participants’ importance considerations and attitudes.
Impression Formation Online
Authors: Magee Robert G.
Published: November 2012

Sensations of physical temperature can serve as a peripheral cue when some individuals interact with communication technology, but this phenomenon has been shown to occur only when individuals were engaged in peripheral-route associative processing. In an experiment (N = 211) with physical temperature and Web page color as between-subjects factors and need for cognition as a measured independent variable, participants viewed an organization’s Web page. Cognitive misers who experienced physical cold (versus warmth) reported less favorable attitudes toward the Web page. This interaction disappeared, however, when they viewed a Web page that featured a red color scheme, as red seemed to have stimulated an increase in central-route analytic cognitive processing. This pattern of results illustrates the utility of the elaboration likelihood model in studying impression formation in online contexts.
Index-coupled surface porous grating distributed feedback quantum cascade laser
Authors: Zhang J. C. , Liu F. Q. , Zhao L. H. , Wang L. J. , Yao D. Y. , Zhai S. Q. , Liu J. Q. , Wang Z. G.
Published: November 2012

We report design of special low loss, index-coupled surface porous grating distributed feedback profile by using holographic lithography combined with electro-chemical etching technology. Room temperature continuous-wave (cw) operation of single-mode quantum cascade lasers emitting at λ ∼ 7.6 μm has been achieved. Due to attenuate interplay between the surface plasmon waves and the waveguide waves, the waveguide loss of the lasers is significantly reduced, when compared to conventional surface metal/semiconductor grating devices. This resulted in an improved overall laser performance, such as a reduction of the threshold current density and an increase in cw output power.
Mechanism for adaptive remodeling of the bacterial flagellar switch
Authors: Lele Pushkar P. , Branch Richard W. , Nathan Vedhavalli S. J. , Berg Howard C.
Published: November 2012

The bacterial flagellar motor has been shown in previous work to adapt to changes in the steady-state concentration of the chemotaxis signaling molecule, CheY-P, by changing the FliM content. We show here that the number of FliM molecules in the motor and the fraction of FliM molecules that exchange depend on the direction of flagellar rotation, not on CheY-P binding per se. Our results are consistent with a model in which the structural differences associated with the direction of rotation modulate the strength of FliM binding. When the motor spins counterclockwise, FliM binding strengthens, the fraction of FliM molecules that exchanges decreases, and the ring content increases. The larger number of CheY-P binding sites enhances the motor’s sensitivity, i.e., the motor adapts. An interesting unresolved question is how additional copies of FliM might be accommodated.
The role and responsibility of the anonymous: The historic function of mass translations
Authors: Ben-Ari Nitsa
Published: November 2012

A remarkable phenomenon in Hebrew culture of the 1950s was the emergence of a considerable quantity of translations and pseudo-translations of pulp literature. The phenomenon stemmed from the need of the literary system to renew and stratify itself, supplying the general reading public with popular literature in Hebrew that was neither didactic nor engaged. This "healthy" drive was encountered by conservative efforts of the mainstream, which insisted on maintaining high literary norms. Culture-shapers even sought ways of imposing the "right" kind of popular literature on the working classes, rather than allowing it to develop naturally. But the periphery provided pulp fiction – detective stories, romance, thrillers, and erotica—far more popular than any canonical literature. The number of cheap books, booklets, and serials grew rapidly, reaching a peak in the mid 60s. So did the number of printing presses or small publishing firms that emerged almost daily, as well as the number of writers/translators, at least seemingly so, for the vast number of pseudonyms hid a rather limited group or core of participants. This article explores the function of this massive production: on the one hand, the role of the individual non-canonic translators, mostly hiding under pen-names; on the other, the role of this massive corpus of what was then considered "junk". The possible advantages of anonymity will be discussed, as well as the relationship between this production in the periphery and production in the center.
Beam ion losses due to energetic particle geodesic acoustic modes
Authors: Fisher R.K. , Pace D.C. , Kramer G.J. , Van Zeeland M.A. , Nazikian R. , Heidbrink W.W. , García-Muñoz M.
Published: November 2012

We report the first experimental observations of fast-ion loss in a tokamak due to energetic particle driven geodesic acoustic modes (EGAMs). A fast-ion loss detector installed on the DIII-D tokamak observes bursts of beam ion losses coherent with the EGAM frequency. The EGAM activity results in a significant loss of beam ions, comparable to the first orbit losses. The pitch angles and energies of the measured fast-ion losses agree with predictions from a full orbit simulation code SPIRAL, which includes scattering and slowing-down.
A Comparative Study of the Surgically Relevant Mechanical Characteristics of the Topical Skin Adhesives
Authors: Singer Adam J. , Perry Larry
Published: November 2012

Objectives

Topical skin adhesives (TSAs) offer a noninvasive alternative to sutures. The growing trend is to use them in addition to sutures and staples to add strength and provide a microbial barrier. The authors compared the mechanical characteristics of recently approved TSAs that are most likely to be of surgical relevance in the emergency department.

Methods

Linear incisions were made on anesthetized swine and the wounds were approximated with one of six commercially available TSAs. Three‐dimensional bursting strength was measured with a BTC‐2000TM device. Tensile failure force was measured ex vivo using TSA‐approximated porcine skin strips with a tensionometer. Resistance to cyclic loading was measured by subjecting approximated skin strips to repetitive cycles of rotational torque and linear tension. Viscosity was measured with a viscometer and setting times were measured by periodically dabbing the adhesive applied to skin strips with a cotton swab to determine whether it was dry.

Results

Dermabond Advanced TSA provided significantly (p < 0.00001) greater acute in vivo wound bursting strength and ex vivo tensile force, greater mean number of normal tensile loading cycles to failure (while under continuous torsional cycling), and longest time to failure, and the mean setting time was the shortest.

Conclusions

Of all the TSAs tested in this study, Dermabond Advanced was the strongest and most flexible, set in the shortest time, and was a fairly viscous adhesive, all of which are clinically desirable characteristics.
A Model for Emergency Department End‐of‐life Communications After Acute Devastating Events—Part II: Moving From Resuscitative to End‐of‐life or Palliative Treatment
Authors: Limehouse Walter E. , Ramana Feeser V. , Bookman Kelly J. , Derse Arthur
Published: November 2012

The model for emergency department (ED) end‐of‐life communications after acute devastating events addresses decision‐making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end‐of‐life treatments. After completing the steps involved in determining decision‐making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end‐of‐life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them.
Risk of postpartum uterine synechiae following uterine compression suturing during postpartum haemorrhage
Authors: Ibrahim Moustafa I. , Raafat Tarek A. , Ellaithy Mohamed I. , Aly Rehab T.
Published: November 2012

Background

Uterine compression suturing is considered a successful, safe, inexpensive and simple ‎method for the conservative treatment of atonic postpartum haemorrhage (PPH). However, insufficient data are available about the potential risk of subsequent intrauterine ‎synechiae (IUS).

Aim

To determine the risk of postpartum uterine synechiae in women who received isolated uterine compression suturing for the management of major uncontrolled PPH.

Materials & Methods

All women with major PPH from May 2005 to June 2011 were reviewed retrospectively. Diagnostic hysteroscopy was performed to assess the uterine cavity in the 27 women who successfully underwent isolated uterine compression suturing for major atonic PPH and fulfilled the study inclusion and exclusion criteria.

Results

Among the 27 women who underwent isolated uterine compression suturing, 5 (18.5%) were found to have IUS on hysteroscopic examination. The mode of delivery for all women who developed IUS was caesarean section. Among these five women, three had mild IUS, one had moderate IUS and one had severe IUS. All adhesions were later successfully resected by hysteroscopy, except for one case with dense IUS.

Conclusions

Uterine compression suturing was found to be associated with a risk of postpartum uterine synechiae formation, which may subsequently affect future fertility.
The effect of pre‐procedure anxiety on sedative requirements for sedation during colonoscopy
Authors: Chung K.‐C. , Juang S.‐E. , Lee K.‐C. , Hu W.‐H. , Lu C.‐C. , Lu H.‐F. , Hung K.‐C.
Published: November 2012

This study investigated the effects of pre‐procedural anxiety (assessed using the Beck Anxiety Inventory) on sedative requirements in 135 patients undergoing sedation for colonoscopy. Deep sedation was defined as loss of consciousness and no response to colonoscopy, and was achieved by target‐controlled infusion of propofol. Patients' characteristics, baseline haemodynamic profiles, Beck Anxiety Inventory scores, effect‐site propofol concentration at loss of consciousness and characteristics of recovery were recorded. No correlations were found between Beck Anxiety Inventory scores and effect‐site propofol concentration at loss of consciousness or baseline haemodynamic profiles. There was no statistical difference in the characteristics of recovery among patients with different levels of anxiety. In conclusion, in patients receiving deep sedation for colonoscopies, the level of pre‐procedural anxiety did not relate to the sedative requirement or post‐procedural recovery characteristics.
Effects of melatonin on salsolinol‐induced prolactin secretion in goats
Authors: Hashizume Tsutomu , Yaegashi Tomoyoshi , Jin Jin , Sawai Ken , Fülöp Ferenc , Nagy György Miklos
Published: November 2012

The aim of the present study was to clarify the effect of melatonin (MEL) on the salsolinol (SAL)‐induced release of prolactin (PRL) in goats. Female goats were kept at 20°C with 16 h of light, 8 h of darkness, and orally administered saline or MEL for 5 weeks. A single intravenous (i.v.) injection of saline (controls), SAL, thyrotropin‐releasing hormone (TRH) or a dopamine receptor antagonist, sulpiride, was given to the goats 3 weeks after the first oral administrations of saline or MEL, and the responses were compared. The mean basal plasma PRL concentrations in the control group were higher for the saline treatments than MEL treatments (P < 0.05). SAL as well as TRH and sulpiride stimulated the release of PRL promptly after each injection in both the saline‐ and MEL‐treated groups (P < 0.05). The area under the response curve of PRL for the 60‐min period after the i.v. injection of SAL, TRH and sulpiride in the saline‐treated group was greater than each corresponding value in the MEL‐treated group (P < 0.05). These results show that daily exposure to MEL under a long day length reduces the PRL‐releasing response to SAL as well as TRH and sulpiride in goats.
Nucleotide variants of genes encoding components of the Wnt signalling pathway and the risk of non‐syndromic tooth agenesis
Authors: Mostowska A , Biedziak B , Zadurska M , Dunin‐Wilczynska I , Lianeri M , Jagodzinski PP
Published: November 2012

Tooth agenesis is one of the most common dental anomalies, with a complex and not yet fully elucidated aetiology. Given the crucial role of the Wnt signalling pathway during tooth development, the purpose of this study was to determine whether nucleotide variants of genes encoding components of this signalling pathway might be associated with hypodontia and oligodontia in the Polish population. A set of 34 single nucleotide polymorphism (SNPs) in 13 WNT and WNT‐related genes were analyzed in a group of 157 patients with tooth agenesis and a properly matched control group (n = 430). In addition, direct sequencing was performed to detect mutations in the MSX1, PAX9 and WNT10A genes. Both single‐marker and haplotype analyses showed highly significant association between SNPs in the WNT10A gene and the risk for tooth agenesis. Moreover, nine pathogenic mutations within the coding region of the WNT10A gene were identified in 26 out of 42 (62%) tested patients. One novel heterozygous mutation was identified in the PAX9 gene. Borderline association with the risk of non‐syndromic tooth agenesis was also observed for the APC, CTNNB1, DVL2 and WNT11 polymorphisms. In conclusion, nucleotide variants of genes encoding important components of the Wnt signalling pathway might influence the risk of tooth agenesis.
Langerhans cell histiocytosis associated with lichen sclerosus of the vulva: case report and review of the literature
Authors: Chang Jason C. , Blake David G. , Leung Belinda V. , Plaza Jose A.
Published: November 2012

Langerhans cell histiocytosis (LCH) is characterized by a clonal proliferation of bone marrow‐derived Langerhans cells. While cutaneous involvement is relatively common, LCH restricted to the vulvar area is a rare phenomenon and can occur in different clinical settings. Occasionally, vulvar LCH heralds subsequent multi‐organ involvement with an aggressive clinical course. Even cases of LCH isolated to the vulvar area can present with local recurrences despite excision and radiation. We present a case of a 68‐year‐old female with a 1‐month history of pruritic lesions on her vulva. Physical examination showed whitish plaques with scattered nodular areas on the labia majora. A vulvar biopsy showed a background of lichen sclerosus (LS) with foci of oval to polygonal cells with moderately abundant eosinophilic cytoplasm and folded nuclei showing frequent nuclear grooves. Immunohistochemical staining showed that the cells were positive for CD1a and S‐100, confirming the diagnosis of LCH. On further workup, there was no evidence of disseminated disease involving other organs. While vulvar LCH is uncommonly seen, and with only one previous case report in the literature associated in the setting of lichen sclerosus, this case illustrates the importance of recognizing this condition and ensuring proper clinical follow‐up to rule out a systemic involvement.
Basilar artery stroke in childhood
Authors: GOEGGEL SIMONETTI BARBARA , RITTER BARBARA , GAUTSCHI MATTHIAS , WEHRLI EDITH , BOLTSHAUSER EUGEN , SCHMITT‐MECHELKE THOMAS , WEBER PETER , WEISSERT MARKUS , EL‐KOUSSY MARWAN , STEINLIN MAJA
Published: November 2012

Aim  Little is known about basilar artery stroke (BAS) in children. The objective of this study was to calculate the incidence of BAS in children and to analyse the clinical presentation, risk factors, radiological findings, therapeutic approaches, and outcome of BAS in childhood.

Method  A prospective, population‐based study including children with arterial ischaemic stroke and a systematic review of the literature was undertaken.

Results  Seven children with BAS were registered at the Swiss Neuropaediatric Stroke Registry between January 2000 and June 2011 (incidence 0.037 per 100 000 children per year, 95% confidence interval [CI] 0.013–0.080). A further 90 cases were identified through the literature search. The majority of patients were male (73 males, 24 females) and the median age was 9 years (interquartile range [IQR]=6–13y). The median Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score was 15 (IQR=4–27). Presenting signs and symptoms comprised impaired consciousness (n=64), quadri‐ or hemiparesis (n=58), bulbar dysfunction (n=46), vomiting, nausea (n=43), and headache (n=41). Prodromes occurred in 43% of cases. Aetiology was largely vasculopathic (n=38), but often unknown (n=40). Time to diagnosis varied from hours days; six patients received antithrombotic, thrombolytic, or mechanical endovascular treatment 12 hours or less after symptom onset. Outcome was good (modified Rankin Scale 0–2) in 45 patients; eight died. PedNIHSS score of up to 17 was a prognostic factor for good outcome.

Interpretation  BAS is rare in children. Compared with adults, outcome is more favourable despite a considerable delay in diagnosis and treatment. Outcome was better in children with a PedNIHSS score of 17 or less.
Hand sensation in adults with conservatively treated obstetric brachial plexus lesion
Authors: GALEA MARY
Published: November 2012

This commentary is on the original article by Anguelova et al on pages 257‐263 of this issue.
Pulp polyp in traumatized primary teeth – a case–control study
Authors: Jabbar Nadia Salem Abdel , Aldrigui Janaina Merli , Braga Mariana Minatel , Wanderley Marcia Turolla
Published: November 2012

Aim

To assess clinical characteristics and other factors associated with the occurrence of pulp polyp in traumatized primary teeth as well to evaluate the impact of pulp polyp occurrence on clinical decision‐making after traumatic injuries.

Material and methods

This study was divided into three phases. First, occurrence and clinical characteristics of pulp polyp were assessed followed by a descriptive analysis and categorical tests of association. Secondly, a case–control design was used, and the occurrence of pulp polyp was set as the outcome. In third phase, the occurrence of pulp polyp after fracture with pulp exposure was investigated as a variable possibly associated with clinical decision‐making (dental extraction/endodontic treatment). Logistic regression analyses were used, and odds ratios and 95% confidence interval (OR; 95% CI) were calculated in second and third phases.

Results

Occurrence of pulp polyp in traumatized primary teeth was of 2.3%. Hyperplastic tissue color and proliferation size were not associated with the time to seek treatment after injury (P > 0.05). Children up to 2 years of age had more chance of having pulp polyp in comparison with older children (3.15; 1.15–8.64). Teeth with crown–root fracture had more chance of dental extraction in the therapeutic approach than the teeth with only crown fracture (4.36; 1.10–17.32). Presence of pulp polyp was not associated with the treatment carried out.

Conclusions

Occurrence of pulp polyp in traumatized primary teeth is not frequent and is associated with the age when traumatic dental injury occurs but does not interfere directly with the therapeutic approach.
Can cognitive deficits facilitate differential diagnosis between at‐risk mental state for psychosis and depressive disorders?
Authors: Schulze Carla , Zimmermann Ronan , Gschwandtner Ute , Pflueger Marlon O. , Rapp Charlotte , Studerus Erich , Riecher‐Rössler Anita
Published: November 2012

Aim

Many studies have provided evidence of cognitive deficits in individuals in an ‘At Risk Mental State’ (ARMS) for psychosis, which makes neuropsychology potentially useful in the early detection of psychosis. As depression is an important differential diagnosis in prodromal states of psychosis, the specificity of neurocognitive deficits inARMSindividuals as compared with non‐psychotic depressive disorders is investigated.

Methods

Neurocognitive performance of four groups was analysed: 22ARMSindividuals with later transition to psychosis (ARMS‐T), 25ARMSindividuals without later transition to psychosis (ARMS‐NT), 34 controls with depressive disorders and 76 healthy controls. The subjects were assessed with a neurocognitive test battery covering the domains’ intelligence, executive function and attention/ working memory.MANOVAs,ANOVAs and Tukey's tests were applied after adjustment for confounding factors.

Results

ARMS‐T showed significant cognitive deficits in working memory and in certain executive function tasks compared with healthy controls as well as with controls with depression. Controls with depression were only impaired in time per move in the tower of Hanoi test when compared with healthy controls.

Conclusions

The psychosis prodrome seems to be associated with cognitive deficits in the domains of working memory and executive function. In contrast, depressive patients showed no cognitive deficits, but slowing in one executive function task. Neurocognitive testing might therefore contribute to the differential diagnosis between prodromal psychosis and depressive disorders.
Differentiated information on antidepressants at hospital discharge: a hypothesis-generating study
Authors: Desplenter Franciska , Laekeman Gert ,   the GIPPOZ Research Group, Simoens Steven
Published: November 2012

Objectives

This hypothesis-generating study examined the clinical, humanistic and economic impact of providing differentiated medication information depending on the patient's information desire as compared with undifferentiated information to patients with a major depressive episode at hospital discharge.

Methods

A longitudinal multi-centre study with quasi-experimental design comprised two experimental groups ((un)differentiated antidepressant information) and one ‘no information’ group. Patients were followed up for 1 year assessing adherence, economic outcomes (i.e. costs of medicines, consultations, productivity loss and re-admissions), clinical outcomes (i.e. depressive, anxiety and somatic symptoms and side effects) and humanistic outcomes (i.e. quality of life, satisfaction with information). A linear model for repeated measures was applied to assess differences over time and between groups.

Key findings

Ninety-nine patients participated. Still participating 1 year later were 78. No beneficial effect was observed for adherence. Lower productivity loss (P = 0.021) and costs of consultations with healthcare professionals (P = 0.036) were observed in the differentiated group. About one-third of patients were re-admitted within 1 year following discharge. Patients in the ‘no information’ group had significantly more re-admissions than patients in the undifferentiated group (P = 0.031).

Conclusions

The hypothesis of differentiated information could be supported for economic outcomes only. Future medication therapy intervention studies should apply a more rigorous study design.
Assessment of Situational Demands in a Selection Interview: Reflective style or sensitivity?
Authors: Melchers Klaus G. , Bösser Dieter , Hartstein Thomas , Kleinmann Martin
Published: November 2012

Correctly understanding situational demands is necessary to handle social situations appropriately. Past selection research has shown that candidates who are better at identifying the targeted dimensions in an interview or an assessment center, in fact, perform better in these procedures. However, at least two different processes might be responsible for the obtained findings. First, candidates might differ in their ability to correctly interpret given cues, meaning that some candidates generate better (i.e., more accurate) ideas than others. Second, some candidates might generally reflect more upon potential demands and therefore generate more ideas concerning potentially targeted dimensions. The present study used signal detection theory to investigate to what degree these two processes are related to interview performance. The interview was administered during a selection simulation for university graduates (N = 147). Interviewees' assumptions concerning the targeted dimensions were assessed in a postinterview questionnaire in which they had to write down any hypotheses as to what a certain question was trying to assess. We found that generating better ideas was essential for candidates' interview performance and not the degree to which they generally generated ideas about targeted interview dimension.
Fat government, thin populace? Is the growth of obesity prevalence lower in more generous welfare states?
Authors: Vis Barbara , Hylands Tom
Published: November 2012

In the last few decades, the prevalence of obesity has expanded rapidly and now constitutes a grave public health concern across the developed world. Obesity is negatively associated with, among other factors, education and healthcare quality, which are factors that governments can and do influence through welfare policies. This study investigated to what extent the change in the prevalence of obesity is lower in more generous welfare states. Based on pooled time series cross‐section regressions for 15 developed countries over 25 years, we found that the more generous are transfer payments, health policy and education policy, the lower is the increase of obesity prevalence. These findings have important implications for public policy formation and the public health and welfare state literatures.
Effect of number and location of distant metastases on renal cell carcinoma mortality in candidates for cytoreductive nephrectomy: Implications for multimodal therapy
Authors: Capitanio Umberto , Abdollah Firas , Matloob Rayan , Salonia Andrea , Suardi Nazareno , Briganti Alberto , Carenzi Cristina , Rigatti Patrizio , Montorsi Francesco , Bertini Roberto
Published: November 2012

Objective

To test whether the combination of number and location of distant metastases affects cancer‐specific survival in patients with metastatic renal cell carcinoma.

Methods

Overall, 242 metastatic renal cell carcinoma patients with synchronous metastases at diagnosis underwent cytoreductive nephrectomy at a single institution. Combinations of number and location of distant metastases were coded as: single metastasis and single organ affected, multiple metastases and single organ affected, single metastasis for each of the multiple organs affected, and multiple metastases for each of the multiple organs affected. Covariates included age, symptoms, performance status, American Society of Anesthesiologists score, hemoglobin, lactate dehydrogenase, tumor size, Fuhrman grade, T stage, lymph node status, necrosis, sarcomatoid features and metastasectomy at the time of nephrectomy.

Results

The median survival was 34.7 versus 32.3 versus 29.6 versus 8.5 months for single metastasis and single organ affected, multiple metastases and single organ affected single metastasis for each of the multiple organs affected, and multiple metastases for each of the multiple organs affected patients, respectively. At multivariable analyses, the combination of number and location of distant metastases resulted in one of the most informative and independent predictors of cancer‐specific survival in metastatic renal cell carcinoma patients. The lung was the location with the highest rate of single organ affected (50.3% vs 35.1% in other sites; P < 0.001). Considering only patients with a single metastasis, no statistically significantly different cancer‐specific survival rates were recorded (P > 0.3) among different metastatic organs.

Conclusions

Among metastatic renal cell carcinoma patients undergoing cytoreductive nephrectomy, the combination of the number and location of distant metastases is a major independent predictor of cancer‐specific survival. Patients with multiple organs affected by multifocal disease are more likely to have poorer survival.
A pilot study evaluating non‐contact low‐frequency ultrasound and underlying molecular mechanism on diabetic foot ulcers
Authors: Yao Min , Hasturk Hatice , Kantarci Alpdogan , Gu Guosheng , Garcia‐Lavin Silvia , Fabbi Matteo , Park Nanjin , Hayashi Hisae , Attala Khaled , French Michael A , Driver Vickie R
Published: November 2012

Non‐contact low‐frequency ultrasound (NCLF‐US) devices have been increasingly used for the treatment of chronic non‐healing wounds. The appropriate dose for NCLF‐US is still in debate. The aims of this pilot study were to evaluate the relationship between dose and duration of treatment for subjects with non‐healing diabetic foot ulcers (DFUs) and to explore the correlation between wound healing and change of cytokine/proteinase/growth factor profile. This was a prospective randomised clinical study designed to evaluate subjects with non‐healing DFUs for 5 weeks receiving standard of care and/or NCLF‐US treatment. Subjects were randomly assigned to one of the three groups: application of NCLF‐US thrice per week (Group 1), NCLF‐US once per week (Group 2) and the control (Group 3) that received no NCLF‐US. All subjects received standard wound care plus offloading for a total of 4 weeks. Percent area reduction (PAR) of each wound compared with baseline was evaluated weekly. Profiles of cytokines/proteinase/growth factors in wound fluid and biopsied tissue were quantified to explore the correlation between wound healing and cytokines/growth factor expression. Twelve DFU patients, 2 (16·7%) type 1 and 10 (83·3%) type 2 diabetics, with an average age of 58 ± 10 years and a total of 12 foot ulcers were enrolled. Average ulcer duration was 36·44 ± 24·78 weeks and the average ABI was 0·91 ± 0·06. Group 1 showed significant wound area reduction at weeks 3, 4 and 5 compared with baseline, with the greatest PAR, 86% (P < 0·05); Groups 2 and 3 showed 25% PAR and 39% PAR, respectively, but there were no statistically significant differences between Groups 2 and 3 over time. Biochemical and histological analyses indicated a trend towards reduction of pro‐inflammatory cytokines (IL‐6, IL‐8, IL‐1β, TNF‐α and GM‐CSF), matrix metalloproteinase‐9 (MMP‐9), vascular endothelial growth factor (VEGF) and macrophages in response to NCLF‐US consistent with wound reduction, when compared with control group subjects. This proof‐of‐concept pilot study demonstrates that NCLF‐US is effective in treating neuropathic diabetic foot ulcers through, at least in part, inhibiting pro‐inflammatory cytokines in chronic wound and improving tissue regeneration. Therapeutic application of NFLU, thrice (3) per week, renders the best wound area reduction.
Characterization and expression of Cd8 molecules in mandarin fish Siniperca chuatsi
Authors: Guo Z. , Wang G. L. , Fu J. P. , Nie P.
Published: November 2012

The full‐length complementary DNA (cDNA) sequences encoding cd8α and cd8β molecules were sequenced and characterized from mandarin fish Siniperca chuatsi. Conserved motifs and residues were found to be present in derived peptides of the Cd8 molecules. For example, WXR motif, DXGXYXC motif, and four cysteine residues were present in the extracellular region of the Cd8 protein. Threonine, serine and proline residues involved in multiple O‐linked glycosylation events were located in the membrane proximal hinge region. The common CPH motif in the cytoplasmic tail was detected similar to other teleost Cd8 molecules. Different from those in mammals, S. chuatsi Cd8 sequences have many extra cysteine residues (C149 in Cd8α sequence and C46, C51 and C158 in Cd8β sequence), which also exist in other teleost Cd8 molecules. Real‐time polymerase chain reaction (RT‐PCR) and Western blot analyses revealed that the thymus had the highest expression of cd8 messenger (m)RNA and protein. After stimulated with phytohaemagglutinin, polyriboinsine‐polyribocyaidylic acid and concanavalin A (ConA), the expression level of cd8 mRNA increased significantly in head‐kidney lymphocytes at 4 and 8 h, but decreased to normal level at 12 h. Similarly, stimulation with ConA in vivo also led to an increase in the cd8 mRNA level in the spleen. Immunohistochemistry analysis demonstrated that Cd8α‐positive cells can be detected in the thymus, spleen and intestine by using polyclonal anti‐Cd8α antibody.
‘Now that the dust has settled…’ the impacts of Icelandic volcanic eruptions
Authors: Tweed Fiona S.
Published: November 2012

Volcanic eruptions generate hazards, are potent agents of landscape change and have the power to alter global climate. Recent events in Iceland have emphasised the multi‐scale and trans‐boundary nature of hazards from ice‐volcano interactions and have highlighted their local, national and international impacts. Prompted by these recent events, this article reviews a selection of Icelandic volcanic eruptions in order to demonstrate the diversity of hazards and impacts generated by Icelandic volcanic activity. Some of the challenges associated with managing risks from Icelandic volcanic hazards are discussed and future prospects are outlined.
Crinoid localities of the Silurian of the British Isles
Authors: Donovan Stephen K. , Lewis David N. , Fearnhead Fiona E.
Published: November 2012

The first monograph of the British Silurian crinoids was published as early as 1839 and identified 14 species; over 120 are now known. The most productive horizon for both diversity of species and numbers of well‐preserved specimens is the Much Wenlock Limestone Formation at Dudley (Lower Silurian, Wenlock), a site of international significance. Other localities have produced fewer, but different species. Herein, we introduce the most important crinoid localities in the Llandovery to Ludlow of the British Isles, and figure some of the many beautiful and significant specimens that they have produced.