bluuebunny/crossref_metadata_2025 huggingface dataset:
Accessibility of Primary Health Care Workforce in Rural China
Authors: Han Youli , Wei Jihong , Song Xinmin , Sarah Barber J. , Wen Chunmei , Zheng Xiaoying
Published: October 2012

This study aims to develop an accessibility index to illustrate the status of the accessibility of primary health care workers in remote and rural areas in China. Relevant county-level data were used to analyze the number and distribution of primary health care workforce in rural China, and relevant provincial-level data were used to analyze the accessibility index. The study found that the development of rural primary health care workers is suboptimal. The rural Primary Health Care Worker Accessibility index shows that the accessibility to primary health care workers in western rural areas is poor. The correlation between PHCWA index and maternal mortality rate is more significant than that between primary health care workers density and maternal mortality rate. In addition to increasing the number of primary health care workers, strategies addressing the challenge of distance are also required.
Adolescent Optimistic Bias Toward HIV/AIDS in Seoul, South Korea
Authors: Sohn Aeree , Chun Sungsoo , Reid Easton A.
Published: October 2012

The reported rates of HIV/AIDS cases and risky sexual behaviors have increased among adolescents in South Korea. This study reports the presence, impact, and development of optimistic bias toward HIV/AIDS in Korean adolescents. Survey data from 2996 participants were randomly collected from 8 high school and 8 middle school students in Seoul, South Korea. This study found that Korean high and middle school students had greater optimistic bias toward HIV/AIDS compared with their peers ( P = .000). Involvement ( r = −0.19; P < .01) decreased optimistic bias, whereas self-esteem ( r = 0.13; P < .01) and self-control ( r = 0.22; P < .01) increased it. Univariate analysis results indicated that gender and academic performance significantly influenced optimistic bias. However, according to hierarchical multiple regression, this significance was lost, and involvement, self-esteem, and self-control exerted a greater effect. Equipping Korean adolescents with involvement, awareness, and tailored interventions will reduce optimistic bias and yield greater protection against HIV/AIDS.
Two-Year Outcomes of Methadone Maintenance Therapy at a Clinic in Malaysia
Authors: Musa Ramli , Abu Bakar Ahmad Zafri , Ali Khan Umeed
Published: October 2012

Background. The commencement of methadone maintenance therapy (MMT) in 2005 represents a quantum leap in the management of heroin dependence in Malaysia. Objective. To examine the 2-year outcomes of this modality in the treatment of heroin dependence with respect to the quality of life (QOL), heroin abstinence, and rate of employment among heroin dependants attending the Tengku Ampuan Afzan Hospital (HTAA) MMT clinic. Method. This was an experimental study in which the second QOL assessment was conducted 2 years after treatment initiation. Results. A total of 172 patients enrolled at the point of entry to the MMT program. The authors examined 107 patients who remained in the program 2 years later (62.6% retention rate). A paired t test demonstrated sigsnificant improvements in all 4 domains of QOL (physical, psychological, social relationships, and environment; P < .001). The most marked improvement was noted in the psychological domain. Conclusion. The MMT program at HTAA is effective in improving the QOL among heroin dependants.
Impact of the 1994 Alcohol Production and Sales Deregulation Policy on Traffic Crashes and Fatalities in Japan
Authors: Desapriya Ediriweera , Fujiwara Takeo , Dutt Namrata , Arason Neil , Pike Ian
Published: October 2012

Introduction. Many studies have demonstrated a strong relationship between alcohol availability and traffic crashes involving alcohol-impaired drivers. The present analysis focuses on the evaluation of the impact of alcohol availability on the Japanese population by comparing fatal and nonfatal motor vehicle crash rates before and after implementation of the alcohol deregulation policy in 1994. Participants and method. Poisson regression with robust standard error was used to model the before-to-after change in incidence rate ratios (IRRs) in the population. To control for potential confounders, per capita alcohol consumption, unemployment rate, and vehicle miles travelled (VMT) were also added to the model. The exponents of the fitted coefficients are equivalent to the IRRs. Results. Implementation of the policy deregulating alcohol sales and production did not appear to increase traffic fatalities and other traffic crashes in Japan. In the overall study results, nighttime fatalities were reduced statistically significantly by 6% since the implementation of the alcohol deregulation policy in 1994. Discussion. Contrary to previous research, the findings of this study demonstrated lower rates of fatalities and higher compliance with alcohol-related driving legislation. Further well-designed, nonaligned studies on alcohol availability and traffic fatalities in other countries are urgently needed.
Ethical Assessment of National Health Insurance System of Korea
Authors: Lee Yuri , Kim Soyoon , Kim Ganglip
Published: October 2012

The current adverse effects of the health insurance system in Korea are considered to be problems that arise from an insufficient reflection of the notion of respecting human rights. The ethical principles most commonly suggested and used in public health are the 4 principles suggested by Beauchamp and Childress in 1994. From the perspective of the community, these 4 principles of medical ethics can be expanded to resolve problems surrounding existing social systems from a socialistic standpoint. This article describes a flexible, easy-to-use model for incorporating the 4 medical ethics principles into the National Health Insurance System (NHIS). First, the principle of respect for autonomy involves respecting the decision-making capacities of autonomous medical consumers and providers and enabling individuals to make reasoned and informed choices. Second is the principle of good practice. The government and medical institutions should act in a way that benefits the health care consumers. The principle of prohibiting bad practice involves avoiding causing health problems. The National Health Insurance Corporation and health care providers should not harm the health care consumers. Finally, the principle of justice is concerned with distributing benefits, risks, and costs fairly—that is, the notion that patients in similar positions should be treated in a similar manner. If these problems are solved, health system quality could be better and more accessible and sustainable. The ethical assessment of the NHIS could be a trial to match the 4 medical ethics principles and the NHIS. It can be applied internationally to relevant policy makers in different settings.
Globalization of Public Health Law and Ethics
Authors: Sohn Myongsei
Published: October 2012

The Constitution of the World Health Organization (1946) states that the “enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position.” The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas public health law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national public health laws and international obligations relating to public health in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea’s Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national public health laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African.
Elements of Pacific Public Health Laws
Authors: Howse Genevieve
Published: October 2012

Pacific countries are sovereign nations with distinctive histories, ethnicity, customs, primary resources, economies, and health systems. Despite these and other acknowledged differences, similarities exist in many areas such as geography, legal history, and culture. Many share the experience of colonization, with imported British laws and the subsequent experience of independence. Most Pacific countries are also developing countries. This article broadly describes approaches to legislating in public health in Papua New Guinea, Fiji, 1 Vanuatu, and the Solomon Islands and notes common elements in their public health laws, in particular, in relation to administration, allocation of powers and responsibilities, interaction with local government, communicable disease control, and nuisance. The article concludes that many Pacific public health laws could deliver better support for current health policy, more sensitivity to the culture and customs of the region, and better management of public health risk through laws that are better suited to their Pacific environment, easier to understand, more flexible, and more relevant to current health policy.
A Review of Interventions for Substance Use Among Homeless Youth
Authors: Xiang Xiaoling
Published: October 2012

This review summarizes existing evidence on interventions to address substance use problems among homeless youth. Fifteen studies met the inclusion criteria of the review. The quality of included studies was analyzed using explicit and well-validated criteria. Interventions evaluated ranged from individual-focused therapies such as brief motivational intervention, community reinforcement approach, and knowledge and skills training, to broader interventions such as family therapy, support groups, and shelter-based health care and housing programs. Participants reported improvements in substance use outcomes over time in most of the studies. However, the superiority of a specific intervention is difficult to determine because of the heterogeneity of the interventions and the few studies conducted on each intervention. Implications for practice and research are discussed.
Use of the Most Memorable Observation Technique Counseling Couples
Authors: McCurdy Kenneth G. , Gleason Ashley
Published: October 2012

The purpose of this article is to demonstrate how counselors can use Francis Walton’s Most Memorable Observation technique (MMO) in their work with couples. The first section of this article focuses on an introduction to the technique, including a theoretical rationale. The second section is dedicated to a detailed description of the process of using the MMO as a counseling technique with couples. Three case studies are featured within this article to demonstrate how the MMO counseling technique can be utilized when working with diverse couples. A brief review of the techniques limitations concludes this article.
Country Religiosity Declines as Material Security Increases
Authors: Barber Nigel
Published: October 2012

According to the uncertainty hypothesis, religion declines as the quality of life improves. Replicating an earlier study with religious disbelief as the DV, it was predicted that religiosity would decline in developed countries due to greater existential security, including income security (income equality and redistribution via welfare states) and improved health. This study used a uniform data source, improving on the heterogeneous surveys tapped in the earlier work. Predictions were tested by correlation and regression analysis of 114 countries that controlled for Communism and Islamic religion. Religiosity declined with economic and social development (measured by lower agricultural employment and third-level enrollment). income security (low Gini coefficient, high personal taxation tapping the welfare state), and health security (low pathogen prevalence, marginally significant in the regression analysis). Results show that religiosity declines as material security increases, consistent with the uncertainty hypothesis, replicating the earlier study.
Noninvasive Imaging in Pulmonary Embolism According to Age and Gender
Authors: Stein Paul D. , Matta Fadi
Published: October 2012

Some now recommend a lung scan if the plain chest radiograph is normal instead of computed tomographic (CT) angiography to minimize the risks of radiation in younger patients with suspected pulmonary embolism. The purpose of this investigation is to determine practice standards according to age and gender in regard to noninvasive imaging. Data are from the Nationwide Inpatient Patient, 1998 to 2009. In 2006 to 2009, the proportion of females with pulmonary embolism imaged with CT angiography was 275 (90%) of 305 among teenagers and girls, 3990 (87%) of 4570 among women 20 to 40 years, and 25 650 (85%) of 30 160 among women >40 years. Among males the proportion imaged with CT angiography was 175 (92%) of 190 among teenagers and boys, 3000 (89%) of 3370 among men 20 to 40 years, and 21 280 (86%) of 24 800 among men >40 years. In conclusion, contrary to the recommendations of some, CT angiography is usually obtained in young patients.
A criterion for mode shape tracking: application to Campbell diagrams
Authors: Mogenier Guillaume , Baranger Thouraya , Ferraris Guy , Dufour Regis , Durantay Lionel
Published: October 2012

The correlation criterion proposed in this article and called nc2o (normalized cross complex orthogonality) is based on the bi-orthogonality properties between rotor mode shapes calculated at different speeds of rotation. This criterion is proved using an industrial laminated rotor composed of disks and two fluid film bearings, whose characteristics depend on the speed of rotation. The industrial finite element model shows that the nc2o criterion provides a more efficient mode pairing of rotor shapes than those obtained by using classical correlation criteria. Moreover this criterion makes it easier to plot Campbell diagrams for strongly speed-of-rotation-dependent structures.
Margo Wilson’s Influence Continues
Authors: Titterington Victoria B. , Subjack Jeanne
Published: October 2012

Drawing on Margo Wilson and Martin Daly’s cross-national research on the spousal “sex ratio of killing” (SROK), this study examines the overall, relationship-specific, and age-specific SROKs for Texas’ six largest cities. This analysis of Supplementary Homicide Reports for the cities of Austin, Dallas, El Paso, Fort Worth, Houston, and San Antonio indicates that overall sex ratios of killing in Texas were comparable to the United States, whereas four of the six cities had higher intimate partner sex ratios of killing than the state or nation. Wide variation of intimate partner SROKs based on offender age, race, and weapon was also found.
Intrathoracic pseudocyst in a kitten
Authors: Zemer Orly , Brenner Ori , Ginnsburg Roni , Cohen Liat , Milgram Joshua
Published: October 2012

A 2-month-old, intact, female domestic shorthair kitten presented with a history of acute-onset dyspnoea. Severe dyspnoea and tachypnoea were noted on physical examination. Serosanguinous fluid, consistent with a modified transudate, was aspirated from the pleural cavity immediately after the physical examination, with an immediate decrease in respiratory rate and effort. The thorax was radiographed and the entire left hemithorax appeared to be filled with a large soft tissue density mass. Thoracic ultrasound was performed and a cystic structure, measuring 3.0 cm × 1.5 cm, was seen in the left hemithorax. An explorative thoracotomy was performed and a mass obliterating the left hemithorax was found. The mass was removed by a combination of blunt and sharp dissection. A final diagnosis of thoracic pseudocyst was made on histological examination of the tissue. The mass was described as a sterile process characteristic of an organised seroma or haematoma. Recovery from surgery was uneventful and the kitten was discharged 48 h postoperatively. The kitten was still alive with no recurrence of clinical signs at the time of writing this report, 8 months postoperatively.
Agreement between auricular and rectal measurements of body temperature in healthy cats
Authors: Sousa Marlos G , Carareto Roberta , Pereira-Junior Valdo A , Aquino Monally CC
Published: October 2012

Measurement of body temperature is a routine part of the clinical assessment of a patient. However, this procedure may be time-consuming and stressful to most animals because the standard site of temperature acquisition remains the rectal mucosa. Although an increasing number of clinicians have been using auricular temperature to estimate core body temperature, evidence is still lacking regarding agreement between these two methods in cats. In this investigation, we evaluated the agreement between temperatures measured in the rectum and ear in 29 healthy cats over a 2-week period. Temperatures were measured in the rectum (using digital and mercury-in-glass thermometers) and ear once a day for 14 consecutive days, producing 406 temperature readings for each thermometer. Mean temperature and confidence intervals were similar between methods, and Bland–Altman plots showed small biases and narrow limits of agreement acceptable for clinical purposes. The interobserver variability was also checked, which indicated a strong correlation between two near-simultaneous temperature readings. Results are consistent with auricular thermometry being a reliable alternative to rectal thermometry for assessing core body temperature in healthy cats.
Minority coalition governance in Denmark
Authors: Christiansen Flemming Juul , Pedersen Helene Helboe
Published: October 2012

Coalition governance is a challenge for political parties because it involves cooperation and compromises between parties that have different political goals and are competitors in political elections. Coalition coordination is crucial for the intra-coalitional cooperation of the governing parties. A key element in coalition coordination is coalition agreements, which to a varying degree constrain the behaviour of the coalition partners. This article explores the share of laws that were precisely defined in government agreements and/or legislative agreements, and sets out to explain variation in this share of coalition agreement-based laws. The analyses are based on unique data on legislative as well as governmental coalition agreements entered by three Danish governments with varying parliamentary strength. This study brings the blooming literature on coalition agreements one step further by showing that coalition governance is influenced by government strength. The legislative practice of strong coalition governments is less accommodative but more pre-regulated by coalition agreements.
Marketing the HIV Test to MSM
Authors: Lechuga Julia , Owczarzak Jill T. , Petroll Andrew E.
Published: October 2012

Lack of awareness of HIV status is associated with an increased likelihood of HIV transmission. We surveyed 633 men who have sex with men (MSM) from diverse ethnic groups recruited from a variety of community venues in a U.S. Midwestern city with rising HIV infection rates. Our first aim was to describe patterns of sexual risk, annual HIV testing frequency, and venues where information about HIV and HIV testing could be disseminated to inner-city MSM. Our second aim was to identify preferred sources to receive information about HIV testing and determine whether these preferences differed by ethnic background. Results indicated that despite similar proportions of high–sexual risk behaviors, compared with African American and Latino MSM, smaller proportions of non-Hispanic White MSM had received an HIV test in the last 12 months. Despite ethnic differences in health care access, a physician’s office was the most common HIV testing site. Overall, a majority conveyed a preference to see advertisements in mainstream media outlets. However, when preferences were stratified by ethnicity, African American MSM were the least likely to prefer receiving information from mainstream media and conveyed a stronger preference to receive information from authority figures than non-Hispanic White and Hispanic MSM.
Stage of Change and Other Predictors of Participant Retention in a Behavioral Weight Management Program in Primary Care
Authors: Toth-Capelli Katie M. , Brawer Rickie , Plumb James , Daskalakis Constantine
Published: October 2012

High attrition often limits the efficacy of weight management programs, particularly those that serve primary care patients. We investigated stage of change and other predictors of retention in a behavioral intervention program that enrolled adult obese patients at three primary care sites. The program included practice improvements and provider training, as well as individual lifestyle counseling and educational group classes for participants. We analyzed predictors of whether participants returned for counseling visits and whether they attended group classes. The 461 participants were mainly women (84%) and minorities (87%), and most of them were in the preparation stage for dietary and physical activity changes. A total of 134 (29%) participants returned for at least one follow-up visit with their counselor and 85 (18%) attended at least one class. Baseline stage of change was not significantly associated with either return visits or class attendance (p = .875 and .182, respectively). Men and participants with children in the household were less likely to return for subsequent counseling sessions (p = .012 and .027, respectively). Age and employment were associated with class attendance (p = .099 and .034, respectively). Focus groups with participants confirmed that reasons for dropout included physical limitations or health issues, family issues, stress, and lack of social support. We conclude that prescreening of patients for readiness to participate and attention to personal barriers related to family and work might improve program retention. More frequent contacts between visits and stronger provider engagement might also strengthen the intervention.
Worksite Translation of the Diabetes Prevention Program
Authors: DeJoy David M. , Padilla Heather M. , Wilson Mark G. , Vandenberg Robert J. , Davis Marsha A.
Published: October 2012

This article summarizes formative research and pilot study findings from a workplace translation of the Diabetes Prevention Program (DPP). The overarching goal was to devise a relatively straightforward weight management intervention suitable for use in a wide array of work settings. This project was conducted in conjunction with Union Pacific Railroad at one of their locomotive maintenance facilities. Participating employees were predominately male and middle-aged. Formative data were collected through stakeholder interviews, focus groups, and direct observation of the work environment. These results were used to adapt the DPP into a largely self-directed intervention augmented by peer health coaches and the on-site nurse. A small pilot test of the adapted program ( n = 67) produced modest but statistically significant weight reductions at both 6 (core intervention period) and 12 months (maintenance period). These results are discussed in terms of the original DPP and other DPP translation studies.
Training Partnership Dyads for Community-Based Participatory Research
Authors: Andrews Jeannette O. , Cox Melissa J. , Newman Susan D. , Gillenwater Gwen , Warner Gloria , Winkler Joyce A. , White Brandi , Wolf Sharon , Leite Renata , Ford Marvella E. , Slaughter Sabra
Published: October 2012

This article describes the development, implementation, evaluation framework, and initial outcomes of a unique campus–community training initiative for community-based participatory research (CBPR). The South Carolina Clinical & Translational Research Center for Community Health Partnerships, which functions as the institution’s Clinical Translational and Science Award Community Engagement Program, leads the training initiative known as the Community Engaged Scholars Program (CES-P). The CES-P provides simultaneous training to CBPR teams, with each team consisting of at least one community partner and one academic partner. Program elements include 12 months of monthly interactive group sessions, mentorship with apprenticeship opportunities, and funding for a CBPR pilot project. A modified RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework guides the process, impact, and outcome evaluation plan. Lessons learned include challenges of group instruction with varying levels of readiness among the CBPR partners, navigating the institutional review board process with community co-investigators, and finding appropriate academic investigators to match community research interests. Future directions are recommended for this promising and unique dyadic training of academic and community partners.
Physical Activity and Nutrition Program for Seniors (PANS)
Authors: Burke Linda , Jancey Jonine M. , Howat Peter , Lee Andy H. , Shilton Trevor
Published: October 2012

Issue addressed. The Physical Activity and Nutrition Program for Seniors (PANS) program aimed to increase levels of physical activity and improve the diet of insufficiently active community-based seniors aged 60 to 70 years using a range of strategies. Comprehensive process evaluation was used to determine the suitability and appropriateness of the resources and effectiveness of the strategies. Method. Process evaluation data (qualitative and quantitative) were collected on the program strategies and resources throughout, and at the conclusion of the intervention period. Results. The program strategies/resources were found to be relevant to the population, assisting participants to increase their level of physical activity and improve their diet. Participants reported that the program resources were suitable for their age-group (84%), encouraged them to think about physical activity (78%), and nutrition (70%). Participants reported that they used the pedometer (91%) and recorded daily steps (78%). Moreover, the provision of group guides facilitated individuals to set and achieve personal goals. Conclusion. The PANS strategies and resources were appropriate, which supported the seniors in identifying, establishing, and achieving their physical activity and nutrition goals. Minor refinements of the program were recommended based on the findings.
A Severely Infected Diabetic Foot Treated Successfully Without Using Systemic Antibiotics
Authors: Tian Ming , Jiang Yu-Zhi , Niu Yi-Wen , Xiao Yu-Rui , Lu Shu-Liang , Wang Xi-Qiao
Published: October 2012

About 50% to 70% of all lower extremity amputations are related to diabetes infection. And antibiotic therapy is routinely used for all infected wounds to reduce the mortality of diabetic foot. Here, we report a case of diabetic foot with acute and deep severe infection. During hospital therapy, we used negative pressure therapy and extensive debridement without systemic antibiotic application, and we successfully rescued a foot from amputation. Negative pressure therapy and extensive debridement are very important and effective methods to control infection and promote wound healing in diabetes foot.
Endostar Injection Inhibits Rabbit Ear Hypertrophic Scar Formation
Authors: ZhiYong Wang , Fei Song , LianJu Xu , Yingkai Liu , Chun Qing , Shuliang Lu , XiQiao Wang
Published: October 2012

This study aims to investigate the effect of Endostar injection on the rabbit ear hypertrophic scar formation and expand the use of Endostar. The rabbit ear hypertrophic scar models were established 4 weeks postoperation and were treated with Endostar injection; the control group was injected with saline, once a week, 3 times totally. At the seventh week, the scar tissue was harvested and processed with hematoxylin and eosin (HE) staining and CD34 immunohistochemistry and cell apoptosis assay. In addition, the endothelial cell was cultured and seeded on Martrigel with different concentrations of Endostar to observe the vessel tube formation. The results showed that the volume of the hypertrophic scar with Endostar injection was greatly reduced compared with what was seen in the control group; meanwhile, HE staining showed that the cell number decreased and collagen density became looser. In addition, the CD34 staining indicated that microvessel formation in the study group also decreased and cell apoptosis increased. In vitro, the addition of Endostar could reduce vessel tube formation in a dose-dependent manner. In conclusion, the Endostar is effective for hypertrophic scar inhibition and could be a potential tool to treat scars.
Reconstruction of Traumatic Lower Extremity Soft Tissue Defects With the Combination of Ipsilateral and Contralateral Perforator Flaps
Authors: Demiralp Cemil Özerk , Akkaya Hüseyin , Duman Yakup , Armangil Mehmet , Demirseren Mustafa Erol
Published: October 2012

Many flaps have been used to repair complex soft tissue defects of the leg. When the affected areas are relatively small and the local flaps are not suitable, microsurgical operation seems to be an excessive treatment and thus perforator flaps can be used. The authors present the combination of ipsilateral and contralateral perforator flaps for coverage of the traumatic lower extremity.
Apotemnophilia or Body Integrity Identity Disorder
Authors: Khalil Rami Bou , Richa Sami
Published: October 2012

Apotemnophilia or body integrity identity disorder (BIID) denotes a syndrome in which a person is preoccupied with the desire to amputate a healthy limb. In this report, we review the available case reports in the literature in order to enhance psychiatrists’ and physicians’ comprehension of this disorder. A search for the case reports available via MEDLINE was done since the first case report published by Money et al in 1977 till May 2011, using the following terms: apotemnophilia, self-demand amputation, body integrity identity disorder, and BIID. In all, 14 case reports were found relevant to our search. The desire to amputate one’s healthy limb seems to be related to a major disturbance in the person’s perception of one’s own identity, where limb amputation can relieve temporarily the patient’s feeling of distress without necessarily and uniformly adjusting the patient’s own identity misperception. More investigations are needed in this domain in order to develop noninvasive treatment strategies that approach this aspect of the patient’s distress within a globalist perspective. In addition, the health professionals’ awareness regarding this disorder is required to ensure professional management of patients’ suffering.
Aegle marmelos (L.) Correa (Bael) and Its Phytochemicals in the Treatment and Prevention of Cancer
Authors: Baliga Manjeshwar Shrinath , Thilakchand Karadka Ramdas , Rai Manoj Ponadka , Rao Suresh , Venkatesh Ponemone
Published: October 2012

Aegle marmelos, commonly known as Bael and belonging to the family Rutaceae is an important medicinal plant in the traditional Indian system of medicine, the Ayurveda. The extract prepared by boiling the bark, leaves or roots in water is useful as laxative, febrifuge, and expectorant. The extract is also useful in ophthalmia, deafness, inflammations, catarrh, diabetes, and asthmatic complaints. The fruits are used in treating diarrhea, dysentery, stomach ache, and cardiac ailments. Scientific studies have validated many of Bael’s ethnomedicinal properties and its potential antimicrobial effects, hypoglycemic, astringent, antidiarrheal, antidysenteric, demulcent, analgesic, anti-inflammatory, antipyretic, wound-healing, insecticidal, and gastroprotective properties. In addition, studies have also shown that Bael and some of the Bael phytochemicals possess antineoplastic, radioprotective, chemoprotective, and chemopreventive effects, properties efficacious in the treatment and prevention of cancer. For the first time, the current review summarizes the results related to these properties and emphasizes aspects that require further investigation for Bael’s safe and effective use in the near future.
Thymoquinone Efficiently Inhibits the Survival of EBV-Infected B Cells and Alters EBV Gene Expression
Authors: Zihlif Malek A. , Mahmoud Ismail S. , Ghanim Majd T. , Zreikat Manar S. , Alrabadi Nasr , Imraish Amer , Odeh Fadwa , Abbas Manal A. , Ismail Said I.
Published: October 2012

Epstein–Barr virus (EBV) is a human virus with oncogenic potentials that is implicated in various human diseases and malignancies. In this study, the modulator activity of the potent herbal extract drug thymoquinone on EBV was assessed in vitro. Thymoquinone was tested for cytotoxicity on human cells of lymphoblastoid cells, Raji Burkitt’s lymphoma, DG-75 Burkitt’s lymphoma, peripheral blood mononuclear cells, and periodontal ligament fibroblast. Apoptosis induction was analyzed via TUNEL assay and activity studies of caspase-3. The effect of thymoquinone on EBV gene expression was determined using real-time polymerase chain reaction. We report here, for the first time, a promising selective inhibitory affect of thymoquinone on EBV-infected B cell lines in vitro, compared with lower activity on EBV negative B cell line and very low toxicity on human peripheral blood mononuclear cells and periodontal ligament fibroblasts. Moreover, the drug was found to efficiently suppress the RNA expression of EBNA2, LMP1, and EBNA1 genes. Specifically, EBNA2 expression levels were the most affected indicating that this gene might have a major contribution to thymoquinone potency against EBV infected cells. Overall, our results suggest that thymoquinone has the potential to suppress the growth of EBV-infected B cells efficiently.
Possible Genetic Component to the Etiology of Perigraft Hygromas
Authors: Sun Raphael C. , Nicholson Rachael , Sharp William J. , Sharafuddin Melhem , Kresowik Timothy
Published: October 2012

Perigraft hygroma is a known complication of prosthetic graft implantation. The specific etiology of perigraft hygromas is still unknown. We report 2 brothers who underwent open abdominal aortic aneurysm repairs with polytetrafluoroethylene grafts that developed progressively enlarging perigraft hygromas. This is the first case report of 2 brothers developing sac hygromas after open abdominal aortic aneurysm repair. This case demonstrates that there could be a genetic component associated with the development of perigraft hygromas and further investigation of genetic etiologies should be considered.
Motivational Implications of Faculty Performance Standards
Authors: Hardré Patricia L. , Kollmann Sherry L.
Published: October 2012

Expectations and how they are communicated influence employees’ motivation, effort, goals, efficacy and performance. This study examined faculty performance evaluation standards and processes of 60 academic departments in research universities for motivationally relevant elements. Characteristics were systematically analysed to understand their content and motivational implications. They were examined for features influential on employee engagement, effort, persistence, innovation and organizational commitment, in an iterative, qualitative process. The researchers distilled eight key features of performance standards with influential, research-based motivational implications and analysed how they are demonstrated in the standards. These eight motivationally positive components were evident, but not consistent across these standards. Findings suggest that higher education institutions re-examine their faculty performance standards, consider their motivational messages and implications. Further research on faculty performance standards is also indicated.
Ventricular tachycardia during basilar-type migraine attack
Authors: Pitarokoili Kalliopi , Dahlhaus Stefanie , Hellwig Kerstin , Boehm Susanne , Neubauer Horst , Gold Ralf , Krogias Christos
Published: October 2012

Autonomic dysfunction is a characteristic of migraine attacks, rarely, even cardiac repolarization abnormalities have been associated with migraine. We report a case of documented ventricular tachycardia during basilar-type migraine attack. The therapeutic implications of such a co-occurrence as well as a possible relationship between ventricular tachycardia and the underlying biology of basilar-type migraine are discussed.
The Underlying Osseous Deformity in Plantar Plate Tears
Authors: Klein Erin E. , Weil Lowell , Weil Lowell Scott , Knight Jessica
Published: October 2012

Purpose. Plantar plate tears can cause pain and deformity of the forefoot. The purpose of this study is to correlate common radiographic findings with observed intra-operative pathology in patients with plantar plate pathology. Methods. Bilateral weight-bearing radiographs were reviewed for 88 patients (106 feet) who underwent surgical repair of suspected plantar plate pathology. Parameters reviewed included the first intermetatarsal angle, the metatarsus adductus angle, the second and third metatarsophalangeal angles, splaying of the second and third toes, evaluation of the metatarsal parabola by 3 different methods, the first and second lateral declination angles, and the second lateral metatarsophalangeal angle. Results. Of 106 feet, 97 had intra-operative plantar plate tears. The radiographs of patients with plantar plate tears had an increased amount of digital splay on the anteroposterior radiograph compared to patients without pathology. For patients with unilateral plantar plate pathology, the metatarsal parabola of the symptomatic foot was compared with that of the asymptomatic foot. A significantly increased second metatarsal protrusion distance as measured by 2 different methods was noted in the symptomatic foot. Odds ratios revealed that patients with an intermetatarsal angle >12, medial deviation of the second toe, and splaying of the digits were more likely to be diagnosed with a plantar plate tear intra-operatively. Conclusion. Although radiographs do not definitively diagnose plantar plate tears, understanding osseous forefoot architecture will aid with diagnosis in the absence of other osseous pathology. Furthermore, these data suggest that parabola should be corrected to maintain long-term correction of plantar plate pathology.

Level of Evidence: Prognostic, Level II
The prevalence and mechanisms of metabolic syndrome in schizophrenia: a review
Authors: Papanastasiou Evangelos
Published: October 2012

Metabolic syndrome (MetS), a constellation of central obesity, hypertension, dyslipidaemia and glucose intolerance, is highly prevalent in individuals with schizophrenia and conveys significant cardiovascular risk and mortality. Associated risk factors are female sex, some ethnic groups, advanced age, long duration of illness, smoking and exposure to antipsychotic agents. The prevalence of MetS varies across countries and psychiatric populations, and its development can be very rapid. Regular monitoring of all features of MetS is the cornerstone of its early detection and management. Future research needs to focus more on genetic determinants of MetS in the context of schizophrenic illness. This review aims to update the reader with the latest knowledge about the prevalence of MetS in schizophrenia and what might be the underlying pathophysiological mechanisms.
PI3K-PKB hyperactivation augments human plasmacytoid dendritic cell development and function
Authors: van de Laar Lianne , van den Bosch Aniek , Boonstra André , Binda Rekha S. , Buitenhuis Miranda , Janssen Harry L. A. , Coffer Paul J. , Woltman Andrea M.
Published: October 2012

Plasmacytoid dendritic cells (pDCs) are considered potential tools or targets for immunotherapy. However, current knowledge concerning methodologies to manipulate their development or function remains limited. Here, we investigated the role of the phosphatidylinositol 3-kinase (PI3K)–protein kinase B (PKB)–mammalian target of rapamycin (mTOR) axis in human pDC development, survival, and function. In vitro pDC generation from human cord blood–derived CD34+ hematopoietic progenitors was reduced by pharmacologic inhibition of PI3K, PKB, or mTOR activity, and peripheral blood pDCs required PI3K-PKB-mTOR signaling to survive. Accordingly, activity of this pathway in circulating pDCs correlated with their abundance in peripheral blood. Importantly, introduction of constitutively active PKB or pharmacologic inhibition of negative regulator phosphatase and tensin homolog (PTEN) resulted in increased pDC numbers in vitro and in vivo. Furthermore, MHC class II and costimulatory molecule expression, and production of IFN-α and TNF-α, were augmented, which could be explained by enhanced IRF7 and NF-κB activation. Finally, the numerically and functionally impaired pDCs of chronic hepatitis B patients demonstrated reduced PI3K-PKB-mTOR activity. In conclusion, intact PI3K-PKB-mTOR signaling regulates development, survival, and function of human pDCs, and pDC development and functionality can be promoted by PI3K-PKB hyperactivation. Manipulation of this pathway or its downstream targets could be used to improve the generation and function of pDCs to augment immunity.
Phosphatase of regenerating liver-3 directly interacts with integrin β1 and regulates its phosphorylation at tyrosine 783
Authors: Tian Wei , Qu Like , Meng Lin , Liu Caiyun , Wu Jian , Shou Chengchao
Published: October 2012

Background

Phosphatase of regenerating liver-3 (PRL-3 or PTP4A3) has been implicated in controlling cancer cell proliferation, motility, metastasis, and angiogenesis. Deregulated expression of PRL-3 is highly correlated with cancer progression and predicts poor survival. Although PRL-3 was categorized as a tyrosine phosphatase, its cellular substrates remain largely unknown.

Results

We demonstrated that PRL-3 interacts with integrin β1 in cancer cells. Recombinant PRL-3 associates with the intracellular domain of integrin β1 in vitro. Silencing of integrin α1 enhances PRL-3-integrin β1 interaction. Furthermore, PRL-3 diminishes tyrosine phosphorylation of integrin β1 in vitro and in vivo. With site-specific anti-phosphotyrosine antibodies against residues in the intracellular domain of integrin β1, tyrosine-783, but not tyrosine-795, is shown to be dephosphorylated by PRL-3 in a catalytic activity-dependant manner. Phosphorylation of Y783 is potentiated by ablation of PRL-3 or by treatment with a chemical inhibitor of PRL-3. Conversely, depletion of integrin α1 decreases the phosphorylation of this site.

Conclusions

Our results revealed a direct interaction between PRL-3 and integrin β1 and characterized Y783 of integrin β1 as a bona fide substrate of PRL-3, which is negatively regulated by integrin α1.
Systems mapping of HIV-1 infection
Authors: Hou Wei , Sui Yihan , Wang Zhong , Wang Yaqun , Wang Ningtao , Liu Jingyuan , Li Yao , Goodenow Maureen , Yin Li , Wang Zuoheng , Wu Rongling
Published: October 2012

Mathematical models of viral dynamics in vivo provide incredible insights into the mechanisms for the nonlinear interaction between virus and host cell populations, the dynamics of viral drug resistance, and the way to eliminate virus infection from individual patients by drug treatment. The integration of these mathematical models with high-throughput genetic and genomic data within a statistical framework will raise a hope for effective treatment of infections with HIV virus through developing potent antiviral drugs based on individual patients’ genetic makeup. In this opinion article, we will show a conceptual model for mapping and dictating a comprehensive picture of genetic control mechanisms for viral dynamics through incorporating a group of differential equations that quantify the emergent properties of a system.
Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation
Authors: Ban Andrea , Ismail Aniza , Harun Roslan , Abdul Rahman Azahirafairud , Sulung Saperi , Syed Mohamed Aljunid
Published: October 2012

Background

Exacerbations, a leading cause of hospitalization in patients with chronic obstructive pulmonary disease (COPD), affect the quality of life and prognosis. Treatment recommendations as provided in the evidence-based guidelines are not consistently followed, partly due to absence of simplified task-oriented approach to care. In this study, we describe the development and implementation of a clinical pathway (CP) and evaluate its effectiveness in the management of COPD exacerbation.

Methods

We developed a CP and evaluated its effectiveness in a non-randomized prospective study with historical controls on patients admitted for exacerbation of COPD to Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Consecutive patients who were admitted between June 2009 and December 2010 were prospectively recruited into the CP group. Non-CP historical controls were obtained from case records of patients admitted between January 2008 and January 2009. Clinical outcomes were evaluated by comparing the length of stay (LOS), complication rates, readmissions, and mortality rates.

Results

Ninety-five patients were recruited in the CP group and 98 patients were included in the non-CP historical group. Both groups were comparable with no significant differences in age, sex and severity of COPD (p = 0.641). For clinical outcome measures, patients in the CP group had shorter length of stay than the non-CP group (median (IQR): 5 (4–7) days versus 7 (7–9) days, p < 0.001) and 24.1% less complications (14.7% versus 38.8%, p < 0.001). We did not find any significant differences in readmission and mortality rates.

Conclusion

The implementation of CP –reduced the length of stay and complication rates of patients hospitalized for acute exacerbation of COPD.