bluuebunny/crossref_metadata_2025 huggingface dataset:
Sociology of normal ageing
Authors: Harper Sarah
Published: January 2013

Research on the sociology of normal ageing has focused on understanding the paradigms of ‘successful ageing’. In an apparent reaction to ‘disengagement theory’ which proposed that to withdraw from roles and relationships in old age was normal, a new conceptual framework was developed in the late 1960s and 1970s which attempted to explain how individuals adapted to the constraints of ageing and old age. This has been variously measured in terms of good health, high levels of physical and mental functioning, and active engagement with one's social and physical environment. While post-modernism and critical gerontology have attempted to refocus the debate, the emphasis of most research and writing has remained within the framework of understanding, explaining, and even facilitating, ‘success’ in old age. There is also a body of research which recognizes the importance of the life course perspective, and that throughout an individual's life, he or she is faced with continuities and discontinuities which have to be negotiated and resolved. Old age is but part of this life-long process. Changes which occur in later life, such as retirement and widowhood, will lead to discontinuities in roles and relationships, other aspects of our lives will undergo little change allowing continuity. Alongside this, perspectives from anthropology, history and the social constructionist school of thought have also been recently influential. This chapter will discuss concepts of age, generation, and cohort. It will consider the contribution of the life course approach to understanding ageing, and the manner in which other perspectives, such as social constructionism, narrative psychology and anthropology, have contributed to the sociology of normal ageing.
Mild cognitive impairment
Authors: Jacova Claudia , Feldman Howard H.
Published: January 2013

Within the cognitive functioning continuum from normal ageing to dementia three broad states can be distinguished: normal functioning for age, clear-cut impairment meeting diagnostic criteria for dementia, and mild cognitive impairment (MCI), which falls below normal but short of dementia in severity (Fig. 8.5.1.1.1). There is active debate over what MCI is, how to define and classify this state, and where to set its borders on the described continuum. Some definitions depict MCI as the tail-end of normal cognitive ageing whereas in other definitions MCI embodies the early clinical manifestation of Alzheimer Disease (AD) and other dementias. In 2003, the key elements of different MCI definitions were integrated into a consensus diagnostic and classification framework, thus establishing some common ground in a field that is still evolving. MCI has also been positioned as a potentially important target for early treatment interventions to delay progression to dementia. Nosologically, MCI is not currently included as a diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Classification of Diseases, 10th revision. The diagnostic categories of Mild Neurocognitive Disorder (DSM-IV-TR) and Mild Cognitive Disorder (ICD-10) are similar to MCI because they require the presence of cognitive impairment but these categories can only be assigned if a specific neurological or general medical condition can be identified to account for the cognitive symptoms. Much of the current condition of MCI does not fit as it has no aetiologic specification. Nevertheless, MCI is increasingly a presenting condition in primary and specialized settings of care. Medical practice guidelines have recognized MCI as a risk state for dementia and recommend careful clinical evaluation and monitoring of individuals with this diagnosis.
Schizophrenia and paranoid disorders in late life
Authors: Palmer Barton W. , Savla Gauri N. , Meeks Thomas W.
Published: January 2013

Estimates of the point-prevalence of paranoia and other psychotic symptoms among persons age ⋚ 65 years have ranged from approximately 4 per cent to 6 per cent, and may be as high as 10 per cent among those age ⋚ 85 years. Although the majority of these symptoms occur as secondary psychoses in the context of Alzheimer’s disease or related dementias, the population of people with schizophrenia is ageing along with the general ‘greying’ of the industrialized world, and mental health care for older adults with schizophrenia is expected to be an increasingly important public health concern. This chapter covers clinical features, classification systems, diagnosis and differential diagnosis, epidemiology, aetiology, course and prognosis, treatment, and management.
Personality disorders in the elderly
Authors: Holroyd Suzanne
Published: January 2013

The study of personality disorder (PD) in late life presents conceptual, diagnostic, and methodological difficulties. By definition, PD is considered a group of personality traits that relatively persistent through adulthood. However, the concept of PD persisting throughout the lifespan contradicts widespread clinical belief that they become less severe with ageing. There are difficulties in studying PD in the elderly. One is the instability of the definition of PD over time, making it difficult to relate earlier studies to those using current definitions of PD. In addition, diagnostic criteria are subject to criticism when applied to the elderly, in that they may be ‘age-biased’. Finally, the methodology used to diagnose PD has been highly variable and difficult to interpret between studies. This chapter covers clinical features, diagnosis, epidemiology and aetiology, course and prognosis, and treatment and management.
Autism and the pervasive developmental disorders
Authors: Volkmar Fred R. , Klin Ami
Published: January 2013

The pervasive developmental disorders (PDDs) are characterized by patterns of deviance and delay in social-communicative development in the first years of life, which are associated with restricted patterns of interest or behaviour. The prototypic PDD is childhood autism; other conditions included in the PDD class in ICD-10 include Rett's syndrome, childhood disintegrative disorder, Asperger's syndrome, and atypical autism. Except for one additional category in ICD-10 (hyperkinetic stereotyped movement disorder), the disorders included in ICD-10 and DSM-IV are essentially identical. In this chapter each of these conditions will be reviewed in terms of their clinical features, definition, epidemiology, course, and aetiology; final sections of the chapter address aspects of treatment and prevention for the group of disorders as a whole (Box 9.2.3.1).
Sleep disorders in children and adolescents
Authors: Stores Gregory
Published: January 2013

It was argued in Chapter 4.14.1 that sleep disorders medicine should be viewed as an integral part of psychiatry, whatever the age group of patients, because of the various close connections between sleep disturbance and psychological disorders seen in clinical practice. This is certainly the case regarding child and adolescent psychiatry in view of the high rates of psychiatric disorder of which sleep disturbance is often a part, and also the frequent occurrence of sleep disorders in young people with potentially serious developmental effects of a psychological and sometimes physical nature. The temptation to view children's sleep disorders as merely transitory problems, mainly in infancy, encountered by many parents and of no lasting or serious significance, should be resisted. This may be true for some families but is frequently not the case in others. The following account summarizes sleep disorders in childhood and adolescence. Familiarity is assumed with the earlier accounts of sleep disorders in adults (4.14.1), including the introduction to that section which covers basic aspects of sleep and other fundamental issues.
The relationship between physical and mental health in children and adolescents
Authors: Gledhill Julia , Garralda M. Elena
Published: January 2013

The link between physical and psychological disorder in children and adolescents is well established. Children with chronic illness are at increased risk of emotional and behavioural disorders. In addition, repeated presentations with physical symptoms may represent underlying psychological distress or psychiatric disorder. Because of the inextricable links between young people and the family in which they live, it is inappropriate to consider symptoms in an index child in isolation. The effects of symptomatology on family functioning, parent, and sibling relationships should be considered. This may have important aetiological and prognostic significance.
Cognitive behaviour therapies for children and families
Authors: Graham Philip
Published: January 2013

Cognitive behaviour therapy (CBT) is derived from both behavioural and cognitive theories. Using concepts such as operant conditioning and reinforcement, behavioural theories treat behaviour as explicable without recourse to description of mental activity. In contrast, mental activity is central to all concepts derived from cognitive psychology. Both sets of theories have been of value in explaining psychological disorders and, in the design of interventions they have proved an effective combination. Central to that part of cognitive theory that is relevant to CBT is the concept of ‘schemas’, first described in detail by Jean Piaget. A schema is a mental ‘structure for screening, coding, and evaluating impinging stimuli’. The origin of mental schemas lies in the pre-verbal phase when material is encoded in non-verbal images that, as the child's language develops, gradually become verbally labelled. They form part of a dynamic system interacting with an individual child's physiology, emotional functioning, and behaviour with their operation depending on the social context in which the child is living. There are similarities but also differences between schemas and related concepts in psychoanalysis, such as Freudian ‘complexes’ and Kleinian ‘positions’. Schemas can be seen as organized around anything in the child's world, especially objects, beliefs, or emotions. They develop from past experience. The processing of new information in relation to such schemas can usefully be seen as involving the evaluation of discrepancies between information that is received and information that is expected. If there is a discrepancy, (the information not corresponding with that expected), then during the coding process information may be distorted so that it no longer creates discomfort, or, more adaptively, it may be incorporated into a modified schema.
Organization of services for children and adolescents with mental health problems
Authors: Wolpert Miranda
Published: January 2013

This chapter aims to guide the thinking of practitioners who might be involved in developing services to meet the needs of children and young people with mental health difficulties. Anyone involved in this challenging but vital endeavour will need to address the following questions: ♦ Who should the service be for? ♦ What sort of interventions should be provided? ♦ How should the service be structured? ♦ Who should the staff be? ♦ How can the service be made most accessible? ♦ How can service quality be ensured? This chapter will look at each of these issues in turn to explore how each might best be approached.
Prevalence of intellectual disabilities and epidemiology of mental ill-health in adults with intellectual disabilities
Authors: Cooper Sally-Ann , Smiley Elita
Published: January 2013

♦ The prevalence of intellectual disabilities varies, depending upon definition, country, time, age range, and methods of population ascertainment. Reported rates vary substantially, and may be in the order of 9–14/1000 childhood populations, 3–8/1000 adult populations in developed countries, and higher in developing countries. ♦ Mental ill-health is more commonly experienced by adults with intellectual disabilities than the general population. Point prevalence is about 40 per cent, with problem behaviours being the most prevalent type. ♦ Dementia, problem behaviours, autism, bipolar disorder, and psychoses are more prevalent than for the general population. ♦ Incident mental ill-health is also greater than for the general population, at about 8 per cent per year. Common mental disorders and psychoses both have higher incidence than that for the general population. ♦ There is limited information on the protective and vulnerability factors for mental ill-health. ♦ Some factors related to prevalence and incidence of mental ill-health are similar to those found in the general population suggesting similar underlying causative mechanisms, but other factors differ, suggesting that inferences cannot necessarily be drawn from general population data and applied to the population with intellectual disabilities. ♦ Identifying high-risk groups within the population may allow for the provision of early interventions and supports, whilst some causative factors may be amenable to interventions to prevent or improve mental ill-health in this population. We need to gain a better understanding of these issues.
Aetiology of intellectual disability: general issues and prevention
Authors: Kaski Markus
Published: January 2013

Intellectual disability can follow any of the biological, environmental, and psychological events that are capable of producing a decline of cognitive functions. Some factors do not directly or inevitably cause intellectual disability but add to the effects of a previous primary cause. Genetic causes may be hereditary or non-hereditary, and may or may not produce specific syndromes. Some lead to inborn errors of metabolism. Causation, how to assess cause, and why knowledge of causation is important is covered in detail, followed by primary, secondary, and tertiary prevention, ethical problems of prevention, and the important of taking preventive aspects into account in all general and specific legislation, in operating procedures, and professional practice.
Families with a member with intellectual disability and their needs
Authors: Gath Ann , McCarthy Jane
Published: January 2013

Having a child with intellectual disability is a major and usually totally unexpected blow to any family. However, most families show great resourcefulness and adapt to give their normal child as well as themselves a happy, rewarding life. Parents strongly resent being treated as potential psychiatric patients and have vigorously thrown out the concept of ‘the handicapped family’. They do suffer understandable grief. From the point of discharge, the encouragement of informal support is more useful than providing hospital-based services. Children with all sorts of disability go to school early and the provision of unobtrusive familiar services is helpful. Unfortunately, there is often a gap in services between children's services and those for older adolescents and adults. The gap occurs at the worst time for parents who of all times require a familiar knowledgeable person who can offer a service throughout the transition period. The services required by the parents are practical help, such as appropriate equipment, respite care, advice about behaviour, and the ability to find emergency or specialized help at short notice. Parents also require some notice to be taken of their increasing age and/or infirmity, the financial difficulties arising out of the disability, and their anxiety that a humane plan can be made for their son or daughter when they die.
The planning and provision of psychiatric services for adults with intellectual disability
Authors: Bouras Nick , Holt Geraldine
Published: January 2013

The functioning of people with intellectual disability (ID) is affected by many factors. As well as their ID, their ability to communicate with others, their social competency, personality, life experiences and circumstances, and their health (including mental health) also influence their behaviour and adjustment. This chapter focuses on the development and provision of services for adults with ID who have additional psychiatric and behavioural disorders. Developments have taken place in various parts of the world in recent years and a wide range of services has emerged.
Associations between psychiatric disorder and offending
Authors: Thomson Lindsay , Darjee Rajan
Published: January 2013

The associations between psychiatric disorder and offending are complex. There has been a great deal of research into certain disorders and violent offending particularly over the last two decades. In summary, this has found a clear and consistent association between schizophreniform psychoses and violence, the importance of premorbid antisocial behaviour in predicting future violence, and the adjunctive effect of co-morbid substance misuse and antisocial personality disorder in the prevalence of violence. In addition, it has allowed the development of neuropsychiatric models to begin to explain violence in the context of mental disorder. Substance use disorders and learning disability are discussed in Chapters 11.3.2 and 11.3.3.
Offending, substance misuse, and mental disorder
Authors: Johns Andrew
Published: January 2013

This chapter deals with the relationship between offending, substance misuse, and mental disorder, and also describes approaches to clinical and medico-legal assessment.
Querulous behaviour: vexatious litigation, abnormally persistent complaining and petitioning
Authors: Mullen Paul E.
Published: January 2013

The querulant pursue their vision of justice through litigation in the court, through petitions to the powerful, and finally through the various agencies of accountability. In practice all three avenues are often explored. In the nineteenth and early twentieth century it was the civil courts in which these dramas were usually played out. Today the main burden falls on the complaints organizations. After a brief historical overview, this chapter addresses clinical features, clinical assessment, and management.
Assessing and managing the risks of violence towards others
Authors: Mullen Paul E. , Ogloff James R. P.
Published: January 2013

Assessing and managing the risk of our patients being violent towards others now occupies a prominent position in virtually all forms of mental health practice, but it remains a contentious area. At the highest level researchers, psychometricians, and statisticians argue about almost every aspect, even whether anything useful can be said about individual outcomes rather than group indicators. At the next level an industry flourishes of selling training, and risk assessment tinstruments, to those who then appear as experts in a wide range of mental health and criminal justice contexts. On the ground, almost everyone in mental health is drawn into filling out purpose-designed forms and complying with protocols, most of little or no demonstrated validity. This chapter is intended to make clinicians aware of both the possibilities and limitations of existing approaches to the assessments of risk. Given that there is no reason for mental health professionals to evaluate risk without gaining information to manage it, this chapter will also address the management of risk for aggression and violence.
Management of offenders with mental disorder in specialist forensic mental health services
Authors: Taylor Pamela J. , Dunn Emma
Published: January 2013

Specialist forensic mental health (fmh) services are for people with serious mental disorders and grave offending behaviour who tend to be rejected from mainstream services. Although often triggered by single high profile cases, these specialist services are among the best planned and commissioned services in psychiatry, founded in evidence of need, risk and efficacy of interventions. They are grounded in a multidisciplinary clinical perspective and often have integrated academic units. They interface both with other clinical services and with the criminal justice service. Good relationships with the local community are vital for establishment and growth. Secure psychiatric hospitals have two overarching aims: improving health and delivering safety for patients and others. In secure hospitals, patients’ autonomy is limited in a number of important ways: they may not be allowed to leave the hospital at all, may be confined to a particular area within the hospital, and/or treatment may be enforced. Although these restrictions are undoubtedly at least partly in the interests of the patients themselves, they are commonly also in the interests of others. This chapter looks at service structure, including planning principles, principles of assessment, admission criteria, the pathway to treatment, and finally assessing outcomes.
Palliative Care Consultation
Authors: Mulkerin Colleen M.
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Palliative Care in Long-Term Care Facilities
Authors: Mercedes Bern-Klug , Kelsey Simons
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Addressing Suffering in Palliative Care: Two Psychotherapeutic Models
Authors: Parsonnet Lissa , Lethborg Carrie
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Spirituality and Social Work Practice in Palliative Care
Authors: Reese Dona J.
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Discovering Strengths and Growth in Palliative Care
Authors: Cadell Susan , Shermak Sheryl , Johnston Meaghen
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Families and Family Conferencing
Authors: Fineberg Iris Cohen , Bauer Amy
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Social Work, HIV Disease, and Palliative Care
Authors: Goeren William
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Palliative Care with Vulnerable Populations
Authors: Gehlert Sarah , Moro Teresa
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Palliative Care with Lesbian, Gay, Bisexual, and Transgender Persons
Authors: Smolinski Kathryn M. , Colón Yvette
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Social Work and Psychology
Authors: Anderson Becky A. , Marasco Louise E. , Kasl-Godley Julia , Kennedy Sheila G.
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Social Work, Fund-Raising, and Philanthropy: It's Not Just about Money
Authors: Benson Laura , Messner Carolyn
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Social Work and Psychiatry
Authors: Holland Jimmie C. , Martin Anne
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Social Work and Creative Arts Therapy Services
Authors: Mondanaro John , Needleman Stacey
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Palliative Social Work in Japan
Authors: Kurihara Yukie
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Palliative Social Work in Israel
Authors: Perry Shlomit
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Pediatric Palliative Care Ethics and Decision Making
Authors: Jacobs Hollye Harrington
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Social Work Research Agenda in Palliative and End-of-Life Care
Authors: Palos Guadalupe R.
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Self-Care as Best Practice in Palliative Care
Authors: Clark Elizabeth J.
Published: January 2013

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following:
Age dating stellar populations in the near infrared: an absolute age indicator from the presence/absence of red supergiants
Authors: Gazak J. Z. , Bastian N. , Kudritzki R.-P. , Adamo A. , Davies B. , Plez B. , Urbaneja M. A.
Published: December 2012

The determination of age is a critical component in the study of a population of stellar clusters. In this Letter, we present a new absolute age indicator for young massive star clusters based on J−H colour. This novel method identifies clusters as older or younger than 5.7 ± 0.8 Myr based on the appearance of the first population of red supergiant stars. We test the technique on the stellar cluster population of the nearby spiral galaxy, M83, finding good agreement with the theoretical predictions. The localization of this technique to the near-IR promises that it may be used well into the future with space- and ground-based missions optimized for near-IR observations.
Zel’dovich approximation and general relativity
Authors: Rampf Cornelius , Rigopoulos Gerasimos
Published: December 2012

We show how the Zel’dovich approximation and the second-order displacement field of Lagrangian perturbation theory can be obtained from a general relativistic gradient expansion in Λ cold dark matter cosmology. The displacement field arises as a result of a second-order non-local coordinate transformation which brings the synchronous/comoving metric into a Newtonian form. We find that, with a small modification, the Zel’dovich approximation holds even on scales comparable to the horizon. The corresponding density perturbation is not related to the Newtonian potential via the usual Poisson equation but via a modified Helmholtz equation. This is a consequence of causality not present in the Newtonian theory. The second-order displacement field receives relativistic corrections that are subdominant on short scales but are comparable to the second-order Newtonian result on scales approaching the horizon. The corrections are easy to include when setting up initial conditions in large N-body simulations.
RNA dimerization plays a role in ribosomal frameshifting of the SARS coronavirus
Authors: Ishimaru Daniella , Plant Ewan P. , Sims Amy C. , Yount Boyd L. , Roth Braden M. , Eldho Nadukkudy V. , Pérez-Alvarado Gabriela C. , Armbruster David W. , Baric Ralph S. , Dinman Jonathan D. , Taylor Deborah R. , Hennig Mirko
Published: December 2012

Messenger RNA encoded signals that are involved in programmed -1 ribosomal frameshifting (-1 PRF) are typically two-stemmed hairpin (H)-type pseudoknots (pks). We previously described an unusual three-stemmed pseudoknot from the severe acute respiratory syndrome (SARS) coronavirus (CoV) that stimulated -1 PRF. The conserved existence of a third stem–loop suggested an important hitherto unknown function. Here we present new information describing structure and function of the third stem of the SARS pseudoknot. We uncovered RNA dimerization through a palindromic sequence embedded in the SARS-CoV Stem 3. Further in vitro analysis revealed that SARS-CoV RNA dimers assemble through ‘kissing’ loop–loop interactions. We also show that loop–loop kissing complex formation becomes more efficient at physiological temperature and in the presence of magnesium. When the palindromic sequence was mutated, in vitro RNA dimerization was abolished, and frameshifting was reduced from 15 to 5.7%. Furthermore, the inability to dimerize caused by the silent codon change in Stem 3 of SARS-CoV changed the viral growth kinetics and affected the levels of genomic and subgenomic RNA in infected cells. These results suggest that the homodimeric RNA complex formed by the SARS pseudoknot occurs in the cellular environment and that loop–loop kissing interactions involving Stem 3 modulate -1 PRF and play a role in subgenomic and full-length RNA synthesis.
A Step toward Nonrobotic Total Endoscopic Coronary Bypass Grafting: 40 Coronary Anastomoses in a Biomechanical Beating Heart Model
Authors: Gorki Hagen , Patel Nirav C. , Liewald Christian , Wildhirt Stephen , Subramanian Valavanur A. , Liebold Andreas
Published: December 2012

Objective

Nonrobotic total endoscopic coronary bypass grafting is commonly considered as technically too difficult. After endoscopic practicing in a simple box model, we questioned this statement in a more sophisticated training model.

Methods

In a handmade chest model containing a mechanically actuated porcine heart, anastomoses between homologous vein and shunted anterior coronary artery were performed using Prolene 7–0 sutures or U-clips in 20 anastomoses each. Commercially available endoscopic instruments and exclusive two-dimensional endoscopic vision were used. As quality control, the procedures were recorded, flow was measured, indocyanine green dye angiograms were performed, vinylpolysiloxane endocasts were produced, and finally the anastomoses were assessed from the endothelial side. Three-dimensional computed tomographic reconstruction was explored for cast measuring.

Results

All anastomoses were completed successfully in a time of 51 ± 14 minutes (Prolene) and 48 ± 10 minutes (U-clips). Despite suboptimal equipment, a reproducible sequence of the procedure was established and documented. Improving surgical performance was reflected in a reduction in anastomotic leakage and time requirement. The quality assessment protocol showed a learning curve and problems itself, which are briefly discussed.

Conclusions

A beating heart model is an adamant requirement of training for the technically demanding procedure of nonrobotic total endoscopic coronary bypass grafting. Refinement of the model and quality assessment as well as expansion of training to other regions of the heart should prepare for a cost-effective, broad-based clinical application of nonrobotic endoscopic techniques in coronary surgery. Available high-definition three-dimensional vision systems and the development of appropriate (articulating) instruments will make the procedure safer and quicker and will cut the learning curve.
Does Body Mass Index Affect Outcomes in Robotic-Assisted Coronary Artery Bypass Procedures?
Authors: Hemli Jonathan M. , Darla Lincoln S. , Panetta Christopher R. , Jennings Joan , Subramanian Valavanur A. , Patel Nirav C.
Published: December 2012

Objective

Obese patients pose unique technical challenges for minimal-access cardiac surgery. We sought to examine the effect of body mass index on short-term outcomes in robotic-assisted coronary surgery.

Methods

From January 2010 to November 2011, a total of 110 consecutive patients underwent robotic-assisted coronary surgery at our institution. All patients had robotic-assisted mobilization of the left internal mammary artery. Some patients then underwent direct coronary anastomosis to the left anterior descending coronary artery via a left mini thoracotomy, whereas others had a complete robotic endoscopic procedure within the closed chest. The short-term outcomes of obese patients (n = 39), defined as body mass index greater than 30 kg/m2, were compared with those of nonobese patients (n = 71).

Results

Mean left internal mammary artery harvest time was longer in obese patients than in nonobese patients (51.03 vs 39.94 minutes; P = 0.007), as was overall operative time (218.15 vs 186.72 minutes; P = 0.034). There were no significant differences in mortality or major morbidity between obese and nonobese patients.

Conclusions

Obesity does not adversely affect short-term outcomes in robotic-assisted coronary surgery, although operative times are somewhat longer for these patients. Robotic-assisted coronary techniques can be safely pursued in obese patients.
Management of Pleural Empyema with Single-Port Video-Assisted Thoracoscopy
Authors: Marra Alessandro , Huenermann Christoph , Ross Bernd , Hillejan Ludger
Published: December 2012

Objective

The aim of this study was to evaluate the safety and efficacy of an original technique of single-port video-assisted thoracoscopy (S-VATS) for the minimally invasive treatment of pleural empyema in fibrinopurulent stage.

Methods

Single-port video-assisted thoracoscopy was performed under general anesthesia and single-lung ventilation using a 2-cm incision after ultrasound localization of the projected midpoint of the pleural effusion. Through the single access, a video scope and standard thoracoscopy instruments were simultaneously introduced to perform debridement and lavage of the pleural cavity. Postoperatively, patients underwent continuous or intermittent pleural irrigation through the chest tube until microbiological confirmation of sterility of the pleural fluid.

Results

Between November 2004 and December 2009, a total of 61 patients underwent S-VATS for pleural empyema in stage I(7%) or II (93%). Median age was 63.5 years (range, 22–94 years). Male-to-female ratio was 4.2. Surgery was performed 3 to 60 days after the onset of symptoms. Macroscopically complete debridement of the pleural cavity was achieved in most (98%) cases. Median operation time was 53 minutes (range, 29–90 minutes). No intraoperative complications occurred. In-hospital mortality and morbidity rates were 3% and 16%, respectively. Deaths were caused by diffuse metastatic colon cancer in one case and severe apoplectic insult in the other. Chest tube was removed after a median time of 12 days (range, 4–64 days). Four (6.5%) patients experienced a relapse of empyema; this was caused by complicated residual pleural space (two cases), persistent pleuropulmonary fistula (one case), or both (one case).

Conclusions

It seems that S-VATS is a safe and effective procedure for the treatment of pleural empyema in fibrinopurulent stage.
Serum 25‐Hydroxyvitamin D Levels in Preschool‐Age Children in Northern Sweden Are Inadequate After Summer and Diminish Further During Winter
Authors: Öhlund Inger , Silfverdal Sven‐Arne , Hernell Olle , Lind Torbjörn
Published: December 2012

Background and Objective:

Despite studies indicating that vitamin D intake among Swedish children does not meet the recommendation, little is known of their vitamin D status. The aim of the present study was to examine vitamin D status in preschool‐age children in relation to vitamin D intake, season, body mass index, and skin color.

Methods:

Preschool‐age children (n = 90; mean age 54 ± 7.1 months), all living in northern Sweden (latitude 63° north), half of them with fair skin, half with darker complexion, were recruited from well‐baby clinics. The study group was examined first in August–September (late summer) and then the following January–February (winter). Skin type, vitamin D intake, anthropometrics, serum 25‐hydroxyvitamin D (S‐25[OH] D), and serum parathyroid hormone were assessed.

Results:

Mean ± SD S‐25(OH) D in summer and winter were 60 ± 15 nmol/L and 55 ± 16 nmol/L, respectively (P < 0.001). Fifteen percent and 10% had S‐25(OH) D ≥75 nmol/L, and 25% and 40% had S‐25(OH) D <50 nmol/L, respectively. The mean vitamin D intake was higher in dark‐skinned compared with fair‐skinned children. In spite of this, S‐25(OH) D in dark‐skinned children was lower compared with fair‐skinned children during both seasons. The dietary intake of vitamin D was positively associated with S‐25(OH) D levels.

Conclusions:

Vitamin D status is inadequate in preschool‐age children living in northern Sweden, especially in dark‐skinned children and during the winter despite vitamin D intakes meeting the recommendations, prompting strategies to improve intake of vitamin D in this population.
Metabolic Effects of Roux‐en‐Y Gastric Bypass in Obese Adolescents and Young Adults
Authors: Sinha Manasi , Stanley Takara L. , Webb Jessica , Scirica Christina , Corey Kathleen , Pratt Janey , Boepple Paul A. , Hoppin Alison , Misra Madhusmita
Published: December 2012

Weight loss surgery is an increasingly common treatment option for obese adolescents, but data are limited regarding the metabolic effects of surgical weight loss procedures. We performed a retrospective review of the electronic medical record to determine metabolic outcomes for 24 adolescents and young adults ages 15 to 22 years undergoing Roux‐en‐Y gastric bypass from 2009 to 2011 as well as 24 age‐, sex‐, and BMI‐matched controls. During a median follow‐up of 6 months after Roux‐en‐Y gastric bypass, fasting glucose, hemoglobin A1c, low‐density lipoprotein, triglyceride, and high‐sensitivity C‐reactive protein decreased significantly. Changes in these measures were not significantly associated with age or extent of weight loss.
Identification of dosage-sensitive genes in Saccharomyces cerevisiae using the genetic tug-of-war method
Authors: Makanae Koji , Kintaka Reiko , Makino Takashi , Kitano Hiroaki , Moriya Hisao
Published: December 2012

Gene overexpression beyond a permissible limit causes defects in cellular functions. However, the permissible limits of most genes are unclear. Previously, we developed a genetic method designated genetic tug-of-war (gTOW) to measure the copy number limit of overexpression of a target gene. In the current study, we applied gTOW to the analysis of all protein-coding genes in the budding yeast Saccharomyces cerevisiae. We showed that the yeast cellular system was robust against an increase in the copy number by up to 100 copies in >80% of the genes. After frameshift and segmentation analyses, we isolated 115 dosage-sensitive genes (DSGs) with copy number limits of 10 or less. DSGs contained a significant number of genes involved in cytoskeletal organization and intracellular transport. DSGs tended to be highly expressed and to encode protein complex members. We demonstrated that the protein burden caused the dosage sensitivity of highly expressed genes using a gTOW experiment in which the open reading frame was replaced with GFP. Dosage sensitivities of some DSGs were rescued by the simultaneous increase in the copy numbers of partner genes, indicating that stoichiometric imbalances among complexes cause dosage sensitivity. The results obtained in this study will provide basic knowledge about the physiology of chromosomal abnormalities and the evolution of chromosomal composition.
Contrasting the supramolecular structures in the isomeric pair 5-bromo-3-nitrosalicylaldehyde phenylhydrazone and 3-bromo-5-nitrosalicylaldehyde phenylhydrazone
Authors: Gomes Ligia R. , Low John Nicolson , Wardell James L.
Published: January 2013

Isomeric 5-bromo-3-nitrosalicylaldehyde phenylhydrazone and 3-bromo-5-nitrosalicylaldehyde phenylhydrazone, C13H10BrN3O3, both crystallize with two molecules in the asymmetric unit. In both isomers, an intramolecular O—H...N hydrogen bond links the hydroxy group and the imine N atom. In the 5-bromo-3-nitro isomer, there are two independent N—H...O hydrogen-bonded chains, each molecule in the asymmetric unit forming its own chain. These chains are then linked to form a three-dimensional framework by a combination of weak C—H...O, C—H...Br, C—H...π and π–π stacking interactions. In the 3-bromo-5-nitro isomer, N—H...O hydrogen bonds link the independent molecules alternately into a zigzag chain, which is reinforced by a weak C—H...O interaction. Individual chains are linked by a C—H...Br interaction and a three-dimensional framework is generated by π–π stacking interactions.
Stability of Essential Oils: A Review
Authors: Turek Claudia , Stintzing Florian C.
Published: January 2013

In recent years, consumers have developed an ever‐increasing interest in natural products as alternatives for artificial additives or pharmacologically relevant agents. Among them, essential oils have gained great popularity in the food, cosmetic, as well as the pharmaceutical industries. Constituting an array of many lipophilic and highly volatile components derived from a great range of different chemical classes, essential oils are known to be susceptible to conversion and degradation reactions. Oxidative and polymerization processes may result in a loss of quality and pharmacological properties. Despite their relevance for consumers, there is a paucity of information available addressing this issue. Therefore, the present review provides a comprehensive summary on possible changes in essential oils and factors affecting their stability. Focusing on individual essential oils, the various paths of degradation upon exposure to extrinsic parameters are outlined. Especially temperature, light, and oxygen availability are recognized to have a crucial impact on essential oil integrity. Finally, analytical methods to assess both genuine as well as altered essential oil profiles are evaluated with respect to their suitability to track chemical alterations. It is believed that only a careful inspection of essential oils by a set of convenient methods allows profound quality assessment that is relevant to producers and consumers alike.
The social consequences of conspiracism: Exposure to conspiracy theories decreases intentions to engage in politics and to reduce one's carbon footprint
Authors: Jolley Daniel , Douglas Karen M.
Published: January 2013

The current studies explored the social consequences of exposure to conspiracy theories. In Study 1, participants were exposed to a range of conspiracy theories concerning government involvement in significant events such as the death of Diana, Princess of Wales. Results revealed that exposure to information supporting conspiracy theories reduced participants' intentions to engage in politics, relative to participants who were given information refuting conspiracy theories. This effect was mediated by feelings of political powerlessness. In Study 2, participants were exposed to conspiracy theories concerning the issue of climate change. Results revealed that exposure to information supporting the conspiracy theories reduced participants' intentions to reduce their carbon footprint, relative to participants who were given refuting information, or those in a control condition. This effect was mediated by powerlessness with respect to climate change, uncertainty, and disillusionment. Exposure to climate change conspiracy theories also influenced political intentions, an effect mediated by political powerlessness. The current findings suggest that conspiracy theories may have potentially significant social consequences, and highlight the need for further research on the social psychology of conspiracism.
Glioblastoma with Oligodendroglioma Component (GBM‐O): Molecular Genetic and Clinical Characteristics
Authors: Appin Christina L. , Gao Jingjing , Chisolm Candace , Torian Mike , Alexis Dianne , Vincentelli Cristina , Schniederjan Matthew J. , Hadjipanayis Costas , Olson Jeffrey J. , Hunter Stephen , Hao Chunhai , Brat Daniel J.
Published: January 2013

Glioblastoma (GBM) is an aggressive primary brain tumor with an average survival of approximately 1 year. A recently recognized subtype, glioblastoma with oligodendroglioma component (GBM‐O), was designated by the World Health Organization (WHO) in 2007. We investigated GBM‐Os for their clinical and molecular characteristics as compared to other forms of GBM. Tissue samples were used to determine EGFR, PTEN, and 1p and 19q status by fluorescence in situ hybridization (FISH); p53 and mutant IDH1 protein expression by immunohistochemistry (IHC); and MGMT promoter status by methylation‐specific polymerase chain reaction (PCR). GBM‐Os accounted for 11.9% of all GBMs. GBM‐Os arose in younger patients compared to other forms of GBMs (50.7 years vs. 58.7 years, respectively), were more frequently secondary neoplasms, had a higher frequency of IDH1 mutations and had a lower frequency of PTEN deletions. Survival was longer in patients with GBM‐Os compared to those with other GBMs, with median survivals of 16.2 and 8.1 months, respectively. Most of the survival advantage for GBM‐O appeared to be associated with a younger age at presentation. Among patients with GBM‐O, younger age at presentation and 1p deletion were most significant in conferring prolonged survival. Thus, GBM‐O represents a subset of GBMs with distinctive morphologic, clinical and molecular characteristics.
Identification of novel caspase/autophagy‐related gene switch to cell fate decisions in breast cancers
Authors: Fu L.‐L. , Yang Y. , Xu H.‐L. , Cheng Y. , Wen X. , Ouyang L. , Bao J.‐K. , Wei Y.‐Q. , Liu B.
Published: January 2013

Objectives

Caspases, a family of cysteine proteases with unique substrate specificities, contribute to apoptosis, whereas autophagy‐related genes (ATGs) regulate cytoprotective autophagy or autophagic cell death in cancer. Accumulating evidence has recently revealed underlying mechanisms of apoptosis and autophagy; however, their intricate relationships still remain to be clarified. Identification of caspase/ATG switches between apoptosis and autophagy may address this problem.

Materials and methods

Identification of caspase/ATG switches was carried out using a series of elegant systems biology & bioinformatics approaches, such as network construction, hub protein identification, microarray analyses, targeted microRNA prediction and molecular docking.

Results

We computationally constructed the global human network from several online databases and further modified it into the basic caspase/ATG network. On the basis of apoptotic or autophagic gene differential expressions, we identified three molecular switches [including androgen receptor, serine/threonine‐protein kinase PAK‐1 (PAK‐1) and mitogen‐activated protein kinase‐3 (MAPK‐3)] between certain caspases and ATGs in human breast carcinoma MCF‐7 cells. Subsequently, we identified microRNAs (miRNAs) able to target androgen receptor, PAK‐1 and MAPK‐3, respectively. Ultimately, we screened a range of small molecule compounds from DrugBank, able to target the three above‐mentioned molecular switches in breast cancer cells.

Conclusions

We have systematically identified novel caspase/ATG switches involved in miRNA regulation, and predicted targeted anti‐cancer drugs. These findings may uncover intricate relationships between apoptosis and autophagy and thus provide further new clues towards possible cancer drug discovery.