bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlates of Adiponectin in Hepatitis C–Infected Children
Authors: Delgado‐Borrego Aymin , Gonzalez‐Peralta Regino P. , Raza Roshan , Negre Betania , Goodman Zachary D. , Jonas Maureen M. , Chung Raymond T. , Ludwig David A. ,   PEDS‐C Clinical Research Network
Published: October 2014

Objectives:

Adiponectin is a regulator of cytokines that, in turn, play a vital role in inflammatory and immune responses. Adiponectin is therefore likely to have a contributory role in hepatitis C virus (HCV) infection. We sought to characterize adiponectin levels and examine correlates in a pediatric HCV‐infected cohort.

Methods:

We performed a cross‐sectional study in children (5–17 years of age, n = 86) in the Pediatric Study of Hepatitis C (PEDS‐C) trial. Adiponectin levels were univariately correlated with patient demographics, anthropometrics, and viral and histological measures. Multivariate regression models were used to identify the unique (ie, nonconfounded) associations with adiponectin concentrations.

Results:

Body mass index (BMI) had the highest univariate inverse correlation with loge adiponectin (r = −0.5, P < 0.0001). In multivariate analysis, BMI remained inversely correlated with loge adiponectin after accounting for age and route of HCV transmission (r = −0.38, P = 0.0003). Steatosis and fibrosis were inversely related to loge adiponectin in univariate analysis, but these associations were not statistically significant after multivariate adjustments (P ≥ 0.1827).

Conclusions:

High BMI among HCV‐infected children is associated with lower adiponectin levels. Practitioners should be cognizant of the possible risks of low adiponectin when managing HCV‐infected children who are overweight. Further studies are indicated to determine the impact of having low adiponectin on HCV infection in youth.
Facilitating change in primary education: the role of existing school facilities in ICT initiatives
Authors: Cardellino Paula , Leiringer Roine
Published: October 2014

Purpose

– The aim of this paper is to illuminate the impact that the implementation of the Plan Ceibal imposes on the existing school infrastructure and how the use and upkeep of available facilities might need to be altered and changed to accommodate the new technology. Uruguay is, through the Plan Ceibal, the first country to provide every public primary school child with a laptop free of charge. The Plan represents a major investment to promote digital literacy and improve the quality of education.

Design/methodology/approach

– Empirical data are drawn from a multiple case study of five public primary schools. Particular attention is given to how school facilities and their immediate surroundings mediate the successful introduction and adoption of individual laptops.

Findings

– Plan Ceibal has the potential to change traditional teaching methods and behavioural patterns, which will in turn have an impact on how facilities and spaces are used. Questions are raised regarding the ultimate effectiveness of the initiative and if the aspired to improvements might be curtailed by a lack of investment in other areas, such as the school infrastructure. We argue for a context-sensitive view on research that not only considers the technology and potential changes in pedagogical approaches but also the physical environment in which these changes are to take place.

Originality/value

– Research into facilities and asset management has an important role to play in the achievement of effective learning environments and the successful uptake of information communication technology (ICT) initiatives.
Y in the workplace: comparative analysis of values, skills and perceptions of government communication amongst university students and government staff
Authors: Berry Jeremy
Published: October 2014

Purpose

– This article aims to advance understanding of the various and differing aspects of government communication as a means to determine where the various generations’ values converge and diverge and to forecast the future implications of the findings by analyzing similarities and differences between the Generation Y public relations (PR) student sample at a Western Canadian university and the working generations of a communications branch within a provincial government, specifically Generation Y.

Design/methodology/approach

– This comparative study uses data from two previous studies to identify and analyze trends among Generation Y communicators – both those in the university setting and those already working within government – specific to values, skills and perceptions of the government communication function. It asks: how do the values and opinions of Generation Y university PR students compare and contrast with values and opinions from Generation Y communication staff within a provincial government?

Findings

– Along with supporting some of the assumptions and previous findings relating to Generation Y, the findings from this purposive survey and subsequent comparative analysis offer a new and deeper understanding of the workplace needs and wants of those represented by the particular sample. The findings also provide a glimpse into what the future of government communications might look like and the skills the next generation of employees will need to have.

Research limitations/implications

– The sample size used in this article is small and purposive, and should not be read as representative. The intent is not to generalize broad populations and generations, but to add to knowledge in a very specific area.

Practical implications

– The results of this study directly inform the practice of government communication by addressing current and future recruitment challenges.

Originality/value

– A study of generational values within Canadian Government communication has not been conducted previously by scholars and academics. This study fills a gap in the research and offers valuable insight for future research.
The Spare Heirs and Henriksen resort at Surprise lake
Authors: Pratt Catherine
Published: October 2014

Purpose

– The purpose of this paper is to explore family business, leadership development, family dynamics, succession, and governance. It is appropriate for undergraduate and graduate family business and leadership courses; and to facilitate dialogue among members of family enterprises to introduce the need to address family dynamics and leadership issues.

Design/methodology/approach

– This case blends issues arising out of several family firms known to the author. Events, people, details, and location have been merged and adapted into this one case. The case method is used for the purposes of identifying key issues and provoking discussion on areas critical to multi-generational family enterprises.

Findings

– The case study method allows readers to explore and dialogue possible options for dealing with issues of unexpected family business leadership transition.

Practical implications

– Every family enterprise generation has unique challenges and opportunities. This case facilitates discussion that helps explore leadership succession issues and leadership development. For family business members, it is vehicle for neutral exploration of possible issues in their own organizations.

Originality/value

– This is an original case study based on the blending of issues and adaptation from several family firms.
Four essential dimensions of workplace learning
Authors: Hopwood Nick
Published: October 2014

Purpose

– This conceptual paper aims to argue that times, spaces, bodies and things constitute four essential dimensions of workplace learning. It examines how practices relate or hang together, taking Gherardi’s texture of practices or connectedness in action as the foundation for making visible essential but often overlooked dimensions of workplace learning.

Design/methodology/approach

– This framework is located within and adds to contemporary sociomaterial- or practice-based approaches, in which learning is understood as an emergent requirement and product of ongoing practice that cannot be specified in advance.

Findings

– The four dimensions are essential in two senses: they are the constitutive essence of textures of practices: what they are made of and they are non-optional; it is not possible to conceive a texture of practices without all of these dimensions present. Although the conceptual terrains to which they point overlap considerably, they remain useful as analytic points of departure. Each reveals something that is less clear in the others.

Research limitations/implications

– This innovative framework responds to calls to better understand how practices hang together, and offers a toolkit that reflects the multifaceted nature of practice. It presents a distinctive basis for making sense of connectedness in action, and thus for understanding learning in work.

Originality/value

– The paper offers a novel conceptual framework, expanding the texture of practices through dimensions of times, spaces, bodies and things, rendering visible aspects that might otherwise be ignored.
Characterizing the degree of amplitude‐variation‐with‐offset nonlinearity in seismic physical modelling reflection data
Authors: Innanen Kristopher A. , Mahmoudian Faranak
Published: October 2014

The nonlinearity of the seismic amplitude‐variation‐with‐offset response is investigated with physical modelling data. Nonlinearity in amplitude‐variation‐with‐offset becomes important in the presence of large relative changes in acoustic and elastic medium properties. A procedure for pre‐processing physical modelling reflection data is enacted on the reflection from a water‐plexiglas boundary. The resulting picked and processed amplitudes are compared with the exact solutions of the plane‐wave Zoeppritz equations, as well as approximations that are first, second, and third order in , , and . In the low angle range of 0°–20°, the third‐order plane‐wave approximation is sufficient to capture the nonlinearity of the amplitude‐variation‐with‐offset response of a liquid‐solid boundary with , , and ρ contrasts of 1485–2745 m/s, 0–1380 m/s, and 1.00–1.19 gm/cc respectively, to an accuracy value of roughly 1%. This is in contrast to the linear Aki–Richards approximation, which is in error by as much as 25% in the same angle range. Even‐order nonlinear corrective terms are observed to be primarily involved in correcting the angle dependence of , whereas the odd‐order nonlinear terms are involved in determining the absolute amplitude‐variation‐with‐offset magnitudes.
Do intraspecific or interspecific interactions determine responses to predators feeding on a shared size‐structured prey community?
Authors: ten Brink Hanna , Mazumdar Abul Kalam Azad , Huddart Joseph , Persson Lennart , Cameron Tom C.
Published: October 2014

Coexistence of predators that share the same prey is common. This is still the case in size‐structured predator communities where predators consume prey species of different sizes (interspecific prey responses) or consume different size classes of the same species of prey (intraspecific prey responses).

A mechanism has recently been proposed to explain coexistence between predators that differ in size but share the same prey species, emergent facilitation, which is dependent on strong intraspecific responses from one or more prey species. Under emergent facilitation, predators can depend on each other for invasion, persistence or success in a size‐structured prey community.

Experimental evidence for intraspecific size‐structured responses in prey populations remains rare, and further questions remain about direct interactions between predators that could prevent or limit any positive effects between predators [e.g. intraguild predation (IGP)].

Here, we provide a community‐wide experiment on emergent facilitation including natural predators. We investigate both the direct interactions between two predators that differ in body size (fish vs. invertebrate predator), and the indirect interaction between them via their shared prey community (zooplankton).

Our evidence supports the most likely expectation of interactions between differently sized predators that IGP rates are high, and interspecific interactions in the shared prey community dominate the response to predation (i.e. predator‐mediated competition). The question of whether emergent facilitation occurs frequently in nature requires more empirical and theoretical attention, specifically to address the likelihood that its pre‐conditions may co‐occur with high rates of IGP.
Minocycline can delay the development of morphine tolerance, but cannot reverse existing tolerance in the maintenance period of neuropathic pain in rats
Authors: Zhang Xin , Wang Jing , Yu Tingting , Du Dongping , Jiang Wei
Published: October 2014

Neuropathic pain is a challenge for physicians and basic science researchers, because it often does not respond to routine treatment. The administration of morphine has been considered one of the effective recommended treatments, but its wide application is limited because of the development of antinociceptive tolerance. In general, basic science studies focus on neuropathic pain and morphine tolerance separately. However, we tried to investigate the effect of microglial activation on morphine tolerance in spinal nerve ligation (SNL) rats during the maintenance period of neuropathic pain. This study produced the following results. The morphine tolerance model in neuropathic pain was established by repeated administration of morphine twice daily (10 mg/kg s.c) in the maintenance period of SNL rats. Minocycline, the microglial activation inhibitor, was given once daily (30 mg/kg, i.p.) at different time‐points. The CD11b protein level was measured by western blot to monitor microglial activation. Rats’ mechanical allodynia was assessed using the 50% paw withdrawal threshold, and the tail antinociception was determined using the percentage of the maximal possible antinociceptive effect. First, the repeated administration of morphine induced the development of antinociceptive tolerance during the maintenance period of neuropathic pain. Second, during the development of morphine tolerance, microglial activation, which is related to the analgesic effect of morphine, decreased in the first few days, but this pattern was reversed in the following days with the development of morphine tolerance. Third, the repeated administration of minocycline, a microglial activation inhibitor, did not influence the antinociceptive effect of a single dose of morphine. Fourth, the pre‐administration of minocycline can delay the development of morphine tolerance, but repeated minocycline administration cannot reverse existing morphine tolerance. We concluded that microglial activation contributes to the morphine tolerance of SNL rats in the maintenance period of neuropathic pain, and that minocycline delays the development of morphine tolerance, but does not reverse existing morphine tolerance during the maintenance period of neuropathic pain in rats. These findings might be useful for clinical pain management.
Pharmacology of manipulating lean body mass
Authors: Sepulveda Patricio V , Bush Ernest D , Baar Keith
Published: October 2014

Dysfunction and wasting of skeletal muscle as a consequence of illness decreases the length and quality of life. Currently, there are few, if any, effective treatments available to address these conditions. Hence, the existence of this unmet medical need has fuelled large scientific efforts. Fortunately, these efforts have shown many of the underlying mechanisms adversely affecting skeletal muscle health. With increased understanding have come breakthrough disease‐specific and broad spectrum interventions, some progressing through clinical development. The present review focuses its attention on the role of the antagonistic process regulating skeletal muscle mass before branching into prospective promising therapeutic targets and interventions. Special attention is given to therapies in development against cancer cachexia and Duchenne muscular dystrophy before closing remarks on design and conceptualization of future therapies are presented to the reader.
High‐fat diet and chronic stress reduce central pressor and tachycardic effects of apelin in Sprague–Dawley rats
Authors: Cudnoch‐Jedrzejewska Agnieszka , Gomolka Ryszard , Szczepanska‐Sadowska Ewa , Czarzasta Katarzyna , Wrzesien Robert , Koperski Lukasz , Puchalska Liana , Wsol Agnieszka
Published: October 2014

Summary

Central application of apelin elevates blood pressure and influences neuroendocrine responses to stress and food consumption. However, it is not known whether the central cardiovascular effects of apelin depend also on caloric intake or chronic stress. The purpose of the present study was to determine the effects of intracerebroventricular administration of apelin on blood pressure (mean arterial blood pressure) and heart rate in conscious Sprague–Dawley rats consuming either a normal‐fat diet (NFD) or high‐fat diet (HFD) for 12 weeks. During the last 4 weeks of the food regime, the rats were exposed (NFDS and HFDS groups) or not exposed (NFDNS and HFDNS groups) to chronic stress. Each group was divided into two subgroups receiving intracerebroventricular infusions of either vehicle or apelin. Apelin elicited significant increase of mean arterial blood pressure and heart rate in the NFDNS rats. This effect was abolished in the HFDNS, HFDS and NFDS groups. HFD resulted in a significant elevation of blood concentrations of total cholesterol, triglycerides glucose and insulin. Chronic stress reduced plasma concentration of total and high‐density lipoprotein cholesterol, and increased plasma corticosterone concentration and APJ receptor mRNA expression in the hypothalamus, whereas a combination of a HFD with chronic stress resulted in the elevation of plasma triglycerides, total cholesterol and low‐density lipoprotein cholesterol, and in increased plasma corticosterone concentration, apelin concentration and APJ receptor mRNA expression in the hypothalamus. It is concluded that a HFD and chronic stress result in significant suppression of the central pressor action of apelin, and cause significant though not unidirectional changes of metabolic and endocrine parameters.
Subxyphoid single‐incision thoracoscopic pulmonary metastasectomy
Authors: Liu Chia‐Chuan , Wang Bing‐Yen , Shih Chih‐Shiun , Lin Wei‐Cheng
Published: October 2014

Single‐incision thoracoscopic surgery has increasingly attracted public interest and been applied in numerous thoracic procedures. However, single‐incision thoracoscopic surgery is associated with requiring subsequent procedures, such as intercostal neuralgia. Herein, we extend the single‐port technique of pulmonary metastasectomy through a single subxiphoid approach, and report the first two cases of this procedure to date.
Alcohol in the second half of life: do usual quantity and frequency of drinking to intoxication increase with increased drinking frequency?
Authors: Brunborg Geir Scott , Østhus Ståle
Published: October 2014

Aims

We investigated if increased drinking frequency among adults in the second half of life co‐occurred with increased usual quantity and increased intoxication frequency.

Design

Two‐wave panel study.

Setting

Norway.

Participants

Norwegian adults (1017 women and 959 men) aged 40–79 years.

Measurements

Drinking frequency, usual quantity and intoxication frequency was measured by self‐report in 2002/03 and again in 2007/08. Information about gender, age and level of education was obtained from the public register. Health was collected by self‐report.

Findings

Because of a significant gender × change in drinking frequency interaction effect on change in intoxication frequency (b = 0.02, P = 0.013), women and men were analysed separately. After adjusting for covariates, women who increase their drinking frequency showed a non‐significant decrease in usual quantity [low initial usual quantity (LIUQ): β = −0.01, P = 0.879; high initial usual quantity (HIUQ): β = −0.06, P = 0.164] and a non‐significant increase in intoxication frequency (LIUQ: β = 0.04, P = 0.569; HIUQ: β = 0.09, P = 0.251). Men who increased their drinking frequency showed a small decrease in usual quantity (LIUQ: β = −0.06, P = 0.049; HIUQ: β = −0.05, P = 0.002) and a small increase in intoxication frequency (LIUQ: β = 0.05, P = 0.035; HIUQ: β = 0.13, P = 0.004).

Conclusion

Among Norwegian adults in the second half of life, increased drinking frequency appears to be associated with a small reduction in usual quantity, and a small increase in frequency of drinking to intoxication.
Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients
Authors: Gryczynski Jan , Kelly Sharon M. , Mitchell Shannon Gwin , Kirk Arethusa , O'Grady Kevin E. , Schwartz Robert P.
Published: October 2014

Background and Aims

The World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) has strong support as a clinical screening tool and research instrument, but has only been validated with adults. This study evaluated the ASSIST and ASSIST‐Lite in an adolescent population.

Design

Internal consistency, concurrent validity, discriminant validity and diagnostic accuracy were examined for tobacco, alcohol and cannabis ASSIST scores. An abbreviated version (the ASSIST‐Lite) was evaluated for cannabis.

Setting

Three community health centers in Baltimore, MD, USA.

Participants

A total of 525 primary care patients, ages 12–17 years.

Measurements

Measures included the ASSIST, the CRAFFT screening tool and items from the Composite International Diagnostic Interview (CIDI) corresponding to substance use disorder criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Findings

The ASSIST had good internal consistency (α = 0.68–0.88), good concurrent validity with the CRAFFT (r = 0.41–0.76; P < 0.001), and was able to discriminate between gradations of cannabis problem severity. In receiver operating characteristics analysis of optimal clinical cut‐points, the ASSIST accurately identified tobacco, alcohol and cannabis use disorders (sensitivities = 95–100%; specificities = 79–93%; area under the curve [AUC] = 0.90–0.94), but did so at minimally low cut‐points (indicative of any use in the past 3 months). The ASSIST‐Lite performed similarly to the ASSIST in identifying cannabis use disorders (sensitivity = 96%; specificity = 88%; AUC = 0.92), also at a minimally low cut‐point. However, confirmatory factor analysis of the ASSIST indicated poor model fit.

Conclusions

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is promising as a research and screening/brief assessment tool with adolescents, but revisions to clinical risk thresholds are warranted. The ASSIST‐Lite is sufficiently informative for rapid clinical screening of adolescents for cannabis use disorders.
Capturing illicit drug use where and when it happens: an ecological momentary assessment of the social, physical and activity environment of using versus craving illicit drugs
Authors: Linas Beth S. , Latkin Carl , Westergaard Ryan P. , Chang Larry W. , Bollinger Robert C. , Genz Andrew , Kirk Gregory D.
Published: October 2014

Aims

To understand the environmental and contextual influences of illicit cocaine and heroin use and craving using mobile health (mHealth) methods.

Design

Interactive mHealth methods of ecological momentary assessment (EMA) were utilized in the Exposure Assessment in Current Time (EXACT) study to assess drug use and craving among urban drug users in real time. Participants were provided with mobile devices and asked to self‐report every time they either craved (without using) or used heroin or cocaine for 30 days from November 2008 through May 2013.

Setting

Baltimore, MD, USA.

Participants

A total of 109 participants from the AIDS Linked to the IntraVenous Experience (ALIVE) study.

Measurements

For each drug use or craving event, participants answered questions concerning their drug use, current mood and their social, physical and activity environments. Odds ratios (OR) of drug use versus craving were obtained from logistic regression models with generalized estimating equations of all reported events.

Findings

Participants were a median of 48.5 years old, 90% African American, 52% male and 59% HIV‐infected. Participants were significantly more likely to report use rather than craving drugs if they were with someone who was using drugs [adjusted odds ratio (aOR) = 1.45, 95% confidence interval (CI) = 1.13, 1.86), in an abandoned space (aOR = 6.65, 95% CI = 1.78, 24.84) or walking/wandering (aOR = 1.68, 95% CI = 1.11, 2.54). Craving drugs was associated with being with a child (aOR = 0.26, 95% CI = 0.12, 0.59), eating (aOR = 0.54, 95% CI = 0.34, 0.85) or being at the doctor's office (aOR = 0.31, 95% CI = 0.12, 0.80).

Conclusions

There are distinct drug using and craving environments among urban drug users, which may provide a framework for developing real‐time context‐sensitive interventions.
Range extension and conservation status of Cymbula nigra (Gastropoda: Patellidae) in the Tunisian shores
Authors: Boukhicha Jihen , Ben Hassine Oum Kalthoum , Tlig‐Zouari Sabiha
Published: October 2014

Cymbula nigra is the largest limpet in the Mediterranean. It has been listed since 1993, as an ‘endangered species’. Its historical range in the Mediterranean includes the southern Spanish, the Moroccan and the Algerian coasts. Recent observations have confirmed its proliferation in southern Spain and its progression along the European and North African Mediterranean coasts. Field surveys carried out along the Tunisian coasts during winter 2011 revealed the presence of this species in the Gulf of Tunis and the Cap Bon. The finding of C. nigra represents a range extension possibly enhanced by the current global warming, as it is a ‘warm‐water species’. The absence of records in previous surveys to the same sampling sites (2006–2007), together with the small sizes recorded in 2011, confirms the recent installation of the species. The limpet was recorded in areas spared of pollution, characterized by a predominant influence of the Atlantic current, and also showed a preference for steep cliffs exposed to strong waves. This is the first population study of this endangered gastropod outside of its original range of distribution. The determination of the ecological characteristics of newly colonized habitats might serve as a starting point for the establishment of appropriate recommendations for its conservation.
Superoxide anions in the paraventricular nucleus mediate cardiac sympathetic afferent reflex in insulin resistance rats
Authors: Sun H.‐J. , Zhou H. , Feng X.‐M. , Gao Q. , Ding L. , Tang C.‐S. , Zhu G.‐Q. , Zhou Y.‐B.
Published: October 2014

Aim

Cardiac sympathetic afferent reflex (CSAR) participates in sympathetic over‐excitation. Superoxide anions and angiotensin II (Ang II) mechanisms are associated with sympathetic outflow and CSAR in the paraventricular nucleus (PVN). This study was designed to investigate whether PVN superoxide anions mediate CSAR and Ang II‐induced CSAR enhancement response in fructose‐induced insulin resistance (IR) rats.

Methods

CSAR was evaluated with the changes of renal sympathetic nerve activity (RSNA) and mean arterial pressure (MAP) responses to the epicardial application of capsaicin (CAP) in anaesthetized rats.

Results

Compared with Control rats, IR rats showed that CSAR, PVN NAD(P)H oxidase activity, superoxide anions, malondialdehyde (MDA), Ang II and AT1 receptor levels were significantly increased, whereas PVN superoxide dismutase (SOD) and catalase (CAT) activities were decreased. In Control and IR rats, PVN microinjection of superoxide anions scavengers tempol, tiron and PEG‐SOD (an analogue of endogenous superoxide dismutase) or inhibition of PVN NAD(P)H oxidase with apocynin caused significant reduction of CSAR, respectively, but DETC (a superoxide dismutase inhibitor) strengthened the CSAR. PVN pre‐treatment with tempol abolished, whereas DETC potentiated, Ang II‐induced CSAR enhancement response. Moreover, PVN pre‐treatment with tempol or losartan prevented superoxide anions increase caused by Ang II in IR rats.

Conclusion

PVN superoxide anions mediate CSAR and Ang II‐induced CSAR response in IR rats. In IR state, increased NAD(P)H oxidase activity and decreased SOD and CAT activities in the PVN promote superoxide anions increase to involve in CSAR enhancement. Ang II may increase NAD(P)H oxidase activity via AT1 receptor to induce superoxide anion production.
The Poet and the Psychotherapist: In Gratitude for the Life and Work of Seamus Heaney (1939–2013)
Authors: Ward Siobhan
Published: October 2014

In this paper, I explore the question whether the inclusion in clinical training of a more observational and research‐based approach focused on evidence of outcome, as advocated by Knox (2013), risks eroding the subjective experience which is at the heart of the analytic encounter. I suggest that psychotherapists have always had to maintain a dual perspective of objective observer and experiencing subject. I compare the duality of the psychotherapist and the duality of the poet, using the poetry of Seamus Heaney for illustration purposes. I refer to themes and values shared by psychotherapy and Heaney's poetry, which make this comparison especially apposite. I refer to Heaney's poetry to illustrate that the maintenance of objectivity need not be at the expense of subjectivity and that the tension between the two perspectives makes for creativity. I also refer to certain of Heaney's poems for their educational value in expressing eloquently certain key concepts and aims of psychoanalytic psychotherapy. I liken Heaney's inclusiveness and non‐sectarianism to Knox's willingness to include within clinical trainings and practice an approach which seeks out and learns from research in other related disciplines.
Critical Looks: An Analysis of Body Dysmorphic Disorder
Authors: Parker Rozsika
Published: October 2014

This paper sets out a framework for a comprehensive theory of Body Dysmorphic Disorder (BDD), based on interview data and theoretical reading. It combines psychoanalytic, cultural and political insights. It develops the author's earlier work on body hatred (Parker, 2003). The role of the other – actual, imagined or fantasized – is central, and ambivalence about the body, inflated by shame, is key to this dynamic. Any part of the body may be involved, and checking is compulsive, betraying an omnipotent struggle for acceptability and normality. The author suggests that BDD sufferers are especially sensitive to the power, pleasure and pain of looking and being looked at, with the objective sense of self dominating any subjective sense. Object relations provides explanations of individual differences in susceptibility to BDD, through failures of maternal mirroring. Lacan's theory of the mirror stage explains the origin of the ambivalent relation of the subject to his/her own image, rivalry with self and other, shame and desire, as well as the enduring power of cultural norms of appearance. Freud's ideas on taboo and ambivalence, and their dynamics in changing cultural forms, are illustrated and linked to Douglas's ideas of pollution and taboo.
Oxidative Glial Cell Damage Associated with White Matter Lesions in the Aging Human Brain
Authors: Al‐Mashhadi Sufana , Simpson Julie E. , Heath Paul R. , Dickman Mark , Forster Gillian , Matthews Fiona E. , Brayne Carol , Ince Paul G. , Wharton Stephen B. ,   Medical Research Council Cognitive Function and Ageing Study
Published: October 2014

White matter lesions (WML) are common in brain aging and are associated with dementia. We aimed to investigate whether oxidative DNA damage and occur in WML and in apparently normal white matter in cases with lesions. Tissue from WML and control white matter from brains with lesions (controls lesional) and without lesions (controls non‐lesional) were obtained, using post‐mortem magnetic resonance imaging‐guided sampling, from the Medical Research Council Cognitive Function and Ageing Study. Oxidative damage was assessed by immunohistochemistry to 8‐hydroxy‐2′‐deoxoguanosine (8‐OHdG) and Western blotting for malondialdehyde. DNA response was assessed by phosphorylated histone H2AX (γH2AX), p53, senescence markers and by quantitative Reverse transcription polymerase chain reaction (RT‐PCR) panel for candidate DNA damage‐associated genes. 8‐OHdG was expressed in glia and endothelium, with increased expression in both WML and controls lesional compared with controls non‐lesional (P < 0.001). γH2Ax showed a similar, although attenuated difference among groups (P = 0.03). Expression of senescence‐associated β‐galactosidase and p16 suggested induction of senescence mechanisms in glia. Oxidative DNA damage and a DNA damage response are features of WML pathogenesis and suggest candidate mechanisms for glial dysfunction. Their expression in apparently normal white matter in cases with WML suggests that white matter dysfunction is not restricted to lesions. The role of this field‐effect lesion pathogenesis and cognitive impairment are areas to be defined.
Early Life Status Epilepticus and Stress Have Distinct and Sex‐Specific Effects on Learning, Subsequent Seizure Outcomes, Including Anticonvulsant Response to Phenobarbital
Authors: Akman Ozlem , Moshé Solomon L. , Galanopoulou Aristea S.
Published: October 2014

Aims

Neonatal status epilepticus (SE) is often associated with adverse cognitive and epilepsy outcomes. We investigate the effects of three episodes of kainic acid‐induced SE (3KA‐SE) and maternal separation in immature rats on subsequent learning, seizure susceptibility, and consequences, and the anticonvulsant effects of phenobarbital, according to sex, type, and age at early life (EL) event.

Methods

3KA‐SE or maternal separation was induced on postnatal days (PN) 4–6 or 14–16. Rats were tested on Barnes maze (PN16–19), or lithium–pilocarpine SE (PN19) or flurothyl seizures (PN32). The anticonvulsant effects of phenobarbital (20 or 40 mg/kg/rat, intraperitoneally) pretreatment were tested on flurothyl seizures. FluoroJadeB staining assessed hippocampal injury.

Results

3KA‐SE or separation on PN4–6 caused more transient learning delays in males and did not alter lithium–pilocarpine SE latencies, but aggravated its outcomes in females. Anticonvulsant effects of phenobarbital were preserved and potentiated in specific groups depending on sex, type, and age at EL event.

Conclusions

Early life 3KA‐SE and maternal separation cause more but transient cognitive deficits in males but aggravate the consequences of subsequent lithium–pilocarpine SE in females. In contrast, on flurothyl seizures, EL events showed either beneficial or no effect, depending on gender, type, and age at EL events.
Influence of age and gender in the normal values of Sino Nasal Outcome Test–22
Authors: Gregório L.L. , Andrade J.S.C. , Caparroz F.A. , Saraceni Neto P. , Kosugi E.M.
Published: October 2014

Objectives

Sino Nasal Outcome Test (SNOT)‐22 is a disease‐specific outcomes measure questionnaire that combines rhinologic issues with general health issues. These issues may have variable weight on quality of life perception, and the influence of several factors such as gender, ethnicity, age, socio‐cultural status and co‐morbidities is unknown. The aim of this study was to evaluate the influence of gender and age on normal values of SNOT‐22.

Design

Cross‐sectional study based on application of SNOT‐22 questionnaires to healthy volunteers. Participants were divided according to gender, and each gender was subdivided into age groups: 18–30 years, 31–40 years, 41–50 years, 51–60 years and over 60 years.

Setting

Rhinology Section, Sao Paulo Federal University.

Participants

A total of 539 healthy volunteers (253 men and 286 women) were selected, so that each age group of each gender consisted of at least 50 individuals.

Main outcomes measures

We applied SNOT‐22 questionnaire to volunteers with no nasal or sinus disease. Median of score distribution was used as normal reference.

Results

Men presented lower scores than women (7 versus 9, P = 0.005). Subjects over 60 years presented significantly lower scores than other age groups (18–30 years = 10; 31–40 years = 8; 41–50 years = 9; 51–60 years = 9; over 60 years = 7). Men presented lower scores than women especially in 41–50 year and 51–60 year groups.

Conclusion

Men and elderly presented the lowest Brazilian version SNOT‐22 scores. The range of 0–8 points seemed to be more suitable as a normal value for this instrument, but this cut‐off score could be tailored to age and gender specificities.
Factors affecting the fate of faecal diversion in patients with perianal Crohn's disease
Authors: Gu J. , Valente M. A. , Remzi F. H. , Stocchi L.
Published: October 2014

Aim

A study was carried out with the aim of identifying potential factors which might influence the fate of patients undergoing faecal diversion by stoma in perianal Crohn's disease.

Method

Patients with severe perianal Crohn's disease undergoing faecal diversion between 1994 and 2012 were identified and the factors associated with stoma closure were assessed using univariate and multivariate analysis.

Results

Of 138 diverted patients, 30 (22%) achieved stoma closure, 45 (33%) had a stoma with the rectum left in situ and 63 (45%) underwent proctectomy with permanent stoma formation after a mean follow‐up of 5.7 years. Univariate analysis demonstrated that synchronous colonic (P = 0.004) or rectal (P = 0.021) disease involvement and an increased frequency of loose seton placement (P = 0.001) adversely affected successful stoma closure rates. Multivariate analysis indicated a significant association between the inability to achieve stoma closure and persisting rectal involvement (OR 7.5, 95% CI 2.4–33.4), one or two placements of a loose seton (OR 3.3, 95% CI 1.4–8.8) and more than two placements (OR 6.9, 95% CI 1.2–132.5). No specific medical management was associated with an improved stoma closure rate, including biological agents when these were available (P = 0.25).

Conclusion

The fate of temporary faecal diversion in patients with perianal Crohn's disease is adversely affected by aggressive disease characteristics. No particular treatment, including biological therapy, was associated with an improved outcome.
Hernia incidence following single‐site vs standard laparoscopic colorectal surgery
Authors: Sangster W. , Kulaylat A. N. , Stewart D. B. , Schubart J. R. , Koltun W. A. , Messaris E.
Published: October 2014

Aim

Compared with standard laparoscopic (SDL) approaches, less is known about the incidence of hernias after single‐site laparoscopic (SSL) colorectal surgery. This study hypothesized that SSL colorectal surgery was associated with an increased risk of hernia development.

Method

Institutional retrospective chart review (September 2008–June 2013) identified 276 evaluable patients who underwent laparoscopic colorectal procedures. The following data were collected: demographic data, risk factors for the development of a hernia, operative details and postoperative course including the development of a hernia. Patients were stratified by laparoscopic technique to compare the characteristics of those undergoing SDL and SSL. Patients were subsequently stratified by the presence or absence of a hernia to identify associated factors.

Results

One hundred and nineteen patients (43.1%) underwent SDL and 157 patients (56.9%) underwent SSL surgery. The development of an incisional hernia was observed in 7.6% (9/119) of SDL patients compared with 17.0% (18/106) of SSL patients (P = 0.03) over a median 18‐month follow‐up. Similar proportions of patients developed parastomal hernias in both groups [SDL 16.7% (10/60) vs SSL 15.9% (13/80)]. Hernias were diagnosed at a median of 8.1 (SDL) and 6.5 (SSL) months following the index operation and were less likely to be incarcerated in the SSL group [SDL 38.9% (7/18) vs SSL 6.5% (2/31), P = 0.01].

Conclusion

SSL colorectal surgery is associated with an increase in the incidence of incisional hernias but not parastomal hernias. Site of specimen extraction in SSL may contribute to the development of an incisional hernia.
Visceral fat area is associated with a high risk for early postoperative recurrence in Crohn's disease
Authors: Li Y. , Zhu W. , Gong J. , Zhang W. , Gu L. , Guo Z. , Cao L. , Shen B. , Li N. , Li J.
Published: October 2014

Aim

Mesenteric hypertrophy has been recognized as an indicator of the complicated course of Crohn's disease. The aim of this study was to investigate whether the visceral fat area (VFA) is associated with postoperative clinical and endoscopic recurrence.

Method

Computed tomography was used to measure the subcutaneous fat area and VFA, and the mesenteric fat index (MFI) was defined as the ratio of the VFA to the subcutaneous fat area. Associations between body mass index, subcutaneous fat area, VFA and MFI and postoperative clinical and endoscopic recurrence were investigated.

Results

The factors associated with postoperative endoscopic recurrence at 6 months after surgery were a high VFA value (P = 0.019) and MFI values above the median (P = 0.008). VFA values were significantly correlated with endoscopic recurrence (r = 0.895, P = 0.040) and endoscopic lesions (r = 0.617, P < 0.0001). Additionally, MFI values correlated well with endoscopic recurrence (r = 0.918, P = 0.02) and endoscopic scores (r = 0.584, P < 0.0001). Multivariate analysis indicated that VFA values above the median (hazard ratio 2.63, 95% CI 1.03–6.74) were predictive of postoperative clinical recurrence in Crohn's disease.

Conclusion

A high VFA value is associated with postoperative recurrence of Crohn's disease and has clinical implications with respect to optimizing prophylaxis for each individual. However, further studies are needed to confirm the predictive role of this biomarker in a different data set.
Pharmacological interventions for preventing or delaying onset of type 2 diabetes mellitus
Authors: Bethel M. A. , Xu W. , Theodorakis M. J.
Published: October 2014

Prevention or delay of onset of type 2 diabetes in individuals at varying risk across the dysglycaemia continuum before overt diabetes becomes clinically manifest constitutes a leading objective of global disease prevention schemes. Pharmacological intervention has been suggested as a means to help prevent diabetes and reduce the global burden of this chronic condition. However, there is no credible evidence that early pharmacological intervention leads to long‐term benefit in reducing diabetes‐related complications or preventing early mortality, compared to treating people with diagnosed diabetes who have crossed the glycaemic threshold. In this review, we examine published evidence from trials using pharmacological agents to delay or prevent progression to diabetes. We also explore the benefit/risk impact of such therapies, safety issues and relevant off‐target effects. Current evidence suggests none of the drugs currently available sustainably lower cumulative diabetes incidence, none provides a durable delay in diabetes diagnosis and none provides a convincing concomitant excess benefit for microvascular or macrovascular risk.
Pulp necrosis of teeth retained at the mandibular fracture site and the effect of dexamethasone on its occurrence
Authors: Snäll Johanna , Kormi Eeva , Lindqvist Christian , Suominen Anna‐Liisa , Koivusalo Anna‐Maria , Törnwall Jyrki , Thorén Hanna
Published: October 2014

Objectives

The main purpose was to determine the occurrence of pulp necrosis (PN) of teeth retained at the mandibular fracture site. An additional purpose was to investigate whether perioperative use of dexamethasone increases the risk of PN.

Patients and methods

A follow‐up study on 24 adult dentate patients with mandibular body, symphysis or parasymphysis fracture. These patients had been selected from a larger cohort who had participated in a randomized study of maxillofacial fractures and dexamethasone. All patients who were suspected of having a need for endodontic treatment were evaluated by an endodontist.

Results

PN was diagnosed in six patients (25.0%) in one or two teeth. Of a total of 33 teeth situated in the fracture line, six (18.2%) were diagnosed as having PN. PN was more common in teeth in which the fracture line ran through the apex (21.7%) than in those in which the fracture line was in contact with the tooth cranially to the apex (10.0%). The association between PN and dexamethasone was not significant.

Conclusion

PN is common after mandibular fractures, particularly when the fracture line runs through the apex of the tooth. Use of short‐term, high‐dose dexamethasone perioperatively did not significantly increase the risk for PN.
Antibiosis in wheat interacts with crowding stress to affect Metopolophium dirhodum development and susceptibility to malathion
Authors: Clayson Paul J. , Michaud J.P. , van Emden Helmut F.
Published: October 2014

We used a laboratory study to compare the performance of rose‐grain aphid, Metopolophium dirhodum (Walker) (Hemiptera: Aphididae), on the wheat cultivars ‘Huntsman’ (susceptible) and ‘Rapier’ (partially resistant) in both low density (uncrowded) and high density (crowded) colonies and examined the consequences for aphid susceptibility to malathion. Adult apterae that developed on Rapier wheat had their mean relative growth rate (MRGR) reduced by 6 and 9% under uncrowded and crowded conditions, respectively, whereas the crowding treatment reduced MRGR by 3%, but only in Rapier aphids. Rapier resistance also reduced adult dry weight by 13 and 14% under crowded and uncrowded conditions, respectively, whereas crowding reduced it by 34 and 35% in Rapier and Huntsman aphids, respectively. Development on Rapier substantially reduced the topical LC50 of malathion by 37.8 and 34.8% under crowded and uncrowded conditions, suggesting that plant antibiosis increased malathion susceptibility. By comparison, crowding only reduced the LC50 by 29.5 and 26.0% on Huntsman and Rapier. The LD50 data showed that reductions on aphid body size on Rapier and through crowding did not fully explain the differences in LC50. This was particularly in the values for crowded aphids that were actually 80% higher than for uncrowded ones. This apparent tolerance of crowded aphids, however, may partly be due to loss of insecticide from small aphids at dosing. Evidence of synergy between plant resistance and insecticide susceptibility raises the possibility of using reduced concentrations of pesticides to control aphids on resistant crop cultivars, with diminished impacts on non‐target and beneficial species important in integrated pest management (IPM) programs.
Effects of non‐thermal atmospheric pressure pulsed plasma on the adhesion and durability of resin composite to dentin
Authors: Han Geum‐Jun , Kim Jae‐Hoon , Chung Sung‐No , Chun Bae‐Hyeock , Kim Chang‐Keun , Seo Deog‐Gyu , Son Ho‐Hyun , Cho Byeong‐Hoon
Published: October 2014

This study investigated the effect of low‐power, non‐thermal atmospheric pressure plasma (NT‐APP) treatments, in pulsed and conventional modes, on the adhesion of resin composite to dentin and on the durability of the bond between resin composite and dentin. A pencil‐type NT‐APP jet was applied in pulsed and conventional modes to acid‐etched dentin. The microtensile bond strength (MTBS) of resin composite to dentin was evaluated at 24 h and after thermocycling in one control group (no plasma) and in two experimental groups (pulsed plasma and conventional plasma groups) using the Scotchbond Multi‐Purpose Plus Adhesive System. Data were analyzed using two‐factor repeated‐measures anova and Weibull statistics. Fractured surfaces and the bonded interfaces were evaluated using a field‐emission scanning electron microscope. Although there were no significant differences between the plasma treatment groups, the plasma treatment improved the MTBS compared with the control group. After thermocycling, the MTBS did not decrease in the control or conventional plasma group but increased in the pulsed plasma group. Thermocycling increased the Weibull moduli of plasma‐treated groups. In conclusion, plasma treatment using NT‐APP improved the adhesion of resin composite to dentin. Using a pulsed energy source, the energy delivered to the dentin was effectively reduced without any reduction in bond strength or durability.