bluuebunny/crossref_metadata_2025 huggingface dataset:
Strain-based piezoelectric energy harvesting for wireless sensor systems in a tire
Authors: Lee Jaeyun , Oh Jaegeun , Kim Hyoungseok , Choi Bumkyoo
Published: July 2014

Vehicle safety can be improved by tire pressure monitoring with a wireless sensor system. Since a battery-powered wireless sensor system for tire pressure information is limited by the life of the battery, energy harvesting technology is applied. In order to develop an energy harvester based on a piezoelectric material for the tires, modeling of tire behavior and the energy harvester, and the validation of the modeling were performed. The structural behavior of a tire was numerically modeled and verified by comparing the simulation results with experimental data. In order to compare the generated voltages between the modeling and the experiment, comparisons of the root-mean-square voltage values for various velocities and loads, the distortion factor using the root-mean-square value of the wave form, and the crest factor for verifying the efficiency of the peak value of the wave form were conducted. The results showed that the differences are on average 10% for the loads between 300 and 700 kgf and velocities between 20 and 60 km/h (430 r/min). For the improvement of the energy harvester’s performance, the thickness of substrate was controlled and the generated voltage was increased. If a sensor for measuring radius is applicable to the tire, the strain on the tire can be collected, and thus the loads applied to the tire can be estimated. With a wireless sensor system for measuring radius driven by energy harvesting, we can be one step closer to the embodiment of an intelligent tire.
Material tailoring in finite torsional deformations of axially graded Mooney–Rivlin circular cylinder
Authors: Batra RC
Published: July 2014

We study direct and material tailoring (or inverse) problems for finite torsional deformations of a solid circular cylinder made of a Mooney–Rivlin material with the two elastic moduli continuously varying in the axial direction and deformed by applying equal and opposite torques on its two end faces. We note that a Mooney–Rivlin material is isotropic and incompressible. For the direct problem, we derive the condition that the two material moduli must satisfy in order for the problem to have a solution. In particular, it is shown that finite torsional deformations can be produced if one modulus equals the negative one-half of the other one. For the material tailoring problem, we find the axial variation of the two material moduli to produce finite torsional deformations with prescribed axial variation of the angle of twist per unit length.
Incomplete information and bargaining in the EU: An explanation of first-reading non-agreements
Authors: Wøien Hansen Vibeke
Published: July 2014

According to the logic of standard veto bargaining models with complete information, bargaining in the European Union should never reach the second reading of the ordinary legislative procedure (co-decision). Even so, non-agreement at the first reading occurs frequently in European Union decision making. How can this be explained? Drawing upon game theory on bargaining with incomplete information, two specific predictions with regard to the occurrence of first-reading non-agreements can be generated. First-reading agreements are less likely to occur (1) the greater the distance between the ideal point of the Council and the ideal point of the European Parliament and (2) the greater the salience attached to the proposal. This article combines positional and proposal-specific data and finds robust support for both hypotheses in two different empirical tests.
Implementing ‘insider’ ethnography: lessons from the Public Conversations about HIV/AIDS project in rural South Africa
Authors: Angotti Nicole , Sennott Christie
Published: July 2014

We describe the conceptualization and implementation of a research methodology in which ‘insider’ community members work with ‘outsider’ investigators as participant observers to document everyday conversations taking place in public settings in their communities. Our study took place in a resource-poor area of rural South Africa and focused on HIV/AIDS, yet we aim here to provide a road map for those interested in implementing this approach in other contexts for various empirical ends. Because this approach is unusual, we highlight considerations in selecting a team of ethnographers, describe the training process, and offer ways to ensure the data collected are trustworthy and confidential. We describe the advantages and limitations of utilizing ‘insider ethnography’ in contexts where being indigenous to the study site provides access to perspectives that cannot be obtained through other methods. Finally, we examine how mutuality and the positionality of the research team affect data collection and quality.
The social construction of mental illness for lesbian, gay, bisexual, and transgender persons in the United States
Authors: Perone Angela K
Published: July 2014

In A Sociological Approach to Social Problems, Noel Timms underscores the importance of understanding how historical and social contexts shape the framing of social problems—insights that remain true as we approach the book’s semicentennial. This article applies Timms’ concepts to the social construction of mental illness for lesbian, gay, bisexual, and transgender (LGBT) persons over time in the United States, by comparing changes in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Variations between versions reflect how mental illness diagnoses associated with LGBT persons are highly intertwined with dominant social and cultural norms of sexuality and gender at a given time.
Seeking Wholeheartedness in Education
Authors: Duenkel Nicky , Pratt Judy , Sullivan Julie
Published: July 2014

This article describes a Cooperative Inquiry (CI) undertaken by seven transformative educators who set out to explore how they could better walk with the authority inherent in their professional roles so as to avoid unconsciously replicating unhealthy power dynamics. Their process revealed the insidious and cyclical nature of hegemony, enabling co-inquirers to uncover deeply ingrained patterns vis-a-vis power. Action/reflection cycles highlighted the role of self-policing, vulnerability, hegemonic traps, interruption practices, and the significance of wholeheartedness. Furthermore, the CI process itself was found to be empowering, as presentational knowledge and collective meaning-making supported the dismantling of isolation and shame that often accompanied and perpetuated feelings of disempowerment. Co-inquirers more effectively identified when and how cultural constructs affected them, thereby claiming greater agency in both personal and professional lives. The need for ongoing individual and collaborative reflexivity to reinforce and affirm positive, wholesome power dynamics was also shown.
Predicting the Performance of Motor Imagery in Stroke Patients
Authors: Park Chang-hyun , Chang Won Hyuk , Lee Minji , Kwon Gyu Hyun , Kim Laehyun , Kim Sung Tae , Kim Yun-Hee
Published: July 2014

Background. In a brain–computer interface for stroke rehabilitation, motor imagery is a preferred means for providing a gateway to an effector action or behavior. However, stroke patients often exhibit failure to comply with motor imagery, and therefore their motor imagery performance is highly variable. Objective. We sought to identify motor cortical areas responsible for motor imagery performance in stroke patients, specifically by using a multivariate pattern analysis of functional magnetic resonance imaging data. Methods. We adopted an imaginary finger tapping task in which motor imagery performance could be monitored for 12 chronic stroke patients with subcortical infarcts and 12 age- and sex-matched healthy controls. We identified the typical activation pattern elicited for motor imagery in healthy controls, as computed over the voxels within each searchlight in the motor cortex. Then we measured the similarity of each individual’s activation pattern to the typical activation pattern. Results. In terms of activation levels, the stroke patients showed no activation in the ipsilesional primary motor cortex (M1); in terms of activation patterns, they showed lower similarity to the typical activation pattern in the area than the healthy controls. Furthermore, the stroke patients were better able to perform motor imagery if their activation patterns in the bilateral supplementary motor areas and ipsilesional M1 were close to the typical activation pattern. Conclusions. These findings suggest functional roles of the motor cortical areas for compliance with motor imagery in stroke, which can be applied to the implementation of motor imagery–based brain–computer interface for stroke rehabilitation.
Genetic etiology of coronary artery disease considering NOS 3 gene variant rs1799983
Authors: Nawaz Syed Kashif , Rani Asima , Yousaf Memoona , Noreen Aasma , Arshad Muhammad
Published: July 2014

Reduced production of nitric oxide due to rs1799983 single nucleotide polymorphism in nitric oxide synthase 3 gene (NOS3) may enhance the risk of coronary artery disease. The association of rs1799983 polymorphism with coronary artery disease was investigated in the local population of Pakistan. Study consisted of 376 individuals, out of which 198 were coronary artery disease patients and 178 were normal healthy individuals. Allele-specific polymerase chain reaction (PCR) based strategy was used for the detection of different genotypes of rs1799983 polymorphism. PCR amplification results were obtained for 354 samples. Frequency of T allele was higher as compared to G allele in our population. Strong association between rs1799983 and coronary artery disease was observed (p < 0.01). TT genotype was found to enhance 5.717 times the risk of coronary artery disease (odds ratio (OR): 5.717; 95% confidence interval (95% CI) 3.586–9.115). On the basis of present results, it can be concluded that rs1799983 is strongly associated with coronary artery disease in our population and TT genotype of this polymorphism enhanced the risk of coronary artery disease in Pakistani population.
Ethical considerations in design of a study to evaluate a US Food and Drug Administration–approved indication: Antivenom versus placebo for copperhead envenomation
Authors: Gerardo Charles J , Lavonas Eric J , McKinney Ross E
Published: July 2014

Background:

In 2000, the US Food and Drug Administration approved CroFab® Crotalidae Polyvalent Immune Fab, ovine (FabAV), which had received orphan drug designation, for use in patients with minimal to moderate North American crotaline envenomations including copperhead snakes. As existing evidence on the effectiveness of FabAV for this indication is limited, wide practice variation in its use exists. In order to provide more definitive clinical evidence as to the role of this treatment, a new randomized, placebo-controlled trial of FabAV specifically for copperhead bites was initiated.

Purpose:

In light of the existing US Food and Drug Administration approval, ethical considerations of participation in this trial have been raised. We discuss the ethical principles pertinent to this randomized, placebo-controlled trial with placebo arm. We apply an accepted framework for ethical research to this trial. Due to the evidence gap in the literature, wide-ranging treatment recommendations by medical experts, and broad practice variation, clinical equipoise exists in the treatment of copperhead envenomation with FabAV. The impact of this clinical equipoise on the value and scientific validity of the trial is discussed. The trial’s risk–benefit ratio is also considered. Potential risks to the patients are minimized as the protocol includes a plan for rescue therapy in the event that patients progress to severe envenomation symptoms. Overall, risks are further minimized by the inclusion of an interim analysis with stopping rules based on demonstrated efficacy should the therapy clearly prove to be beneficial.

Conclusion:

Although a post-marketing clinical study of this nature is unusual for an approved indication, this trial adheres to all ethical preconditions found in existing guidelines for clinical research involving human subjects.
An Orchestral Audience: Classical Music and Continued Patterns of Distinction
Authors: Crawford Garry , Gosling Victoria , Bagnall Gaynor , Light Ben
Published: July 2014

This paper considers the key findings of a year-long collaborative research project focusing on the audience of the London Symphony Orchestra and their introduction of a new mobile telephone (‘app’) ticketing system. A mixed-method approach was employed, utilizing focus groups and questionnaires with over 80 participants, to research a sample group of university students. This research develops our understanding of classical music audiences, and highlights the continued individualistic, middle-class, and exclusionary culture of classical music attendance and patterns of behaviours. The research also suggests that a mobile phone app does prove a useful mechanism for selling discounted tickets, but shows little indication of being a useful means of expanding this audience beyond its traditional demographic.
Sharps injury reduction: a six-year, three-phase study comparing use of a small patient-room sharps disposal container with a larger engineered container
Authors: Grimmond T , Naisoro W
Published: July 2014

A 350-bed Sydney hospital noted excessive container-associated sharps injuries (CASI) using small sharps containers and compared the effect from 2004 to 2010 of using a larger container engineered to reduce CASI. In Phase 1 (Ph1), disposable 1.4L containers (BD Australia) were carried to/from patients’ rooms. In Phase 2 (Ph2), this stopped and a safety-engineered 32L reusable container (the Device; Sharpsmart, SteriHealth) was mounted in medication stations only and sharps were carried to and from patient rooms using kidney dishes. In Phase 3 (Ph3), the Device was wall-mounted in patient rooms. Sharps injuries were categorised as ‘during-procedure’, ‘after-procedure but before disposal’, ‘CASI’, and ‘improper disposal SI’. Disposal-related SI comprised CASI plus improper-disposal SI. Injuries per 100 full-time-equivalent staff were analysed using Chi2; p ≤ 0.05; and relative risk and 95% confidence limits were calculated. In Ph1 (small containers) 19.4% of SI were CASI and transport injuries were zero. In Ph2 (Device in medication station) CASI fell 94.9% ( p <0.001); Disposal-related SI fell 71.1% ( p=0.002) but transport injuries rose significantly. In Ph3 (Device in patient room) zero CASI occurred ( p<0.001); Disposal-related SI fell 83.1% ( p=0.001). Recapping SI fell 85.1% ( p=0.01) with the Device. The Device’s volume, large aperture, passive overfill-protection and close-at-hand siting are postulated as SI reduction factors.
Outcomes of single‐dose peri‐procedural antibiotic prophylaxis for endoscopic ultrasound‐guided fine‐needle aspiration of pancreatic cystic lesions
Authors: Marinos Emmanuel , Lee Sunny , Jones Brian , Corte Crispin , Kwok Avelyn , Leong Rupert W
Published: July 2014

Background

Endoscopic ultrasound (EUS)‐guided fine‐needle aspiration (FNA) is a technique frequently used to diagnose solid and cystic lesions of the pancreas. Antibiotic prophylaxis has been recommended for EUS‐FNA of pancreatic cystic lesions but is not universally observed. The most effective antibiotic and the most efficacious route and regimen of administration are also unknown.

Objective

This cohort study was undertaken to evaluate whether single‐dose piperacillin/tazobactam or ciprofloxacin given at the time of the procedure effectively prevents major adverse events and to audit the adherence to this protocol in the setting of EUS‐FNA of pancreatic cystic lesions.

Design

Consecutive EUS‐FNA procedures of pancreatic cystic lesions were performed at Concord Hospital and significant variables regarding the procedure and adverse events were recorded. Patients were also contacted by telephone to follow‐up any subacute adverse events they may have experienced.

Patients

Over a 30 month period (January 2010–July 2012), a total of 85 EUS‐FNAs of pancreatic cysts were performed on 80 different patients. The mean age was 63.2 years (range 17–89 years; 58% females).

Interventions

Single‐dose piperacillin/tazobactam IVs was administered to 87% of patients, while 12% of patients received ciprofloxacin IVs.

Results

No patients developed cyst infection, fever, or sepsis (0%) and one patient (1.2%) was hospitalised for self‐limited nausea without adverse sequelae.

Conclusions

Single‐dose piperacillin/tazobactam at the time of EUS‐FNA of pancreatic cysts is an effective prophylaxis of cyst infection or sepsis and can be conveniently given as a single‐dose peri‐procedurally without further oral antibiotics.
Materials for future gas turbine applications
Authors: Rugg D.
Published: July 2014

The complexity of adopting new or using existing advanced alloy systems in demanding environments where safety is paramount is highlighted. Of particular importance is the ability to define operative deformation and degradation mechanisms that may limit part life or functionality. With respect to the underlying fundamental material science there is a high degree of commonality between the aero and power generation sectors. The vast array of new experimental and modelling techniques that can be brought to bear on long standing technical challenges offers the potential for a renaissance in materials science. Of particular interest from an industrial context would be the ability to ‘design’ material microstructure and texture optimised for service use manufactured via the most energy and time efficient route. The requirements and potential for progress in this area is summarised with an emphasis on gas turbine and nuclear reactor applications for hcp metals.
Tribological properties of metal matrix composite coatings produced by electrodeposition of copper
Authors: Bhat A. , Bourell D.
Published: July 2014

Porous templates of graphite and silicon carbide–carbon fibres were fabricated on a copper-110 alloy plate using indirect laser sintering. Copper was deposited electrochemically into the pore network to achieve metal matrix composite coatings using a redox flow battery apparatus. Densities of 89 and 96% were achieved on the copper–graphite composite and copper–SiC composites, respectively. The coefficient of friction and volumetric rate of material loss was determined under a load of 5 N for the coatings and three different sliding speeds of 1200, 1800 and 2400 mm min−1 in sliding wear test. The copper–SiC coatings exhibited a higher wear resistance compared to the copper-110 alloy, while the copper–graphite coatings exhibited a very low coefficient of friction.
Antibiotics influence the toxicity of the delta endotoxins of Bacillus thuringiensis towards the cotton bollworm, Helicoverpa armigera
Authors: Paramasiva Inakarla , Sharma Hari C , Krishnayya Pulipaka Venkata
Published: July 2014

Background

The cotton bollworm, Helicoverpa armigera is one of the most important crop pests worldwide. It has developed high levels of resistance to synthetic insecticides, and hence, Bacillus thuringiensis (Bt) formulations are used as a safer pesticide and the Bt genes have been deployed in transgenic crops for controlling this pest. There is an apprehension that H. armigera might develop resistance to transgenic crops in future. Therefore, we studied the role of gut microbes by eliminating them with antibiotics in H. armigera larvae on the toxicity of Bt toxins against this pest.

Results

Commercial formulation of Bt (Biolep®) and the pure Cry1Ab and Cry1Ac toxin proteins were evaluated at ED50, LC50, and LC90 dosages against the H. armigera larvae with and without antibiotics (which removed the gut microbes). Lowest H. armigera larval mortality due to Bt formulation and the Bt toxins Cry1Ab and Cry1Ac was recorded in insects reared on diets with 250 and 500 μg ml−1 diet of each of the four antibiotics (gentamicin, penicillin, rifampicin, and streptomycin), while the highest larval mortality was recorded in insects reared on diets without the antibiotics. Mortality of H. armigera larvae fed on diets with Bt formulation and the δ-endotoxins Cry1Ab and Cry1Ac was inversely proportional to the concentration of antibiotics in the artificial diet. Nearly 30% reduction in larval mortality was observed in H. armigera larvae from F1 to F3 generation when the larvae were reared on diets without antibiotics (with gut microbes) and fed on 0.15% Bt or 12 μg Cry1Ab or Cry1Ac ml−1 diet, indicating development of resistance to Bt in the presence of gut microflora. However, there were no differences in larval mortality due to Bt, Cry1Ab or Cry1Ac across generations in insects when they were reared on diets with 250 μg of each antibiotic ml−1 diet (without gut microflora).

Conclusions

The results suggested that antibiotics which eliminated gut microflora influenced the toxicity of Bt towards H. armigera, and any variation in diversity and abundance of gut microflora will have a major bearing on development of resistance to Bt toxins applied as foliar sprays or deployed in transgenic crops for pest management.
High KLF4 level in normal tissue predicts poor survival in colorectal cancer patients
Authors: Lee Ha-young , Ahn Joong Bae , Rha Sun Young , Chung Hyun Cheol , Park Kyu Hyun , Kim Tae Soo , Kim Nam Kyu , Shin Sang Joon
Published: July 2014

Background

Krüppel-like factor 4 (KLF4) is involved in many important cellular processes such as growth, development, differentiation, proliferation, and apoptosis. The purpose of this study was to determine the significance of KLF4 in both tumors and normal tissues of patients with colorectal cancer (CRC).

Methods

Between January 2003 and June 2005, 125 patients with CRC receiving treatment at the Yonsei Cancer Center were selected. We examined the mRNA level of the KLF4 gene in primary CRC specimens and matched normal colon tissues using real-time RT-PCR. Correlation of survival with clinicopathological parameters, including KLF4 level, was investigated with univariate and multivariate analyses.

Results

CRC tissue had a significantly lower KLF4 level when compared with matched normal tissues (KLF4 in tumors: 2007 ± 1531 copies/μl, KLF4 in normal tissues: 6586 ± 2834 copies/μl; P <0.0001). However, there was a correlation between the KLF4 level in tumors and normal tissues. Patients with a high KLF4 level in matched normal tissues were more likely than those with a low KLF4 level to develop recurrence and had poorer overall survival (P = 0.005). Therefore, the KLF4 level in the normal tissue of individuals was associated with prognosis of individuals.

Conclusions

Our data suggest that KLF4 mRNA expression level in normal tissues and tumors may be a useful prognostic marker in patients with CRC.
Adult stem cells and tissue engineering strategies for salivary gland regeneration: a review
Authors: Yoo Chankee , Vines Jeremy B , Alexander Grant , Murdock Kyle , Hwang Patrick , Jun Ho-Wook
Published: July 2014

Saliva is an important compound produced by the salivary glands and performs numerous functions. Hyposalivation (dry mouth syndrome) is a deleterious condition often resulting from radiotherapy for patients with head and neck cancer, Sjogren’s Syndrome, or as a side effect of certain medications. Hyposalivation negatively affects speaking, mastication, and swallowing in afflicted patients, greatly reducing their quality of life. Current treatments for this pathology include modifying lifestyle, synthetic saliva supplementation, and the utilization of salivary gland stimulants and sialagogues. However, many of these treatments do not address the underlying issues and others are pervaded by numerous side effects. In order to address the shortcomings related to current treatment modalities, many groups have diverted their attention to utilizing tissue engineering and regenerative medicine approaches. Tissue engineering is defined as the application of life sciences and materials engineering toward the development of tissue substitutes that are capable of mimicking the structure and function of their natural analogues within the body. The general underlying strategy behind the development of tissue engineered organ substitutes is the utilization of a combination of cells, biomaterials, and biochemical cues intended to recreate the natural organ environment. The purpose of this review is to highlight current bioengineering approaches for salivary gland tissue engineering and the adult stem cell sources used for this purpose. Additionally, future considerations in regard to salivary gland tissue engineering strategies are discussed.
Broadening horizons: holistic viewpoints from the Biology of Genomes
Authors: Carr Ambrose , Pe’er Dana
Published: July 2014

A report on the Cold Spring Harbor Laboratory 27th annual meeting on the Biology of Genomes, held in Cold Spring Harbor, New York, USA, 6-10 May 2014.
Early Intervention With Intranasal NPY Prevents Single Prolonged Stress-Triggered Impairments in Hypothalamus and Ventral Hippocampus in Male Rats
Authors: Laukova Marcela , Alaluf Lishay G. , Serova Lidia I. , Arango Victoria , Sabban Esther L.
Published: July 2014

Intranasal administration of neuropeptide Y (NPY) is a promising treatment strategy to reduce traumatic stress-induced neuropsychiatric symptoms of posttraumatic stress disorder (PTSD). We evaluated the potential of intranasal NPY to prevent dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, a core neuroendocrine feature of PTSD. Rats were exposed to single prolonged stress (SPS), a PTSD animal model, and infused intranasally with vehicle or NPY immediately after SPS stressors. After 7 days undisturbed, hypothalamus and hippocampus, 2 structures regulating the HPA axis activity, were examined for changes in glucocorticoid receptor (GR) and CRH expression. Plasma ACTH and corticosterone, and hypothalamic CRH mRNA, were significantly higher in the vehicle but not NPY-treated group, compared with unstressed controls. Although total GR levels were not altered in hypothalamus, a significant decrease of GR phosphorylated on Ser232 and increased FK506-binding protein 5 mRNA were observed with the vehicle but not in animals infused with intranasal NPY. In contrast, in the ventral hippocampus, only vehicle-treated animals demonstrated elevated GR protein expression and increased GR phosphorylation on Ser232, specifically in the nuclear fraction. Additionally, SPS-induced increase of CRH mRNA in the ventral hippocampus was accompanied by apparent decrease of CRH peptide particularly in the CA3 subfield, both prevented by NPY. The results show that early intervention with intranasal NPY can prevent traumatic stress-triggered dysregulation of the HPA axis likely by restoring HPA axis proper negative feedback inhibition via GR. Thus, intranasal NPY has a potential as a noninvasive therapy to prevent negative effects of traumatic stress.
β-Cell Induction In Vivo in Severely Diabetic Male Mice by Changing the Circulating Levels and Pattern of the Ratios of Estradiol to Androgens
Authors: Inada Akari , Inada Oogi , Fujii Nobuharu L. , Fujishima Kei , Inai Tetsuichiro , Fujii Hiroshi , Sueishi Katsuo , Kurachi Kotoku
Published: July 2014

Previously we have generated transgenic (Tg) mice developing severe diabetes early in life with a profound depletion of β-cells with β-cell-directed expression of inducible cAMP early repressor-Iγ. Only male mice continue to demonstrate hyperglycemia throughout life. To investigate this sexual dimorphism, we treated severely diabetic male Tg mice with orchiectomy (ORX) or 17β-estradiol (E2) pellet implantation alone or in combination with ORX and E2-implantation to change the circulating levels and patterns of the ratio of estradiol to androgens. In the Tg-ORX group, the blood-glucose levels decreased to a certain level within several weeks but never reached the female Tg-control level. In contrast, the Tg-ORX+E2 or Tg-E2 group showed a more rapid drop in blood glucose to the basal level with a substantial increase in β-cells, thus preventing the occurrence of severe diabetes in the male mice. The β-cells, not only within islet but also in and adjacent to ducts and scattered β-cell clusters, were strongly induced by 1 week after treatment, and the islet morphology dramatically changed. Enhanced β-cell induction in the ducts occurred concomitantly with markedly increased levels of pancreatic duodenal homeobox-1 and related transcription factors. The glucose-lowering and β-cell-increasing effects were independent of the age at which the treatment is started. These data provide evidence that the circulating level of E2 and the ratio of E2 to T greatly affect the blood glucose levels, the β-cell induction, and the islet morphology in diabetic male Tg mice. This novel mechanism offers great potential for developing strategies to increase the number of β-cells in vivo.
Continuous Glucose Monitoring Effects on Maternal Glycemic Control and Pregnancy Outcomes in Patients With Gestational Diabetes Mellitus: A Prospective Cohort Study
Authors: Yu Fan , Lv Lijuan , Liang Zhijiang , Wang Yi , Wen Jiying , Lin Xiaohong , Zhou Yuheng , Mai Caiyuan , Niu Jianmin
Published: July 2014

Context:

Clinical evidence on the consequential effects of continuous glucose monitoring (CGM) on pregnancy outcomes in women with gestational diabetes mellitus (GDM) is scarcely available.

Objective:

Our objective was to evaluate the effectiveness of CGM on maternal glycemic control and pregnancy outcomes in patients with GDM .

Patients:

In total, 340 Chinese pregnant women with GDM were allocated to either the routine care group (n = 190) or the CGM group (n =150).

Design and Setting:

This was a prospective cohort study in the Department of Obstetrics of GuangDong Women and Children Hospital in China. Recruitment started in April 2011 and stopped in August 2012.

Interventions:

A 72-hour CGM system was used as a supplementary tool for glucose monitoring in the CGM group.

Primary Outcome Measurements:

The parameters of glycemic variability included mean blood glucose, the SD of blood glucose, mean amplitude of glycemic excursions (MAGEs), and the mean of daily differences. The maternal outcomes (preeclampsia and cesarean delivery) and composite neonatal outcomes were analyzed.

Results:

The SD of blood glucose, MAGEs, and mean of daily differences values were significantly lower in the CGM group compared with those of the routine care group (P < .001). Subjects in the CGM group were at lower risk of preeclampsia and primary cesarean delivery compared with the routine care group (P < .05). The mean infant birth weight of women in the CGM group was lower than infants of women in the routine care group (P < .001). The MAGE was associated with birth weight (β = 0.196, P < .001), and it was an independent factor for preeclampsia (odds ratio, 3.66; 95% confidence interval 2.16–6.20) and composite neonatal outcome (odds ratio, 1.34; 95% confidence interval 1.01–1.77).

Conclusions:

The use of supplementary CGM combined with routine antenatal care can improve the glycemic control and pregnancy outcomes of patients with GDM.
TSH Levels and Risk of Miscarriage in Women on Long-Term Levothyroxine: A Community-Based Study
Authors: Taylor Peter N. , Minassian Caroline , Rehman Anis , Iqbal Ahmed , Draman Mohd Shazli , Hamilton William , Dunlop Diana , Robinson Anthony , Vaidya Bijay , Lazarus John H. , Thomas Sara , Dayan Colin M. , Okosieme Onyebuchi E.
Published: July 2014

Context:

Thyroid dysfunction is associated with adverse obstetric outcomes, but there is limited information on pregnancy outcomes in women established on levothyroxine.

Objective:

The objective of the study was to determine the relationship between TSH levels and pregnancy outcomes in levothyroxine-treated women in a large community-based database.

Design:

This was a historical cohort analysis.

Patients:

Individuals with a first prescription of levothyroxine from 2001 through 2009 (n = 55 501) were identified from the UK General Practice Research Database (population 5 million). Of these, we identified 7978 women of child-bearing age (18–45 y) and 1013 pregnancies in which levothyroxine had been initiated at least 6 months before conception.

Main Outcome Measures:

TSH, miscarriage/delivery status, and obstetric outcomes were measured.

Results:

Forty-six percent of levothyroxine-treated women aged 18–45 years had a TSH level greater than 2.5mU/L (recommended upper level in the first trimester). Among pregnant women who had their TSH measured in the first trimester, 62.8% had a TSH level greater than 2.5 mU/L, with 7.4% greater than 10 mU/L. Women with TSH greater than 2.5 mU/L in the first trimester had an increased risk of miscarriage compared with women with TSH 0.2–2.5 mU/L after adjusting for age, year of pregnancy, diabetes, and social class (P = .008). The risk of miscarriage was increased in women with TSH 4.51–10 mU/L [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.03, 3.14)] and TSH greater than 10 mU/L (OR 3.95, 95% CI 1.87, 8.37) but not with TSH 2.51–4.5 mU/L (OR 1.09, 95% CI 0.61, 1.93).

Conclusions:

The majority of levothyroxine-treated women have early gestational TSH levels above the recommended targets (>2.5 mU/L) with a strong risk of miscarriage at levels exceeding 4.5 mU/L. There is an urgent need to improve the adequacy of thyroid hormone replacement in early pregnancy.
Differential Transcriptional and Posttranslational Transcription Factor 7-Like 2 Regulation Among Nondiabetic Individuals and Type 2 Diabetic Patients
Authors: Pradas-Juni M. , Nicod N. , Fernández-Rebollo E. , Gomis R.
Published: July 2014

Human genetic studies have revealed that the T minor allele of single nucleotide polymorphism rs7903146 in the transcription factor 7-like 2 (TCF7L2) gene is strongly associated with an increased risk of diabetes by 30%–40%. Molecular and clinical studies are of great importance for understanding how this unique variation in TCF7L2 influences type 2 diabetes (T2D) onset and progression. At the molecular level, some studies have been performed in diabetic mice and pancreatic islets from healthy human donors. Whereas TCF7L2 mRNA levels are up-regulated in islets, protein levels are down-regulated. We performed studies on TCF7L2 splicing, mRNA expression, and protein levels in immortalized human lymphocytes from nondiabetic individuals and T2D patients carrying the C/C or the at-risk T/T genotype. Our results show differential expression of TCF7L2 splice variants between nondiabetic and T2D patients carrying the at-risk genotype, as well as differences in protein levels. Therefore, we investigated the regulation of splice variants, and our results propose that splicing of exon 4 is under control of the serine-arginine–rich factor transformer 2 β (TRA2B). Finally, we studied the endoplasmic reticulum stress pathways, looking for a posttranslational explanation. We saw a shift in the activation of these pathways between nondiabetic individuals and T2D patients carrying the at-risk genotype. These results suggest that, in human immortalized lymphocytes carrying the at-risk T/T genotype, first the differential expression of TCF7L2 splice variants implies a regulation, at least for exon 4, by TRA2B and second, the differential protein levels between both T/T carriers point to a different activation of endoplasmic reticulum stress pathways.
Pedagogy of Constructivism: From Idea to Technology
Authors: Бершадский  , Bershadskiy Mikhail
Published: July 2014

The paper considers how to design educational technologies, based on ideas of constructivist pedagogy. J. Piaget’s and G. Kelly’s writings show that

educational outcomes emerge as structures in the form of mental representations, which learners have to construct in the course of active cognitive

activities. Recommendations on how to organize educational process, developed by constructivist educators on the basis of these ideas, can be useful in

designing educational technologies. The paper examines J. Piaget’s and G. Kelly’s writings and reveals limitations and inner contradictoriness inherent

in mechanism of self-constructing mental representations. The author provides arguments refuting that recommendations of constructivist pedagogy

result from the moderate constructivism ideas. Moreover, these recommendations are inconsistent with the logic of cognitive experience gaining which

results from theories of cognitive load and human cognitive architecture. These recommendations also lack operationality, needed for the educational

process to be reproduced. Thus the paper concludes, constructivist pedagogy cannot be used as a basis for designing educational technologies.
About the Role of Artistic and Pedagogical Analysis of Art Works
Authors: Руднева  , Rudneva Olga
Published: July 2014

With respect to current thinking on goals and objectives of modern education the paper highlights philosophic, methodological and mindset-based

approaches to analyzing works of art in the context of artistic education. The author articulates certain propositions, emphasizing importance of

analyzing works of art within case studies as one of the essential conditions for learners to socialize.
Burnout Syndrome and Analytical Hypnosis
Authors: Carolusson Susanna
Published: July 2014

The author aims to discuss her experience that patients with Burnout syndromes need to recover in a unique individualised relational therapy and that they need a slower pace than national authorities are implementing through contemporary national guidelines for health and care systems.The author reviews published definitions of the syndrome and then presents two cases to illustrate the principle of finding the patients' own resources, the value of exploring the history of their drive to achieve and also how to utilize resistance as information about defences and their functions. She uses hypnosis, hypnoanalysis and ego state imagery as a tool for finding the patient's pace, needs and unique ways for recovery.
The mediating role of coping in the relationships between religiousness and mental health.
Authors: Krok Dariusz
Published: July 2014

The aim of this study was to assess the relationships between religiousness and mental health within the mediational perspective of religious coping. The existing empirical evidence indicates that specific aspects of religiousness are associated with mental health indices. Yet, less is known about the nature of these associations and mediating mechanisms between both factors. The theory of religious coping as a mediator was employed so as to explain how religiousness is linked with mental health and what mechanisms shape the associations. The results demonstrated that religious coping can be regarded as a mediator between religiousness and mental health dimensions. Religious coping is expressed in two main forms: positive and negative that are linked to positive and negative mental health outcomes, respectively. People draw on these two religious coping methods in times of major life crises in order to make sense of trauma and loss, and to alleviate stress. The theoretical analyses showed that when religiousness contains structures of orientation and meaning, it enables individuals to attain positive functioning and well-being that reflects mental health.
The occurrence of emotional problems in somatic diseases based on psychodermatology
Authors: Makara-Studzińska Marta , Partyka Iwona , Ziemecki Piotr , Ziemecka Anna
Published: July 2014

Aim of the study

The aim of this study is to present selected aspects of psychosocial problems in chronic somatic diseases based on the example of dermatology with an impact on psoriasis as a model type of psychodermatological disease. This review does not include the theoretical basis for somatization as the issue exceeds the size of this article.

Subject or material and methods

The analysis of present literature related to the subject.

Results

Confirmed the connection between emotional problems and the course of an illness and proved the usefulness of psychodermatology in improving the quality of life of patients with chronic skin diseases.

Discussion

Comparison of demographically and culturally varied groups. The use of different research methods evokes the need of unification.

Conclusions

Relation between emotional factors and the course of psychosomatic disease is unquestionable and mutual. Promising trends include social support, multidisciplinary care and creating adequate tools for assessment of emotional problems in psychosomatic problems and practical use. Developing research tendencies compare impairment in dermatological problems with other somatic disease.
Drop-out in the systemic therapy from the family’s perspective.
Authors: Chwal Martyna , Jurek Joanna , Janusz Bernadetta , de Barbaro Bogdan
Published: July 2014

Aim of the study

The problem of premature ending of therapy is a common phenomenon and is taken under consideration as closely related to effectiveness of therapy. The crucial aim of presented study was to investigate how members of a family interpret this phenomenon.

Subject or material and methods

The research was based on interviews with drop-out clients who had participated in systematic couple therapy. The qualitative data was analyzed using the four stages methodology of grounded theory. The program used to code the data was Weft QDA.

Results

The result pointed out, that drop-out from therapy is a procesual phenomenon and is connected with: a context of application, a kind of relationship between partners, an assessment of therapy. It was confirmed in the research group that the level of satisfaction from effects of therapy was related to premature termination.

Discussion

The research indicated how consequences of drop-out can affect the family system.

Conclusions

The high frequency of positive emotions and opinions occurring in drop-out context shows that drop-out phenomenon should not be considered only as a therapeutic failure.
Full Stability in Finite-Dimensional Optimization
Authors: Mordukhovich B. S. , Nghia T. T. A. , Rockafellar R. T.
Published: July 2014

The paper is devoted to full stability of optimal solutions in general settings of finite-dimensional optimization with applications to particular models of constrained optimization problems, including those of conic and specifically semidefinite programming. Developing a new technique of variational analysis and generalized differentiation, we derive second-order characterizations of full stability, in both Lipschitzian and Hölderian settings, and establish their relationships with the conventional notions of strong regularity and strong stability for a large class of problems of constrained optimization with twice continuously differentiable data.
Sugar-free gum and dental caries: a high-impact approach
Authors: Dodds Mike , Reeves Juliette
Published: July 2014

Dental caries remain a major public health problem. However, research has demonstrated that minimal intervention and management approaches can make a dramatic impact in preventing dental caries. Among the most impactful tools in this new approach is sugar-free chewing gum
An introduction to air polishing and its benefits
Authors: Gallie Amanda
Published: July 2014

Air polishing is more comfortable and quicker to use than traditional scale and polish cleaning methods, and is suitable for a range of patients. Offering this service could also be an effective way of promoting your practice
Making prevention work in practice: A course review
Authors: O’ Shea Kaelan
Published: July 2014

This report monitors the development of clinical knowledge and confidence levels in a group of dental nurses enrolled in the ‘Making Prevention Work in Practice’ training scheme
A survey of physiotherapy students’ experiences and attitudes towards treating individuals with mental illness
Authors: Dandridge Tamara , Stubbs Brendon , Roskell Carolyn , Soundy Andrew
Published: July 2014

Introduction:

Very few research articles have considered the views and attitudes of student physiotherapists towards treating individuals with a mental illness (MI). Therefore, this study's objective was to consider the experiences and attitudes of student physiotherapists towards treating individuals with MI.

Methods:

A cross-sectional cohort design was used. One hundred and eighty one physiotherapy undergraduate degree students at UK institutions participated in the survey. The survey had been specifically designed for this study, and contained a mixture of open and closed questions.

Results:

Seventy one per cent (123/173) of the students were exposed to less than 4 hours teaching time about MI, and 76% (131/173) wanted further education on MI. Students were concerned about limited knowledge of MI conditions and how to approach patients who have a MI. A summary of the specific concerns of students is identified within the text.

Conclusions:

Further education about MI is required to give students greater confidence in treating patients who have an MI. Education would also likely benefit some students who identify negative characteristics of patients with MI.
Eccentric exercise therapy in the treatment of subacromial impingement syndrome: A critical review
Authors: Dervey Emily , Marshall Sophia , Rouse Simon , Bernhardsson Susanne , Camargo Paula Rezende , McVeigh Joseph G
Published: July 2014

Aim:

This critical review explores the current evidence underpinning eccentric exercise therapy in the treatment of subacromial impingement syndrome (SAIS).

Method:

A critical review method was used. Four large databases, CINAHL, MEDLINE, SportDiscus and Pubmed, as well as the PEDro and Cochrane electronic libraries were searched. The search terms ‘subacromial impingement’ or ‘SAI’ or ‘shoulder impingement’ and ‘eccentric exercises’ or ‘eccentric loading’ or ‘eccentrics’ were used. All available studies were marked against predetermined inclusion and exclusion criteria.

Results:

Five studies met the inclusion criteria, two of which were RCTs, one a case series, one a single subject A–B experimental design and one a pilot study. Similarities in the nature of the eccentric exercise programmes in these five studies included the exercise regime. Commonly, these studies’ exercise regimes followed three sets of 15 repetitions, twice each day for 2 months, and the resistance was either hand weights or resistance bands, and used the pain monitoring model as a measure of readiness to progress resistance. Main differences in the programmes were the arm position chosen for performance of the exercises and the shoulder muscle groups targeted.

Conclusions:

Although there is a clinical consensus, which would appear to support the above regime, there is limited empirical evidence. Therefore, more research on such areas as the best arm position and exercise regime is required. In addition, while the pain-monitoring model appears to be supported clinically; again, further empirical evidence is needed before it can be recommended as a means of monitoring readiness for exercise progression. More research is needed to determine the best arm position and exercise regime for optimum results.
News Analysis
Authors: Learner Sue , Nazarko Linda
Published: July 2014

In an overhaul of end-of-life care, the Priorities for Care will replace the Liverpool Care Pathway. This will highlight and respect the requests of the person nearing end of life
Refusing treatment: practical, legal and ethical issues
Authors: Dempsey Debbie
Published: July 2014

The right to refuse treatment is an integral part of advance care planning. Debbie Dempsey looks at the various implications for the individual, their family and the staff caring for them
What is changing about the way we are regulated?
Authors: Frankova Helena
Published: July 2014

With a variety of inspecting changes soon to be implemented by the Care Quality Commission, Helena Frankova clarifies how nursing and care home owners can ensure their services are of the highest possible standard
Do not attempt resuscitation: the legal issues
Authors: Irwin Anne-Marie , Wand Daniel
Published: July 2014

With ‘do not attempt cardiopulmonary resuscitation’ notices becomes more frequently requested, Anne-Marie Irwin and Daniel Ward present the legal issues to be considered in association with this continually controversial topic