bluuebunny/crossref_metadata_2025 huggingface dataset:
Significance of viral status on recurrence of hepatitis B‐related hepatocellular carcinoma after curative therapy: A meta‐analysis
Authors: Qu Li‐Shuai , Liu Jin‐Xia , Kuai Xiao‐Ling , Xu Zheng‐Fu , Jin Fei , Zhou Guo‐Xiong
Published: May 2013

Aim

The impact of viral status on recurrence of hepatitis B‐related hepatocellular carcinoma (HCC) after curative therapy remains controversial. This meta‐analysis aimed to determine whether the presence of viral load, genotype, specific mutation and antiviral therapy influenced HCC recurrence after curative therapy.

Methods

We performed a meta‐analysis including 20 studies to assess the effect of viral status and antiviral therapy with nucleoside analog on recurrence of HCC after curative therapy. The pooled odds ratios (OR) were calculated using a random or fixed effects model. PUBMED, MEDLINE, EMBASE and the Cochrane Database were searched for articles published from 1990 to December 2012.

Results

Our results showed that the presence of high viral load significantly increased overall HCC recurrence risk after curative therapy. Pooled data from four studies on the recurrence rate among patients with genotype C infection compared with genotype B showed an increased risk of recurrence. Basal core promoter (BCP) mutation was associated with a significant risk in the recurrence of HCC. The pooled estimate of treatment effect was significantly in favor of a preventive effectiveness of antiviral therapy.

Conclusion

The present study suggested that HCC patients with high viral load, genotype C and BCP mutation had a significantly higher risk of recurrence. Antiviral therapy has potential beneficial effects after the curative treatment of HCC in terms of tumor recurrence.
A systematic review of research into black and ethnic minority patients' views on self‐management of type 2 diabetes
Authors: Majeed‐Ariss Rabiya , Jackson Cath , Knapp Peter , Cheater Francine M.
Published: May 2013

Context

Eliciting patients' views of type 2 diabetes self‐management provides insights on how policy and services might better support the needs of this population.

Objective

To synthesize black and ethnic minority patients' views on the barriers and facilitators influencing the self‐management of type 2 diabetes.

Search strategy

A systematic search of international literature published in nine electronic databases was undertaken in 2008. Search strategies used both MeSH and free‐text terms. Two relevant journals were also hand searched.

Inclusion criteria

Any primary empirical study published in the English language since 1986 that reported black and ethnic minority patients' views on type 2 diabetes self‐management.

Data extraction and synthesis

Data were extracted and study quality was formally assessed. Data were analysed using thematic synthesis.

Main results

Fifty‐seven studies were included, of qualitative (n = 54), mixed‐method (n = 2) or quantitative (n = 1) design. Studies were from North America (n = 41), Europe (n = 14) and Australia (n = 2), including 1735 participants in total. Three analytical themes emerged: ‘Importance of identity’; ‘Being understood by others’ and ‘Making sense of condition’, all linked conceptually under the overarching theme ‘Sense of self’. The quality of the studies varied.

Discussion and conclusions

The findings provide insight into what black and minority ethnic people regard as the barriers to, and facilitators of self‐management, as opposed to what health professionals, policy makers and trial researchers may have assumed. Recognition of the views of people with diabetes is essential for the design and delivery of patient‐centred care and policies.
Nurses' perceptions about health sector privatization in Turkey
Authors: Harmanci Seren A.K. , Yildirim A.
Published: May 2013

Aim

The aim of this study is to identify the perceptions of the nurses about the privatization implementation, as it pertains to privatization, health services privatization and the impact of privatization on nursing in Turkey.

Background

Turkey is taking important steps in health services privatization but the related choices made in political arena are not shared with the employees of the health institutions where the privatization implementations are to take place.

Methods

The study was conducted among nurses who are working for the state health institutions and the members of professional organizations of healthcare workers, which are operating in Istanbul in Turkey. Data were collected via Nurses' Privatization Perception Scale in 2009 and were analysed using mean calculations, analysis of variance, Mann–Whitney U‐test, t‐test, Kruskal–Wallis test and Cronbach's alpha analyses.

Findings

Nurses' perceptions of privatization in general, health services privatization and the impact of privatization on nursing were found to be negative in all of the three sub‐domains of the scale, as well as their perceptions of privatization implementations measured throughout the scale. The conducted comparisons showed that nurses' perceptions of the privatization implementations varied in accordance with independent variables.

Conclusions

The privatization implementations put in place in health services are perceived negatively by nurses. Policy makers in relevant fields are recommended to take the findings of this study into consideration.
Determination of Temperature‐Dependent Heat Conductivity and Thermal Diffusivity of Waste Glass Melter Feed
Authors: Pokorny Richard , Rice Jarrett A. , Schweiger Michael J. , Hrma Pavel
Published: May 2013

The cold cap is a layer of reacting glass batch floating on the surface of melt in an all‐electric continuous glass melter. The heat needed for the conversion of the melter feed to molten glass must be transferred to and through the cold cap. Since the heat flux into the cold cap influences the rate of melting, the heat conductivity is a key property of the reacting feed. We designed an experimental setup consisting of a large cylindrical crucible with an assembly of thermocouples (TC) that monitors the evolution of the temperature field while the crucible is heated at a constant rate. Then we used two methods to calculate the heat conductivity and thermal diffusivity of the reacting feed: the approximation of the temperature field by polynomial functions and the finite‐volume method (FVM) coupled with least‐squares analysis. Up to 680°C, the heat conductivity of the reacting melter feed was represented by a linear function of temperature.
The nursing profession: public image, self‐concept and professional identity. A discussion paper
Authors: Hoeve Yvonne ten , Jansen Gerard , Roodbol Petrie
Published: May 2013

Aim

To discuss the actual public image of nurses and other factors that influence the development of nurses' self‐concept and professional identity.

Background

Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always value the skills and competences nurses have acquired through education and innovation.

Design

Discussion paper.

Data sources

We identified 1216 relevant studies by searching MEDLINE, CINAHL and PsycINFO databases in the period 1997–2010. Finally, 18 studies met our inclusion criteria.

Discussion

The included studies show that the actual public image of nursing is diverse and incongruous. This image is partly self‐created by nurses due to their invisibility and their lack of public discourse. Nurses derive their self‐concept and professional identity from their public image, work environment, work values, education and traditional social and cultural values.

Implications for nursing

Nurses should work harder to communicate their professionalism to the public. Social media like the Internet and YouTube can be used to show the public what they really do.

Conclusion

To improve their public image and to obtain a stronger position in healthcare organizations, nurses need to increase their visibility. This could be realized by ongoing education and a challenging work environment that encourages nurses to stand up for themselves. Furthermore, nurses should make better use of strategic positions, such as case manager, nurse educator or clinical nurse specialist and use their professionalism to show the public what their work really entails.
Towards the Prevention of Behavioural and Psychiatric Disorders in People with Intellectual Disabilities
Authors: Allen David , Langthorne Paul , Tonge Bruce , Emerson Eric , McGill Peter , Fletcher Robert , Dosen Anton , Kennedy Craig
Published: May 2013

Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas.
Comparison of Balloon Catheter Ablation Technologies for Pulmonary Vein Isolation: The Laser Versus Cryo Study
Authors: BORDIGNON STEFANO , CHUN KR JULIAN , GUNAWARDENE MELANIE , FUERNKRANZ ALEXANDER , URBAN VERENA , SCHULTE‐HAHN BRITTA , NOWAK BERND , SCHMIDT BORIS
Published: May 2013

Laser‐ Versus CryoBalloon for PVI

Introduction

Balloon catheters have been developed to facilitate pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). We sought to compare the safety and efficacy of the cryoballoon (CB) and the laserballoon (LB) in a pilot study.

Methods and Results

One hundred and forty patients with drug‐refractory PAF were prospectively allocated in a 1:1 fashion to undergo a PVI procedure with the 28 mm CB or the LB and were followed for 12 months using 3‐day Holter ECG recording. The primary efficacy endpoint was a documented AF recurrence ≥30 seconds between 90 and 365 days after the index ablation.

In total, 269 of 270 PVs (99.6%) and 270 of 273 PVs (98.9%) were acutely isolated in the CB and LB group, respectively. Mean procedural time was 136 ± 30 minutes for the CB group and 144 ± 33 minutes for the LB group (P = 0.13). Mean fluoroscopy time was longer in the CB group (21 ± 9 minutes vs 15 ± 6 minutes; P < 0.001). During 12 months follow‐up, 37% of patients in the CB group and 27% in the LB group experienced an AF recurrence (P = 0.18). Phrenic nerve palsies occurred in 5.7% (CB) and 4.2% (LB) of patients, respectively.

Conclusion

Balloon catheters are a viable option to safely perform a PVI procedure in patients with drug‐refractory PAF. Ninety‐nine percent of PVs may be acutely isolated with a single balloon catheter. The AF free survival rate after a single ablation procedure was not statistically different between groups.
Procedural Arrhythmia Termination and Long‐Term Single‐Procedure Clinical Outcome in Patients with Non‐paroxysmal Atrial Fibrillation
Authors: ZHOU GENQING , CHEN SONGWEN , CHEN GANG , ZHANG FENG , MENG WEIDONG , YAN YIWEN , LU XIAOFENG , WEI YONG , LIU SHAOWEN
Published: May 2013

Arrhythmia Termination and Long‐Term Outcome

Background

The influence of procedural arrhythmia termination on long‐term single‐procedure clinical outcome in patients with non‐paroxysmal atrial fibrillation (AF) remains controversial.

Methods

An individualized stepwise ablation strategy was used in 200 consecutive patients with non‐paroxysmal AF who underwent first‐time radiofrequency catheter ablation, with pulmonary vein isolation and sinus rhythm (SR) restoration as the primary endpoints.

Results

SR was restored by ablation in 94 patients, including 32 with AF directly and 62 with intermediate atrial tachycardia (AT). Cardioversion was performed to restore SR in 106 patients, including 31 with intermediate AT, and 75 with sustained AF. During a mean follow‐up of 50.0 ± 9.3 months, single‐procedure success was achieved in 99 (49.5%) patients. There was a significant difference in long‐term success between patients with SR restoration by ablation and by cardioversion (63.8% vs 36.8%; P < 0.001), but not between patients with AF termination by ablation and by cardioversion (53.6% vs 42.7%; P = 0.146). SR restoration by ablation (odds ratio = 3.032; 95% confidence interval = 1.703–5.398; P < 0.001) was the only predictor of single‐procedure success by logistic regression analyses. In patients with intermediate AT (n = 93), AT termination by ablation was associated with a higher success rate than AT termination by cardioversion (62.9% vs 22.6%; P < 0.001).

Conclusions

SR restoration and AT termination by ablation were both associated with an improved long‐term single‐procedure clinical outcome in patients with non‐paroxysmal AF.
Differential expression of mitogen activating protein kinases in periodontitis
Authors: Travan Suncica , Li Fei , D'Silva Nisha J. , Slate Elizabeth H. , Kirkwood Keith L.
Published: May 2013

Aim

Following toll‐like receptor (TLR) engagement, lipopolysaccharide (LPS) can stimulate the expression of pro‐inflammatory cytokines thus activating the innate immune response. The production of inflammatory cytokines results, in part, from the activation of kinase‐induced signalling cascades and transcriptional factors. Of the four distinct classes of mitogen‐activated protein kinases (MAPK) described in mammals, p38, c‐Jun N‐terminal activated kinases (JNK1‐3) and extracellular activated kinases (ERK1,2) are the best studied. Previous data have established that p38 MAPK signalling is required for inflammation and bone loss in periodontal disease pre‐clinical animal models.

Materials & Methods

In this study, we obtained healthy and diseased periodontal tissues along with clinical parameters and microbiological parameters. Excised fixed tissues were immunostained with total and phospho‐specific antibodies against p38, JNK and ERK kinases.

Results

Intensity scoring from immunostained tissues was correlated with clinical periodontal parameters. Rank correlations with clinical indices were statistically significantly positive (p‐value < 0.05) for total p38 (correlations ranging 0.49–0.68), phospho‐p38 (range 0.44–0.56), and total ERK (range 0.52–0.59) levels, and correlations with JNK levels also supported association (range 0.42–0.59). Phospho‐JNK and phospho‐ERK showed no significant positive correlation with clinical parameters of disease.

Conclusion

These data strongly implicate p38 MAPK as a major MAPK involved in human periodontal inflammation and severity.
Aflatoxin Detoxification Potential of Ocimum Tenuiflorum
Authors: Panda Pragyanshree , Mehta Alka
Published: May 2013

Aflatoxins are the secondary toxic metabolites produced by a group of toxigenic fungi. They are the common contaminants of food and feed that cause severe economic and health losses. The present study concerns control of aflatoxin B1 (AFB1) synthesis from Aspergillus flavus, direct degradation of AFB1 and its decontamination on rice by the aqueous extract of Ocimum tenuiflorum. In the presence of Ocimum extract, the culture of A. flavus in yeast extract sucrose medium showed an increase in mycelium mass and reduction in AFB1 production up to 64%. The direct treatment of AFB1 with extract at 85C for 4 h led to 74.7% degradation. Whereas in rice spiked with AFB1, the degradation was 70.2%. This degradation resulted in detoxification, which was confirmed using mammalian cell culture method. The results of the study showed that Ocimum extract can be used efficiently to eliminate the AFB1 threat.

Practical Applications

Mycotoxin contamination of food and feed is a major concern in food and agricultural sector. Continuous research in the area of physical and chemical methods to eliminate mycotoxin is being carried out but there is a need to find more safe natural agents to reduce the mycotoxin threat. This study demonstrates the efficacy of Ocimum as a safe additive, which not only inhibits the aflatoxin production but also degrades the existing toxin. Hence, the Ocimum can be safely used for the reduction and removal of aflatoxin to the safe level from the food and feed chain.
Cognitive‐Behavioral Treatment for Comorbid Insomnia and Osteoarthritis Pain in Primary Care: The Lifestyles Randomized Controlled Trial
Authors: Vitiello Michael V. , McCurry Susan M. , Shortreed Susan M. , Balderson Benjamin H. , Baker Laura D. , Keefe Francis J. , Rybarczyk Bruce D. , Von Korff Michael
Published: May 2013

Objectives

To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive–behavioral therapy for pain and insomnia (CBT‐PI), a cognitive–behavioral pain coping skills intervention (CBT‐P), and an education‐only control (EOC) differed in sleep and pain outcomes.

Design

Double‐blind, cluster‐randomized controlled trial with 9‐month follow‐up.

Setting

Group Health and University of Washington, 2009 to 2011.

Participants

Three hundred sixty‐seven older adults with OA pain and insomnia.

Interventions

Six weekly group sessions of CBT‐PI, CBT‐P, or EOC delivered in participants' primary care clinics.

Measurements

Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms.

Results

CBT‐PI reduced insomnia severity (score range 0–28) more than EOC (adjusted mean difference = −1.89, 95% confidence interval = −2.83 to −0.96; P < .001) and CBT‐P (adjusted mean difference = −2.03, 95% CI = −3.01 to −1.04; P < .001) and improved sleep efficiency (score range 0–100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44–4.84; P = .02). CBT‐P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85–4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results.

Conclusion

Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes.
Single‐Leg Squats Identify Independent Stair Negotiation Ability in Older Adults Referred for a Physiotherapy Mobility Assessment at a Rural Hospital
Authors: Hockings Rowena L. , Schmidt David D. , Cheung Christopher W.
Published: May 2013

Objectives

To determine whether single‐leg squats identify ability to negotiate stairs in older adults at a rural hospital.

Design

Cross‐sectional analytical study.

Setting

Acute wards and emergency department of a rural hospital in Australia.

Participants

A systematic sample of 143 older adults (72 men, 71 women, 80.0 ± 6.8 years) from the emergency department or acute wards of Shoalhaven Hospital referred for a physiotherapy mobility assessment.

Measurements

Ability to complete up to three single‐leg squats and negotiate up to three steps were measured. Covariates and demographic variables were collected.

Results

The squat test had 86% sensitivity, 100% specificity, 100% positive predictive value, and 49% negative predictive value in correctly identifying stair negotiation ability. Participants who could complete single‐leg squats were 57 times more likely to be able to independently negotiate stairs than participants who could not complete squats. Multivariate regression analysis indicated that walker use, pain severity and whether participants lived alone were significant and independent predictors of ability to negotiate stairs independently.

Conclusion

Single‐leg squats may be an accurate identifier of stair negotiation ability in older adults admitted to the hospital for an acute illness or injury. A traditional stairs assessment would be required if older adults were unable to complete the squat test or had moderate to severe pain, used a walker to ambulate, or did not live alone. The squat test is a potentially more‐efficient assessment tool than traditional stair assessments in determining an individual's ability to negotiate stairs and suitability for discharge where poor mobility is a problem.
Nutritional rehabilitation after ICU – does it happen: a qualitative interview and observational study
Authors: Merriweather Judith , Smith Pam , Walsh Timothy
Published: May 2013

Aims and objectives

To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83).

Background

Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation.

Design

The study is a qualitative study based on patient interviews and observations of ward practice.

Methods

Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi‐structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post‐ICU discharge, and a semi‐structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay.

Results

Current nutritional practice for post‐intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service‐centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness.

Conclusions

The NICE guideline provides few nutrition‐specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway.

Relevance to clinical practice

Nutritional care of post‐ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake.
Structural Shifts in Credit Rating Standards
Authors: ALP AYSUN
Published: May 2013

I examine the time‐series variation in corporate credit rating standards from 1985 to 2007. A divergent pattern exists between investment‐grade and speculative‐grade rating standards from 1985 to 2002 as investment‐grade standards tighten and speculative‐grade loosen. In 2002, a structural shift occurs toward more stringent ratings. Holding characteristics constant, firms experience a drop of 1.5 notches in ratings due to tightened standards from 2002 to 2007. Credit spread tests suggest that the variation in standards is not completely due to changes in the economic climate. Rating standards affect credit spreads. Loose ratings are associated with higher default rates.
Elevated level of serum growth differentiation factor 15 is associated with oral leukoplakia and oral squamous cell carcinoma
Authors: Yang Cheng‐Zhe , Ma Jie , Luo Qing‐Qiong , Neskey David M. , Zhu Dong‐Wang , Liu Ying , Myers Jeffrey N. , Zhang Chen‐Ping , Zhang Zhi‐Yuan , Zhong Lai‐Ping
Published: May 2013

Background

Although molecular mechanism of growth differentiation factor 15 (GDF15) in tumorigenesis of oral squamous cell carcinoma (OSCC) is not clear, the diagnostic and prognostic value of serum GDF15 detection has been noticed. However, serum GDF15 levels in patients with oral leukoplakia and GDF15 as a potential predictive biomarker for response to induction chemotherapy in patients with OSCC have not been reported.

Methods

Pretreatment serum GDF15 concentration was detected using an enzyme‐linked immunosorbent assay in 30 healthy persons, 24 patients with oral leukoplakia, and 60 patients with OSCC.

Results

Serum GDF15 concentration was significantly higher in patients with oral leukoplakia and OSCC, compared with healthy controls (F = 13.701, df = 2, P < 0.001). From a diagnostic standpoint, a cutoff value of 346.9 ng/l of serum GDF15 concentration was calculated using receiver operating characteristic curve, with a sensitivity of 0.750, specificity of 0.867, Youden's Index of 0.617, and area under curve of 0.863. From a prognostic standpoint, patients with serum GDF15 concentration <346.9 ng/l had an improved 3‐year disease‐free survival rate (64.3% vs 56.5%) compared with those above 346.9 ng/l, but the difference was not statistically significant. A decreased concentration of GDF15 (<346.9 ng/l) showed a predictive trend toward an improved response to induction chemotherapy compared with elevated concentration with clinical response rates of 100% and 71.4%, respectively, but the difference was not significant.

Conclusion

Elevated GDF15 level may be not only a diagnostic biomarker for oral leukoplakia, but also a prognostic/predictive biomarker associated with decreased survival and diminished response to induction chemotherapy for patients with OSCC.
ABSORPTIVE CAPACITY, KNOWLEDGE FLOWS, AND INNOVATION IN U.S. METROPOLITAN AREAS
Authors: Mukherji Nivedita , Silberman Jonathan
Published: May 2013

High growth and progressive regions possess a culture that promotes innovation. Innovation depends on a region's ability to use its own existing knowledge and knowledge generated elsewhere. This paper demonstrates the importance of the ability to absorb external knowledge in explaining innovation productivity for 106 U.S. metropolitan areas. Using a spatial interaction model of patent citation flows with origin and destination dependence, the destination fixed‐effects coefficients provides a measure of a region's absorptive capacity. We identify local conditions that shape a region's absorptive capacity and demonstrate it has a positive and significant impact on innovation productivity.
Dexamethasone-releasing cochlear implant coatings: application of artificial neural networks for modelling of formulation parameters and drug release profile
Authors: Nemati Pedram , Imani Mohammad , Farahmandghavi Farhid , Mirzadeh Hamid , Marzban-Rad Ehsan , Nasrabadi Ali Motie
Published: May 2013

Objectives

Over the past few decades, mathematical modelling and simulation of drug delivery systems has been steadily gained interest as a focus for academic and industrial attention. Here, simulation of dexamethasone (DEX, a corticosteroid anti-inflammatory agent) release profile from drug-eluting cochlear implant coatings is reported using artificial neural networks.

Methods

The devices were fabricated as monolithic dispersions of the pharmaceutically active ingredient in a silicone rubber matrix. A two-phase exponential model was fitted on the experimentally obtained DEX release profiles. An artificial neural network (ANN) was trained to determine formulation parameters (i.e. DEX loading percentage, the devices surface area and their geometry) for a specific experimentally obtained drug release profile. In a reverse strategy, an ANN was trained for determining expected drug release profiles for the same set of formulation parameters.

Key findings

An algorithm was developed by combining the two previously developed ANNs in a serial manner, and this was successfully used for simulating the developed drug-eluting cochlear implant coatings. The models were validated by a leave-one-out method and performing new experiments.

Conclusions

The developed ANN algorithms were capable to bilaterally predict drug release profile for a known set of formulation parameters or find out the levels for input formulation parameters to obtain a desired DEX release profile.
The relationship between strategic reading instruction, student learning of L2‐based reading strategies and L2 reading achievement
Authors: Akkakoson Songyut
Published: May 2013

This study investigates the relationship between strategic reading instruction, the process of learning second language‐based reading strategies and English reading achievement for Thai university students of science and technology. In a course in reading general English texts for 16 weeks, 82 students were taught using a strategies‐based approach (experimental cohort), whereas another 82 students were taught using a traditional, teacher‐centred approach (control cohort). A pre‐test/post‐test research design was employed, and a portfolio approach was used to investigate the experimental cohort students' process of learning reading strategies. The results showed that the experimental cohort outperformed the control cohort in the post‐course standardised English test. The higher‐level reading proficiency learners in the experimental cohort were also found to be better than their low‐level peers at learning to use second language‐based reading strategies effectively. Implications are discussed for alternative instructional practice of reading in English as a foreign language (EFL).
Tense in Adjuncts Part 2: Temporal Adverbial Clauses
Authors: von Stechow Arnim , Grønn Atle
Published: May 2013

Part 1 of this article treats tense in relative clauses in English, Russian and Japanese. The temporal center in relative clauses can always be anaphoric, and sometimes it has to be the anaphoric Tpro. In Part 2, we investigate tense in temporal adverbial clauses (TACs) headed by ‘after’, ‘before’ and ‘when’. We argue for the following points: 1. English TAC Tense is bound in Present adjuncts under matrix ‘will’, in other constructions the TAC Tense is deictic. Tense licensing is non‐local in bound constructions, while in deictic constructions it is local. 2. Russian TAC Tense is deictic, and the tense licensing is local. 3. Japanese TAC Tense is bound. We have a ‘tenseless’ construction in the adjunct, and tense licensing is local.
Tense in Adjuncts Part 1: Relative Clauses
Authors: von Stechow Arnim , Grønn Atle
Published: May 2013

Part 1 of Tense in Adjuncts presents a compositional analysis of tense in relative clauses (RCs). The languages under investigation are English, Russian, and Japanese. We introduce the syntax and semantics of tense and the theory of feature transmission under variable binding, which mediates between syntax/semantics and morphology. In sequence of tense languages such as English, the morphology of the tense in a RC will be licensed by a non‐local tense if the RC is embedded under will. In other constructions, the RC tense is licensed by a local tense. In non‐sequence of tense languages, the tense in the RC is also determined by a local tense. The paper says which factors are responsible for the tense distribution in the different languages under consideration.
Structure of a translocation signal domain mediating conjugative transfer by type IV secretion systems
Authors: Redzej Adam , Ilangovan Aravindan , Lang Silvia , Gruber Christian J. , Topf Maya , Zangger Klaus , Zechner Ellen L. , Waksman Gabriel
Published: May 2013

Relaxases are proteins responsible for the transfer of plasmid and chromosomal DNA from one bacterium to another during conjugation. They covalently react with a specific phosphodiester bond within DNA origin of transfer sequences, forming a nucleo‐protein complex which is subsequently recruited for transport by a plasmid‐encoded type IV secretion system. In previous work we identified the targeting translocation signals presented by the conjugative relaxase TraI of plasmid R1. Here we report the structure of TraI translocation signal TSA. In contrast to known translocation signals we show that TSA is an independent folding unit and thus forms a bona fide structural domain. This domain can be further divided into three subdomains with striking structural homology with helicase subdomains of the SF1B family. We also show that TSA is part of a larger vestigial helicase domain which has lost its helicase activity but not its single‐stranded DNA binding capability. Finally, we further delineate the binding site responsible for translocation activity of TSA by targeting single residues for mutations. Overall, this study provides the first evidence that translocation signals can be part of larger structural scaffolds, overlapping with translocation‐independent activities.
Lyme disease spirochaetes possess an aggrecan‐binding protease with aggrecanase activity
Authors: Russell Theresa M. , Johnson Barbara J. B.
Published: May 2013

Connective tissues are the most common area of colonization for the Lyme disease spirochaete Borrelia burgdorferi. Colonization is aided by the interaction between numerous bacterial adhesins with components of the extracellular matrix (ECM). Here we describe a novel interaction between B. burgdorferi and the major ECM proteoglycan found in joints, aggrecan. Using affinity chromatography and mass spectrometry we identify two borrelial aggrecan‐binding proteins: the known ECM ligand Bgp (BB0588) and an uncharacterized protease BbHtrA (BB0104). Proteinase K studies demonstrate that BbHtrA is surface exposed. Immunoblots using sera from patients with both early and late Lyme disease establish that BbHtrA is expressed during human disease, immunogenic, and conserved in the three major Lyme disease spirochaete species. Consequences of the interaction between aggrecan and BbHtrA were examined by proteolysis assays. BbHtrA cleaves aggrecan at a site known to destroy aggrecan function and which has been previously observed in the synovial fluid of patients with Lyme arthritis. These data demonstrate that B. burgdorferi possess aggrecan‐binding proteins which may provide the organism with additional capability to colonize connective tissues. Moreover, our studies provide the first evidence that B. burgdorferi possess proteolytic activity which may contribute to the pathogenesis of Lyme arthritis.
Posaconazole prophylaxis – impact on incidence of invasive fungal disease and antifungal treatment in haematological patients
Authors: Peterson Lisa , Ostermann Julia , Rieger Heidi , Ostermann Helmut , Rieger Christina Theresa
Published: May 2013

Since two large‐scale, randomised studies on posaconazole prophylaxis have demonstrated a clear benefit for patients at high risk for contracting invasive fungal disease (IFD), posaconazole prophylaxis has been adopted as standard of care for this patient collective. Several years on from implementation at our institution, we wanted to evaluate its impact on the incidence and use of empirical antifungal therapy in a real‐life setting. We analysed retrospectively incidence and severity of IFD in high‐risk patients with prophylaxis, using a historical cohort as comparator. A total of 200 patients had either received the extended spectrum triazole posaconazole in prophylactic dosage of 200 mg tid or empirical antifungal therapy. Disease events were analysed by application of the revised EORTC/MSG definitions for IFD. Before posaconazole prophylaxis, we recorded 57/100 cases of IFD which was reduced to 28/100 with prophylaxis. The empirical use of antifungal drugs was reduced to 41% from 91% in the non‐prophylaxis cohort. Furthermore, we observed a shift in the categorisation of IFD according to EORTC/MSG criteria. Our data suggest that posaconazole was effective in reducing the rate and probability of invasive fungal disease in high‐risk patients.
Strategies of emotion management: not just on, but off the job
Authors: Hammonds Clare , Cadge Wendy
Published: May 2013

Intensive care nurses, like professionals in other intense occupations characterized by high degrees of uncertainty, manage the emotions that result from their work both on and off the job. We focus on the job strategies – calling‐in, sharing their experiences with others and engaging in a range of activities oriented to emotional recovery – that 37 intensive care nurses use to manage their emotions off the job. These strategies show how the social organization and division of labor in intensive care units influences nurses' emotional management outside of them and how organizational troubles for hospitals becomes personal ones for staff. They further support theoretical approaches that view emotions as dynamic elements belonging to individuals rather than aspects of people that can be fully appropriated by organizations.
Adaptive support ventilation for complete ventilatory support in acute respiratory distress syndrome: A pilot, randomized controlled trial
Authors: Agarwal Ritesh , Srinivasan Arjun , Aggarwal Ashutosh N. , Gupta Dheeraj
Published: May 2013

Background and objective

Low tidal volume ventilation has been shown to improve survival in acute respiratory distress syndrome (ARDS). Adaptive support ventilation (ASV), a closed‐loop ventilatory mode, can minimize the work of breathing, and thus potentially improve the outcomes in ARDS. The aim of this pilot, randomized clinical trial was to compare the outcomes of ASV versus volume‐cycled ventilation (VCV) in ARDS.

Methods

Patients with ARDS were randomly allocated to either ASV or VCV. The primary outcomes were duration of mechanical ventilation, new‐onset organ dysfunction and hospital length of stay. The secondary outcomes were ease of use of the ventilator mode (assessed using the visual analogue scale (VAS)), number of daily arterial blood gas analyses, daily requirements of sedative and neuromuscular blockers, and mortality.

Results

Forty‐eight patients (28 males, 20 females) with ARDS were randomized to receive either ASV (n = 23) or VCV (n = 25) during the study period. The baseline characteristics were almost similar in the two groups. The duration of mechanical ventilation, delta sequential organ failure assessment scores, intensive care unit and hospital stay were comparable in the two groups. The mortality (VCV‐36% vs ASV‐34.7%), ease of use of mechanical ventilation, daily midazolam and vecuronium doses, and the number of arterial blood gas analyses performed were also similar in the two groups.

Conclusions

There was no significant difference in the outcomes of patients with ARDS ventilated with either VCV or ASV in this study.
Implications of Shifting Retail Market Shares for Loan Monitoring in a Dominant‐Bank Model
Authors: VanHoose David
Published: May 2013

This study utilizes a dominant‐bank model to investigate whether an increase in retail loan and deposit‐market concentration increases the incentives for both dominant and fringe banks to monitor their loans and thereby improve the quality of their loan portfolios. It shows that the effects on banks' incentives to engage in monitoring aimed at eliminating loan default losses in response to increased concentration of retail market shares of loans and deposits depend critically on whether the banks' asset and liability choices are interdependent. When the asset and liability decisions of both dominant and fringe banks are independent, a shift in market shares in favor of the dominant bank generates a straightforward increase in the incentives of all banks to monitor their loans. Under portfolio interdependence, the effects on monitoring outcomes at dominant banks and at banks within the competitive fringe depend on more complicated configurations of parameters. This fact helps explain mixed empirical evidence on the relationships between bank competition and measures of bank risk and soundness.
Linking a prolonged Neo‐Tethyan magmatic arc in South Asia: Zircon U‐Pb and Hf isotopic constraints from the Lohit Batholith, NE India
Authors: Lin Te‐Hsien , Chung Sun‐Lin , Kumar Anil , Wu Fu‐Yuan , Chiu Han‐Yi , Lin I‐Jhen
Published: May 2013

The Neo‐Tethyan subduction that operated before the India‐Asia collision resulted in an Andean‐type convergent margin in South Asia and was associated with extensive arc magmatism that formed the Transhimalayan batholiths. Magmatism in the Gangdese Batholith, the largest batholith exposed in the Lhasa terrane of southern Tibet, is considered to have lasted from the early Jurassic to Eocene. However, eastward correlation of the Gangdese Batholith is uncertain because it is truncated by the eastern Himalayan syntaxis. Here, we report new data from the Lohit Batholith, NE India, including: (i) zircon U‐Pb ages of five granitoids from ca. 148 to 96 Ma; and (ii) zircon Hf isotopes of these rocks that yield high and positive εHf(T) values. We argue that the Lohit Batholith is the eastward extension of the Gangdese Batholith, and can be correlated southward to the Wuntho‐Popa arc in West Burma, thus linking a prolonged Neo‐Tethyan magmatic arc system from southern Tibet to Southeast Asia.
Adaptive Model Estimation of Vibration Motion for a Nanopositioner With Moving Horizon Optimized Extended Kalman Filter
Authors: Polóni Tomáš , Aas Eielsen Arnfinn , Rohal’-Ilkiv Boris , Arne Johansen Tor
Published: May 2013

Fast, reliable online estimation and model adaptation is the first step towards high-performance model-based nanopositioning control and monitoring systems. This paper considers the identification of parameters and the estimation of states of a nanopositioner with a variable payload based on the novel moving horizon optimized extended Kalman filter (MHEKF). The MHEKF is experimentally tested and verified with measured data from the capacitive displacement sensor. The payload, attached to the nanopositioner's sample platform, suddenly changes during the experiment triggering the transient motion of the vibration signal. The transient is observed through the load dependent parameters of a single-degree-of-freedom vibration model, such as spring, damping, and actuator gain constants. The platform, before and after the payload change, is driven by the excitation signal applied to the piezoelectric actuator. The information regarding displacement and velocity, together with the system parameters and a modeled force disturbance, is estimated through the algorithm involving the iterative sequential quadratic programming (SQP) optimization procedure defined on a moving horizon window. The MHEKF provided superior performance in comparison with the benchmark method, extended Kalman filter (EKF), in terms of faster convergence.
Clinical supervisors: are they the key to making care safer?
Authors: Walton Merrilyn , Barraclough Bruce
Published: May 2013

The evidence shows that notwithstanding efforts by health professionals and hospital managers to improve the quality and safety of healthcare, adverse events remain prevalent. Clinical supervision is understandably dominated by transferring discipline knowledge and skills but the environment today requires equal attention to integrating patient safety concepts and principles into clinical supervision. Trainees learn from supervisors who themselves often have inadequate patient safety knowledge and skills. This conundrum may partly explain why there has been no visible reduction in adverse events. Patient safety literature has emphasised that clinical errors are rarely linked with incompetent doctors or trainees with inadequate knowledge but rather to failures in appreciating the context, complexity and uncertainty of clinical decisions made under the pressure of time. It is time to consider whether clinical supervisors themselves first need to demonstrate patient safety competencies before being responsible for supervising trainees.
Uncontrolled organ donation after circulatory death: potential donors in the emergency department
Authors: Reed Matthew James , Lua Stephanie Boon Hui
Published: May 2013

Background

The continuing shortfall of organs for transplantation has led to interest in Maastricht Category II (uncontrolled) Donation after Circulatory Death (DCD) organ donation. As preparation for a proposed pilot, this study aimed to explore the potential of uncontrolled DCD organ donation from patients presenting in cardiac arrest to the emergency department (ED) who are unsuccessfully resuscitated.

Methods

We identified all patients who died in our ED following unsuccessful resuscitation after cardiac arrest who were aged between 16 years and 60 years, whose collapse was witnessed, in whom the paramedics arrived within 15 min, whose death in the ED was less than 2 h after their collapse, who were on the organ donation register and who arrived in the ED during the working week (Monday to Friday between 9:00 and 17:00).

Results

During a 14-month period from 1 August 2008 to 30 September 2009, 564 patients had a cardiac arrest in the Lothian region. Four patients may have been eligible to participate in an uncontrolled DCD organ donation programme.

Conclusions

Identifying potential organ donors in the ED who are unsuccessfully resuscitated from cardiac arrest may contribute to reducing the shortfall of organs for transplantation, although numbers are likely to be small. If such a programme was to be introduced during weekday working hours, there may be around four donors a year. However, even one additional donor per year from hospitals across the UK with an ED and a transplantation service would add considerably to the overall organ donation rate.
Bicyclist mortality between 2006 and 2010 in China: findings from national Disease Surveillance Points (DSP) data
Authors: Zhou Maigeng , Hu Guoqing , Wang Lijun , Ma Sai , Wang Lin , Li Qingfeng , Hyder Adnan A
Published: May 2013

Context

While road traffic mortality has been reported to be seriously undercounted by the police in China, non–police-reported data have not been explored previously to examine vulnerable road user mortality.

Objective

To examine changes in bicyclist mortality between 2006 and 2010 in China, using the Disease Surveillance Points (DSP) data of China.

Design, setting and data source

Mortality data of 2006–2010 from DSP data, covering 73 million population, was analysed. Poisson regression was used to examine the significance of year after controlling for sex, age and urban/rural location.

Main outcome measure(s)

Mortality rate and mortality rate ratio (MRR).

Results

Between 2006 and 2010, the mortality rate for bicyclists increased from 1.1 to 1.6 per 100 000 population according to DSP data. Between 2006 and 2010, more than 90% of bicyclist deaths were undercounted by the police compared to the findings from DSP data. Contrary to the 34% increase between 2006 and 2010 reflected by DSP data (adjusted MRR: 1.34, 95% CI 1.23 to 1.46), police data revealed a 64% decrease in bicyclist mortality (unadjusted MRR: 0.36, 95% CI 0.32 to 0.40) in the study time period.

Conclusions

Health data should be used to assess the road traffic injuries in China. The recent increase in bicyclist mortality merits attention from policy makers and researchers.
Parental use of antidepressant medication and family type in the risk for incident psychiatric morbidity in offspring
Authors: Joutsenniemi Kaisla , Moustgaard Heta , Martikainen Pekka
Published: May 2013

Background

Maternal depression increases the risk for psychiatric morbidity in offspring but the effects of paternal depression and family type are less studied.

Methods

We assessed the effects of parental antidepressant use on offspring psychiatric morbidity in various family settings.

Results

Our register-based study followed 132637 children for incident psychiatric morbidity in 1998–2003. The highest risk for psychiatric morbidity was in children living with both parents on antidepressants or with a lone parent on antidepressants. We found little variation in the effects according to parental or offspring gender.

Conclusions

Parental depression as measured by antidepressant use, and single parenthood pose a risk for psychiatric morbidity in offspring.