bluuebunny/crossref_metadata_2025 huggingface dataset:
Reciprocity Between Depressive Symptoms and Physical Limitations Pre- and Postretirement
Authors: Gayman Mathew D. , Pai Manacy , Kail Ben Lennox , Taylor Miles G.
Published: March 2013

Objectives: This study assesses (a) the reciprocity between mental and physical health pre- and postretirement, and (b) the extent to which these associations vary by race. Method: Data are from the 1994 to 2008 waves of the Health and Retirement Study. Results: Analyses based on structural equation modeling reveal that depression and physical health exert reciprocal effects for Whites pre- and postretirement. For Blacks preretirement, physical limitations predict changes in depression but there is no evidence of the reverse association. Further, the association between physical limitations and changes in depressive symptoms among Blacks is no longer significant after retirement. Discussion: The transition into retirement alleviates the translation of physical limitations into depressive symptoms for Blacks only. The findings underscore the relevance of retirement for reciprocity between mental and physical health and suggest that the health implications associated with this life course transition vary by race.
Language-Trained Chimpanzees (Pan troglodytes) Name What They Have Seen but Look First at What They Have Not Seen
Authors: Beran Michael J. , Smith J. David , Perdue Bonnie M.
Published: March 2013

Metacognition can be defined as knowing what one knows, and the question of whether nonhuman animals are metacognitive has driven an intense debate. We tested 3 language-trained chimpanzees in an information-seeking task in which the identity of a food item was the critical piece of information needed to obtain the food. The chimpanzees could either report the identity of the food immediately or first check a container in which the food had been hidden. In two experiments, the chimpanzees were significantly more likely to visit the container first on trials in which they could not know its contents but were more likely to just name the food item without looking into the container on trials in which they had seen its contents. Thus, chimpanzees showed efficient information-seeking behavior that suggested they knew what they had or had not already seen when it was time to name a hidden item.
Visual Working Memory Modulates Rapid Eye Movements to Simple Onset Targets
Authors: Hollingworth Andrew , Matsukura Michi , Luck Steven J.
Published: March 2013

Representations in visual working memory (VWM) influence attention and gaze control in complex tasks, such as visual search, that require top-down selection to resolve stimulus competition. VWM and visual attention clearly interact, but the mechanism of that interaction is not well understood. In the research reported here, we demonstrated that in the absence of stimulus competition or goal-level biases, VWM representations of object features influence the spatiotemporal dynamics of extremely simple eye movements. The influence of VWM therefore extends into the most basic operations of the oculomotor system.
Sexualization: A state of injury
Authors: Duschinsky Robbie
Published: March 2013

I shall contend that avowedly feminist media and policy discussions of “sexualization” in the UK have risked inadvertently problematizing not sexism but propriety. As a result, these discourses on sexualization have contributed to what Wendy Brown has called a “state of injury”: a situation in which representations of wound or threat are mobilized within identity politics on behalf of a dominated group in society, and this strategy backfires by supporting social and state institutions in regulating and normalizing precisely this very group. Rather than challenging the sexist division of unmarried women into pure and impure, innocent children and whores, I shall show, using the Papadopoulos Review, that feminist discourses on “sexualization” have risked tacitly affirming this division, situating the sexuality and desires of young women as deviations from their true essence. Moreover, a further unintended consequence has been to provide support to a neo-liberal political agenda in the UK, which contrasts the innocence that should be the property of unsexualized girls with the self-reliance that should characterize adult citizens and can only be hindered by welfare state protections.
Incidence of Shiga toxin–producing Escherichia coli strains in beef, pork, chicken, deer, boar, bison, and rabbit retail meat
Authors: Magwedere Kudakwashe , Dang Huu Anh , Mills Edward W. , Cutter Catherine N. , Roberts Elisabeth L. , DebRoy Chitrita
Published: March 2013

The objective of the current study was to determine the incidence of contamination by the top 7 Shiga toxin–producing Escherichia coli (STEC) O-groups, responsible for the majority of E. coli infections in human beings, in retail meat from different animal species. Samples from ground beef ( n = 51), ground pork ( n = 16), ground chicken ( n = 16), and game meat (deer, wild boar, bison, and rabbit; n = 55) were collected from retail vendors for the detection of 7 STEC O-groups (O26, O45, O103, O111, O121, O145, and O157). Meat samples were tested by using a multiplex polymerase chain reaction assay targeting the wzx gene of O antigen gene clusters of the 7 STEC O-groups. The positive samples were further tested for Shiga toxin genes ( stx1 and stx2). Out of a total of 83 ground beef, pork, and chicken samples, 17 (20%) carried O121, 9 (10%) carried O45, 8 (9%) carried O157, 3 (3%) carried O103, and 1 (1%) carried O145. None of the samples were positive for O26, O111, or the stx gene. All 3 white-tailed deer samples (100%) were positive for O45, O103, or both, 2 (10%) out of 20 red deer samples exhibited the presence of O103, and all 3 bison samples were contaminated with either O121, O145, or O157. One sample from ground deer, contaminated with E. coli O45, carried the stx1 gene. This preliminary investigation illustrates the importance of microbiological testing of pathogens in meat products, as well as the recognized need for increased surveillance and research on foodborne pathogens.
An evaluation of the prevalence of Bovine herpesvirus 1 abortions based on diagnostic submissions to five U.S.-based veterinary diagnostic laboratories
Authors: Gould Stacie , Cooper Vicky L. , Reichardt Niles , O’Connor Annette M.
Published: March 2013

Bovine herpesvirus 1 (BoHV-1) is 1 of several viruses considered to be causal agents of bovine abortion. The current retrospective study examined data on bovine abortion submissions from 5 veterinary diagnostic laboratories from 2000 to 2011. The objective of the study was to describe prevalence of BoHV-1–associated abortion in submissions at veterinary diagnostic laboratories. There were 3 specific aims: 1) to examine the proportion of BoHV-1–related abortions with the introduction of new diagnostic assays such as polymerase chain reaction (PCR), 2) to evaluate the agreement of the histopathology report of the abortion submissions and the result of the assay used, and 3) to evaluate if there was an association between farm history of vaccination against BoHV-1 and BoHV-1–positive abortion submissions. An extended Mantel–Haenszel χ2 for linear trend was used to analyze the prevalence of BoHV-1 over the study period and showed that collectively there is evidence of an increase of positive BoHV-1 abortions ( P < 0.001). The comparison of the proportion of BoHV-1–positive submissions pre- and postadoption of PCR was not significant ( P = 0.25). Using Cohen kappa coefficient test of agreement, a kappa value of 0.81 ( P < 0.001) was found, suggesting high agreement of lesions reported and assay result. It was found that using a χ2 test, a P value of 0.068 for nonmatched data (i.e., a history of vaccination against BoHV-1 in the herd) was associated with reduced detection of BoHV-1–positive abortion submissions.
An investigation into beef calf mortality on five high-altitude ranches that selected sires with low pulmonary arterial pressures for over 20 years
Authors: Neary Joseph M. , Gould Daniel H. , Garry Franklyn B. , Knight Anthony P. , Dargatz David A. , Holt Timothy N.
Published: March 2013

Producer reports from ranches over 2,438 meters in southwest Colorado suggest that the mortality of preweaned beef calves may be substantially higher than the national average despite the selection of low pulmonary pressure herd sires for over 20 years. Diagnostic investigations of this death loss problem have been limited due to the extensive mountainous terrain over which these calves are grazed with their dams. The objective of the current study was to determine the causes of calf mortality on 5 high-altitude ranches in Colorado that have been selectively breeding sires with low pulmonary pressure (<45 mmHg) for over 20 years. Calves were followed from branding (6 weeks of age) in the spring to weaning in the fall (7 months of age). Clinical signs were recorded, and blood samples were taken from sick calves. Postmortem examinations were performed, and select tissue samples were submitted for aerobic culture and/or histopathology. On the principal study ranch, 9.6% (59/612) of the calves that were branded in the spring either died or were presumed dead by weaning in the fall. In total, 28 necropsies were performed: 14 calves (50%) had lesions consistent with pulmonary hypertension and right-sided heart failure, and 14 calves (50%) died from bronchopneumonia. Remodeling of the pulmonary arterial system, indicative of pulmonary hypertension, was evident in the former and to varying degrees in the latter. There is a need to better characterize the additional risk factors that complicate pulmonary arterial pressure testing of herd sires as a strategy to control pulmonary hypertension.
Necrotic pharyngitis associated with Mycoplasma bovis infections in American bison (Bison bison)
Authors: Dyer Neil , Register Karen B. , Miskimins Dale , Newell Teresa
Published: March 2013

Mycoplasma bovis has emerged as a significant and costly infectious disease problem in bison, generally presenting as severe, caseonecrotic pneumonia. Three diagnostic cases in which M. bovis is associated with necrotic pharyngitis in bison are described in the current study. The bacterium was isolated from lesions of the pharynx or lung of 3 American bison ( Bison bison), at 2 different locations in the upper Midwestern United States, with severe, necrotic pharyngeal abscesses. Chronic caseonecrotic inflammation typical of M. bovis infection in bovines was observed microscopically in the pharynxes of affected bison. A mixed population of bacteria was recovered from the pharyngeal lesions, and Trueperella pyogenes, a frequent secondary pathogen in ruminant respiratory disease, was consistently isolated from the affected animals. Distinctive histopathological features of the pharyngeal lesions favor causation by M. bovis, although a role for T. pyogenes in the clinical presentation cannot be excluded. Veterinarians and producers working with bison should be aware that M. bovis may be associated with pharyngitis in bison.
Canine intestinal histoplasmosis containing hyphal forms
Authors: Schumacher Loni L. , Love Brenda C. , Ferrell Mark , DeSilva Udaya , Fernando Ruchika , Ritchey Jerry W.
Published: March 2013

A 12-year-old intact male Miniature Schnauzer dog with chronic diarrhea that was unresponsive to empirical treatment was presented to a referring veterinarian. A laparotomy was performed, and formalin-fixed biopsies of duodenum, jejunum, and colon were sent to Oklahoma Animal Disease Diagnostic Laboratory for evaluation. Histologic examination revealed a severe, diffuse, granulomatous enteritis and colitis with intralesional yeast and hyphal forms. Grocott methenamine silver stains revealed short, aseptate hyphae co-mingled with 2–8 µm, oval to round yeast organisms consistent with Histoplasma capsulatum. The atypical presentation of both yeast and hyphal forms prompted identification of the organism. Direct sequencing of a polymerase chain reaction product from paraffin-embedded intestinal samples confirmed the presence of Ajellomyces capsulatus with a homology over 99% to several sequences in GenBank. Ajellomyces capsulatus is the holomorphic name for H. capsulatum. Therefore, the mycelial form of a dimorphic fungus such as H. capsulatum can coexist with yeast cells within lesions of histoplasmosis. Following diagnosis, the dog was treated with itraconazole for 6 months and has improved.
Psychological Distress in Adolescent and Young Adult Survivors of Childhood Cancer in Korea
Authors: Kim Min Ah , Yi Jaehee
Published: March 2013

This study examined psychological distress levels, their differences across groups based on sociodemographic and medical variables, and risk factors for significant distress in adolescent and young adult childhood cancer survivors in Korea. Participants consisted of 223 Korean survivors of childhood cancer between 15 and 39 years of age. Psychological distress was measured using the Brief Symptom Inventory–18. A series of t tests, binomial proportion tests, analysis of variance, and univariable and multivariable logistic regressions were used. One fifth of the participants were classified as psychologically distressed. Significant levels of psychological distress were associated with age, economic status, and time since diagnosis. The results indicate a greater need for monitoring and follow-up care related to psychological health in childhood cancer survivors. Outreach and collaboration with health care professionals to increase mental health referrals could provide opportunities to address the needs of childhood cancer survivors in terms of their psychological well-being.
Implementing Evidence-Based Practice Education in Social Work
Authors: Bellamy Jennifer L. , Mullen Edward J. , Satterfield Jason M. , Newhouse Robin P. , Ferguson Molly , Brownson Ross C. , Spring Bonnie
Published: March 2013

Evidence based practice (EBP) is reflected in social work publications, accreditation standards, research, and funding opportunities. However, implementing EBP in social work practice and education has proven challenging, highlighting the need for additional resources. This paper describes the Transdisciplinary Model of EBP, a model based on advances in EBP across health disciplines including social work and its application to the development of an online EBP training portal. Utility of the Transdiciplinary Model and a training portal for social work education is discussed. Also included is a description of the training modules, the Council on Social Work Education Educational Policy and Accreditation Standards competencies reflected in the modules, and a case example using the modules in a master s of social work course.
Confirmatory Factor Analysis on the Professional Suitability Scale for Social Work Practice
Authors: Tam Dora M. Y. , Twigg Robert C. , Boey Kam-Wing , Kwok Siu-Ming
Published: March 2013

Objective:

This article presents a validation study to examine the factor structure of an instrument designed to measure professional suitability for social work practice.

Method:

Data were collected from registered social workers in a provincial mailed survey. The response rate was 23.2%. After eliminating five cases with multivariate outliers, confirmatory factor analysis using maximum likelihood estimation was performed on 285 cases.

Results:

A 22-item four-factor model achieved an acceptable good fit. Reliability testing results indicate an overall Cronbach’s α valued at .90 and subscale αs ranged between .75 and .89.

Conclusion:

Findings affirm good-to-excellent internal consistency of the Professional Suitability scale with two previous studies and provide acceptable results on construct validity.
Increasing Student Access to Content Area Textbooks
Authors: Bruhn Allison Leigh , Hasselbring Ted S.
Published: March 2013

Teachers, particularly at the middle and high school levels, rely heavily on textbooks to deliver curricular content. Often, students are asked to dive right into the content of a textbook that may or may not contain relevant information, is difficult to navigate, or requires prior content knowledge they do not have. To combat these issues and maximize the utility of textbooks, they must be selected carefully and implemented soundly. Yet, even these steps may not enable all students, specifically those with disabilities, to access them. Fortunately, digital textbooks may be an accessible option for some students. This article provides suggestions on (a) how teachers can carefully select textbooks, (b) effective methods for implementing textbooks, and (c) accessibility ideas for digital text for students with disabilities.
Using Alternate Texts to Support Comprehension of the Core Content Curriculum
Authors: Fenty Nicole S. , Barnett Kathleen N.
Published: March 2013

Although students with learning disabilities are likely to be included in general education content area classrooms, they often experience difficulties in these settings because of struggles in reading text. Curriculum complexity and difficulty accessing texts increase as students progress to the higher grades. This creates a barrier for adolescents with learning disabilities in reading to experience success in general education content area classrooms. This article helps teachers support adolescents with learning disabilities in reading to succeed with content area curriculum by incorporating readability-controlled alternate texts (e.g., trade books and magazines) during instruction. A rationale for the need to expose adolescents with learning disabilities in reading to alternate content area texts that they can read on their level is provided. Ideas for how teachers may structure planning and instruction are also discussed.
Burglary in Gated Communities
Authors: Breetzke Gregory D. , Cohn Ellen G.
Published: March 2013

Gated communities have experienced phenomenal growth worldwide due in part to increasing fear of urban crime and violence. However, very little is known about the effect of gating a neighborhood on rates of criminal victimization. In this article, we fill this gap by examining the relationship between residential burglary and gated communities in Tshwane, South Africa. South Africa has over 26,000 registered gated communities and high levels of violent and property crime, making it a suitable geographical focus area for research of this nature. Using variables informed by routine activities theory, we ran a series of regression models to assess the independent effect of gating on rates of day and night time burglary. The findings indicate that gated neighborhoods have a significant positive association with burglary rates in both day and night time models, suggesting that residing in a gated community actually increases one’s risk of burglary victimization. Possible explanations for these unexpected findings are discussed in the context of South Africa’s unique sociopolitical past.
The Good Lives Model (GLM)
Authors: Willis Gwenda M. , Ward Tony , Levenson Jill S.
Published: March 2013

The good lives model (GLM) has become an increasingly popular theoretical framework underpinning sex offender treatment programs, and preliminary research suggests that the GLM may enhance the efficacy of programs that adhere to the Risk, Need, and Responsivity (RNR) principles. However, this potential rests on the appropriate operationalization of the GLM in practice. Operationalized appropriately, the GLM aims to facilitate risk reduction alongside equipping clients with the tools to live personally meaningful and fulfilling lives. However, misguided operationalization of the GLM could result in ineffective treatment and ultimately higher rates of reoffending. This article presents findings from a multisite study exploring how the GLM has been operationalized and the degree to which the GLM has been integrated in a sample of 13 North American treatment programs. A comprehensive coding protocol was developed that included items related to program aims and client induction/orientation, assessment, intervention planning, intervention content, and intervention delivery. Each site was visited and items were rated through a review of program documentation, interviews with program directors/managers, and observations of treatment groups. Findings from inductive (how the GLM was operationalized) and deductive (the extent to which the GLM was integrated) analyses are presented and GLM consistent and inconsistent practices are highlighted. The article concludes with suggestions for ways in which program responsiveness to the GLM could be enhanced.
Accuracy of Sexually Violent Person Assessments of Juveniles Adjudicated for Sexual Offenses
Authors: Caldwell Michael F.
Published: March 2013

This study reviewed the records of 198 juveniles who were committed to secured custody after being adjudicated delinquent for a sexually violent offense that qualified them for possible commitment under a Sexually Violent Person’s (SVP) civil commitment law. For an individual to be committed, the statute requires that the individual have a qualifying mental disorder and is “likely,” to commit a future act of sexual violence. Each youth was screened by at least two expert examiners in a two-step process. Fifty-four of the youth were found to meet the commitment criteria in an initial examination and were subject to an SVP petition. The remaining 144 were screened out. Subsequent criminal charges were collected over a 4.97-year mean follow-up. The results showed that the prevalence rates for general sexual offending and felony sexual offending did not differ between youth who were screened out and those who were subject to a petition. Among petitioned youth, 11.76% were charged with a new sexual offense including 9.80% who were charged with a felony sexual assault. By comparison, 17.36% of the youth that were screened out were charged with a sexual offense including 13.19% who were charged with a felony sexual assault, a nonsignificant difference.
Uncovering Collaborative Value Creation Patterns and Establishing Corresponding Customer Roles
Authors: Moeller Sabine , Ciuchita Robert , Mahr Dominik , Odekerken-Schröder Gaby , Fassnacht Martin
Published: March 2013

Research on value creation traditionally has focused on value created by the company, though customers increasingly serve as active partners, able to create value with firms in a collaborative manner. Despite interest by both scholars and managers, existing research has not yet clarified the interdependencies of service offerings and customer role patterns. This article explores value creation rooted in three generic offerings (configuration, solution, and network) and identifies differences in their prerequisites, customer activities, challenges, abilities, ability enhancers, and perceived benefits that arise in collaborative value creation (CVC). Data from 105 collaborations, collected through in-depth interviews, support the qualitative and quantitative analyses that reveal distinct patterns in customers’ value creation for each service offering. A categorical principal components analysis, combined with cluster analysis, identifies five customer roles: bargain-hunting independent, comprehensive help seeker, engaged problem solver, technology-savvy networker, and self-reliant customizer. Our theoretical contribution includes the identification of customer roles across generic offerings and empirical evidence that customers perform multiple roles when engaging in CVC processes. Our findings provide managers engaged in CVC with recommendations on criteria for segmenting customer groups, on the role of the service provider in various value creation processes, and on tailored communication strategies to attract customers.
Reproduction and the risk of multiple sclerosis
Authors: Magyari Melinda , Koch-Henriksen Nils , Pfleger Claudia C , Sørensen Per Soelberg
Published: March 2013

Background:

The incidence of multiple sclerosis (MS) in Denmark has doubled in women since 1970, whereas it has been almost unchanged in men.

Objectives:

To investigate whether age at first childbirth and number of births have an effect on the risk of developing MS.

Methods:

The cohort consisted of 1403 patients with MS of both sexes, identified through the Danish Multiple Sclerosis Registry, with clinical onset between 2000 and 2004. For each case, 25 control persons were drawn by random from the Danish Civil Registration System matched by sex, year of birth, and residential municipality.

Results:

More female cases than controls had no childbirths or fewer births before clinical onset ( p=0.018) but only in the last five years preceding onset ( p<0.0001). Childbirths within five years before clinical onset reduced the risk of MS onset in women: OR=0.54 (95% CI 0.41–0.70, p<0.0001) for one child and OR=0.68 (95% CI 0.53–0.87, p=0.002) for more than one child. Parental age at first childbirth had no effect on the risk of MS.

Conclusions:

The data did not suggest reversed causality between childbirth and MS.
Technologies of Captivation
Authors: Ash James
Published: March 2013

This article analyses the skills and knowledges involved in multiplayer first-person shooting games, specifically Call of Duty 4 for the Xbox 360 games console. In doing so, it argues that the environments of first-person shooting games are designed to be intense spaces that produce captivated subjects – users who play attentively for long periods of time. Developing Heidegger’s concept of attunement and Stiegler’s account of retention, the article unpacks the somatic and sensory skills involved in videogame play and discusses how videogame environments cultivate a sense of captivation. In conclusion the article reflects on the politics of captivation for the bodies that engage with these games through the idea of vulnerability as an ‘opening of the body’s capacity for sense’.
The Education of Affect
Authors: Hardy Kristen A.
Published: March 2013

This article examines the cultural dimensions of synthetic ‘body fat replicas’, anatomically modelled objects used in educational and medical settings to train subjects in particular affective responses to fat/ness. Specifically, I focus on theorizing the phenomenological experience of embodied engagements with such models, and exploring the manner in which the replicas are designed to participate in the shaping of emotional orientations toward one’s own body and those of others. Appealing to the work of contemporary social and cultural theorists, I consider how the capacity of objects to act as nexuses for the commingling of abstract and concrete, psychological and material, inner space and outer life, and meaning and affect situates these lumps of polyvinyl chloride as valuable aids to elucidating the cultural polyvalence of ‘fat’. This article is oriented around the application of a selection of insightful theoretical work, drawn from the multidisciplinary field of science and technology studies, as well as from sociological research on medicine and the body. I argue that, by moving toward an understanding of fat/ness as a phenomenon comprised, in Annemarie Mol’s terminology, of ‘multiple enactments’, we can better understand how ‘fat’ has come to embody particular sets of meanings and emotions in the context of a contemporary medicalized transnational culture.
Face, Authenticity, Transformations and Aesthetics in Second Life
Authors: Bloustien Geraldine F. , Wood Denise
Published: March 2013

In such 3D virtual environments (3DVEs) as Second Life, one can ‘be’ re-created as avatar in whatever form one wants to be, facilitated by extensive beauty and cosmetic industries to help the residents of this world achieve a particular kind of glamorous image – limited only by their imaginations and Linden Dollar accounts. Yet, others in 3DVEs are working hard to re-create their avatars to be replicas of their ‘offline’ selves, appearing as they do in actuality. Such phenomena provide a rich opportunity to explore the cultural contexts of ‘self-making’, the process of ‘becoming’ and the transformative, often transgressive, processes of ‘beauty practices’ as bodily praxis and serious play. Drawing on their international ethnographic research undertaken in Second Life, the authors explore the phenomenon of image, affect, subjectivity and representation in this alternative arena. We focus specifically on three interrelated and paradoxical aspects of self-making in this 3D virtual world: first, the ways in which many of our respondents described their avatar personae as symbolically representing their ‘authentic inner selves’; second, the ways our respondents used photography and video to verify and authenticate these ‘inner selves’, through capturing representations of their avatar bodies in action; and, third, the ways ‘authenticity’, for many of our respondents, depended on their avatar image aligning as closely as possible with their bodily appearance off-screen. The concept of what residents of Second Life understand as constituting the ‘authentic inner self’ both in and outside of the virtual world becomes particularly pertinent here.
Embodiment and Abjection
Authors: Russell Amy M.
Published: March 2013

Research into human trafficking for sexual exploitation often conceptualizes the experience through the lens of migration and/or sex work. Women’s bodies are often politicized and the corporeal experiences of trafficking are neglected. The gendered stigma attached to women who have been trafficked for sexual exploitation is clearly evident across cultures and requires further analysis as part of wider societal responses to sexual violence. Through the analysis of letters written by women who have been trafficked and sexually exploited from post-Soviet countries to Israel, this article argues that conceptualizing women’s bodies as bounded spaces allows an investigation of the transgression of those boundaries and opens up a thought-provoking framework for theorizing experiences of, and social responses to, sexual violence, stigma and social exclusion. It explores themes of pollution and dirt as ways to communicate social exclusion through references to boundaries crossed and spaces rendered abject. Women’s narratives of trafficking are examined utilizing the theory of abjection, and the embodied effects of sexual violence and body boundary transgression are elucidated. This analysis shows that the women in this study articulate an embodied narrative of trafficking that is experienced in relation to body boundaries and expressed through motifs of dirt, smell, disgust and pollution.
Consumption of a boiled Greek type of coffee is associated with improved endothelial function: The Ikaria Study
Authors: Siasos Gerasimos , Oikonomou Evangelos , Chrysohoou Christina , Tousoulis Dimitris , Panagiotakos Demosthenes , Zaromitidou Marina , Zisimos Konstantinos , Kokkou Eleni , Marinos Georgios , Papavassiliou Athanasios G , Pitsavos Christos , Stefanadis Christodoulos
Published: March 2013

Objective:

The association of coffee consumption with cardiovascular disease remains controversial. Endothelial function is associated with cardiovascular risk. We examined the association between chronic coffee consumption and endothelium function in elderly inhabitants of the island of Ikaria.

Methods:

The analysis was conducted on 142 elderly subjects (aged 66–91 years) of the Ikaria Study. Endothelial function was evaluated by ultrasound measurement of flow-mediated dilation (FMD). Coffee consumption was evaluated based on a food frequency questionnaire and was categorized as ‘low’ (< 200 ml/day), ‘moderate’ (200–450 ml/day), or ‘high’ (> 450 ml/day).

Results:

From the subjects included in the study, 87% consumed a boiled Greek type of coffee. Moreover, 40% had a ‘low’, 48% a ‘moderate’ and 13% a ‘high’ daily coffee consumption. There was a linear increase in FMD according to coffee consumption (‘low’: 4.33 ± 2.51% vs ‘moderate’: 5.39 ± 3.09% vs ‘high’: 6.47 ± 2.72%; p = 0.032). Moreover, subjects consuming mainly a boiled Greek type of coffee had a significantly higher FMD compared with those consuming other types of coffee beverages ( p = 0.035).

Conclusions:

Chronic coffee consumption is associated with improved endothelial function in elderly subjects, providing a new connection between nutrition and vascular health.
Peripheral artery disease is associated with severe impairment of vascular function
Authors: Kiani Soroosh , Aasen Jonathan G , Holbrook Monika , Khemka Abhishek , Sharmeen Farhana , LeLeiko Rebecca M , Tabit Corey E , Farber Alik , Eberhardt Robert T , Gokce Noyan , Vita Joseph A , Hamburg Naomi M
Published: March 2013

Patients with peripheral artery disease (PAD) have higher cardiovascular event rates than patients with established coronary artery disease (CAD) and abnormal endothelial function predicts cardiovascular risk in PAD and CAD. We investigated the hypothesis that PAD is associated with a greater degree of impairment in vascular function than CAD. We used several non-invasive tests to evaluate endothelial function in 1320 men and women with combined PAD and CAD ( n = 198), PAD alone ( n = 179), CAD alone ( n = 466), or controls aged > 45 years without CAD or PAD ( n = 477). Patients with PAD had lower brachial artery flow-mediated dilation (5.1 ± 3.9% PAD and CAD, 5.9 ± 4.4% PAD alone) compared to patients with CAD alone (7.0 ± 4.5%) and no PAD or CAD (8.1 ± 5.1%, p < 0.0001). In multivariable models adjusting for clinical covariates and the presence of CAD, PAD remained associated with lower flow-mediated dilation ( p < 0.0001). PAD was associated also with lower nitroglycerin-mediated dilation and reactive hyperemia. Patients with both PAD and CAD had a lower digital pulse amplitude tonometry (PAT) ratio in unadjusted models but not in adjusted models. Flow-mediated dilation was modestly associated with PAT ratio in patients with atherosclerotic disease ( r = 0.23, p < 0.0001) but not among control participants ( r = 0.008, p = 0.93). Our findings indicate that patients with PAD have greater impairment of vasodilator function and are consistent with the possibility that endothelial dysfunction may contribute to adverse cardiovascular prognosis in PAD.
The role of psychosocial factors in socioeconomic differences in physical activity: A population-based study
Authors: Lehto Elviira , Konttinen Hanna , Jousilahti Pekka , Haukkala Ari
Published: March 2013

Aims: Socioeconomic health inequalities are partly attributed to different physical activity (PA) patterns. Psychosocial factors interacting with PA are suggested to explain the socioeconomic differences in PA to some extent. The aim of the present study was to examine whether PA self-efficacy, PA social support, and general self-control contribute to the socioeconomic status (SES) differences in leisure time physical activity (LTPA) and in total PA. Methods: The sample consisted of 25–74-year-old Finnish men ( n = 2325) and women ( n = 2699), who participated in the cross-sectional FINRISK Study in 2007. Physical activity was measured as total PA (MET-h/week) and as LTPA (inactive/active). A psychosocial factor questionnaire included scales measuring PA self-efficacy, PA social support, and general self-control. SES was defined by household gross income and years of education. Results: Both higher education and income were associated with higher levels of LTPA, whereas total PA was higher among those with lower SES. Subjects with high SES reported higher levels of PA self-efficacy and PA social support, but general self-control correlated only with higher income. PA self-efficacy, PA social support and general self-control had positive associations with both LTPA and total PA. These psychosocial factors partly explained the SES differences in LTPA, but not in total PA. Conclusions: Future intervention studies should examine whether, by influencing PA self-efficacy, PA social support, and general self-control, it is possible to diminish the SES differences in PA.
Fifty-Four Emergent Cricothyroidotomies: Are Surgeons Reluctant Teachers?
Authors: King D. , Ogilvie M. , Michailidou M. , Velmahos G. , Alam H. , deMoya M. , Fikry K.
Published: March 2013

Background

Emergent cricothyroidotomy remains an uncommon, but life-saving, core procedural training requirement for emergency medicine (EM) physician training. We hypothesized that, although most cricothyroidotomies occur in the emergency department (ED), they are rarely performed by EM physicians.

Methods

We conducted a retrospective analysis of all emergent cricothyroidotomies performed at two large level one trauma centers over 10 years. Operators and assistants for all procedures were identified, as well as mechanism of injury and patient demographics were examined.

Results

Fifty-four cricothyroidotomies were performed. Patients were: mean age of 50, 80% male and 90% blunt trauma. The most common primary operator was a surgeon (n = 47, 87%), followed by an Emergency Medical Services (EMS) provider (n = 6, 11%) and a EM physician (n = 1, 2%). In all cases, except those performed by EMS, the operator or assistant was an attending surgeon. All EMS procedures resulted in serious complications compared to in-hospital procedures (p < 0.0001).

Conclusions

1. Pre-hospital cricothyroidotomy results in serious complications. 2. Despite the ubiquitous presence of emergency medicine physicians in the ED, all cricothyroidotomies were performed by a surgeon, which may represent a serious emergency medicine training deficiency.
Proximal Bowel Necrosis after High Ligation of the Inferior Mesenteric Artery in Colorectal Surgery
Authors: Tsujinaka S. , Kawamura Y. J. , Tan K.-Y. , Mizokami K. , Sasaki J. , Maeda T. , Kuwahara Y. , Konishi F. , Lefor A.
Published: March 2013

Background and Aims

High ligation of the inferior mesenteric artery may jeopardize blood supply to the proximal bowel. We undertook this study to review the clinical features and outcomes of patients who developed proximal bowel necrosis after high ligation of the inferior mesenteric artery, and to assess the incidence and the risk factors for this complication.

Materials and Methods

A retrospective analysis of patients undergoing high or low ligation for sigmoid colon and rectal cancer with a primary anastomosis between April 2004 and March 2009 was performed. Patient and tumor characteristics and the incidence of bowel necrosis were reviewed.

Results

Four hundred and nine patients were included to the analysis. Six out of 302 patients (2.0%) with high ligation developed proximal bowel necrosis, while the remaining 107 patients with low ligation did not suffer from this complication. All patients who developed proximal bowel necrosis underwent secondary surgery with resection of necrotic bowel. The pathological examination of the resected specimen revealed mucosal to transmural ischemic necrosis without the evidence of vascular thrombosis or embolic occlusion. Univariate analysis revealed that advanced age, cerebrovascular disease, and hypertension were significantly associated with proximal bowel necrosis. Multivariate analysis demonstrated that cerebrovascular disease was an independent predictor of this complication. Of these six patients, two died from associated complications.

Conclusions

Proximal bowel necrosis after high ligation is potentially fatal, and this report provides a warning in clinical settings where high ligation is indicated. Further studies are warranted to evaluate its distinct relationship with high ligation and to clarify whether low ligation would be a safeguard.
Survival after Adjuvant Chemoradiotherapy or Surgery Alone in Resectable Adenocarcinoma at the Gastro-Esophageal Junction
Authors: Kofoed S. C. , Muhic A. , Baeksgaard L. , Jendresen M. , Gustafsen J. , Holm J. , Bardram L. , Brandt B. , Brenø J. , Svendsen L. B.
Published: March 2013

Background and Aims

Longterm survival after curative resection for adenocarcinoma at the gastro-esophageal junction (GEJ) range between 18% and 50%. In the pivotal Intergroup-0116 Phase III trial by Macdonald et all, adjuvant chemoradiotherapy improved both disease-free and overall survival in curatively resected patients with mainly gastric adenocarcinoma. We compared survival data for curatively resected patients with adenocarcinoma solely at the gastro-esophageal junction (GEJ), treated with surgery alone or surgery and adjuvant chemoradiotherapy.

Methods

From 2003 to 2009, 211 patients underwent curative resection. Surgery alone was performed in 95 patients and 116 patients received adjuvant therapy after resection. All patients underwent Lewis-Tanner operation with D1 node resection including coliac nodes (D1+). Informations about recurrence and death were collected from the Danish Cancer Register and the Central Death Register. Patients who died after experiencing severe complications after surgery were excluded from the survival analysis. Patients with T0N0 or T1N0 were also excluded because patients of this category were not given adjuvant therapy according to the Macdonald protocol.

Results

Patients with positive node status in the resected specimen, the 3-year disease-free survival after adjuvant chemoradiotherapy (n = 91) or surgery alone (n = 43) was 24% and 37%, respectively. Median time of survival was prolonged by 10 month in favour of those who received chemoradiotherapy. However, after controlling for the confounding effect of age and node status, only positive node status in the resected specimen had significant partial effect on survival.

Conclusion

Chemoradiotherapy according to the Intergroup-0116 protocol might still be a reasonable option after curative resection in patients with GEJ adenocarcinomas and positive lymph node status, who did not receive neoadjuvant chemotherapy.
The Introduction of a Laparoscopic Liver Surgery Programme: A Cost Analysis of Initial Experience in a University Hospital
Authors: Stoot J. H. M. B. , van Dam R. M. , Coelen R. J. S. , Winkens B. , Damink S. W. M. Olde , Bemelmans M. H. A. , Dejong C. H. C.
Published: March 2013

Background and Aims

In the era of expanding costs of healthcare, this study was conducted to perform a cost analysis of introducing a laparoscopic liver surgery programme for left sided liver lesions.

Materials and Methods

Consecutive patients treated by laparoscopic liver resections of left lateral segments were included. Controls were a group of 14 patients undergoing open resection for similar pathology. Primary outcomes were costs. Secondary outcomes were complications, conversions, blood loss, length of operation, and length of hospital stay.

Results

The laparoscopic approach for hepatic left lateral resection (bisegmentectomy 2 and 3) was performed in fourteen patients (group I, median age 54 [range 26–82] years). In the open group, fourteen patients from a prospectively collected database with the same type of resection were selected (group II, median age 64 [range 29–76] years). Costs of theatre usage in the laparoscopic group were significantly lower (p = 0.031). No significant differences in costs of disposable instruments, ward stay and total costs were observed between the two groups. There were three complications in the laparoscopic group compared with two complications in the open group. In the laparoscopic group there were 2 conversions (14%). Median blood loss was significantly lower in the laparoscopic group (50 mls [range 0–750], (p = 0.001) versus the open group (500 mls [range 150–750]). Furthermore, operation time was also significantly lower in the laparoscopic group (116 [range 85–261] minutes) versus the open group (165 [range 96–217] minutes, p = 0.016). Median length of stay was 6 [range 4–11] days in group I versus 6 [range 5–13] days in group II (p = 0.508).

Conclusion

Costs of laparoscopic liver resections proved to be equivalent to open surgery. Furthermore, implementation of a laparoscopic liver resection programme seems feasible and safe with reduced blood loss and operation time and comparable morbidity and length of stay.
Preliminary Study Analyzing the Methylated Genes in the Plasma of Patients with Pancreatic Cancer
Authors: Park J. W. , Baek I. H. , Kim Y. T.
Published: March 2013

Background and Aims

CpG islands of the promoter region of some genes are methylated in pancreatic cancer tissue and the detection of this methylation has been suggested to be useful in the diagnosis of various cancers. The aim of this study was to investigate whether the detection of methylated CpG islands in plasma can be used in the diagnosis of pancreatic cancer.

Material and Methods

Plasma DNA was collected from patients with pancreatic cancer, chronic pancreatitis, and healthy controls. The methylation status of six genes, UCHL1, NPTX2, SARP2, ppENK, p16, and RASSF1A, was checked by methylation-specific PCR and was subsequently confirmed by direct sequencing after bisulfite treatment.

Results

CpG island methylation was detectable in 13 of 16 patients (81.3%) with pancreatic cancer, 1 of 29 healthy controls (3.5%), and 8 of 13 patients with chronic pancreatitis (61.5%). The mean number of genes with CpG island methylation was 1.6 ± 1.2 in pancreatic cancer, 0.04 ± 0.19 in healthy controls, and 1.2 ± 1.1 in chronic pancreatitis. Among six genes, p16 was more specifically methylated in pancreatic cancer compared with chronic pancreatitis ( p = 0.016). The methylation status was not correlated with smoking history, tumor size, or cancer stage.

Conclusions

The detection of methylated genes in the plasma may have a role in differentiating between pancreatic cancers and healthy controls but not between pancreatic cancer and chronic pancreatitis.
Characteristics and Differences in Necrotizing Fasciitis and Gas Forming Myonecrosis: A Series of 36 Patients
Authors: Tilkorn D. J. , Citak M. , Fehmer T. , Ring A. , Hauser J. , Benna S. Al , Steinstraesser L. , Roetman B. , Steinau H.-U.
Published: March 2013

Background and Aims

Necrotizing fasciitis (NF) and gas forming myonecrosis (GFM), both being subtypes of necrotizing soft tissue infection (NSTI), are life threatening conditions sharing certain similarities. Despite the necessity of early and radical surgical debridement in necrotizing infections, the distinction between these entities is of clinical relevance since gas forming myonecrosis in a number of cases results from an underlying abdominal cause and the focus of infection can be missed. This study was to evaluate the incidence and risk factors as well as the mortality rate in patients with NSTI and GFM.

Material and Methods

All patients with NSTI treated in the authors' hospital between January 2005 and December 2009 were enrolled in the study. Medical records, histological slides, microbiological and laboratory parameters as well as Computerized Tomography (CT) and magnetic resonance imaging (MRI) scans were reviewed for all patients. Differences between NF and GFM regarding hospital stay, number of surgical interventions and pre-existing comorbidities as well as mortality rate were analyzed. The laboratory risk factor for necrotizing fasciitis (LRINEC) score was calculated in all patients on admission.

Results and Conclusions

Thirty patients (17 female, 13 male) with necrotizing fasciitis with a mean age of 55 years (SD 15.5) were included in the study. There was no statistically significant difference between survivors and deceased patients comparing the LRINEC score (n.s.). Patients with necrotizing fasciitis secondarily involving the trunk had a significantly higher mortality rate (OR 11.2; 95% CI = 1.7–72.3). In the majority of cases (12 cases), minor skin lesions were identified as the site of origin. Amongst all necrotizing soft tissue infections six patients (female n = 3; male n = 3) with a mean age of 61.5 years (SD 12.2) with non-clostridial gas forming myonecrosis were identified. Three patients had a history of malignancy and in three patients the infection was secondary to major surgery. The mean LRINEC score was 8.5 (SD 1). Three patients (50%) died due to GFM. Early diagnosis and appropriate intervention is critical to provide accurate treatment decisions. Eradicating the differing primary sources of infection in GFM and NF will have a positive impact on outcome.