bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposiciones rábicas en Colombia: evaluación del sistema de vigilancia desde los actores
Authors: Roncancio-Melgarejo Claudia P. , Buitrago-Medina Daniel A. , Posada-Zapata Isabel C. , Grisales-Romero Hugo
Published: October 2015

Objetivo: identificar la percepción que tienen los actores frente a los atributos del sistema de vigilancia de las exposiciones rábicas para generar las recomendaciones que se requieran. Metodología: se utilizó la teoría fundada hasta análisis de categorías interpretativas; once entrevistas semiestructuradas enmarcadas en los atributos considerados por los Centros de Control y Prevención de Enfermedades (CDC) para la evaluación de sistemas de vigilancia se realizaron a personas con un rol activo (desde notificación hasta administrador del sistema), en los departamentos con mayor y menor notificación del evento en el país. Resultados: emergieron catorce categorías descriptivas relacionadas con los nueve atributos, sistema de vigilancia, rabia y propuestas para la mejora; de éstas, cinco categorías analíticas las enmarcan con recursos para la operación, experiencia, control directo de la rabia y papel de los actores en el proceso. Se destacó la importancia del sistema en la recolección de información en Salud Pública; se desconocen publicaciones relacionadas y se percibió como baja la participación de los actores en la planificación. Se manifestaron dificultades con la calidad de la información: clasificación de casos, afectando la representatividad y sensibilidad. La aceptabilidad se relaciona con las tareas del sistema y el tiempo dedicado al proceso. La oportunidad varía en procesos de notificación y ajuste.Conclusiones: la percepción sobre los atributos denota la articulación de conceptos del sistema y la experiencia adquirida; aspectos positivos como representatividad e historia y negativos relacionados con calidad, sensibilidad, utilidad y aceptabilidad. Recomendaciones: realizar publicaciones y mejorar la participación en la planificación del sistema.
Prácticas culturales y gestión del riesgo sísmico: la cultura de las buenas costumbres
Authors: Zambrano-Hernández Lina A. , Gómez Serna Edwin A.
Published: October 2015

Objetivo: reconocer y comprender las prácticas culturales y sentidos referidos a la gestión del riesgo sísmico de un grupo poblacional que ha vivido diversas situaciones de este tipo, en la ciudad de Manizales, Caldas. Metodología: este estudio se ubicó en el campo de la investigación cualitativa, basado en la micro-etnografía y el análisis cualitativo, asumiendo como fundamento que la investigación de este tipo centra sus análisis en el contexto histórico cultural de las comunidades. Resultados: las prácticas culturales relacionadas con la gestión del riesgo son creaciones de significado que a partir del saber popular se configuran con su particular modelo de internalización cultural frente al fenómeno sísmico. Este proceso de aprendizaje comunitario se soporta a partir de convenciones morales y valores familiares que apremian desde una ideología de prevención y supervivencia, lo que se constituye para dicha comunidad en un hecho legítimo. Por otra parte, se encuentra, la no apropiación simbólica del conocimiento de carácter técnico-científico, situación que genera resistencias comunitarias a la apropiación de los nuevos contenidos, por no sentir un verdadero respeto e inclusión de su tradición cultural. Conclusión: la gestión del riesgo no es sólo la reducción de éste, sino la comprensión social de las prácticas culturales, de conductas y modos de vida (incluso de ideologías y de perspectivas de mundo, de vida, de religión), que en términos sociales, requiere de la participación de los diversos estratos, sectores de interés y grupos representativos, y así, reconocer cómo se construye en colectivo la gestión del riesgo como una cultura de las buenas costumbres.
Arte y música en la educación obligatoria, algo más que un detalle curricular de buen tono
Authors: Cabedo-Mas Alberto , Díaz-Gómez Maravillas
Published: October 2015

Arts and Music Education can be powerful vehicles for values education that promotes the acquisition of skills focused on learning to live together. However, the new Spanish Educational legislation neglects in its curriculum development the possibilities of art to improve coexistence. This study analyzes the views of 23 graduate students of a master's degree focused on educational psychology and specific teaching. Such opinions are collected through a qualitative questionnaire that, from a selection of certain texts, includes some questions that delve into the main theme, which is then the object of joint reflection with the interviewer. Data were analyzed using interpretive phenomenological analysis techniques. The results support the view extolling the possibilities of Arts and Music Education as a tool for improving coexistence in and beyond the school and confirm the need for recognition by legislators, educators and institutions as well as the requirement of promoting a responsive and inclusive attitude towards Arts in school.
Compared the Activation System Dependent People
Authors: Majidi Rezgar , Yarahmadi Yahya
Published: October 2015

The purpose of this study compared, the activation system dependent people, glass, opium and ordinary on the basis of revised reinforcement sensitivity theory was. Therefore, of among the population of through available sampling a total of 90 people in three groups of 30 selected, and data were collected using a questionnaire Gary – Wilson. The results of analysis of variance showed that between the activation system dependent people, glass, opium and ordinary there is a significant difference. Also Tukey test results showed that between ordinary people and dependent people of glass, and ordinary people and dependent people of opium in behavioral activation system were significant differences, but in the activation system between the members of glass and opium, significant difference was not observed
Adiposopathy and Obesity Paradox
Authors: Sukmawati Indriyanti Rafi , Wijaya Andi
Published: October 2015

BACKGROUND: Obesity has reached global epidemic proportions in both adults and children and is associated with numerous comorbidities, including hypertension, type 2 diabetes mellitus (T2DM), dyslipidemia and major cardiovascular diseases (CVD).CONTENT: Adiposity may cause adipocyte and adipose tissue anatomic and functional abnormalities, termed adiposopathy (adipose-opathy) or "sick fat," that result in endocrine and immune derangements. Adiposopathy may directly contribute to CVD through pericardiac and perivascular effects on the myocardium and blood vessels. Adiposopathy may also indirectly contribute to CVD through promoting or worsening major CVD risk factors such as T2DM, high blood pressure, and dyslipidemia. Despite this adverse association, numerous studies have documented an obesity paradox in which overweight and obese people with established CVD, including hypertension, heart failure, coronary heart disease, and peripheral arterial disease, have a better prognosis compared with nonoverweight/nonobese patients. These paradoxical findings are made less paradoxical when the pathogenic potential of excessive body fat is assessed based on adipose tissue dysfunction rather than simply on increased fat mass alone.SUMMARY: Adiposopathy is defined as pathological adipose tissue function that may be promoted and exacerbated by fat accumulation (adiposity) and sedentary lifestyle in genetically susceptible patients. Adiposopathy is a root cause of some of the most common metabolic diseases observed in clinical practice, including T2DM, hypertension and dyslipidemia.KEYWORDS: adiposopathy, adiposity, obesity paradox, adipocyte dysfunction, adipose hypertrophy, adipose hyperplasia
Perivascular Adipose Tissue and Cardiometabolic Disease
Authors: Meiliana Anna , Wijaya Andi
Published: October 2015

BACKGROUND: Obesity is associated with insulin resistance, hypertension, and cardiovascular disease, but the mechanisms underlying these associations are incompletely understood. Microvascular dysfunction may play an important role in the pathogenesis of both insulin resistance and hypertension in obesity.CONTENT: Perivascular adipose tissue (PVAT) is a local deposit of adipose tissue surrounding the vasculature. PVAT is present throughout the body and has been shown to have a local effect on blood vessels. The influence of PVAT on the vasculature changes with increasing adiposity. PVAT similarly to other fat depots, is metabolically active, secreting a wide array of bioactive substances, termed ‘adipokines’. Adipokines include cytokines, chemokines and hormones that can act in a paracrine, autocrine or endocrine fashion. Many of the proinflammatory adipokines upregulated in obesity are known to influence vascular function, including endothelial function, oxidative stress, vascular stiffness and smooth muscle migration. Adipokines also stimulate immune cell migration into the vascular wall, potentially contributing to the inflammation found in atherosclerosis. Finally, adipokines modulate the effect of insulin on the vasculature, thereby decreasing insulin-mediated muscle glucose uptake. This leads to alterations in nitric oxide signaling, insulin resistance and potentially atherogenesis.SUMMARY: PVAT surrounds blood vessels. PVAT and the adventitial layer of blood vessels are in direct contact with each other. Healthy PVAT secretes adipokines and regulates vascular function. Obesity is associated with changes in adipokine secretion and the resultant inflammation of PVAT. The dysregulation of adipokines changes the effect of PVAT on the vasculature. Changes in perivascular adipokines secretion in obesity appear to contribute to the development of obesity-mediated vascular disease.KEYWORDS: obesity, perivascular adipose tissue, PVAT, cardiometabolic disease, adipokine
Concentration of Endogenous Secretory Receptor for Advanced Glycation End Products and Matrix Gla Protein in Controlled and Uncontrolled Type 2 Diabetes Mellitus Patients
Authors: Daulay Dwi Yuniati , As'ad Suryani , Mappahya Ali Aspar , Wijaya Andi
Published: October 2015

BACKGROUND: Advanced glycation end products (AGE) and their receptor (RAGE) system play an important role in the development of diabetic vascular complications. Recently, an endogenous secretory RAGE (esRAGE) has been identified as a novel splice variant, which lacks the transmembrane domain and is secreted in human sera. Interestingly, it was reported that esRAGE binds AGE ligands and neutralizes AGE actions. Many studies have reported that diabetes mellitus correlates with vascular calcification event and increases progressively in uncontrolled diabetes. Matrix Gla Protein (MGP) is known to act as an inhibitor in vascular calcification. The aim of this study was to observe progress of vascular calcification in uncontrolled diabetes patient by biochemical markers MGP as inhibitor in vascular calcification, via mechanism of AGEs.METHODS: This study was an observational study with cross sectional design on adult type 2 diabetic male patients who were defined by the 2011 Indonesian diabetes mellitus consensus criteria.RESULTS: The results of this study showed that there was a positive significant correlation between esRAGE and HbA1C (r=0.651, p=0.009), and negative correlation between MGP and HbA1C (r=-0.465, p=0.081) in controlled diabetes group. In uncontrolled diabetes group there was a positive significant correlation between MGP and HbA1C (r=0.350, p=0.023), despite the fact esRAGE showed no significant correlation with HbA1C. There was no significant difference in level of esRAGE and MGP in controlled and uncontrolled diabetes group, but MGP showed lower level in uncontrolled diabetes group, contrary to esRAGE that had higher concentration.CONCLUSION: In diabetes condition, complications of vascular calcification are caused by the mechanism of increased AGE formation represented by esRAGE. In diabetes control it is very important to keep the blood vessels from complications caused by vascular calcification.KEYWORDS: type 2 diabetes mellitus, vascular calcification, esRAGE, MGP, HbA1C
Altered Level of Soluble fms-like Tyrosine Kinase 1 (sFlt1) and Hypoxia Inducible Factor-1alpha (HIF-1alpha) in Normotensive Pregnancy and Preeclampsia
Authors: Wantania John , Bakri Syakib , Pandelaki Karel , Chalid Maisuri
Published: October 2015

BACKGROUND: Preeclampsia is still a significant problem worldwide. Of the many suggested mechanisms of its pathogenesis, the latest one is the balance of angiogenic factor and its relationship with hypoxia factors. The objective of this study was to observe changes or dynamic process of soluble fms-like tyrosine kinase 1 (sFlt1) as anti-angiogenic factor and hypoxia inducible factor 1-alpha (HIF-1α) as hypoxia marker in normotensive pregnancy and preeclampsia in mid-term and full-term pregnancies.METHODS: A cohort study was conducted on 36 normotensive subjects, first examination was conducted at 20-28 weeks of gestation. Then second examination was conducted at the time of preeclampsia diagnosed or full-term pregnancy. Preeclampsia was characterized by hypertension of systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, with two readings separated in 4-6 hours period, and/or proteinuria with urine dipstick of ≥1+ or ≥300 mg per 24 hours. Examinations of sFlt-1 and HIF-1α were done by enzyme-linked immunosorbent assay method. Statistical analysis was done using a significance level of p<0.05.RESULTS: Concentration of sFlt-1 was elevated in normotensive pregnancy and preeclampsia. Higher sFlt-1 concentration elevation was seen in preeclamptic group comparing to normotensive group, although not significant. This finding was related to the fact that investigated subjects were mostly developing mild preeclampsia merely. Comparing to normotensive group, preeclamptic group had higher HIF-1α concentration-per-week elevation, but not significant. There was a positive correlation between concentrations of sFlt-1 and HIF-1α, but not significant.CONCLUSION: sFlt-1 concentration elevation was correlated with preeclampsia. Therefore comparing to averages, changes of sFlt-1 concentrations were more important. Concentrations of HIF-1α and sFlt-1 were positively correlated.KEYWORDS: sFlt-1, HIF-1α, preeclampsia, normotension
Vascular Stem Cells in Vascular Remodeling and Diseases
Authors: Meiliana Anna , Wijaya Andi
Published: October 2015

BACKGROUND: Blood vessels are a source of stem and progenitor cells, which likely contribute to a variety of vascular processes and diseases. Emerging concepts in this field could influence therapeutic approaches to diseases of blood vessels such as atherosclerosis.CONTENT: Vascular Stem Cells (VSCs) field is only beginning to emerge, and thus, many issues regarding VSCs’s identity and function remain poorly understood. In fact, even after decades of intensive research, Mesenchymal Stem Cells (MSC), which is suggested to be VSCs, is still having many outstanding issues of its own. And, on top of this, likewise decades-long intensive pericyte research has not been able resolve the identity issue. While favors Adventitial Progenitor Cells (APCs) over pericytes as the likely VSC candidate, it should be pointed out that currently the opposite view (i.e., pericytes as VSCs) is more prevalent, and many excellent reviews, including a recent one, have discussed this issue extensively.SUMMARY: It has been postulated that, within the vasculature, APCs could differentiate into pericytes (CD34- CD31- CD140b+ SMA-), endothelial cells (CD34+ CD31+ CD140b- SMA-), and smooth muscle cells (SMCs) (CD34- CD31- CD140b- SMA+); and during tissue expansion or repair, APCs could also differentiate into tissue-specific cell types (e.g., muscle and fat) Thus, in vitro, APCs fulfill all criteria for being VSCs. Meanwhile, in vivo evidence is still limited and will require further investigation.KEYWORDS: vascular stem cells, VSC, mesenchymal stem cells, MSC, endothelial progenitor cells, EPC, adventitial progenitor cells, APC
The Pharmacogenetics of Cytochrome P450 2C19 Enzymes - Effects on Clopidogrel and Proton Pump Inhibitors
Authors: Yusmiati Yusmiati , Muliaty Dewi
Published: October 2015

BACKGROUND: Cytochrome P450 (CYP) enzymes play important roles in human, including drug metabolism. CYP2 is the largest family of human CYP, with its sequence comprising almost one third of all CYP sequences, and responsible for the metabolism of approximately 2% of clinically administrated drugs. One of the most important enzymes in this family is the CYP2C19 enzyme. The CYP2C19 gene is polymorphic, and the variation is common especially in the Asian population.CONTENT: CYP2C19 is responsible for the metabolism of various drugs, including proton pump inhibitors (PPIs) such as omeprazole and lansoprazole, psychotropic drugs including diazepam and imipramine, anticonvulsants such as phenobarbital and mephenytoin. and the recently most studied the anti-platelet drug, clopidogrel, and many others. Drugs metabolized predominantly by this enzyme like clopidogrel and PPIs might be much affected by the genotype status of CYP2C19. Clopidogrel is a pro-drug requiring a group of enzymes to convert to its active form, particularly the CYP2C19. PPIs are metabolized to its inactive metabolites mainly by CYP2C19 in the liver. Some PPIs are inhibitor of CYP2C19 enzymes, and interaction of PPIs and clopidogrel has been widely studied.SUMMARY: The association of CYP2C19 genotypes with the plasma level of active clopidogrel and platelet reactivity in individual taking this drug is well-established. Although conflicting results still exist for the association of CYP2C19 genotypes to the clinical outcomes of clopidogrel therapy, this effect seems to be consistent in patients receiving clopidogrel for coronary stents. Due to the interaction of certain PPIs and clopidogrel, the use of PPIs other than omeprazole is recommended, especially for patients taking dual anti platelet therapy of clopidogrel and aspirin.KEYWORDS: pharmacogenetics, CYP2C19, proton pump inhibitors, clopidogrel
Dynamic Pattern of Interleukin-1beta and -10 in Cerebrospinal Fluid following Aneurysmal Subarachnoid Hemorrhage
Authors: Yunus Yesaya , July Julius , Islam Andi Asadul , Wahjoepramono Eka Julianta , Yusuf Irawan
Published: October 2015

BACKGROUND: Inflammation following aneurysmal subarachnoid hemorrhage (SAH) is associated with patient outcome. This study aimed to analyze the dynamics pattern of the pro-inflammatory interleukin (IL)-1β and anti-inflammatory cytokine IL-10 in the cerebrospinal fluid (CSF) following aneurysmal SAH.METHODS: This is a prospective observational study. The CSF was collected prior to surgery, and on the 2nd, 4th and 6th days after surgery. The CSF was then analyzed for IL-1β and -10 using enzyme-linked immunosorbent assay. Delayed Ischemic Neurological Deficits (DIND) was determined based on new neurological deficits within the first week after surgery. Data was analysed with T test or Wilcoxon Rank-Sum test to evaluate the pattern of biomarkers between DIND and non-DIND groups.RESULTS: There were 33 patients enrolled in this study, 16 patients (48.48%) who experienced DIND and 17 patients (51.52%) were non-DIND. There were significant increase dynamic levels of IL-10 and -1β in DIND patients (p<0.05).CONCLUSION: Significant increase levels of IL-10 and -1β in CSF after aneurysmal SAH are associated with DIND.KEYWORDS: IL-1β, IL-10, DIND
Role of Postmortem Multislice Computed Tomography Scan in Close Blunt Head Injury
Authors: Sidipratomo Prijo , Prija Trijono Karmawan Sukana , Murtala Bachtiar , Purwadianto Agus , Lawrence Gatot Susilo
Published: October 2015

BACKGROUND: Conventional autopsy in Indonesia is not well accepted as it is contrary to religion and culture. New radiological imaging method such as multislice computed tomography (MSCT) scan has potential to be a diagnostic tool in forensic pathology. The purpose of this study is to determine the ability of MSCT scan in finding abnormalities in close blunt head injury compared with autopsy.METHODS: This study used descriptive qualitative method. Postmortem cases in Department of Forensic Medicine and Radiology of Dr. Cipto Mangunkusumo Hospital were selected based on inclusion criteria. Then MSCT scan and autopsy were conducted. MSCT scan and autopsy results were compared and analyzed.RESULTS: There were 491 postmortem cases of blunt head injury. However, only 10 cases fulfilled inclusion criteria. Subarachnoid haemorrhages were identified 100% with MSCT scan and 80% with autopsy. Cerebral oedemas were identified 100% either with MSCT scan and autopsy. Subdural haemorrhages were identified 100% with MSCT scan, while 50% with autopsy. Multiple fractures were identified 80% with MSCT scan, while 40% with auto.CONCLUSION: MSCT scan showed a sensitive detection in finding abnormalities in close blunt head injury. Therefore it could be as an alternative choice of examination in close blunt head injury cases.KEYWORDS: multislice computed tomography scan, postmortem, blunt head injury, autopsy
Application of Umbilical Cord Blood Stem Cells in Regenerative Medicine
Authors: Meiliana Anna , Wijaya Andi
Published: October 2015

BACKGROUND: Since the first umbilical cord blood (UCB) transplant, performed 25 years ago, UCB banks have been established worldwide for the collection and cryopreservation of UCB for autologous and allogeneic transplants.CONTENT: Much has been learned in a relatively short time on the properties of UCB hematopoietic progenitors and their clinical application. More interestingly, non-hematopoietic stem cells have been isolated from UCB. These cells can be grown and differentiated into various tissues including bone, cartilage, liver, pancreas, nerve, muscle and so on. The non-hematopoietic stem cells have an advantage over other sources of stem cells, such as embryonic stem cells or induced pluripotent stem cells, because their supply is unlimited, they can be used in autologous or allogeneic situations, they need minimal manipulation and they raise no ethical concerns. Future studies will test the potential of UCB cells for the treatment of several diseases including, among other possibilities, diabetes, arthritis, burns, neurological disorder and myocardial infarction.SUMMARY: In addition to hematopoietic stem cells, UCB contain a large number of non-hematopoietic stem cells. In the absence of ethical concern, the unlimited supply of UCB cells explains the increasing interest of using UCB for developing regenerative medicine.KEYWORDS: UCB, transplantation, UCB bank, HSC, MSC, CD34, CD133, VSEL
Brucea javanica Leaf Extract Induced Apoptosis in Human Oral Squamous Cell Carcinoma (HSC2) Cells by Attenuation of Mitochondrial Membrane Permeability
Authors: Wicaksono Britanto Dani , Tangkearung Enos , Sandra Ferry
Published: October 2015

BACKGROUND: Brucea javanica extract has been reported to have anti-proliferative and cell death induction activities. B. javanica extract was reported to induce apoptosis through caspase cascade. Most of investigated B. javanica extracts were derived from seeds and fruits, or commercially available oil emulsion. Therefore we conducted a study on B. javanica leaf extract (BJLE) in oral cancer cells.METHODS: B. javanica leaves were collected, identified, minced, dried, extracted with distilled ethanol at room temperature for 24 hours, filtered and evaporated. Resulted BJLE was stored at 4°C. Human oral squamous cell carcinoma (HSC)-2 cells were fasted for 12 hours and treated with BJLE in various concentrations for 24 hours. Cells were then quantified with 3-(4,5-dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium bromide (MTT) assay, demonstrated with 4',6'-diamidino-2-phenylindole (DAPI) staining. To find out mitochondrial membrane permeability (MMP), mitochondrial membrane potential (ΔΨM) was analyzed.RESULTS: BJLE reduced percentage of viable HSC-2 cells in a concentration dependent manner. BJLE induced apoptosis in HSC-2 cells. With treatment of 50 μg/ml BJLE, fragmented nuclei were seen. ΔΨM of HSC-2 cells treated with 50 μg/ml BJLE were shifted to the left, meaning that BJLE induced reduction of ΔΨM and attenuation of MMP.CONCLUSION: Our results suggested that BJLE could induce apoptosis by attenuating MMP.KEYWORDS: Brucea javanica, leaf, apoptosis, HSC-2, MTT, DAPI, mitochondria, permeability
Γνώσεις και στάσεις των επαγγελματιών υγείας στη χρήση των εναλλακτικών θεραπειών
Authors: Ανδρικόπουλος Αλέξανδρος , Ρεκλείτη Μαρία , Σαρίδη Μαρία , Κατρή Ειρήνη , Πατελάκης Αθανάσιος , Σουλιώτης Κυριάκος
Published: October 2015

Πρόσφατα φαίνεται να υπάρχει ενδιαφέρον για τις συμπληρωματικές θεραπείες, με αποτέλεσμα να παρατηρείται αξιοσημείωτη αύξηση της χρήσης τους. Σκοπός: της μελέτης ήταν η διερεύνηση των γνώσεων και των στάσεων των επαγγελματιών υγείας, που εργάζονται σε ένα γενικό περιφερειακό νοσοκομείο, ως προς τη χρήση των εναλλακτικών θεραπειών στη θεραπευτική τους πρακτική. Υλικό και Μέθοδος: Τον μελετώμενο πληθυσμό αποτέλεσαν 234 επαγγελματίες υγείας του Γενικού Νοσοκομείου επαρχιακής πόλης. Χρησιμοποιήθηκε έγκυρο και ανώνυμο ερωτηματολόγιο. Η συλλογή των δεδομένων πραγματοποιήθηκε από το Μάρτιο ως το Μάιο του 2013 και η στατιστική ανάλυση των δεδομένων έγινε με το πρόγραμμα SPSS 17.0 (p < 0.05). Αποτελέσματα: Το γενικό προφίλ των συμμετεχόντων ήταν κυρίως γυναίκες (75.6%) νοσηλεύτριες (56.9%), απόφοιτοι ΤΕΙ (46.1%), με μέσο όρο ηλικίας τα 47,08 ± 9,18 έτη και έγγαμες (62.3%). Η πλειοψηφία του δείγματος γνώριζε, τι είναι οι εναλλακτικές θεραπείες και που εφαρμόζονται (79,2%, n=186), ενώ οι 79 (33,8%) δήλωσαν ότι είχαν καταφύγει τουλάχιστον μία φορά σε κάποια μορφή εναλλακτικής θεραπείας, με το 61,5% (n=143), να δηλώνει αρκετά/πολύ ικανοποιημένο από τα αποτελέσματα των θεραπειών αυτών. Το 91% (n=211) των συμμετεχόντων θεωρούσε απαραίτητη την εποπτεία για την εφαρμογή των εναλλακτικών θεραπειών και οι περισσότεροι συμμετέχοντες πληροφορήθηκαν για αυτές τις μεθόδους από άλλους επαγγελματίες υγείας (38,8%), το φιλικό η συγγενικό περιβάλλον τους (38%) και το διαδίκτυο (34,6%). Συμπεράσματα: Οι εναλλακτικές θεραπείες αποτελούν μια σύγχρονη συνεργατική προσέγγιση της θεραπευτικής, με αποτέλεσμα να γίνεται ανάγκη η απόκτηση εξειδικευμένης γνώσης για τους επαγγελματίες υγείας.
Heterogeneity in Trajectories of Child Maltreatment Severity: A Two-Part Growth Mixture Model
Authors: Yampolskaya Svetlana , Greenbaum Paul E. , Brown C. Hendricks , Armstrong Mary I.
Published: October 2015

This study examined the trajectories of maltreatment severity and substantiation over a 24-month period among children (N = 82,396) with repeated maltreatment reports. Findings revealed 2 different longitudinal patterns. The first pattern, Elevated Severity, showed a higher level of maltreatment during the initial incident and increased maltreatment severity during subsequent incidents, but the substantiation rates for this class decreased over time. The second pattern, Lowered Severity, showed a much lower level of severity, but the likelihood of substantiation increased over time. The Elevated Severity class was composed of children with an elevated risk profile because of both individual and contextual risk factors including older age, female gender, caregivers’ substance use problems, and a higher number of previous maltreatment reports. Implications of the findings are discussed.
Survivors of Homicide: Mental Health Outcomes, Social Support, and Service Use Among a Community-Based Sample
Authors: Rheingold Alyssa A. , Williams Joah L.
Published: October 2015

This study aims to explore rates of bereavement-related mental health outcomes and diagnostic comorbidity along with the associations between mental health outcomes, perceived social support, knowledge of services, and service use among a diverse sample of 47 survivors 2 years postloss. Findings are consistent with prior studies in that homicide is associated with an overlapping of significant symptom presentation of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and complicated grief (CG). Lack of grief-specific social support was demonstrated to be associated with PTSD and MDD but not with CG. Although a significant number of survivors reported poor mental health outcomes, a limited number were using services.
The Effect of Subepithelial Connective Tissue Graft Placement on Esthetic Outcomes After Immediate Implant Placement: Systematic Review
Authors: Lee Chun‐Teh , Tao Chih‐Yun , Stoupel Janet
Published: October 2015

Background: Immediate implantation, despite many advantages, carries a risk of gingival recession, papilla loss, collapse of ridge contour, and other esthetic complications. Soft tissue graft placement combined with immediate implantation may be used to reduce these concerns. This review aims to systematically analyze clinical esthetic outcomes of the immediate implant combined with soft tissue graft (IMITG).

Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines for systematic reviews were used. The electronic search was conducted using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from January 1980 to October 2014. Quality assessments of selected articles were performed. Mid‐buccal gingival level, interproximal gingival level, facial gingival thickness, gingival ridge dimension, and width of keratinized gingiva were the esthetic outcomes reviewed. Weighted mean difference of mid‐buccal gingival level (WDBGL), papilla index score (WDPIS), and width of keratinized gingiva (WDKG) between initial and last measurements were calculated. Other esthetic outcomes were assessed by the descriptive analysis.

Results: Ten studies with a minimum of 6‐month follow‐up were included, and reported esthetic outcomes were analyzed. Mid‐buccal gingival level (WDBGL, 0.07 mm; 95% confidence interval [CI] = −0.44 to 0.59; P = 0.12) and interproximal gingival level did not significantly change after IMITG (WDPIS in the mesial site, 0.31; 95% CI = −0.01 to 0.64; P = 0.06; and WDPIS in the distal site, 0.29; 95% CI = −0.06 to 0.65; P = 0.11). Width of keratinized gingiva significantly increased after IMITG (WDKG, 1.27 mm; 95% CI = −0.08 to 2.46; P = 0.04). Facial gingival thickness and gingival ridge dimension could be increased after IMITG.

Conclusions: Because of the heterogeneity and limited number of selected studies, no conclusive statement could be made regarding the benefit of IMITG on esthetic outcomes. More randomized controlled trials are needed to provide definite clinical evidence.
Long‐Term Results Comparing Xenogeneic Collagen Matrix and Autogenous Connective Tissue Grafts With Coronally Advanced Flaps for Treatment of Dehiscence‐Type Recession Defects
Authors: McGuire Michael K. , Scheyer E. Todd
Published: October 2015

Background: Although connective tissue grafts with coronally advanced flaps (CTG + CAF) have been deemed the gold standard for recession defect treatment, to provide adequate recession coverage, the periodontal profession continues to pursue lower‐morbidity, patient‐preferred substitutes that are more convenient and of unlimited supply.

Methods: Using a randomized, controlled, and masked contralateral comparison of matched‐pair, within‐patient recession defects, collagen matrix (CMX) + CAF therapy was compared with CTG + CAF at 6 months and 5 years. The primary efficacy endpoint was percentage of root coverage (RC). Secondary efficacy parameters included width of keratinized tissue (KTw), probing depth (PD), clinical attachment level (CAL), clinician rating of color and texture compared with surrounding tissues, and patient esthetic satisfaction.

Results: Seventeen patients were available for the 5‐year recall. Mean RC between 6 months and 5 years changed from 89.5% to 77.6% for CMX + CAF test sites and 97.5% to 95.5% for CTG + CAF control sites. KTw averaged >3 mm for both test and control sites at 5 years. PD was equivalent at all time points. The 6‐month to 5‐year changes for RC, KTw, and PD were not significantly different between therapies. CAL change from 6 months to 5 years was greater for CTG + CAF (0.26 mm) than CMX + CAF (−0.21 mm). Tissue color match to surrounding tissues remained similar for both therapies throughout the study. There was a difference in tissue texture at both 6 months and 5 years, with CMX + CAF sites tending to be “equally firm” and CTG + CAF sites “more firm.” Patient satisfaction was high, with no statistical difference in satisfaction between therapies at any time point.

Conclusion: When balanced with patient‐reported satisfaction, clinical rankings of esthetics, and control and historical RC results reported by other investigators, CMX + CAF appears to present a viable and long‐term alternative to traditional CTG + CAF therapy.
Homonegative Attitudes and Risk Behaviors for HIV and Other Sexually Transmitted Infections Among Sexually Active Men in the United States
Authors: Jeffries William L. , Johnson Oshea D.
Published: October 2015

Objectives. We examined associations between homonegative attitudes and HIV and other sexually transmitted infection (HIV/STI) risk behaviors among sexually active US men.

Methods. We used the 2006–2010 National Survey of Family Growth (n = 10 403) and multivariable logistic regression models to examine homonegative attitudes in relation to condom use, number of past-year sex partners, HIV/STI testing, and STI diagnoses.

Results. Among men who had sex with men, homonegative attitudes were associated with lower odds of condom use during anal sex with women (before the past year) and past-year STI testing. Among men who had sex with men and women, homonegative attitudes were associated with lower odds of condom use during vaginal sex and sex with men, having 4 or more partners, and HIV testing ever. Among men who had sex with women, homonegative attitudes were associated with lower odds of condom use during vaginal sex and sex with men (before the past year), HIV testing ever, and contracting herpes, human papillomavirus, or syphilis.

Conclusions. Homonegative attitudes may promote HIV/STI acquisition and transmission among sexually active men of all sexual orientations. Interventions should address homonegative attitudes in the United States.
Early Childhood Caries, Mouth Pain, and Nutritional Threats in Vietnam
Authors: Khanh Linh Ngo , Ivey Susan L. , Sokal-Gutierrez Karen , Barkan Howard , Ngo Kimberly M. , Hoang Hung T. , Vuong Ivy , Thai Nam
Published: October 2015

Objectives. We investigated the relationships among early childhood caries (ECC), mouth pain, and nutritional status in children aged 1 to 6 years in Southern and Central Vietnam.

Methods. A total of 593 parent–child pairs were recruited from 5 kindergartens or preschools in Ho-Chi Minh City and Da Nang. Parents completed surveys about dietary habits, oral health practices, and children’s mouth pain experience; children received anthropometric assessment and dental examinations.

Results. There was a high prevalence of dental caries (74.4%), mostly untreated, and mouth pain (47.1%). Moderate correlations were found between parents’ and children’s consumption of soda (ρ = 0.361; P < .001) and salty snacks (ρ = 0.292; P < .001). Severity of ECC was associated with decreased weight- and body mass index-for-age z-scores. Presence of pulp-involved caries was associated with strikingly lower height-for-age (mean difference = 0.66; P = .001), weight-for-age (mean difference = 1.17; P < .001), and body mass index-for-age (mean difference = 1.18; P < .001) z-scores. Mouth pain was associated with lower body mass index-for-age z-scores (mean difference = 0.29; P = .013).

Conclusions. ECC might negatively affect children’s nutritional status, which might be mediated by the depth of decay, chronic inflammation, and mouth pain. Family-based and prevention-oriented nutrition and oral health programs are needed and should start during pregnancy and infancy.
What Matters in Recruiting Public Health Employees: Considerations for Filling Workforce Gaps
Authors: Yeager Valerie A. , Wisniewski Janna M. , Amos Kathleen , Bialek Ron
Published: October 2015

We examined factors that influence the decision to join the public health workforce. In this cross-sectional study, we used 2010 secondary data representing 6939 public health workers. Factors influencing the decision to take jobs in public health were significantly associated with specific previous employment settings. Respondents generally rated organizational factors as more influential than personal factors in terms of their decision to work in governmental public health. Leaders should consider tailoring recruitment efforts to maximize job uptake and enhance the potential for long-term retention.
Sexual Violence in America: Public Funding and Social Priority
Authors: Waechter Randall , Ma Van
Published: October 2015

We compared lifetime risk, annual incidence, and annual economic burden of sexual violence with other major public health issues in the United States: cardiovascular disease, cancer, diabetes, and HIV/AIDS.

With public funding data from 2013, we examined how much public funding is allocated to these public health issues as a proxy of the social priority of addressing each of them.

Although sexual violence is as prevalent as and more costly than are these other major public health issues, it receives a fraction of the public funds that they receive.
Characteristics of Transgender Residents of Massachusetts Cities With High HIV Prevalence
Authors: White Hughto Jaclyn M. , Reisner Sari L. , Mimiaga Matthew J.
Published: October 2015

Geographic context can influence individual risk in populations disproportionately susceptible to HIV infection, such as transgender people. We examined factors associated with residing in Massachusetts cities with the highest HIV prevalence (geographic “hotspots”) in a 2013 sample of 433 transgender adults who were not infected with HIV. Residing in hotspots was associated with older age, non-White race/ethnicity, low income, incarceration history, polydrug use, smoking, binge drinking, and condomless receptive anal sex during one’s most recent sexual encounter with a partner who was assigned male sex at birth. Future research to understand the interpersonal and socio-structural factors that drive localized epidemics among transgender people is warranted.
Associations of Neighborhood and School Socioeconomic and Social Contexts With Body Mass Index Among Urban Preadolescent Students
Authors: Carroll-Scott Amy , Gilstad-Hayden Kathryn , Rosenthal Lisa , Eldahan Adam , McCaslin Catherine , Peters Susan M. , Ickovics Jeannette R.
Published: October 2015

Objectives. We examined independent and synergistic effects of school and neighborhood environments on preadolescent body mass index (BMI) to determine why obesity rates nearly double during preadolescence.

Methods. Physical measures and health surveys from fifth and sixth graders in 12 randomly selected schools in New Haven, Connecticut, in 2009 were matched to student sociodemographics and school- and residential census tract–level data, for a total of 811 urban preadolescents. Key independent variables included school connectedness, neighborhood social ties, and school and neighborhood socioeconomic status. We estimated cross-classified random-effects hierarchical linear models to examine associations between key school and neighborhood characteristics with student BMI.

Results. Greater average connectedness felt by students to their school was significantly associated with lower BMI. This association was stronger among students living in neighborhoods with higher concentrations of affluent neighbors.

Conclusions. How schools engage and support students may affect obesity rates preferentially in higher-income neighborhoods. Further research should explore the associations between multiple environments to which children are exposed and obesity-related behaviors and outcomes. This understanding of the multiple social–spatial contexts that children occupy has potential to inform comprehensive and sustainable child obesity prevention efforts.
The Myth Regarding the High Cost of End-of-Life Care
Authors: Aldridge Melissa D. , Kelley Amy S.
Published: October 2015

Health care reform debate in the United States is largely focused on the highly concentrated health care costs among a small proportion of the population and policy proposals to identify and target this “high-cost” group. To better understand this population, we conducted an analysis for the Institute of Medicine Committee on Approaching Death using existing national data sets, peer-reviewed literature, and published reports. We estimated that in 2011, among those with the highest costs, only 11% were in their last year of life, and approximately 13% of the $1.6 trillion spent on personal health care costs in the United States was devoted to care of individuals in their last year of life. Public health interventions to reduce health care costs should target those with long-term chronic conditions and functional limitations.
Limb Deformity Caused by Distal Femoral and Proximal Tibial Growth Arrest After ACL Reconstruction in a Child
Authors: Tomatsuri Masaki , Yoshiya Shinichi , Kuroda Ryosuke , Matsushita Takehiko , Kurosaka Masahiro
Published: October 2015

Case:

We report the case of a twelve-year-old boy with limb deformity caused by physeal closure after transphyseal intra-articular reconstruction of the anterior cruciate ligament of the left knee at the age of seven years. We treated premature closure of the physis with a Langenskiöld procedure. Lengthening and correction of the deformity were accomplished with use of the Ilizarov method. Although gross instability remained, reasonable limb alignment was attained with prolonged treatment.

Conclusion:

We document growth arrest and severe limb deformity after transepiphyseal anterior cruciate ligament reconstruction with an artificial polyester ligament and successful surgical correction.
Sternoclavicular Joint Infection Treated with Debridement, Vancomycin-Loaded Calcium Sulfate, and Partial Pectoralis Muscle Flap
Authors: Huang Kai , Zhang Chun
Published: October 2015

Case:

We report the case of a forty-six-year-old man with a left sternoclavicular joint infection that was treated effectively with surgical debridement, the implantation of vancomycin-loaded calcium sulfate, a partial pectoralis major muscle flap, and two weeks of intravenous antibiotics.

Conclusion:

Sternoclavicular joint infection is a rare problem that has received little attention in the orthopaedic literature. The combined surgical procedure detailed here provided good soft-tissue coverage, avoided the potential toxic effect of prolonged systemic antibiotic therapy, and resulted in a good clinical outcome.
Nontuberculous Mycobacterial Osteomyelitis of the Thumb: Successful Treatment with Serial Debridement, Antimicrobial Therapy, External Fixation, and Interphalangeal Arthrodesis
Authors: Ehrlichman Lauren K. , Kadzielski John J. , Hyle Emily P. , Jupiter Jesse B.
Published: October 2015

Case:

We present the case of a fifty-seven-year-old woman treated for persistent inflammation of her thumb initially thought to be due to tuberculous osteomyelitis but which ultimately proved to be due to infection caused by a novel nontuberculous mycobacterial species. The establishment of this diagnosis and her treatment are described.

Conclusion:

Indolent hand infections caused by atypical mycobacterial species may occur even in immunocompetent hosts, and their diagnosis remains challenging and often elusive. Surgeons should have a low threshold of suspicion for nontuberculous mycobacteria in cases refractory to treatment by standard protocols. The miniature external fixator provides stability and allows for soft-tissue healing in the setting of hand infections.
New Method for Determining Mineralogy and Matrix Properties From Elemental Chemistry Measured by Gamma Ray Spectroscopy Logging Tools
Authors: Freedman R.. , Herron S.. , Anand V.. , Herron M.. , May D.. , Rose D..
Published: October 2015

Methods for predicting mineralogy from logging-tool measurements have been an active area of research for several decades. In spite of these efforts, methods for predicting quantitative mineralogy including clay types from well-logging data were not fully achieved. The introduction of geochemical logging tools in the 1980s offered promise; however, early versions of geochemical logging tools did not measure elemental chemistry with enough accuracy and precision to enable reliable and quantitative determination of mineralogy. Recent advances in geochemical-logging-tool technology now enable accurate and robust measurements of the chemical elemental concentrations that are needed to determine continuous quantitative and detailed logs of mineralogy.

This paper presents a novel approach for determining more accurate and more detailed mineralogy from an elemental spectroscopy logging tool. This work was made possible by three recent developments: the introduction of a new neutron-induced gamma ray spectroscopy logging tool, a new research database consisting of chemistry and mineralogy measured on cores acquired worldwide from conventional and unconventional reservoirs, and a new model-independent inversion method that overcomes the limitations of previous model-dependent methods.

The model-independent inversion makes use of the database that includes clean sands, shaly sands, shales, carbonates, and complex mixed lithologies. The database contains laboratory measurements of dry-weight elemental chemistry and mineralogy measured by transmission Fourier-transform infrared (FTIR) spectroscopy. The database is used to derive a model-independent mapping function that accurately represents the complex functional relationship between the elemental concentrations and the mineral concentrations. After the mapping function is determined from the database, one can use it to predict quantitative mineralogy from elemental concentrations derived from the logging-tool measurements. Unlike previous inversion methods, the model-independent mapping function does not have any adjustable parameters or require any user inputs such as mineral properties or endpoints.

The mapping function is used to predict continuous logs of matrix densities plus concentrations of 14 minerals (i.e., illite, smectite, kaolinite, chlorite, quartz, calcite, dolomite, ankerite, plagioclase, orthoclase, mica, pyrite, siderite, and anhydrite) from eight dry-weight elemental concentrations derived from the logging tool. The new method was applied to well-log data acquired worldwide in numerous conventional and unconventional reservoirs with a wide variety of complex mineralogies. The predicted mineralogies and matrix densities are generally found to be consistent with core-derived mineralogies and matrix densities.