bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-Level Evaluation of Community-Based, Multifactorial Intervention to Prevent Diabetic Nephropathy in Northern Alberta, Canada
Authors: Gamble John-Michael , Hoang Holly , Eurich Dean T. , Jindal Kailash K. , Senior Peter A.
Published: December 2011

Objective: To examine whether patients with type 2 diabetes enrolled in community-based clinics uniformly benefit from interventions designed to achieve multiple risk factor targets. Methods: Using data from community-based clinics in Alberta, Canada, we examined whether patients achieved targets for blood pressure (<130/80 mm Hg), A1c (≤7%), low-density lipoprotein (LDL) cholesterol (<2.5 mmol/L), weight reduction, exercising, smoking cessation, and meal plan management among 235 patients between 2004 to 2007 with a 1-year follow-up. The effectiveness of the clinics was assessed by the number of targets achieved by individual patients. Patients achieving different degrees of success (0-2, 3-4, and ≥5 targets) were compared. Results: Mean age of patients at baseline was 62 years (standard deviation [SD], 12 years), 43% were female, 77% had a history of cardiovascular disease, and mean diabetes duration was 9 years (SD, 9 years). Overall, 47 patients achieved 0 to 2 targets (group 1), 132 achieved 3 to 4 targets (group 2), and 56 achieved ≥5 targets (group 3) out of 7 targets. More patients in group 1 were male and had longer diabetes duration and were more likely to smoke or use insulin. Despite reductions in A1c in all groups and similar use of antihypertensives, there was no improvement in weight or systolic blood pressure (which actually increased) in group 1. Successful patients (group 3) were more likely to report adherence with exercise and a meal plan. Conclusions: Despite equally intensive, target-driven pharmacotherapy, this community-based multifactorial intervention was less effective among a subset of patients who did not adhere to lifestyle changes. Strategies to effectively address lifestyle factors will be important as this intervention is refined.
Association Between Physician Recommendation for Adolescents to Join a Weight Loss Program and BMI Change
Authors: Woolford Susan J. , Sallinen Bethany J. , Clark Sarah J. , IglayReger Heidi B. , Gordon Paul M.
Published: December 2011

Objective: To explore whether reasons for enrollment in a pediatric multidisciplinary weight management program (PMWMP) are associated with subsequent weight loss. Method: A retrospective analysis of obese adolescents (12-18 years old, body mass index [BMI] > 95th percentile) who enrolled in a PMWMP from April 2007 to March 2009, and had BMI measurements at weeks 1 and 12. Reasons for enrollment were obtained from parents’ responses to an enrollment questionnaire (which allowed selection of more than one reason). The most common reasons for enrollment were computed. Linear regression was used to explore associations between mean change in BMI and reasons for enrollment, controlling for demographic and anthropometric factors. Results: Most of the 90 adolescents who met the inclusion criteria were female (70%) and white (57%). Mean age was 14.5 years and mean initial BMI was 42 kg/m2. The most common reasons for enrolling in the PMWMP were due to concerns about adolescents’ physical health (96%), concerns about adolescents’ mental health (76%), and because of a physician recommendation (73%). The mean 12-week change in BMI showed a greater decrease for those who enrolled due to a physicians’ recommendation versus those who did not (−1.5 vs −0.5 kg/m2: P < .05). This finding remained significant even when controlling for the covariates of interest. Conclusions: A physician’s recommendation to join a PMWMP appears to be associated with greater weight loss among obese adolescents than other reasons for enrollment. Further research should explore how physician involvement affects long-term weight loss.
Expansion of functionally defined mouse hematopoietic stem and progenitor cells by a short isoform of RUNX1/AML1
Authors: Tsuzuki Shinobu , Seto Masao
Published: December 2011

Self-renewal activity is essential for the maintenance and regeneration of the hematopoietic system. The search for molecules capable of promoting self-renewal and expanding hematopoietic stem cells (HSCs) has met with limited success. Here, we show that a short isoform (AML1a) of RUNX1/AML1 has such activities. Enforced AML1a expression expanded functionally defined HSCs, with an efficiency that was at least 20 times greater than that of the control in vivo and by 18-fold within 7 days ex vivo. The ex vivo–expanded HSCs could repopulate hosts after secondary transplantations. Moreover, AML1a expression resulted in vigorous and long-term (> 106-fold at 4 weeks) ex vivo expansion of progenitor cell populations capable of differentiating into multilineages. Gene expression analysis revealed that AML1a expression was associated with up-regulation of genes, including Hoxa9, Meis1, Stat1, and Ski. shRNA-mediated silencing of these genes attenuated AML1a-mediated activities. Overall, these findings establish AML1a as an isoform-specific molecule that can influence several transcriptional regulators associated with HSCs, leading to enhanced self-renewal activity and hematopoietic stem/progenitor cell expansion ex vivo and in vivo. Therefore, the abilities of AML1a may have implications for HSC transplantation and transfusion medicine, given that the effects also can be obtained by cell-penetrating AML1a protein.
Vitamin K antagonists in children with heart disease: height and VKORC1 genotype are the main determinants of the warfarin dose requirement
Authors: Moreau Caroline , Bajolle Fanny , Siguret Virginie , Lasne Dominique , Golmard Jean-Louis , Elie Caroline , Beaune Philippe , Cheurfi Radhia , Bonnet Damien , Loriot Marie-Anne
Published: December 2011

Managing vitamin K antagonist (VKA) therapy is challenging in children because of a narrow therapeutic range and wide inter- and intra-individual variability in dose response. Only a few small studies have investigated the effect of nongenetic and genetic factors on the dose response to VKAs in children. In a cohort study including 118 children (median age 9 years; range, 3 months-18 years) mostly with cardiac disease, we evaluated by multivariate analysis the relative contribution of nongenetic factors and VKORC1/CYP2C9/CYP4F2 genotypes on warfarin (n = 83) or fluindione (n = 35) maintenance dose and the influence of these factors on the time spent within/above/below the range. The results showed that height, target international normalized ratio and VKORC1 and CYP2C9 genotypes were the main determinants of warfarin dose requirement, accounting for 48.1%, 4.4%, 18.2%, and 2.0% of variability, respectively, and explaining 69.7% of the variability. Our model predicted the warfarin dose within 7 mg/wk in 86.7% of patients. None of the covariates was associated with the time spent above or below the international normalized ratio range. Whether this model predicts accurately the effective maintenance dose is currently being investigated.
Moxifloxacinversusamoxicillin/clavulanic acid in outpatient acute exacerbations of COPD: MAESTRAL results
Authors: Wilson Robert , Anzueto Antonio , Miravitlles Marc , Arvis Pierre , Alder Jeff , Haverstock Daniel , Trajanovic Mila , Sethi Sanjay
Published: December 2011

Bacterial infections causing acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently require antibacterial treatment. More evidence is needed to guide antibiotic choice.

The Moxifloxacin in Acute Exacerbations of Chronic Bronchitis TriaL (MAESTRAL) was a multiregional, randomised, double-blind non-inferiority outpatient study. Patients were aged ≥60 yrs, with an Anthonisen type I exacerbation, a forced expiratory volume in 1 s <60% predicted and two or more exacerbations in the last year. Following stratification by steroid use patients received moxifloxacin 400 mgp.o. q.d.(5 days) or amoxicillin/clavulanic acid 875/125 mgp.o. b.i.d.(7 days). The primary end-point was clinical failure 8 weeks post-therapy in the per protocol population.

Moxifloxacin was noninferior to amoxicillin/clavulanic acid at the primary end-point (111 (20.6%) out of 538,versus114 (22.0%) out of 518, respectively; 95% CI -5.89–3.83%). In patients with confirmed bacterial AECOPD, moxifloxacin led to significantly lower clinical failure rates than amoxicillin/clavulanic acid (in the intent-to-treat with pathogens, 62 (19.0%) out of 327versus85 (25.4%) out of 335, respectively; p=0.016). Confirmed bacterial eradication at end of therapy was associated with higher clinical cure rates at 8 weeks post-therapy overall (p=0.0014) and for moxifloxacin (p=0.003). Patients treated with oral corticosteroids had more severe disease and higher failure rates.

The MAESTRAL study showed that moxifloxacin was as effective as amoxicillin/clavulanic acid in the treatment of outpatients with AECOPD. Both therapies were well tolerated.
Building gene expression profile classifiers with a simple and efficient rejection option in R
Authors: Benso Alfredo , Di Carlo Stefano , Politano Gianfranco , Savino Alessandro , Hafeezurrehman Hafeez
Published: December 2011

Background

The collection of gene expression profiles from DNA microarrays and their analysis with pattern recognition algorithms is a powerful technology applied to several biological problems. Common pattern recognition systems classify samples assigning them to a set of known classes. However, in a clinical diagnostics setup, novel and unknown classes (new pathologies) may appear and one must be able to reject those samples that do not fit the trained model. The problem of implementing a rejection option in a multi-class classifier has not been widely addressed in the statistical literature. Gene expression profiles represent a critical case study since they suffer from the curse of dimensionality problem that negatively reflects on the reliability of both traditional rejection models and also more recent approaches such as one-class classifiers.

Results

This paper presents a set of empirical decision rules that can be used to implement a rejection option in a set of multi-class classifiers widely used for the analysis of gene expression profiles. In particular, we focus on the classifiers implemented in the R Language and Environment for Statistical Computing (R for short in the remaining of this paper). The main contribution of the proposed rules is their simplicity, which enables an easy integration with available data analysis environments. Since in the definition of a rejection model tuning of the involved parameters is often a complex and delicate task, in this paper we exploit an evolutionary strategy to automate this process. This allows the final user to maximize the rejection accuracy with minimum manual intervention.

Conclusions

This paper shows how the use of simple decision rules can be used to help the use of complex machine learning algorithms in real experimental setups. The proposed approach is almost completely automated and therefore a good candidate for being integrated in data analysis flows in labs where the machine learning expertise required to tune traditional classifiers might not be available.
Prediction of dinucleotide-specific RNA-binding sites in proteins
Authors: Fernandez Michael , Kumagai Yutaro , Standley Daron M , Sarai Akinori , Mizuguchi Kenji , Ahmad Shandar
Published: December 2011

Background

Regulation of gene expression, protein synthesis, replication and assembly of many viruses involve RNA–protein interactions. Although some successful computational tools have been reported to recognize RNA binding sites in proteins, the problem of specificity remains poorly investigated. After the nucleotide base composition, the dinucleotide is the smallest unit of RNA sequence information and many RNA-binding proteins simply bind to regions enriched in one dinucleotide. Interaction preferences of protein subsequences and dinucleotides can be inferred from protein-RNA complex structures, enabling a training-based prediction approach.

Results

We analyzed basic statistics of amino acid-dinucleotide contacts in protein-RNA complexes and found their pairing preferences could be identified. Using a standard approach to represent protein subsequences by their evolutionary profile, we trained neural networks to predict multiclass target vectors corresponding to 16 possible contacting dinucleotide subsequences. In the cross-validation experiments, the accuracies of the optimum network, measured as areas under the curve (AUC) of the receiver operating characteristic (ROC) graphs, were in the range of 65-80%.

Conclusions

Dinucleotide-specific contact predictions have also been extended to the prediction of interacting protein and RNA fragment pairs, which shows the applicability of this method to predict targets of RNA-binding proteins. A web server predicting the 16-dimensional contact probability matrix directly from a user-defined protein sequence was implemented and made available at: http://tardis.nibio.go.jp/netasa/srcpred.
Genetic copy number variants in myocardial infarction patients with hyperlipidemia
Authors: Shia Wei-Chung , Ku Tien-Hsiung , Tsao Yu-Ming , Hsia Chien-Hsun , Chang Yung-Ming , Huang Ching-Hui , Chung Yeh-Ching , Hsu Shih-Lan , Liang Kae-Woei , Hsu Fang-Rong
Published: December 2011

Background

Cardiovascular disease is the chief cause of death in Taiwan and many countries, of which myocardial infarction (MI) is the most serious condition. Hyperlipidemia appears to be a significant cause of myocardial infarction, because it causes atherosclerosis directly. In recent years, copy number variation (CNV) has been analyzed in genomewide association studies of complex diseases. In this study, CNV was analyzed in blood samples and SNP arrays from 31 myocardial infarction patients with hyperlipidemia.

Results

We identified seven CNV regions that were associated significantly with hyperlipidemia and myocardial infarction in our patients through multistage analysis (P<0.001), at 1p21.3, 1q31.2 (CDC73), 1q42.2 (DISC1), 3p21.31 (CDCP1), 10q11.21 (RET) 12p12.3 (PIK3C2G) and 16q23.3 (CDH13), respectively. In particular, the CNV region at 10q11.21 was examined by quantitative real-time PCR, the results of which were consistent with microarray findings.

Conclusions

Our preliminary results constitute an alternative method of evaluating the relationship between CNV regions and cardiovascular disease. These susceptibility CNV regions may be used as biomarkers for early-stage diagnosis of hyperlipidemia and myocardial infarction, rendering them valuable for further research and discussion.
13-hydroxy linoleic acid increases expression of the cholesterol transporters ABCA1, ABCG1 and SR-BI and stimulates apoA-I-dependent cholesterol efflux in RAW264.7 macrophages
Authors: Kämmerer Ines , Ringseis Robert , Biemann Ronald , Wen Gaiping , Eder Klaus
Published: December 2011

Background

Synthetic activators of peroxisome proliferator-activated receptors (PPARs) stimulate cholesterol removal from macrophages through PPAR-dependent up-regulation of liver × receptor α (LXRα) and subsequent induction of cholesterol exporters such as ATP-binding cassette transporter A1 (ABCA1) and scavenger receptor class B type 1 (SR-BI). The present study aimed to test the hypothesis that the hydroxylated derivative of linoleic acid (LA), 13-HODE, which is a natural PPAR agonist, has similar effects in RAW264.7 macrophages.

Methods

RAW264.7 macrophages were treated without (control) or with LA or 13-HODE in the presence and absence of PPARα or PPARγ antagonists and determined protein levels of LXRα, ABCA1, ABCG1, SR-BI, PPARα and PPARγ and apolipoprotein A-I mediated lipid efflux.

Results

Treatment of RAW264.7 cells with 13-HODE increased PPAR-transactivation activity and protein concentrations of LXRα, ABCA1, ABCG1 and SR-BI when compared to control treatment (P < 0.05). In addition, 13-HODE enhanced cholesterol concentration in the medium but decreased cellular cholesterol concentration during incubation of cells with the extracellular lipid acceptor apolipoprotein A-I (P < 0.05). Pre-treatment of cells with a selective PPARα or PPARγ antagonist completely abolished the effects of 13-HODE on cholesterol efflux and protein levels of genes investigated. In contrast to 13-HODE, LA had no effect on either of these parameters compared to control cells.

Conclusion

13-HODE induces cholesterol efflux from macrophages via the PPAR-LXRα-ABCA1/SR-BI-pathway.
The fine specificity of IgM anti-citrullinated protein antibodies (ACPA) is different from that of IgG ACPA
Authors: Suwannalai Parawee , Willemze Annemiek , van Toorn Linda , Stoeken-Rijsbergen Gerrie , Levarht Nivine , Drijfhout Jan Wouter , J Huizinga Tom W , M Toes Rene E , Trouw Leendert A
Published: December 2011

Introduction

The antigen recognition pattern of immunoglobulin M (IgM) could, when directed against protein antigens, provide an indication of the antigenic moieties triggering new B cells. The half-life of IgM is short and memory B cells against T-cell-dependent protein antigens typically produce IgG and not IgM antibodies. In this study, we analyzed whether a difference exists between the fine specificity of IgM versus IgG anti-citrullinated protein antibodies (ACPAs).

Methods

We determined the fine specificity of IgM and IgG ACPAs in 113 ACPA-positive rheumatoid arthritis patients with IgM cyclic citrullinated peptide 2 (CCP2) levels above 100 AU/ml. Fine specificity was assessed by performing ELISA using citrullinated peptides derived from vimentin, fibrinogen-β, fibrinogen-α and α-enolase, as well as citrullinated proteins fibrinogen and myelin basic protein. The arginine counterparts were used as controls.

Results

Recognition of defined citrullinated antigens by IgM ACPA was confined to samples that also displayed recognition by IgG ACPA. However, the IgM ACPA response displayed a more restricted antigen recognition profile than IgG ACPA (OR = 0.26, P < 0.0001).

Conclusion

Our data show that several defined citrullinated antigens are recognized only by IgG ACPA, whereas others are also recognized by IgM ACPA. These observations suggest that not all citrullinated antigens are able to activate new B cells despite concurrent recognition by IgG ACPA.
Dipyridamole augments the antiinflammatory response during human endotoxemia
Authors: Ramakers Bart P , Riksen Niels P , Stal Thijmen H , Heemskerk Suzanne , van den Broek Petra , Peters Wilbert HM , van der Hoeven Johannes G , Smits Paul , Pickkers Peter
Published: December 2011

Introduction

In animal models of systemic inflammation, the endogenous nucleoside adenosine controls inflammation and prevents organ injury. Dipyridamole blocks the cellular uptake of endogenous adenosine and increases the extracellular adenosine concentration. We studied the effects of oral dipyridamole treatment on innate immunity and organ injury during human experimental endotoxemia.

Methods

In a randomized double-blind placebo-controlled study, 20 healthy male subjects received 2 ng/kg Escherichia coli endotoxin (lipopolysaccharide; LPS) intravenously after 7-day pretreatment with dipyridamole, 200 mg slow release twice daily, or placebo.

Results

Nucleoside transporter activity on circulating erythrocytes was reduced by dipyridamole with 89% ± 2% (P < 0.0001), and the circulating endogenous adenosine concentration was increased. Treatment with dipyridamole augmented the LPS-induced increase in the antiinflammatory cytokine interleukin (IL)-10 with 274%, and resulted in a more rapid decrease in proinflammatory cytokines tumor necrosis factor-α (TNF-α) and IL-6 levels directly after their peak level (P < 0.05 and < 0.01, respectively). A strong correlation was found between the plasma dipyridamole concentration and the adenosine concentration (r = 0.82; P < 0.01), and between the adenosine concentration and the IL-10 concentration (r = 0.88; P < 0.0001), and the subsequent decrease in TNF-α (r = -0.54; P = 0.02). Dipyridamole treatment did not affect the LPS-induced endothelial dysfunction or renal injury during experimental endotoxemia.

Conclusions

Seven-day oral treatment with dipyridamole increases the circulating adenosine concentration and augments the antiinflammatory response during experimental human endotoxemia, which is associated with a faster decline in proinflammatory cytokines.

Trial registration

ClinicalTrials (NCT): NCT01091571.
Assessment of Learning Gains Associated with Independent Exam Analysis in Introductory Biology
Authors: Williams Adrienne E. , Aguilar-Roca Nancy M. , Tsai Michelle , Wong Matthew , Beaupré Marin Moravec , O’Dowd Diane K.
Published: December 2011

This study evaluates the impact of an independent postmidterm question analysis exercise on the ability of students to answer subsequent exam questions on the same topics. It was conducted in three sections (∼400 students/section) of introductory biology. Graded midterms were returned electronically, and each student was assigned a subset of questions answered incorrectly by more than 40% of the class to analyze as homework. The majority of questions were at Bloom's application/analysis level; this exercise therefore emphasized learning at these higher levels of cognition. Students in each section answered final exam questions matched by topic to all homework questions, providing a within-class control group for each question. The percentage of students who correctly answered the matched final exam question was significantly higher (p < 0.05) in the Topic Analysis versus Control Analysis group for seven of 19 questions. We identified two factors that influenced activity effectiveness: 1) similarity in topic emphasis of the midterm–final exam question pair and 2) quality of the completed analysis homework. Our data suggest that this easy-to-implement exercise will be useful in large-enrollment classes to help students develop self-regulated learning skills. Additional strategies to help introductory students gain a broader understanding of topic areas are discussed.
Myeloperoxidase associated with neutrophil extracellular traps is active and mediates bacterial killing in the presence of hydrogen peroxide
Authors: Parker Heather , Albrett Amelia M , Kettle Anthony J , Winterbourn Christine C
Published: December 2011

A variety of inflammatory stimuli induces NETs. These structures consist of a network of chromatin strands associated with predominately granule proteins, including MPO. NETs exhibit antimicrobial activity, which is proposed to augment the more-established mechanism of phagosomal killing. They may also be detrimental to the host in situations such as chronic inflammation or severe sepsis. The objective of this study was to establish whether MPO associated with NETs is active and able to kill bacteria. Neutrophils were stimulated with PMA to release NETs. Peroxidase activity measurements were performed and showed that enzymatically active MPO was released from the neutrophils, 2–4 h after stimulation, concomitant with NET formation. Approximately 30% of the total cellular MPO was released, with the majority bound to the NETs. The bound enzyme retained its activity. Staphylococcus aureus were not killed when added to preformed NETs under our assay conditions. However, addition of H2O2 to the bacteria in the presence of NETs resulted in MPO-dependent killing, which was observed with NETs in situ and with NETs when they were removed from the neutrophils by limited DNase digestion. Our results show that the enzymatic activity of MPO on NETs could contribute to antimicrobial activity or tissue injury when NETs are released from neutrophils at sites of infection or inflammation.
Azithromycin drives in vitro GM-CSF/IL-4-induced differentiation of human blood monocytes toward dendritic-like cells with regulatory properties
Authors: Polančec Darija Stupin , Munić Kos Vesna , Banjanac Mihailo , Vrančić Mila , Čužić Snježana , Belamarić Daniela , Parnham Michael J , Polančec Denis , Haber Vesna Eraković
Published: December 2011

Azithromycin, a macrolide antibacterial, has been shown to modify the phenotype of macrophages. We have investigated whether azithromycin in vitro is able to modulate the differentiation of human blood monocytes to DCs. iA-DCs appear to have a unique phenotype, characterized by increased granularity, adherence, and a surface molecule expression profile similar to that of MDCs, namely, CD1a–CD14–CD71+CD209high, as well as high CD86 and HLA-DR expression. The iA-DC phenotype is associated with increased IL-6 and IL-10 release, increased CCL2 and CCL18 expression and release, and M-CSF expression, as well as reduced CCL17 expression and release. Upon maturation with LPS, A-DCs and MDCs exhibit decreased expression of HLA-DR and costimulatory molecules, CD40 and CD83, as well as an increase in IL-10 and a decrease in CCL17 and CXCL11 secretion. These modulated responses of iA-DCs were associated with the ability to reduce a MLR, together with enhanced phagocytic and efferocytotic properties. Azithromycin, added 2 h before activation of iDCs with LPS, enhanced IL-10 release and inhibited IL-6, IL-12p40, CXCL10, CXCL11, and CCL22 release. In conclusion, azithromycin modulates the differentiation of blood monocyte-derived DCs to form iA-DCs with a distinct phenotype similar to that of iMDCs, accompanied by enhanced phagocytic and efferocytic capabilities. It also modifies LPS-induced DC maturation by decreasing surface molecule expression required for T cell activation, increasing IL-10 production, and inducing MLR-reducing properties.
Stimulation of Ly-6G on neutrophils in LPS-primed mice induces platelet-activating factor (PAF)-mediated anaphylaxis-like shock
Authors: Tanaka Yukinori , Nagai Yasuhiro , Kuroishi Toshinobu , Endo Yasuo , Sugawara Shunji
Published: December 2011

Previously, two anti-Ly-6G mAb—RB6-8C5 and 1A8—have been used to deplete neutrophils in mice and to clarify their involvement in immune responses. During the course of experiments on neutrophil depletion, we noticed that i.v. injection of RB6-8C5 or 1A8 induced anaphylaxis-like shock in mice pretreated i.v. with LPS. Signs of shock, such as hypothermia, appeared within a few minutes, and the mice died of shock within 20 min of the antibody injection. In vivo experiments, including depletion of various cell types, indicated that neutrophils and macrophages (but not platelets, basophils, or mast cells) are involved in the shock. Experiments using various drugs and gene-targeted mice demonstrated that PAF is the central mediator of the shock. Optimal LPS priming required at least 1 h, and the priming was associated with neutrophil accumulation within pulmonary and hepatic blood vessels. Consistently, following 1A8 injection into LPS-pretreated mice, the mRNA for LysoPAFAT (a PAF biosynthetic enzyme) was markedly up-regulated in neutrophils accumulated in the lung but not in macrophages. These results suggest that (1) stimulation of Ly-6G on LPS-primed neutrophils induces PAF-mediated anaphylaxis-like shock in mice, (2) neutrophils are primed by LPS during and/or after their accumulation in lung and liver to rapidly induce LysoPAFAT, and (3) macrophages may play a pivotal role in the priming phase and/or in the challenge phase by unknown mechanisms. These findings may be related to adult respiratory distress syndrome, although the natural ligand for Ly-6G remains to be identified.
Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis
Authors: Leamy Mary , Bird Victoria , Boutillier Clair Le , Williams Julie , Slade Mike
Published: December 2011

Background

No systematic review and narrative synthesis on personal recovery in mental illness has been undertaken.

Aims

To synthesise published descriptions and models of personal recovery into an empirically based conceptual framework.

Method

Systematic review and modified narrative synthesis.

Results

Out of 5208 papers that were identified and 366 that were reviewed, a total of 97 papers were included in this review. The emergent conceptual framework consists of: (a) 13 characteristics of the recovery journey; (b) five recovery processes comprising: connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (giving the acronym CHIME); and (c) recovery stage descriptions which mapped onto the transtheoretical model of change. Studies that focused on recovery for individuals of Black and minority ethnic (BME) origin showed a greater emphasis on spirituality and stigma and also identified two additional themes: culturally specific facilitating factors and collectivist notions of recovery.

Conclusions

The conceptual framework is a theoretically defensible and robust synthesis of people's experiences of recovery in mental illness. This provides an empirical basis for future recovery-oriented research and practice.
Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months
Authors: Patel Vikram , Weiss Helen A. , Chowdhary Neerja , Naik Smita , Pednekar Sulochana , Chatterjee Sudipto , Bhat Bhargav , Araya Ricardo , King Michael , Simon Gregory , Verdeli Helena , Kirkwood Betty R.
Published: December 2011

Background

Depressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare.

Aims

To test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders.

Method

Twenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with clinicaltrials.gov (NCT00446407).

Results

A total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53–0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59–0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR = 0.64, 95% CI 0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities.

Conclusions

Trained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.
Physical health disparities and mental illness: the scandal of premature mortality
Authors: Thornicroft Graham
Published: December 2011

A 20-year mortality gap for men, and 15 years for women, is still experienced by people with mental illness in high-income countries. The combination of lifestyle risk factors, higher rates of unnatural deaths and poorer physical healthcare contribute to this scandal of premature mortality that contravenes international conventions for the ‘right to health.’
The population impact of improvements in mental health services: the case of Australia
Authors: Jorm Anthony F.
Published: December 2011

A national survey in 1997 found that Australia had a high prevalence of mental disorders with low rates of treatment. Since then, treatment availability has increased greatly and unmet need has reduced. However, there is little evidence that the nation's mental health has improved.
Improving psychiatric diagnosis in multidisciplinary child and adolescent mental health services
Authors: Michelson Daniel , Rock Stephen , Holliday Sophia , Myers Gil , Tilki Susan , Murphy Elizabeth , Day Crispin
Published: December 2011

Aims and method

We examined learning outcomes, practice impacts and implementation processes for a training intervention in diagnostic skills delivered to multidisciplinary child and adolescent mental health service practitioners (n = 63).

Results

Training was viewed positively by most participants and associated with significant increases in practitioner self-efficacy, with the effect sustained at 8-month follow-up. A comparative audit before and after training indicated that clinicians were significantly more likely to assign an Axis I diagnosis following the training intervention. However, absolute rates of Axis I classification remained relatively low (< 40%) both before and after training. Practitioners were moderately successful at following through on personal plans for implementing new learning; inconsistent support for implementation was provided within teams.

Clinical implications

A brief training workshop may have limited effects in changing practitioners' behaviour so that diagnoses are made more promptly and appropriately recorded. Future workforce development initiatives should consider more comprehensive and diversified strategies, including targeted post-training support, if increased self-efficacy following training is to be translated into sustained changes in diagnostic practice.
Adsorption Properties of Micro-/Meso-Porous Carbons Obtained by Colloidal Templating and Post-Synthesis KOH Activation
Authors: Choma Jerzy , Dziura Aleksandra , Gorka Joanna , Jaroniec Mietek
Published: December 2011

Nitrogen adsorption studies have been employed to examine the structural properties of micro-/meso-porous carbons obtained by colloidal templating and post-synthesis KOH activation. These carbons were prepared by polymerizing phenol and formaldehyde in the pores of a colloidal silica template followed by carbonization, silica dissolution and post-synthesis KOH activation. Colloidal silica was used to create spherical mesopores, while KOH activation was performed to create additional microporosity and to enlarge the surface area of the resulting carbons. Nitrogen adsorption studies showed that a single impregnation of the colloidal silica template with phenolic resin precursors afforded carbons with relatively thin pore walls which did not withstand the post-synthesis KOH activation; however, a double impregnation generated mesoporous carbons with thicker pore walls. Activation of these latter carbons with KOH created micropores in the mesopore walls without significant deterioration of the mesopore structure. The resulting mesoporous carbons possessed high specific surface areas (ca. 800 m2/g) and large single-point pore volumes (ca. 1.8 cm3/g). The post-synthesis KOH activation enlarged the surface area up to 1500 m2/g, which was achieved via the creation of microporosity. Hence, the carbon obtained by double impregnation and activation exhibited a single-point pore volume of ca. 2 cm3/g with a relatively high microporosity which attained 17% of the total porosity. High-surface-area micro-/meso-porous carbons are attractive for adsorption, catalysis and energy-related applications such as capacitors and batteries.
Diffusion of Particles on a Fluctuating Surface
Authors: Tarasenko Alexander , Jastrabik Lubomir
Published: December 2011

Using kinetic Monte Carlo simulations, we have investigated within the framework of a simple lattice–gas diffusion model, the diffusion of particles adsorbed onto a lattice with moving surface atoms. Dynamic surface reconstruction was found to substantially increase the particle diffusion coefficient and change the activation energy.
Kinematic Analysis of Planar Deployable Structures with Angulated Beams Based on Equilibrium Matrix
Authors: Lu Jinyu , Li Na , Luo Yaozhi
Published: December 2011

This paper mainly deals with the kinematics of those widely used planar deployable structures, which are formed by angulated beams connected at with pivots. The equilibrium matrix method, which is quite different from displacement based methods, has been used to study their kinematic properties and as the basis for numerical simulations of the deployment movements. Two typical angulated beams, i.e. the depth multi-angulated beam (DMAB) and the breadth multi-angulated beam (BMAB), are explained and the corresponding equilibrium matrices deduced using matrix reduction theory, in addition, for these macro elements, the nature of the relationships between the equilibrium matrix and the stiffness matrix is discussed. Kinematic properties, e.g. infinitesimal movements and self-stress modes etc., have been studied and interpreted based on the orthogonal subspace of the equilibrium matrix. In this paper, an algorithm based on the equilibrium matrix SVD adopting an incremental procedure is described and applied to the motion analysis of deployable structures. Some typical numerical examples are illustrated to demonstrate the validity and efficiency of the proposed method.
An Indeterminate Strut-Tie Model and Load Distribution Ratio for RC Deep Beams - (I) Model & Load Distribution Ratio
Authors: Kim Byung-Hun , Yun Young-Mook
Published: December 2011

The ultimate strength of simply supported reinforced concrete deep beams is governed by the capacity of the shear resistance mechanism. The structural behavior of the deep beams is controlled mainly by the mechanical relationships between the primary design variables including shear span-to-effective depth ratio, flexural reinforcement ratio, and the compressive strength of concrete. In this study, a simple indeterminate strut-tie model which reflects all characteristics of the ultimate strength and behavior of the deep beams was presented. A load distribution ratio, defined as the fraction of load transferred by a truss mechanism, was also proposed to help structural designers perform the rational design of deep beams by using the strut-tie model approaches of current design codes. In the determination of the load distribution ratio, a concept of balanced shear reinforcement ratio which ensures the ductile shear design of the deep beams was introduced, and the effect of the primary design variables was reflected through numerous numerical analyses of the presented indeterminate strut-tie model. In the companion paper, the validity of the presented model and load distribution ratio was examined by applying them to the evaluation of ultimate strength of 234 simply supported reinforced concrete deep beams tested to failure.
Field Measurements of Dynamic Properties of High-Rise Buildings
Authors: Kwok K.C.S. , Tse K.T. , Campbell S.
Published: December 2011

Field measurement techniques, including ambient wind excitation, crane excitation, synchronised human excitation and mechanical shaker methods, commonly employed to measure the dynamic properties of high-rise buildings are presented. The instrumentation, test methodology, merits and limitations of these techniques, including a purpose-built computer-based mechanical shaker, are discussed. The dynamic properties of four residential buildings in Hong Kong ranging in height from 130 m to 256 m were determined using these field measurement techniques. The results show that the dynamic properties, including natural frequencies of vibration, damping values, and deflected mode shapes can be accurately determined. These measured dynamic properties are compared with values suggested by wind load standards, empirical predictors and computed values from finite element models. The measured natural frequencies were found to be in good agreement with the Japanese empirical predictor of 67 divided by building height, attributable in part to the design requirements in both regions to resist typhoon loading.
Analysis of Cantilever Plates with Stepped Section Using p-Convergent Transition Element for Solid-to-Shell Connections
Authors: Ahn J.S. , Woo K.S.
Published: December 2011

This paper presents efficient modeling technique using the p-convergent transition element for analysis of cantilever plates with stepped section. For the efficient modeling, firstly, the high-precision element is formulated by combination of one- and two-dimensional shape functions. Secondly, for another three-dimensional modeling, the reduced-precision element is proposed by assuming a piecewise linear variation of in-plane displacements and a constant value of the lateral displacement across the thickness. Thirdly, two-dimensional shell element with higher-order shape functions is formulated using first-order shear deformation theory. Lastly, the p-convergent transition element is proposed in order to connect three element types formulated. All the elements considered are on the basis of subparametric element concept. The elements are applied with cantilever plates with stepped section subjected to in-plane and transversal loadings. The present models using the p-convergent transition element are demonstrated to be more practical and economical than previously p-version FEM using only single element type.
Modifying the Shear Buckling Loads of Metal Shear Walls for Improving Their Energy Absorption Capacity
Authors: Shahab S. , Mirtaheri M. , Mirzaeifar R. , Bahai H.
Published: December 2011

In this paper, an approximate method is proposed for achieving predefined increases in the buckling threshold of a metal shear wall in order to increase its energy absorption capacity. The first and second-order derivatives of shear buckling loads of a shear wall with respect to the thickness in its different regions are calculated. Based on these eigenderivatives, and by using the first and second order Taylor expansions, the necessary change in the thickness of plate in various regions is calculated for increasing the shear buckling loads by a specific value. The presented modification algorithm is implemented for shear walls with different aspect ratios, material properties and boundary conditions. An initial sensitivity analysis is carried out for finding the regions within the shear wall where modifying the thickness has the most influence on the buckling loads. Based on the sensitivity analysis results, appropriate regions of plate are selected and the necessary modification in thickness of these regions is calculated for achieving a relatively large predefined change in shear buckling load. By simulating the post-buckling response of both initial and modified plates in a case study, the improvement in the energy absorption capability of the modified plate is also studied.
Fatigue Crack Closure in Residual Stress Bearing Materials
Authors: Hill Michael R. , Kim Jihwi
Published: December 2011

During fatigue crack growth, the two opposing faces of a fatigue crack can make physical contact while unloading from a maximum level of cyclic load, so that the crack tip state at the minimum cyclic load depends on the host geometry, material properties, and loading history. Although significant work has been performed in order to examine the effects of crack face contact, often called crack closure, under variations of applied loading history, little work has been done to understand the details of crack closure in materials that contain bulk residual stress fields. For an elastic material, variations of applied load history create changes in the crack tip behavior that are directly related to the current levels of cyclic stress, with no effect of prior loading. For an elastic-plastic material, variations of the applied load history cause the crack tip behavior to depend on the current and former loading cycles, because of plastic deformation in the crack wake. In an elastic material with bulk residual stress, crack closure occurs because the strain fields locked into the material, which are the source of the residual stress, alter the shape of the crack faces, so that the details of closure depend on the residual stress field and crack geometry. Residual stresses might therefore affect fatigue crack growth in two distinct ways: first, by combining with applied loads to affect the stress intensity factor (at the current crack size), and second, by altering crack closure. We emphasize that the effect of bulk residual stresses on crack closure described here is an elastic effect, which distinguishes it from the more commonly discussed forms of closure, such as arise from plasticity or roughness. The paper describes a means to forecast crack closure due to bulk residual stress fields and assesses schemes to account for its effects on fatigue crack growth.
Faster Thalamocortical Processing for Dark than Light Visual Targets
Authors: Jin Jianzhong , Wang Yushi , Lashgari Reza , Swadlow Harvey A. , Alonso Jose-Manuel
Published: December 2011

ON and OFF visual pathways originate in the retina at the synapse between photoreceptor and bipolar cells. OFF bipolar cells are shorter in length and use receptors with faster kinetics than ON bipolar cells and, therefore, process information faster. Here, we demonstrate that this temporal advantage is maintained through thalamocortical processing, with OFF visual responses reaching cortex ∼3–6 ms before ON visual responses. Faster OFF visual responses could be demonstrated in recordings from large populations of cat thalamic neurons representing the center of vision (both X and Y) and from subpopulations making connection with the same cortical orientation column. While the OFF temporal advantage diminished as visual responses reached their peak, the integral of the impulse response was greater in OFF than ON neurons. Given the stimulus preferences from OFF and ON channels, our results indicate that darks are processed faster than lights in the thalamocortical pathway.
On the Dynamic Nature of the Engram: Evidence for Circuit-Level Reorganization of Object Memory Traces following Reactivation
Authors: Winters Boyer D. , Tucci Mark C. , Jacklin Derek L. , Reid James M. , Newsome James
Published: December 2011

Research has implicated the perirhinal cortex (PRh) in several aspects of object recognition memory. The specific role of the hippocampus (HPC) remains controversial, but its involvement in object recognition may pertain to processing contextual information in relation to objects rather than object representationper se. Here we investigated the roles of the PRh and HPC in object memory reconsolidation using the spontaneous object recognition task for rats. Intra-PRh infusions of the protein synthesis inhibitor anisomycin immediately following memory reactivation prevented object memory reconsolidation. Similar deficits were observed when a novel object or a salient contextual change was introduced during the reactivation phase. Intra-HPC infusions of anisomycin, however, blocked object memory reconsolidation only when a contextual change was introduced during reactivation. Moreover, disrupting functional interaction between the HPC and PRh by infusing anisomycin unilaterally into each structure in opposite hemispheres also impaired reconsolidation when reactivation was done in an altered context. These results show for the first time that the PRh is critical for reconsolidation of object memory traces and provide insight into the dynamic process of object memory storage; the selective requirement for hippocampal involvement following reactivation in an altered context suggests a substantial circuit level object trace reorganization whereby an initially PRh-dependent object memory becomes reliant on both the HPC and PRh and their interaction. Such trace reorganization may play a central role in reconsolidation-mediated memory updating and could represent an important aspect of lingering consolidation processes proposed to underlie long-term memory modulation and stabilization.