bluuebunny/crossref_metadata_2025 huggingface dataset:
Requesting Cesareans without Medical Indications: An Option Being Considered by Young Canadian Women
Authors: Gallagher Frances , Bell Linda , Waddell Guy , Benoît Annie , Côté Nathalie
Published: January 2012

Abstract:  Background:  Cesarean delivery on maternal request is a worldwide growing phenomenon. The goal of this study was to describe young nulliparous women’s attitudes about cesarean delivery on maternal request.

Methods:  A total of 140 nulliparous women in Canada aged between 18 and 24 years and attending school from the vocational (n = 53), college (n = 61), and university (n = 18) levels (n = 8 other) participated in the survey. The self‐administered questionnaire consisted of 23 open‐ended questions. The outcome measure was the participant’s attitude toward cesarean delivery on maternal request. Descriptive, bivariate, and multiple regression analyses were performed.

Results:  Many of the respondents (63%) had previously heard about cesarean delivery on maternal request, and of these women 28.6 percent had a favorable attitude toward the procedure. Sociodemographic variables were not associated with participants’ attitudes toward cesarean delivery on maternal request except for place of residence and type of professional preferred for pregnancy care. Thinking that vaginal birth was more painful than cesarean delivery (p = 0.012) and had more consequences for the mother (p < 0.001) were related to a positive attitude toward cesarean delivery on maternal request. A positive attitude by peers was also associated with participants’ favorable attitude toward cesarean delivery on maternal request (p < 0.001). The overall predictive success of the model was 66.5 percent.

Conclusions:  Young women are spreading the word about cesarean delivery on maternal request and may influence one another about their preferred delivery method. During prenatal visits practitioners need to address women’s fear of vaginal birth and its consequences for the mother, counseling, and women’s understanding of the consequences of cesarean delivery. This study supports the urgent need to systematically document cesarean delivery on maternal request as a medical procedure and to study its prevalence and related factors. (BIRTH 39:1 March 2012)
Web‐based News Reports on Midwives Compared with Obstetricians: A Prospective Analysis
Authors: Dahlen Hannah G. , Homer Caroline S. E.
Published: January 2012

Abstract:  Background:  The media both creates and reflects public opinion. The way in which health professionals are depicted in the media is likely to influence views held by and about different health professions. The aim of this study was to examine how midwives and obstetricians are reported in English language web‐based news reports from around the world.

Methods:  News alerts from the Internet search engine Google were created to search for the terms “midwife,”“midwives,”“midwifery,”“obstetrics,” and “obstetricians.” These alerts were received over a 12‐month period (May 1, 2006–April 31, 2007), downloaded, and analyzed using quantitative content analysis.

Results:  A total of 522 web‐based news reports for midwifery and 564 for obstetrics (n = 1,086) were found. Dominant categories for midwives were: “mainstreaming midwives” (models of care/rise of midwifery) (28%); “the Cinderella of the maternity care” (workforce/industrial) (27%); “delivering the baby with your hands tied” (funding, insurance, and legislation) (21%); “ask the expert” (education, research, and health advice) (8%), “recognizing midwives” (awards and announcements) (7%), “unsafe midwives” (litigation) (6%); and “the art of birth” (books, film, and photographs) (2%). Dominant categories for obstetricians were: “ask the expert” (research and advice) (26%); “doctors are heroes amongst us” (awards and announcements) (19%); “obstetric workforce woes” (workforce/industrial) (19%); “new frontiers” (trends in care and new technology) (17%); “the disappearing obstetrician” (insurance and litigation) (10%); and “human‐interest news reports” (9%). Obstetricians were more likely to be recognized as experts on pregnancy and birth and receive public recognition compared with midwives. Midwives were more likely to be depicted as struggling to be a mainstream option while being hampered by lack of funding, insurance, and legislative barriers.

Conclusions:  Although midwives have rising acceptance, they still struggle with recognition. Obstetricians have both acceptance and recognition. Countries where midwifery is a mainstream option have more news reports related to midwifery than obstetrics. Different issues appear more dominant in some countries, such as work force in the United Kingdom and funding, insurance, and legislation in the United States. (BIRTH 39:1 March 2012)
High‐resolution geochemical record of fluid–rock interaction in a mid‐crustal shear zone: a comparative study of major element and oxygen isotope transport in garnet
Authors: RAIMONDO T. , CLARK C. , HAND M. , CLIFF J. , HARRIS C.
Published: January 2012

Garnet grains from an intensely metasomatized mid‐crustal shear zone in the Reynolds Range, central Australia, exhibit a diverse assortment of textural and compositional characteristics that provide important insights into the geochemical effects of fluid–rock interaction. Electron microprobe X‐ray maps and major element profiles, in situ secondary ion mass spectrometry oxygen isotope analyses, and U–Pb and Sm–Nd geochronology are used to reconstruct their thermal, temporal and fluid evolution. These techniques reveal a detailed sequence of garnet growth, re‐equilibration and dissolution during intracontinental reworking associated with the Ordovician–Carboniferous (450–300 Ma) Alice Springs Orogeny. A euhedral garnet porphyroblast displays bell‐shaped major element profiles diagnostic of prograde growth zoning during shear zone burial. Coexisting granulitic garnet porphyroclasts inherited from precursor wall rocks show extensive cation re‐equilibration assisted by fracturing and fragmentation. Oxygen isotope variations in the former are inversely correlated with the molar proportion of grossular, suggesting that isotopic fractionation is linked to Ca substitution. The latter generally show close correspondence to the isotopic composition of their precursor, indicating slow intergranular diffusion of O relative to Fe2+, Mg and Mn. Peak metamorphism associated with shearing (∼550 °C; 5.0–6.5 kbar) occurred at c. 360 Ma, followed by rapid exhumation and cooling. Progressive Mn enrichment in rim domains indicates that the retrograde evolution caused partial garnet dissolution. Accompanying intra‐mineral porosity production then stimulated limited oxygen isotope exchange between relict granulitic garnet grains and adjacent metasomatic biotite, resulting in increased garnet δ18O values over length scales <200 μm. Spatially restricted oxygen interdiffusion was thus facilitated by increased fluid access to reaction interfaces. The concentration of Ca in channelled fracture networks suggests that its mobility was enhanced by a similar mechanism. In contrast, the intergranular diffusion of Fe2+, Mg and Mn was rock‐wide under the same P–T regime, as demonstrated by a lack of local spatial variations in the re‐equilibration of these components. The extraction of detailed reaction histories from garnet must therefore take into account the variable length‐ and time‐scales of elemental and isotopic exchange, particularly where the involvement of a fluid phase enhances the possibility of measureable resetting profiles being generated for slowly diffusing components such as Ca and O, even at low ambient temperatures and relatively fast cooling rates.
Transdermal Sumatriptan for Acute Treatment of Migraineurs With Baseline Nausea
Authors: Schulman Elliot A.
Published: January 2012

Objective.— To evaluate the efficacy and safety of transdermal sumatriptan in migraine patients who have baseline nausea.

Background.— Migraine‐associated nausea and vomiting can limit the effectiveness of acute treatment with oral agents by causing delays, avoidance, or incomplete absorption of medication due to post‐dose vomiting.

Methods.— In a multicenter, randomized, double‐blind, placebo‐controlled study in adult (aged 18‐66 years) migraineurs, 530 patients were randomized to receive transdermal sumatriptan or a placebo patch and remained in the study until they had treated a single moderate to severe migraine attack or had gone 2 months without treatment. At baseline (before applying the study patch), patients recorded headache pain intensity and the presence or absence of migraine‐associated symptoms, including nausea. The use of analgesic or anti‐emetic rescue medications within 2 hours of patch activation was prohibited. Post‐hoc analyses were conducted to assess the proportion of patients with nausea at baseline who experienced headache relief and who were free from nausea, photophobia, and phonophobia at 1 and 2 hours post‐activation.

Results.— A total of 454 patients were included in the intent‐to‐treat population for efficacy analyses. Baseline demographic and migraine headache characteristics were generally similar between the treatment groups. In the overall study population, transdermal sumatriptan was significantly superior to placebo at 1 hour post‐activation for pain relief (29% vs 19%, respectively; P < .0135) and freedom from nausea (71% vs 58%, respectively; P < .05) and at 2 hours post‐activation for freedom from pain (18% vs 9%, respectively; P < .009), pain relief (53% vs 29%, respectively; P < .0001), freedom from nausea (84% vs 63% respectively; P < .001), freedom from photophobia (51% vs 36%, respectively; P < .0028), freedom from phonophobia (55% vs 39%, respectively; P < .0002); and freedom from migraine (16% vs 8%, respectively; P < .0135). In the post‐hoc analysis, transdermal sumatriptan was markedly superior to placebo for pain relief and freedom from pain, nausea, photo‐, and phonophobia at 1 and 2 hours post‐activation.

Conclusions.— Transdermal sumatriptan is superior to oral triptans for migraine patients whose baseline nausea causes them to delay or avoid acute treatment.
Successful Dose Finding with Sublingual Fentanyl Tablet: Combined Results from 2 Open‐Label Titration Studies
Authors: Nalamachu Srinivas R. , Rauck Richard L. , Wallace Mark S. , Hassman David , Howell Julian
Published: January 2012

Objective:  This analysis was conducted to determine the likelihood of identifying an effective dose of fentanyl sublingual tablet during the initial titration phase of 2 clinical trials, to characterize the actual effective dose in patients achieving successful titration, and to examine the relationship between baseline characteristics and likelihood of achieving an effective dose.

Methods:  Data were derived from 2 clinical trials (Study 1, n = 131; Study 2, n = 139) of fentanyl sublingual tablet in patients with cancer‐associated breakthrough pain (BTP). Both trials comprised a 2‐week titration phase and 12‐month maintenance phase. The initial dose was 100 μg, titrated to an effective dose (producing effective relief of all BTP episodes on 2 consecutive days) of 100 to 800 μg.

Results:  A total of 270 patients entered the titration phase. Mean (SD) baseline BTP opioid dose was 25.7 (88.9) mg morphine equivalent, and mean baseline around‐the‐clock opioid dose was 196.5 (151.6) mg morphine equivalent. Using conservative criteria for determining effective dose, 174 patients (64.4%) were successfully titrated to an effective dose (mean [SD], 498.2 [234.8] μg). The most frequent (27.6%) effective dose was 800 μg, and more than 85% of patients required an effective dose ≥ 300 μg. There were no significant relationships between any baseline characteristics and titration success.

Conclusion:  Despite stringent criteria, 64.4% of patients achieved an effective dose of fentanyl sublingual tablet within the dose range of 100 to 800 μg. Baseline characteristics were not identified to be associated with the likelihood of successful titration or with the actual effective dose of fentanyl sublingual tablet.
Real‐World Role of Tricyclic Antidepressants in the Treatment of Fibromyalgia
Authors: Reed Catherine , Birnbaum Howard G. , Ivanova Jasmina I. , Schiller Matt , Waldman Tracy , Mullen Rose E. , Swindle Ralph
Published: January 2012

Objective:  To examine the real‐world role of tricyclic antidepressants (TCAs) in fibromyalgia (FM) treatment.

Methods:  Using privately insured U.S. administrative claims data, this study examined TCA use for newly diagnosed FM patients. Patients ages 18 to 64 years with ≥ 2 FM diagnoses (ICD‐9‐CM: 729.1) during Q1:2007 to Q1:2009, no previous FM diagnosis, and continuous eligibility for insurance during the year before and after the first FM diagnosis (“study period”) were identified as newly diagnosed (N = 10,129). Treatment with TCAs was examined over the first treatment episode (allowing up to a 45‐day gap between refills). A sensitivity analysis was performed excluding patients with depression/anxiety diagnoses during the study period.

Results:  During the study period, 8.9% of patients with FM used TCAs at anytime, 5.0% used TCAs during the year before FM diagnosis, and 7.2% used TCAs during the year after. The mean (median) duration of the first treatment episode was 150 (58) days. During this episode, 84.0% used other medications concomitantly, with 60.3% using analgesics and 39.6% using other antidepressants. Additionally, 60.8% augmented TCA use with other drugs, 61.8% switched to another drug at the end of their TCA episode, and 22.8% discontinued TCAs without switching. Similar patterns were observed for the subset of patients with no depression or anxiety (N = 7,655).

Discussion:  Research covering 1999 to 2005 using the same methods found that 15.9% of patients with FM used TCAs during the year before FM diagnosis and 20.7% used TCAs during the year after. These findings suggest that TCA use among the patients with FM is uncommon and may be declining in real‐world practice.
Prevalence of anti‐dengue immunoglobulin G antibodies among American Red Cross blood donors in Puerto Rico, 2006
Authors: Mohammed Hamish , Tomashek Kay M. , Stramer Susan L. , Hunsperger Elizabeth
Published: January 2012

BACKGROUND: Dengue is endemic in Puerto Rico and causes periodic outbreaks involving thousands of persons. Seroprevalence studies among blood donors can provide useful data on the immune status of the adult population. The objective of this study was to determine the prevalence of anti‐dengue immunoglobulin (Ig)G antibodies in a random sample of blood donors to the American Red Cross (ARC) in Puerto Rico.

STUDY DESIGN AND METHODS: Three‐hundred randomly selected blood donations collected by the ARC from February 1 to March 31, 2006, were tested using an anti‐dengue IgG enzyme‐linked immunosorbent assay. One‐third of the positive specimens were randomly selected and tested by a microneutralization test (MNT) to determine the serotypes of previous dengue infections.

RESULTS: Most (84%) blood donors were male, and the mean age was 44.6 years (range, 18‐80 years). The prevalence (95% confidence interval) of anti‐dengue IgG antibodies was 92% (89%‐95%). Of the 92 specimens tested by the MNT, reactivity to all four dengue serotypes was observed and 96% were secondary infections. The predominant serotype with the highest neutralization titers, as identified by at least a fourfold higher titer compared to any other serotype tested, was identified in 32 specimens; the most common predominant serotypes identified by the MNT were DENV‐3 and DENV‐2 (63%). Recent infection with DENV‐1 was detected but, in 2005, routine surveillance did not detect any cases of this serotype.

CONCLUSION: Supplementary serologic testing of donated blood can potentially provide information on the silent circulation or introduction of dengue serotypes.
Factor VIII/von Willebrand factor concentrate therapy for ventricular assist device–associated acquired von Willebrand disease
Authors: Cushing Melissa , Kawaguchi Kathy , Friedman Kenneth D. , Mark Tomer
Published: January 2012

BACKGROUND: Acquired von Willebrand disease (aVWD) can lead to a propensity to bleed, and many different modalities have been used to treat this condition. The efficacy of these agents in patients with aVWD secondary to cardiac assist devices is not fully understood.

STUDY DESIGN AND METHODS: A case is reported of a patient with two risk factors for aVWD, multiple myeloma and ventricular assist device (VAD), who was successfully treated with von Willebrand factor (VWF)/Factor VIII concentrate (Humate‐P, CSL Behring) during the bridge to VAD replacement.

RESULTS: Although continued absence of high‐molecular‐weight VWF persisted after VWF replacement with Humate‐P, the patient's VWF antigen and activity increased and clinical hemostasis was achieved. The VAD clotted on a few occasions, despite a continuous heparin infusion; however, these events were resolved with temporarily holding the Humate‐P. A VAD exchange was performed and the patient was successfully bridged to heart transplant.

CONCLUSION: The treatment of VAD‐associated aVWD may be augmented with Humate‐P, and successful treatment can allow a bridge to heart transplantation. However, careful monitoring for thrombosis in the VAD circuit must be undertaken.
Challenges and opportunities to prevent transfusion errors: a Qualitative Evaluation for Safer Transfusion (QUEST)
Authors: Heddle Nancy M. , Fung Mark , Hervig Tor , Szczepiorkowski Zbigniew M. , Torretta Lorella , Arnold Emmie , Lane Shannon , Murphy Michael F. ,   for the BEST Collaborative
Published: January 2012

BACKGROUND: One of the most frequent causes of transfusion‐associated morbidity or mortality is the transfusion of the wrong blood to the wrong patient. This problem persists in spite of the incorporation of numerous procedures into the pretransfusion checking process in an effort to improve patient safety. A qualitative study was undertaken to understand this process from the perspective of those who administer blood products and to identify concerns and suggestions to improve safety.

STUDY DESIGN AND METHODS: Twelve focus group discussions and seven individual interviews were conducted at six hospitals in five countries (n = 72 individuals). Health care professionals from a variety of clinical areas participated. Data analysis identified common themes using the constant comparison method.

RESULTS: Five major themes emerged from the analysis: the pretransfusion checking process, training, policy, error, and monitoring. Findings include the following: staff were aware and appreciative of the seriousness of errors and were receptive to continuous monitoring, the focus was on checking the bag label with the paperwork rather than the bag label with the patient at the bedside, training methods varied with most perceived to have minimal effectiveness, and access to policies was challenging and keeping up to date was difficult. Other factors that could contribute to errors included high volume of workload distractions and interruptions and familiarity or lack of familiarity with patients.

CONCLUSIONS: Multiple factors can contribute to errors during the pretransfusion checking limiting the effectiveness of any individual intervention designed to improve safety. Areas of further research to improve safety of blood administration were identified.
Monitoring Device Acceptance in Implantable Cardioverter Defibrillator Patients Using the Florida Patient Acceptance Survey
Authors: VERSTEEG HENNEKE , STARRENBURG ANNEMIEKE , DENOLLET JOHAN , PALEN JOB VAN DER , SEARS SAMUEL F. , PEDERSEN SUSANNE S.
Published: January 2012

Background:

Patient device acceptance might be essential in identifying patients at risk for adverse patient‐reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified correlates of device acceptance in a Dutch cohort of ICD patients.

Methods:

Patients with a first‐time ICD (N = 272, mean age = 59.2 ± 11.9, 82% men) recruited from the Erasmus Medical Center, Rotterdam, or the Medisch Spectrum Twente, Enschede, The Netherlands completed the FPAS, the Type D Scale, and the Hospital Anxiety and Depression Scale.

Results:

Exploratory and confirmatory factor analyses indicated that eliminating three items from the FPAS, leaving 12 items contributing to three factors, is equivalent to the original four‐factor version of the FPAS. The abbreviated FPAS had a high internal consistency both for the total scale and all subscales, with Cronbach's alphas ranging from 0.76 to 0.82. Anxiety (odds ratio [OR]: 9.75; 95% confidence interval [CI]: 2.38–39.87; P = 0.002), depression (OR: 2.96; 95% CI: 0.98–8.93; P = 0.05), and the distressed (Type D) personality (OR: 5.04; 95% CI: 1.50–16.92; P = 0.01), but not demographic and clinical factors including shocks, were significant independent correlates of poor device acceptance.

Conclusion:

A shortened 12‐item, three‐factor version of the FPAS was shown to be a valid and internally consistent instrument to assess device acceptance in Dutch ICD patients. Psychological but not clinical factors were the primary correlates of device acceptance, which underlines the importance of taking into account the patient's psychological profile when seeking to identify patients at risk for adjustment difficulties after ICD implantation. (PACE 2011;XX:1–10)
Visually Guided Sequential Pulmonary Vein Isolation: Insights into Techniques and Predictors of Acute Success
Authors: SCHMIDT BORIS , GUNAWARDENE MELANIE , URBAN VERENA , KULIKOGLU MEHMET , SCHULTE‐HAHN BRITTA , NOWAK BERND , BORDIGNON STEFANO , CHUN KR J.
Published: January 2012

Sequential PVI with Laser Balloon. Introduction: Pulmonary vein isolation (PVI) is a challenging procedure most often requiring sophisticated technical aids such as electroanatomical mapping, double transseptal access, and the use of a circular mapping catheter. We sought to develop a PVI strategy solely based on visual guidance with a single ablation device as well as a single transseptal puncture using the endoscopic ablation system (EAS).

Methods and Results: In 35 patients with drug‐refractory atrial fibrillation (18 male, mean age: 62 ± 9 years) ablation was performed. PVI was achieved in 96 of 137 PVs (70%) purely by visually guided circular ablation. Predictors of acute isolation were the degree of PV occlusion by EAS as well as the number of catheter repositionings but not total ablation energy or the number of laser applications. Conduction gaps were detected at sites with suboptimal occlusion as well as esophageal temperature elevations. Further EAS ablation resulted in a 98% acute isolation rate. Mean procedure and fluoroscopy times were 154 ± 38 minutes and 16 ± 6 minutes, respectively. Between the first and last 12 cases, a reduction in procedure times (175 ± 48 minutes vs 138 ± 26 minutes; P = 0.05) was observed. One pericardial tamponade and 1 right‐sided phrenic nerve palsy occurred. During a median follow‐up of 266 days (q‐q3: 218–389), 27 of 35 patients (77%) remained free of any tachyarrhythmia recurrence off antiarrhythmic drugs.

Conclusions: Sequential PVI based solely on endoscopic visual information with a single device and a single transseptal puncture is feasible. Optimal PV occlusion and few controlled repositionings facilitate PVI. (J Cardiovasc Electrophysiol, Vol. 23, pp. 576–582, June 2012)
Mitral Isthmus Ablation with and Without Temporary Spot Occlusion of the Coronary Sinus: A Randomized Clinical Comparison of Acute Outcomes
Authors: HOCINI MÉLÈZE , SHAH ASHOK J. , NAULT ISABELLE , RIVARD LENA , LINTON NICK , NARAYAN SANJIV , MYIAZAKI SHINSUKE , JADIDI AMIR S. , KNECHT SÉBASTIEN , SCHERR DANIEL , WILTON STEPHEN B. , ROTEN LAURENT , PASCALE PATRIZIO , PEDERSEN MICHALA , DERVAL NICOLAS , SACHER FRÉDÉRIC , JAÏS PIERRE , CLÉMENTY JACQUES , HAÏSSAGUERRE MICHEL
Published: January 2012

Role of CS Occlusion for Mitral Isthmus Ablation. Objective: To evaluate the safety and outcomes of mitral isthmus (MI) linear ablation with temporary spot occlusion of the coronary sinus (CS).

Background: CS blood flow cools local tissue precluding transmurality and bidirectional block across MI lesion.

Methods: In a randomized, controlled trial (CS‐occlusion = 20, Control = 22), MI ablation was performed during continuous CS pacing to monitor the moment of block. CS was occluded at the ablation site using 1 cm spherical balloon, Swan–Ganz catheter with angiographic confirmation. Ablation was started at posterior mitral annulus and continued up to left inferior pulmonary vein (LIPV) ostium using an irrigated‐tip catheter. If block was achieved, balloon was deflated and linear block confirmed. If not, additional ablation was performed epicardially (power ≤25 W). Ablation was abandoned after ∼30 minutes, if block was not achieved.

Results: CS occlusion (mean duration −27 ± 9 minutes) was achieved in all cases. Complete MI block was achieved in 13/20 (65%) and 15/22 (68%) patients in the CS‐occlusion and control arms, respectively, P = 0.76. Block was achieved with significantly small number (0.5 ± 0.8 vs 1.9 ± 1.1, P = 0.0008) and duration (1.2 ± 1.7 vs 4.2 ± 3.5 minutes, P = 0.009) of epicardial radiofrequency (RF) applications and significantly lower amount of epicardial energy (1.3 ± 2.4 vs 6.3 ± 5.7 kJ, P = 0.006) in the CS‐occlusion versus control arm, respectively. There was no difference in total RF (22 ± 9 vs 23 ± 11 minutes, P = 0.76), procedural (36 ± 16 vs 39 ± 20 minutes, P = 0.57), and fluoroscopic (13 ± 7 vs 15 ± 10 minutes, P = 0.46) durations for MI ablation between the 2 arms. Clinically uneventful CS dissection occurred in 1 patient

Conclusions: Temporary spot occlusion of CS is safe and significantly reduces the requirement of epicardial ablation to achieve MI block. It does not improve overall procedural success rate and procedural duration. Tissue cooling by CS blood flow is just one of the several challenges in MI ablation. (J Cardiovasc Electrophysiol, Vol. 23, pp. 489‐496, May 2012)
Moderators of the synchrony of change between decreasing depression severity and disability
Authors: Verboom C. E. , Ormel J. , Nolen W. A. , Penninx B. W. J. H. , Sijtsema J. J.
Published: January 2012

Verboom CE, Ormel J, Nolen WA, Penninx BWJH, Sijtsema JJ. Moderators of the synchrony of change between decreasing depression severity and disability.

Objective:  To identify moderators of synchrony of change between depression severity and disability.

Method:  From a large cohort study with 2 years of follow‐up, patients with major depressive disorder at baseline who decreased at least 25% in depression severity after 2 years (n = 245) were selected. We measured overall and domain‐specific disability at baseline, and at 1‐ and 2‐year follow‐up. Possible moderators, among which several demographic, clinical, personality, and contextual factors, were measured at baseline. We used linear mixed models to analyze the data.

Results:  Decrease in depression severity correlated strongly with reductions of overall disability (r = 0.54). Synchrony of change for the disability domains ranged from 0.13 for self‐care to 0.47 for participation. From the possible moderators, only age and work stress moderated the association between change in depression severity and disability, with stronger synchrony of change among younger patients and patients who experienced moderate work stress.

Conclusion:  Strong synchrony of change exists between depression severity and disability. Perhaps, because of the strength of this synchrony, few contextual characteristics moderated the association. Clinicians should be aware of the risk of slower or incomplete functional recovery in older people and those without a job or those experiencing low work stress.
Sublime Disembodiment? Self‐as‐Other in Anne Carson’s Decreation
Authors: Disney Dan
Published: January 2012

Anne Carson’s Decreation (2006) interrogates both the reality of the real and the possibilities for expressing glimpsed, sublime meta‐realities. The article argues that Carson reverses conventional (masculine) responses to sublime experience, and recuperates the feminine sublime as a radical, exemplary mode that removes – rather than enshrines – boundaries between the subject and immersion in the real.1
Mannose‐binding lectin genotype and serum levels in patients with chronic and allergic pulmonary aspergillosis
Authors: Harrison E. , Singh A. , Morris J. , Smith N. L. , Fraczek M. G. , Moore C. B. , Denning D. W.
Published: January 2012

Several studies suggest mannose‐binding lectin (MBL) deficiency is associated with various manifestations of aspergillosis. MBL serum levels and function are genetically determined, but levels rise during inflammation. We address the relative frequency of deficient genotypes, the relationship between serum level and genotype and both age and disease manifestations in patients with chronic pulmonary (CPA) and allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS). DNA was extracted from blood samples, and MBL2 genotyping was performed using the INNO‐LiPA MBL2 kit. Serum MBL concentrations were determined using ELISA. One hundred and eight patients were evaluated, 70 (65%) with CPA, 38 (35%) with allergic disease (ABPA, SAFS or undefined) and 13 (12%) had both CPA and ABPA. The mean MBL serum level was 1849 μg L−1 and did not differ between groups. Forty subjects (37%) had exon 1 genotypes producing nonfunctional MBL (A/B, A/C, A/D and O/O), a frequency not different from published normal controls. A/A subjects with CPA had higher levels (2981 μg L−1) compared with allergic A/A subjects (2202 μg L−1) (pc0.012). No single haplotype, genotype or allele was significantly related to any aspergillosis phenotype. Worse breathlessness was associated with higher MBL levels among A/A subjects (P = 0.009) and conversely nonfunctional genotypes. Mean MBL values were higher in those with an Medical Research Council (MRC) breathlessness score of 5 compared with those with and MRC score of 1 (P = 0.023). A/A allergic subjects (n = 27) in this study were ∼11 years younger than allergic A/O subjects (n = 11, P = 0.02). Subjects with worse respiratory status or more severe CPA had higher MBL serum levels (P = 0.023; P = 0.034). Bronchiectasis was not associated with MBL levels in CPA or allergic aspergillosis. MBL genotype and serum level modulate progression of aspergillosis.
Detection of two HLA‐B*27 alleles, B*27:25 and B*27:86, in two Taiwanese blood donors by sequence‐based typing
Authors: Yang E. K. L. , Lee S. K. , Lin P. Y.
Published: January 2012

We report here two HLA‐B*27 alleles, B*27:86 and B*27:25, found in two Taiwanese blood donors. The new sequence of B*27:86 is identical to B*27:04:01 in exons 2 and 3, except at nucleotide 602 (A→G) in exon 3. The nucleotide change caused an amino acid substitution from E to G at amino acid residue 177. The sequence of B*27:25 is identical to B*27:04:01 in exons 2, 3, 4, 5, 6 and 7 except at nucleotides 538, 539, 559 and 560 in exon 4. The nucleotide changes caused amino acid substitutions from L to W and from E to L at residues 156 and 163, respectively. The generation of B*27:86 was probably resulted by a point mutation while the generation of B*27:25 may have been derived from a sequence recombination event between B*46:01:01 and B*27:04:01. The probable HLA‐A, ‐B and ‐DRB1 haplotypes in association with B*27:86 and B*27:25 may be deduced as A*11:53‐B*27:86‐DRB1*12 and A*11:01‐B*27:25‐DRB1*04:05, respectively.
RECOVERY AND UTILIZATION OF PROTEIN DERIVED FROM SURIMI WASH‐WATER
Authors: STINE J.J. , PEDERSEN L. , SMILEY S. , BECHTEL P.J.
Published: January 2012

Surimi processors are committed to improve utilization of seafood resources, increase productivity and reduce organic matter discharged into the environment. The object of this study was to recover protein from pollock surimi processing wash‐water using membrane filtration and characterize properties of the recovered material. A pilot unit equipped with membrane elements concentrated protein from the surimi wash‐water. Membrane concentrate and control surimi samples were analyzed for proximate composition, lipid oxidation, color, sodium dodecyl sulfate gel electrophoresis, amino acids and minerals. Membrane concentrate, membrane concentrate plus surimi and control surimi were monitored for 180 days of storage at −20C. The membrane concentrate had significantly higher moisture and lipid, but lower protein content than surimi. As determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis, membrane concentrate proteins displayed a greater amount of lower molar mass molecules compared with surimi. The amino acid profile was comparable to control surimi and the recovered membrane concentrate proteins had similar nutritional values to that of surimi. The results indicate that the addition of 5% membrane concentrate to surimi will not adversely affect the storage at −20C and that the recovered wash‐water protein could be used to obtain a fish protein ingredient or added back at a low percentage to surimi products.

PRACTICAL APPLICATIONS

In order to increase productivity and improve utilization of seafood resources, surimi processors are looking into alternative technologies to recover proteins and other material from the wastewater. Membrane filtration is a promising option for the concentration of wastewater. This study was conducted to determine the recovery and characterize the material recovered from surimi wash‐water using a commercial membrane filtration unit. It was demonstrated that the recoverable material is nutritionally similar to the final surimi product and that the overall yield can be increased using membrane technology. In addition to the benefit of recovering protein, the membrane filtration can reduce the amount of material in the waste stream.
FUNDAMENTAL RHEOLOGY AND QUALITY CHARACTERISTICS OF SOUS‐VIDE PROCESSED APPLE PUREES CONTAINING APPLE OR BLACKCURRANT POMACE INCLUSIONS
Authors: KEENAN DEREK F. , BRUNTON NIGEL P. , GORMLEY RONAN , BUTLER FRANCIS
Published: January 2012

The effect of pomace type and level of inclusion on the quality and rheological characteristics of sous‐vide processed apple puree (Bramley's Seedling) was evaluated. Purees containing apple (Shampion freeze‐dried, Shampion, Ariwa) and blackcurrant pomaces, at inclusion levels of 0, 2.5 and 5% w/w, were processed by sous‐vide (P90 > 10 min). Reductions in L* color values (P < 0.001) were observed in pomace type and inclusion level. Shampion pomace had the highest (P < 0.001) sensory acceptability (3.63) of the pomaces (control 4.21). Both pomace type and increasing pomace inclusions influenced (P < 0.001) rheological properties. This was supported by texture analysis, i.e., increase (P < 0.001) in extruded force with increasing pomace inclusion. The best performing pomace (Shampion) was included in sous‐vide purees at eight levels (0, 2.5, 5, 6, 7.5, 9, 10 and 12.5%, w/w). The highest pomace inclusion gave the firmest purees without affecting color. Sensory data indicated that purees with up to 7.5% w/w pomace were acceptable.

PRACTICAL APPLICATIONS

Research has concluded that consumption of fruits and vegetables in Europe is substantially below World Health Organization guidelines (<400–600 g/day). As fruits are a significant source of fiber, it is important that their intake is maintained as part of a healthy diet. Providing a choice of fresh and minimally processed fruit products is the key to increasing consumption. Following the success of ready‐meals, the expectation for similar retail success exists for ready‐desserts. This study focused on assessing the effect of pomace inclusions on the quality parameters of sous‐vide processed Bramley's Seedling apple purees. The development of these products would benefit both consumers (health) and processors (cost‐effective way of adding value) alike. Inclusions of pomaces had significant effects on color, sensory and rheological parameters of apple purees. These outcomes may be of benefit to the food industry to develop better products.
First record of two fungivorous tenebrionids, Ischnodactylus parallelicornis (Nakane) and Platydema higonium Lewis (Coleoptera: Tenebrionidae: Diaperinae) from Korea with new fungal hosts
Authors: JUNG Boo Hee , LEE Jong Wook
Published: January 2012

Fungivorous tenebrionids, Ischnodactylus parallelicornis (Nakane 1956) and Platydema higonium Lewis, 1894 in the tribe Diaperini (Coleoptera: Tenebrionidae: Diaperinae), are recorded for the first time from Korea. Both I. parallelicornis and P. higonium are rare inhabitants of fungi on deciduous trees in Korea. These species all exhibit monophagy, with I. parallelicornis only inhabiting the fruiting body of Tramates orientalis and P. higonium only inhabiting the fruiting body of Stereum hirsutum and Stereum ostrea throughout their lives. A description, key to the Korean Ischnodoctylus and Platydema, fungal hosts, biological notes, photographs of adults and illustrations of diagnostic characteristics are provided herein.
Efficacy of fenofibrate in Chinese patients with primary biliary cirrhosis partially responding to ursodeoxycholic acid therapy
Authors: HAN Xiao Feng , WANG Qi Xia , LIU Yuan , YOU Zheng Rui , BIAN Zhao Lian , QIU De Kai , MA Xiong
Published: January 2012

OBJECTIVE:  To investigate the efficacy of fenofibrate combination therapy in Chinese patients with primary biliary cirrhosis (PBC) who had a partial response to standard dose of ursodeoxycholic acid (UDCA) for at least one year.

METHODS:  PBC patients were treated with UDCA (13–15 mg/kg/day) for more than one year. The biochemical response to UDCA treatment was evaluated after treatment. Fenofibrate (200 mg/day) was added to 22 patients with partial response to UDCA.

RESULTS:  In patients with partial response to UDCA, serum alkaline phosphatase (ALP) and γ‐glutamyl transpeptidase levels significantly decreased after 3‐month combination therapy of UDCA and fenofibrate, 68% of these patients even reached normal ALP level. Serum triglyceride (TG) and cholesterol levels were improved, and alanine transaminase (ALT) and aspartate transaminase (AST) were also decreased during the combination therapy. However, fenofibrate had no significant effect on serum bilirubin levels. The improvement of liver biochemical tests was maintained in some patients with long‐term therapy (at least 6 months). No obvious adverse effects were observed in patients taking fenofibrate.

CONCLUSIONS:  Fenofibrate is effective for improving liver biochemical tests in patients who have partial response to UDCA monotherapy. It is worth exploring the efficacy of fenofibrate on histological changes in PBC patients.
Inflammatory bowel disease in the 21st century in China: Turning challenges into opportunities
Authors: OUYANG Qin , XUE Lin Yun
Published: January 2012

Inflammatory bowel disease (IBD) has been an international hot spot for research for a long period of time. In China, the prevalence of IBD is rapidly increasing in recent years, mimicking the same fast growing footsteps of the developed world. Chinese literature of the 20th century shows that the total number of IBD cases increased by approximately 2.5‐fold over the previous decade, in particular a 15.7‐fold in patients with Crohn's disease (CD). Articles on basic research have increased 4.3‐fold, with a particular 9.9‐fold increase on immunological mechanisms. The predominantly Traditional Chinese Medicine (TCM) related clinical trials implied tendency to use a combination of Western Medicine and TCM in the management of Chinese IBD patients. IBD research and collaborations overseas have been markedly promoted since the Chinese Organization for the Study of Inflammatory Bowel Disease (COIBD) was founded at the beginning of the 21st century. From the second decade of the century onwards, we need to focus on the research hot spots to catch up with the rapid advances worldwide. Big challenges and present achievements provide us with great opportunities for further developments of the study on IBD. The development of some novel target pathogenic factors of the disease will provide us with more effective roll for modern management and optimistic treatment of IBD during this century.
Evaluation of cell population data on the UniCel DxH 800 Coulter Cellular Analysis system as a screening for viral infection in children
Authors: JUNG Y‐J. , KIM J‐H. , PARK Y‐J. , KAHNG J. , LEE H. , LEE K‐Y. , KIM M. Y. , HAN K. , LEE W.
Published: January 2012

Introduction:  The utility of WBC cell population data (CPD) for the differential diagnosis of viral infection from normal control, bacterial infection, and tuberculosis in children was investigated.

Methods:  A data set of 602 total whole‐blood samples were analyzed on the DxH 800 System for complete blood cell count (CBC) with leukocyte differential from children with the following sample breakdown: 77 confirmed diagnoses of viral infections (Epstein–Barr virus; 30, influenza A; 19, rota virus; 11, other viruses;17), 54 normal control, 71 bacterial infection, 17 TB patients, and 383 with various diseases. The mean (MN) and standard deviation (SD) of the volume (V), conductivity (C), five light‐scatter measurements, and 14 calculated parameters were obtained for the leukocytes.

Results:  Using a combination of the CBC and CPD parameter values, a decision rule, composed of 21 parameters, for the screening of viral infection in children was developed. Using this decision rule, 74 of 77 (96.1%) viral infections, two of 54 (3.7%) normal samples, one of 17 (5.9%) TB, and six of 71 (8.5%) bacterial infection samples were identified. The sensitivity was 96.1%, and specificity for normal control was 96.3% with an overall specificity of 93.7%. Fifty‐nine samples of 383 samples (15.4%) collected from in‐patient children with various diseases without confirmation of viral infection were included in this decision rule.

Conclusion:  In conclusion, the implementation of leukocytes CPD parameters can be useful in the detection of viral infection in children.
Association of Low Plasma Adiponectin With Early Diastolic Dysfunction
Authors: Negi Smita I. , Jeong Euy‐Myoung , Shukrullah Irfan , Raicu Mihai , Dudley, Jr Samuel C.
Published: January 2012

Diastolic dysfunction (DD) with preserved left ventricular (LV) ejection fraction (EF) has been linked to obesity. Adiponectin is a cytokine related to obesity and obesity‐linked cardiovascular complications. The authors aimed to determine the independent association of DD with adiponectin. Fifty patients with impaired relaxation DD and a normal EF and age‐matched normal controls were recruited. Plasma levels of total and high molecular weight (HMW) adiponectin were measured. Mid and low molecular weight (MMW+LMW) fractions of adiponectin were calculated by subtracting HMW fraction from total adiponectin. The DD group had significantly lower total (median, 4.4 vs 12.7 μg/mL; P=.001), HMW fraction (median, 1.3 vs 3.4 μg/mL; P=.02), and MMW+LMW fraction of adiponectin (median, 3.8 vs 7.2 μg/mL; P=.01). Body mass index (BMI) negatively correlated with total (r:−0.46, P=.003), HMW (r:−0.32, P=.038), and MMW+LMW (r:−0.40, P=.006) fractions of adiponectin. DD had an independent association with both BMI (P<.05) and total adiponectin (P<.001) in linear regression model using sex, BMI, blood pressure, and total adiponectin as covariates. DD was associated with BMI (P=.02), HMW fraction (P=.03), and MMW+LMW fraction (P=.004) in similar linear regression analyses. Adiponectin deficiency may be one explanation for the adiposity‐related cardiac oxidation known to be involved in the pathogenesis of DD.
Subclinical Anthracycline Cardiotoxicity in Patients With Acute Promyelocytic Leukemia in Long‐Term Remission After the AIDA Protocol
Authors: Pellicori Pierpaolo , Calicchia Angela , Lococo Francesco , Cimino Giuseppe , Torromeo Concetta
Published: January 2012

Anthracycline chemotherapy remains a critical component of cancer treatment despite its established risk of cardiotoxicity. To investigate whether the AIDA protocol, which combines idarubicin, mitoxantrone, and all‐trans retinoic acid (ATRA) for treatment of acute promyelocytic leukemia (APL) results in late cardiotoxicity, 34 APL patients in long‐term remission were evaluated. The cumulative dose of idarubicin and mitoxantrone were 80 mg/m2 and 50 mg/m2, respectively. Median follow‐up was 7 years. Segmental wall motion abnormalities (SWMAs) were detected in 11 AIDA patients who still presented with an ejection fraction (EF) within normal limits (EF 56% in the AIDA group vs 59% in the control group, P=.01). However, parameters of diastolic dysfunction were significantly impaired in the AIDA group (E/A ratio: 1.04 in the AIDA group vs 1.28 in the control group, P=.001; E/E’ lateral ratio: 10.04 in the AIDA group vs 5.79 in the control group, P≤.001) as well as left atrial volume (52 mL in the AIDA group vs 35 mL in the control group, P<.001). Cardiac toxicity due to anthracycline therapy is often frequent. Changes in diastolic function are helpful in the detection of subclinical anthracycline cardiotoxicity in long‐term cardiac follow‐up despite a preserved systolic ventricular function.
Caregiver causal attributions in youth psychosis
Authors: Clarke Kerrie , Couchman Grace
Published: January 2012

Aim: Caregiver causal attributions influence patient and caregiver reactions to psychosis. The current study describes common caregiver causal attributions about psychosis onset in youth, including a subset of first‐episode psychosis patients, and the patient and caregiver characteristics that influence these attributions. It also examines if caregiver views are affected by contact with youth mental health services.

Methods: Fifty‐one caregivers of 50 youth patients with a diagnosed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) psychotic disorder were interviewed about their causal attributions. Patient and caregiver demographic and clinical predictors were also collected.

Results: Caregivers most highly endorsed substance use, genetics, negative peer influences and school stress as individual causes. These findings were consistent across the total sample. Principal components analysis derived three causal categories. Caregivers most frequently endorsed a biological and substance use lifestyle causal category, followed by psychological vulnerability and stress‐reactivity causal categories. There was evidence that caregiver and patient factors, as well as contact with youth mental health services, influenced the causal attributions caregivers made about the onset of psychosis.

Conclusion: Caregivers of youth with psychosis are making causal attributions that are consistent with current aetiological theories of psychosis in youth. The study showed that caregivers are particularly cognizant of genetic and substance use factors in the development and maintenance of psychosis. However, youth mental health services may need to particularly focus on increasing caregiver understanding of the dynamics of stress factors as symptoms, and not causes, of psychosis early in the illness course.
Surgical and implant‐supported fixed prosthetic treatment of a patient with ectodermal dysplasia: a case report
Authors: Al‐Ibrahim Hind A. , Al‐Hadlaq Solaiman M. , Abduljabbar Tariq S. , Al‐Hamdan Khalid S. , Abdin Hassan A.
Published: January 2012

Ectodermal dysplasia (ED) is a hereditary disorder that affects ectodermal structures. The main clinical oral manifestations of ED include oligodontia and deficient alveolar ridges. This case report presents the oral rehabilitation of a 15‐year‐old female patient who never received an accurate diagnosis or appropriate dental care. Treatment included a combination of surgical intervention, a maxillary tooth‐supported fixed detachable telescopic prosthesis, and an implant‐supported mandibular fixed partial denture. The results showed a significant improvement in the esthetics, function, and psychological status of the patient. This article stresses the importance of appropriate care in providing an acceptable quality of life for patients with ED.