bluuebunny/crossref_metadata_2025 huggingface dataset:
Unfavorable influence of structured exercise program on total leisure‐time physical activity
Authors: Wasenius N. , Venojärvi M. , Manderoos S. , Surakka J. , Lindholm H. , Heinonen O. J. , Eriksson J. G. , Mälkiä E. , Aunola S.
Published: November 2012

In randomized controlled trials (RCTs), with customized structured physical exercise activity (SPEA) interventions, the dose of leisure‐time physical activity (LTPA) should exceed the LTPA dose of the nonexercising control (C) group. This increase is required to substantiate health improvements achievable by exercise. We aimed to compare the dose of SPEA, LTPA, and total LTPA (SPEA + LTPA) between a randomized Nordic walking (NW) group, a power‐type resistance training (RT) group, and a C group during a 12‐week exercise intervention in obese middle‐aged men (n = 144) with impaired glucose regulation. The dose of physical activity was measured with diaries using metabolic equivalents. No significant difference (P > 0.107) between the groups was found in volume of total LTPA. The volume of LTPA was, however, significantly higher (P < 0.050) in the C group than in the NW group, but not compared with the RT group. These results indicate that structured exercise does not automatically increase the total LTPA level, possibly, as a result of compensation of LTPA with structured exercise or spontaneous activation of the C group. Thus, the dose of total LTPA and the possible changes in spontaneous LTPA should be taken into account when implementing a RCT design with exercise intervention.
Exhaled nitric oxide concentration upon acute exposure to moderate altitude
Authors: Caspersen C. , Stang J. , Thorsen E. , Stensrud T.
Published: November 2012

The purpose of this study was to assess immediate changes in the partial pressure of nitric oxide (NO) in exhaled gas (PENO) in healthy trained subjects who were acutely exposed to moderate altitude. One group of nine and another group of 20 healthy subjects were exposed to an ambient pressure of 728 hPa (546 mmHg) corresponding to an altitude of 2800 m for 5 and 90 min, respectively, in an altitude chamber. PENO was measured offline by sampling exhaled gas in tight metal foil bags at 5, 30, 60, and 90 min. A correction for increased expiratory flow rate due to gas density effects at altitude was performed (PENOcorr). PENO was significantly decreased by 13–16%, while the fraction of NO in exhaled gas (FENO) was increased by 16–19% compared to sea level. There was no significant change in PENOcorr after exposure to altitude for 5, 30, 60, and 90 min. We conclude that there was no change in PENO upon arrival at altitude after correcting for gas density effects on expiratory flow rate. Corrections for altitude effects must be done before comparing measurements performed at different altitudes when using measurements of FENO to monitor athletes who have asthma during training at altitude.
Assessment of the water quality and identification of pollution sources of Kaduna River in Niger State (Nigeria) using exploratory data analysis
Authors: Ogwueleka Toochukwu Chibueze
Published: November 2012

Exploratory data analysis such as hierarchical cluster analysis and principal component analysis were applied to water quality dataset of the Kaduna River, obtained during 3 years (2008–2010), monthly monitoring of eight key different sampling sites for 19 parameters to extract correlations and similarities between variables and to classify river sampling sites in groups of similar quality. Hierarchical cluster analysis grouped eight sampling sites into three statistically significant clusters of similar water composition. Six varifactors were obtained after varimax rotation of initial principal components using principal component analysis. These techniques gave an insight into the sources of pollution. Anthropogenic influence (municipal, industrial wastewater and agricultural run‐off) was the major source of river water pollution.
Appendicular sarcoidosis mimicking acute appendicitis
Authors: Hunjan Tia , Chaudery Muzzafer , Zaidi Ahsan , Beggs Andrew D
Published: November 2012

Appendicular sarcoidosis is a very rare cause of acute abdominal pain, with only seven cases reported previously in the literature. A 45-year-old woman, known to have sarcoidosis, presented to the emergency department with a 1-week history of epigastric and right iliac fossa abdominal pain. At diagnostic laparoscopy, an acutely inflamed appendix was found and removed as well as an omental mass which was biopsied. Subsequent histopathological examination of the appendix demonstrated appendicular sarcoidosis without acute appendicitis and chronic inflammatory changes in the omental biopsy. The patients’ symptoms completely resolved postoperatively. It is important to undertake urgent operative intervention in patients with sarcoidosis who present with right iliac fossa pain, owing to the high risk of perforation.
Retroperitoneal haematoma causing gastric outflow obstruction following endovascular repair of a ruptured abdominal aortic aneurysm
Authors: Hunter Benjamin , Tod Laura , Ghosh Jonathan
Published: November 2012

A 74-year-old man presented with back pain and collapse. A ruptured infrarenal abdominal aortic aneurysm was successfully managed by endovascular aneurysm repair. Postoperatively, he developed gastric outlet obstruction owing to duodenal compression from the unevacuated retroperitoneal haematoma. In the absence of abdominal compartment syndrome, conservative management with gastric decompression and parenteral nutrition led to a full recovery.
Extensive venous thrombosis in a healthy young man with a short inferior vena cava syndrome treated successfully with rivaroxaban
Authors: Khalafallah Alhossain A , Renu Shamsunnaher , Sharp Colin , Hannan Terry
Published: November 2012

We report a case of an incidental finding of congenital absence of the intrahepatic segment of the inferior vena cava (IVC) complicated by extensive bilateral deep venous thrombosis (DVT) with significant oedema following a long-distance road trip. Initially the patient failed treatment with standard anticoagulation therapy with enoxaparin and warfarin. However, he has responded to the new oral antifactor-Xa anticoagulant (rivaroxaban). Within a few days, rivaroxaban improved the oedema and DVT. The significant features of this case are the unusual presentation, the poor response to initial standard anticoagulation therapy and the beneficial outcomes when managed with the novel new anticoagulant. The patient has continued the new treatment regularly for the last 12 months with good toleration and without side effects. This report presents the findings, management and outcomes in a case of extensive bilateral DVT in a previously healthy young man who was found to have a congenital short IVC.
An adverse event of suprapubic catheter SPC insertion. A call for updating the existing guidelines
Authors: Jalil Rozh , Mukundan Chandrika , Bhatti Tahir S
Published: November 2012

The suprapubic catheter (SPC) is a useful and widely used tool in urological practice. However, complications can arise from its insertion or ongoing care. We add to the literature a case of an adverse event of its insertion where it has gone through a vascular graft and recommending updating the SPC insertion guidelines.
Haematological, neurological and electrocardiographic findings in secondary hypothermia
Authors: Dickinson Oana , Hanson Brian , Benditt David G , Duran-Nelson Alisa M
Published: November 2012

The association between secondary hypothermia and pancytopaenia is uncommon. A young woman presented with chronic hypothermia (28.8–34.6°C) secondary to surgical hypothalamic injury postcraniopharyingioma resection as a child. Associated findings included pancytopaenia (haemoglobin 8.1 g/dl, leucocytes 3500/mm3, platelets 63 000/mm3), ataxia, upper motor neuron signs, decreased level of consciousness and new ECG changes. An extensive evaluation failed to reveal any cause of pancytopaenia other than chronic hypothermia. The haematological and neurological changes improved after active rewarming.
An exploration of the word ‘palliative’ in the 19th century: searching the BMJ archives for clues
Authors: Taubert Mark , Fielding Helen , Mathews Emma , Frazer Ricky
Published: November 2012

Background

Palliative care went through a significant evolution in the 20th century, but the 19th century has been seen my some scholars as the real turning point toward the more modern concept of hospices and palliative care.

Methods

To investigate some examples of earlier uses of the word ‘palliative’, a literature search was conducted within the earliest available BMJ archive sections, the years 1840 to 1842. This provided a glimpse into how the word was used in the medical literature in Victorian times, mid-nineteenth century.

Results

Search results brought up a number of case reports, and the word was employed to describe medicines (‘use of palliatives’) as well as passive, non-active treatment approaches, probably best described as a watch-and-wait strategy. Of note is that the first recorded use of the word in the archives is by a surgeon.

Conclusions

Some doctors associated the word palliative with there not being any prospect for cure and only for the relief of symptoms and greater comfort of the patient. There were, however, early reflections on whether palliative treatments may in some cases increase the length of patients’ lives.
KLEIN–GORDON SOLUTIONS ON NON-GLOBALLY HYPERBOLIC STANDARD STATIC SPACETIMES
Authors: BULLOCK DAVID M. A.
Published: November 2012

We construct a class of solutions to the Cauchy problem of the Klein–Gordon equation on any standard static spacetime. Specifically, we have constructed solutions to the Cauchy problem based on any self-adjoint extension (satisfying a technical condition: "acceptability") of (some variant of) the Laplace–Beltrami operator defined on test functions in an L2-space of the static hypersurface. The proof of the existence of this construction completes and extends work originally done by Wald. Further results include: the uniqueness of these solutions; their support properties; the construction of the space of solutions and the energy and symplectic form on this space; an analysis of certain symmetries on the space of solutions; and various examples of this method, including the construction of a non-bounded below acceptable self-adjoint extension generating the dynamics.
CONCENTRATING ARBITRARY FOUR-PHOTON LESS-ENTANGLED CLUSTER STATE BY SINGLE PHOTONS
Authors: XU TING-TING , XIONG WEI , YE LIU
Published: November 2012

We present a protocol for concentrating an arbitrary four-photon entangled state into a maximally entangled state assisted with singled photons. The concentration protocol uses the linear optics and the cross-Kerr nonlinearity based on the post selection principle. Four parties called Alice, Bob, Charlie and Dan in different distant locations can obtain the cluster state from an arbitrary entangled four-photon state with a certain probability. Quantum non-demolition (QND) measurements are available in this protocol. Moreover, this scheme can be steady with a higher success possibility.
NORMALIZED UNITS IN SIMULATION OF LASER/PARTICLE INTERACTIONS
Authors: YUAN C. J. , WANG J. X. , WANG W. , WANG P. X.
Published: November 2012

An algorithm for simulation of laser/particle interactions using normalized units related to different laser frequencies was studied. Correct and wrong conversion methods between different normalized units were investigated in simulations of vacuum laser acceleration. The dynamic characteristics obtained with different processing methods differ greatly and some good acceleration results are actually no other than errors stemming from incorrect treatments of the normalized units.
TWISTED ALEXANDER POLYNOMIALS OF 2-BRIDGE KNOTS
Authors: HOSTE JIM , SHANAHAN PATRICK D.
Published: November 2012

We investigate the twisted Alexander polynomial of a 2-bridge knot associated to a Fox coloring. For several families of 2-bridge knots, including but not limited to, torus knots and genus-one knots, we derive formulae for these twisted Alexander polynomials. We use these formulae to confirm a conjecture of Hirasawa and Murasugi for these knots.
A GOOD PRESENTATION OF (-2, 3, 2s + 1)-TYPE PRETZEL KNOT GROUP AND ℝ-COVERED FOLIATION
Authors: NAKAE YASUHARU
Published: November 2012

Let Ksbe a (-2, 3, 2s + 1)-type pretzel knot (s ≧ 3) and EKs(p/q) be a closed manifold obtained by Dehn surgery along Kswith a slope p/q. We prove that if q > 0, p/q ≧ 4s + 7 and p is odd, then EKs(p/q) cannot contain an ℝ-covered foliation. This result is an extended theorem of a part of works of Jun for (-2, 3, 7)-pretzel knot.
ACCELERATED DARK FLOWS AND THE COSMOLOGICAL AXIS
Authors: TSAGAS CHRISTOS G.
Published: November 2012

A number of recent independent surveys have indicated the presence of large-scale peculiar motions much larger and much faster than anticipated by the current cosmological paradigm. These are the so-called "dark flows". We argue that observers living inside such fast dark flows can experience locally accelerated expansion within a globally decelerating universe. Moreover, to these observers, the universe should also appear to accelerate slightly faster in one direction and equally slower in the opposite. Interestingly, an increasing number of reports claim that such a weak dipolar anisotropy, which is sometimes referred to as the "cosmological axis", may actually reside within the supernovae data.
OPTIMIZATION OF ONLINE PROMOTION: A PROFIT-MAXIMIZING MODEL INTEGRATING PRICE DISCOUNT AND PRODUCT RECOMMENDATION
Authors: JIANG YUANCHUN , LIU YEZHENG
Published: November 2012

Price promotion and product recommendation are important tactics to gain market share in the e-commerce context. To increase sales and enhance promotion profits, practitioners often recommend non-discounted products in the promotional campaign for a product. However, no analytical model is hitherto available to jointly optimize the price discount for the promoted product and the product portfolio to recommend. This paper provides a probability model to complete the task. The proposed model motivates customers through an attractive price discount for the promoted product, while simultaneously encouraging customers to purchase the non-discounted products through the recommendation system. The numerical studies show that the proposed method attains higher profits than do conventional methods. Finally, we offer managerial insights and provide useful guidelines to help e-tailers to make the most profitable online promotional decisions.
FACILE AND LARGE-SCALE FABRICATION OF Ni NANOCHAINS BY A CHEMICAL REDUCTION METHOD WITH THE ASSISTANCE OF EXTERNAL MAGNETIC FIELD
Authors: LIAO J. Y. , LI H. , LIANG J. J. , FENG Y. F. , ZHANG X. B. , YIN Y. Q. , TAO H. X.
Published: November 2012

Magnetic Ni micro/nanostructures with controlled morphology have drawn intensive attention due to their interesting physicochemical properties and potential applications in micro/nanodevices. In this study, one-dimensional Ni nanochains with an average diameter of about 140 nm were prepared by a magnetic-field-assisted chemical reduction of Ni2+ with hydrazine hydrate free of any template or surfactant. It was found that the morphology and the size of the Ni chains could be adjusted by changing the complexant used in the synthesis. The usage of surfactant in the synthesis would retard the firm connection of Ni nanoparticles and thus resulted in the formation of Ni nanochains consisting of loosely aggregated Ni nanoparticles. The magnetic measurement at room temperature indicated that the coercivity of the Ni sample reached 133.2 Oe, which was much higher than that of bulk Ni metal.
ON THE VOLUME OF FLUID METHOD FOR MULTIPHASE FLUID FLOW SIMULATION
Authors: KUMAR BIPIN , CRANE MARTIN , DELAURÉ YAN
Published: November 2012

Numerical study of multiphase fluid flows require mathematical methods for distinguishing interface between two fluids. The volume of fluid (VOF) method is one of such method which takes care of fluid shape in a local domain and reconstructs the interface from volume fraction of one fluid. Maintaining sharp interface during reconstruction is a challenging task and geometrical approach of VOF method better suits for incompressible fluids. This paper provides a complete mathematical discussion of extended form of VOF method using a approach known as piecewise linear interface calculation (PLIC). An analytical relation between volume fraction and interface position has been explored with the help of primitive geometrical shapes. The method with this analytical relation has been applied to multiphase fluid flow benchmark problems and found to be in good agreement.
Search for geochemical indicators of pre-urban habitation sites: case study from the Skomantai hill-fort and settlement, western Lithuania
Authors: Taraškevičius Ričardas , Stančikaitė Miglė , Bliujienė Audronė , Stakėnienė Rimutė , Zinkutė Rimantė , Kusiak Jarosław
Published: November 2012

Thermoluminescence dating of potsherds found in the Skomantai hill-fort and settlement areas in western Lithuania confirms that they were fired from the 4th to the 10th century and historical human activity existed at Skomantai. The aim of this research was to investigate the relationship of chemical elements with total organic carbon and total inorganic carbon and distinguish possible anthropogenic indicators in the study area which is characterised by sandy sediments and wooden construction. Twenty-six chemical elements were determined by EDXRF. Two groups of possible anthropogenic indicators were distinguished: Ca, Zn, Mn, Cu, Ba, P and S, Pb, Br, Cl. All of them are significantly positively correlated with total organic and inorganic carbon. The enrichment factors of possible anthropogenic indicators were calculated based on the local background concentration of sand. Elevated enrichment factors in topsoil indicate regional and local anthropogenic influence; in the layer at 20–50 cm depth they give evidence of historical human activity. The descending sequence of their average enrichment factors in the latter layer of the hill-fort and settlement areas is as follows: S(18.7)> P(7.0)>Cl(4.3)>Mn(4.2)>Cu(3.8)>Zn(3.3)>Br(2.4)> Ca(1.8)>Pb(1.7)>Ba(1.1). The additive index of group S, Pb, Br, Cl is much higher than the additive index of the group Ca, Zn, Mn, Cu, Ba. However, the relative part of the additive index of the group Ca, Zn, Mn, Cu, Ba increases in the settlement area compared to the hill-fort.
Fractionation of trace metals in a contaminated freshwater stream using membrane filtration, ultrafiltration, DGT and transplanted aquatic moss
Authors: Öhlander Björn , Forsberg Jerry , Österlund Heléne , Ingri Johan , Ecke Frauke , Alakangas Lena
Published: November 2012

Four metal speciation and fractionation techniques – DGT (diffusive gradients in thin films), 1-kDa ultrafiltration, 0.22-µm membrane filtration and aquatic moss – were simultaneously applied to a small, contaminated freshwater stream in northern Sweden to investigate differences and similarities between the methods regarding trace metal speciation and their dependence on geochemical water properties. The investigated metals comprise Al, Cd, Co, Cu, Fe, Mn, Ni, and Zn. The normal DGT devices with Chelex cation exchanger were used. Shoots from the aquatic moss
Fontinalis antipyretica
L ex Hedw. were collected in a non-polluted brook and transplanted to the sampling site for exposure. It was evident that 0.22-µm membrane filtration, 1-kDa ultrafiltration and DGT generally measured different metal fractions where <1-kDa ultrafiltered concentrations were lower than DGT labile concentrations which in turn were lower than <0.22-µm concentrations. The differences between DGT and <1-kDa concentrations indicate the occurrence of labile colloids discriminated by ultrafiltration. Strong correlations between DGT and <1 kDa concentrations were found for Al, Cu, Cd, Co and Zn. Despite a rigorous sample cleaning, retention of particulate matter on the moss samples was revealed by a significant correlation between metal concentrations in moss and particulate Fe. Generally, elevated trace metal concentrations were found in moss exposed at the sampling site compared to reference moss from the non-polluted brook. No significant correlations were found between DGT-labile concentrations and moss concentrations.

Supplementary material:

DGT – labile concentrations of Al, Cd, Co, Cu, Fe, Mn, Ni and Zn from deployments in Gråbergsbäcken Stream is available online at
http://www.geolsoc.org.uk/SUP18566
. A hard copy can be obtained from the Society Library.
Medicinal
terra sigillata
: a historical, geographical and typological review
Authors: Macgregor Arthur
Published: November 2012

For over two millennia, clays with perceived medicinal or alexipharmic properties have been recovered in bulk, processed into small troches or pastilles and stamped with a device or ‘seal’ as an indicator of their origin; this practice lent them their commonly applied name –
terra sigillata
or sealed earth. The first records are confined to the Mediterranean and Aegean regions, but early in the post-medieval period other sources in central and northern Europe came to be exploited. The history of this process of expansion is traced, the principal products of the major sources are identified by their respective seals, and some assessment is made of the validity of claims made for the effectiveness of such clays.
Five eighteenth-century medical polymaths
Authors: Hull Gillian C.
Published: November 2012

Five eighteenth-century medical men, like many of their contemporaries, achieved renown for their medical skills and research abilities. They lived during an exciting period marked by the questioning of many traditional beliefs. Coeval scientific achievements increased knowledge of the challenging natural world around them. Outside medicine, John Wall (1708–1776) established the fashionable spa of Malvern, known for the purity of its water, and co-founded the prestigious Worcester Porcelain Company. Erasmus Darwin (1731–1802) had a remarkably inventive mind ranging over many interests, including canal construction, steering equipment for carriages and a copying machine for documents. Edward Jenner (1749–1823) was interested in bird migration, and researched the brood parasitism of the cuckoo. His vaccination of cowpox to prevent smallpox eventually led to the elimination of the disease in 1980. Caleb Parry (1755–1822) practised medicine in Bath and was admired for his knowledge and integrity. He was interested in sheep and produced high-quality merino wool. Since boyhood he had hunted for fossils with his friend, Edward Jenner. John MacCulloch (1773–1835) produced the first geological map of Scotland, published posthumously in 1836. A prolific writer, his book on the Western Isles (1819) is considered a classic.
The influence of geology in the development of public health
Authors: Bergman Beverly P.
Published: November 2012

Public health, the protection of the health of populations through community engagement, is a modern specialty originating in post-Industrial Revolution Britain, while environmental geochemistry is of even more recent origin. The influence of geology on health was first recognized in Classical times, although it was later supplanted by the miasma theory of disease. During the Renaissance, medical teaching began to concentrate more on diagnosis and treatment of the sick individual and less on preserving the health of populations. The concept of geology as a determinant of health re-emerged with the growth of scientific knowledge during the Enlightenment period of the eighteenth century. The nineteenth century saw the first identification of trace element deficiency disease and the publication of a textbook of public health which described geological influences on health. Over the next 100 years both public health and environmental geochemistry became established on a firm footing, although as separate disciplines. Recently the public health focus has been on lifestyle choices, but environmental geochemistry remains a potentially powerful partner in the fight to protect health, and there is much scope to enhance collaborative working. The legacy of the pioneers of both public health and geology must not be forgotten.
Functions of MicroRNAs in Cardiovascular Biology and Disease
Authors: Hata Akiko
Published: November 2012

In 1993, lin-4 was discovered as a critical modulator of temporal development in Caenorhabditis elegans and, most notably, as the first in the class of small, single-stranded noncoding RNAs now defined as microRNAs (miRNAs). Another eight years elapsed before miRNA expression was detected in mammalian cells. Since then, explosive advancements in the field of miRNA biology have elucidated the basic mechanism of miRNA biogenesis, regulation, and gene-regulatory function. The discovery of this new class of small RNAs has augmented the complexity of gene-regulatory programs as well as the understanding of developmental and pathological processes in the cardiovascular system. Indeed, the contributions of miRNAs in cardiovascular development and function have been widely explored, revealing the extensive role of these small regulatory RNAs in cardiovascular physiology.
The timing of administration of a clinically relevant dose of losartan influences the healing process after contusion induced muscle injury
Authors: Kobayashi Tetsuo , Uehara Kenji , Ota Shusuke , Tobita Kimimasa , Ambrosio Fabrisia , Cummins James H. , Terada Satoshi , Fu Freddie H. , Huard Johnny
Published: November 2012

Losartan (Los) is a Food and Drug Administration-approved antihypertensive medication that has a well-tolerated side effect profile. We have demonstrated that treatment with Los immediately after injury was effective at promoting muscle healing and inducing an antifibrotic effect in a murine model of skeletal muscle injury. We initially investigated the minimum effective dose of Los administration immediately after injury and subsequently determined whether the timing of administering a clinically relevant dose of Los would influence its effectiveness at improving muscle healing after muscle injury. In the first part of this study, mice were administered 3, 10, 30, or 300 mg·kg−1·day−1 of Los immediately after injury, and the healing process was evaluated histologically and physiologically 4 wk after injury. In the second study, the clinically relevant dose of 10 mg·kg−1·day−1 was administered immediately or started at 3 or 7 days postinjury. The administration of 300 mg·kg−1·day−1 immediately following injury led to a significant increase in muscle regeneration, a significant decrease in fibrosis, and an improvement in muscle function. Moreover, we observed a significant decrease in fibrosis and a significant increase in muscle regeneration at 4 wk postinjury, when the clinically relevant dose of 10 mg·kg−1·day−1 was administered at 3 or 7 days postinjury. Functional evaluation also demonstrated a significant improvement compared with the injured untreated control when Los treatment was initiated 3 days after injury. Our study revealed accelerated muscle healing when the 300 mg·kg−1·day−1 of Los was administered immediately after injury and a clinically relevant dose of 10 mg·kg−1·day−1 of Los was administered at 3 or 7 days postinjury.
The effect of hypoxemia and exercise on acute mountain sickness symptoms
Authors: Rupp Thomas , Jubeau Marc , Millet Guillaume Y. , Perrey Stéphane , Esteve François , Wuyam Bernard , Levy Patrick , Verges Samuel
Published: November 2012

Performing exercise during the first hours of hypoxic exposure is thought to exacerbate acute mountain sickness (AMS), but whether this is due to increased hypoxemia or other mechanisms associated with exercise remains unclear. In 12 healthy men, AMS symptoms were assessed during three 11-h experimental sessions: 1) in Hypoxia-exercise, inspiratory O2 fraction (FiO2) was 0.12, and subjects performed 4-h cycling at 45% FiO2-specific maximal power output from the 4th to the 8th hour; 2) in Hypoxia-rest, FiO2 was continuously adjusted to match the same arterial oxygen saturation as in Hypoxia-exercise, and subjects remained at rest; and 3) in Normoxia-exercise, FiO2 was 0.21, and subjects cycled as in Hypoxia-exercise at 45% FiO2-specific maximal power output. AMS scores did not differ significantly between Hypoxia-exercise and Hypoxia-rest, while they were significantly lower in Normoxia-exercise (Lake Louise score: 5.5 ± 2.1, 4.4 ± 2.4, and 2.3 ± 1.5, and cerebral Environmental Symptom Questionnaire: 1.2 ± 0.7, 1.0 ± 1.0, and 0.3 ± 0.4, in Hypoxia-exercise, Hypoxia-rest, and Normoxia-exercise, respectively; P < 0.01). Headache scored by visual analog scale was higher in Hypoxia-exercise and Hypoxia-rest compared with Normoxia-exercise (36 ± 22, 35 ± 25, and 5 ± 6, P < 0.001), while the perception of fatigue was higher in Hypoxia-exercise compared with Hypoxia-rest (60 ± 24, 32 ± 22, and 46 ± 23, in Hypoxia-exercise, Hypoxia-rest, and Normoxia-exercise, respectively; P < 0.01). Despite significant physiological stress during hypoxic exercise and some AMS symptoms induced by normoxic cycling at similar relative workload, exercise does not significantly worsen AMS severity during the first hours of hypoxic exposure at a given arterial oxygen desaturation. Hypoxemia per se appears, therefore, to be the main mechanism underlying AMS, whether or not exercise is performed.
KRAS Testing and Epidermal Growth Factor Receptor Inhibitor Treatment for Colorectal Cancer in Community Settings
Authors: Webster Jennifer , Kauffman Tia L. , Feigelson Heather Spencer , Pawloski Pamala A. , Onitilo Adedayo A. , Potosky Arnold L. , Cross Deanna , Meier Paul R. , Mirabedi Anousheh S. , Delate Thomas , Daida Yihe , Williams Andrew E. , Alexander Gwen L. , McCarty Catherine A. , Honda Stacey , Kushi Lawrence H. , Goddard Katrina A.B. ,   on behalf of the CERGEN study team
Published: November 2012

Background: In metastatic colorectal cancer (mCRC), mutations in the KRAS gene predict poor response to EGF receptor (EGFR) inhibitors. Clinical treatment guidelines now recommend KRAS testing if EGFR inhibitors are considered. Our study investigates the clinical uptake and utilization of KRAS testing.

Methods: We included 1,188 patients with mCRCs diagnosed from 2004 to 2009, from seven integrated health care delivery systems with a combined membership of 5.5 million. We used electronic medical records and targeted manual chart review to capture the complexity and breadth of real-world clinical oncology care.

Results: Overall, 428 patients (36%) received KRAS testing during their clinical care, and 266 (22%) were treated with EGFR inhibitors. Age at diagnosis (P = 0.0034), comorbid conditions (P = 0.0316), and survival time from diagnosis (P < 0.0001) influence KRAS testing and EGFR inhibitor prescribing. The proportion who received KRAS testing increased from 7% to 97% for those treated in 2006 and 2010, respectively, and 83% of all treated patients had a KRAS wild-type genotype. Most patients with a KRAS mutation (86%) were not treated with EGFR inhibitors. The interval between mCRC diagnosis and receipt of KRAS testing decreased from 26 months (2006) to 10 months (2009).

Conclusions: These findings show rapid uptake and incorporation of this predictive biomarker into clinical oncology care.

Impact: In this delivery setting, KRAS testing is widely used to guide treatment decisions with EGFR inhibitors in patients with mCRCs. An important future research goal is to evaluate utilization of KRAS testing in other delivery settings in the United States. Cancer Epidemiol Biomarkers Prev; 22(1); 91–101. ©2012 AACR.
Group Treatment for Depression in Mothers of Young Children Compared to Standard Individual Therapy
Authors: Frisch Ulrike , Hofecker-Fallahpour Maria , Stieglitz Rolf-Dieter , Riecher-Rössler Anita
Published: November 2012

Background: Studies on specific psychotherapy for depressed mothers of small children are rare. The aim of the present study was to investigate the effectiveness of a newly developed cognitive-behavioral group intervention for depressed mothers compared to standard individual therapy. Sampling and Methods: In a naturalistic design, 31 mothers suffering from depressive disorders with children aged ≤4 years who had consecutively been admitted to our specialized clinic for mentally ill mothers were assigned to the group treatment, and the following 21 were admitted to the control group receiving standard individual therapy. The group treatment consisted of 12 group sessions and 1 couple session and was administered to five consecutive groups. Participants completed interviews and questionnaires – the Beck Depression Inventory and the Symptom Checklist- 90-R – before and 3 months after therapy. Results: The treatment group and the control group showed a significant improvement in their depression, with no significant differences between the two treatment strategies. The women in group therapy, however, required fewer antidepressants, and group treatment was observed to be more effective in reducing anger and hostility. Conclusion: This form of group treatment for depressed women in early motherhood may have some important advantages over individual therapy; effects were small, however, and should be replicated in a further study.
Olfaction in Affective and Anxiety Disorders: A Review of the Literature
Authors: Burón Emma , Bulbena Antonio
Published: November 2012

Background: Olfaction and its relation to mental health is an area of growing interest. Brain areas linked to olfaction partially overlap with brain areas involved in psychiatric disorders; consequently, the study of olfactory function allows us to explore the integrity of these brain areas with a non-invasive and effective method. Accordingly, the aim of this paper is to review olfactory function in affective and anxiety disorders. Methods: For this purpose, an extensive literature review of English-language studies on olfactory function in patients with the aforementioned pathologies was performed using several online databases. A manual search of relevant journals and books as well as reference lists from selected papers was also performed. Results: The available data show that depressed patients are usually characterised by preserved olfactory function, except for detection threshold, where contrasting reports have been found. Bipolar disorder has been studied to a lesser extent, but the findings have shown a lack of impairment in most cases. Research on seasonal affective disorders is scant, and future studies are needed to make conclusions. Anxiety disorders have been scarcely approached, but the results note identification deficits in obsessive-compulsive and posttraumatic stress disorders. Conclusions: Olfactory assessment appears to be a complementary, valuable research tool in the study of psychiatric disorders. However, further investigation is needed to improve our understanding of olfactory function in these disorders.
‘A Rose Is a Rose Is a Rose’, but At-Risk Criteria Differ
Authors: Schultze-Lutter Frauke , Schimmelmann Benno G. , Ruhrmann Stephan , Michel Chantal
Published: November 2012

Background: Over the last 15 years, efforts to detect psychoses early in their prodromal states have greatly progressed; meanwhile, ultra-high risk (UHR) criteria have been the subject of such consensus that parts of them have been proposed for inclusion in DSM-5 in terms of an attenuated psychosis syndrome. However, it is frequently unacknowledged that the definitions and operationalizations of UHR-related at-risk criteria, including the relevant attenuated psychotic symptoms, vary considerably across centers and time and, thus, between prediction studies. Methods: These variations in UHR criteria are described and discussed with reference to the rates of transition to psychosis, their prevalence in the general population and the proposed new operationalization of the attenuated psychosis syndrome. Results: A comparison of samples recruited according to different UHR operationalizations reveals differences in the distribution of UHR criteria and transition rates as well as in the prevalence rates of at-risk criteria in the general population. Conclusion: The evidence base for the introduction of such a new syndrome is weaker than the number of studies using supposedly equal UHR criteria would at first suggest. Thus, studies comparing the effects of different (sub-)criteria not only on transition rates and outcomes but also on other important aspects, such as neurocognitive performance and brain imaging results, are necessary. Meanwhile, the preliminary attenuated psychosis syndrome in DSM-5 should not follow an altogether new definition but, rather, the currently most reliable UHR definition, which must still demonstrate its reliability and validity outside specialized psychiatric services.
Creativity and Psychiatric Illness: The Search for a Missing Link - An Historical Context for Current Research
Authors: Thys E. , Sabbe B. , De Hert M.
Published: November 2012

Creativity is an important human quality upon which many achievements of humankind are based. Defined as the ability to produce something that is novel and useful or meaningful, it is difficult to operationalize for research. This text provides an overview of the historical and cultural context of this research. The assumption that creativity is related to psychiatric vulnerability dates back to antiquity. The modern interest in the subject stems from the romantic era and gained a scientific aura in the 19th century. In the 20th century, a further entanglement of creativity and psychopathology came about through the influence of patient artists on regular art. Psychometric, psychodiagnostic and genetic research supports a connection between creativity and psychiatric illness within the bipolar-psychotic continuum, with schizotypy/thymotypy as prototypes of creativity-related disorders. Evolutionary hypotheses link the schizophrenia paradox to a survival advantage through enhanced creative ability. The relevance of scientific research in this complex and heterogeneous area can be increased if creativity and psychopathology are further operationalized and if underlying art concepts are made explicit and placed in a broader cultural context. There is a continuing need for meaningful definitions and measures, as well as a multidisciplinary collaboration.
Screening for Very Mild Subcortical Vascular Dementia Patients Aged 75 and Above Using the Montreal Cognitive Assessment and Mini-Mental State Examination in a Community: The Kurihara Project
Authors: Kasai Mari , Meguro Kenichi , Nakamura Kei , Nakatsuka Masahiro , Ouchi Yoshitaka , Tanaka Naofumi
Published: November 2012

Aims: To examine the effectiveness of the Montreal Cognitive Assessment (MoCA) to screen people with mild cognitive impairment (MCI), to associate the MoCA score with the presence of infarction, and to detect the characteristics of people with very mild subcortical vascular dementia (vmSVD). Methods: 392 out of 886 community dwellers aged 75 years and above living in Kurihara, Northern Japan, agreed to participate in our study; 164 scored a Clinical Dementia Rating (CDR) of 0 (healthy), 184 scored a CDR of 0.5 (MCI) and 44 scored a CDR of 1+ (dementia). The participants scoring a CDR of 0.5 were divided into 2 subtypes: 37 had vmSVD and 147 had other types of dementia. The objective variables were the total MoCA, the MoCA subscale and the Mini-Mental State Examination (MMSE). Results: There was a difference in the MoCA and MMSE scores between the 3 CDR groups. The MoCA score overlapped in participants with CDR 0 and 0.5. There were significant CDR effects, while there were no significant infarction effects for the MoCA and MMSE. vmSVD participants had lower scores on the total MoCA, the MoCA attention subscale and MMSE than healthy elderly people and participants with other types of dementia. Conclusion: Our results suggested that MMSE performed rather well and that the MoCA is not superior to MMSE in MCI and vmSVD participants aged 75 and above in a community.
Hereditary Neuropathy with Liability to Pressure Palsy: An Investigation in a Rare and Large Chinese Family
Authors: He Yuan , Wu Qiang , Xu Zhipeng , Wang Qianqian , Wang Weili , Li Dezhong , Liu Wanhong , He Xiaohua
Published: November 2012

Background: Hereditary neuropathy with liability to pressure palsy (HNPP), mainly associated with the peripheral myelin protein 22 (PMP22) gene, is generally an autosomal-dominant inherited peripheral neuropathy. The present large family including four generations provides an exciting opportunity to gain important insights into HNPP in China. Patients and Methods: A large 43-member family with ten members suspected to be affected by HNPP was studied. Neurologic examinations, electrophysiological and neuropathological studies and molecular genetic testing were used for these kindred. Results: Clinically, the proband had limb hyposthenia and atrophy, and his mother showed declined tendon reflexes in the right lower limb. Electrophysiologically, sensory and motor nerve conduction velocities were generalized reduced. Sural nerve biopsy for the proband showed focal thickesning of the myelin sheaths. Furthermore, real-time quantitative PCR demonstrated that the PMP22 gene has a higher Ct value than reference gene in all suspected patients. Conclusions: These results indicated that the family is indeed a rare and large pedigree of HNPP caused by the deletion of PMP22 gene. Given that the suspected patient in the fourth generation is absent, this family is still worthy of further follow-up study.
Simultaneous Computed Tomography-Guided Biopsy and Radiofrequency Ablation of Solitary Pulmonary Malignancy in High-Risk Patients
Authors: Schneider T. , Puderbach M. , Kunz J. , Bischof A. , Giesel F.L. , Dienemann H. , Herth F.J.F. , Schnabel P.A. , Safi S. , Hoffmann H. , Heussel C.P.
Published: November 2012

Background: In recent years experience has been accumulated in percutaneous radiofrequency ablation (RFA) of lung malignancies in nonsurgical patients. Objectives: In this study, we retrospectively evaluated a simultaneous diagnostic and therapeutic approach including CT-guided biopsy followed immediately by RFA of solitary malignant pulmonary lesions. Methods: CT-guided transthoracic core needle biopsy of solitary pulmonary lesions suspicious for malignancy was performed and histology was proven based on immediate frozen sections. RFA probes were placed into the pulmonary tumors under CT guidance and the ablation was performed subsequently. The procedure-related morbidity was analyzed. Follow-up included a CT scan and pulmonary function parameters. Results: A total of 33 CT-guided biopsies and subsequent RFA within a single procedure were performed. Morbidity of CT-guided biopsy included pulmonary hemorrhage (24%) and a mild pneumothorax (12%) without need for further interventions. The RFA procedure was not aggravated by the previous biopsy. The rate of pneumothorax requiring chest tube following RFA was 21%. Local tumor control was achieved in 77% with a median follow-up of 12 months. The morbidity of the CT-guided biopsy had no statistical impact on the local recurrence rate. Conclusions: The simultaneous diagnostic and therapeutic approach including CT-guided biopsy followed immediately by RFA of solitary malignant pulmonary lesions is a safe procedure. The potential of this combined approach is to avoid unnecessary therapies and to perform adequate therapies based on histology. Taking the local control rate into account, this approach should only be performed in those patients who are unable to undergo or who refuse surgery.
Water Pipe Smoking and Its Association with Cigarette and Cannabis Use in Young Adults in Switzerland
Authors: Albisser Silvio , Schmidlin Jérome , Schindler Christian , Tamm Michael , Stolz Daiana
Published: November 2012

Background: Water pipe is a traditional method of tobacco use, which is epidemically spreading throughout Europe. There are scarce data about the use of water pipe and its relation to other addictive behaviors among young adults in Western countries. Objectives: It was our aim to identify the sociodemographic characteristics of water pipe users in Switzerland and to describe concurrent cigarette and cannabis smoking habits. Methods: Young adults aged 16-30 years were evaluated based on a 16-item standardized questionnaire on tobacco consumption and exhaled carbon monoxide. Current water pipe smoking was defined as water pipe use at least once within the last 4 weeks; regular water pipe smoking was defined as water pipe use at least once a week during the last 52 weeks. Results: Out of 353 volunteers, a total of 204 subjects (mean age 21 ± 3.5 years, 113 males) met the inclusion criteria for the study. A total of 78% (n = 160), 30.0% (n = 55) and 3.9% (n = 8) reported ever, current and regular water pipe smoking, respectively. Males smoked more often than females: 2.8 sessions/year (interquartile range 1.1-8) versus 2 sessions/year (interquartile range 0-4; p = 0.022). The major risk factor for ever smoking water pipe was cigarette smoking (odds ratio 6.22, 95% confidence interval 2.33-16.62), followed by cannabis consumption (odds ratio 1.44, 95% confidence interval 1.29-1.62). Ever water pipe smoking was more common among current cannabis users (100 vs. 0%; p < 0.0001) and related to higher exhaled carbon monoxide values (6.0 ± 9.0 vs. 2.1 ± 4.6 ppm; p < 0.001). Conclusion: Water pipe smoking is common among young adults and strongly associated with cigarette smoking and cannabis consumption.
Rationale and Design of the ‘MITOCARE’ Study: A Phase II, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Safety and Efficacy of TRO40303 for the Reduction of Reperfusion Injury in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction
Authors: MITOCARE Study Group
Published: November 2012

Treatment of acute ST-elevation myocardial infarction (STEMI) by reperfusion using percutaneous coronary intervention (PCI) or thrombolysis has provided clinical benefits; however, it also induces considerable cell death. This process is called reperfusion injury. The continuing high rates of mortality and heart failure after acute myocardial infarction (AMI) emphasize the need for improved strategies to limit reperfusion injury and improve clinical outcomes. The objective of this study is to assess safety and efficacy of TRO40303 in limiting reperfusion injury in patients treated for STEMI. TRO40303 targets the mitochondrial permeability transition pore, a promising target for the prevention of reperfusion injury. This multicenter, double-blind study will randomize patients with STEMI to TRO40303 or placebo administered just before balloon inflation or thromboaspiration during PCI. The primary outcome measure will be reduction in infarct size (assessed as plasma creatine kinase and troponin I area under the curve over 3 days). The main secondary endpoint will be infarct size normalized to the myocardium at risk (expressed by the myocardial salvage index assessed by cardiac magnetic resonance). The study is being financed under an EU-FP7 grant and conducted under the auspices of the MITOCARE research consortium, which includes experts from clinical and basic research centers, as well as commercial enterprises, throughout Europe. Results from this study will contribute to a better understanding of the complex pathophysiology underlying myocardial injury after STEMI. The present paper describes the rationale, design and the methods of the trial.