bluuebunny/crossref_metadata_2025 huggingface dataset:
Internalized Homophobia and Reduced HIV Testing Among Men Who Have Sex With Men in China
Authors: Pyun Thomas , Santos Glenn-Milo , Arreola Sonya , Do Tri , Hebert Pato , Beck Jack , Makofane Keletso , Wilson Patrick A. , Ayala George
Published: February 2014

Although previous research has examined barriers and facilitators of HIV testing among men who have sex with men (MSM) in China, few studies have focused on social factors, including homophobia and internalized homophobia. This study utilized data from a global online survey to determine correlates of HIV testing as part of a subanalysis focused on Chinese MSM. Controlling for age, HIV knowledge, number of sexual partners, and other covariates, ever having tested for HIV was significantly correlated with lower internalized homophobia. This study suggests that stigma associated with sexual orientation may serve as a barrier to participation in HIV testing and other health-promoting behaviors.
The Australian, US, Scandinavian Imaging Exchange (AUSSIE): an innovative, virtually-integrated health research network embedded in health care
Authors: Looi Jeffrey CL , Velakoulis Dennis , Walterfang Mark , Georgiou-Karistianis Nellie , Macfarlane Matthew D , Power Brian D , Nilsson Christer , Styner Martin , Thompson Paul M , Van Westen Danielle , Wilkes Fiona A , Wahlund Lars-Olof
Published: February 2014

Objective:

To describe the development, design and function of an innovative international clinical research network for neuroimaging research, based in Australia, within a joint state health service/medical school. This Australian, US, Scandinavian Imaging Exchange (AUSSIE) network focuses upon identifying neuroimaging biomarkers for neuropsychiatric and neurodegenerative disease.

Methods:

We describe a case study of the iterative development of the network, identifying characteristic features and methods which may serve as potential models for virtual clinical research networks. This network was established to analyse clinically-derived neuroimaging data relevant to neuropsychiatric and neurodegenerative disease, specifically in relation to subcortical brain structures.

Results:

The AUSSIE network has harnessed synergies from the individual expertise of the component groups, primarily clinical neuroscience researchers, to analyse a variety of clinical data.

Conclusion:

AUSSIE is an active virtual clinical research network, analogous to a connectome, which is embedded in health care and has produced significant research, advancing our understanding of neuropsychiatric and neurodegenerative disease through the lens of neuroimaging.
Ethanol Locks in the Prevention and Treatment of Catheter-Related Bloodstream Infections
Authors: Tan Marisela , Lau Jackie , Guglielmo B. Joseph
Published: February 2014

Objective: To evaluate the evidence regarding the use of ethanol lock therapy (ELT) for catheter-related bloodstream infection (CRBSI) prophylaxis and treatment. Data Sources: A literature search was conducted using PubMed (August 2003-January 2013) with search terms: ethanol lock, ethanol locks, ethanol lock therapy, prophylaxis, prevention, catheter-related bloodstream infection, and catheter-related infection. Additional sources were identified through a subsequent review of relevant articles. Study Selection and Data Extraction: All English-language studies with >1 patient and a primary outcome of rates of infection, clinical cure, catheter removal or line salvage were evaluated. Studies where ELT was not used for CRBSI prophylaxis or treatment, review articles, and in vitro studies were excluded. Data were abstracted through an independent review of all articles by 2 authors. Discrepancies were discussed and resolved. Data Synthesis: 13 prophylaxis studies evaluated 617 patients; all studies reported decreased rates of infection and catheter removal with ELT. The ELT regimen associated with the most consistent benefit was 70% ethanol, a 2- to 4-hour dwell time, and daily exchange for ≥1 month. 9 treatment studies evaluated 213 catheters, with 90% (192/213) cure and 84% (179/213) line salvage. ELT was always used in combination with systemic antibiotics. The most common ELT treatment regimen was 70% ethanol, a 12- to 24-hour dwell time, and a duration of 1-5 days. No serious adverse events were reported. Conclusion: The current literature suggests that prophylactic ELT decreases the rates of infection and catheter removal, and ELT treatment appears efficacious in combination with systemic antibiotics.
Sustainability, Globalization, and the Energy Sector Europe in a Global Perspective
Authors: Waisman Henri-David , Cassen Christophe , Hamdi-Chérif Meriem , Hourcade Jean-Charles
Published: February 2014

In this article, we analyze the socioeconomic effects of energy sustainability challenges raised by oil depletion and climate change at the European and global levels. We assess macroeconomic impacts at different period markers from 2010 to 2100 and under different visions of the future of globalization. Fragmented capital markets affect the pace and direction of change and induce additional economic losses in the long term. Regionalized good markets have a positive effect in the long term because less intense international trade moderates the effects of fossil fuel constraints. A sustainable energy future will require implementing policies and measures that are able to (a) provide correct incentives for long-term investments by resorting to other signals than current market prices, (b) incorporate sectoral measures that act complementarily to pricing scheme measures for sectors confronted with biased agents’ behaviors or strong inertias, and (c) foster globalization patterns that are consistent with energy sustainability objectives. The challenge consists in articulating the objectives and the instruments of these different policy and measures triggering the transition toward a sustainable future.
Eco-Innovation in NICs: Conditions for Export Success With an Application to Biofuels in Transport
Authors: Köhler Jonathan , Walz Rainer , Marscheider-Weidemann Frank
Published: February 2014

This article looks at sustainable development and globalization from the perspective of the eco-innovation literature for the case of biofuels in transport. It assesses the potential for newly industrialized countries (NICs) to develop technology and hence export markets in biofuel equipment. An analysis of innovation indicators suggests those countries that have strong capacities in eco-innovation in general. The analysis considers demand and regulatory factors in addition to technological capabilities in biofuels and complementary sectors. A very large global market in biofuels for transport could develop. The case of biofuels in Brazil shows that demand-oriented innovation policy coordinated with supply-oriented research and development policies can be successful in NICs for developing markets in new technologies for sustainability. Brazil, China, Malaysia, Mexico, and South Africa, as well as Indonesia, Thailand, and possibly India, have the favorable combination of high biofuel production potential and the requisite technological capability to develop internationally competitive second-generation biofuel production technologies.
Maglev vehicle-guideway coupling vibration test rig based on the similarity theory
Authors: Cui Yuxi , Shen Gang , Wang Hui
Published: February 2014

Based on the study of the dynamic properties of the Maglev vehicle-guideway coupling vibration system under the control of a full state feedback controller, the similarity processing was carried out between the coupling vibration system and a small scale model. The similarity ratio coefficients were obtained according to the similarity theory. The results show that the Maglev control method, calculating the controller output with the vibration information of the guideway low order mode and the magnet, is effective and can keep the system stable. For the coupling vibration system the first three modes can give, respectively, an accurate description of the system dynamic characteristics. When investigating the lower frequency characteristics of the system, the first mode will also be sufficient, especially when a large difference between the lower frequencies exists. The small scale model obtained according to the similarity theory is coincident with the original model in dynamic performance, which provides an effective methodology to set up small scale test rig for the investigation of the Maglev vehicle-guideway coupling vibration.
Health, Dietary Habits, and Achievement Motivation in College Students With Self-Reported ADHD Diagnosis
Authors: Merkt Julia , Gawrilow Caterina
Published: February 2014

Objective: The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD. Method: Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation. Results: College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis. Conclusion: College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms.
Towards simultaneous measurements of skin friction and contact area: Results and experiences
Authors: Duvefelt Kenneth BK , Olofsson Ulf L-O , Johannesson Carl Michael J
Published: February 2014

This article investigates one of the important parameters when designing for feel, namely the friction coefficient. An experiment was performed to evaluate how fringe projection could be used to investigate the topography of the fingertip, especially while in contact and sliding on a smooth surface. By allowing this smooth surface to be a small sheet of glass, a topographic camera could take pictures through it. The glass was also connected to a universal force gauge to measure normal and tangential forces from which the coefficient of friction could be calculated. The intention was to get dependable data on the forces, coefficient of friction, apparent contact area and actual contact area. This set-up was tested using 66 students who used one and three fingers in both dry and wet conditions and with a rubber glove. In order to measure natural everyday friction, they were not given any particular instructions on how to clean or slide their fingers. This method resulted in a much higher variation in friction coefficients than has been found in previous research. In particular, many higher values were noticed. This illustrates that the friction coefficient is a very hard parameter to rely on when it comes to designing surfaces for feel.
Investigation of outer cortical magnetisation transfer ratio abnormalities in multiple sclerosis clinical subgroups
Authors: Samson Rebecca S , Cardoso Manuel J , Muhlert Nils , Sethi Varun , Wheeler-Kingshott Claudia AM , Ron Maria , Ourselin Sebastian , Miller David H , Chard Declan T
Published: February 2014

Background:

Pathological abnormalities including demyelination and neuronal loss are reported in the outer cortex in multiple sclerosis (MS).

Objective:

We investigated for in vivo evidence of outer cortical abnormalities by measuring the magnetisation transfer ratio (MTR) in MS patients of different subgroups.

Methods:

Forty-four relapsing–remitting (RR) (mean age 41.9 years, median Expanded Disability Status Scale (EDSS) 2.0), 25 secondary progressive (SP) (54.1 years, EDSS 6.5) and 19 primary progressive (PP) (53.1 years, EDSS 6.0) MS patients and 35 healthy control subjects (mean age 39.2 years) were studied. Three-dimensional (3D) 1×1×1mm3 T1-weighted images and MTR data were acquired. The cortex was segmented, then subdivided into outer and inner bands, and MTR values were calculated for each band.

Results:

In a pairwise analysis, mean outer cortical MTR was lower than mean inner cortical MTR in all MS groups and controls ( p<0.001). Compared with controls, outer cortical MTR was decreased in SPMS ( p<0.001) and RRMS ( p<0.01), but not PPMS. Outer cortical MTR was lower in SPMS than PPMS ( p<0.01) and RRMS ( p<0.01).

Conclusions:

Lower outer than inner cortical MTR in healthy controls may reflect differences in myelin content. The lowest outer cortical MTR was seen in SPMS and is consistent with more extensive outer cortical (including subpial) pathology, such as demyelination and neuronal loss, as observed in post-mortem studies of SPMS patients.
Consuming the Lama
Authors: Zivkovic Tanya Maria
Published: February 2014

Tibetan understandings about the bodies of spiritual teachers or lamas challenge the idea of a singular and bounded form. Tibetan Buddhists believe that the presence of the lama does not depend on their skin-encapsulated temporal body, or a singular lifespan. After death, it is not uncommon for a lama to materialize in other appearances or to become incorporated into the bodies of others through devotees’ consumption of their bodily remains. In this article, I discuss how the European ingestion of the holy bodies of Tibetan lamas creates new possibilities for embodied intersubjectivity, and also how this practice repositions bodily substance in cannibal discourse.
Relation of mitochondrial oxygen consumption in peripheral blood mononuclear cells to vascular function in type 2 diabetes mellitus
Authors: Hartman Mor-Li , Shirihai Orian S , Holbrook Monika , Xu Guoquan , Kocherla Marsha , Shah Akash , Fetterman Jessica L , Kluge Matthew A , Frame Alissa A , Hamburg Naomi M , Vita Joseph A
Published: February 2014

Recent studies have shown mitochondrial dysfunction and increased production of reactive oxygen species in peripheral blood mononuclear cells (PBMCs) and endothelial cells from patients with diabetes mellitus. Mitochondria oxygen consumption is coupled to adenosine triphosphate (ATP) production and also occurs in an uncoupled fashion during formation of reactive oxygen species by components of the electron transport chain and other enzymatic sites. We therefore hypothesized that diabetes would be associated with higher total and uncoupled oxygen consumption in PBMCs that would correlate with endothelial dysfunction. We developed a method to measure oxygen consumption in freshly isolated PBMCs and applied it to 26 patients with type 2 diabetes mellitus and 28 non-diabetic controls. Basal (192±47 vs 161±44 pmoles/min, p=0.01), uncoupled (64±16 vs 53±13 pmoles/min, p=0.007), and maximal (795±87 vs 715±128 pmoles/min, p=0.01) oxygen consumption rates were higher in diabetic patients compared to controls. There were no significant correlations between oxygen consumption rates and endothelium-dependent flow-mediated dilation measured by vascular ultrasound. Non-endothelium-dependent nitroglycerin-mediated dilation was lower in diabetics (10.1±6.6 vs 15.8±4.8%, p=0.03) and correlated with maximal oxygen consumption ( r = −0.64, p=0.001). In summary, we found that diabetes mellitus is associated with a pattern of mitochondrial oxygen consumption consistent with higher production of reactive oxygen species. The correlation between oxygen consumption and nitroglycerin-mediated dilation may suggest a link between mitochondrial dysfunction and vascular smooth muscle cell dysfunction that merits further study. Finally, the described method may have utility for the assessment of mitochondrial function in larger scale observational and interventional studies in humans.
Efficacy of a short course of complex lymphedema therapy or graduated compression stocking therapy in the treatment of post-thrombotic syndrome
Authors: Holmes Chris E , Bambace Nadia M , Lewis Patricia , Callas Peter W , Cushman Mary
Published: February 2014

Treatment options for established post-thrombotic syndrome (PTS) are limited. Complex lymphedema therapy (CLT), a non-invasive treatment that improves lymphatic flow, may have the potential to improve PTS. We conducted a single-center, investigator-blind, randomized controlled trial of 31 patients with a clinically established diagnosis of PTS and compared the efficacy of graduated compression stockings alone (30–40 mmHg) with CLT, a treatment that includes compression stockings, exercise, patient education, skin care and lymphatic drainage. Primary outcomes were the 1- and 3-month changes in PTS severity by the Villalta score and disease-specific quality of life using the VEINES-QOL (Venous Insufficiency Epidemiological and Economic Study Quality of Life) questionnaire. Analysis was by intent-to-treat. We found from a baseline average score of 9.9 points, CLT reduced mean PTS severity scores by −2.4 points ( p=0.02) at the 1-month and −2.3 points ( p=0.05) at the 3-month follow-up. Score reductions with stockings only were similar at −2.1 ( p=0.03) and −3.3 points ( p=0.03) at 1 and 3 months. The differences in score between treatments were not significant. Neither treatment significantly changed the VEINES-QOL score except in patients with severe disease. Patients with moderate to severe PTS derived the greatest benefit from either therapy and the two therapies differentially impacted PTS signs and symptoms. We found a short course of lymphedema therapy and compression stockings offer similar benefit in patients with PTS; however, larger studies are needed to further explore the potential use of CLT in PTS, particularly in patients with more severe disease. ClinicalTrials.gov Identifier: NCT00633971.
Adolescent muscle dysmorphia and family-based treatment: A case report
Authors: Murray Stuart B , Griffiths Scott
Published: February 2014

A growing body of evidence suggests that the prevalence of male body dissatisfaction and muscle dysmorphia is rising. To date, however, there is no published evidence on the efficacy of treatments for muscle dysmorphia. We present the case of a 15-year-old boy who met full diagnostic criteria for muscle dysmorphia, whose symptoms were treated into remission with eating disorder-focused, family-based treatment. The age of this patient fell within the time period in which symptoms of muscle dysmorphia are most likely to develop and this case represents the first published case report of family-based treatment for muscle dysmorphia in this age group. Thus, this case report has important implications for clinicians considering treatment options for presentations of muscle dysmorphia when first presenting in adolescence. Implications for the development of treatment guidelines for muscle dysmorphia and for the diagnostic debate surrounding muscle dysmorphia are also discussed.
Constructing a digital storycircle: Digital infrastructure and mutual recognition
Authors: Couldry Nick , MacDonald Richard , Stephansen Hilde , Clark Wilma , Dickens Luke , Fotopoulou Aristea
Published: February 2014

Building on the principles of the digital storytelling movement, this article asks whether the narrative exchange within the ‘storycircles’ of storymakers created in face-to-face workshops can be further replicated by drawing on digital infrastructure in specific ways. It addresses this question by reporting on the successes and limitations of a five-stream project of funded action research with partners in north-west England that explored the contribution of digital infrastructure to processes of narrative exchange and the wider processes of mutual recognition that flow from narrative exchange. Three main dimensions of a digital storycircle are explored: multiplications, spatializations (or the building of narratives around sets of individual narratives), and habits of mutual recognition. Limitations relate to the factors of time, and levels of digital development and basic digital access.
Alcohol use and early mortality in Swedish middle-aged women: Nine-year follow-up of the Women’s Health in Lund Area study
Authors: Rundberg Jenny , Nilsson Peter M , Samsioe Göran , Öjehagen Agneta
Published: February 2014

Aims: The majority of prospective studies on alcohol use and mortality risk indicate that non-drinkers are at increased risk of death compared to moderate drinkers. This article investigates the association between middle-aged women’s alcohol use and mortality, controlling for socio-demographic and health variables. An association between alcohol use and hospital in-patient care is also analysed. Methods: Baseline data were collected during 1995–2000 in a population-based cohort of 6917 women aged 50–59 years living in southern Sweden, the Women’s Health in Lund Area (WHILA). After 9 years, a register follow-up was performed from the National cause-of-death register and the Swedish hospital discharge register. Cox proportional hazards regression were used to analyse differences in survival. Results: During the observation period, 201 (2.9%) women died. In a crude model, non-drinkers had a significantly increased risk for death. When including socio-demographic predictors in the model, there was a strong indication that non-drinkers were at increased risk for death compared to moderate drinkers. Adding health predictors, not drinking alcohol was no longer a risk factor for death. Further, analyses of in-patient care indicate that non-drinkers had poorer health during their entire adult life. Conclusions: This study underlines the importance of including health status at base-line when prospectively studying the association between alcohol use and mortality, otherwise moderate alcohol consumption may appear more beneficial than is the case.
The emergence of network media logic in political communication: A theoretical approach
Authors: Klinger Ulrike , Svensson Jakob
Published: February 2014

In this article we propose a concept of network media logic in order to discuss how online social media platforms change political communication without resorting to technological determinism or normalization. We argue that social media platforms operate with a distinctly different logic from that of traditional mass media, though overlapping with it. This is leading to different ways of producing content, distributing information and using media. By discussing the differences between traditional mass media and social media platforms in terms of production, consumption and use, we carve out the central elements of network media logic – that is, the rules/format of communication on social media platforms – and some consequences for political communication.
Effect of cylinder deactivation on the tribo-dynamics and acoustic emission of overlay big end bearings
Authors: Mohammadpour M , Rahmani R , Rahnejat H
Published: February 2014

The paper presents an integrated tribo-dynamics analysis of elliptic bore overlay big end bearings of internal combustion engines. The analysis focuses on bearing stability, frictional power loss and acoustic emission from these bearings, particularly with cylinder deactivation with larger fluctuations in engine loading. The integrated approach represents a tribo-dynamics analysis, not hitherto reported in literature, particularly under cylinder deactivation. The analysis shows that cylinder deactivation makes marginal differences in parasitic frictional losses in engine bearing performance and any significant gain would depend on the brake specific fuel consumption. It is also shown that sufficient swept volume with retained residual exhaust gas charge within the deactivated cylinders can ensure bearing whirl stability. Partially deactivated engine configurations exhibit a lower average steady noise emission, but with a higher degree of transient content. This suggests that there would be a greater contribution to engine rumble with deactivated cylinders.
Fractographic analysis of compression failures in unidirectional carbon fiber reinforced plastic composites
Authors: Kumar M Suresh , Raghavendra K , Ambresh M , Ramachandra HV , Venkataswamy MA , Ranganath VR
Published: February 2014

Resin infusion process with/without the application of external pressure was employed for fabrication of unidirectional carbon fiber reinforced plastic composites. The prepared samples were tested under compression loads. Three kinds of fracture modes, viz., in-plane shear, complex fracture and through-thickness shear fractures were noticed. It was observed that samples fabricated with application of pressure exhibited in-plane and complex fracture modes whereas other samples displayed through-thickness fracture. Detailed fractographic analysis suggested that in-plane and through-thickness shear fractures resulted due to microbuckling of individual fibers; on the other hand, complex failure is governed by longitudinal splitting followed by microbuckling. Microbuckling directions for both in-plane and through-thickness shear fractures were established. These and other microstructral characterization results were analyzed and an effort was made to identify the reasons for variations in fracture modes and resulting compression properties.
Managing the politics of value propositions
Authors: Corvellec Hervé , Hultman Johan
Published: February 2014

This article contributes to the ongoing discussion, revived by the service-dominant logic thesis, on value propositions in service organizations. Against a backdrop of understanding value as a pluralistic social construct that takes place across different institutionalized practices of valuation or regimes of value, we argue that value propositions transcend the immediate localness of both value in exchange and value in use. Correspondingly, we claim that service practitioners may draw advantages from engaging with a politics of value that addresses multiple regimes of value, whether commensurable or not. A case study of waste management services in Sweden serves as an illustration of such a politics that combines practical, economic, political, and environmental aspects of value propositions.
In situ damage classification for composite laminates using Gaussian discriminant analysis
Authors: Larrosa Cecilia , Lonkar Kuldeep , Chang Fu-Kuo
Published: February 2014

An investigation was performed to develop a damage classification method to characterize sensor data from built-in piezoelectric actuators on laminated composites in terms of matrix micro-cracking and delamination. Traditional signal processing techniques (time-domain analysis and short-time Fourier transform) combined with Gaussian discriminant analysis were proposed to characterize damage in composite plates in this study. Composite coupons of different layup configurations with surfaced mounted arrays of piezoelectric actuators and sensors were subjected to cyclic loading to induce matrix micro-cracking and delamination. Sensor data as well as X-ray images were acquired through the coupon’s life. These experimental data were used to train a classifier as well as test the performance and robustness of the learned model. Classification performance was measured via 75–25 holdout and leave-one-sample-out cross-validation. Results show that the proposed method has a misclassification rate of 21%, with high precision and recall values, and it is sensitive to layup configuration.
Exercise Reduces Infarct Volume and Facilitates Neurobehavioral Recovery
Authors: Egan Kieren J. , Janssen Heidi , Sena Emily S. , Longley Lesa , Speare Sally , Howells David W. , Spratt Neil J. , Macleod Malcolm R. , Mead Gillian E. , Bernhardt Julie
Published: February 2014

Background. Regular exercise reduces the risk of a first-ever stroke and is associated with smaller infarcts. Although evidence has suggested that therapeutic exercise following stroke is beneficial, we do not yet know whether exercise reduces stroke severity and improves functional recovery. The mechanisms underlying any benefit remain unclear. Objective. To conduct a systematic review and meta-analysis of studies testing exercise in animal models of ischemic stroke where outcomes were measured as infarct volume, neurobehavioral score, neurogenesis, or a combination of these. We also sought evidence of publication bias. Methods. We searched 3 online databases for publications reporting the use of exercise in focal cerebral ischemia. We used DerSimonian and Laird normalized random-effects meta-analysis and meta-regression to determine the impact of study quality and design on the efficacy of exercise. Results. Overall, exercise reduced infarct volume by 25.2% (95% confidence interval [CI] = 19.0%-31.3%; 65 experiments and 986 animals) and improved neurobehavioral score by 38.2% (95% CI = 29.1%-47.3%; 42 experiments; n = 771). For both outcomes, larger effects were seen when exercise preceded ischemia rather than came after it. For neurobehavioral scores, we found evidence of publication bias. Reported study quality was moderate (median score 5/10). Both model-specific (eg, type of ischemia) and exercise-specific characteristics influenced reported outcome. Conclusion. Exercise, either before or after ischemia, reduced infarct volume and improved neurobehavioral score. However, overall estimates of efficacy were higher in studies at risk of bias, and for neurobehavioral outcomes, there was evidence of a substantial publication bias.
Combined Use of Multiple Computational Intracranial EEG Analysis Techniques for the Localization of Epileptogenic Zones in Lennox–Gastaut Syndrome
Authors: Kim Jeong-Youn , Kang Hoon-Chul , Cho Jae-Hyun , Lee Ji Hyun , Kim Heung Dong , Im Chang-Hwan
Published: February 2014

Traditionally, identification of epileptogenic zones primarily relied on visual inspection of intracranial electroencephalography (iEEG) recordings by experienced epileptologists; however, removal of epileptogenic zones identified by iEEG does not always guarantee favorable surgical outcomes. To confirm visual inspection results, and assist in making decisions about surgical resection areas, computational iEEG analysis methods have recently been used for the localization of epileptogenic zones. In this study, we have proposed a new approach for the localization of epileptogenic zones in Lennox–Gastaut syndrome (LGS), and have investigated whether the proposed approach could confirm surgical resection areas and predict seizure outcome before surgery. The proposed approach simultaneously used results of 2 iEEG analysis methods, directed transfer function (DTF) and time delay estimation, to enhance localization accuracy. This new combined method was applied to patients who became seizure-free after resective epilepsy surgery, as well as those who had unsuccessful surgery. A quantitative metric was also introduced that can measure how well the localized epileptogenic zones coincided with the surgical resection areas, with the aim of verifying whether the approach could confirm surgical resection areas determined by epileptologists. The estimated epileptogenic zones more strongly coincided with surgical resection areas in patients with successful, compared to those with unsuccessful surgical outcomes. Both qualitative and quantitative analyses showed that the combined use of 2 iEEG analyses resulted in a more accurate estimate of epileptogenic zones in LGS than the use of a single method. A combination of multiple iEEG analyses could not only enhance overall accuracy of localizing epileptogenic zones in LGS, but also has the potential to predict outcomes before resective surgery.
Results of syndactyly release using a modification of the Flatt technique
Authors: Barabás A. G. , Pickford M. A.
Published: February 2014

The results of 144 congenital syndactyly releases over a 12-year period by a single surgeon using a modified Flatt technique (dorsal hourglass flap, interdigitating zigzag flaps, and full-thickness skin grafts) are analyzed considering the association of skin grafts and web creep. The mean follow-up was 5 years. There were seven cases of graft failure, only one of which developed web creep. Web creep occurred in 4.2% of web releases. The results suggest that avoiding longitudinal straight-line scars across the web space may be an important factor in avoiding web creep when performing the modified Flatt technique described.
Outcome of carpal tunnel release – Correlation with wrist and wrist–palm anthropomorphic measurements
Authors: Lee L. H. , Al-Maiyah M. , Al-Bahrani R. Z. , Bhargava A. , Auyeung J. , Stothard J.
Published: February 2014

Wrist and wrist–palm measurements have been associated with the diagnosis of carpal tunnel syndrome. We found no reported study about how this correlation affects the outcome after surgery. We investigated the role of the measurements in predicting outcome after open carpal tunnel release. A total of 131 patients (88 female, 43 male) responded to our postal questionnaire using the Boston Carpal Tunnel assessment (65% response rate) at a minimum of 9 months post-operatively. Symptom and functional scores showed a strong correlation. There was no statistical difference in the outcome between wrist ratio (≥0.7 vs <0.7), wrist–palm ratio (≥0.41 vs <0.41) and gender, but a better functional score was very weakly correlated with a higher wrist ratio. A very large study would be needed to show any statistical correlation between both measurement and outcome.
The painful ear
Authors: Toh Alex S L
Published: February 2014

In the UK, 15% of consultations in general practice involve complaints relating to the upper respiratory tract or head and neck. Of these, painful ear is one of the most common presentations especially in children younger than 5 years in age. It is also the most common reason for a parent to call a doctor out-of-hours for their child. However, a painful ear can affect people of all ages and there are many causes. It is therefore important for GPs to have knowledge of its most common presentations, the pitfalls in diagnosis, treatments and when to involve secondary care.
Negative Pressure Wound Therapy With Low Pressure and Gauze Dressings to Treat Diabetic Foot Wounds
Authors: Lavery Lawrence A. , Murdoch Douglas P. , Kim Paul J. , Fontaine Javier La , Thakral Gaurav , Davis Kathryn E.
Published: February 2014

Objective:

This study was a prospective cohort study to evaluate negative pressure wound therapy (NPWT) with low pressure and a gauze dressing to treat diabetic foot wounds.

Methods:

Thirty patients with diabetic foot wounds were consented to a prospective study to evaluate wound closure and complications to evaluate NPWT with low pressure (80 mmHg) and a gauze dressing interface (EZCare, Smith and Nephew) for up to 5 weeks. NPWT was changed 3 times a week. Study subjects were evaluated once a week for adverse events and wound measurements.

Results:

Of study subjects, 43% attained at least a 50% wound area reduction after 4 weeks of therapy.

Conclusion:

Our results suggest that a high rate of wound closure could be expected with low pressure and a gauze interface.
Analytical Performance of Glucose Monitoring Systems at Different Blood Glucose Ranges and Analysis of Outliers in a Clinical Setting
Authors: Hasslacher Christoph , Kulozik Felix , Platten Isabel
Published: February 2014

Background:

We investigated the analytical accuracy of 27 glucose monitoring systems (GMS) in a clinical setting, using the new ISO accuracy limits. In addition to measuring accuracy at blood glucose (BG) levels < 100 mg/dl and > 100 mg/dl, we also analyzed devices performance with respect to these criteria at 5 specific BG level ranges, making it possible to further differentiate between devices with regard to overall performance.

Methods:

Carbohydrate meals and insulin injections were used to induce an increase or decrease in BG levels in 37 insulin-dependent patients. Capillary blood samples were collected at 10-minute intervals, and BG levels determined simultaneously using GMS and a laboratory-based method. Results obtained via both methods were analyzed according to the new ISO criteria.

Results:

Only 12 of 27 devices tested met overall requirements of the new ISO accuracy limits. When accuracy was assessed at BG levels < 100 mg/dl and > 100 mg/dl, criteria were met by 14 and 13 devices, respectively. A more detailed analysis involving 5 different BG level ranges revealed that 13 (48.1%) devices met the required criteria at BG levels between 50 and 150 mg/dl, whereas 19 (70.3%) met these criteria at BG levels above 250 mg/dl. The overall frequency of outliers was low.

Conclusions:

The assessment of analytical accuracy of GMS at a number of BG level ranges made it possible to further differentiate between devices with regard to overall performance, a process that is of particular importance given the user-centered nature of the devices’ intended use.
Parent-Informed Anticipatory Guidance to Promote Family Meals
Authors: Moss Deborah R. , Ploof Dianna L. , Reis Evelyn Cohen
Published: February 2014

Objective. To learn what families report as common facilitating factors as well as barriers faced in having regular family meals (FMs). Methods. Cross-sectional descriptive study involving administration of an 18-item survey to a convenience sample of parents in waiting rooms of 8 participating pediatric offices. Results. In all, 251 surveys were completed from 8 sites; 89% of respondents rated having FMs as important, and 88% reported the meals as enjoyable. However, 48% reported having FMs less often than desired. Nearly half were interested in learning how to have FMs more often (46%) or making mealtime more enjoyable (56%). The distribution of most frequently reported factors making FMs difficult to enjoy (schedules, food, and mood issues) differed from factors making it difficult to have FMs (predominantly schedules). The most frequently reported factor making mealtimes enjoyable was interaction. Conclusions. Our findings showed that most families are having FMs at least 3 times a week. However, many are not satisfied with the frequency or quality of the meal experience and are receptive to learning more about this. Our study highlights the value of offering simple interventions to help families improve the frequency and quality of mealtime experience.
Sports Hernia/Athletic Pubalgia
Authors: Larson Christopher M.
Published: February 2014

Context:

Sports hernia/athletic pubalgia has received increasing attention as a source of disability and time lost from athletics. Studies are limited, however, lacking consistent objective criteria for making the diagnosis and assessing outcomes.

Evidence Acquisition:

PubMed database through January 2013 and hand searches of the reference lists of pertinent articles.

Study Design:

Review article.

Level of Evidence:

Level 5.

Results:

Nonsurgical outcomes have not been well reported. Various surgical approaches have return-to–athletic activity rates of >80% regardless of the approach. The variety of procedures and lack of outcomes measures in these studies make it difficult to compare one surgical approach to another. There is increasing evidence that there is an association between range of motion–limiting hip disorders (femoroacetabular impingement) and sports hernia/athletic pubalgia in a subset of athletes. This has added increased complexity to the decision-making process regarding treatment.

Conclusion:

An association between femoroacetabular impingement and athletic pubalgia has been recognized, with better outcomes reported when both are managed concurrently or in a staged manner.
A Painful Finger as First Sign of a Malignancy
Authors: van Veenendaal Linde M. , de Klerk Gijs , Velde Detlef van der
Published: February 2014

Introduction:

Bone metastases are frequently seen in patients with malignancies, but only 0.007% to 0.3% of these metastases are located in the hand or foot. In 16%, the metastasis is the first manifestation of a malignancy. These acrometastases have a poor prognoses with a median survival of 6 months. Treatment is usually palliative and consists of radiation or amputation.

Case Description:

An 83-year-old woman was seen with pain and swelling of the right middle finger since 3 months. A radiograph of this finger showed a lytic lesion of the proximal phalanx. A metastasis, primary bone tumor, or osteomyelitis was considered. Because of a radically resected colon carcinoma in patient’s medical history, the carcinoembryonic antigen level was analyzed and proved to be elevated. Computed tomography scan of thorax and abdomen showed 2 (primary) pulmonary tumors with mesenteric metastases. Patient refrained from further analysis and treatment of these lung tumors. However, because of persistent pain the right middle finger was amputated. Pathological examination of the finger confirmed the diagnosis of an adenocarcinoma most likely to be a metastasis of lung cancer. Lung cancer is in most cases responsible for metastases in the hand.

Conclusion:

Acrometastasis may be the first manifestation of malignancy. Given the poor prognosis, early diagnosis is important to offer adequate treatment. Delay of appropriate treatment can adversely affect the quality of life in these often preterminal patients. This case report could contribute to a (more) rapid recognition of acrometastases as patients with acrometastases are often presented to specialists who do not frequently deal with cancer.
Determinants of a City Manager’s Tenure in Office
Authors: Mani Bonnie G.
Published: February 2014

Appointed officials in municipalities influence policy decisions and the distribution of services that affect everyday life. So stability or turnover of appointed officials is likely to affect efficiency and effectiveness of critical services like police protection, fire fighting and prevention, land use regulation, and public utilities. Seeking to explain the relationship between four groups of variables and appointed officials’ long or short terms in office, quantitative data collected from a random sample of appointed municipal officials in North Carolina were analyzed using hierarchical logistic regression. Tenure in office divided at median years in office was the dichotomous dependent variable. Four groups of independent variables related to the person, the job, the city, and election systems were entered hierarchically in four logistic regression models. Qualitative data collected from the same appointed officials further explain the results of the quantitative analysis. Results show that competence in formulating and implementing budgets and city government experience lead to longer terms in office, higher education leads to shorter terms in office, and political variables have no significant effect on appointed officials’ job security in North Carolina. This is useful information for city managers setting long-term career goals, citizens judging local governments’ service delivery, and elected officials making decisions about appointments and terminations.
“Young People These Days … ”
Authors: Trzesniewski Kali H. , Donnellan M. Brent
Published: February 2014

The current study investigated perceptions of emerging adults (aged 18–25) and found indications that ratings of attributes ascribed to this group are more negative than ratings of older groups. An Internet sample ranging in age from 18 to 87 ( N = 641) tended to have more positive feelings toward adults and older adults than emerging adults and adolescents. In particular, emerging adults were seen as more immoral, narcissistic, and overconfident than adults and less agreeable and emotionally stable. Participants generally rated today’s emerging adults as more self-centered, less hardworking, lazier, and promiscuous when compared to emerging adults of the past. Likewise, spontaneous descriptors of emerging adults were negative. A second sample of Mechanical Turk workers ( N = 1,118) was used to evaluate how perceptions of different age groups compare to ratings of the average adult. In total, we found converging evidence for the existence of negative impressions about emerging adults.
Mitochondrial metabolism contributes to oxidative stress and reveals therapeutic targets in chronic lymphocytic leukemia
Authors: Jitschin Regina , Hofmann Andreas D. , Bruns Heiko , Gießl Andreas , Bricks Juliane , Berger Jana , Saul Domenica , Eckart Michael J. , Mackensen Andreas , Mougiakakos Dimitrios
Published: February 2014

Key Points

Increased mitochondrial ROS production, adaptation to intrinsic oxidative stress, and mitochondrial biogenesis are interconnected in CLL. Targeting the respiratory chain and promoting mitochondrial ROS lead to selective cytotoxicity in CLL cells.
CALR exon 9 mutations are somatically acquired events in familial cases of essential thrombocythemia or primary myelofibrosis
Authors: Rumi Elisa , Harutyunyan Ashot S. , Pietra Daniela , Milosevic Jelena D. , Casetti Ilaria C. , Bellini Marta , Them Nicole C. C. , Cavalloni Chiara , Ferretti Virginia V. , Milanesi Chiara , Berg Tiina , Sant’Antonio Emanuela , Boveri Emanuela , Pascutto Cristiana , Astori Cesare , Kralovics Robert , Cazzola Mario
Published: February 2014

Key Points

Somatic indels of CALR exon 9 are present in about 20% to 25% of sporadic patients with essential thrombocythemia or primary myelofibrosis. These mutations are found also in familial cases of essential thrombocythemia or primary myelofibrosis as somatically acquired events.
Somatic mutations in MYD88 and CXCR4 are determinants of clinical presentation and overall survival in Waldenström macroglobulinemia
Authors: Treon Steven P. , Cao Yang , Xu Lian , Yang Guang , Liu Xia , Hunter Zachary R.
Published: February 2014

Key Points

Activating MYD88 as well as nonsense and frameshift WHIM-like CXCR4 somatic mutations are common in WM. CXCR4 NS mutations are present in aggressive cases including hyperviscosity syndrome, and MYD88 status is a determinant of survival.
An update on lung transplantation
Authors: Fuller Julia , Fisher Andrew J.
Published: February 2014

Over the last 25 years, lung transplantation has developed into a well-established treatment option for selected patients with very advanced lung disease.

In 2010, over a 12-month period, more than 3500 new lung transplant procedures were reported to the International Society of Heart and Lung Transplantation (ISHLT) Registry [1]. In 2011, 1830 lung transplants were performed in the USA [2]. In 2012, 690 were performed in the �Eurotransplant� region [3] and a further 170 within the UK [4]. New transplant programmes are now being established around Europe, increasing access to this life saving intervention and benefitting from sharing experience with more established centres. Although worldwide activity has increased year on year over the last decade (fig. 1), demand has also increased meaning the significant shortage of suitable donor lungs accounts for an unacceptably high waiting list mortality rate in many countries.

Figure 1

The number of adult lung transplants reported to the ISHLT each year since 1985. Reproduced from [1] with permission from the publisher.

Clinical experience shared between transplant centres worldwide has helped refine the assessment process so that those added to a waiting list are those who are most likely to benefit. Furthermore, a meticulous approach to post-transplant management in the immediate post-operative period, in the early and long-term has contributed to continually improving long-term survival after lung transplantation.