bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Oncology Medical Records as per NABH Standards
Authors: Sinha Rajesh Kumar , Shenoy Nandana
Published: September 2013

Background: A complete, accurate, adequate and timely medical documentation helps in reducing medical errors and serves as important medical–legal evidence.

Objective: To evaluate Oncology Medical Records based on the National Accreditation Board of Hospitals Information Management System (NABH.IMS) and Patient Rights and Education (NABH.PRE) standards.

Methods: This retrospective study was conducted to assess the policies and procedures in relation to medical documentation against NABH.IMS 1–7 standards and NABH.PRE-3 Standards. A total of 520 discharged inpatient records were analyzed to understand the quality of medical documentation in practice.

Results: The existing policies and procedures were found to be compliant with NABH.IMS and NABH.PRE standards. The analysis of medical records showed maximum compliance in Nurse’s records, Doctor’s order forms, Anaesthesia reports of Breast and Head & Neck Cancer and Radiotherapy Charts in Cervical Cancer.

Conclusion: Overall documentation was found to be satisfactory as per the standards set by NABH. The study results revealed that the attention to compulsorily document patient clinical data in the respective forms of the medical records will enhance the completeness and accuracy of medical documentation of the hospital.
Choosing between Traditional Medicine and Allopathy During Pregnancy: Health Practices in Prenatal and Reproductive Health Care in Ecuador
Authors: Torri Maria Costanza
Published: September 2013

Research and programmes to date have addressed the prevalence of maternal morbidity and mortality in many developing countries. Literature has explored the direct and indirect factors influencing maternal risk, and programmes have attempted to mitigate many of the persistent factors. While addressing health system factors and socioeconomic barriers is imperative, understanding women’s perceptions within the cultural context in which they live is a necessary step for improving interventions aimed at reducing maternal morbidity and mortality. This study seeks to contribute to the existing evidence regarding Ecuadorian women’s prenatal health care seeking perceptions and behaviours. The paper will explore and describe the perceptions and experiences of pregnant women attending the antenatal intercultural clinic regarding the care they receive from both midwives and obstetricians. It will also provide recommendations for improving current strategies being implemented in Ecuador in the domain of prenatal and reproductive health care, with a special focus on indigenous people and intercultural health.
Health Communication and Behavioural Change: An Exploratory Study among Marginalized Communities in Rural West Bengal, India
Authors: Ghosh Saswata , Saha Manashi
Published: September 2013

A small-scale research/intervention project that aimed to develop and test an integrated package of communication campaign on health awareness among women belonging to the marginalized community was implemented in an underdeveloped setting of West Bengal, India during 2010–11. A quasi-experimental research design, with cross-sectional surveys conducted in six intervention and control villages at the baseline and endline, was used to evaluate the outcome of intervention among 1,196 respondents. This article examines the impact of behaviour change communication intervention on knowledge, reporting of illnesses and treatment-seeking of symptoms of general and gynaecological morbidity. Analyses included multiple, binary logistic and multinomial logistic regressions using a Difference-in-Difference estimator. Results of the evaluation suggest that the net effect of exposure to the intervention had a positive and significant impact on most of the indicators reflecting an increased level of awareness about signs and symptoms of general and reproductive complications. However, the net effect of exposure was mixed for the indicators of reporting of illnesses, pattern and sources of seeking treatment. The experience of implementing the project demonstrates that it is possible to improve women’s general and reproductive health awareness and practices which could have resulted in positive health outcomes in the long run.
Spirituality and Resilience among Post-Graduate University Students
Authors: Gnanaprakash C.
Published: September 2013

Spirituality relates more to personal search and personal growth, and to find greater meaning and ‘purpose of one’s existence’. Spirituality is believed to connect human beings with the powerful divine force that exists in the Universe. Likewise, it is also believed that spirituality plays a major role in coping with the life stressors. Coping is the process of managing and expending efforts to solve personal problems, and seeking to master, reduce or tolerate it.

The aim of the study is to examine the existing relationship between spirituality and the ability to cope with stress among university post-graduate students. The sample for the study consisted of 100 university post-graduate students from various departments (50 men and 50 women) selected through the random sampling method. The examined research hypotheses are: ( a) there is a significant relationship between spirituality and stress coping ability among university students; ( b) there is a significant difference between men and women with regard to spirituality; and ( c) there is a significant difference between men and women with regard to stress-coping ability.

In this study the spirituality level and coping ability for the sample were measured. The results reveal that students who have scored on spirituality are better able to cope with their stressors, are better able to adapt and have a positive outlook towards their problem situations.
Prospective Clarification of the Utility of the Palliative Prognostic Index for Patients With Advanced Cancer in the Home Care Setting
Authors: Hamano Jun , Kizawa Yoshiyuki , Maeno Takami , Nagaoka Hiroka , Shima Yasuo , Maeno Tetsuhiro
Published: September 2013

Aims:

This study aimed to prospectively clarify the accuracy of the Palliative Prognostic Index (PPI) for advanced cancer patients in home care settings.

Method:

The study included 66 advanced cancer patients who received home visiting services between April 2010 and June 2012, and who died at home or in the hospital. Using medical records from initial home visits, we prospectively calculated PPI scores along with sensitivity and specificity.

Results:

For 3- and 6-week survival, prognostic prediction showed respective sensitivities of 60% and 70.6%, and specificities of 87.0% and 71.9%.

Conclusion:

The sensitivity of the PPI for advanced cancer patients in home care settings was lower than that reported for patients in palliative care units. Development of prognostic tools suitable for home care settings is needed.
Comparison of Extramedullary Versus Intramedullary Referencing for Tibial Component Alignment in Total Ankle Arthroplasty
Authors: Adams Samuel B. , Demetracopoulos Constantine A. , Viens Nicholas A. , DeOrio James K. , Easley Mark E. , Queen Robin M. , Nunley James A.
Published: September 2013

Background:

The majority of total ankle arthroplasty (TAA) systems use extramedullary alignment guides for tibial component placement. However, at least 1 system offers intramedullary referencing. In total knee arthroplasty, studies suggest that tibial component placement is more accurate with intramedullary referencing. The purpose of this study was to compare the accuracy of extramedullary referencing with intramedullary referencing for tibial component placement in total ankle arthroplasty.

Methods:

The coronal and sagittal tibial component alignment was evaluated on the postoperative weight-bearing anteroposterior (AP) and lateral radiographs of 236 consecutive fixed-bearing TAAs. Radiographs were measured blindly by 2 investigators. The postoperative alignment of the prosthesis was compared with the surgeon’s intended alignment in both planes. The accuracy of tibial component alignment was compared between the extramedullary and intramedullary referencing techniques using unpaired t tests. Interrater and intrarater reliabilities were assessed with intraclass correlation coefficients (ICCs).

Results:

Eighty-three tibial components placed with an extramedullary referencing technique were compared with 153 implants placed with an intramedullary referencing technique. The accuracy of the extramedullary referencing was within a mean of 1.5 ± 1.4 degrees and 4.1 ± 2.9 degrees in the coronal and sagittal planes, respectively. The accuracy of intramedullary referencing was within a mean of 1.4 ± 1.1 degrees and 2.5 ± 1.8 degrees in the coronal and sagittal planes, respectively. There was a significant difference ( P < .001) between the 2 techniques with respect to the sagittal plane alignment. Interrater ICCs for coronal and sagittal alignment were high (0.81 and 0.94, respectively). Intrarater ICCs for coronal and sagittal alignment were high for both investigators.

Conclusions:

Initial sagittal plane tibial component alignment was notably more accurate when intramedullary referencing was used. Further studies are needed to determine the effect of this difference on clinical outcomes and long-term survivability of the implants.

Level of Evidence:

Level III, retrospective comparative study.
Trans-iliac pin/bolt/screw internal fixation for sacroiliac luxation or separation in cats: six cases
Authors: Yap Fui W , Dunn Andrew L , Farrell Michael , Calvo Ignacio
Published: September 2013

Trans-iliac pin, bolt or screw stabilisation was performed on six cats with sacroiliac (SI) luxation and separation. For the purpose of this study, SI luxation is defined as the separation of the iliac wing from the sacrum without fracture of the sacral or iliac wing; SI separation is defined as the separation of the iliac wing from the sacrum secondary to fracture of the sacrum and/or the iliac wing. Complications, surgical time and medium-to-long-term outcome were assessed by a retrospective review of the clinical records and owner questionnaires. Postoperative reduction of the SI joint was good-to-excellent in all cases and the outcome was considered good-excellent in all cats apart from one, where the trans-iliac bolt migrated dorsally from the iliac wing. This cat had bilateral SI luxations. Based on our results, trans-iliac fixation of SI luxation/separation is associated with good clinical outcome and should be considered as a treatment option in unilateral SI luxation in cats. Caution should be exercised in the use of trans-iliac pin/bolt as the sole method of stabilisation in bilateral SI luxations.
Effects of age and reproductive status on postoperative pain after routine ovariohysterectomy in cats
Authors: Polson Sally , Taylor Polly M , Yates David
Published: September 2013

A prospective clinical trial to compare the effects of age and reproductive status on postoperative pain was conducted in 145 female cats undergoing ovariohysterectomy using injectable anaesthesia. The cats were grouped appropriately: 60 kittens <4 months old (K), 85 adults >4 months old (A) and, within the adult group, 57 normal adults (nA) and 28 adults who were either pregnant or in oestrus (rA). Pain was assessed using a simple descriptive scale (SDS; 0–3), a dynamic and interactive visual scale (DIVAS; 0–100 mm) and mechanical nociceptive thresholds (MNT; N, 2 mm diameter probe) pre-operatively and at 4 and 24 h postoperatively. Kittens had lower DIVAS areas under the time curve and SDS than adults ( P <0.05), but similar MNT (K: 3.3 ± 2.6, A: 4.3 ± 2.5 N at 4 h, P >0.05). Data from nA and rA were not different ( P >0.05). Kittens had similar wound tenderness, but less affective pain than adults, and reproductive status had no effect.
Association of genotypes at the matrix metalloproteinase (MMP) loci with carotid IMT and presence of carotid and femoral atherosclerotic plaques
Authors: Panayiotou Andrie G , Griffin Maura B , Tyllis Theodosis , Georgiou Niki , Bond Dawn , Humphries Steve E , Nicolaides Andrew N
Published: September 2013

We aimed to test the association between matrix metalloproteinase ( MMP) genetic polymorphisms and (a) intima–media thickness in the common carotid (IMTcc) and (b) the presence of plaques in the carotid and femoral bifurcations. Carotid and femoral bifurcations were scanned with ultrasound in 762 Cypriot community dwellers (46% men) over the age of 40 years. IMTcc and the presence of plaques were recorded. The MMP1 1G/2G, MMP3 5A/6A, MMP7 -181A>G, MMP9 R279Q, and MMP12 -82A>G polymorphisms were determined with the TaqMan method. In men, the presence of plaques in any bifurcation was associated with the MMP9 279Q allele (ORadjusted=4.50; 95% CI=2.0 to 10.1; p<0.001) and the MMP7 -181A allele was associated with the presence of femoral plaques (ORadjusted=2.61; 95% CI=1.36 to 4.99; p=0.004). In women, the presence of femoral plaques was associated with the MMP12 -82G allele (ORadjusted=1.9; 95% CI=1.14 to 3.16; p=0.014). Our results suggest that the effect of common MMP genotypes on plaque presence may be site- and sex-dependent.
Time-domain analysis of passenger comfort on cruise ships under motion responses in waves
Authors: Kim Jae-Han , Kim Yonghwan
Published: September 2013

The assessment of passenger comfort in modern cruise ships is considered from a hydrodynamic point of view, in addition to improvement using stabilizing fins. Passenger comfort is evaluated in this study based on the symptoms of motion sickness on ships provoked by low-frequency whole-body vibration. Motion sickness dose value is an index used to quantify seasickness and is chosen as a primary index to evaluate passenger comfort. To calculate motion sickness dose value in the time domain, a time series of vertical accelerations should be processed using frequency filters, which are defined in the international standards and guidelines provided by classification societies as forms of transfer functions in the frequency domain. Digital frequency band–limiting and weighting filters are formulated as a form of infinite impulse response filter and then applied to the present case. Two pairs of stabilizing fins are equipped to reduce the roll and pitch motions and to improve the passenger comfort on a model cruise ship. A linear optimal control algorithm, linear quadratic Gaussian, is considered to actuate each stabilizing fin. Numerical computations are carried out based on practical operating conditions for the cruise ship model using a time-domain ship motion program, which integrates the motion control algorithm and the passenger comfort analysis. The results of computations show that passenger comfort on a cruise ship can be evaluated appropriately by computing the index motion sickness dose value in the time domain. The motion stabilization by the stabilizing fins can be considered as a good method to reduce the motion of the present cruise ship model and eventually contribute to improve passenger comfort.
Slow ethics: A sustainable approach to ethical care practices?
Authors: Gallagher Ann
Published: September 2013

Recent UK reports have revealed extensive evidence of unethical care practices. Older and vulnerable patients in some British health services have experienced appalling and avoidable suffering. Explanations for, and solutions to, these care failures have been proposed with wide-ranging recommendations. Many of these have direct implications for clinical ethics with additional frameworks for ethical values proposed, a heightened awareness of the moral culture of organisations acknowledged and a renewed interest in the ethics component of professional education debated. In this paper, I suggest that we integrate insights from the slow movement into clinical ethics practice. Distinctions are made between fast and slow healthcare practice and between fast and slow ethics. I argue that, whilst there is a place for both, slow ethics enables us to assume a more positive stance in relation to ‘crisis’, and requires that we learn from past accounts and scholarship and consider the role of clinical ethics in sustaining caring cultures.
Compassion in 21st century medicine: Is it sustainable?
Authors: Zulueta Paquita de
Published: September 2013

Philosophical and scientific understandings of compassion converge, both stressing its necessity for the moral life and human flourishing. I conceptualise a dynamic and frangible account of professional virtues, including compassion, and propose that mechanistic organisational systems of care and the biomedical paradigm create a strong risk of dehumanisation and the obliteration of compassion in healthcare. Additionally, the neoliberal market ideology, with its instrumental approach to individuals and commodification of healthcare creates a corrosive influence that alienates clinicians from their patients and severely curtails the scope for compassionate practice. The tension between efficiency and patient orientated care – although they need not be mutually exclusive – has become more acute in the current economic climate, at a time when the boundaries of medicine have broadened and expectations for healthcare have risen. This has created an unsustainable dynamic within which alienated healthcare professionals struggle to fulfil their healing roles and patients experience abandonment and more anxiety.
Deep Vein Thrombosis After Total Hip Arthroplasty and Total Knee Arthroplasty in Patients With Previous Ischemic Stroke
Authors: Qin Jizheng , Xu Zhihong , Shi Dongquan , Chen Dongyang , Dai Jin , Teng Huajian , Jiang Qing
Published: September 2013

The present study evaluated the prevalence and therapy of deep vein thrombosis (DVT) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in 57 patients with previous ischemic stroke. Postoperative anticoagulants were used for DVT prophylaxis, and batroxobin and prolonged anticoagulants were used for thrombolysis in DVT subjects. The incidence of DVT after THA and TKA in patients with previous ischemic stroke was 16.2% and 20%, respectively. No bleeding complications were observed and no new ischemic stroke occurred during the following 3 months. The prevalence DVT after THA and TKA in patients with previous ischemic stroke was not specific, and the treatment of DVT with batroxobin and anticoagulants was effective and safe.
Influence of the Location of Nonischemic Diabetic Forefoot Osteomyelitis on Time to Healing After Undergoing Surgery
Authors: Cecilia-Matilla Almudena , Lázaro-Martínez José Luis , Aragón-Sánchez Javier , García-Álvarez Yolanda , Chana-Valero Pedro , Beneit-Montesinos Juan Vicente
Published: September 2013

The forefoot has been reported as the most frequent location of osteomyelitis in the feet of patients with diabetes. The forefoot includes toes and metatarsal heads as common locations of bone infections, but the anatomy of these bones is quite different. As a result, such differences in anatomy may have an impact on the outcomes. The aim of the present study was to determine whether different locations of osteomyelitis in the forefoot have any influence on time to healing after undergoing surgery in a prospective series including 195 patients without peripheral arterial disease and osteomyelitis confirmed by histopathology. Location of the lesion was classified into 4 groups: hallux, first metatarsal head, lesser metatarsal heads, and lesser toes. The time required to achieve healing and the cumulative rate of wounds healed and likelihood of healing were analyzed at 4, 8, and 12 weeks after surgery. Time of healing (mean ± SD) in the whole series was 10.7 ± 8.4 weeks. Osteomyelitis located in the lesser toes has a higher probability of healing by the fourth week (odds ratio [OR] = 5.7, 95% confidence interval [CI] = 2.8-11.6, P < .001), eighth week (OR = 3.2, 95% CI = 1.6-6.4, P < .001), or twelfth week (OR = 3.1, 95% CI = 1.3-7.0, P = .008) than other osteomyelitis locations. Osteomyelitis located in the first metatarsal joint was less likely to heal by the eighth week (OR = 0.4, 95% CI = 0.2-0.9, P = .037) and 12th week (OR = 0.4, 95% CI = 0.2-1.0, P = .040). In conclusion, time to healing is significantly different according to the location of the bone infection in the forefoot.
The Clinical Effectiveness of Two Compression Stocking Treatments on Venous Leg Ulcer Recurrence
Authors: Kapp Suzanne , Miller Charne , Donohue Lisa
Published: September 2013

Venous leg ulcers affect up to 3% of people aged 65 years and older, present significant pain and suffering, and are associated with long episodes of health care. These chronic wounds recur at rates of up to 69%. A double blind randomized controlled trial was conducted in a home nursing setting in Victoria, Australia to compare the effectiveness of a 23 to 32 mm Hg (moderate) and a 34 to 46 mm Hg (high) compression stocking treatment on venous ulcer recurrence. Participants (n = 100) were monitored for 26 weeks. Study wound recurrence was low (11.8%), and the average time to recurrence was 77.91 days. Adherence to treatment was low (44%) with nonadherence significantly higher in the high-compression stocking group, χ2(1) = 8.827, P = .003. Regression modeling found that adherence to treatment significantly predicted study wound recurrence, Wald(1) = 7.917, P = .005. Estimated hazard ratios showed that participants who did not adhere were 9 times more likely to have their wound recur. Risk of recurrence was 3 times greater for those randomized to moderate compression when compared with the high-compression stocking. Implementing strategies that optimize adherence to compression will reduce ulcer recurrence. Once this has been realized, the potential to adhere to high-compression treatment would further reduce the risk of recurrence.
Umbilical Cord Mesenchymal Stem Cell Transplantation Ameliorates Burn-Induced Acute Kidney Injury in Rats
Authors: Lu Gang , Huang Sha , Chen Yongbin , Ma Kui
Published: September 2013

Excessive systemic inflammation following burns could lead to acute kidney injury (AKI). Mesenchymal stromal cells (MSCs) suppress immune cell responses and have beneficial effects in various inflammatory-related immune disorders. However, autologous MSCs are not vital enough for the treatment because of the severely burned patients’ deleterious condition. Umbilical cord–derived mesenchymal stem cells (UC-MSCs) could be a suitable substitute cell candidate but no data are available on the therapeutic effectiveness of UC-MSCs transplantation for burn injury and its consequences. In this study, UC-MSCs or ulinastatin was administered intravenously in the rats with burn trauma, and the therapeutic effects of UC-MSCs on the survival of severe burn-induced AKI rats and functional protection of kidney were analyzed. Results showed that UC-MSCs promoted the survival and prevented commitment to apoptosis of resident kidney cells and reduced organ microscopic damage in kidneys after thermal trauma. Thus, our study demonstrates that intravenously delivered UC-MSCs protected the host from death caused by kidney injury subsequent to severe burn, identifying UC-MSCs transplantation may be an attractive candidate for cell-based treatments for burns and induced organ damage.
Shewanella putrefaciens, a Rare Cause of Osteomyelitis
Authors: Carlson Russell M. , Dux Katherine
Published: September 2013

Shewanella putrefaciens is a Gram-negative bacillus with a distinguishable characteristic of hydrogen sulfide production and routinely found in a marine environment. This organism has been cultured as a pathogen in a small number of soft tissue infections, but has rarely been the causative agent in osteomyelitis. This case report details calcaneal osteomyelitis due to S putrefaciens in a 77-year-old male with bilateral heel ulcerations and peripheral vascular disease.
Endovascular Coil Embolization of a Costocervical Trunk Pseudoaneurysm After Bullectomy With Pleural Abrasion
Authors: Yu Dong , Sun Xi-Wen , Chen Chang , Jie Bing , Jiang Sen
Published: September 2013

Transarterial embolization (TAE) is less invasive than surgery for the treatment of pseudoaneurysms. Costocervical trunk (CCT) pseudoaneurysms are extremely rare. We herein report an unusual case of a 45-year-old man with a CCT pseudoaneurysm caused by a bullectomy with pleural abrasion, which had been performed to manage a spontaneous pneumothorax. The patient presented with chronic chest pain and successfully underwent TAE with a metallic coil. The chest pain completely disappeared 2 weeks after the TAE, and follow-up computed tomography showed that the pseudoaneurysm had almost completely disappeared 9 months after the TAE.
Reflections on access: too vulnerable to research?
Authors: Witham Gary , Beddow Anna , Haigh Carol
Published: September 2013

This paper seeks to highlight the challenges facing researchers when recruiting vulnerable patients to a research study. We explore the difficulties experienced in gatekeeping for a project involving people with dementia, intellectual disabilities and mental health problems who are also having treatment for cancer. It is argued that the challenges in identifying and recruiting vulnerable participants extend beyond ethics committees and governance to the perceptions and judgements of health care professionals in ‘allowing’ access to particular patient groups. These positions and judgements appear to be embedded in certain construction(s) of cancer and discourses surrounding dementia, intellectual disabilities and mental health.
Prevalence of tobacco use among adults in Egypt, 2009
Authors: Fouad Heba , Awa Fatimah El , Naga Randa Abou El , Emam Awatef Hussien , Labib Sahar , Palipudi Krishna Mohan , Andes Linda J. , Asma Samira , Talley Brandon
Published: September 2013

Introduction:

We assessed the differences in overall use of tobacco and in the use of various tobacco products, by sex and by frequency of use across various demographic groups.

Methods:

We used data from the Global Adult Tobacco Survey (GATS), conducted in 2009 in Egypt. The data consist of answers to GATS by 20,924 respondents from a nationally representative, multistage probability sample of adults aged 15 years or older from all regions of Egypt. Current tobacco use was defined as current smoking or use of smokeless tobacco products, either daily or occasionally. We analyzed the differences in current cigarette, shisha, and smokeless tobacco use by sex and frequency of use (daily or occasional); and by demographic characteristics that included age, region, education level and employment status.

Results:

Overall, 19.7% of the Egyptian population currently use some form of tobacco. Men (38.1% [95% confidence interval (CI) 36.8–39.4]) are much more likely than women (0.6% [95% CI 0.4–0.9]) to use tobacco. Almost 96% of men who use tobacco, do so daily. Men are more likely to use manufactured cigarettes (31.8% [95% CI 30.6–33.1]) than shisha (6.2% [95% CI 5.6–6.9]) or smokeless tobacco (4.1% [95% CI 3.4–4.8]). Few women use tobacco (cigarettes (0.2%), shisha (0.3%) and smokeless tobacco (0.3%)); however, all women who currently smoke shisha, do so daily. Lower educational status, being between ages 25–64 and being employed predicted a higher use of tobacco.

Conclusion:

Egypt has implemented several initiatives to reduce tobacco use. The World Health Organization (WHO) MPOWER technical package, which aims to reverse the tobacco epidemic, is implemented at various levels throughout the country. Our findings show that there is significant variation in the prevalence of tobacco use and types of tobacco used by adult men and women in Egypt. GATS data can be used to better understand comparative patterns of tobacco use by adults, which in turn can be used to develop interventions.
Exposure to secondhand smoke among adults – Philippines, 2009
Authors: Baquilod Marina M , Segarra Agnes B. , Barcenas Glen , Mercado Susan P. , Rarick James , Palipudi Krishna Mohan , Asma Samira , Andes Linda J. , Talley Brandon
Published: September 2013

Introduction:

We assessed the differences in exposure to secondhand smoke (SHS) among adults at home, in indoor workplaces, and in various public places in the Philippines across various socio-demographic groups.

Methods:

Data from the Global Adult Tobacco Survey conducted in 2009 in the Philippines were used. The data consist of survey answers from 9705 respondents from a nationally representative, multistage probability sample of adults aged 15 years or older. We considered that respondents were exposed to SHS if during the previous 30 days they reported that they lived in a home, worked in a building, or visited a public place where people smoked. The public places included in our analysis were indoor workplaces, public transportation vehicles, restaurants, government buildings or offices, and healthcare facilities. The differences in various socioeconomic and demographic groups’ exposure to SHS in these places were also examined.

Results:

Of respondents who reported working indoors, 36.8% were exposed to SHS. Men (43.3% [95% CI 39.7–46.9]) were more likely than women (28.8% [95% CI 25.4–32.4]) to be exposed to SHS ( p < 0.001). Of those working in sites where smoking was not allowed, 13.9% were exposed to SHS, whereas 66.5% were exposed where smoking is allowed in some enclosed areas, and 90.7% were exposed where smoking is allowed everywhere. During the 30 days preceding the survey, more than 50% of those who took public transportation were exposed to SHS; exposure for those who visited public buildings was 33.6% in restaurants, 25.5% in government buildings or offices, and 7.6% in healthcare facilities.

Conclusion:

Despite a national law passed and several local government ordinances that have promulgated smoke-free workplaces, schools, government offices, and healthcare facilities, our findings show that a large proportion of adults were exposed to SHS at work and in public places, which offers opportunities to strengthen and improve enforcement of the smoke-free initiatives and ordinances in the Philippines.
How Does Respect for the Environment Affect Final Prices in the Hospitality Sector? A Hedonic Pricing Approach
Authors: Sánchez-Ollero José Luis , García-Pozo Alejandro , Marchante-Mera Andrés
Published: September 2013

Hedonic pricing theory states that the price of a room is determined by a set of characteristics (e.g., structural, location, and environmental) of the establishment. Set within the framework of this methodology, and using raw data from the Quality, Productivity, and Competitiveness in the Hospitality Industry for Andalusia project, this article discusses the impact on room pricing of hotels implementing environmental sustainability measures based on a sample of 232 hotels (3-, 4-, and 5-stars) in Andalusia (Southern Spain). This sample is statistically representative of hotel accommodations in the region. A distinguishing feature of this study is the creation of a variable derived from the replies given by hotel managers to a questionnaire designed by the authors. The questionnaire presented questions about the measures the managers implemented in their establishments to improve environmental sustainability. The use of this variable in the semilogarithmic hedonic model suggests that the prices of hotel rooms are 5.15-percent higher for each environmentally sustainable measure implemented in the hotel; in some cases, the price increase could be as much as 36.05 percent. Other variables that were also introduced in the model yielded estimates consistent with those obtained in previous studies.
Amyloid β-Related Central Nervous System Angiitis Presenting With an Isolated Seizure
Authors: Ishii Makoto , Lavi Ehud , Kamel Hooman , Gupta Ajay , Iadecola Costantino , Navi Babak B.
Published: September 2013

Amyloid beta-related angiitis (ABRA) of the central nervous system (CNS) is a very rare inflammatory disorder that causes destruction of CNS arteries and subsequent neuronal injury. Most patients with ABRA are old and present with cognitive dysfunction and stroke; however, some patients may present atypically. In this article, we report a 44-year-old man who presented with a first-time seizure but was otherwise neurologically intact and denied any headache. Brain MRI showed right hemispheric and bilateral medial frontal lobe hyperintensities and microhemorrhages that were most suspicious for a mass lesion. An extensive diagnostic evaluation including CSF analysis and catheter angiography was unremarkable. A brain biopsy with specific stains for amyloid surprisingly demonstrated ABRA and led to immunosuppressive treatment. The patient has remained neurologically intact and seizure-free 1 year after presentation. This case demonstrates that ABRA can occur in young patients without headache or neurologic deficits, and should be considered in patients with new-onset seizures and mass lesions. It also reinforces the need to consider a brain biopsy in patients with idiopathic brain lesions and negative non-invasive testing, as it is virtually impossible to confirm the diagnosis of ABRA otherwise.
Expanding Roles for Noninvasive Ventilation in Perioperative Care
Authors: Aldrich J. Matthew , Yost C. Spencer
Published: September 2013

Over the past several years, less invasive methods of providing ventilatory support have arisen to help support patients with respiratory insufficiency and airway obstruction. The application of noninvasive ventilation (NIV) in these situations can provide short- to medium-term aid for certain patient populations without introducing the risks associated with endotracheal intubation. In this article, we review the basics of NIV, discuss the accepted indications for NIV in the ICU, explore the perioperative indications for NIV, including use in patients with obstructive sleep apnea, and finally, provide practical tips for implementing NIV in the ICU and anesthesia recovery areas.
Milwaukee’s Disregarded Population
Authors: Wells Lenard
Published: September 2013

The research was a partial replication of Devah Pager’s study of the effect of a criminal record on employment opportunities in the Milwaukee, Wisconsin labor market. A quantitative and qualitative method was utilized to examine the effects of a criminal record, race, and the relationship between employers’ willingness to hire ex-offenders and their actual hiring of ex-offenders. An experimental audit was conducted by two testers (one Black male and one White male) to audit 30 employers. The results supported Pager’s findings. There was a dramatic negative effect for the Black male tester. Three themes emerged from the testers’ diaries and debriefings: (a) the application process was influenced in the favor of the White male by a “gatekeeper,” (b) racism was evident, and (c) an emotional effect was noted on both testers. Finally, during a telephone survey of the same employers, they indicated a willingness to hire both ex-offenders regardless of their race, yet the audit revealed the opposite.
Role of Women in Sericulture and Community Development
Authors: Kasi Eswarappa
Published: September 2013

In any discourse on sociology and anthropology, one fact that clearly emerges is that women can generally be trusted to perform their duties with utmost care and attention. This is more so in the case of agriculture and allied activities. No wonder women are playing a very important role in the sericulture industry. Their qualities like maternal instincts and loving care of those under their charge prove to be very helpful in the successful breeding of silk worms. The sericulture industry has opened up phenomenal employment avenues and helped women to become important players in the decision-making process—whether in the household or in the community at large. The active involvement of women is very essential for the success of the any community development initiative. This has been proved on many occasions all over the world—more so in the developing countries. For instance, the success of Self Help Groups (SHGs) in Andhra Pradesh and other states of India is all due to the active role played by women. The thrust of this article is on the role of women in promotion of sericulture activities in the village, and how their participation has led to community development. Given the above backdrop, the present article is based on an empirical work undertaken in Kotha Indlu village, Chittoor District of Andhra Pradesh in South India. Sericulture is an important means for generating employment, income enhancement crop enterprises, and is a most appropriate household activity. In all these activities, women have shown their mettle and performed their tasks most skillfully. In the village under study, women are playing an important role in silk rearing and processing activities. This article will endeavor to show how “sericulture,” an agro-based activity, has brought about overall development of individual households, the village, and the community at large.
Exploring Societal Cultural Values and Human Rights and Development
Authors: Bertsch Andy , Warner-Søderholm Gillian
Published: September 2013

This study is an exploration of the relationships between societal cultural values and various observable societal practices. We drew on extant data sources and explored relationships between societal values and human development indexes of 52 cross-listed societies. Correlations were explored using secondary data from notable and valid sources. Data analysis includes Pearson correlation, stepwise regression analyses, and R2 analyses to explore possible operational models. Statistical analyses offer support for the development of two usable models to explain cultural value dimensions that act as independent variables. This exploratory study identifies relationships between societal values and civil liberties and corruption indexes. These findings add to the debate of which cultural values and traditions may support or hinder human rights and human capital development.
Genome-wide analysis of small RNAs reveals eight fiber elongation-related and 257 novel microRNAs in elongating cotton fiber cells
Authors: Xue Wei , Wang Zhengming , Du Mingjian , Liu Yidi , Liu Jin-Yuan
Published: September 2013

Background

MicroRNAs (miRNAs) and other types of small regulatory RNAs play critical roles in the regulation of gene expression at the post-transcriptional level in plants. Cotton is one of the most economically important crops, but little is known about the roles of miRNAs during cotton fiber elongation.

Results

Here, we combined high-throughput sequencing with computational analysis to identify small RNAs (sRNAs) related to cotton fiber elongation in Gossypium hirsutum L. (G. hirsutum). The sequence analysis confirmed the expression of 79 known miRNA families in elongating fiber cells and identified 257 novel miRNAs, primarily derived from corresponding specific loci in the Gossypium raimondii Ulbr. (G. raimondii) genome. Furthermore, a comparison of the miRNAomes revealed that 46 miRNA families were differentially expressed throughout the elongation period. Importantly, the predicted and experimentally validated targets of eight miRNAs were associated with fiber elongation, with obvious functional relationships with calcium and auxin signal transduction, fatty acid metabolism, anthocyanin synthesis and the xylem tissue differentiation. Moreover, one tasiRNA was also identified, and its target, ARF4, was experimentally validated in vivo.

Conclusion

This study not only facilitated the discovery of 257 novel low-abundance miRNAs in elongating cotton fiber cells but also revealed a potential regulatory network of nine sRNAs important for fiber elongation. The identification and characterization of miRNAs in elongating cotton fiber cells might promote the further study of fiber miRNA regulation mechanisms and provide insight into the importance of miRNAs in cotton.
Deletion of the HAMP domains from the histidine kinase CaNik1p of Candida albicans or treatment with fungicides activates the MAP kinase Hog1p in S. cerevisiae transformants
Authors: El-Mowafy Mohammed , Bahgat Mahmoud M , Bilitewski Ursula
Published: September 2013

Background

Microorganisms use two-component signal transduction (TCST) systems to regulate the response of the organism to changes of environmental conditions. Such systems are absent from mammalian cells and are thus of interest as drug targets. Fungal TCST systems are usually composed of a hybrid histidine kinase, comprising the histidine kinase (HisKA) domain and a receiver domain, a histidine phosphotransfer protein and a response regulator. Among the 11 groups of fungal histidine kinases, group III histidine kinases are of particular relevance as they are essential for the activity of different groups of fungicides. A characteristic feature is the N-terminal amino acid repeat domain comprising multiple HAMP domains, of which the function is still largely unknown. In Candida albicans, a fungal human pathogen, three histidine kinases were identified, of which CaNik1p is a group III histidine kinase. Heterologous expression of this protein in Sacchromyces cerevisiae conferred susceptibility to different fungicides. Fungicide activity was associated with phosphorylation of the mitogen activated protein kinase Hog1p.

Results

We have constructed mutated versions of CaNik1p, from which either all HAMP domains were deleted (CaNik1pΔHAMP) or in which the histidine kinase or the receiver domains were not-functional. Expression of CaNIK1ΔHAMP in S. cerevisiae led to severe growth inhibition. Normal growth could be restored by either replacing the phosphate-accepting histidine residue in CaNik1pΔHAMP or by expressing CaNIK1ΔHAMP in S. cerevisiae mutants, in which single genes encoding several components of the HOG pathway were deleted. Expression of proteins with non-functional histidine kinase or receiver domains resulted in complete loss of susceptibility to antifungals, such as fludioxonil. Conditions leading to growth inhibition of transformants also led to phosphorylation of the MAP kinase Hog1p.

Conclusion

Our results show that functional histidine kinase and receiver domains of CaNik1p were essential for antifungal susceptibility and for activation of the Hog1p. Moreover, for the first time we show that deletion of all HAMP domains from CaNik1p led to activation of Hog1p without an external stimulus. This phenotype was similar to the effects obtained upon treatment with fungicides, as in both cases growth inhibition correlated with Hog1p activation and was dependent on the functionality of the conserved phosphate-accepting histidine residue.
Prognostic impact of tumor infiltrating CD8+ T cells in association with cell proliferation in ovarian cancer patients - a study of the OVCAD consortium
Authors: Bachmayr-Heyda Anna , Aust Stefanie , Heinze Georg , Polterauer Stephan , Grimm Christoph , Braicu Elena Ioana , Sehouli Jalid , Lambrechts Sandrina , Vergote Ignace , Mahner Sven , Pils Dietmar , Schuster Eva , Thalhammer Theresia , Horvat Reinhard , Denkert Carsten , Zeillinger Robert , Castillo-Tong Dan Cacsire
Published: September 2013

Background

Epithelial ovarian cancer is one of the most lethal gynecologic malignancies. Clinicopathological factors do not permit precise prognosis and cannot provide guidance to specific treatments. In this study we assessed tumor infiltrating CD8+ T cells in association with Ki67 proliferation index and evaluated their prognostic impact in EOC samples.

Methods

CD8+ cells and Ki67 proliferation index were immunohistochemically determined on tissue microarrays including 203 primary epithelial ovarian tumors. Additionally, CD8 gene expression was assessed with RT-qPCR. Correlations were analyzed using Pearson’s correlation coefficients, ANOVA or T-test, or Fischer’s exact tests. Prognostic impact was evaluated using the Kaplan-Meier method and Cox regression model.

Results

The density of CD8+ infiltrating lymphocytes did not correlate with tumor cell proliferation. Epithelial ovarian cancer patients with no Ki67+ cells in the tumor had a more than three times higher risk to die compared to the population with Ki67+ cells in the tumor (Hazard ratio (HR) = 3.34, 95%CI 1.59-7.04). High CD8+ cell infiltration was associated with improved overall survival (HR = 0.82, 95%CI 0.73-0.92).

Conclusions

The density of tumor infiltrating lymphocytes is independent of tumor cell proliferation. Ovarian cancer patients with Ki67- tumors showed a significantly reduced overall survival, presumably due to no or poor response to platinum-based chemotherapy. Moreover, the association of high densities of tumor infiltrating cytotoxic T lymphocytes with a better overall survival was confirmed.
Metabolic markers and microecological characteristics of tongue coating in patients with chronic gastritis
Authors: Sun Zhu-Mei , Zhao Jie , Qian Peng , Wang Yi-Qin , Zhang Wei-Fei , Guo Chun-Rong , Pang Xiao-Yan , Wang Shun-Chun , Li Fu-Feng , Li Qi
Published: September 2013

Background

In Traditional Chinese Medicine (TCM), tongue diagnosis has been an important diagnostic method for the last 3000 years. Tongue diagnosis is a non-invasive, simple and valuable diagnostic tool. TCM treats the tongue coating on a very sensitive scale that reflects physiological and pathological changes in the organs, especially the spleen and stomach. Tongue coating can diagnose disease severity and determine the TCM syndrome (“Zheng” in Chinese). The biological bases of different tongue coating appearances are still poorly understood and lack systematic investigation at the molecular level.

Methods

Tongue coating samples were collected from 70 chronic gastritis patients and 20 normal controls. 16S rRNA denatured gradient gel electrophoresis (16S rRNA–DGGE) and liquid chromatography and mass spectrometry (LC–MS) were designed to profile tongue coatings. The statistical techniques used were principal component analysis and partial least squares–discriminate analysis.

Results

Ten potential metabolites or markers were found in chronic gastritis patients, including UDP-D-galactose, 3-ketolactose, and vitamin D2, based on LC–MS. Eight significantly different strips were observed in samples from chronic gastritis patients based on 16S rRNA–DGGE. Two strips, Strips 8 and 10, were selected for gene sequencing. Strip 10 sequencing showed a 100% similarity to Rothia mucilaginosa. Strip 8 sequencing showed a 96.2% similarity to Moraxella catarrhalis.

Conclusions

Changes in glucose metabolism could possibly form the basis of tongue coating conformation in chronic gastritis patients. The study revealed important connections between metabolic components, microecological components and tongue coating in chronic gastritis patients. Compared with other diagnostic regimens, such as blood tests or tissue biopsies, tongue coating is more amenable to, and more convenient for, both patients and doctors.
HIV infection and drugs of abuse: role of acute phase proteins
Authors: Samikkannu Thangavel , Rao Kurapati VK , Arias Adriana Y , Kalaichezian Aarthi , Sagar Vidya , Yoo Changwon , Nair Madhavan PN
Published: September 2013

Background

HIV infection and drugs of abuse such as methamphetamine (METH), cocaine, and alcohol use have been identified as risk factors for triggering inflammation. Acute phase proteins such as C-reactive protein (CRP) and serum amyloid A (SAA) are the biomarkers of inflammation. Hence, the interactive effect of drugs of abuse with acute phase proteins in HIV-positive subjects was investigated.

Methods

Plasma samples were utilized from 75 subjects with METH use, cocaine use, alcohol use, and HIV-positive alone and HIV-positive METH, cocaine, and alcohol users, and age-matched control subjects. The plasma CRP and SAA levels were measured by ELISA and western blot respectively and the CD4 counts were also measured.

Results

Observed results indicated that the CRP and SAA levels in HIV-positive subjects who are METH, cocaine and alcohol users were significantly higher when compared with either drugs of abuse or HIV-positive alone. The CD4 counts were also dramatically reduced in HIV-positive with drugs of abuse subjects compared with only HIV-positive subjects.

Conclusions

These results suggest that, in HIV-positive subjects, drugs of abuse increase the levels of CRP and SAA, which may impact on the HIV infection and disease progression.