bluuebunny/crossref_metadata_2025 huggingface dataset:
Global asthma prevalence in adults: findings from the cross-sectional world health survey
Authors: To Teresa , Stanojevic Sanja , Moores Ginette , Gershon Andrea S , Bateman Eric D , Cruz Alvaro A , Boulet Louis-Philippe
Published: March 2012

Background

Asthma is a major cause of disability, health resource utilization and poor quality of life world-wide. We set out to generate estimates of the global burden of asthma in adults, which may inform the development of strategies to address this common disease.

Methods

The World Health Survey (WHS) was developed and implemented by the World Health Organization in 2002-2003. A total of 178,215 individuals from 70 countries aged 18 to 45 years responded to questions related to asthma and related symptoms. The prevalence of asthma was based on responses to questions relating to self-reported doctor diagnosed asthma, clinical/treated asthma, and wheezing in the last 12 months.

Results

The global prevalence rates of doctor diagnosed asthma, clinical/treated asthma and wheezing in adults were 4.3%, 4.5%, and 8.6% respectively, and varied by as much as 21-fold amongst the 70 countries. Australia reported the highest rate of doctor diagnosed, clinical/treated asthma, and wheezing (21.0%, 21.5%, and 27.4%). Amongst those with clinical/treated asthma, almost 24% were current smokers, half reported wheezing, and 20% had never been treated for asthma.

Conclusions

This study provides a global estimate of the burden of asthma in adults, and suggests that asthma continues to be a major public health concern worldwide. The high prevalence of smoking remains a major barrier to combating the global burden of asthma. While the highest prevalence rates were observed in resource-rich countries, resource-poor nations were also significantly affected, posing a barrier to development as it stretches further the demands of non-communicable diseases.
Epidemiology of tobacco use and dependence in adults in a poor peri-urban community in Lima, Peru
Authors: Weygandt Paul Logan , Vidal-Cardenas Elisa , Gilman Robert H , Avila-Tang Erika , Cabrera Lilia , Checkley William
Published: March 2012

Background

Tobacco smoking is an important public health concern worldwide leading to both chronic disease and early death. In Latin America, smoking prevalence is estimated at approximately 30% and prior studies suggest that the prevalence in Peru is 22% to 38%. We sought to determine the prevalence of daily smoking in a poor peri-urban community in Lima, Peru.

Methods

We conducted a cross-sectional survey in a random sample of adults ≥40 years of age living in Pampas de San Juan de Miraflores, Lima, Peru. We asked participants to respond to a survey that included questions on sociodemographics, tobacco use and dependence.

Results

We enrolled 316 participants. Average monthly household income was ≤ 400 USD and nearly all homes had running water, sewage, and electricity. Most individuals had not completed high school. Smoking prevalence was 16% overall, yet daily smoking prevalence was 1.9%. Former daily smokers comprised 3.8% of current nonsmokers and 9.1% current occasional smokers. Average scores for the Fagerstrom Test for Nicotine Dependence for daily smokers and occasional smokers were 1.5 and 0, respectively.

Conclusions

Daily use of tobacco is uncommon among adults in peri-urban communities of Lima, Peru, unlike their counterparts in Lima and other Latin American capital cities. Tobacco dependence is also low. Hence, efforts aimed at primary prevention are of utmost importance in these communities. This study provides an accurate baseline using an internationally recognized assessment tool (Global Adult Tobacco Survey), allowing for accurate assessment of tobacco control interventions over time.
Modelling the dynamics of Plasmodium falciparum histidine-rich protein 2 in human malaria to better understand malaria rapid diagnostic test performance
Authors: Marquart Louise , Butterworth Alice , McCarthy James S , Gatton Michelle L
Published: March 2012

Background

Effective diagnosis of malaria is a major component of case management. Rapid diagnostic tests (RDTs) based on Plasmodium falciparum histidine-rich protein 2 (Pf HRP2) are popular for diagnosis of this most virulent malaria infection. However, concerns have been raised about the longevity of the Pf HRP2 antigenaemia following curative treatment in endemic regions.

Methods

A model of Pf HRP2 production and decay was developed to mimic the kinetics of Pf HRP2 antigenaemia during infections. Data from two human infection studies was used to fit the model, and to investigate Pf HRP2 kinetics. Four malaria RDTs were assessed in the laboratory to determine the minimum detectable concentration of Pf HRP2.

Results

Fitting of the Pf HRP2 dynamics model indicated that in malaria naïve hosts, P. falciparum parasites of the 3D7 strain produce 1.4 × 10-13 g of Pf HRP2 per parasite per replication cycle. The four RDTs had minimum detection thresholds between 6.9 and 27.8 ng/mL. Combining these detection thresholds with the kinetics of Pf HRP2, it is predicted that as few as 8 parasites/μL may be required to maintain a positive RDT in a chronic infection.

Conclusions

The results of the model indicate that good quality Pf HRP2-based RDTs should be able to detect parasites on the first day of symptoms, and that the persistence of the antigen will cause the tests to remain positive for at least seven days after treatment. The duration of a positive test result following curative treatment is dependent on the duration and density of parasitaemia prior to treatment and the presence and affinity of anti-Pf HRP2 antibodies.
Serum profiling by MALDI-TOF mass spectrometry as a diagnostic tool for domoic acid toxicosis in California sea lions
Authors: Neely Benjamin A , Soper Jennifer L , Greig Denise J , Carlin Kevin P , Favre Elizabeth G , Gulland Frances MD , Almeida Jonas S , Janech Michael G
Published: March 2012

Background

There are currently no reliable markers of acute domoic acid toxicosis (DAT) for California sea lions. We investigated whether patterns of serum peptides could diagnose acute DAT. Serum peptides were analyzed by MALDI-TOF mass spectrometry from 107 sea lions (acute DAT n = 34; non-DAT n = 73). Artificial neural networks (ANN) were trained using MALDI-TOF data. Individual peaks and neural networks were qualified using an independent test set (n = 20).

Results

No single peak was a good classifier of acute DAT, and ANN models were the best predictors of acute DAT. Performance measures for a single median ANN were: sensitivity, 100%; specificity, 60%; positive predictive value, 71%; negative predictive value, 100%. When 101 ANNs were combined and allowed to vote for the outcome, the performance measures were: sensitivity, 30%; specificity, 100%; positive predictive value, 100%; negative predictive value, 59%.

Conclusions

These results suggest that MALDI-TOF peptide profiling and neural networks can perform either as a highly sensitive (100% negative predictive value) or a highly specific (100% positive predictive value) diagnostic tool for acute DAT. This also suggests that machine learning directed by populations of predictive models offer the ability to modulate the predictive effort into a specific type of error.
Cost effectiveness of community-based and in-patient therapeutic feeding programs to treat severe acute malnutrition in Ethiopia
Authors: Tekeste Asayehegn , Wondafrash Mekitie , Azene Girma , Deribe Kebede
Published: March 2012

Background

This study estimated the cost effectiveness of community-based therapeutic care (CTC) for children with severe acute malnutrition (SAM) in Sidama Zone, Ethiopia compared to facility based therapeutic feeding center (TFC).

Methods

A cost effectiveness analysis comparing costs and outcomes of two treatment programmes was conducted. The societal perspective, which considers costs to all sectors of the society, was employed. Outcomes and health service costs of CTC and TFC were obtained from Save the Children USA (SC/USA) CTC and TFC programme, government health services and UNICEF(in kind supplies) cost estimates of unit costs. Parental costs were estimated through interviewing 306 caretakers. Cost categories were compared and a single cost effectiveness ratio of costs to treat a child with SAM in each program (regardless of outcome) was computed and compared.

Results

A total of 328 patient cards/records of children treated in the programs were reviewed; out of which 306 (157 CTC and 149 TFC) were traced back to their households to interview their caretakers. The cure rate in TFC was 95.36% compared to 94.30% in CTC. The death rate in TFC was 0% and in CTC 1.2%. The mean cost per child treated was $284.56 in TFC and $134.88 in CTC. The institutional cost per child treated was $262.62 in TFC and $128.58 in CTC. Out of these institutional costs in TFC 46.6% was personnel cost. In contrast, majority (43.2%) of the institutional costs in CTC went to ready to use therapeutic food (RUTF). The opportunity cost per caretaker in the TFC was $21.01 whereas it was $5.87 in CTC. The result of this study shows that community based CTC was two times more cost effective than TFC.

Conclusion

CTC was found to be relatively more cost effective than TFC in this setting. This indicates that CTC is a viable approach on just economic grounds in addition to other benefits such improved access, sustainability and appropriateness documented elsewhere. If costs of RUTF can be reduced such as through local production the CTC costs per child can be further reduced as RUTF constitutes the highest cost in these study settings.
Therapeutic targeting of Krüppel-like factor 4 abrogates microglial activation
Authors: Kaushik Deepak Kumar , Mukhopadhyay Rupanjan , Kumawat Kanhaiya Lal , Gupta Malvika , Basu Anirban
Published: March 2012

Background

Neuroinflammation occurs as a result of microglial activation in response to invading micro-organisms or other inflammatory stimuli within the central nervous system. According to our earlier findings, Krüppel-like factor 4 (Klf4), a zinc finger transcription factor, is involved in microglial activation and subsequent release of proinflammatory cytokines, tumor necrosis factor alpha, macrophage chemoattractant protein-1 and interleukin-6 as well as proinflammatory enzymes, inducible nitric oxide synthase and cyclooxygenase-2 in lipopolysaccharide-treated microglial cells. Our current study focuses on finding the molecular mechanism of the anti-inflammatory activities of honokiol in lipopolysaccharide-treated microglia with emphasis on the regulation of Klf4.

Methods

For in vitro studies, mouse microglial BV-2 cell lines as well as primary microglia were treated with 500 ng/mL lipopolysaccharide as well as 1 μM and 10 μM of honokiol. We cloned full-length Klf4 cDNA in pcDNA3.1 expression vector and transfected BV-2 cells with this construct using lipofectamine for overexpression studies. For in vivo studies, brain tissues were isolated from BALB/c mice treated with 5 mg/kg body weight of lipopolysaccharide either with or without 2.5 or 5 mg/kg body weight of honokiol. Expression of Klf4, cyclooxygenase-2, inducible nitric oxide synthase and phospho-nuclear factor-kappa B was measured using immunoblotting. We also measured the levels of cytokines, reactive oxygen species and nitric oxide in different conditions.

Results

Our findings suggest that honokiol can substantially downregulate the production of proinflammatory cytokines and inflammatory enzymes in lipopolysaccharide-stimulated microglia. In addition, honokiol downregulates lipopolysaccharide-induced upregulation of both Klf4 and phospho-nuclear factor-kappa B in these cells. We also found that overexpression of Klf4 in BV-2 cells suppresses the anti-inflammatory action of honokiol.

Conclusions

Honokiol potentially reduces inflammation in activated microglia in a Klf4-dependent manner.
Hypofractionated stereotactic radiotherapy for brain metastases larger than three centimeters
Authors: Jiang Xue-song , Xiao Jian-ping , Zhang Ye , Xu Ying-jie , Li Xiang-pan , Chen Xiu-jun , Huang Xiao-dong , Yi Jun-lin , Gao Li , Li Ye-xiong
Published: March 2012

Background

To evaluate the efficacy and outcomes of hypofractionated stereotactic radiotherapy (HSRT) for brain metastases > 3 cm.

Methods

From March 2003 to October 2009, 40 patients with brain metastases larger than 3 cm were treated by HSRT. HSRT was applied in 29 patients for primary treatment and in 11 patients for rescue. Single brain metastasis was detected in 21 patients. Whole brain radiotherapy was incorporated into HSRT in 10 patients for primary treatment. HSRT boosts were applied in 23 patients. The diameters of the brain metastases ranged from 3.1 to 5.5 cm (median, 4.1 cm). The median prescribed dose (not including HSRT boosts) was 40 Gy (range, 20-53 Gy) with a median of 10 fractions (range, 4-15 fractions) to the 90% isodose line. The median dose of the boost was 20 Gy (range, 10-35 Gy) in 4 fractions (range, 2-10 fractions).

Result

The median overall survival time was 15 months. The overall survival and local control rate at 12 months was 55.3% and 94.2%, respectively. Four patients experienced local progression of large brain metastases. Nine patients died of intracranial disease progression. One patient died of radiation necrosis with brain edema.

Conclusion

HSRT was a safe and effective treatment for patients with brain metastases ranged from 3.1 to 5.5 cm. Dose escalation of HSRT boost may improve local control with an acceptable toxicity.
Effect of mineral-enriched diet and medicinal herbs on Fe, Mn, Zn, and Cu uptake in chicken
Authors: Stef Ducu Sandu , Gergen Iosif
Published: March 2012

Background

The goal of our study was to evaluate the effects of different medicinal herbs rich in polyphenol (Lemon balm, Sage, St. John's wort and Small-flowered Willowherb) used as dietary supplements on bioaccumulation of some essential metals (Fe, Mn, Zn and Cu) in different chicken meats (liver, legs and breast).

Results

In different type of chicken meats (liver, legs and breast) from chickens fed with diets enriched in minerals and medicinal herbs, beneficial metals (Fe, Mn, Zn and Cu) were analysed by flame atomic absorption spectrometry. Fe is the predominant metal in liver and Zn is the predominant metal in legs and breast chicken meats. The addition of metal salts in the feed influences the accumulations of all metals in the liver, legs and breast chicken meat with specific difference to the type of metal and meat. The greatest influences were observed in legs meat for Fe and Mn. Under the influence of polyphenol-rich medicinal herbs, accumulation of metals in the liver, legs and breast chicken meat presents specific differences for each medicinal herb, to the control group that received a diet supplemented with metal salts only. Great influence on all metal accumulation factors was observed in diet enriched with sage, which had significantly positive effect for all type of chicken meats.

Conclusions

Under the influence of medicinal herbs rich in different type of polyphenol, accumulation of metals in the liver, legs and breast chicken meat presents significant differences from the group that received a diet supplemented only with metal salts. Each medicinal herb from diet had a specific influence on the accumulation of metals and generally moderate or poor correlations were observed between total phenols and accumulation of metals. This may be due to antagonism between metal ions and presence of other chelating agents (amino acids and protein) from feeding diets which can act as competitor for complexation of metals and influence accumulation of metals in chicken meat.

Graphical abstract
Obesity and carotid atherosclerosis in African black and Caucasian women with established rheumatoid arthritis: a cross-sectional study
Authors: Solomon Ahmed , Norton Gavin R , Woodiwiss Angela J , Dessein Patrick H
Published: March 2012

Introduction

Reported findings on the relationship between adiposity and atherosclerotic cardiovascular disease (ACVD) risk in rheumatoid arthritis (RA) are contradictory and originate in developed populations. Approximately 80% of ACVD now occurs in developing countries. We aimed to ascertain the associations of clinical obesity measures with metabolic cardiovascular risk and atherosclerosis in African women with RA from a developing black and developed Caucasian population.

Methods

The associations of body mass index (BMI) as an indicator of overall adiposity and waist circumference and waist-to-height and waist-to-hip ratios as abdominal obesity indices with metabolic risk factors and high resolution B-mode ultrasound-determined carotid artery atherosclerosis were assessed in multivariate regression models in 203 African women with established RA; 108 were black and 95 Caucasian.

Results

BMI and waist-to-height ratio were higher in African black compared to Caucasian women (29.9 (6.6) versus 25.3 (4.9) kg/m2, P = 0.002 and 0.59 (0.09) versus 0.53 (0.08), P = 0.01, respectively). Interactions between population origin and anthropometric measures were not related to metabolic risk factors but were associated with atherosclerosis, independent of confounders and individual terms. In all patients, BMI was related to systolic and diastolic blood pressure but not with serum lipid concentrations whereas abdominal obesity indices were associated with serum lipid concentrations but not with blood pressure values; obesity measures that were associated with plasma glucose concentrations comprised BMI, waist circumference and waist-to-height ratio (P < 0.05 in multiple confounder adjusted analysis). In African Caucasian women, BMI was associated with common carotid artery intima-media thickness (standardized β (95% confidence interval (CI)) = 0.21 (0.03 to 0.38)) and waist-to-hip ratio with plaque (odds ratio (OR) (95% CI) = 1.83 (1.03 to 3.25) for one standard deviation (SD) increase). These relationships were independent of multiple non-metabolic risk factors and explained by metabolic risk factors. In African black women with RA, none of the obesity measures was related to atherosclerosis.

Conclusions

Obesity in women with RA from developing groups of black African descent does not as yet translate into atheroma. In Caucasian women with RA that belong to developed populations, BMI and waist-to-hip ratio should be considered in ACVD risk assessment.
Sustained rheumatoid arthritis remission is uncommon in clinical practice
Authors: Prince Femke HM , Bykerk Vivian P , Shadick Nancy A , Lu Bing , Cui Jing , Frits Michelle , Iannaccone Christine K , Weinblatt Michael E , Solomon Daniel H
Published: March 2012

Introduction

Remission is an important goal of therapy in rheumatoid arthritis (RA), but data on duration of remission are lacking. Our objective was to describe the duration of remission in RA, assessed by different criteria.

Methods

We evaluated patients from the Brigham and Women's Rheumatoid Arthritis Sequential Study (BRASS) not in remission at baseline with at least 2 years of follow-up. Remission was assessed according to the Disease Activity Score 28-C-reactive protein (DAS28-CRP4), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) scores, and the recently proposed American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) criteria for remission. Analyses were performed by using Kaplan-Meier survival curves.

Results

We identified 871 subjects with ≥2 years of follow-up. Of these subjects, 394 were in remission at one or more time-points and not in remission at baseline, according to at least one of the following criteria: DAS28-CRP < 2.6 (n = 309), DAS28-CRP < 2.3 (n = 275), SDAI (n = 168), CDAI (n = 170), and 2010 ACR/EULAR (n = 158). The median age for the 394 subjects at entrance to BRASS was 56 years; median disease duration was 8 years; 81% were female patients; and 72% were seropositive. Survival analysis performed separately for each remission criterion demonstrated that < 50% of subjects remained in remission 1 year later. Median remission survival time was 1 year. Kaplan-Meier curves of the various remission criteria did not significantly differ (P = 0.29 according to the log-rank test).

Conclusions

This study shows that in clinical practice, a minority of RA patients are in sustained remission.
Insulin-like growth factor 1 attenuates antiestrogen- and antiprogestin-induced apoptosis in ER+ breast cancer cells by MEK1 regulation of the BH3-only pro-apoptotic protein Bim
Authors: Periyasamy-Thandavan Sudharsan , Takhar Suchreet , Singer Adam , Dohn Michael Robert , Jackson William Hutch , Welborn April Eve , LeRoith Derek , Marrero Mario , Thangaraju Muthusamy , Huang Shuang , Schoenlein Patricia Veronica
Published: March 2012

Introduction

In this pre-clinical in vitro study conducted in estrogen receptor positive (ER+) breast cancer cells, we have characterized the effects of insulin-like growth factor I (IGF-1) on the cytostatic and cytotoxic action of antiestrogen treatment when used as a single agent or in combination with the antiprogestin mifepristone (MIF). Our goal was to identify new molecular targets to improve the efficacy of hormonal therapy in breast cancer patients that have a poor response to hormonal therapy, in part, due to high circulating levels of unbound insulinIGF-1.

Methods

IGF-1-mediated effects on cytostasis and apoptotic cell death were determined with cell counts conducted in the presence and absence of trypan blue; enzyme-linked immunosorbent assays to determine the intracellular levels of cleaved cytokeratin 18, a marker of epithelial cancer cell apoptosis; and immunoblot analysis to determine the levels of cleaved poly-ADP ribose polymerase (PARP) and lamin A that result from caspase-dependent apoptosis. Cytotoxicity was further characterized by determination of the levels of reactive oxygen species (ROS) and the percent of mitochondrial membrane depolarization in cell populations treated with the different hormones in the presence and absence of IGF-1. Small molecule inhibitors of the dual-specificity protein kinase MEK1, MEK1 siRNA, Bim siRNA, and vectors overexpressing MEK1 wild type and mutant, dominant negative cDNA were used to identify key IGF-1 downstream prosurvival effectors.

Results

IGF-1, at physiologically relevant levels, blocked the cytotoxic action(s) of the antiestrogens 4-hydroxytamoxifen (4-OHT) and tamoxifen (TAM) when used as single agents or in combination with the antiprogestin MIF. The antiapoptotic action of IGF-1 was mediated primarily through the action of MEK1. MEK1 expression reduced the levels of ROS and mitochondrial membrane depolarization induced by the hormonal treatments via a mechanism that involved the phosphorylation and proteasomal turnover of the proapoptotic BH3-only Bcl-2 family member Bim. Importantly, small-molecule inhibitors of MEK1 circumvented the prosurvival action of IGF-1 by restoring Bim to levels that more effectively mediated apoptosis in ER+ breast cancer cells.

Conclusion

his study provides strong support for the use of MEK1 inhibitors in combination with hormonal therapy to effectively affect cytostasis and activate a Bim-dependent apoptotic pathway in ER+ breast cancer cells. We discuss that MEK1 blockade may be a particularly effective treatment for women with high circulating levels of IGF-1, which have been correlated to a poor prognosis.
Rule-based induction method for haplotype comparison and identification of candidate disease loci
Authors: Karinen Sirkku , Saarinen Silva , Lehtonen Rainer , Rastas Pasi , Vahteristo Pia , Aaltonen Lauri A , Hautaniemi Sampsa
Published: March 2012

There is a need for methods that are able to identify rare variants that cause low or moderate penetrance disease susceptibility. To answer this need, we introduce a rule-based haplotype comparison method, Haplous, which identifies haplotypes within multiple samples from phased genotype data and compares them within and between sample groups. We demonstrate that Haplous is able to accurately identify haplotypes that are identical by descent, exclude common haplotypes in the studied population and select rare haplotypes from the data. Our analysis of three families with multiple individuals affected by lymphoma identified several interesting haplotypes shared by distantly related patients.
Crisis without a Legacy: Reflections on Institutional and Regulatory Reform
Authors: Thomadakis Stavros B.
Published: March 2012

The scope of the present global financial crisis is comparable to that of the 1930s. Public policies responding to each have been very different, however. The large macroeconomic response of the past three years has averted a new Great Depression, but regulation of the financial sector has been much softer than in the 1930s. This is partly due to financial globalization that extends beyond the capacities of national regulators. Macroeconomic antidepression measures have created new realities: the rise of indebted states. The sovereign crisis imposes market discipline on states while, conversely, states are too weak to impose regulatory discipline on markets. New modes of supranational regulation and a new ethics of the public interest are necessary for a new era of balanced prosperity.
Political Rights, Development, and Corruption in the Balkan and Arab Mediterranean Countries
Authors: Sioussiouras Petros , Vavouras Ioannis
Published: March 2012

This essay provides an account of the phenomenon of corruption in the Balkan and Arab countries of the Mediterranean. The analysis focuses on the effects that the political system—approached through the lens of political rights—and the level of economic development have on corruption. These factors are of critical importance for analyzing the scale of corruption in the region and should form the core of any anticorruption strategies.
Is benign tertian malaria actually benign?
Authors: Gogia Atul , Kakar Atul , Byotra S P
Published: March 2012

This retrospective study was conducted in order to determine the incidence of various complications of Plasmodium vivax malaria based on a review of case records in a tertiary care hospital in New Delhi, India. The case records of all confirmed cases of malaria over the period of one year were studied. Complete blood count, peripheral blood findings, liver and kidney functions were reviewed. There were 165 confirmed cases. Of these, 121 were due to P. vivax and 42 to P. falciparum. Two cases had mixed infection. The complications seen in the P. vivax cases were: thrombocytopenia; hepatic dysfunction; renal damage; and acute respiratory distress syndrome (ARDS). There were three deaths as a result of ARDS. This paper highlights the fact that P. vivax malaria, although considered to be a benign entity, can have a severe and complicated course, which is usually associated with P. falciparum malaria.
Avoiding scrotal haematoma after repair of extensive scrotal hernias by postoperative scrotal compression through scrotal suspension by scrotal-abdominal skin suture
Authors: Wilms Miriam C , Hellmold Peter
Published: March 2012

Scrotal haematoma and oedema are the most frequent complications of scrotal surgery and are associated with high morbidity. Through early postoperative compression on the scrotal sac these complications can be avoided. Compression can be assured by the following simple surgical method independent of the quality of the postoperative care: extending the scrotal sac over the abdominal wall and fixing it with skin sutures under tension at the lower abdominal wall over a pile of gauzes. This method was shown to be effective after hernia repair of scrotal hernias but also seems promising for other scrotal surgery.
Drain site evisceration of fallopian tube, another reason to discourage abdominal drain: report of a case and brief review of literature
Authors: Saini Pradeep , Faridi M S , Agarwal Nitin , Gupta Arun , Kaur Navneet
Published: March 2012

Placement of a drain following abdominal surgery is common despite a lack of convincing evidence in the current literature to support this practice. The use of intra-abdominal drain is associated with many potential and serious complications. We report a drain site evisceration of the right fallopian tube after the removal of an intra-abdominal drain. The drain was placed in the right iliac fossa in a patient who underwent a lower segment Caesarean section (LSCS) for meconium liquor with fetal distress. The Pfannenstiel incision made for LSCS was reopened and the protruding inflamed fimbrial end of the right fallopian tube was excised. The patient made an uneventful recovery. Routine intra-abdominal prophylactic drain following an abdominal surgery including LSCS should be discouraged.
Use of fine needle aspiration cytology in the diagnosis of cutaneous leishmaniasis: a comparison with the conventional scraping method
Authors: Hosseinzadeh Massood , Omidifar Navid , Lohrasb Mohamad Hosein
Published: March 2012

Cutaneous leishmaniasis is endemic in Iran. Scraping smears are widely used and fine needle aspiration (FNA) cytology is now attracting more attention. Both methods were performed on the clinically suspected cases in our study. Smears were stained using Giemsa. We compared the sensitivity, specificity and some other aspects of these two methods. Of our 400 patients, 346 had specimens that were positive for leishman body, and of these 328 were detected using both methods. However, 42 cases were confirmed positive by FNA cytology and 18 as a result of scraping smears. There was a significant difference between the two methods in the detection of leishman body and microgranuloma, slide background and patient comfort. The sensitivity of FNA cytology was greater even though the specificity was the same. Our study confirmed the advantages of FNA cytology as a reliable method for the diagnosis of cutaneous leishmaniasis.
Treatment outcome of HIV-associated tuberculosis in a resource-poor setting
Authors: Ifebunandu Ngozi A , Ukwaja Kingsley N , Obi Samuel N
Published: March 2012

Nigeria is among the countries with the world's highest tuberculosis (TB) burden, and HIV/TB co-infection is an important cause of mortality. We evaluate the treatment outcome of HIV-infected TB patients in Abakaliki, Nigeria. A retrospective cohort study of all TB patients registered at a tertiary hospital between January 2006 and December 2010 was conducted. Of 671 TB patients, 189 (28.2%) were HIV co-infected. Of these, 147 (77.8%) had pulmonary TB and 42 (22.2%) had extra-pulmonary TB. The overall treatment success rate was 52.4% ( n = 99) and the defaulted in treatment rate was 30.2% ( n = 57). Twenty-one (11.1%) died, and one (0.5%) had treatment failure. Younger age group (<15 years; P = 0.0024) and smear-positive status ( P = 0.0056) were independent predictors of successful treatment. TB/HIV co-infection is associated with high mortality and alarming default rates during treatment.
Animal bites in children: burden in urban Delhi
Authors: Mehndiratta Sumit
Published: March 2012

Animal bites pose a significant problem throughout India. Despite the advances in and availability of modern vaccines, there remains a lack of awareness of the proper management of these bites. This study was conducted in a tertiary level referral hospital in Delhi in order to study the profile of paediatric victims of animal bites and to review the myths regarding the disease and management practices adopted by the parents of bite victims. It was found that parents are mostly unaware of the correct management practices regarding animal bites.
Challenges and Opportunities in the Application Process for Fellowship Training in Pathology
Authors: Bernacki Kurt D. , McKenna Barbara J. , Myers Jeffrey L.
Published: March 2012

A survey completed by 366 pathology residents and fellows examined preferences for 3 fellowship application systems: keeping the current system, a National Resident Matching Program (NRMP)–style match, and a unified time line. All groups showed a strong preference for a time line, accounting for 62.1% of first choices vs the current system (17.3%) or a match (20.6%). When asked for a second choice after time line was ranked first, 60.5% of respondents whose fellowship of choice was available at their residency institution and 63.5% who had accepted fellowship positions at their residency institution preferred the current system; 51.4% whose fellowship of choice was not available at their residency institution and 50.6% of those who had accepted fellowship positions elsewhere preferred a match. Location and family/personal reasons were more important than subspecialty competitiveness and program prestige when accepting fellowship positions. Pressure to choose and apply early for fellowship persists and is greatest for anatomic pathology–only and clinical pathology–only residents.
Application of graph theory and topological models for the determination of fundamentals of the aromatic character of pi-conjugated hydrocarbons
Authors: Cyrański Michał K. , Ciesielski Arkadiusz , Krygowski Tadeusz M. , Stępień Dorota K.
Published: March 2012

Application of topological analysis and graph theory to benzenoid hydrocarbons leads to the determination of fundamentals of aromaticity: the Hückel rule and the Clar rule. The approach, based on a treatment of the adjacency matrix, allows resonance energy (RE)-like characteristics to be estimated with quite good accuracy, and magnetic aromaticity indices to be derived for both the individual rings and the whole molecules. It also allows an effective approach for interpreting ring current formation in molecules when exposed to an external magnetic field. The transformation of the perturbation matrix into a form describing the canonical structures allows their gradation and determination of their stabilizing/destabilizing character.
The Finite Phase-Field Method - A Numerical Diffuse Interface Approach for Microstructure Simulation with Minimized Discretization Error
Authors: Eiken Janin
Published: March 2012

The Phase-field method is recognized as the method of choice for space-resolved microstructure simulation. In theoretic phase-field approaches, the underlying diffuse interface representation is discussed in the sharp interface limit. Applied phase-field models, however, have to cope with interfaces of finite size. Numerical solution based on finite differences naturally implies a discretization error. This error may result in significant deviations from the analytical sharp-interface solution, especially in cases of interface-controlled growth. Benchmark simula-tions revealed a direct correlation between the accuracy of the finite-difference solution and the number of numerical cells used to resolve the finite-sized interface width. This poses a problem, because high numbers of interface cells are unfavorable for numerical performance. To enable efficient high-accuracy computations, a new Finite Phase-Field approach is proposed, which closely links phase-field modeling and numerical discretization. The approach is based on a parabolic potential function, corresponding to phase-field solutions with a sinusoidal interface pro-file. Consideration of this profile during numerical differentiation allows an exact quantification of the bias evoked by grid spacing and interface width, which then a priori can be compensated.
Enraizamento de estacas caulinares e radiculares de cultivares de amoreira-preta coletadas em diferentes épocas, armazenadas a frio e tratadas com AIB
Authors: Campagnolo Marcelo Angelo , Pio Rafael
Published: March 2012

O objetivo do presente trabalho foi avaliar o enraizamento de estacas caulinares e radiculares de cultivares de amoreira-preta, coletadas em diferentes épocas, armazenadas a frio e tratadas com AIB. No primeiro experimento, estacas radiculares e caulinares da amoreira-preta 'Tupy' foram coletadas no momento da poda hibernal, realizada nas seguintes épocas: 07/06, 22/06, 08/07, 22/07, 06/08 e 20/08 de 2009. Já no segundo experimento, metade das estacas caulinares e radiculares da mesma cultivar foi armazenada a frio por 30 dias e a outra metade das estacas foi colocada diretamente para enraizar. Todas as estacas foram tratadas com diferentes concentrações de ácido indolbutírico (AIB): 1000, 2000, 3000 e 4000mg L-1 por 10s., além do controle composto somente por água. No terceiro experimento, foram coletadas estacas radiculares das cultivares 'Choctaw', 'Ébano', 'Guarani', 'Arapaho', 'Brazos', 'Cherokee', 'Comanche', 'Caingangue', 'Tupy' e 'Xavante' na poda realizada no dia 22 de junho do ano seguinte. As estacas foram armazenadas a frio por 30 dias e não foi realizado tratamento com AIB. Em ambos os experimentos, as estacas caulinares foram enterradas 2/3 de seu comprimento na posição vertical e as estacas radiculares foram totalmente imersas na posição horizontal, utilizando a vermiculita de grânulos finos como substrato, em telado com sombreamento de 50%. Após 90 dias, pode-se concluir que as estacas radiculares apresentam melhores resultados, devendo ser armazenadas a frio e não tratadas com AIB, mas há diferença do potencial propagativo entre os cultivares de amoreira-preta.
Critical Analysis of Consecutive Unilateral Cleft Lip Repairs: Determining Ideal Sample Size
Authors: Power Stephanie M. , Matic Damir B.
Published: March 2012

Objective

Cleft surgeons often show 10 consecutive lip repairs to reduce presentation bias, however the validity remains unknown. The purpose of this study is to determine the number of consecutive cases that represent average outcomes. Secondary objectives are to determine if outcomes correlate with cleft severity and to calculate interrater reliability.

Design

Consecutive preoperative and 2-year postoperative photographs of the unilateral cleft lip–nose complex were randomized and evaluated by cleft surgeons. Parametric analysis was performed according to chronologic, consecutive order. The mean standard deviation over all raters enabled calculation of expected 95% confidence intervals around a mean tested for various sample sizes.

Setting

Meeting of the American Cleft Palate–Craniofacial Association in 2009.

Patients, Participants

Ten senior cleft surgeons evaluated 39 consecutive lip repairs.

Main Outcome Measures

Preoperative severity and postoperative outcomes were evaluated using descriptive and quantitative scales.

Results

Intraclass correlation coefficients for cleft severity and postoperative evaluations were 0.65 and 0.21, respectively. Outcomes did not correlate with cleft severity ( P = .28). Calculations for 10 consecutive cases demonstrated wide 95% confidence intervals, spanning two points on both postoperative grading scales. Ninety-five percent confidence intervals narrowed within one qualitative grade (±0.30) and one point (±0.50) on the 10-point scale for 27 consecutive cases.

Conclusions

Larger numbers of consecutive cases (n > 27) are increasingly representative of average results, but less practical in presentation format. Ten consecutive cases lack statistical support. Cleft surgeons showed low interrater reliability for postoperative assessments, which may reflect personal bias when evaluating another surgeon's results.
Why are metapopulations so rare?
Authors: Fronhofer Emanuel A. , Kubisch Alexander , Hilker Frank M. , Hovestadt Thomas , Poethke Hans Joachim
Published: March 2012

Roughly 40 years after its introduction, the metapopulation concept is central to population ecology. The notion that local populations and their dynamics may be coupled by dispersal is without any doubt of great importance for our understanding of population‐level processes.

A metapopulation describes a set of subpopulations linked by (rare) dispersal events in a dynamic equilibrium of extinctions and recolonizations. In the large body of literature that has accumulated, the term “metapopulation” is often used in a very broad sense; most of the time it simply implies spatial heterogeneity. A number of reviews have recently addressed this problem and have pointed out that, despite the large and still growing popularity of the metapopulation concept, there are only very few empirical examples that conform with the strict classical metapopulation (CM) definition.

In order to understand this discrepancy between theory and observation, we use an individual‐based modeling approach that allows us to pinpoint the environmental conditions and the life‐history attributes required for the emergence of a CM structure. We find that CM dynamics are restricted to a specific parameter range at the border between spatially structured but completely occupied and globally extinct populations. Considering general life‐history attributes, our simulations suggest that CMs are more likely to occur in arthropod species than in (large) vertebrates.

Since the specific type of spatial population structure determines conservation concepts, our findings have important implications for conservation biology. Our model suggests that most spatially structured populations are panmictic, patchy, or of mainland–island type, which makes efforts spent on increasing connectivity (e.g., corridors) questionable. If one does observe a true CM structure, this means that the focal metapopulation is on the brink of extinction and that drastic conservation measures are needed.
Separating selection by diurnal and nocturnal pollinators on floral display and spur length in Gymnadenia conopsea
Authors: Sletvold Nina , Trunschke Judith , Wimmergren Carolina , Ågren Jon
Published: March 2012

Most plants attract multiple flower visitors that may vary widely in their effectiveness as pollinators. Floral evolution is expected to reflect interactions with the most important pollinators, but few studies have quantified the contribution of different pollinators to current selection on floral traits. To compare selection mediated by diurnal and nocturnal pollinators on floral display and spur length in the rewarding orchid Gymnadenia conopsea, we manipulated the environment by conducting supplemental hand‐pollinations and selective pollinator exclusions in two populations in central Norway. In both populations, the exclusion of diurnal pollinators significantly reduced seed production compared to open pollination, whereas the exclusion of nocturnal pollinators did not. There was significant selection on traits expected to influence pollinator attraction and pollination efficiency in both the diurnal and nocturnal pollination treatment. The relative strength of selection among plants exposed to diurnal and nocturnal visitors varied among traits and populations, but the direction of selection was consistent. The results suggest that diurnal pollinators are more important than nocturnal pollinators for seed production in the study populations, but that both categories contribute to selection on floral morphology. The study illustrates how experimental manipulations can link specific categories of pollinators to observed selection on floral traits, and thus improve our understanding of how species interactions shape patterns of selection.
Death, Drugs, and Disaster: Mortality Among New Orleans’ Homeless
Authors: Rayburn Rachel L. , Pals Heili , Wright James D.
Published: March 2012

Tracking homeless individuals over time has proved to be extremely difficult; thus, only limited longitudinal data on the homeless exist. We analyze longitudinal data originally collected from the New Orleans Homeless Substance Abusers Program in 1991–1993, supplemented with mortality data for the same sample by year 2010. We use social bonding theory to examine the effect of conventional social ties on mortality among a sample of substance abusing homeless people. This is of special concern when researching the older homeless persons. We find that social bonding theory does not help to understand mortality among this population. However, alcohol abuse, as compared to crack cocaine, does increase the likelihood of early mortality.
Phonological and Visuospatial Short-Term Memory in Children With Specific Language Impairment
Authors: Henry Lucy A. , Messer David J. , Nash Gilly
Published: March 2012

An investigation was carried out into the phonological short-term memory (PSTM) and visuospatial short-term memory (VSSTM) skills of children with specific language impairment (SLI;n= 41) using memory span tasks. Individuals with SLI were compared with children who had milder degrees of language difficulty (“low language functioning” [LLF];n= 31) and children with typical development (n= 88). Regression analyses examined the effects of group after controlling for age and nonverbal IQ; further regressions included an additional control for verbal IQ. Even after controlling for all of these variables, children with SLI and LLF showed significantly weaker PSTM than children with typical development. For VSSTM, there were no overall group differences in performance. The findings imply that the PSTM difficulties that have been reported in children with SLI are substantial, whereas VSSTM appears to be an area of relative strength for most children with SLI.
Effects of Ethnic/Racial Identification on Case-Based Learning Outcomes in a Psychology Course at a Historically Black College/University
Authors: Whaley Arthur L.
Published: March 2012

African American students tend to have better learning outcomes if they can identify with the educational process. Two types of schemata may account for the influence of ethnic/racial identification on learning outcomes: the schema that reflects the ethnic/racial or cultural identity of African American students, and a second schema paradigm that is the relational schema induction theory. Ethnic/racial identification with a learning task facilitates Black students’ ability to identify the relations among the elements of the task, create a mental analog, and apply it to novel learning situations. This notion was tested in a post hoc evaluation of a case-based learning approach to teaching abnormal psychology to a class of 39 undergraduate students at a historically Black college or university (HBCU). This study compared case studies about an African American, European American, and Native American in terms of their effect on learning outcomes. The hypothesis was that the African American case would be associated more strongly with learning outcomes. Results from structural equation modeling analyses supported the hypothesis. Implications for teaching and learning among African American students are discussed.
Exponential dichotomies for linear discrete-time systems in Banach spaces
Authors: Popa Ioan-Lucian , Megan Mihail , Ceauşu Traian
Published: March 2012

In this paper we investigate some dichotomy concepts for linear difference
equations in Banach spaces. Characterizations of these concepts are given.
Some illustrating examples clarifies the relations between these concepts.
Coping with socially sensitive topics discourse on interethnic marriages among elderly members of the Serbian minority in Hungary
Authors: Ilic Marija
Published: March 2012

Drawing on the field research conducted in the Serbian community in
Szigetcs?p, Hungary, the paper examines interlocutors? oral discourse on
interethnic marriages. Until the Second World War, the Serbs in Hungary,
rural communities in particular, mainly practised endogamy. In the post-war
era, however, they tended to be among the minority groups with the highest
rate of exogamic marriages. Conse?quently, the interviewees established
discourse links between ?interethnic marriages?, ?loss of native language?
and ?fear of identity loss?. The analytical focus is on the interlocutors?
internal dialogism between the authoritative word of the ancestors and
autobiographical assertions.
The ideal of Balkan unity from a European perspective (1789-1945)
Authors: Hassiotis Loukianos
Published: March 2012

The federal movement in the Balkans is especially interesting, not because it
was an ideological trend based on distinctive local characteristics, but
precisely because it emerged concurrently with similar political and
ideological trends on the rest of the continent, thus reflecting the close
connection and mutual dependence between the various regions of Europe. The
article approaches the different attempts for Balkan cooperation between the
end of the eighteenth century and the beginning of the Cold War in reference
to the corresponding movements for the European reconciliation and
unification, using comparatively the relevant bibliography.