bluuebunny/crossref_metadata_2025 huggingface dataset:
Human albumin in extracorporeal prime: effect on platelet function and bleeding
Authors: Kamra C , Beney A
Published: June 2013

Purpose:

Synthetic starches have been positioned as an equivalent substitute for human albumin in extracorporeal prime, with both providing osmotic and oncotic pressure. Another effect of albumin is its ability to coat the synthetic surfaces of an extracorporeal circuit with a biopassivating protein monolayer. Whether this protein biopassivation has any benefit to the patient, assessed by platelet count, platelet function and 24-hour bleeding rate, is considered.

Methods:

Patients presenting for coronary artery bypass at a Canadian tertiary care hospital were randomized into two groups until a final study size of 20 patients was obtained. The Study Group received 2.5 g of human albumin in the extracorporeal prime and the Control Group remained protein free. Both groups included Voluven 6% as a synthetic starch. Blood samples were obtained at three intervals; Pre-bypass, During bypass (30 minutes after initiation of bypass), and Post-bypass. These samples were assayed for platelet function, platelet count and hemoglobin. Chest tube drainage over a 24-hour period was monitored.

Results:

Platelet count was significantly higher in the During sample in the Study Group (196 ± 56.5 x 109/ml versus 160 ± 18.5 x 109/ml, p<0.05), however, this difference was no longer significant with the Post-bypass sample (135 ±36.0 x 109/mL versus 127 ±19 x 109/mL). Platelet function assays (PFA) showed no significant differences. Chest tube drainage after 24 hours was significantly lower in the Study Group (586 ± 131.8 ml/24 h versus 741 ± 272.5 ml/24 h, p<0.05).

Conclusions:

Human albumin can passivate the synthetic surfaces of the extracorporeal circuit, which is supported by observations of preserved platelet count and reduced chest tube drainage. Although some statistically significant benefits were observed, the practical benefits of passivating an extracorporeal circuit with human albumin may be minimal.
Link between Process and Appraisal in Coverage Decisions
Authors: Fischer Katharina E. , Stollenwerk Björn , Rogowski Wolf H.
Published: June 2013

Background. To achieve fair-coverage decision making, both material criteria and criteria of procedural justice have been proposed. The relationship between these is still unclear. Objective. To analyze hypotheses underlying the assumption that more assessment, transparency, and participation have a positive impact on the reasonableness of coverage decisions. Methods. We developed a structural equation model in which the process components were considered latent constructs and operationalized by a set of observable indicators. The dependent variable “reasonableness” was defined by the relevance of clinical, economic, and other ethical criteria in technology appraisal (as opposed to appraisal based on stakeholder lobbying). We conducted an Internet survey among conference participants familiar with coverage decisions of third-party payers in industrialized countries between 2006 and 2011. Partial least squares path modeling (PLS-PM) was used, which allows analyzing small sample sizes without distributional assumptions. Data on 97 coverage decisions from 15 countries and 40 experts were used for model estimation. Results. Stakeholder participation (regression coefficient [RC] =0.289; P = 0.005) and scientific rigor of assessment (RC = 0.485; P < 0.001) had a significant influence on the construct of reasonableness. The path from transparency to reasonableness was not significant (RC = 0.289; P = 0.358). For the reasonableness construct, a considerable share of the variance was explained ( R2 = 0.44). Biases from missing data and nesting effects were assessed through sensitivity analyses. Limitations. The results are limited by a small sample size and the overrepresentation of some decision makers. Conclusions. Rigorous assessment and intense stakeholder participation appeared effective in promoting reasonable decision making, whereas the influence of transparency was not significant. A sound evidence base seems most important as the degree of scientific rigor of assessment had the strongest effect.
A Discrete Choice Experiment to Obtain a Tariff for Valuing Informal Care Situations Measured with the CarerQol Instrument
Authors: Hoefman Renske J. , van Exel Job , Rose John M. , van de Wetering E. J. , Brouwer Werner B. F.
Published: June 2013

Background/Objective. Economic evaluations adopting a societal perspective need to include informal care whenever relevant. However, in practice, informal care is often neglected, because there are few validated instruments to measure and value informal care for inclusion in economic evaluations. The CarerQol, which is such an instrument, measures the impact of informal care on 7 important burden dimensions (CarerQol-7D) and values this in terms of general quality of life (CarerQol-VAS). The objective of the study was to calculate utility scores based on relative utility weights for the CarerQol-7D. These tariffs will facilitate inclusion of informal care in economic evaluations. Methods. The CarerQol-7D tariff was derived with a discrete choice experiment conducted as an Internet survey among the general adult population in the Netherlands ( N = 992). The choice set contained 2 unlabeled alternatives described in terms of the 7 CarerQol-7D dimensions (level range: “no,”“some,” and “a lot”). An efficient experimental design with priors obtained from a pilot study ( N = 104) was used. Data were analyzed with a panel mixed multinomial parameter model including main and interaction effects of the attributes. Results. The utility attached to informal care situations was significantly higher when this situation was more attractive in terms of fewer problems and more fulfillment or support. The interaction term between the CarerQol-7D dimensions physical health and mental health problems also significantly explained this utility. The tariff was constructed by adding up the relative utility weights per category of all CarerQol-7D dimensions and the interaction term. Conclusions. We obtained a tariff providing standard utility scores for caring situations described with the CarerQol-7D. This facilitates the inclusion of informal care in economic evaluations.
Association between child and adolescent obesity and parental weight status: A cross-sectional study from rural north China
Authors: Jiang Mo-han , Yang Yang , Guo Xiao-fan , Sun Ying-xian
Published: June 2013

Objective

To investigate the relationship between child and adolescent obesity, and parental weight status.

Methods

Height and weight were measured in Chinese children and adolescents aged 6–17 years old. Information was collected concerning parental weight and height, and possible covariates, using a questionnaire. The body mass index (BMI) of each study participant and their parents was calculated. On the basis of the BMI, parents were categorized as normal, overweight or obese, and children and adolescents were categorized as normal or obese.

Results

Of the 5 041 participants included in the study, 6.82% were obese. Child or adolescent obesity was significantly associated with parental obesity. When both parents were obese, there was a 3.62-fold increased risk of obesity compared with those whose parents were of normal weight. Obesity in fathers was associated with a heightened risk of obesity in female children, whereas obesity in mothers was associated with a heightened risk of obesity in male children.

Conclusions

Parental obesity was a predictor of obesity in children and adolescents. It is therefore of key importance to prevent obesity in children who have one or more obese parents.
Impairment of vascular endothelial function following reperfusion therapy in patients with acute myocardial infarction
Authors: Yang Zhaoying , Li Jinliang , Kong Jian , Wu Suisheng
Published: June 2013

Objective

To investigate vascular endothelial impairment as a result of reperfusion therapy in patients with acute myocardial infarction (AMI).

Methods

Patients with AMI underwent reperfusion therapy (percutaneous cardiac intervention [PCI] or thrombolytic therapy) or conservative drug therapy. Healthy control subjects were recruited. Endothelial impairment was assessed via endothelial nitric oxide (NO) synthase (eNOS), NO and endothelin-1 (ET-1) levels, 24 h after reperfusion or on enrolment, as appropriate.

Results

Patients who underwent PCI ( n = 47) or thrombolytic therapy ( n = 45) had significantly lower eNOS and NO levels, and higher ET-1 levels than those who received conservative drug therapy ( n = 46). All patient groups had significantly lower eNOS and NO levels, and higher ET-1 levels, than controls ( n = 45). There was a significant positive correlation between eNOS and NO, as well as significant negative correlations between eNOS/ET-1 and NO/ET-1 in all four groups.

Conclusions

Patients with AMI who underwent reperfusion therapy displayed low eNOS activity. This may result in impairment of endothelial function via downregulation of NO and upregulation of ET-1.
Prevalence and clinical implications of diverticulosis of the vermiform appendix
Authors: Käser Samuel Andreas , Willi Niels , Maurer Christoph Andreas
Published: June 2013

Objective

The epidemiology and the aetiology of inflammatory diseases of the vermiform appendix remain poorly understood. The prevalence of appendiceal diverticulosis and diverticulitis in patients undergoing appendectomy for suspected acute appendicitis was investigated.

Methods

A retrospective study was completed on patients who underwent appendectomy for suspected acute appendicitis. Pathology reports of all patients were screened for diverticula of the vermiform appendix. Patients with either diverticulitis of the vermiform appendix or normal appendicitis were compared.

Results

Out of two sets of consecutive patients ( n = 1073), nine (0.8%) were identified with diverticulosis of the vermiform appendix. Two of these patients had diverticulitis of the vermiform appendix without appendicitis, three had diverticulitis with consecutive localized appendicitis, and four had proper acute appendicitis with a noninflamed diverticulum of the vermiform appendix. One patient had perforated appendicitis. Two patients had an obstructing neuroendocrine carcinoid which may have caused diverticular formation.

Conclusions

Diverticula of the vermiform appendix are rare. If inflamed, they mimic acute appendicitis and are treated by appendectomy. If not inflamed, and diagnosed intraoperatively, incidental appendectomy is recommended.
High-dose N-acetylcysteine decreases silica-induced lung fibrosis in the rat
Authors: Zhang Hua , Yin Gang , Jiang Hao , Zhang Chunling
Published: June 2013

Objective

To study the potential of high-dose N-acetylcysteine (NAC) to attenuate silica-induced pulmonary fibrosis in the rat.

Methods

Rats exposed to intratracheal instillation of silica particles were treated with 500 mg/kg NAC orally every day for 7 days, before and up to 28 days after silica administration ( n = 32), or received no treatment following silica exposure ( n = 32); a third group received intratracheal saline ( n = 32). Fibrosis score, and hydroxyproline (HYP) and malondialdehyde (MDA) content, were assessed in lung tissue. Bronchoalveolar lavage fluid (BALF) and serum levels of tumour necrosis factor (TNF)-α, interleukin (IL)-8 and high-sensitivity C-reactive protein (hsCRP) were assessed by enzyme-linked immunosorbent assay.

Results

Histopathology revealed inflammation and fibrosis in lung tissue from rats exposed to silica, but not in saline controls. The fibrosis score was significantly lower in animals treated with NAC compared with silica-exposed untreated rats. HYP and MDA content were significantly lower at all timepoints, following NAC treatment versus no treatment, in silica-exposed rats. NAC attenuated silica-induced increases in TNF-α, IL-8 and hsCRP in BALF and serum.

Conclusions

Oral treatment with high-dose NAC during early silica exposure can ameliorate the activity of proinflammatory cytokines, thus attenuating subsequent lung fibrosis. These results suggest that NAC has potential as a treatment for silica-induced lung fibrosis.
Successful therapy for temporomandibular pain alters anterior insula and cerebellar representations of occlusion
Authors: Lickteig Rita , Lotze Martin , Kordass Bernd
Published: June 2013

Aim

Craniomandibular disorders (CMD) are widespread, but we know little about the cerebral representations associated with this pain syndrome and nothing about changes in cerebral representations of occlusion induced by common therapy approaches.

Methods

In a longitudinal therapy study, we applied functional magnetic resonance imaging (fMRI) in 14 patients with mild CMD during occlusal movements. fMRI, pain scoring, kinematic investigations of occlusal movements, and jaw muscle electromyography (EMG) were measured before and after two weeks of therapy with an individually optimized Michigan splint.

Results

The patients’ subjective pain ratings decreased, and the symmetry of condylar movements increased over the period of therapy. After therapy, EMG of the jaw muscles demonstrated more relaxed resting conditions and increased activity during maximal occlusion. fMRI during occlusion showed an activation decrease in the right anterior insula and right cerebellum over the course of therapy. Correlation analysis between pain score and fMRI activation decreases identified right anterior insula, left posterior insula and left cerebellar hemisphere. Left cerebellar and right primary motor activation magnitude was negatively associated with symmetry of the condylar movements.

Conclusions

Our findings highlight the impact of the anterior insula for the internal monitoring and the anticipation of temporomandibular joint (TMJ) pain. In addition, an increase of symmetry of condylar movements after therapy has been associated with a decrease of activation magnitude in primary motor and cerebellar regions.
Prevalence and Incidence of New Meniscus and Cartilage Injuries After a Nonoperative Treatment Algorithm for ACL Tears in Skeletally Immature Children
Authors: Moksnes Håvard , Engebretsen Lars , Risberg May Arna
Published: June 2013

Background:

The increased risk of long-term osteoarthritis from concomitant injuries to the menisci or cartilage after an anterior cruciate ligament (ACL) injury in adults is well established. In skeletally immature children, ACL reconstruction is often recommended to reduce the risk of new intra-articular injuries. However, the prevalence and incidence of new injuries after nonoperative treatment of ACL injuries in children are unknown.

Purpose:

To prospectively investigate the incidence of new injuries to the menisci and joint cartilage in nonoperatively treated, skeletally immature children with a known ACL injury by use of bilateral 3.0-T MRI.

Study Design:

Case series; Level of evidence, 4.

Methods:

Forty skeletally immature children with a ruptured ACL (41 knees) followed a nonoperative treatment algorithm and were evaluated with bilateral 3.0-T MRI on 2 occasions (MRI1 and MRI2). The intra-articular structures were analyzed by 2 independent MRI radiologists. Monitoring of participation in physical activities was accomplished through a monthly online activity survey. Descriptive statistics and frequencies were extracted from the scoring forms and compared using the Fisher exact test.

Results:

Fourteen girls (35%) and 26 boys (65%) with a mean age of 11.0 ± 1.4 years at the time of injury were included. Time from injury to the final follow-up was 3.8 ± 1.4 years. Eighty-eight percent of the ACL-deficient children confirmed monthly participation in pivoting sports and/or in physical education classes in school. The prevalence of meniscus injuries in the 28 nonreconstructed knees was 28.5% at MRI1 and MRI2, and the incidence of new meniscus and cartilage injuries in the nonreconstructed knees from MRI1 to MRI2 was 3.6%. Thirteen children underwent ACL reconstruction, with a prevalence of meniscus procedures of 46.2%. The incidence of new meniscus injuries from diagnostic MRI to final follow-up was 19.5%. Surgical treatments for meniscus injuries were performed in 8 of the 41 knees.

Conclusion:

The incidence of new injuries to menisci and joint cartilage was low between MRI1 and MRI2 in the 28 nonreconstructed knees. Thirty-two percent of the knees required ACL reconstruction, and 19.5% required meniscus surgeries during the 3.8 ± 1.4 years of follow-up from injury. Further follow-up is needed to evaluate the long-term knee health in these children.
Forecasting the settlement of a bioreactor landfill based on gas pressure changes
Authors: Qiu Gang , Li Liang , Sun Hongjun
Published: June 2013

In order to study the influence of settlement under gas pressure in bioreactor landfill, the landfill is simplified as a one-way gas seepage field, combining Darcy’s Law, the gas equation of state, and the principle of effective stress and fluid dynamics of porous media theory. First assume that the bioreactor landfill leachate is fully recharged on the basis of gas mass conservation, then according to the changes in gas pressure (inside the landfill and surrounding atmosphere) during the gas leakage time and settlement in the landfill, establish a numerical model of bioreactor landfill settlement under the action of the gas pressure, and use the finite difference method to solve it. Through a case study, the model’s improved prediction of the settlement of bioreactor landfill is demonstrated.
Assessment and optimization of an ultrasound-assisted washing process using organic solvents for polychlorinated biphenyl-contaminated soil
Authors: Bezama Alberto , Flores Alejandra , Araneda Alberto , Barra Ricardo , Pereira Eduardo , Hernández Víctor , Moya Heriberto , Konrad Odorico , Quiroz Roberto
Published: June 2013

The goal of this work was to evaluate a washing process that uses organic solutions for polychlorinated biphenyl (PCB)-contaminated soil, and includes an ultrasound pre-treatment step to reduce operational times and organic solvent losses. In a preliminary trial, the suitability of 10 washing solutions of different polarities were tested, from which three n-hexane-based solutions were selected for further evaluation. A second set of experiments was designed using a three-level Taguchi L27 orthogonal array to model the desorption processes of seven different PCB congeners in terms of the variability of their PCB concentration levels, polarity of the washing solution, sonication time, the ratio washing solution/soil, number of extraction steps and total washing time. Linear models were developed for the desorption processes of all congeners. These models provide a good fit with the results obtained. Moreover, statistically significant outcomes were achieved from the analysis of variance tests carried out. It was determined that sonication time and ratio of washing solution/soil were the most influential process parameters. For this reason they were studied in a third set of experiments, constructed as a full factorial design. The process was eventually optimized, achieving desorption rates of more than 90% for all congeners, thus obtaining concentrations lower than 5 ppb in all cases. The use of an ultrasound-assisted soil washing process for PCB-contaminated soils that uses organic solvents seems therefore to be a viable option, especially with the incorporation of an extra step in the sonication process relating to temperature control, which is intended to prevent the loss of the lighter congeners.
Licorice treatment prevents oxidative stress, restores cardiac function, and salvages myocardium in rat model of myocardial injury
Authors: Ojha Shreesh Kumar , Sharma Charu , Golechha Mahaveer Jain , Bhatia Jagriti , Kumari Santosh , Arya Dharamvir Singh
Published: June 2013

The present study examined the effects of licorice on antioxidant defense, functional impairment, histopathology, and ultrastructural alterations in isoproterenol (ISP)-induced myocardial injury in rats. Myocardial necrosis was induced by two subcutaneous injection of ISP (85 mg/kg) at an interval of 24 h. Licorice was administered orally for 30 days in the doses of 100, 200, 400, or 800 mg/kg. ISP-treated rats showed impaired hemodynamics, left ventricular dysfunction, and caused depletion of antioxidants and marker enzymes along with lipid peroxidation from myocardium. ISP also induced histopathological and ultrastructural alterations in myocardium. Pretreatment with licorice prevented the depletion of endogenous antioxidants and myocyte injury marker enzymes, inhibited lipid peroxidation, and showed recovery of hemodynamic and ventricular functions. Licorice treatment also reduced myonecrosis, edema, and infiltration of inflammatory cells and showed preservation of subcellular and ultrastructural components. Our results demonstrate that licorice exerts cardioprotection by reducing oxidative stress, augmenting endogenous antioxidants, and restoring functional parameters as well as maintaining structural integrity.
Short-term responses of selected endocrine parameters in juvenile rainbow trout (Oncorhynchus mykiss) exposed to 4-nonylphenol
Authors: Naderi Mohammad , Zargham Davood , Asadi Asad , Bashti Tayebeh , Kamayi Kianoosh
Published: June 2013

The synthetic organic compound 4-nonylphenol (4-NP) has been shown to have a wide range of adverse effects on the endocrine system of various animals including fish. The present study evaluated the potential effects of 4-NP on vitellogenin (VTG) synthesis, steroid, and thyroid hormone concentrations in both juvenile male and female rainbow trout ( Oncorhynchus mykiss). Fish were exposed by intraperitoneal injection to different doses of 4-NP (1, 10, 50, and 100 μg g−1) or vehicle (coconut oil) over a period of 14 days. Blood samples were collected 7 and 14 days after initiation of treatment. Plasma VTG levels in 4-NP-treated fish were detected by sodium dodecyl sulfate polyacrylamide gel electrophoresis as a high molecular weight protein band of 180 KDa. In addition, plasma VTG concentrations were quantified indirectly using plasma alkali-labile phosphate (ALP) and plasma calcium. Both ALP and calcium levels in plasma showed similar and parallel increase patterns after exposure to 4-NP that were significantly higher compared with controls. The analysis of plasma sex steroid levels revealed a significant increase in 17β-estradiol and testosterone in plasma of juvenile males and females, respectively. Furthermore, a significant increase was observed in plasma cortisol levels. On the other hand, 4-NP decreased both plasma triiodothyronine and thyroxine after 7 and 14 days of treatment. These results suggest that 4-NP can affect different parts of the endocrine system, which may lead to serious impairments in physiological homeostasis of juvenile rainbow trout.
Proinflammatory and anti-inflammatory cytokines in adolescents from Southeast Bulgarian cities with different levels of air pollution
Authors: Dobreva Zlatka Georgieva , Kostadinova Gergana Stoianova , Popov Borislav Nikolov , Petkov Georgi Stefanov , Stanilova Spaska Angelova
Published: June 2013

Epidemiological studies demonstrated that the exposure of different air pollutants including particulate matter (PM) has been related to adverse effect on immune system. Current study was designed to investigate cytokines in blood plasma of adolescent persons continuously exposed to different degrees of ambient air pollutions. Tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), IL-12p40, and IL-10 were chosen as cytokines of proinflammatory and anti-inflammatory immune response. The peripheral venous blood was taken from adolescents living in the cities of Stara Zagora region, Southeast Bulgaria, that is, in Stara Zagora, Kazanlak, and Chirpan. The quantity of cytokines in plasma samples was determined by enzyme-linked immunosorbent assay. Results demonstrated that youths living in Stara Zagora showed significantly smaller quantity of TNF-α, compared with adolescents from Kazanlak and Chirpan. Moreover, adolescents living in Stara Zagora showed significantly higher quantity of IL-10 than students from Kazanlak and Chirpan. Analysis of the data of air quality gives reason to assert that PM10 and PM2.5 have been the main atmospheric pollutants around the monitoring points. The complex air quality assessment based on these criteria determined that the highest air pollution was in the city of Stara Zagora, followed by Chirpan and the relatively unpolluted town was Kazanlak. We concluded that air pollutants, mostly PM2.5, can modulate cytokine production and can change the balance between proinflammatory TNF-α and anti-inflammatory IL-10 production. Increased levels of IL-10 combined with decreased level of TNF-α in adolescents living in Stara Zagora can serve as a biomarker for suppression of T helper 1 (Th1) cell-mediated immunity and exacerbation of Th2 humoral immune response and could be a prerequisite for the development of allergic and autoimmune diseases.
Three New PLP1 Splicing Mutations Demonstrate Pathogenic and Phenotypic Diversity of Pelizaeus-Merzbacher Disease
Authors: Laššuthová Petra , Žaliová Markéta , Inoue Ken , Haberlová Jana , Sixtová Klára , Sakmaryová Iva , Paděrová Kateřina , Mazanec Radim , Zámečník Josef , Šišková Dana , Garbern Jim , Seeman Pavel
Published: June 2013

Pelizaeus-Merzbacher disease is a severe X-linked disorder of central myelination caused by mutations affecting the proteolipid protein gene. We describe 3 new PLP1 splicing mutations, their effect on splicing and associated phenotypes. Mutation c.453_453+6del7insA affects the exon 3B donor splice site and disrupts the PLP1-transcript without affecting the DM20, was found in a patient with severe Pelizaeus-Merzbacher disease and in his female cousin with early-onset spastic paraparesis. Mutation c.191+1G>A causes exon 2 skipping with a frame shift, is expected to result in a functionally null allele, and was found in a patient with mild Pelizaeus-Merzbacher disease and in his aunt with late-onset spastic paraparesis. Mutation c.696+1G>A utilizes a cryptic splice site in exon 5, causes partial exon 5 skipping and in-frame deletion, and was found in an isolated patient with a severe classical Pelizaeus-Merzbacher. PLP1 splice-site mutations express a variety of disease phenotypes mediated by different molecular pathogenic mechanisms.
Ibuprofen-loaded chitosan/poly(maleic anhydride-alt-vinyl acetate) submicronic capsules for pain treatment
Authors: Iurea (Raţă) Delia Mihaela , Popa Marcel , Chailan Jean-François , Tamba Bogdan Ionel , Tudorancea Ionut , Peptu Cătălina Anişoara
Published: June 2013

A new approach to prepare polymeric capsules was developed to obtain an efficient controlled release system for pain treatment. Capsules with a mean diameter between 400 and 1000 nm were prepared using an interfacial condensation method between a natural polymer, chitosan, and a synthetic one, poly(maleic anhydride- alt-vinyl acetate). The influence of different reaction parameters on capsule diameter and properties was investigated. Zeta-potential determinations indicated a good stability of the capsules in aqueous solution containing KCl. Scanning electron microscopy confirmed the submicron dimensions and the spherical shape of the capsules. The thermal properties of the capsules were determined by differential scanning calorimetry and thermogravimetric analysis. In addition, these particles presented a good swelling capacity, which was influenced by the reaction parameters used in this study (molar ratio between the two polymers, the volume ratio between aqueous and organic phase, the amount of surfactant and the reaction time). The ibuprofen loading and release capacity were influenced by the swelling degree. In vivo, the ibuprofen-loaded capsules presented a delayed effect in peripheral pain inhibition and a sustained effect in central pain inhibition.
Hybrid biodegradable membranes of silane-treated chitosan/soy protein for biomedical applications
Authors: Silva Simone S , Oliveira Joaquim M , Benesch Johan , Caridade Sofia G , Mano João F , Reis Rui R
Published: June 2013

In recent years, progress in the field of hybrid materials has been accelerated through use of the sol–gel process for creating materials and devices, which benefit from the incorporation of both inorganic and organic components. In this work, organic–inorganic hybrid membranes were prepared from tetraethoxysilane and a blend system composed of chitosan and soy protein. By introducing a small amount of siloxane bond into the chitosan/soy protein system, the chitosan/soy protein hybrid membranes were improved in terms of structure, topography and mechanical properties. It appears that the chitosan/soy protein hybrid membranes were formed by discrete inorganic moieties entrapped in the chitosan/soy protein blend, which improved the stability and mechanical performance assessed by the dynamic mechanical analysis as compared to chitosan/soy protein membrane. Also, in vitro cell culture studies evidenced that the chitosan/soy protein hybrid membranes are non-cytotoxic over a mouse fibroblast-like cell line. The hybrid membranes of silane-treated chitosan/soy protein developed in this work have potential in biomedical applications, including tissue engineering.
Hydroxyapatite scaffold pore architecture effects in large bone defects in vivo
Authors: Guda Teja , Walker John A , Singleton Brian , Hernandez Jesus , Oh Daniel S , Appleford Mark R , Ong Joo L , Wenke Joseph C
Published: June 2013

To examine the effect of scaffold pore size on bone regeneration within hydroxyapatite scaffolds in large segmental defects, this study evaluated two porous interconnected architectures having similar porosity and strut thickness but different pore sizes. Using a 10 mm segmental rabbit radius defect model, a bilayer scaffold architecture mimicking the cortical-cancellous organization of bone (pore size 200 µm outer layer, 450 µm inner layer) was compared to a purely trabecular-like architecture (pore size 340 µm) and an untreated defect. Bone regeneration was measured using micro-computed tomography and histology after four and eight weeks of in vivo implantation, and the mechanical strength of the defect site after eight weeks’ implantation was assessed using flexural testing. Although both bilayer and trabecular architectures promoted bone growth, the trabecular scaffolds were observed to have more uniform new bone distribution within the scaffold interior at four weeks and greater bone regeneration overall after eight weeks’ implantation (149 ± 9 mm3 compared to 121 ± 8 mm3 in the bilayer and 66 ± 14 mm3 in the defect). Additionally, the trabecular scaffolds were observed to exhibit significantly greater flexural strength (124% increase) and toughness (388% increase) when compared to the empty defects after eight weeks’ implantation. It was concluded from this study that a larger uniform pore size led to greater functional bone regeneration over a longer implantation period for large segmental defects.
Direct numerical simulation of fracture behaviour for random short wood fibre-reinforced composites in comparison with digital image correlation experiments
Authors: Shen Min , Touchard Fabienne , Bezine Gérard , Brillaud Jean
Published: June 2013

The present work is to predict the fracture behaviour of biocomposites from the tensile properties of its components. In this work, a direct numerical simulation was realized for fracture behaviour of random short spruce fibre-reinforced composites. For calculations, wood fibres were considered as linear elastic bodies and polypropylene matrix as an elastic–plastic material. Then, the numerical results were compared with the experimental results obtained by digital image correlation (DIC). This comparison indicates that random fibre finite element (FE) model can be able to fairly reflect the influence of random fibre microstructure on the fracture behaviour of the composites. The calculation and comparison show that in a region in the front of the crack tip, the average values of J-integral of both random fibre and homogeneous FE model are in good agreement with that of DIC experiment under the same extension load.
Governing urban climate change adaptation in China
Authors: Li Bingqin
Published: June 2013

There is a growing, although still far from comprehensive, literature within China on the impacts of climate change in urban areas; also an evolving policy framework at national level to address these concerns and an increased interest in climate change adaptation from many local governments. This paper summarizes the urban risks and vulnerabilities highlighted by the literature, and reviews central and local government responses. It then assesses policy response, including how this considers vulnerability and future risks, formulates an adaptation strategy, engages stakeholders and assesses adaptive capacity. This shows how the Chinese system limits the influence on climate change adaptation of residents and small businesses, and of social scientists. The reasons for this include the tendency to use climate change as an economic growth engine (and GDP growth remains the most important factor for assessing local government officials’ performance), little provision for participation in policy-making, and weak post-implementation evaluation once a policy has been scaled up at national level. These have affected the quality of evidence-based policy-making and make it difficult to draw lessons from unsuccessful practice.
Gender representation in the 1999 Nigerian constitution: A critical discourse analysis for socio-political equity
Authors: Ezeifeka Chinwe R , Osakwe Nneka N
Published: June 2013

The article appraises gender representation in the 1999 Nigerian Constitution using insights from critical discourse analysis, feminism and systemic functional linguistics, with particular emphasis on grammatical cohesion. Specifically, it examines lexical and grammatical expressions that encode gender in the Constitution, the ideological positions evident in these expressions, and their impact on gender parity and socio-political equity. The focus is on the reference-antecedent cohesion of gender-marked pronouns and nouns used to refer to individuals and social/political positions. Our findings show a preponderance of generic masculine noun and pronoun references, tracking antecedents that refer to social and political positions open to eligible individuals in Nigeria, while the single feminine referent was a marked case. These findings buttress the ‘male-as-norm’ ideology and the relegation to anonymity of the female gender in this important national document. For equity and fairness, the article recommends revising the Constitution with epicene expressions to expunge gender biases.
The discursive representation of Iran’s supreme leader in online media
Authors: Mohd Don Zuraidah , May Alan
Published: June 2013

This study examines the interplay of politics, religion and discourse in the representation of the Iranian Supreme Leader, Ali Khamenei, in government-controlled news websites in Iran. It is grounded in critical discourse analysis (CDA), and Van Leeuwen’s social actor network model (2008) is used as the theoretical framework to analyse the linguistic representation of the Iranian leader. In the samples analysed, Khamenei is discursively depicted by features associated with the Prophet Muhammad and the 12 infallible Imams of the Shia tradition. Such representations elevate the authority of Khamenei in texts, and naturalise the ideology of Velayat-e Faqih, which authorises a Faqih (Jurist) to assume political leadership in Iran. In this way, the texts are used to maintain and reinforce the dominance of people in positions of power.
Resilience in Competitive Athletes With Spinal Cord Injury
Authors: Machida Moe , Irwin Brandon , Feltz Deborah
Published: June 2013

Individuals who experience loss of their physical abilities often face the challenges of adapting to a new way of life. Past research has shown that sport participation can assist the physical and psychological adaptation to acquired physical disabilities. The purposes of our study were to examine the following: (a) the resilience process of sport participants with acquired spinal cord injury, and (b) the role of sport participation in the resilience process. We conducted semistructured phenomenological interviews with 12 male quadriplegic wheelchair rugby players. Results show that the development of resilience is a multifactorial process involving pre-existing factors and pre-adversity experiences, disturbance/disturbing emotions, various types and sources of social support, special opportunities and experiences, various behavioral and cognitive coping strategies, motivation to adapt to changes, and learned attributes or gains from the resilience process. We discuss implications for future research and practice.
Stigma in AIDS Nursing Care in Sub-Saharan Africa and the Caribbean
Authors: Mill Judy , Harrowing Jean , Rae Tania , Richter Solina , Minnie Karin , Mbalinda Scovia , Hepburn-Brown Cerese
Published: June 2013

Some nurses who provide AIDS care, in addition to experiencing stigma themselves, also exhibit negative attitudes and perpetrate stigma and discrimination toward persons living with HIV (PLWHAs). We used a participatory research approach to explore the nature, context, and influence of stigma on the nursing care provided to PLWHAs in four low- and middle-income countries: Jamaica, Kenya, South Africa, and Uganda. Eighty-four registered nurses, enrolled nurses, and midwives participated in interviews and 79 participated in 11 focus groups. Nurses were very aware of the stigma and discrimination that AIDS evoked, and made adjustments to their care to decrease the manifestation of AIDS stigma. Despite the assurance that PLWHAs were treated equally, and that universal precautions were used consistently, we found that in reality, nurses sometimes made decisions about nursing care that were based on the appearance of the patient or knowledge of his or her status.
Emerging Adults’ Lived Experience of Formative Family Stress
Authors: Valdez Carmen R. , Chavez Tom , Woulfe Julie
Published: June 2013

In this article, we use a phenomenology framework to explore emerging adults’ formative experiences of family stress. Fourteen college students participated in a qualitative interview about their experience of family stress. We analyzed the interviews using the empirical phenomenological psychology method. Participants described a variety of family stressors, including parental conflict and divorce, physical or mental illness, and emotional or sexual abuse by a family member. Two general types of parallel processes were essential to the experience of family stress for participants. First, the family stressor was experienced in shifts and progressions reflecting the young person’s attempts to manage the stressor, and second, these shifts and progressions were interdependent with deeply personal psychological meanings of self, sociality, physical and emotional expression, agency, place, space, project, and discourse. We describe each of these parallel processes and their subprocesses, and conclude with implications for mental health practice and research.
Near-Anatomic Allograft Tenodesis of Chronic Lateral Ankle Instability
Authors: Miller Adam G. , Raikin Steven M. , Ahmad Jamal
Published: June 2013

Background:

Current operative treatment options for chronic lateral ankle instability include anatomic repairs utilizing existing local tissue and nonanatomic reconstructions sacrificing the peroneus brevis tendon to mechanically stabilize the ankle. Recent studies have modified these techniques to create an anatomic reconstruction utilizing allograft tendons. The purpose of this study was to retrospectively examine the clinical outcomes of a near-anatomic ligament reconstruction utilizing an allograft tendon for recurrent or complex lateral ankle instability.

Methods:

Twenty-eight patients underwent a near-anatomic allograft lateral ankle ligament reconstruction with a semitendinosis allograft for severe or recurrent lateral ankle ligamentous instability, and all of them were available for follow-up at an average 32 months. Twelve patients had previously undergone lateral ankle ligament stabilizing surgery, 4 had Ehlers Danlos syndrome with poor local tissue, 5 had greater than 30 degrees of varus angulation of talar tilt, while 12 had associated hindfoot varus requiring concomitant reconstruction. Patients were assessed pre- and postoperatively for Visual Analog Scores (VAS) for pain, Foot and Ankle Ability Measures (FAAM), patient satisfaction, radiographic correction, and complications.

Results:

Median VAS of pain decreased from 8 before surgery to 1 after surgery ( P < .001). Median FAAM score increased from 41.7 to 95.2 after surgery ( P < .001). Radiographic comparison demonstrated correction of preoperative varus malalignment in all but 1 patient. No patients developed subsequent subtalar arthritis or pain. Three patients had mild persistent instability, all of which was managed nonoperatively. One of the patients with persistent instability also developed chronic regional pain syndrome following surgery. At final follow-up, 25 of 28 patients rated their satisfaction as good or excellent and 3 as fair. No patients required revision surgery.

Conclusion:

Lateral ligament reconstruction utilizing a near-anatomically placed and tensioned allograft tendon was a viable option in treating recurrent and complex lateral instability. Not sacrificing the peroneal tendons avoided loss of eversion strength. Near-anatomic placement of the allograft provided good ankle stability without sacrificing subtalar motion or predisposition to subtalar arthritis in short-term follow-up.

Level of Evidence:

Level IV, retrospective case series.
Co-payments and the Use of Emergency Department Services in the Children’s Health Insurance Program
Authors: Becker David J. , Blackburn Justin , Morrisey Michael A. , Sen Bisakha , Kilgore Meredith L. , Caldwell Cathy , Menachemi Nir
Published: June 2013

Research suggests that more than half of all emergency department (ED) visits in the United States are for nonurgent conditions, leading to billions of dollars in potentially avoidable spending annually. In this study, we examine the effects of co-payment changes on ED utilization among children enrolled in ALL Kids, Alabama’s Children’s Health Insurance Program We separately model the effect of the 2003 co-payment increases on the monthly probability of any ED visit, and visits within three severity categories, using linear probability models that control for beneficiary characteristics and time trends that are allowed to vary in the pre- and postperiods. We observe a small decline in the probability of ED visits 1 year after the co-payment increase. However, low-severity visits, which we hypothesize to be more price sensitive, show no significant evidence of a decline. Our study suggests that the modest co-payment changes were not effective in improving the efficiency of ED utilization.
Safety Assessment of a Hydroethanolic Extract of Caralluma fimbriata
Authors: Odendaal Antoinette Y. , Deshmukh Narendra S. , Marx Tennille K. , Schauss Alexander G. , Endres John R. , Clewell Amy E.
Published: June 2013

This toxicological assessment evaluated the safety of a hydroethanolic extract prepared from Caralluma fimbriata (CFE), a dietary supplement marketed worldwide as an appetite suppressant. Studies included 2 in vitro genotoxicity assays, a repeated dose oral toxicity study, and a developmental study in rats. No evidence of in vitro mutagenicity or clastogenicity surfaced in the in vitro studies at concentrations up to 5000 μg of extract/plate (Ames test) or 5000 μg of extract/mL (chromosomal aberration test). No deaths or treatment-related toxicity were seen in the 6-month chronic oral toxicity study in Sprague-Dawley rats conducted at 3 doses (100, 300, and 1000 mg/kg body weight (bw)/d). The no observed effect level for CFE in this study was considered to be 1000 mg/kg bw/d. A prenatal developmental toxicity study conducted at 3 doses (250, 500, and 1000 mg/kg bw/d) in female Sprague-Dawley rats resulted in no treatment-related external, visceral, or skeletal fetal abnormalities, and no treatment-related maternal or pregnancy alterations were seen at and up to the maximum dose tested. CFE was not associated with any toxicity or adverse events.
A Prospective Study of Mobile Phones for Dermatology in a Clinical Setting
Authors: Weingast Jessika , Scheibböck Christian , Wurm Elisabeth Mt , Ranharter Elisabeth , Porkert Stefanie , Dreiseitl Stephan , Posch Christian , Binder Michael
Published: June 2013

We evaluated the accuracy of diagnoses made from pictures taken with the built-in cameras of mobile phones in a ‘real-life’ clinical setting. A total of 263 patients took part, who photographed their own lesions where possible, and provided clinical information via a questionnaire. After the teledermatology procedure, each patient was examined face-to-face and a gold standard diagnosis was made. The telemedicine data and pictures were diagnosed by 15 dermatologists. The 299 cases contained 1–22 clinical images each (median 3). Nine dermatologists finished all the cases and the remaining six completed some of them, thus providing 2893 decisions. Overall, 61% of all cases were rated as possible to diagnose and of those, 80% were correct in comparison with the face-to-face diagnosis. Image quality was evaluated and the median was 5 on a 10-point scale. There was a significant correlation between the correct diagnosis and the quality of the photographs taken ( P & 0.001). In nearly two-thirds of all cases, a teledermatology diagnosis was possible; however, there was insufficient information to make a telemedicine diagnosis in about one-third of the cases. If applied carefully, mobile phones could be a powerful tool for people to optimize their health care status.
Video telehealth for weight maintenance of African-American women
Authors: Gerber Ben S , Schiffer Linda , Brown Allison A , Berbaum Michael L , Rimmer James H , Braunschweig Carol L , Fitzgibbon Marian L
Published: June 2013

We evaluated the effect of home telehealth on weight maintenance after a group-based weight loss programme. The home telehealth intervention comprised telephone counselling and home Internet-enabled digital video recorders (DVRs) with three channels of video programmes. The video content provided reinforcement and support to promote problem solving, prevent relapse and sustain motivation. Eighty-eight obese or overweight African-American women were randomized to receive monthly telephone counselling (control) or the home telehealth intervention. The weight change during maintenance was not significant in either group (0.6 kg in the intervention group, 0.0 kg in the control group), and there was no significant difference between them. Changes in diet, physical activity, social support and self-efficacy during the maintenance period did not differ significantly between groups. DVR use was low: during the intervention, the number of valid DVR viewings ranged from zero to 42 per person. DVR use was positively associated with previous attendance at the weight loss classes. Home video-based telehealth is a new method of delivering a weight loss maintenance intervention to African-American women. It had no effect on weight maintenance in the present study.