bluuebunny/crossref_metadata_2025 huggingface dataset:
The relation between endometriosis and ovarian cancer – a review
Authors: Heidemann Lene N. , Hartwell Dorthe , Heidemann Christian H. , Jochumsen Kirsten M.
Published: September 2013

Background

Endometriosis is known to harbor characteristics substantiating its possible role as a precursor of ovarian cancer.

Objective

To assess the quality of the literature regarding the association between endometriosis and ovarian cancer and to estimate the extent of this relation.

Methods

An electronic literature search was conducted in PubMed and 1112 articles dealing with the relation between endometriosis and ovarian cancer were identified. Original articles based on case‐control studies, cohort studies and cross‐sectional studies were included. Studies consisting of populations with self‐reported endometriosis were excluded, as were articles with fewer than 20 cases of ovarian cancer. Twenty‐eight studies underwent detailed quality assessments based on the checklists developed by the Scottish Intercollegiate Guidelines Network (SIGN). Meta‐analyses were conducted on selected subgroups of ovarian cancer with coexisting endometriosis.

Results

None of the 28 studies was given the highest possible rating using the SIGN checklists. The risk of ovarian cancer in women with endometriosis was reported to be a standardized incidence ratio of 1.43–8.95, a rate ratio of 1.6–2.88, an odds ratio of 1.34, with a prevalence of ovarian cancer in 2.0–17.0% of women with endometriosis. Conversely, the prevalence of endometriosis in women with ovarian cancer ranged from 3.4 to 52.6%. Meta‐analysis results were weakened by heterogeneity.

Conclusion

There is sufficient evidence to conclude that there is an increased risk of developing clear‐cell and endometrioid epithelial ovarian cancer for women with histologically verified endometriosis. Nonetheless, prospective cohort studies assessing the relation between endometriosis and ovarian cancer will increase knowledge in this field.
Clinical evaluation of the ADE scorecards as a decision support tool for adverse drug event analysis and medication safety management
Authors: Hackl Werner O. , Ammenwerth Elske , Marcilly Romaric , Chazard Emmanuel , Luyckx Michel , Leurs Pascale , Beuscart Regis
Published: September 2013

Aims

The prevention of adverse drug events (ADEs) demands co‐ordination of different health care professionals. ADE scorecards are a novel approach to raise the team awareness regarding ADE risks and causes. It makes information on numbers and on possible causes of possible ADE cases available to the clinical team. The aim of the study was to investigate the usage and acceptance of ADE scorecards by healthcare professionals and their impact on rates of possible ADEs.

Methods

ADE scorecards were introduced in three departments of a French hospital. A controlled time series analysis of ADE data was conducted to assess the impact of the ADE scorecards. In addition, qualitative interviews and a standardized survey with all participating staff members were performed.

Results

Physicians, nurses and pharmacists found ADE scorecards effective to increase medication safety and recommended future usage. The time‐series analysis did not show changes in rates of possible ADEs.

Conclusion

ADE scorecards appear to be useful to raise awareness of ADE‐related issues among professionals. Although the evaluation did not show significant reductions of ADE rates, the participating physicians, nurses and pharmacists believed that the ADE scorecards could contribute to increased patient safety and to a reduction in ADE rates. Strategies need to be designed to integrate ADE scorecards better into the clinical routine and to increase the precision of ADE detection.
Development of a standardized knowledge base to generate individualized medication plans automatically with drug administration recommendations
Authors: Send Alexander F. J. , Al‐Ayyash Adel , Schecher Sabrina , Rudofsky Gottfried , Klein Ulrike , Schaier Matthias , Pruszydlo Markus G. , Witticke Diana , Lohmann Kristina , Kaltschmidt Jens , Haefeli Walter E. , Seidling Hanna M.
Published: September 2013

Aims

We aimed to develop a generic knowledge base with drug administration recommendations which allows the generation of a dynamic and comprehensive medication plan and to evaluate its comprehensibility and potential benefit in a qualitative pilot study with patients and physicians.

Methods

Based on a literature search and previously published medication plans, a prototype was developed and iteratively refined through qualitative evaluation (interviews with patients and focus group discussions with physicians). To develop the recommendations for safe administration of specific drugs we screened the summary of product characteristics (SmPC) of different exemplary brands, allocated the generated advice to groups with brands potentially requiring the same advice, and reviewed these allocations regarding applicability and appropriateness of the recommendations.

Results

For the recommendations, 411 SmPCs of 140 different active ingredients including all available galenic formulations, routes of administrations except infusions, and administration devices were screened. Finally, 515 distinct administration recommendations were included in the database. In 926 different generic groups, 29 879 allocations of brands to general advice, food advice, indications, step‐by‐step instructions, or combinations thereof were made. Thereby, 27 216 of the preselected allocations (91.1%) were confirmed as appropriate. In total, one third of the German drug market was labelled with information.

Conclusions

Generic grouping of brands according to their active ingredient and other drug characteristics and allocation of standardized administration recommendations is feasible for a large drug market and can be integrated in a medication plan.
A new approach to identify, classify and count drug‐related events
Authors: Bürkle Thomas , Müller Fabian , Patapovas Andrius , Sonst Anja , Pfistermeister Barbara , Plank‐Kiegele Bettina , Dormann Harald , Maas Renke
Published: September 2013

Aims

The incidence of clinical events related to medication errors and/or adverse drug reactions reported in the literature varies by a degree that cannot solely be explained by the clinical setting, the varying scrutiny of investigators or varying definitions of drug‐related events. Our hypothesis was that the individual complexity of many clinical cases may pose relevant limitations for current definitions and algorithms used to identify, classify and count adverse drug‐related events.

Methods

Based on clinical cases derived from an observational study we identified and classified common clinical problems that cannot be adequately characterized by the currently used definitions and algorithms.

Results

It appears that some key models currently used to describe the relation of medication errors (MEs), adverse drug reactions (ADRs) and adverse drug events (ADEs) can easily be misinterpreted or contain logical inconsistencies that limit their accurate use to all but the simplest clinical cases. A key limitation of current models is the inability to deal with complex interactions such as one drug causing two clinically distinct side effects or multiple drugs contributing to a single clinical event. Using a large set of clinical cases we developed a revised model of the interdependence between MEs, ADEs and ADRs and extended current event definitions when multiple medications cause multiple types of problems. We propose algorithms that may help to improve the identification, classification and counting of drug‐related events.

Conclusions

The new model may help to overcome some of the limitations that complex clinical cases pose to current paper‐ or software‐based drug therapy safety.
Research in the field of drug therapy safety management
Authors: Möller Horst , Aly Amin‐Farid
Published: September 2013

In August 2011, the Coordination Group for the implementation and continuation of the agenda for improving medication safety in Germany published a memorandum on the development of research in the field of drug therapy safety management (Memorandum on Drug Therapy Safety Management Research). The memorandum highlights the need for research into this field for the German health care system. It describes current research objectives, thematic priorities and the characteristics of the methodology of drug therapy safety management research. After presenting the current state of research into drug therapy safety management, suggestions are made regarding further necessary activities.
Disturbances in reality testing as markers of risk in offspring of parents with bipolar disorder: a systematic review from a developmental psychopathology perspective
Authors: Narayan Angela J , Allen Timothy A , Cullen Kathryn R , Klimes‐Dougan Bonnie
Published: September 2013

Objectives

This comprehensive review examined the prevalence and progression of disturbances in reality testing (DRT), defined as psychotic symptoms, cognitive disruptions, and thought problems, in offspring of parents with bipolar disorder (O‐BD). Our approach was grounded in a developmental psychopathology perspective and considered a broader phenotype of risk within the bipolar–schizophrenia spectrum as measured by categorical and dimensional assessments ofDRTin high‐risk youth.

Methods

Relevant studies were identified from numerous sources (e.g., PubMed, reference sections, and colleagues). Inclusion criteria were: (i) family risk studies published between 1975 and 2012 in which O‐BDwere contrasted with a comparison group (e.g., offspring of parents who had other psychiatric disorders or were healthy) onDRToutcomes and (ii) results reported for categorical or dimensional assessments ofDRT(e.g., schizophrenia, psychotic symptoms, cluster A personality traits, or thought problems), yielding a total of 23 studies.

Results

Three key findings emerged: (i) categorical approaches ofDRTin O‐BDproduced low incidence base rates and almost no evidence of significant differences inDRTbetween O‐BDand comparison groups, whereas (ii) many studies using dimensional assessments ofDRTyielded significant group differences inDRT. Furthermore, (iii) preliminary evidence from dimensional measures suggested that the developmental progression ofDRTin O‐BDmight represent a prodrome of severe psychological impairment.

Conclusions

Preliminary but promising evidence suggests thatDRTis a probable marker of risk for future impairment in O‐BD. Methodological strengths and weaknesses, the psychometric properties of primaryDRTconstructs, and future directions for developmental and longitudinal research with O‐BDare discussed.
Rasburicase in the prevention of laboratory/clinical tumour lysis syndrome in children with advanced mature B‐NHL: a Children's Oncology Group Report
Authors: Galardy Paul J. , Hochberg Jessica , Perkins Sherrie L. , Harrison Lauren , Goldman Stanton , Cairo Mitchell S.
Published: September 2013

Laboratory (LTLS) and clinical (CTLS) tumour lysis syndrome (TLS) are frequent complications in newly diagnosed children with advanced mature B cell non‐Hodgkin lymphoma (B‐NHL). Rasburicase, compared to allopurinol, results in more rapid reduction of uric acid in paediatric patients at risk for TLS. However, the safety and efficacy of rasburicase for the treatment or or prevention of TLS has not been prospectively evaluated. Children with newly diagnosed stage III‐IV, bone marrow+ and/or central nervous system+ mature B‐NHL received hydration and rasburicase prior to cytoreductive therapy. Rasburicase was safe and well‐tolerated and there were no grade III–IV toxicities probably or directly related to rasburicase. Patients with an initial lactate dehydrogenase ≥2× upper limit of normal had a significantly elevated uric acid level (P = 0·005), increased incidence of TLS (P−0·005) and lower glomerular filtration rate (GFR; P < 0·001). Following rasburicase, there was only a 9% and 5% incidence of LTLS and CTLS, respectively. Furthermore, there was a significant improvement in estimated GFR from Day 0 to Day 7 following rasburicase (P = 0·0007) and only 1·3% of patients required new onset renal assisted support after rasburicase administration. A TLS strategy incorporating rasburicase prior to cytoreductive chemotherapy proved safe and effective in preventing new onset renal failure and was associated with a significant improvement in GFR.
Cholinergic interactions between donepezil and prucalopride in human colon: potential to treat severe intestinal dysmotility
Authors: Broad J , Kung V W S , Boundouki G , Aziz Q , De Maeyer J H , Knowles C H , Sanger G J
Published: September 2013

Background and Purpose

Cholinesterase inhibitors such as neostigmine are used for acute colonic pseudo‐obstruction, but cardio‐bronchial side‐effects limit use. To minimize side‐effects, lower doses could be combined with a 5‐HT4 receptor agonist, which also facilitates intestinal cholinergic activity. However, safety concerns, especially in the elderly, require drugs with good selectivity of action. These include the AChE inhibitor donepezil (used for Alzheimer's disease, with reduced cardio‐bronchial liability) and prucalopride, the first selective, clinically available 5‐HT4 receptor agonist. This study examined their individual and potential synergistic activities in human colon.

Experimental Approach

Neuronally mediated muscle contractions and relaxations of human colon were evoked by electrical field stimulation (EFS) and defined phenotypically as cholinergic, nitrergic or tachykinergic using pharmacological tools; the effects of drugs were determined as changes in ‘area under the curve’.

Key Results

Prucalopride increased cholinergically mediated contractions (EC50 855 nM; 33% maximum increase), consistent with its ability to stimulate intestinal motility; donepezil (477%) and neostigmine (2326%) had greater efficacy. Concentrations of donepezil (30–100 nM) found in venous plasma after therapeutic doses had minimal ability to enhance cholinergic activity. However, donepezil (30 nM) together with prucalopride (3, 10 μM) markedly increased EFS‐evoked contractions compared with prucalopride alone (P = 0.04). For example, the increases observed with donepezil and prucalopride 10 μM together or alone were, respectively, 105 ± 35%, 4 ± 6% and 35 ± 21% (n = 3–7, each concentration).

Conclusions and Implications

Potential synergy between prucalopride and donepezil activity calls for exploration of this combination as a safer, more effective treatment of colonic pseudo‐obstruction.
Antitumor efficacy of C‐X‐C motif chemokine ligand 14 in hepatocellular carcinoma in vitro and in vivo
Authors: Wang Weilin , Huang Pengfei , Zhang Lufei , Wei Jianfeng , Xie Qingsong , Sun Qiang , Zhou Xiaohu , Xie Haiyang , Zhou Lin , Zheng Shusen
Published: September 2013

C‐X‐C motif chemokine ligand 14 (CXCL14) is a novel gene that is expressed in many normal cells but is absent from or expressed at very low levels in cancerous tissues such as head and neck squamous cell carcinoma (HNSCC), prostate cancer, and pancreatic cancer. However, the relationship between CXCL14 and hepatocellular carcinoma (HCC) remains unclear. Therefore, the exact function of CXCL14, which may modulate antitumor immune responses in certain cancers, was evaluated. CXCL14 was downregulated in HCC tissues compared to adjacent normal tissues. Moreover, overexpression of CXCL14 had an inhibitory effect on cell proliferation, induced apoptosis and inhibited the invasion of HCC cells in vitro. Upregulation of CXCL14 by lentivirus also significantly suppressed the growth of subcutaneous tumors in nude mice in vivo. We further demonstrated that the loss of CXCL14 expression was regulated by promoter hypermethylation. CXCL14 induced tumor cell apoptosis through both the mitochondrial and nuclear apoptosis pathways. CXCL14 suppressed tumor cell proliferation through regulation of the cell cycle by downregulation of cyclins and cyclin‐dependent kinases. In conclusion, CXCL14 plays a pivotal role as a potential tumor suppressor in HCC. The re‐expression or upregulation of this gene may provide a novel strategy in HCC therapy in the future.
Transanal endoscopic microsurgery: a new technique for completion proctectomy
Authors: Liyanage C. , Ramwell A. , Harris G. J. , Levy B. F. , Simson J. N. L.
Published: September 2013

Aim

Following subtotal colectomy, the retained rectal stump is a potential source of morbidity. Although restorative ileal pouch‐anal anastomosis is the gold standard for ulcerative colitis, up to 14% of patients will opt for a permanent ileostomy and undergo completion proctectomy, traditionally by an abdomino‐perineal approach, which itself carries significant morbidity. We describe a new technique of perineal proctectomy using transanal endoscopic microsurgery (TEMS) equipment. To our knowledge, this technique has not previously been described in the literature.

Method

Twelve patients, mean (SD) age 66 (±13) years, underwent TEMS proctectomy, performed by a single surgeon between January 2007 and October 2011. Excision began with an intersphincteric dissection following which the TEMS (WOLF) proctoscope was inserted and close rectal dissection was performed, entering the peritoneal cavity (if the top of the stump was intraperitoneal). Following perineal extraction of the specimen, the external sphincter and skin were closed with an absorbable suture.

Results

Nine patients had inflammatory bowel disease, two had neoplasia and one had intractable radiation proctitis. The mean (SD) rectal stump length was 17.8 (±6.1) cm and the peritoneal cavity was entered in nine patients, with no small‐bowel injury. The median postoperative hospital stay was 5.5 days. In four patients there was delayed healing of the perineal wound. There was no perioperative mortality.

Conclusion

TEMS perineal proctectomy is a novel, but safe, technique that may avoid the need for a traditional abdominoperineal approach in selected patients.
Estimation of muscle atrophy based on muscle thickness in knee surgery patients
Authors: Hioki Maya , Furukawa Takemitsu , Akima Hiroshi
Published: September 2013

The purpose of this study was to establish an accurate estimation of muscle atrophy in the quadriceps femoris (QF) muscle group. Eighteen individuals who underwent meniscectomy participated in the study (nine men and nine women, mean age 44·4 years). Both operated and non‐operated thighs were scanned by magnetic resonance imaging to determine the volume and thickness of the QF muscle group. Muscle volume was estimated using eleven axial images, and muscle thickness was measured at the anterior, lateral and medial regions of the proximal, mid‐ and distal thigh, respectively. A stepwise linear regression analysis was performed to obtain the relationship between the difference in muscle volume and the difference in muscle thickness between operated and non‐operated limbs. There was no significant difference in muscle volume of the QF between operated (806·6 ± 220·0 cm3) and non‐operated (913·7 ± 241·5 cm3) limbs. Based on the stepwise linear regression analysis, the difference in muscle volume was significantly correlated with the difference in muscle thickness at the anterior proximal thigh and lateral mid‐thigh and anterior mid‐thigh (R = 0·93, P<0·01). In conclusion, the difference in muscle volume between operated and non‐operated limbs can be estimated accurately by measuring muscle thickness of the QF at three sites: the anterior proximal thigh, the lateral mid‐thigh and anterior mid‐thigh. Muscle thickness can be measured easily using imaging techniques such as ultrasonography. We propose that this method provides an easy and accurate estimate of knee surgery‐induced muscle atrophy in clinical medicine.
Hypocalcemia immediately after renal transplantation
Authors: Nobata Hironobu , Tominaga Yoshihiro , Imai Hirokazu , Uchida Kazuharu
Published: September 2013

Background

After renal transplantation (RTX), hypercalcemia, mainly due to persistent hyperparathyroidism, and hypophosphatemia, caused by the improved ability to excrete phosphorus in the renal tubules, are expected. However, immediately after RTX, a transient reduction in serum calcium (Ca) levels has been previously reported, the reason for which is not clear.

Patients and Methods

In 21 patients receiving ABO compatible living donor kidney transplants, serum levels of Ca, phosphorus, intact parathyroid hormone (iPTH), 1,25‐dihydroxyvitamin D, and tacrolimus were measured within three wk after RTX, along with urinary Ca and phosphorus excretion. The immunosuppressive regimen consisted of a three‐drug combination including a glucocorticoid, a calcineurin inhibitor, and an antimetabolite agent.

Results

Serum Ca levels declined significantly during the first post‐operative week. Urinary Ca excretion increased immediately after RTX and gradually normalized. Increased urinary Ca excretion did not correlate with serum levels of iPTH and tacrolimus.

Conclusions

Immediately after RTX, regardless of serum iPTH and tacrolimus levels, transient increases in urinary Ca excretion and hypocalcemia were observed. Administration of glucocorticoids is one potential cause of inappropriate urinary Ca wasting.
Value of Impedance Cardiography during 6‐Minute Walk Test in Pulmonary Hypertension
Authors: Tonelli Adriano R. , Alkukhun Laith , Arelli Vineesha , Ramos José , Newman Jennie , McCarthy Kevin , Pichurko Bohdan , Minai Omar A. , Dweik Raed A.
Published: September 2013

Background

Methods that predict prognosis and response to therapy in pulmonary hypertension (PH) are lacking. We tested whether the noninvasive estimation of hemodynamic parameters during 6‐minute walk test (6MWT) in PH patients provides information that can improve the value of the test.

Methods

We estimated hemodynamic parameters during the 6MWT using a portable, signal‐morphology‐based, impedance cardiograph (PhysioFlow Enduro) with real‐time wireless monitoring via a bluetooth USB adapter.

Results

We recruited 48 subjects in the study (30 with PH and 18 healthy controls). PH patients had significantly lower maximum stroke volume (SV) and CI and slower cardiac output (CO) acceleration and decelerations slopes during the test when compared with healthy controls. In PH patients, CI change was associated with total distance walked (R = 0.62; P < 0.001) and percentage of predicted (R = 0.4, P = 0.03), HR recovery at 1 minute (0.57, P < 0.001), 2 minutes (0.65, P < 0.001), and 3 minutes (0.66, P < 0.001). Interestingly, in PH patients CO change during the test was predominantly related to an increase in SV instead of HR.

Conclusions

Estimation of hemodynamic parameters such as cardiac index during 6‐minute walk test is feasible and may provide useful information in patients with PH. Clin Trans Sci 2013; Volume #: 1–7
Ontario freshwater fishes demonstrate differing range‐boundary shifts in a warming climate
Authors: Alofs Karen M. , Jackson Donald A. , Lester Nigel P.
Published: September 2013

Aim

Northerly shifts, related to recent climate warming, have been observed in the distributions of taxa in many ecosystems and ecological roles. However, significant variation occurs among species in the magnitude of these shifts. Few studies have investigated the effects of climate warming on the distributions of freshwater species.

Location

A total of 1527 lakes across Ontario, Canada.

Methods

We used contemporary and historical survey data to examine the relationships between species occurrences and climate and to measure the magnitude and direction of northern range‐boundary shifts in 13 warm and coolwater freshwater fishes. We also tested whether range‐boundary shifts differed between baitfishes and sportfishes. We then related differences in species range‐boundary shifts to species traits including those related to dispersal, reproduction and ecological niche breadth.

Results

Many fishes are now more likely to occur in lakes where climate was historically limiting. Sportfish northern range boundaries shifted northward significantly over nearly 30 years at a rate of approximately 12.9–17.5 km per decade depending on the measure used; in contrast, baitfish northern range boundaries often shifted southward. Also, species traits explained much of the variation in species range boundaries.

Main conclusions

The northern range boundaries of warm and coolwater sportfishes in Ontario lakes appear to be shifting northward as expected based on observed climate warming. These species are shifting at rates comparable with taxa in marine and terrestrial ecosystems around the globe. In contrast to expectations, the northern range boundaries of small‐bodied baitfishes appear to often contract southward. Differences in range shifts by sportfishes and baitfishes may be related to dispersal, particularly by anglers and/or their ecological roles. Understanding the range‐boundary shifts underway in Ontario lake communities will help predict future shifts by freshwater fishes.
Participation, political economy and protection: food aid governance in Darfur, Sudan
Authors: Young Helen , Maxwell Daniel
Published: September 2013

Humanitarian food assistance aims to meet short‐term emergency needs, yet often it is sustained over many years and develops its own systems and infrastructure that interact with local governance and local communities. This paper explores the links between participation and local governance, as well as the implications for exclusion of certain groups, the dignity of those involved, and protection issues. The paper proposes a framework for reviewing the governance functions and capacities of local Food Relief Committees, based on the following criteria: accountability; gender equity; legitimacy and authority; representativeness; responsiveness; and transparency. A case study of the Darfur region reviews how local governance evolves as a result of both the wider conflict and of adapting to the international humanitarian system, itself a form of governance. The paper concludes by proposing three strategies for enhancing participation and applying lessons learned: improved analysis of participation; linking programming strategies and protection; and taking account of governance functions and capacities.
Winners and losers: analysing post‐disaster spatial economic demand shift
Authors: Xiao Yu , Nilawar Uttara
Published: September 2013

Disasters produce winners and losers. This paper evaluates such winners and losers in a spatial context. The hypothesis is that, because of severe damage to the core disaster area and the constraints associated with the cost of transportation, economic demand would shift to the immediate edge of the disaster zone where either minor or no damage is observed. Empirical analysis of growth patterns in counties/parishes in the states of Alabama, Louisiana, and Mississippi in the United States after Hurricane Katrina (August 2005) verified the spatial demand shift hypothesis. The study found that the post‐Katrina core disaster area became a ‘doughnut hole’ of low income and employment growth, surrounded by a ring of high growth counties/parishes on the edge of the hole. The short‐run adjustment in growth rates may have altered permanently the spatial distribution of employment and income both at the core and in the areas at the edge.
Providing health services during a civil war: the experience of a garrison town in South Sudan
Authors: Kevlihan Rob
Published: September 2013

The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict‐related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter‐insurgency ‘hearts‐and‐minds’ strategies. This paper describes the dynamics associated with the provision of health services in Malakal, an important garrison town in South Sudan, during the second Sudanese civil war (1983–2005). Drawing on the concepts of opportunity hoarding and exploitation, it explores the social and political dynamics of service provision in and around the town during the war. These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict‐related complex emergencies.
Responding to security threats: livelihoods under protracted conflict in Sri Lanka
Authors: Kulatunga Sasini T.K. , Lakshman Rajith W.D.
Published: September 2013

Populations affected by violent conflicts often withstand threats to their security as well as threats to their livelihoods. Their response to the former threats nontrivially affects their response to the latter threats, and vice versa. This paper examines the interplay between protection and livelihood strategies using a sample of households selected from the Anuradhapura district of Sri Lanka. The fieldwork for this study was completed in 2008, producing evidence that the protection and livelihood strategies employed by households affected by the protracted conflict in Sri Lanka are interlaced. In addition, the research discovered that Muslim and Sinhalese households largely responded to the protracted conflict in ways that are unique to their ethnic group. Certain vulnerabilities that impinge on protection and certain opportunities that support livelihoods are shown to be ethnicised. Hence, the final livelihood outcome, which is defined narrowly here as the household's income, also appears to be ethnicised.
A critique of the official report on the evacuation of the World Trade Center: continued doubts
Authors: Hotchkiss H. Lawrence , Aguirre B.E. , Best Eric
Published: September 2013

This paper criticises the conclusions and the unanswered questions in the National Institute of Standards and Technology (NIST)'s official report on the evacuation of the World Trade Center in New York City, United States, on 11 September 2001. It reviews the extent to which the report disregards several conventional statistical methods and comments on the NIST's refusal to share the machine‐readable data file with the scientific community for replication and further analysis. Problems lie in the sampling methods employed, the treatment of missing data, the use of ordinary least squares (OLS) with binary dependent variables, the failure to document the scalability of the scales used, the lack of tests to check for constant error variance, and the absence of overall fit tests of the model. There are also conceptual and theoretical issues, such as the absence in the report of considerations of the influence of group‐level processes and their impact on the collective behaviour of evacuating collectivities.
The Ohio Hospital for Epileptics—The first “epilepsy colony” in America
Authors: Kissiov Djem , Dewall Taylor , Hermann Bruce
Published: September 2013

This review examines the planning, development, and course of the first established colony for epilepsy in the United States—The Ohio Hospital for Epileptics. The events leading to the development of the colony, its early course, and the people who were instrumental in its establishment and maintenance are reviewed. At approximately the same time as the development of the Ohio Hospital for Epileptics, eugenics was gaining momentum in America, which affected epilepsy deeply. How this movement influenced thinking and practice at the Ohio Hospital is also reviewed.
Radiographic and radiological assessment of laminitis
Authors: Sherlock C. , Parks A.
Published: September 2013

Radiographic studies are an essential component in evaluation of horses with laminitis. The standard radiographs that should be obtained to aid assessment of horses with laminitis are the lateromedial, horizontal dorsopalmar and dorsal 45° proximal palmarodistal oblique views. This article will summarise the assessment of these 3 projections in the laminitic horse as well as discuss the prognostic significance of common radiological abnormalities in horses with laminitis.
The effects of three‐month oral supplementation with a nutraceutical and exercise on the locomotor pattern of aged horses
Authors: Higler M. H. , Brommer H. , L'Ami J. J. , de Grauw J. C. , Nielen M. , van Weeren P. R. , Laverty S. , Barneveld A. , Back W.
Published: September 2013

Reasons for performing study

Multiplein vitrostudies assessing articular tissues have indicated that glucosamine and chondroitin sulphate may possess anti‐inflammatory effects, but little is known of their clinical effectsin vivo. Many old horses have stiff joints, which is likely to be attributable to inflammation and therapy with these nutraceutical compounds could improve joint function.

Objectives

To assess the clinical effects of a mixed supplement on the improvement of stiff gait in aged horses.

Study design

Randomised, blinded, placebo‐controlled study.

Methods

A group of 24 geriatric equids (age 29 ± 4 years; mean ± s.d.) received either 3 months oral supplementation with a test compound (containing glucosamine, chondroitin sulfate and methyl sulfonyl methane), or a placebo. Kinematic outcome criteria (primary: stride length; secondary: carpal flexion, fore fetlock extension and tarsal range of motion) were objectively quantified on a treadmill at a walk and trot before and after treatment.

Results

Stride length did not change significantly in the treated horses at the end of the trial. In the control group, carpal flexion and fore fetlock extension were significantly increased (P<0.05).

Conclusions

There were no indications of effect of the supplement on gait characteristics. The observations in the control group may have been due to a habituation or exercise effect. This study does not support the use of a glucosamine/chondroitin sulfate/methyl sulfonyl methane supplement to improve stiff gait in geriatric horses because of the lack of a sizeable effect. The significant changes in gait parameters in the control group may indicate the usefulness of exercise regimens in older horses.
Arterial oxygen tension and pulmonary ventilation in horses placed in theAndersonSling suspension system after a period of lateral recumbency and anaesthetised with constant rate infusions of romifidine and ketamine
Authors: François I. , Lalèyê F.‐X. , Micat M. , Benredouane K. , Portier K.
Published: September 2013

Reasons for performing study

Some controversy exists over whether or not horses' recovery and cardiopulmonary function are affected by suspension in slings.

Objectives

To measure arterial oxygen tension and pulmonary ventilation in anaesthetised horses placed in a standing position in an Anderson Sling (AS) after a period of right lateral recumbency (RLR).

Study design

Randomised crossover experimental study.

Methods

Six Standardbred horses were anaesthetised twice. Catheters were inserted into the right jugular vein and the left carotid artery. After premedication with romifidine, anaesthesia was induced with diazepam and ketamine. Following 50 min in RLR, horses were maintained in eitherRLRorASfor an additional 60 min through to recovery. Anaesthesia was maintained i.v. with a constant rate infusion of romifidine and ketamine. Heart rate, respiratory rate, mean arterial pressure, expiratory tidal volume, minute volumes and end tidalCO2were monitored continuously. Venous and arterial bloods were sampled for lactate concentration, creatine kinase activity and blood gas analysis before premedication, after induction, every 20 min for 100 min, as soon as the horse was standing (TR), and 24 h later. The data were averaged within 2 anaesthetic periods:P1, 0–20 min; andP2, 40–100 min.

Results

DuringP2, horses in theRLRgroup had lower arterial oxygen tension (P = 0.001), higher alveolar‐arterial oxygen tension gradient (P = 0.005), higher respiratory rate (P = 0.04) and higher minute volumes (P = 0.04) than horses in theASgroup. ArterialCO2tension and mean arterial pressure increased in theASgroup duringP2(P = 0.01 and 0.02 respectively). The recoveries were judged better in theASgroup than in theRLRgroup (P = 0.01). DuringTR, lactate were higher in theRLRgroup than in theASgroup (P = 0.007). Creatine kinase activities were higher in theASgroup at 24 h vs.TR(P = 0.02).

Conclusions

AndersonSling suspension after a period of recumbency improves cardiopulmonary function and recovery quality in horses and therefore might be considered for use to recover hypoxic horses.
Do frogs bounce, and if so, by how much? Responses to the ‘Big Wet’ following the ‘Big Dry’ in south‐eastern Australia
Authors: Mac Nally Ralph , Nerenberg Shana , Thomson James R. , Lada Hania , Clarke Rohan H.
Published: September 2013

Aim

We assessed the resistance and resilience of anuran amphibians to an abrupt change in weather conditions in 2010–12 (the ‘Big Wet’) following the most pronounced drought in eastern Australia's records (1997–2010, the ‘Big Dry’).

Location

Five pairs of landscapes (each of 19.6 km2) spread across 30,000 km2 in temperate, inland Australia. One in each pair was eucalypt woodland while the other was cleared agricultural land; there were eight representative waterbodies in each landscape.

Methods

We collected data on anuran abundances, species richness and breeding by using aural surveys and visual searches. We surveyed six times during the austral winter–springs of 2006 and 2007 (the Big Dry) and six times in the corresponding seasons of 2011 and 2012 (the Big Wet); our results refer only to species breeding in the winter–spring season.

Results

Mean species richness, total numbers of calling males and numbers of the five most common species of anurans increased in the Big Wet compared with the Big Dry, but the least common species did not. Proportions of waterbodies with eggs or tadpoles increased in the Big Wet, but the occurrence of eggs and tadpoles was still low (evidence of presence in < 50% of waterbodies). The most common species had relatively high resistance to the first 5 years of the Big Dry, but all declined sharply after a decade of drought. Four of the common species showed some resilience, but reporting rates fell much below the peak values prior to the Big Dry. There were virtually no records for seven other species that had been recorded previously in the region.

Main conclusions

The pressure of drying, warming climates, even when broken by shorter wet periods, seems to be sufficient to induce regional‐scale declines even among species that, from global analyses of risk factors, might be expected to be relatively immune from such effects.
Factors Influencing the Stream‐Aquifer Flow Exchange Coefficient
Authors: Morel‐Seytoux Hubert J. , Mehl Steffen , Morgado Kyle
Published: September 2013

Knowledge of river gain from or loss to a hydraulically connected water table aquifer is crucial in issues of water rights and also when attempting to optimize conjunctive use of surface and ground waters. Typically in groundwater models this exchange flow is related to a difference in head between the river and some point in the aquifer, through a “coefficient.” This coefficient has been defined differently as well as the location for the head in the aquifer. This paper proposes a new coefficient, analytically derived, and a specific location for the point where the aquifer head is used in the difference. The dimensionless part of the coefficient is referred to as the SAFE (stream‐aquifer flow exchange) dimensionless conductance. The paper investigates the factors that influence the value of this new conductance. Among these factors are (1) the wetted perimeter of the cross‐section, (2) the degree of penetration of the cross‐section, and (3) the shape of the cross‐section. The study shows that these factors just listed are indeed ordered in their respective level of importance. In addition the study verifies that the analytical correct value of the coefficient is matched by finite difference simulation only if the grid system is sufficiently fine. Thus the use of the analytical value of the coefficient is an accurate and efficient alternative to ad hoc estimates for the coefficient typically used in finite difference and finite element methods.
The CD4:CD8 ratio is associated with markers of age‐associated disease in virally suppressed HIV‐infected patients with immunological recovery
Authors: Serrano‐Villar S , Moreno S , Fuentes‐Ferrer M , Sánchez‐Marcos C , Ávila M , Sainz T , de Villar NGP , Fernández‐Cruz A , Estrada V
Published: September 2013

Objectives

Inversion of the CD4:CD8 ratio (< 1) has been identified as a hallmark of inmmunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and markers of age‐associated disease in treated HIV‐infected patients with good immunovirological response.

Methods

A cross‐sectional analysis was conducted in 132 HIV‐infected adults on antiretroviral therapy (ART), with plasma HIV RNA < 50 HIV‐1 RNA copies/mL for at least 1 year, CD4 count > 350 cells/μL and age < 65 years. We analysed the associations between the CD4:CD8 ratio and subclinical atherosclerosis [assessed using carotid intima‐media thickness (IMT)], arterial stiffness [assessed using the augmentation index (AIx)], the estimated glomerular filtration rate (eGFR), muscle wasting and sarcopenia [assessed using appendicular lean mass/height2 (ALM) measured by dual‐energy X‐ray absorptiometry (DEXA)].

Results

CD4:CD8 ratio inversion was associated with higher IMT, lower eGFR and lower ALM (all values P < 0.05), but not with AIx. In multivariate analyses adjusted for age, sex, hypertriglyceridaemia, tobacco use and cumulative ART exposure, inversion of the CD4:CD8 ratio was independently associated with higher IMT [odds ratio (OR) 2.9; 95% confidence interval (CI) 1.2–7.1], arterial stiffness (OR 4.8; 95% CI 1.0–23.5) and lower eGFR (OR 5.2; 95% CI 1.0–64.4), but not sarcopenia (OR 0.7; 95% CI 0.2–2.7). These associations persisted when models were applied to subjects with nadir CD4 counts > 200 cells/μL and those with CD4 counts > 500 cells/μL.

Conclusions

The CD4:CD8 ratio in treated HIV‐infected subjects with good immunovirological response is independently associated with markers of age‐associated disease. Hence, it might be a clinically useful predictor of non‐AIDS‐defining conditions.
Evaluation of Mechanical Properties Variations for Kr Ion‐Irradiated 6H‐SiC by Nanoindentation Methods
Authors: Yang Tao , Zang, Hang , He Chaohui , Guo Daxi , Zhang Peng , Xi Jianqi , Ma Li , Wang Zhiguang , Shen Tielong , Pang Lilong , Yao Cunfeng
Published: September 2013

Nanoindentation experiments were performed to investigate the irradiation effects on the mechanical properties of 6H‐SiC irradiated by 4 MeV Kr ions at high fluences from room temperature (RT) to 550°C. The irradiation temperature is the primary factor that affects modifications of the comprehensive mechanical properties, while the effect of the fluence is less significant. Elastic modulus and hardness decrease drastically for RT‐irradiated samples, but they almost recover for elevated temperature samples, with hardness slightly higher than its original value. The hardness increases first and then decreases with increasing temperature, and the elastic modulus decreases linearly as the swelling increases. Meyer's index is related to the indentation size effect of hardness and the magnitude of the lattice damage. The ratio of irreversible work is associated with the degree of elastic recovery and the ratio of hardness to elastic modulus of SiC. Compared with the unirradiated value, fracture toughness changes slightly for RT irradiation, while increasing significantly for elevated temperature irradiation and has the same variation tendency of hardness. Results indicate that mechanical properties change with the variations of interatomic bond strength, dislocation mobility, and the behavior of crack propagation, which is strongly affected by the defects induced by heavy‐ion irradiation.
Frequent False‐positive results of lupus anticoagulant tests in plasmas of patients receiving the new oral anticoagulants and enoxaparin
Authors: Martinuzzo M. E. , Barrera L. H. , D 'Adamo M. A. , Otaso J. C. , Gimenez M. I. , Oyhamburu J.
Published: September 2013

Introduction

Oral direct thrombin and Xa inhibitors are worldwide distributed for prevention and treatment of thrombosis. It is important to recognize their effects on lupus anticoagulant (LA) testing. The aim of the study is to describe the rate of false‐positive results of LA tests on plasmas of patients with previous negative LA tests results that receive dabigatran etexilate (DAB) 110 mg/twice a day, rivaroxaban (RIV) 10 mg/day or 15 mg/twice a day, or enoxaparin 40 mg/day.

Methods

Blood was taken between 1.5 and 4 h post administration. Tests evaluated are as follows: prothrombin time, APTT, dilute Russell viper venom time (DRVVT) screen, APTT, and DRVVT mixing studies, index of circulating anticoagulant (ICA) with normal plasma, screen/confirm normalized ratio (NR) for DRVVT and silica clotting time (SCT).

Results

Plasmas from patients taking DAB (n = 22) presented 100% prolonged APTT and DRVVT with ICA above the cutoff point and 81.8% positive screen/confirm NR, 100% prolonged SCT screen, but 4.5% positive confirmatory NR. All patients receiving RIV at 15 mg/twice a day (n = 4) presented positive DRVVT screen, mixing, and confirmatory tests, 75% and 100% prolonged APTT and SCT screen, with negative screen/confirm NR. Those taking RIV 10 mg/day (n = 22) showed 81.8% prolonged DRVVT screen, 82.3% and 76.5% of them with positive mixing and confirmatory studies. Patients receiving enoxaparin also presented high prevalence of APTT and DRVVT false‐positive results.

Conclusion

Dabigatran etexilate, RIV, and enoxaparin affect tests for LA not only in screening and mixing, but also in confirmatory studies. We considered that LA testing should not to be performed when patients are taken these drugs, particularly if blood is collected at peak, in order to avoid false‐positive results.
Use of Sysmex XE‐2100 and XE‐5000 hematology analyzers for the diagnosis of malaria in a nonendemic country (France)
Authors: Dubreuil P. , Pihet M. , Cau S. , Croquefer S. , Deguigne P. A. , Godon A. , Genevieve F. , De Gentile L. , Zandecki M.
Published: September 2013

Introduction

Most studies dealing with automated hematology analyzers (HAs) and malaria diagnosis are conducted in endemic countries.

Methods

We retrospectively studied cell blood counts (CBCs) performed with Sysmex XE‐2100 and XE‐5000 HAs in our center (Angers, France) regarding 67 patients returning from endemic areas and infected with various Plasmodium species.

Results

In 83% of infected samples with Plasmodium vivax (Pv), ovale (Po), or malariae (Pm), extra clouds of dots were present in neutrophil and/or eosinophil area(s) on routine differential (DIFF) scattergrams. In contrast, samples infected with Plasmodium falciparum (Pf) failed to show such DIFF scattergrams, or any other suggesting malaria infection (0/ 49 pts). Abnormal areas from DIFF scattergrams were related to the presence of mature schizonts and gametocytes, undestroyed by lysis agent, the latter not observed in Pf‐infected patients from our series. The internal parameter WBC[DIFF] − WBC[BASO] raised in parallel to parasitemia in Pv, Po, and Pm samples but could not be used as a surrogate for parasitemia. In Pf infection, reticulocyte/ immature reticulocyte fraction (IRF) ratio showed a significant correlation with parasitemia (P < 0.05). A diagnostic model developed for Pf in endemic countries showed sensitivity of 77%.

Conclusion

Using SYSMEX analyzers, Pv, Po, and Pm infections are easy to ascertain as DIFF scattergrams are almost specific (specificity = 99.9%). Pf infection diagnosis by CBC may be a more promising tool.