bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic Gastrocnemius Recession for the Treatment of Isolated Gastrocnemius Contracture
Authors: Phisitkul Phinit , Rungprai Chamnanni , Femino John E. , Arunakul Marut , Amendola Annunziato
Published: May 2014

Background:

Endoscopic gastrocnemius recession has been proposed as a minimally invasive technique for the treatment of isolated gastrocnemius contracture. We report on the safety and efficacy of endoscopic gastrocnemius recession, as an isolated procedure or combined with other concomitant procedures in terms of improvement in ankle dorsiflexion, functional outcome, and postoperative morbidities.

Methods:

The data were prospectively collected in this case series. Endoscopic gastrocnemius recession was performed by a single surgeon in 320 consecutive patients (344 feet) who were diagnosed with isolated gastrocnemius contracture and failed nonoperative treatments between March 2009 and December 2012. There were 180 women and 140 men with mean age, 47.1 ± 15.7 years. The minimum follow-up was 1 year (mean, 18 months; range, 12 to 53 months). Pre- and postoperative ankle dorsiflexion, pain (Visual Analog Scale [VAS]), SF-36, and Foot Function Index (FFI) were obtained and compared using paired sample t test and Wilcoxon signed-rank test.

Results:

The mean ankle dorsiflexion significantly improved from −0.8 ± 5.4 degrees preoperatively to 11.0 ± 6.6 degrees at average of 13 months postoperatively (n = 294) ( P < .001). Complete preoperative and 1-year postoperative pain (VAS) (n = 274) and functional outcome scores (n = 185) were collected when possible. The mean pain (VAS) decreased from 7/10 to 3/10 postoperatively (all P < .01). The mean SF-36 including physical component summary score (PCS) and mental component summary score (MCS) increased from 34 and 44 to 45 and 51, respectively (P < .01 for both PCS and MCS). The mean FFI improved from 63 to 42 for pain, 63 to 43 for disability, 68 to 44 for activity limitation, and 61 to 41 for total score postoperatively (all P < .01). Postoperative morbidity included weakness of ankle plantarflexion (N = 11/320; 3.1% respectively) and sural nerve dysesthesia (N = 10/320; 3.4%). Wound complications or Achilles tendon rupture did not occur. There was no difference in the average improvement in ankle dorsiflexion, outcome scores, and rate of complications between the isolated and combined procedures.

Conclusion:

Endoscopic gastrocnemius recession demonstrated promising results in the treatment of isolated gastrocnemius contracture. Ankle dorsiflexion was significantly improved with minimal morbidity. The procedure was found effective in improving functional outcomes and relieving pain as a sole operative treatment and as a part of combined procedures in our patients.

Level of Evidence:

Level IV, case series.
Quantification of Shear Stresses Within a Transtibial Prosthetic Socket
Authors: Schiff Adam , Havey Robery , Carandang Gerard , Wickman Amy , Angelico John , Patwardhan Avinash , Pinzur Michael
Published: May 2014

Background:

There is a paucity of objectively recorded data delineating the pattern of weightbearing distribution within the prosthetic socket of patients with transtibial amputation. Our current knowledge is based primarily on information obtained from finite element analysis computer models.

Methods:

Four high-functioning transtibial amputees were fit with similar custom prosthetic sockets. Three load cells were incorporated into each socket at high stress contact areas predicted by computer modeling. Dynamic recording of prosthetic socket loading was accomplished during rising from a sitting position, stepping from a 2-leg stance to a 1-leg stance, and during the initiation of walking. By comparing the loads measured at each of the 3 critical locations, anterior/posterior shear, superior/inferior shear, and end weightbearing were recorded.

Results:

The same load pattern in all 4 subjects was found during each of the 3 functional activities. The load transmission at the distal end of the amputation residual limbs was negligible. Consistent forces were observed in both the anterior/posterior and superior/inferior planes. Correlation coefficients were used to compare the loads measured in each of the 4 subjects, which ranged from a low of .82 to a high of .98, where a value approaching 1.0 implies a linear relationship amongst subjects.

Conclusion:

This experimental model appears to have accurately recorded loading within a transtibial prosthetic socket consistent with previously reported finite element analysis computer models.

Clinical Relevance:

This clinical model will allow objective measurement of weightbearing within the prosthetic socket of transtibial amputees and allow objective comparison of weightbearing distribution within the prosthetic sockets of patients who have undergone creation of different versions of a transtibial amputation residual limb and prosthetic socket designs.
Functional Treatment or Cast Immobilization After Minimally Invasive Repair of an Acute Achilles Tendon Rupture
Authors: Groetelaers René P. T. G. C. , Janssen Loes , van der Velden Jolanda , Wieland Arvid W. J. , Amendt Angelique G. F. M. , Geelen Peter H. J. , Janzing Heinrich M. J.
Published: May 2014

Background:

Operative repair of an acute Achilles tendon rupture (ATR) reduces the risk of re-rupture and has therefore gained popularity as a standard treatment for ATR, especially in the young and physically active patient. There is ongoing controversy over the best surgical technique and postoperative treatment. In this prospective, randomized trial, we compared cast immobilization and functional treatment with early mobilization and weightbearing after using a minimally invasive surgical technique in patients with ATR.

Methods:

All patients with ATR were included. Exclusion criteria were systemic immunosuppressive therapy, re-ruptures, and severe comorbidity. All included patients underwent minimally invasive surgery, after which a below-knee splint with the foot in 10 degrees of plantar flexion was applied for the first week. Patients were then randomized to the cast immobilization group (IG) for 6 weeks or to the functional group (FG) for 6 weeks. Sixty patients were included. Median age was 43 years (range, 19-65), and 78% were male. Most ATRs were sports related. Data were collected preoperatively and during the outpatient checks at 1, 3, and 6 weeks; 3 and 6 months; and 1 year. Outcome parameters were return to work or sport, complications including re-rupture, Achilles rupture performance score (ARPS), loss of strength, range of motion, subjective result, and quality-of-life (QoL) scores.

Results:

In our follow-up period, we did not see differences in strength, QoL scores, return to work or sports, or ARPS between the 2 treatment groups. The patients in the FG reported more complaints, mostly pain, in the first weeks after surgery, probably because of the exercise program starting 1 week postsurgery. The overall complication rate was low. In each group, we had 1 re-rupture; in the IG, however, 2 patients had a deep venous thrombosis, despite low-molecular-weight heparin.

Conclusion:

The minimally invasive repair of ATR was a safe and reliable technique with good results. Early mobilization seemed to be as safe as more traditional postoperative immobilization with equal patient satisfaction. Although not significantly different, we saw more major complications in the IG.

Level of Evidence:

Level I, prospective randomized trial.
Dorsal Approach for Plantar Plate Repair With Weil Osteotomy
Authors: Watson Troy S. , Reid Dorian Y. , Frerichs Timothy L.
Published: May 2014

In recent years, the role of the plantar plate in lesser metatarsophalangeal joint stability has increasingly been recognized. Tearing or attenuation of the plantar plate often will result in crossover or hammertoe deformity with hyperextension of the MTP joint. Some patients are able to have resolution of painful symptoms with conservative treatment but for those that fail these measures, surgical fixation of the plantar plate is indicated. While, there have been some described techniques for direct repair of the plantar plate, we present a surgical technique through a dorsal approach with a Weil osteotomy which accomplishes great clinical correction of the plantar plate tear and associated toe deformity as well as relief of patient’s pain. Additionally, we believe this technique is safe, efficient and reproducible.

Level of Evidence: Level V, expert opinion.
Robustness studies of sensor faults and noises for semi-active control strategies using large-scale magnetorheological dampers
Authors: Cha Young-Jin , Agrawal Anil K
Published: May 2014

This paper presents comparative studies for various sensor faults and noise effects on the performance of several recently proposed semi-active control algorithms for the control of large-scale magnetorheological dampers. Sensor faults or noises due to various environmental factors and long-term deteriorations may cause degradations in the performance of the control system. In this paper, the authors have carried out an in-depth literature review of the sensor fault or malfunction and noise problems, diagnostic methods and compensation approaches applicable to semi-active control algorithms. For three recently developed semi-active controllers, namely clipped optimal control, decentralized output feedback polynomial control and Lyapunov controller, an extensive study has been carried out on the robustness of these controllers during sensor faults and noise effects. Based on this research, a new real-time qualitative model-based sensor fault detection and diagnosis (RMSFDD) method has been proposed. This novel RMSFDD method shows a good performance during diverse sensor fault types in semi-active control with a real-time application without any training and heavy computational cost.
ACL Tears
Authors: Shephard Meredith K. , Hoover Donald L. , Neelly Kurt R.
Published: May 2014

This article is the second in a two-part series that addresses the scientific literature on the contributing factors and preventive strategies for anterior cruciate ligament (ACL) injuries. Part 1, which was presented in a previous edition of Home Health Care Management & Practice ( HHCMP), covered contemporary research on the functional anatomy of the knee and precipitating factors to ACL injuries. Part 2, presented here, addresses contemporary trends evident in the peer-reviewed literature on the topic of the rehabilitation of ACL injuries, and it offers suggestions home health care professionals may find useful in the prevention and rehabilitation of this injury.
Effectiveness of Platelet-Rich Plasma and Hyaluronic Acid for the Treatment and Care of Pressure Ulcers
Authors: Ramos-Torrecillas Javier , García-Martínez Olga , De Luna-Bertos Elvira , Ocaña-Peinado Francisco Manuel , Ruiz Concepción
Published: May 2014

Platelet-rich growth factor (PRGF) is a natural source of growth factors (GF), while hyaluronic acid (HA) is a biopolymer present in the extracellular matrix of skin, cartilage, bone, and brain, among other tissues. Both are involved in the pathophysiological mechanisms underlying wound healing. The objective of this study was to evaluate the clinical efficacy (as measured by ulcer area) and safety (as measured by signs of infection) of PRGF and PRGF plus HA in the treatment of pressure ulcers (PUs). Patients ( N = 100) with 124 Stage II–III PUs were randomized to a control group ( n = 25 PUs) for standard care or to case groups for treatment with one ( n = 34 PUs) or two ( n = 25 PUs) doses of PRGF from their own peripheral blood, or two doses of PRGF plus HA ( n = 40 PUs). All ulcers were followed up every 3 days for a 36-day period. At 36 days, a significant reduction in ulcer area ( p ≤ .001) was observed in all treatment groups, with a mean reduction of more than 48.0% versus baseline. The greatest mean reduction (80.4% vs. baseline) was obtained with the PRGF plus HA regimen. Complete wound healing was observed in 32.0% of PUs treated with two doses of PRGF ( p ≤ .002) and in 37.5% of those treated with two doses of PRGF plus HA ( p ≤ .004). There were no signs of infection in any PUs during the 36-day follow-up period. The degree of wound healing was inversely correlated with the consumption of drugs such as statins and with the peripheral blood platelet levels of patients at baseline.
Rising powers, global capitalism and liberal global governance: A historical materialist account of the BRICs challenge
Authors: Stephen Matthew D.
Published: May 2014

This article analyses the phenomenon of rising powers from a historical materialist perspective. It (1) elaborates the key concepts of historical structures of world order, state–society complexes and transnational class formation, and (2) applies them to Brazil, Russia, India, China and other so-called ‘rising powers’ to account for the nature and extent of the challenge they pose to the existing institutions of global governance. A double argument is advanced: first, the integration of rising powers into the historical structure of global capitalism has reduced traditional sources of great power conflict, and made rising powers heavily dependent on the existing institutional framework established by the liberal West. This facilitates their integration into the existing governance order. However, within the limits of the existing order, two factors lend a heartland–contender cleavage to the politics of global governance: the rising powers’ relatively more statist, less market-driven forms of state, and their subsequent failure to be integrated into emergent transnational capitalist class structures. Consequently, it is not the global governance order itself, but its most liberal features, that are contested by rising powers. The result is that, in contrast to realist pessimism and liberal optimism, the rise of new powers is leading to a hybrid governance order that is both transnationally integrated and less liberal.
Do international non-governmental organizations inhibit globalization? The case of capital account liberalization in developing countries
Authors: Pinheiro Diogo , Chwieroth Jeffrey M. , Hicks Alexander
Published: May 2014

Why do countries liberalize capital controls? The literature identifies a range of possible reasons. Yet, despite considerable advances, the impact of international non-governmental organizations has yet to be considered. In fact, surprisingly, systematic analysis of the role of international non-governmental organizations in the diffusion of economic openness, financial or otherwise, has not been pursued previously. We offer the first such analysis by advancing the idea of ‘climatic mimesis,’ which refers to the cultural climate for policymaking that results from country ties to international non-governmental organizations. International non-governmental organizations shape capital account regulation by altering the cultural climate in a country such that liberalization becomes a more problematic policy choice. Our statistical analysis of data from developing countries reveals that international non-governmental organization ties inhibited liberalization, as did relatively high public debt and concentrated domestic banking sectors. The presence of an International Monetary Fund program and liberalization by economic competitors encouraged it. We suggest that these findings have important implications for understanding the potential for convergence and divergence in an era of globalization.
Historicizing historical trauma theory: Troubling the trans-generational transmission paradigm
Authors: Maxwell Krista
Published: May 2014

The premise that “trauma” is transmitted across generations is central to the historical trauma discourse currently circulating in indigenous communities and professional networks in Canada. Historical trauma may be understood as the offspring of two older and apparently antithetical discourses: Native healing, and colonial professional critiques of indigenous family life. While the former has maintained a therapeutic focus on restoring intergenerational social relations, the latter has pathologized indigenous parenting and child-rearing practices. The emergence of historical trauma marks a global shift in the moral economy by which victimhood status, acquired through individual experiences of physical and especially sexual abuse, has come to wield greater currency than collective struggles against colonialism. Providers of contemporary indigenous healing programmes are drawing simultaneously on trauma discourse, which is seen to legitimate individual social suffering, and older therapeutic forms centred on sharing local social histories to restore intergenerational continuities and collective identity. But these invocations of historical trauma may continue the colonial discourse of mental health and social welfare professionals, who blamed indigenous parenting practices for children’s social problems and failure to assimilate. Some contemporary mental health and child development professionals have invoked parents’ and grandparents’ transmission of historical trauma in ways which construct indigenous families as pathological, promote an oversimplified, universalizing understanding of Canadian colonialism, and divert attention from the contemporary continuation of colonial structures and relations.
Rethinking Historical Trauma
Authors: Kirmayer Laurence J. , Gone Joseph P. , Moses Joshua
Published: May 2014

Recent years have seen the rise of historical trauma as a construct to describe the impact of colonization, cultural suppression, and historical oppression of Indigenous peoples in North America (e.g., Native Americans in the United States, Aboriginal peoples in Canada). The discourses of psychiatry and psychology contribute to the conflation of disparate forms of violence by emphasizing presumptively universal aspects of trauma response. Many proponents of this construct have made explicit analogies to the Holocaust as a way to understand the transgenerational effects of genocide. However, the social, cultural, and psychological contexts of the Holocaust and of post-colonial Indigenous “survivance” differ in many striking ways. Indeed, the comparison suggests that the persistent suffering of Indigenous peoples in the Americas reflects not so much past trauma as ongoing structural violence. The comparative study of genocide and other forms of massive, organized violence can do much to illuminate both common mechanisms and distinctive features, and trace the looping effects from political processes to individual experience and back again. The ethics and pragmatics of individual and collective healing, restitution, resilience, and recovery can be understood in terms of the self-vindicating loops between politics, structural violence, public discourse, and embodied experience.
Identifying the most influential parameter affecting natural ventilation performance in high-rise high-density residential buildings
Authors: Fung Y. W. , Lee W. L.
Published: May 2014

Natural ventilation contributes to comfort, reduction of energy use for air conditioning and improving indoor air quality in high-rise high-density residential buildings. Measures to improve its performance should be of interest to the general public. Among factors that have an impact on natural ventilation performance of residential units, openings configuration is perhaps the most investigated. Much research work has been done on investigating the impact of different configuration parameters, but most previous studies are focused on only one impact parameter. In this study, computational fluid dynamics simulations are conducted for evaluating the combined impact of different configuration parameters so as to identify the configuration parameter that has the highest impact on natural ventilation performance of residential units. Statistical analysis of simulation results revealed that amongst the five studied parameters (i.e. ventilation mode, window type, orientation, window-to-wall ratio and living room area), natural ventilation performance, represented by mean age of air, is most affected by the ventilation mode adopted (i.e. cross or single-sided ventilation).
Development and validation of a virtual soot sensor: Part 2: Transient engine operation
Authors: Barro Christophe , Obrecht Peter , Boulouchos Konstantinos
Published: May 2014

The reduction of the legislative emission limits has led to an increased complexity of the engine control unit (ECU) calibration. Integrating feedback of the Particulate Matter (PM) and NOx emissions into the engine management could make fulfilment of legislation easier and reduce the complexity of the necessary calibration process. Due to the fact that production type PM sensors for raw emission feedback will not be available, or will be exceedingly expensive in the near future, in part 1 of this work, a virtual soot sensor (VSS) has been developed. Along with the very good steady state behaviour, the VSS is able to predict PM emissions in transient engine operation with a sufficient precision. This has been approved with different changes in torque demand at constant engine speed. Though an overestimation of the soot occurs during the first cycles of the step in torque demand, the behaviour of the engine out soot was well captured and compared with measurements from a photo-acoustic soot sensor (PASS) and characteristic end values of the representative in-cylinder soot trace (measured by multi-colour pyrometry). The performance of the control structure with integrated VSS is demonstrated on the new European driving cycle and an Urban Dynamometer Driving Schedule. Furthermore, a change in set point value demonstrates the opportunity of changing the raw emission strategy on-line. These results offer the opportunity to expand this cylinder-pressure-based VSS approach to other pollutants (primarily NOx) as well.
Dissection of left iliac artery during anterior lumbar interspace fusion: Report of a case
Authors: Fischer Uwe M , Davies Mark G , Sayed Hosam El
Published: May 2014

Vascular injury is an uncommon complication of spine surgery. Among the different approaches, anterior lumbar interbody fusion has increased potential for vascular injuries, since the great vessels and their branches overly the disc spaces to be operated on, and retraction of these vessels is necessary to gain adequate surgical exposure. The reported incidence for anterior lumbar interbody fusion-associated vascular injuries ranges from 0% to 18.1%, with venous laceration as the most common type. We report a case of anterior lumbar interbody fusion-associated left common iliac artery dissection leading to delayed acute limb ischemia developing in early post-operative period.
Using accumulated knowledge to calibrate theoretical propositions
Authors: Edwards Jeffrey R. , Christian Michael S.
Published: May 2014

In organizational psychology research, most theories put forth directional predictions, such as stating that an increase in one construct will result in an increase or decrease in another construct. Such predictions are imprecise, given that they can be confirmed by a wide range of values, and theories that rely on such predictions bear little risk of falsification. In this article, we present an approach for increasing theoretical precision by using results from meta-analyses to calibrate the predictions embedded in a theory. Our approach provides point values for theoretical predictions along with credibility intervals that capture the likely range of the predicted effects. We illustrate this approach by drawing from research on work engagement and calibrate the predictions represented by two conceptual models. Contributions and limitations of the proposed approach are discussed.
A magneto-active scaffold for stimulation of bone growth
Authors: Markaki A. E. , Justin A. W.
Published: May 2014

Creating ‘smart’ biomedical devices with the potential for controlled actuation in vivo has been a long-standing scientific pursuit in therapeutic medicine. The present work focuses on a bone regeneration scaffold based on ferromagnetic fibres designed to induce in vivo modelling of in-growing periprosthetic bone by the application of an external magnetic field of clinical magnitude. We present the conceptual basis of such a ‘magneto-active scaffold’, the properties of prime interest and how these properties can be controlled.
Fabrication and performance evaluation of PAA/TiO2 self-assembled multilayers
Authors: Yang L. H. , Lin C. G. , Wang L.
Published: May 2014

Strip groove microstructure simulated sharkskin has been prepared on the surface of hydroxylated PDMS by using TiO2/polyacrylic acid (PAA) composite self-assembled technique and thermal stress. The depth changes from 50 to 200 nm by increasing the thickness of self-assemble layers. The span spacing was about 1–3 μm. Strip groove microstructure morphology inhibited more than 66% diatom attached to the surface of PDMS. The double layers have the highest inhibition with 78%. All specimens have no barnacle larva attached.
Influence of unmelted nanoparticles on properties of YSZ nano-coatings
Authors: Bai Y. , Wang Y. H. , Wang Z. , Fu Q. Q. , Han Z. H.
Published: May 2014

In this work, yttria stabilised zirconia (YSZ) based thermal barrier coatings (TBCs) were deposited by a supersonic atmospheric plasma spray (SAPS). The influence of the unmelted nanoparticles on the thermomechanical properties of the nanostructured YSZ coatings was studied by heat insulation and thermal shock tests. The results indicated that nanostructured SAPS-coatings consisted of nano/micro-grains (60–150 nm) and unmelted nanoparticles (20–50 nm) and exhibited a bimodal microstructure. When the unmelted nanoparticle content increased from 4 to 11%, the Weibull modulus (M) decreased by 46% while the coating's insulation temperature increased by 32%. The thermal cycling life of the nanostructured SAPS-coating was maximised when the unmelted nanoparticle content reached approximately 8%.
Determining Young's modulus and Poisson's ratio of thin hard films
Authors: Gong M. F. , Qiao S. R. , Mei F.
Published: May 2014

Young's modulus and Poisson's ratio for thin hard films are quite difficult to measure by traditional testing methods. A series of equations for Young's modulus and Poisson's ratio of films are successfully deduced. A novel tensile process is described in this paper. It concludes that this process is relatively easy to perform and allows reliable determination of elastic constants for thin hard films. The magnitude of Young's modulus and Poisson's ratio for electroplating hard alumina film were 106–166 GPa and 0·26–0·27 respectively. Moreover, Young's modulus of film is influenced by the film's thickness and porosity level. The theoretical analysis is logical and reasonable.
A von Willebrand factor fragment containing the D′D3 domains is sufficient to stabilize coagulation factor VIII in mice
Authors: Yee Andrew , Gildersleeve Robert D. , Gu Shufang , Kretz Colin A. , McGee Beth M. , Carr Keisha M. , Pipe Steven W. , Ginsburg David
Published: May 2014

Key Points

The D′D3 domains of VWF are sufficient to stabilize FVIII in vivo. The prolongation of VWF D′D3 survival in vivo by Fc fusion elevates FVIII levels in the setting of VWF but not FVIII deficiency.
Interaction of TIF-90 and filamin A in the regulation of rRNA synthesis in leukemic cells
Authors: Nguyen Le Xuan Truong , Chan Steven M. , Ngo Tri Duc , Raval Aparna , Kim Kyeong Kyu , Majeti Ravindra , Mitchell Beverly S.
Published: May 2014

Key Points

Akt/FLNA/TIF-90 signaling regulates rRNA synthesis in acute myelogenous leukemia cells. Direct targeting of Akt has potential therapeutic applications in acute myelogenous leukemia treatment.
Consensus guidelines for the diagnosis and clinical management of Erdheim-Chester disease
Authors: Diamond Eli L. , Dagna Lorenzo , Hyman David M. , Cavalli Giulio , Janku Filip , Estrada-Veras Juvianee , Ferrarini Marina , Abdel-Wahab Omar , Heaney Mark L. , Scheel Paul J. , Feeley Nancy K. , Ferrero Elisabetta , McClain Kenneth L. , Vaglio Augusto , Colby Thomas , Arnaud Laurent , Haroche Julien
Published: May 2014

Erdheim-Chester disease (ECD) is a rare, non-Langerhans histiocytosis. Recent findings suggest that ECD is a clonal disorder, marked by recurrent BRAFV600E mutations in >50% of patients, in which chronic uncontrolled inflammation is an important mediator of disease pathogenesis. Although ∼500 to 550 cases have been described in the literature to date, increased physician awareness has driven a dramatic increase in ECD diagnoses over the last decade. ECD frequently involves multiple organ systems and has historically lacked effective therapies. Given the protean clinical manifestations and the lack of a consensus-derived approach for the management of ECD, we provide here the first multidisciplinary consensus guidelines for the clinical management of ECD. These recommendations were outlined at the First International Medical Symposium for ECD, comprised of a comprehensive group of international academicians with expertise in the pathophysiology and therapy of ECD. Detailed recommendations on the initial clinical, laboratory, and radiographic assessment of ECD patients are presented in addition to treatment recommendations based on critical appraisal of the literature and clinical experience. These formalized consensus descriptions will hopefully facilitate ongoing and future research efforts in this disorder.
Delivery, immediate newborn and cord care practices in Pemba Tanzania: a qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices
Authors: Dhingra Usha , Gittelsohn Joel , Suleiman Atifa Moh’d , Suleiman Shekhia Moh’d , Dutta Arup , Ali Said Mohammed , Gupta Shilpi , Black Robert E , Sazawal Sunil
Published: May 2014

Background

Deaths during the neonatal period account for almost two-thirds of all deaths in the first year of life and 40 percent of deaths before the age of five. Most of these deaths could be prevented through proven cost-effective interventions. Although there are some recent data from sub-Saharan Africa, but there is paucity of qualitative data from Zanzibar and cord care practices data from most of East Africa. We undertook a qualitative study in Pemba Island as a pilot to explore the attitudes, beliefs and practices of the community and health workers related to delivery, newborn and cord care with the potential to inform the main chlorhexidine (CHX) trial.

Methods

80 in-depth interviews (IDI) and 11 focus group discussions (FGD) involving mothers, grandmothers, fathers, traditional birth attendants and other health service providers from the community were undertaken. All IDIs and FGDs were audio taped, transcribed and analyzed using ATLAS ti 6.2.

Results

Poor transportation, cost of delivery at hospitals, overcrowding and ill treatment by hospital staff are some of the obstacles for achieving higher institutional delivery. TBAs and health professionals understand the need of using sterilized equipments to reduce risk of infection to both mothers and their babies during delivery. Despite this knowledge, use of gloves during delivery and hand washing before delivery were seldom reported. Early initiation of breastfeeding and feeding colostrum was almost universal. Hospital personnel and trained TBAs understood the importance of keeping babies warm after birth and delayed baby’s first bath. The importance of cord care was well recognized in the community. Nearly all TBAs counseled the mothers to protect the cord from dust, flies and mosquitoes or any other kind of infections by covering it with cloth. There was consensus among respondents that CHX liquid cord cleansing could be successfully implemented in the community with appropriate education and awareness.

Conclusion

The willingness of community in accepting a CHX cord care practice was very high; the only requirement was that a MCH worker needs to do and demonstrate the use to the mother.

Trial registration

ClinicalTrials.gov: NCT01528852
Protective effects of pomegranate (Punica granatum) juice on testes against carbon tetrachloride intoxication in rats
Authors: Al-Olayan Ebtesam M , El-Khadragy Manal F , Metwally Dina M , Abdel Moneim Ahmed E
Published: May 2014

Background

Pomegranate fruit has been extensively used as a natural medicine in many cultures. The present study was aimed at evaluating the protective effects of pomegranate (Punica granatum) juice against carbon tetrachloride (CCl4)-induced oxidative stress and testes injury in adult Wistar rats.

Methods

Twenty eight Wistar albino male rats were divided equally into 4 groups for the assessment of protective potential of pomegranate juice. Rats of group I (control) received only vehicles and had free access to food and water. Rats of groups II and IV were treated with CCl4 (2 ml/kg bwt) via the intraperitoneal route once a week for ten weeks. The pomegranate juice was supplemented via drinking water 2 weeks before and concurrent with CCl4 treatment to group IV. Group III was supplemented with pomegranate juice for twelve weeks. The protective effects of pomegranate on serum sex hormones, oxidative markers, activities of antioxidant enzymes and histopathology of testes were determined in CCl4-induced reproductive toxicity in rats.

Results

Pomegranate juice showed significant elevation in testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) those depleted by the injection of CCl4. Activity levels of endogenous testesticular antioxidant enzymes; superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase (GST) and glutathione reductase (GR) and glutathione (GSH) contents were increased while lipid peroxidation (LPO) and nitric oxide (NO) were decreased with pomegranate juice. Moreover, degeneration of germ and Leydig cells along with deformities in spermatogenesis induced after CCl4 injections were restored with the treatment of pomegranate juice.

Conclusion

The results clearly demonstrated that pomegranate juice augments the antioxidant defense mechanism against carbon tetrachloride-induced reproductive toxicity and provides evidence that it may have a therapeutic role in free radical mediated diseases.
Quality of life in rectal cancer patients after radical surgery: a survey of Chinese patients
Authors: Li Xinxin , Song Xinming , Chen Zhihui , Li Mingzhe , Lu Lifeng , Xu Ying , Zhan Wenhua , He Yulong , Xu Kaiwu
Published: May 2014

Background

We aimed to investigate the impact of sociodemographic and clinical characteristics on health-related quality of life (HRQoL) in disease-free survivors after radical surgery for rectal cancer in a Chinese mainland population.

Methods

We performed a cross-sectional survey from August 2002 to February 2011 by use of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR38 questionnaires of 438 patients who underwent curative surgery for rectal cancer. Patients who were followed up for a minimum of 6 months, had no relevant major comorbidities and whose disease had not recurred were asked to complete both questionnaires. The impact of sociodemographic and clinical characteristics on HRQoL were compared by univariate and multivariate regression analyses.

Results

In total, 285 patients responded to the survey (response rate, 65.1%). Psychological-related HRQoL variables such as emotional function (P = 0.021) and future perspectives (P = 0.044) were poorer for younger patients than for older patients; and physiological-related HRQoL was reflected by physical function (P = 0.039), which was poorer for older patients than for younger patients. In terms of physiologic function and symptoms concerning HRQoL, such as pain (P = 0.002) and insomnia (P = 0.018), females had lower values than males. Low education and unemployment were associated with a worse HRQoL. HRQoL was worse for patients with stomas compared to those without, especially in psychosocial areas such as role function (P = 0.025), social function (P <0.001) and body image (P = 0.004). Financial HRQoL was worse for younger patients and patients with stoma.

Conclusions

HRQoL aspects and degrees to which they were impaired after curative surgery for rectal cancer were different when compared by many sociodemographic and clinical factors in Chinese mainland patients.
Blind spectrum sensing for cognitive radio over time-variant multipath flat-fading channels
Authors: Zhao Chenglin , Sun Mengwei , Li Bin , Zhao Long , Peng Xiao
Published: May 2014

Cognitive radio has more extensive application in recent years, and it may operate in complex wireless environmental condition such as communication systems with time-variant multipath flat-fading channel. As an essential technology for cognitive radio, most existing spectrum sensing methods are designed for time-invariant propagation channel; thus, it could be extremely difficult to achieve acceptable sensing performance when we apply them to deal with time-variant multipath fading channel. In order to overcome this obstacle, we design a novel spectrum sensing method in this investigation. Firstly, a dynamic state-space model is proposed in which two different hidden Markov models are employed to abstract the evolution of primary user state and time-variant multipath flat-fading channel gain. Based on the dynamic state-space model, the spectrum sensing problem is formulated as blind estimation problem. Relying on maximum a posteriori probability criterion and particle filtering technology, a joint estimation algorithm of the time-variant channel gain and primary user state is presented. Experimental simulations demonstrate the superior performance of our presented sensing scheme, which could be used potentially in realistic cognitive radio systems.
Pluripotent muse cells derived from human adipose tissue: a new perspective on regenerative medicine and cell therapy
Authors: Simerman Ariel A , Dumesic Daniel A , Chazenbalk Gregorio D
Published: May 2014

In 2010, Multilineage Differentiating Stress Enduring (Muse) cells were introduced to the scientific community, offering potential resolution to the issue of teratoma formation that plagues both embryonic stem (ES) and induced pluripotent (iPS) stem cells. Isolated from human bone marrow, dermal fibroblasts, adipose tissue and commercially available adipose stem cells (ASCs) under severe cellular stress conditions, Muse cells self‐renew in a controlled manner and do not form teratomas when injected into immune‐deficient mice. Furthermore, Muse cells express classic pluripotency markers and differentiate into cells from the three embryonic germ layers both spontaneously and under media‐specific induction. When transplanted in vivo, Muse cells contribute to tissue generation and repair. This review delves into the aspects of Muse cells that set them apart from ES, iPS, and various reported adult pluripotent stem cell lines, with specific emphasis on Muse cells derived from adipose tissue (Muse‐AT), and their potential to revolutionize the field of regenerative medicine and stem cell therapy.
Pre- and postoperative alcohol consumption in breast cancer patients: impact on early events
Authors: Simonsson Maria , Markkula Andrea , Bendahl Pär-Ola , Rose Carsten , Ingvar Christian , Jernström Helena
Published: May 2014

Purpose

To investigate the association between pre- and postoperative alcohol consumption and risk for early breast cancer events, since the association between alcohol consumption and prognosis in breast cancer patients is unclear.

Methods

Alcohol consumption was recorded for 934 primary breast cancer patients who underwent breast cancer surgery in Lund, Sweden, between 2002 and 2011 and were followed until December 31st 2012. Clinical data were obtained from medical records and population registries. Pre- and postoperative alcohol consumption was analyzed in relation to risk for early events.

Results

Median follow-up time was 3.03 years and 100 breast cancer events, 65 distant metastases, and 76 deaths occurred. Compared to no consumption, any preoperative alcohol consumption was weakly associated with lower risk for early events, adjusted HR 0.69 (0.45-1.04), distant metastases, 0.60 (0.36-1.00) and death, 0.62 (0.38-1.01). In the 572 patients without axillary lymph node involvement, any alcohol consumption was not associated with risk for early events. However, in the 360 patients with axillary lymph node involvement, preoperative alcohol consumption was associated with lower risk for early events (adjusted HR 0.43 0.24-0.77; P
interaction = 0.01).

Conclusion

Pre- and postoperative alcohol consumption was weakly associated with lower risk for early breast cancer events. The data does not support recommending that all breast cancer patients abstain from low to moderate alcohol consumption.
Insight into the impact of diabetes mellitus on the increased risk of hepatocellular carcinoma: mini-review
Authors: Ali Kamkar Maisa Mahmoud , Ahmad Rasheed , Alsmadi Osama , Behbehani Kazem
Published: May 2014

Hepatocellular carcinoma is a multifactorial disease which is associated with a background of many causal risk factors. Diabetes mellitus however is one of the most common co-morbid illnesses found in hepatocellular carcinoma patients that are significantly associated with worsening of hepatocellular carcinoma development, patient prognosis and survival. Therefore, efforts have been focused on understanding the mechanisms underlying progression of hepatocellular carcinoma onset and development especially in diabetic patients. To our knowledge, there are no reports which address the impact of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) along with epigenetic regulations associated with increased risk of hepatocellular carcinoma confounded by diabetes mellitus. Therefore, this mini-review focuses on the possible intermediary mechanisms involved in worsening the onset and progression of hepatocellular carcinoma development confounded by diabetes mellitus. The first approach is to look at the role of inflammatory mediators (TNF-α and IL-6) in apoptosis and inflammation during hepatocarcinogenesis through monitoring levels of apoptotic regulators, B-cell lymphoma 2 protein which is encoded by BCL2 gene and apoptosis regulator BAX known as bcl-2-like protein 4 which is encoded by the BAX gene. The second approach is to focus on the possible epigenomic reprogramming that drives hepatocellular transformation since epigenetic modification of DNA is a key feature in the pathogenesis of hepatocarcinogenesis. Both approaches may suggest role of using Bcl2 and Bax as apoptotic and inflammatory markers for hepatocellular carcinoma detection as well as the importance impact of DNA methylation, hypomethylation or histone modifications as attractive candidates for early-detection biomarkers of hepatocellular carcinoma.
The prevalence of dyslipidemia in patients with diabetes mellitus of ayurveda Hospital
Authors: Dixit Amit Kumar , Dey Ranjit , Suresh Aela , Chaudhuri Siddhartha , Panda Ashok Kumar , Mitra Achintya , Hazra Jayram
Published: May 2014

Background

Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus. Early detection and treatment of dyslipidemia in type-2 diabetes mellitus can prevent risk for atherogenic cardiovascular disorder. The rationale of this study was to detect the lipid abnormality in diabetic patients.

Methods

Necessary data was collected from the medical archives of 150 patients (73 female and 77 male) with diabetes mellitus registered in Department of pathology and biochemistry of a Ayurveda hospital established at Kolkata, India.

Results

The mean ages of female and male subjects were 51.8 ± 10.8 and 53.2 ± 11.3 years respectively. The range and mean value of FBS in females were 113–342 mg/dl and 157.7 ± 6.3 mg/dl, while the range and mean value of PPBS in females were 135–560 mg/dl and 275.5 ± 12.3 mg/dl respectively. Results showed that range and mean value of FBS in males were 111–462 mg/dl and 160.8 ± 7.4 mg/dl, while the range and mean value of PPBS in males were 136–598 mg/dl and 302.1 ± 12.6 mg/dl respectively. Results of serum lipids showed that the mean values for total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) in female patients were 202.2 ± 5.9 mg/dl, 168.3 ± 8.2 mg/dl, 44.9 ± 1.3 mg/dl, 123.6 ± 5.2 mg/dl and 33.7 ± 1.7 mg/dl respectively. The mean values for TC, TG, HDL-C, LDL-C and VLDL-C in male patients were 182.5 ± 4.8 mg/dl, 128.1 ± 10.8 mg/dl, 40.8 ± 1.2 mg/dl, 105.4 ± 4.8 mg/dl and 36.2 ± 2.2 respectively. FBS showed significant positive correlation with PPBS, cholesterol, TG, and VLDL-C. PPBS also demonstrated direct and significant correlations with TG and VLDL-C.

Conclusions

The study showed common lipid abnormalities during diabetes induced dyslipidemia i.e., hypercholesterolemia, hypertriglyceridemia and elevated LDL-C. This study suggests the dominance of hyperlipidemia over increased prevalence of dyslipidemia.
Type 1 regulatory T cells specific for collagen type II as an efficient cell-based therapy in arthritis
Authors: Asnagli Hélène , Martire Delphine , Belmonte Nathalie , Quentin Julie , Bastian Hervé , Boucard-Jourdin Mathilde , Fall Papa Babacar , Mausset-Bonnefont Anne-Laure , Mantello-Moreau Amélie , Rouquier Sandrine , Marchetti Irène , Jorgensen Christian , Foussat Arnaud , Louis-Plence Pascale
Published: May 2014

Introduction

Regulatory T (Treg) cells play a crucial role in preventing autoimmune diseases and are an ideal target for the development of therapies designed to suppress inflammation in an antigen-specific manner. Type 1 regulatory T (Tr1) cells are defined by their capacity to produce high levels of interleukin 10 (IL-10), which contributes to their ability to suppress pathological immune responses in several settings. The aim of this study was to evaluate the therapeutic potential of collagen type II–specific Tr1 (Col-Treg) cells in two models of rheumatoid arthritis (RA) in mice.

Methods

Col-Treg clones were isolated and expanded from collagen-specific TCR transgenic mice. Their cytokine secretion profile and phenotype characterization were studied. The therapeutic potential of Col-Treg cells was evaluated after adoptive transfer in collagen-antibody– and collagen-induced arthritis models. The in vivo suppressive mechanism of Col-Treg clones on effector T-cell proliferation was also investigated.

Results

Col-Treg clones are characterized by their specific cytokine profile (IL-10highIL-4negIFN-γint) and mediate contact-independent immune suppression. They also share with natural Tregs high expression of GITR, CD39 and granzyme B. A single infusion of Col-Treg cells reduced the incidence and clinical symptoms of arthritis in both preventive and curative settings, with a significant impact on collagen type II antibodies. Importantly, injection of antigen-specific Tr1 cells decreased the proliferation of antigen-specific effector T cells in vivo significantly.

Conclusions

Our results demonstrate the therapeutic potential of Col-Treg cells in two models of RA, providing evidence that Col-Treg could be an efficient cell-based therapy for RA patients whose disease is refractory to current treatments.