bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multidimensional Spectral Description of Ocean Variability
Authors: Wortham Cimarron , Wunsch Carl
Published: November 2013

An updated empirical, analytical model for the frequency and wavenumber distribution of balanced motion in the ocean is presented. The spectrum model spans periods longer than the inertial but shorter than a decade and wavelengths between 100 and 10 000 km. Assuming geostrophic dynamics, a spectrum model for the streamfunction is constructed to be consistent with a range of observations, including sea surface height from satellite altimetry, velocity from moored and shipboard instruments, and temperature from moorings. First-order characteristics of the observed spectra, including amplitude and spectral moments, vary slowly geographically. The spectrum model is horizontally anisotropic, accommodating observations that zonal wavenumber–frequency spectra are dominated by a “nondispersive line.” Qualitative and quantitative agreement is found with one-dimensional frequency and wavenumber spectra and observed vertical profiles of variance. Illustrative application is made of the model spectrum to observing-system design, data mapping, and uncertainty estimation for trends.
Social work, exclusionary populism and xenophobia in Italy
Authors: Fazzi Luca
Published: November 2013

The relationship between the emergence of political populism and social work has not been well investigated. This article reports the results of research conducted by means of in-depth interviews and questionnaires on a sample of 90 social workers employed by municipalities governed by populist parties in Italy, where the phenomenon of xenophobic politics has recently grown to particularly worrying proportions. The article describes the effects of populist programmes on social work and highlights the different reactions of social workers in response to the new scenario.
Criminal Propensity, Social Context, and Recidivism
Authors: Wang Xia , Hay Carter , Todak Natalie Erin , Bales William
Published: November 2013

With almost 700,000 inmates released annually in the United States, the predictors of successful reentry have received considerable attention. Prior research documents that recidivism is influenced by both ex-inmate characteristics and social context. Little attention, however, has been paid to the role social context might play in moderating the effects of individual-level risk factors. Using inmate release data from the Florida Department of Corrections and other sources, we examine whether contextual factors that promote crime and antisocial behavior amplify the association between individual criminal propensity and recidivism. Our analysis offers limited support for the moderating effects of context, suggesting that the relationship between criminal propensity and recidivism is substantial and largely independent of community characteristics. We discuss the implications of the findings for theory, research, and policy.
The Persistence of Neighborhood Disadvantage
Authors: Topalli Volkan , Giancola Peter R. , Tarter Ralph E. , Swahn Monica , Martel Michelle M. , Godlaski Aaron J. , Mccoun K. Todd
Published: November 2013

This research examined the combined impact of alcohol and previous experience growing up in a disadvantaged neighborhood on aggression in a laboratory setting. Participants were 505 young adult social drinkers between 21 and 35 years of age who completed a retrospective measure of neighborhood disadvantage and then participated in an experimental procedure, where they either consumed an alcohol or placebo beverage. They were subsequently tested on a laboratory aggression task in which they were provoked by receiving electric shocks from a fictitious opponent under the guise of a competitive reaction-time task. Aggression was operationalized as shock intensities and durations administered, in retaliation, by the participants to their fictitious opponent. Acute alcohol intoxication significantly increased aggression for those who grew up in disadvantaged neighborhoods. Thus, our investigation supports Sampson’s notions of “legacies of neighborhood inequality” with important implications for the etiology and prevention of violence in real-world settings.
Controllability of a class of switching control systems and application to the Kinetic Battery Model
Authors: Zhai Shidong , Yang Xiao-Song
Published: November 2013

This paper is concerned with the controllability of a class of switching control systems in which the zero control is an extreme point of the control constraint set. Sufficient and necessary conditions for local controllability at the origin of such systems are presented. In addition, sufficient conditions for local controllability at a nonzero state of such systems are established. Finally, we use the obtained results to study the controllability of the Kinetic Battery Model.
The Nonprofit Clinic at the University of Pittsburgh: preparing students for transition to professional settings
Authors: Kearns Kevin P
Published: November 2013

The Nonprofit Clinic at the University of Pittsburgh gives graduate students the opportunity to serve as management consultants to nonprofit organizations. This article describes the learning objectives, logistics, and outcomes of the Nonprofit Clinic. Bloom’s 1956 taxonomy of learning objectives is employed to assess learning outcomes.
How Far to the Road Not Taken? The Effect of Psychological Distance on Counterfactual Direction
Authors: Rim SoYon , Summerville Amy
Published: November 2013

Upward and downward counterfactuals serve the distinct motivational functions of self-improvement and self-enhancement, respectively. Drawing on construal level theory, which contends that increasing psychological distance from an event leads people to focus on high-level, self-improvement versus low-level, self-enhancement goals, we propose that distance will alter counterfactual direction in a way that satisfies these distinct motives. We found that people generated more downward counterfactuals about recent versus distant past events, while they tended to generate more upward counterfactuals about distant versus recent past events (Experiment 1). Consistent results were obtained for social distance (Experiment 2). Experiment 3 demonstrated that distance affects the direction of open-ended counterfactual thoughts. Finally, Experiment 4 explored a potential mechanism, demonstrating that manipulating temporal distance produced changes in participants’ self-improvement versus self-enhancement motivations when responding to negative events. Future directions and broader implications for self-control, social support, empathy, and learning are discussed.
Can the Formation of Conditioned Attitudes Be Intentionally Controlled?
Authors: Gawronski Bertram , Balas Robert , Creighton Laura A.
Published: November 2013

Evaluative conditioning (EC) is defined as the change in the evaluation of a conditioned stimulus (CS) due to its pairing with a valenced unconditioned stimulus (US). Counter to views that EC is the product of automatic learning processes, recent research has revealed various characteristics of nonautomatic processing in EC. The current research investigated whether the formation of conditioned attitudes can be intentionally controlled. Whereas EC effects on self-reported evaluations were reduced (enhanced) when participants were instructed to prevent (promote) the influence of CS-US pairings, EC effects on an evaluative priming measure remained unaffected by control instructions. Moreover, although EC effects on self-reported evaluations varied as a function of evaluative priming effects and recollective memory for CS-US pairings, motivation to control the influence of CS-US pairings qualified only the predictive relation of recollective memory. The results highlight functionally distinct contributions of uncontrollable encoding-related processes and controllable expression-related processes to EC effects.
A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations
Authors: Ayers Phil , Adams Stephen , Boullata Joseph , Gervasio Jane , Holcombe Beverly , Kraft Michael D. , Marshall Neil , Neal Antoinette , Sacks Gordon , Seres David S. , Worthington Patricia ,   American Society for Parenteral and Enteral Nutrition
Published: November 2013

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risks for adverse events. Complications can occur as a result of the therapy and as the result of the PN process. These consensus recommendations are based on practices that are generally accepted to minimize errors with PN therapy, categorized in the areas of PN prescribing, order review and verification, compounding, and administration. These recommendations should be used in conjunction with other A.S.P.E.N. publications, and researchers should consider studying the questions brought forth in this document.
A case of left atrial myxoma with unusual tumor vascularity
Authors: Shabestari Mahmoud Mohammadzadeh , Fazlinezhad Afsoon , Moravvej Zahra , Tashnizi Mohammad Abbasi , Azari Ali , Bigdelu Leila
Published: November 2013

A 69-year-old woman presented with a 2-week history of chest pain and mitral and aortic valve replacement 15 and 5 years earlier. Transthoracic echocardiography revealed a well-seated monoleaflet mitral valve and a bileaflet aortic valve with normal function. Cardiac catheterization showed 3-vessel coronary artery disease and an abnormal cluster of new vessels derived from the left atrial circumflex and posterior ventricle branches. Two- and 3-dimensional transesophageal echocardiography identified a semi-mobile oval left atrial mass with multiple internal cystic spaces, attached to the fossa ovalis region in the interatrial septum. The mass was resected. The pathological diagnosis was atrial myxoma.
An analysis of attitudes towards the gifted students with learning difficulties using two samples of Greek and Czech primary school teachers
Authors: Gari Aikaterini , Mylonas Kostas , Portešová Sarka
Published: November 2013

The provision of gifted students with learning difficulties (GSLD) composes a complicated educational problem that deserves special care. This study explores teachers’ attitudes towards the GSLD in two samples of primary school teachers: 225 Greek teachers and 158 teachers in the Czech Republic, 40–59 years of age and with 14–28 years of teaching experience. A questionnaire of 26 questions, created for the purpose of this study, was administered referring to teachers’ attitudes towards opinions and information regarding the GSLD characteristics, along with three open-ended questions on the most preferable types of the GSLD educational provision. Through multidimensional scaling solutions in their trigonometric transformation (MDS-T) one large common and one minor separate system of items emerged for the two samples, which were meaningful in the direction of understanding teachers’ difficulties in accepting the contradictory core of the GSLD characteristics and educational needs. These systems of attitudes are discussed in respect to their relative importance to Czech and Greek teachers and the respective educational settings.
Vitamin D deficiency as a cause of chronic pain in the palliative medicine clinic: Two case reports
Authors: Whitehurst Jane L , Reid Colette M
Published: November 2013

Background:

Vitamin D deficiency is common in the general population and has been implicated as a cause of chronic pain. The palliative care population has a number of risk factors for vitamin D deficiency. We present two cases of unexplained pain in patients attending the palliative medicine outpatient clinic that improved after vitamin D replacement.

Cases:

Case 1 is a 46-year-old man with thalassaemia intermedia and back and leg pain without a clear cause. Case 2 is a 28-year-old woman undergoing treatment for cervical cancer whose initial disease and treatment-related abdominal pain resolved but subsequently reported ongoing non-specific aches and pains.

Case management:

Both patients were found to have vitamin D levels <50 nmol/L and were treated with vitamin D replacement therapy.

Case outcome:

Following vitamin D replacement therapy, pain resolved in both patients allowing a reduction in analgesic therapy.

Conclusions:

The prevalence of vitamin D deficiency in the palliative care population merits further investigation, since these patients are at high risk of deficiency. Having an index of suspicion, particularly in those patients with known risk factors and pain that is not fully explained, may result in better pain control and functional outcomes.
Is balloon kyphoplasty better than percutaneous vertebroplasty for osteoporotic vertebral biconcave-shaped fractures?
Authors: Gan Minfeng , Zou Jun , Song Dawei , Zhu Xuesong , Wang Genlin , Yang Huilin
Published: November 2013

Background

Osteoporotic vertebral biconcave-shaped fractures are not commonly seen in clinical practice. Some articles have been published showing the outcome of vertebroplasty (PV) and balloon kyphoplasty (BKP), but few comparative studies have been performed.

Purpose

To compare the effect and safety of PV and BKP in treating osteoporotic vertebral biconcave-shaped fractures.

Material and Methods

In this retrospective comparative study, 38 patients with osteoporotic vertebral biconcave-shaped fractures were treated by PV, and 41 patients were treated by BKP from May 2005 to July 2011. The heights of the compromised vertebral body and the kyphotic angles were measured. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate pain and functional activity, respectively. The occurrence of refracture and cement leakage were determined, and the costs were recorded.

Results

The mean VAS and ODI scores significantly improved for both procedures at postsurgical measurements ( P < 0.05), and the improvement sustained at the final follow-up. In both groups, there were no significant differences in terms of restoration of the anterior vertebral height and correction of the kyphotic deformity. However, BKP was more effective in restoring the middle vertebral height than PV. Cement leakages were observed in nine (23.7%) treated vertebral bodies in PV group and in three (7.4%) treated vertebral bodies in BKP group, which was a statistically significant difference ( P < 0.05). There were four new osteoporotic vertebral fractures in the PV group and two in the BKP group during the follow-up period. The mean cost in the BKP group (6200 ± 122.1 USD) was higher than the PV group (2100 ± 112.5 USD) ( P < 0.05).

Conclusion

Both PV and BKP achieved similar improvements in pain and functional outcomes for the treatment of osteoporotic vertebral biconcave-shaped fractures. BKP had a significant advantage over PV in terms of the restoration of the middle vertebral height and fewer cement leakages than PV.
Prevalence and types of coronary to pulmonary artery fistula in a Chinese population at dual-source CT coronary angiography
Authors: Zhang Long Jiang , Zhou Chang Sheng , Wang Yining , Jin Zhengyu , Yu Wei , Zhang Zhaoqi , Zhang Bo , Fang Xiangming , Cui Xingyu , Li Kai , Huang Wei , Zheng Ling , Ji Xue Man , Hoffman Cane , Schoepf U Joseph , Lu Guang Ming
Published: November 2013

Background

Coronary to pulmonary artery fistula (CPAF) is rare; reports on the prevalence and types of CPAF in a large cohort of patients are scarce.

Purpose

To analyze the prevalence and types of CPAF on computed tomography coronary angiography (CTCA) in a large Chinese population.

Material and Methods

CTCA data of 58,533 patients from five Chinese tertiary referral medical centers were retrospectively studied. The prevalence, origin, aneurysmal sac, fistula tracts, and extracardiac communication of CPAF were recorded. CTCA findings were compared with conventional coronary angiography when possible.

Results

Ninety-nine patients had CPAF (prevalence of 0.17%). Of the 99 CPAF cases, fistulas were found to originate from either both coronary arteries in 52 patients or from one coronary artery (33 cases from the left and 14 cases from the right coronary artery). Ten CPAF patients were complicated with the communication of extracardiac arteries. Fifteen (15.2%) CPAF patients had aneurysmal sac formation. Thirty (30.3%) patients had a single fistula tract, while 69 (69.7%) patients had multiple fistula tracts. CTCA findings in 16 patients were similar to those at DSA.

Conclusion

Based on this large cohort, the prevalence of CPAF in the Chinese population is about 0.17%, with origin from either the left or right coronary artery or from both. CTCA can clearly visualize the types, abnormal vascular tracts, and aneurysmal sac formation of CPAF.
Chest CT findings of pleural tuberculosis: differential diagnosis of pleural tuberculosis and malignant pleural dissemination
Authors: Kim Jin Sil , Shim Sung Shine , Kim Yookyung , Ryu Yon Ju , Lee Jin Hwa
Published: November 2013

Background

The imaging features of pleural tuberculosis (PTB) can be similar to those of malignant pleural dissemination (MPD) with several case reports of CT findings in atypical presentations of PTB.

Purpose

To describe the computed tomography (CT) features of PTB by comparing these imaging findings with those of MPD and to use the results to differentiate between the two diseases.

Material and Methods

The study included 135 patients with PTB and 69 with MPD. The CT images were assessed in terms of the presence, extent, and contour of pleural thickening. Pleural nodules were analyzed in terms of number, size, and location. The CT findings of PTB and MPD were compared.

Results

The CT findings of PTB included circumferential pleural thickening (32.6%), mediastinal pleural involvement (31.9%), nodular thickening (8.9%), and pleural thickening >1 cm (2.2%). The CT features of MPD included nodular pleural thickening (56.5%), mediastinal pleural involvement (40.6%), circumferential thickening (23.2%), and pleural thickening >1 cm (7.2%). Comparing PTB and MPD, nodular pleural thickening was observed more frequently with MPD than PTB ( P <0.001).

Conclusion

Nodular pleural thickening is observed in 8.9% of the patients with PTB on chest CT. Comparing PTB and MPD, nodular pleural thickening was the only finding significantly associated with MPD, particularly with nodules >10 mm.
The perfect enemy: Maps, laws and sacrifice in the making of borders
Authors: Mathur Shubh
Published: November 2013

Borders are as much social and historical constructs as they are physical entities and run through geographies of the mind as well as over physical landscapes. It is in the borderlands that the narratives of nationhood begin to crumble, where they must be upheld through the full range of the techniques of domination. This paper examines three facets of the maintenance of borders of the post-Independence Indian nation-state. First, the creation of maps which are not mere instruments of utility or direct transcriptions of reality but rather a mixture of historical and political meanings and aspirations. Indian laws regarding maps and borders criminalize any representations of these which do not conform to the official version, even if used for purposes of political or academic discussion or debate. Such laws draw upon archaic, nineteenth century notions of sedition, and in seeking to uphold the “territorial integrity of the nation” serve only to highlight the arbitrary and contingent nature of national boundaries. Second, the laws of exception in effect in the borderlands of Kashmir and the northeast, which give the Indian military absolute power in dealing with the civilian population. In providing immunity from prosecution to military personnel accused of human rights violations, they serve to define the population of the borderlands as those who may be killed with impunity. Third, the maintenance of borders in the mind through public spectacles and displays such as the trial and sentencing of Afzal Guru, a Kashmiri Muslim executed by India, for his alleged role in the attack on the Indian parliament in December 2001. Anthropological writing on sacrifice, particularly the classic work of Hubert and Mauss, is relevant to understanding the meanings and consequences of this performance as it relates to the construction of the national community, its borders and its enemies.
Bargaining demolition in China: A practice of distrust
Authors: Ho Cheuk Yuet
Published: November 2013

This paper presents multivocal exchanges between evictees and frontline demolition personnel regarding urban housing demolition in China. I discovered that evictees and evictors alike stick to the official rules but contest vigorously the interpretation, each in accordance with their tacit understanding of the norm of practising demolition and particular tactics of bending the rules of compensation. This paper provides a detailed, rarely available ethnographic record of the encounters between evictees and evictors, and contributes to the study of how agents strategise and interact within a habitus of micro-power relationships. It is concluded that the agency of various players is simultaneously reproducing the social structure but paradoxically working to sabotage the very structure within which they practice .
The Ligamentum Teres Test
Authors: O’Donnell John , Economopoulos Kostas , Singh Parminder , Bates Daniel , Pritchard Michael
Published: November 2013

Background:

A ligamentum teres (LT) injury is a common finding at the time of hip arthroscopic surgery in patients with chronic groin and hip pain; however, LT tears have been difficult to identify before surgery. There have been no unique features identified on history assessment, physical examination, or imaging that reliably identify injuries of the LT preoperatively.

Purpose:

To report a new clinical examination to assess the presence of an LT tear: the LT test.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

The study consisted of 75 patients undergoing hip arthroscopic surgery for multiple lesions. Each patient was evaluated by 2 independent examiners using the LT test, leading to a total of 150 tests being performed. The LT test is conducted with the hip flexed at 70° and 30° short of full abduction; the hip is then internally and externally rotated to its limits of motion. Pain on either internal or external rotation is consistent with a positive LT test result. Hip arthroscopic surgery was then performed and all intra-articular abnormalities noted. Arthroscopic images were taken of each LT and examined by a third independent examiner who determined the presence or absence of a tear. Clinical examination findings were compared with the arthroscopic findings to determine the sensitivity, specificity, and positive and negative predictive values. In addition, the presence of intra-articular pathological lesions was compared with the test results to determine if there was a correlation between the presence of an intra-articular pathological abnormality and a positive LT test result.

Results:

Of the 150 examinations performed, the test result was positive 55% of the time (77 examinations). The sensitivity and specificity of the test were 90% and 85%, respectively. The positive predictive value was 84%, and the negative predictive value was 91%. The presence of an LT tear, pincer lesion, and labral tear that required repair was associated with a positive LT test result. The κ coefficient for interobserver reliability was .80.

Conclusion:

The LT test is an effective way of assessing the presence of LT tears with moderate to high interobserver reliability. In addition to an LT tear, the presence of a pincer lesion or labral tear requiring repair are also associated with a positive LT test result.
Hidden Dense Middle Cerebral Artery Sign in a 4-Year-Old Boy With Traumatic Subarachnoid Hemorrhage
Authors: Kim Bum-Joon , Choi Jong-Il , Ha Sung-Kon , Lim Dong-Jun , Kim Sang-Dae
Published: November 2013

A 4-year-old boy was admitted with acute onset of hemiplegia of the right side that was secondary to a traffic accident. Initial computed tomography revealed a traumatic subarachnoid hemorrhage, and follow-up computed tomography showed a more localized hematoma of the left sylvian cistern. After a few days of conservative treatment, magnetic resonance imaging (MRI) revealed a cerebral infarction of the left lenticulostriate territory, even though magnetic resonance angiography showed preserved middle cerebral artery flow. Thus, we realized that the hematoma of the sylvian cistern was the so-called dense middle cerebral artery sign. This case of posttraumatic infarction suggested the importance of meticulous investigations and clinical correlations of imaging studies in pediatric patients with head injuries.
High-temperature creep behavior of wheat straw isotactic/impact-modified polypropylene composites
Authors: Tajvidi Mehdi , Simon Leonardo C
Published: November 2013

Short-term creep behavior of wheat straw composites made with either polypropylene homopolymer or impact-modified copolymer was studied at elevated temperatures (50–90°C). Various mineral fillers were tried to enhance creep resistance in the composite materials among which wollastonite was found to be the most effective one. All formulations exhibited higher creep deformations at higher temperatures where the effect of temperature was more pronounced for composites containing the impact-modified copolymer as the matrix. Short-term creep was successfully modeled using a three-parameter power law and Burgers model, and the dependence of the power law model parameters on temperature was evaluated to quantify temperature dependence of creep behavior. Long-term creep at 50°C was predicted based on the short-term data using the time–temperature superposition (TTS) principle, the power law model, and the Burgers model, and the results were compared with actual long-term data. While TTS was found to be the best method to accurately extrapolate short-term data, the failure of the two other methods was found to be related to the time scale of the deformation in short-term creep tests. The results of this study will provide a basis for the design of natural fiber thermoplastic composites to be used in under the hood applications in auto industry.
Trade Associations and the Legitimation of Entrepreneurial Movements
Authors: Esparza Nicole , Walker Edward T. , Rossman Gabriel
Published: November 2013

Trade associations are an important topic of investigation for nonprofit and voluntary sector researchers because they serve civic purposes and help to support innovative areas of entrepreneurship. We examine how local trade associations in the emerging gourmet food truck industry help to reduce uncertainty and augment industry legitimacy by (a) representing collective interests when challenged by regulators and incumbents (e.g., restaurants), (b) generating collective identity and creating cultural capital, and (c) providing a regime to manage “tragedies of the commons,” procure club goods, and promote self-regulation. We draw on social media data and narrative accounts by industry activists to explicate the evolution of the field from 2008 to 2012 in 11 cities. Findings suggest that trade associations, as an often-overlooked type of mutual benefit association, are key players in the legitimation of creative industries.
Delamination damage analysis of laminated bonded tubular single lap joint made of fiber-reinforced polymer composite
Authors: Das Rashmi Ranjan , Pradhan Brajabandhu
Published: November 2013

Onset and growth of delamination damages in laminated fiber-reinforced polymer composite made bonded tubular single lap joints have been thoroughly studied through a finite element analysis-based simulation technique developed in the present research. The model provides sufficient scope for a comprehensive parametric study of the bonded structure in terms of three-dimensional stress analyses within the joint, studying the delamination damage onset and growth characteristics, and investigating its effect on stress distributions in the joint and both the adherends (outer and inner). Quadratic failure criterion has been used to depict delamination damage-induced cohesion failure within the adhesive layer. Whereas Tsai–Wu coupled stress criterion has been used for locating the delamination and adhesion failure prone regions at ply-interfaces of the adherends and adherend–adhesive interfaces within the joint, respectively. Three-dimensional stress analyses revealed that outer adherend of the bonded tubular single lap joints experiences comparatively higher interlaminar peel ([Formula: see text]) and shear stress ([Formula: see text]) concentrations at the free edge of the first ply-interface and is likely to delaminate at this edge. Accordingly, pre-embedded through-the-circumference delamination damages have been simulated at this edge, and contact finite element analyses have been performed in order to avoid interpenetration of delaminated surfaces. Strain energy release rate calculated using modified crack closure integral vis-à-vis virtual crack closure technique has been used as the characterizing parameter for assessing the growth of the damages. Free edge delamination in the outer adherend has been observed to propagate in a self-similar manner mainly in the in-plane shearing mode. It causes peel and shear stress concentrations in regions of the adherend–adhesive interfaces and first ply-interface of the inner adherend, localized to the clamped edge of the joint making the joint and the adherend prone to adhesion failure and delamination damage, respectively.
Pharmacologic Therapy for Erectile Dysfunction and its Interaction With the Cardiovascular System
Authors: Ioakeimidis Nikolaos , Kostis John B.
Published: November 2013

Phosphodiesterase (PDE) enzymes are widely distributed throughout the body, having numerous effects and functions. The PDE type 5 (PDE5) inhibitors are widely used to treat erectile dysfunction (ED). Recent, intense preclinical and clinical research with PDE5 inhibitors has shed light on new mechanisms and has revealed a number of pleiotropic effects on the cardiovascular (CV) system. To date, PDE5 inhibition has been shown to be effective for the treatment of idiopathic pulmonary arterial hypertension, and both sildenafil and tadalafil are approved for this indication. However, current or future PDE5 inhibitors have the potential of becoming clinically useful in a variety of CV conditions such as heart failure, coronary artery disease, and hypertension. The present review discusses recent findings regarding pharmacologic treatment of ED and its interaction with the CV system and highlights current and future clinical applications beyond ED.
Fitness for purpose when there are many different purposes: Who are electronic patient records for?
Authors: Eason Ken , Waterson Patrick
Published: November 2013

Electronic patient record systems serve many purposes for many different kinds of users. Four case studies are reported of the use made by health-care staff of electronic patient record systems that supported health-care pathways. The results demonstrate that the systems fit the purposes of strategic and managerial users of the record, but they are problematic as tools for use by the frontline staff delivering care. As a result, these staff frequently resort to workarounds to accomplish their work goals. An analysis of the design processes that created these systems shows that the specification of the systems was based on strategic and managerial requirements and there was no formal assessment of the needs of frontline users. Efforts to address the needs of frontline staff in the provisions of electronic systems were most often made after the main system was implemented.
Delayed Treatment Seeking Following the April 16th Shootings at Virginia Tech: Impact on a First Responder
Authors: Golden Lauren L. , Jones Russell T. , Donlon Katharine
Published: November 2013

This case study discusses the treatment of an emergency responder to the 2007 shooting on Virginia Tech’s campus where 33 students and faculty members were killed. After a thorough assessment, prolonged exposure (PE) was used to treat the emergency worker, referred to as Jack, for posttraumatic stress disorder (PTSD). Assessment measures administered at the conclusion of treatment, 1 month post-treatment, and 6 months post-treatment suggest that the treatment gains were maintained following the culmination of treatment. The primary aim of this article is to provide support for the effectiveness of PE among emergency responders who develop PTSD. In addition, this case presentation is particularly important given the prevalence of mass shootings in the United States. Several complicating factors, including a delay in treatment seeking, arose over the course of treatment and are discussed.
Food Allergy
Authors: Conroy Michelle E.
Published: November 2013

Food allergy has established itself as a matter of significant public health importance and relevance. It has had substantial impacts across the world and continues to represent the most common cause of anaphylaxis seen in emergent settings. However, its increasing incidence has yielded a silver lining of increased interest and investment, which has powered major research in the field. Much has been learned about food allergy as a result. Recent work has elicited increased understanding about food allergy prevalence, mechanisms, and risk factors. In turn, this has allowed for application of this understanding to potential treatments. Current practice of food allergy treatment through restricted exposure may ultimately be replaced with novel therapies including, perhaps ironically, introduction of the allergenic foods in question. This review presents broad highlights of the rapidly increasing understanding into food allergy mechanisms and experimental therapies.
Role stress revisited
Authors: Conley Sharon , You Sukkyung
Published: November 2013

A previous study examined role stress in relation to work outcomes; in this study, we added job structuring antecedents to a model of role stress and examined the moderating effects of locus of control. Structural equation modeling was used to assess the plausibility of our conceptual model, which specified hypothesized linkages among teachers' perceptions of (a) mechanistic/organic job structuring, (b) role ambiguity, role conflict, and role overload, and (c) commitment, satisfaction, and intentions to leave the school. Respondents to survey questions designed to capture the above constructs included 177 teachers in seven moderately sized comprehensive high schools in Southern California. Results indicated that predicted patterns of relationships were partially moderated by locus of control. The study suggests ways to reduce role stress and enhance the work outcomes of teachers through identifying an appropriate job structure.
Facing the ‘challenge’
Authors: Hajisoteriou Christina , Angelides Panayiotis
Published: November 2013

The overarching purpose of this study is to examine the prospects of school leadership for the development of intercultural education. The article focuses on the ways in which Greek-Cypriot headteachers conceptualize: diversity and intercultural education; and their school leadership roles in culturally diverse settings. To this extent, interviews were carried out with the headteachers of 20 primary schools, which presented high concentrations of immigrant students. In general, two main approaches concerning intercultural education were identified: cultural-deprivation and cultural-celebration. Headteachers, who fostered assimilation in their schools, adopted a transactional leadership style the goal of which was ‘unobstructed’ and ‘unproblematic’ operation of their schools. Conversely, headteachers, who ‘celebrated’ diversity in their schools, opted for the transformation of their school cultures by promoting immigrant parental involvement and community liaison. Nonetheless, there was a third category of headteachers, who held container concepts of diversity, pertaining to both cultural-deficit and cultural-celebration approaches. These headteachers proclaimed the transformation of their schools to accommodate diversity by creating collaborative networks in their schools. However, such suggestions seemed to be rhetorical, while in practice they seemed to seek assimilation.
Comparative efficacy and adverse effects of the addition of ezetimibe to statin versus statin titration in chronic kidney disease patients
Authors: Suzuki Hiromichi , Watanabe Yusuke , Kumagai Hiroo , Shuto Hiroshi
Published: November 2013

Background and Objectives:

The recent SHARP trial clearly demonstrated that a reduction in low-density lipoprotein (LDL) cholesterol with a daily regimen of simvastatin plus ezetimibe safely reduced the incidence of major atherosclerotic events in patients with chronic kidney disease (CKD). We aimed to compare the efficacy of and adverse effects from statin uptitration versus statin in combination with ezetimibe since only a few studies have addressed this question.

Methods:

This was a randomized, open-label, multicenter trial that included 286 patients with CKD whose LDL cholesterol levels were not reduced below 120 mg/dl despite a minimum dose of statin therapy. Patients received double doses of statin or usual statin dose with the addition of ezetimibe 10 mg daily. The observation period was 1 year during which time patients were checked regularly in clinic for adverse effects as well as for usual laboratory examinations. The key prespecified outcome was the incidence of adverse effects, which included skeletal muscle complaints, myalgia, muscle weakness, and muscle cramps with and without elevated CK levels. Increases in alanine transaminase (ALT) or aspartate transaminase (AST) levels >2 times the upper limit of normal (ULN) were considered clinically significant adverse effects.

Results:

Adverse events occurred in 9/145 in the combination group and in 24/141 in the statin uptitration group ( p < 0.01). Moreover, in patients with CKD of stages 3–5, rates were 6/58 in the combination group versus 20/52 in the statin uptitration group ( p < 0.01). No serious adverse effects such as rhabdomyolysis were noted in either group. Serum creatinine levels remained essentially unchanged in both groups except in CKD stages 4 and 5. Reductions in LDL cholesterol were similar between the two groups at the start of and at the end of the study. During the study, no atherosclerotic events were reported in either group.

Conclusion:

When statin uptitration produces adverse effects such as myopathy, combination therapy with ezetimibe is recommended instead of statin alone.
Experience with botulinum toxin type A in the treatment of neurogenic detrusor overactivity in clinical practice
Authors: Knuepfer Stephanie , Juenemann Klaus-Peter
Published: November 2013

Control of the lower urinary tract is a complex, multilevel process that involves both the peripheral and central nervous system. Neurogenic lower urinary tract dysfunction (LUTD) is a widespread chronic illness that impairs millions of people worldwide. Neurogenic LUTD has a major impact on quality of life, affecting emotional, social, sexual, occupational and physical aspects of daily life, and in addition to the debilitating manifestations for patients, it also imposes a substantial economic burden on every healthcare system. First-line treatment for neurogenic LUTD includes antimuscarinics and some form of catheterization, preferably intermittent self-catheterization. However, the treatment effect is often unsatisfactory, so that other options have to be considered. Moreover, neurogenic LUTD is a challenge because all available treatment modalities (i.e. conservative, minimally invasive and invasive therapies) may fail. In recent years, botulinum neurotoxin type A (BoNT/A) treatment has been shown to be an effective pharmacological therapy option in patients refractory to antimuscarinic and neurogenic detrusor overactivity (NDO). Several studies have shown that BoNT/A injection significantly reduces detrusor muscle overactivity. Also BoNT/A treatment of NDO has revealed a significant improvement of lower urinary tract function with regard to reduced urinary incontinence, reduced detrusor pressure, increased bladder capacity and improved quality of life in NDO.
Spatial and Temporal Trends in New Cases of Men with Modified Teeth from Sweden (AD 750–1100)
Authors: Kjellström Anna
Published: November 2013

Vikings with artificially modified teeth have previously been documented in the south-eastern parts of Scandinavia and in England. In a project dealing with life in the Mälaren Valley in Sweden during the period AD 750–1100, new cases of people with modified maxillary teeth were observed. The hypothesis that the practice was entirely associated with adult men dating to the Viking Age was tested. The new cases demonstrate that the habit extended to eastern-central Sweden, including the proto-town of Birka, perhaps as early as in the middle of the eighth century. Additionally, cases from Sigtuna show that the practice may have ended as late as the beginning of the twelfth century. A microanalysis, using a scanning electron microscope, showed the heterogeneous character of the modifications. The affected individuals were all adult men, similar to previously published cases. Some of the men are associated with weapons and violent acts and the cases from Sigtuna were all from cemeteries with a possible association with lower social strata. However, discrepancies in archaeological contexts and in the characteristics of the modifications suggest temporal and spatial variation in the social meaning of the modifications.
Short-term impact of oral hygiene training package to Anganwadi workers on improving oral hygiene of preschool children in North Indian City
Authors: Raj Sonika , Goel Sonu , Sharma Vijay Lakshmi , Goel Naveen Krishan
Published: November 2013

Background

Globally, dental caries is categorized in the list of public health problems in preschool children. In India, lack of availability and affordability of oral health enhances the cost of treatment and care. Empowering community workers like anganwadi workers (AWWs) in oral health, and providing basic oral health awareness to the mothers through them can be feasible model. So, the present study was conducted to evaluate the short-term impact of Oral Hygiene Training Package (OHTP) to AWWs on improving oral hygiene of preschool children.

Methods

This before and after comparison field trial was done in Anganwadi centres (AWCs) of Chandigarh city, India. 534 children aged 36-72 months attending 21 AWCs were examined before and after imparting trainings to AWWs. OHTP was administered to AWWs, which consisted of power-point presentation and demonstrated the skills like proper brushing technique, plaque disclosure, flossing technique, gum massaging etc. The AWWs later imparted training to mothers in their respective AWCs. Post intervention data was collected after three months.

Outcome measures were improvement in oral health status (plaque, debris, gingival health), oral habits (brushing, rinsing) and decrease in caries activity (Snyder test).

Results

Prevalence of dental caries was found to be 48.3%. Only 4.1% of the population reported brushing twice which increased significantly to 9.9% post-intervention (p = 0.000). There was a significant decrease in debris (78.3% to 54.1%), and stage-1 plaque (75.5 to 66.5%) in the oral cavity. Caries activity by Snyder’s test decreased from 48.2% to 31.2% (p = 0.01) post-intervention.

Conclusions

Controlled trials of using AWWs to improve oral hygiene appear to be justified.

Trial registration

CTRI/2012/07/002786
Dental caries status of Dai preschool children in Yunnan Province, China
Authors: Zhang Shinan , Liu Juan , Lo Edward CM , Chu Chun-Hung
Published: November 2013

Background

The Dai people, one of the ethnic minorities in China, have a population of 1,260,000. They have the same origin as one of the main ethnic groups of Laos and Thailand. Most of the Dai live in Yunnan province, which is located in the less-developed southwestern part of China. This study aimed to describe the oral health status of Dai preschool children in China and the factors that influence their oral health status.

Methods

An oral health survey was performed between 2011 and 2012 to select Dai five-year-old children using multi-stage stratified sampling in Yunnan. Their dental caries experience was measured using the “dmft” index, and severe caries was assessed using the “pa” index, which is modified from the “pufa” index. Oral hygiene status was assessed using the visual plaque index (VPI). A questionnaire to study the children’s socio-demographic background and oral health-related behaviours was completed by the children’s parents.

Results

A total of 833 children were examined. Their caries prevalence was 89% and 49% of the children had carious tooth with pulp involvement. The mean (SD) dmft score was 7.0 (5.3). Higher dmft scores were found among children who were girls, were currently bottle-fed, took daily sweet snacks, had higher VPI scores, and had visited a dentist within the last year.

Conclusions

The caries prevalence and experience of the five-year-old Dai children in Yunnan, China was high, and almost half had severe caries. The caries experience was associated with gender, snack habits, dental visit habits, and oral hygiene status.
The emergence of blaCTX-M-15-carrying Escherichia coli of ST131 and new sequence types in Western China
Authors: Zhang Lei , Lü Xiaoju , Zong Zhiyong
Published: November 2013

Background

bla
CTX-M-15, the most widely distributed gene encoding extended-spectrum β-lactamases globally, was not common in China. This study was performed to characterize bla
CTX-M-15-carrying Escherichia coli in western China.

Findings

Out of 144 Escherichia coli isolates from 20 hospitals in western China, 8 were found carrying bla
CTX-M-15. bla
CTX-M-15 was carried by isolates of ST131and 5 new STs (ST3342, ST3513, ST3516, ST3517 and ST3518). The 5 new STs shared 5 identical alleles out of 7 but only had up to 2 alleles identical to ST131. bla
CTX-M-15 was located on plasmids of IncI1 (ST16) or IncFII-related group (four replicon types). The co-transfer of a few antimicrobial resistance genes including qnrA, qnrB, qnrS, qepA, aac (6′)-Ib-cr, aac (3)-II, tetA, bla
TEM and bla
OXA-1 with bla
CTX-M-15 were examined but only bla
TEM-1 was found co-transferring with bla
CTX-M-15.

Conclusions

Five new STs of E. coli and three new types of IncFII-related plasmids carrying bla
CTX-M-15 were identified. This study together with several reports suggested that bla
CTX-M-15 has emerged in China and the interruption of both vertical and horizontal transmission of bla
CTX-M-15 is required to hurdle its further spread.