bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of an optimization method for minimizing vibrations of a hydraulic damper
Authors: Czop Piotr , Sławik Damian , Wszołek Grzegorz
Published: May 2013

The aim of this paper is to provide a mathematical method for minimizing the vibrations produced by hydraulic dampers, while maintaining the same damping force characteristics. The vibration level depends on the force–pressure characteristics of valve systems, which determine the damping force and high-frequency acceleration characteristic of a damper, and which need to be optimally tuned to lower the noise level. The paper considers a model-based approach to obtain the optimal pressure–flow characteristic via simulations conducted with the use of coupled models, including the damper and the servo-hydraulic tester model. The objectives of this work were as follows: (i) develop or adapt a double-tube damper model including pressure–flow valve characteristics; (ii) define key parameters of the valve characteristics influencing the high-frequency piston-rod acceleration, which is considered as a measure of vibration level; (iii) identify the parameter values (trends) minimizing the piston-rod acceleration using two alternative methods, namely a quick-and-dirty method based on a design of experiment (DOE) plan and a nonlinear programming method; (iv) obtain the optimal pressure–flow characteristic minimizing the vibration level by means of simulation; and (v) perform an experimental study comparing the high-frequency content of acceleration produced by the damper assembled with the original and optimized valve system using a laboratory setup.
The Valley of Fear
Authors: VanderMeer Philip R.
Published: May 2013

In 1949 a good government group in Phoenix began a long period of political dominance. Despite winning every mayoral and council election for two decades, during this era the group suffered a major policy defeat, as a grassroots group linked anticommunist fervor and concerns about private property rights to halt the city’s efforts at urban renewal and rehabilitating older urban housing. While this group reflected local concerns, it was also part of a nationwide far-right campaign against urban renewal and the National Municipal League. In Phoenix this campaign delayed establishment of a housing code for a decade, contributing to the further decline of the center city and encouraging suburban growth.
“Divine Providence”
Authors: Cawood Ian , Upton Chris
Published: May 2013

As Erin O’Connor recently noted, “Asiatic cholera exposed the frailties of England’s urban industrial structure,” and it provided the most serious test of the old Poor Law system in Birmingham. This paper intends to explore the response of the medical, political, and religious authorities of Birmingham to the outbreak of cholera in 1832 as well as the popular reaction to this response. It also seeks to explain why, in Asa Briggs’ words, “Birmingham was almost untouched . . . in the cholera outbreak of 1832 (when there were only twenty-one deaths)” by analyzing the geography, social and political structures of the town, and the medical and moral pathology of the disease. By using the minutes of the Birmingham overseers and guardians of the poor, together with contemporary newspaper reports, the paper seeks to uncover the dramatic and entirely unexpected course of events in Birmingham. It offers an analysis of the city’s response to the disease that challenges interpretations of the unreformed Poor Law as passive and unsympathetic and the unincorporated local authorities as chaotic and corrupt. The episode also sheds light on competing cultural attitudes toward death and disease among the communities that made up early nineteenth-century Birmingham. The only areas where the authorities’ actions were significantly interfered with were those where the poorest (including the Irish) lived. Here, swift removal of corpses clashed with traditional funeral practices and the widespread fear of “burking” by anatomists provoked serious disturbances. The paper concludes that Birmingham was spared the pandemic by the happy combination of location (far from the sea in the pre-railway age), infrastructure (with deep artesian wells supplying most drinking water, in contrast to the reliance on streams and rivers elsewhere in Britain) and the uniquely well-organized response to the epidemic by the overseers and guardians of the poor, the town’s medical practitioners, and the Board of Health, chaired by Samuel Galton. The paper concludes that it was to the country’s detriment that the city’s effective response to the disease was largely overlooked at the time and that it took until 1854 when Jon Snow was able to compare those drinking contaminated and uncontaminated water and draw the conclusions that led to the provision of an effective response to the problem of cholera in the cities of Britain.
Through Rose-Colored Glasses
Authors: Osborne Danny , Sibley Chris G.
Published: May 2013

Individual-based and group-based forms of relative deprivation (IRD and GRD, respectively) are linked with individual- and group-based responses to inequality, respectively. System justification theory, however, argues that we are motivated to believe that people’s outcomes are equitably determined. As such, endorsement of system-justifying beliefs should dampen people’s reactions to outcomes perceived to be unequal and ultimately undermine support for political mobilization. We examined these hypotheses in a national probability sample of New Zealanders ( N = 6,886). As expected, IRD predicted individual-based responses to inequality (i.e., satisfaction with one’s standard of living and psychological distress) better than GRD. Conversely, GRD predicted group-based responses to inequality (i.e., perceived discrimination against one’s group and support for political mobilization) better than IRD. Each of these relationships was, however, notably weaker among participants who were high, relative to low, on system justification. These results demonstrate that system-justifying beliefs have a palliative effect on people’s experiences with inequality.
Performance Adaptation
Authors: Baard Samantha K. , Rench Tara A. , Kozlowski Steve W. J.
Published: May 2013

Stability and routine are two words that can rarely be used to describe the present-day workplace. Instead, individuals, teams, and organizations are required to respond to dynamic and changing situations. As a result, researchers have become increasingly interested in understanding performance adaptation, evident in the substantial growth in research over the past two decades. However, what researchers mean when they study adaptation is often broad, vague, and inconsistent—especially at the organizational level—such that drawing solid conclusions is challenging. To move toward integration, we focused the review on individual and team performance adaptation, where the mechanisms of adaptation can be observed. We developed a conceptual taxonomy to map extant research, provide insights for synthesis, and identify directions for future theory building and research. Specifically, we identify four theoretical approaches: (a) a performance construct, (b) an individual difference construct, (c) a change in performance, and (d) a process. Each perspective is reviewed, identifying definitions and key assumptions; discussing conceptual foundations and empirical findings; and highlighting discrepancies, similarities, and opportunities for synthesis. The discussion recommends useful lines of inquiry for future research. Moreover, to promote individual-, team-, and organizational-level integration, we propose a multilevel conceptual architecture specifying the what (nature), where (levels), and how (mechanisms) of adaptation to better define the nature of the phenomenon. In combination, the taxonomy, review content, and conceptual architecture are designed to enhance conceptual clarity and consistency, encourage integration, and advance theory and research on adaptation as a pervasive phenomenon in organizational science.
Overcoming the Illegitimacy Discount: Cultural Entrepreneurship in the US Feature Film Industry
Authors: Zhao Eric Yanfei , Ishihara Masakazu , Lounsbury Michael
Published: May 2013

How can organizations spanning institutionalized categories mitigate against the possibility of reduced attention by audiences? While there has been a good deal of research on the illegitimacy discount of category spanning, scant attention has been paid to how organizations might strategically address this potential problem. In this paper, we explore how the strategic naming of products might enhance audience attention despite the liabilities associated with category spanning. Drawing on a sample of films released in the United States market between 1982 and 2007, we analyze different naming strategies and show that names that simply signal familiarity are not potent enough to offset the illegitimacy discount, while names imbued with known reputations serve as a symbolic device that enhances audience attention to genre-spanning films.
Anemia increases the risk of renal cortical and medullary hypoxia during cardiopulmonary bypass
Authors: Darby PJ , Kim N , Hare GMT , Tsui A , Wang Z , Harrington A , Mazer CD
Published: May 2013

Introduction:

Anemia is an independent predictor of acute kidney injury (AKI) following cardiopulmonary bypass (CPB), possibly due to inadequate renal oxygen delivery. The objective of this study was to investigate the effects of CPB and anemia on tissue oxygen tension (pO2) and blood flow in the renal cortex and medulla.

Methods:

Rats (n=6/group) underwent 1hr of normothermic cardiopulmonary bypass (CPB), with target hemoglobin concentrations (Hb) of 10g/dL (CPB) or 6.5g/dL (anemia-CPB). Renal blood flow (RBF) and tissue PO2 were measured before, during and after 1hr of CPB. To confirm the observed differences in renal cortical and medullary PO2, HIF-1α (ODD) luciferase mice were exposed to 8% O2 (hypoxia) and HIF-1α dependent luminescence was measured in the renal cortex and medulla (n=5).

Results:

Renal tissue PO2 values decreased initially and returned towards baseline, however, values at the end of CPB. Anemia-CPB resulted in a significant increase in both renal cortical and medullary blood flow, PO2 remained significantly reduced throughout anemia-CPB. Renal medullary HIF-1α-dependent luminescence confirmed a greater degree of hypoxia in the renal medulla.

Discussion:

During CPB, renal O2 delivery was transiently jeopardized, but recovered after 1hr. Anemia-CPB resulted in a dramatic and sustained reduction in renal cortical and medullary PO2, which suggests an increased risk of renal hypoxic injury with anemia.

Conclusion:

The clear difference in the degree of hypoxia in the renal cortex and medulla may be useful in understanding the progress of medullary hypoxia during CPB with anemia and the potential development of AKI. Further studies should aim at identifying early markers of medullary hypoxia and potential agents that may decrease the work and O2 consumption in the renal medulla to reduce the risk of hypoxic damage during CPB and anemia.
ATP-binding cassette sub-family F member 1 (ABCF1) is identified as a putative therapeutic target of escitalopram in the inflammatory cytokine pathway
Authors: Powell Timothy R , Tansey Katherine E , Breen Gerome , Farmer Anne E , Craig Ian W , Uher Rudolf , McGuffin Peter , D’Souza Ursula M , Schalkwyk Leonard C
Published: May 2013

The inflammatory cytokine pathway may be a potential therapeutic target for major depressive disorder (MDD). Previous reports suggest that antidepressants have anti-inflammatory properties and can cause a reduction in proinflammatory cytokines. Recent evidence suggests this might be mediated at the level of the transcriptome. The current study investigated the transcription of 86 genes in the inflammatory cytokine pathway both at baseline and after eight weeks of escitalopram treatment in MDD patients who were either clinical responders ( n=25) or non-responders ( n=21), using a subset of samples in the Genome-Based Therapeutic Drugs for Depression project (GENDEP). Changes in expression between baseline and eight weeks of treatment were assessed using two-tailed t-tests. To establish if any significant expression changes related to clinical response, the magnitude of the relative expression change between baseline and eight weeks of treatment was established and binary logistic regressions were used to compare differences between responders and non-responders. ATP-binding cassette sub-family F member 1 ( ABCF1), a translational regulator of the inflammatory cytokine pathway showed a significant increase in expression after escitalopram treatment which was significantly greater in responders compared to non-responders, suggesting that ABCF1 may play a role in mediating antidepressant response.
Preventive treatment for migraine in primary care, a population-based study in the Netherlands
Authors: Dekker F , Dieleman JP , Neven A Knuistingh , Ferrari MD , Assendelft WJJ
Published: May 2013

Background

Preventive treatment of migraine contributes to reducing the impact of migraine but its extent of use in routine care is unknown.

Objective

The objective of this article is to assess current use, previous use, duration and course of preventive treatment of migraine in Dutch general practice.

Methods

We conducted a retrospective cohort study, for the period between 1997 and 2007, in the Interdisciplinary Processing of Clinical Information (IPCI) database, a GP research database in the Netherlands (source population of more than half a million subjects). All prevalent and incident migraine patients ( N = 7367) were included.

Results

About 13% of all migraine patients currently use preventive therapy and almost half of migraine patients have prior use. Of those starting with preventive treatment, 56% (95% CI: 54.3–64.7) still used it after nine months. There was a long delay between migraine diagnosis and preventive treatment start. Forty-four percent (95% CI 43.0–45.7) started preventive therapy in the study period.

Conclusion

This large primary-care database study shows that a limited number of patients are current users of preventive treatment, but many patients have prior use. After diagnosis there is often an extended time before preventive treatment is applied. Also there is often only one attempt. The continuation in time seems appropriate. Preventive therapy in migraine still deserves focus.
Occipital nerve stimulation in medically intractable, chronic cluster headache. The ICON study: Rationale and protocol of a randomised trial
Authors: Wilbrink Leopoldine A , Teernstra Onno PM , Haan Joost , van Zwet Erik W , Evers Silvia MAA , Spincemaille Geert H , Veltink Peter H , Mulleners Wim , Brand Ronald , Huygen Frank JPM , Jensen Rigmor H , Paemeleire Koen , Goadsby Peter J , Visser-Vandewalle Veerle , Ferrari Michel D
Published: May 2013

Background

About 10% of cluster headache patients have the chronic form. At least 10% of this chronic group is intractable to or cannot tolerate medical treatment. Open pilot studies suggest that occipital nerve stimulation (ONS) might offer effective prevention in these patients. Controlled neuromodulation studies in treatments inducing paraesthesias have a general problem in blinding. We have introduced a new design in pain neuromodulation by which we think we can overcome this problem.

Methods/design

We propose a prospective, randomised, double-blind, parallel-group international clinical study in medically intractable, chronic cluster headache patients of high- versus low-amplitude ONS. Primary outcome measure is the mean number of attacks over the last four weeks. After a study period of six months there is an open extension phase of six months. Alongside the randomised trial an economic evaluation study is performed.

Discussion

The ICON study will show if ONS is an effective preventive therapy for patients suffering medically intractable chronic cluster headache and if there is a difference between high- and low-amplitude stimulation. The innovative design of the study will, for the first time, assess efficacy of ONS in a blinded way.
Posterolateral Corner Reconstruction Using the Single Fibular Sling Method for Posterolateral Rotatory Instability of the Knee
Authors: Yang Byoung Se , Bae Woo Han , Ha Jeong Ku , Lee Dhong Won , Jang Hyoung Won , Kim Jin Goo
Published: May 2013

Background:

Recently, posterolateral corner (PLC) reconstruction techniques have been developed based on an anatomic study of cadaveric dissections. However, the best operative method for various anatomic reconstructions remains controversial.

Hypothesis:

The anatomic single fibular sling method for PLC reconstruction would be sufficiently strong to control posterolateral rotatory instability without an additional tibial sling.

Study Design:

Case series; Level of evidence, 4.

Methods:

This retrospective cohort study analyzed 60 knees in 60 patients who underwent anatomic PLC reconstruction using the single fibular sling method with a tibialis anterior allograft, with a minimum follow-up period of 2 years. Ninety percent of the patients had concomitant reconstruction of one or both cruciate ligaments. Preoperative and postoperative dial test, varus stress test, and subjective clinical outcomes including Lysholm score, International Knee Documentation Committee (IKDC) subjective scores, and stress radiographs, including varus and posterior stress, were compared. In addition, intraoperative arthroscopic findings were analyzed.

Results:

The mean length of clinical follow-up was 35.6 months (range, 24-65 months). Forty-two (70%) patients showed no rotational instability postoperatively. Varus laxity improved, with 96.7% of the patients assessed as grade 0 or 1. The mean side-to-side difference in varus stress test was reduced from 2.32 ± 1.33 mm preoperatively to 0.37 ± 1.48 mm postoperatively. Posterior stress radiography in combined posterior cruciate ligament reconstruction showed a mean posterior tibial translation of 14.7 ± 2.83 mm preoperatively and 4.06 ± 1.40 mm at final follow-up. The Lysholm and IKDC subjective scores improved from 52 ± 6.7 to 87.7 ± 12.3 and from 44.8 ± 6.3 to 77.6 ± 14.2 ( P < .001), respectively. There were no significant differences in clinical outcome or varus laxity between isolated PLC and combined injuries.

Conclusion:

Anatomic PLC reconstruction using a single fibular sling method is an effective and relatively simple procedure for most patients with posterolateral rotatory instability, with the exception of those with severe multiple injuries.
Hindfoot Arthroscopic Surgery for Posterior Ankle Impingement
Authors: Smyth Niall A. , Murawski Christopher D. , Levine David S. , Kennedy John G.
Published: May 2013

Background:

Hindfoot arthroscopic surgery has been described as a minimally invasive surgical treatment for posterior ankle impingement syndrome. The current article describes a systematic approach for identifying relevant hindfoot structures as well as the clinical results of a case series.

Purpose:

To present a structured systematic surgical approach for identifying relevant anatomic structures and abnormalities during hindfoot arthroscopic surgery. In addition, we report the clinical results of a case series.

Study Design:

Case series; Level of evidence, 4.

Methods:

The systematic surgical approach divides the extra-articular structures of the hindfoot into quadrants as defined by the intermalleolar ligament. Twenty-two patients underwent hindfoot arthroscopic surgery for the treatment of posterior ankle impingement syndrome. The mean follow-up time was 25 months (range, 14-35 months). Standard patient-reported outcome questionnaires of the Foot and Ankle Outcome Score (FAOS) and Short Form–12 (SF-12) general health survey were administered at standard time points after surgery. Return to sporting activities was also calculated as the time period from the date of surgery until the patient was able to participate at their previous level of activity.

Results:

The mean FAOS score improved from 59 (range, 22-94) preoperatively to 86 (range, 47-100) postoperatively ( P < .01). The mean SF-12 score showed similar improvement with a mean of 66 (range, 42-96) preoperatively to 86 (range, 56-98) postoperatively ( P < .01). Nineteen patients reported competing at some level of athletic sport before surgery. All patients returned to their previous level of competition after surgery. The mean time to return to sporting activities was 12 weeks (range, 6-16 weeks). Two complications were reported postoperatively: 1 wound infection and 1 case of dysesthesia of the deep peroneal nerve.

Conclusion:

Hindfoot arthroscopic surgery is a safe and effective treatment strategy for posterior ankle impingement syndrome. In addition, it allows the patients a rapid return to sporting activities.
Pharmacological evaluation of methanolic leaf extract of Swietenia mahagoni on acrylamide-induced neuropathic pain in rats
Authors: Vanitha Subburaj , Thiagarajan Venkata Rathina Kumar , Muthuraman Arunachalam , Krishnan Shanmugarajan , Aruna Ajithadas , Tharabai R
Published: May 2013

The present study was designed to investigate the antinociceptive effects of methanolic leaf extract of Swietenia mahagoni (MESM) on acrylamide-induced painful neuropathy in rats. The intraperitoneal administration of acrylamide (30 mg/kg; for 24 consecutive days) has been employed for the induction of painful neuropathy. Acrylamide induced nociceptive pain sensitive changes, which have been assessed by hot plate, Von Frey Hair, and tail immersion tests at different time intervals, that is, 0, 6, 12, 18, and 24th day. Furthermore, the biochemical changes, that is, thiobarbituric acid-reactive substances, reduced glutathione, and total calcium levels have been estimated in sciatic nerve tissue on 24th day and histopathological changes have been observed in sciatic nerve tissue sample. MESM and pregabalin have been administered for 14 consecutive days before 1 h of the each acrylamide injection. Administration of acrylamide resulted in significant changes in behavioral and biochemical parameters. Pretreatment of MESM ameliorated acrylamide-induced behavioral, biochemical, and histopathological changes in a dose-dependent manner, which is similar to that of pregabalin-pretreated group. These findings suggested that the neuroprotective effect of S. mahagoni may be due to its potential of antioxidative, calcium channel modulatory, and neuroprotective action.
Amatoxin and phallotoxin concentration in Amanita phalloides spores and tissues
Authors: Kaya Ertugrul , Karahan Selim , Bayram Recep , Yaykasli Kursat Oguz , Colakoglu Serdar , Saritas Ayhan
Published: May 2013

Most of the fatal cases of mushroom poisoning are caused by Amanita phalloides. The amount of toxin in mushroom varies according to climate and environmental conditions. The aim of this study is to measure α-, β-, and γ-amanitin with phalloidin and phallacidin toxin concentrations. Six pieces of A. phalloides mushrooms were gathered from a wooded area of Düzce, Turkey, on November 23, 2011. The mushrooms were broken into pieces as spores, mycelium, pileus, gills, stipe, and volva. α-, β-, and γ-Amanitin with phalloidin and phallacidin were analyzed using reversed-phase high-performance liquid chromatography. As a mobile phase, 50 mM ammonium acetate + acetonitrile (90 + 10, v/v) was used with a flow rate of 1 mL/min. C18 reverse phase column (150 × 4.6 mm; 5 µm particle) was used. The least amount of γ-amanitin toxins was found at the mycelium. The other toxins found to be in the least amount turned out to be the ones at the spores. The maximum amounts of amatoxins and phallotoxin were found at gills and pileus, respectively. In this study, the amount of toxin in the spores of A. phalloides was published for the first time, and this study is pioneering to deal with the amount of toxin in mushrooms grown in Turkey.
Zenobia of Palmyra and the Book of Judith: Common Motifs in Greek, Jewish, and Arabic Historiography
Authors: Weststeijn Johan
Published: May 2013

This article points to the many parallels between the book of Judith and the Arabic account of the life and death of Zenobia of Palmyra. By comparing these two stories with the episode about Zopyros in Herodotus’ Histories and the episode about Sinon in accounts of the fall of Troy, it argues that these similarities can only be explained if we assume that the book of Judith and the Arabic Zenobia Legend are adaptations of the same Vorlage, an earlier story that contained a Holofernes motif (heroine kills enemy) and a Sinon motif (enemy deceives heroine). When this Vorlage was adapted to create the book of Judith, the part of the deceiving Sinon was adapted to create the role of the sincere Achior, whereby he lost his function in the story and became a blind motif.
Prediction of the dynamic response of a plate treated by particle impact damper
Authors: Trigui Moez , Foltete Emmanuel , Bouhaddi Noureddine
Published: May 2013

In this paper, an experimental characterisation of a particle impact damper (PID) under periodic excitation is investigated. The developed method allows the measurement of damping properties of PID without the supplementary use of a primary structure. The passive damping of PID varies with the excitation frequency and its design parameters. The nonlinear damping of PID is then interpreted as an equivalent viscous damping to be introduced in a finite element model of a structure to predict its dynamic response. The results of numerical simulations are in good agreement with those of experiment and show the relevance of the developed method to predict the dynamic behaviour of a structure treated by PID’s.
Modelling railway bridge asset management
Authors: Le Bryant , Andrews John
Published: May 2013

Railway bridges form one of the major railway asset groups with more than 35,000 bridges on the UK rail network. Additionally, the bridge structures are old with more than 50% of the population constructed over 100 years ago. Due to the unique nature of each bridge and their varied means of construction, the decision as to what type of maintenance actions should be performed and when to perform them is a complex problem. Models can be formulated to predict the future condition of assets along with the effect that interventions such as servicing, repair and element replacement will produce. This can be used to support this decision making process. This paper demonstrates a Markov modelling approach to predict the condition of individual bridge elements. For each bridge element the degradation process is determined by examining the maintenance records and analysing the times that each element takes to deteriorate to the point where maintenance of a certain severity classification is required. By combining the elemental models, an overall bridge model is formed which can be used to investigate different maintenance strategies. The model is capable of accounting for a bridge’s current condition, material, route criticality, structural arrangement and environment. The maintenance, opportunistic maintenance and renewal strategy can also be varied in the model along with the service frequency, inspection frequency and repair delay time. Using the model the whole life costs can be predicted for any of the selected maintenance strategies.
Treatment of high-grade anal dysplasia in high-risk patients: outcome at an urban community health centre
Authors: Assoumou S A , Panther L A , Mayer K H
Published: May 2013

Human immunodeficiency (HIV)-infected patients and men who have sex with men (MSM) have a higher rate of high-grade anal intraepithelial neoplasia (HGAIN), a likely precursor to anal cancer. This retrospective study describes the outcome of treating MSM with incident biopsy-proven HGAIN in an urban community health setting with access to outpatient ablation or operative treatment. The main outcome was freedom from HGAIN at follow-up. One hundred and fifty-three met inclusion criteria; 86 (56%) were HIV-infected. Eighty (52%) received outpatient ablation, 49 (61 %) had a follow-up within nine months. Among those, 26 (53%) were free of high-grade disease, 19 (39%) had high-grade disease; and 4 (8%) had unknown grading. In a logistic regression model, a lower extent of anal disease (1 quadrant versus 2, 3 or 4 quadrants) at the time of treatment was significantly associated with a lower probability of high-grade disease ( P value 0.04). HGAIN could be managed in a community health setting; however, systems are needed to ensure follow-up care.
Unexpectedly high HIV prevalence among female sex workers in Bangkok, Thailand in a respondent-driven sampling survey
Authors: Manopaiboon C , Prybylski D , Subhachaturas W , Tanpradech S , Suksripanich O , Siangphoe U , Johnston L G , Akarasewi P , Anand A , Fox K K , Whitehead S J
Published: May 2013

The pattern of sex work in Thailand has shifted substantially over the last two decades from direct commercial establishments to indirect venues and non-venue-based settings. This respondent-driven sampling survey was conducted in Bangkok in 2007 among female sex workers (FSW) in non-venue-based settings to pilot a new approach to surveillance among this hidden population. Fifteen initial participants recruited 707 consenting participants who completed a behavioural questionnaire, and provided oral fluid for HIV testing, and urine for sexually transmitted infection (STI) testing. Overall HIV prevalence was 20.2% (95% confidence interval [CI] 16.3–24.7). Three-quarters of women were street-based (75.8%, 95% CI 69.9–81.1) who had an especially high HIV prevalence (22.7%, 95% CI 18.2–28.4); about 10 times higher than that found in routine sentinel surveillance among venue-based FSW (2.5%). STI prevalence ( Chlamydia trachomatis and Neisseria gonorrhoeae) was 8.7% (95% CI 6.4–10.8) and 1.0% (95% CI 0.2–1.9), respectively. Lower price per sex act and a current STI infection were independently associated with HIV infection ( P < 0.05). High HIV prevalence found among FSW participating in the survey, particularly non-venue-based FSW, identifies need for further prevention efforts. In addition, it identifies a higher-risk segment of FSW not reached through routine sentinel surveillance but accessible through this survey method.
Not so different after all? Comparing patients attending general practice-based locally enhanced services for sexual health with patients attending genitourinary medicine
Authors: Mercer C H , Aicken C R H , Cassell J A , Hartneil V , Davies L , Ryan J , Keane F
Published: May 2013

We did a cross-sectional survey of patients attending genitourinary (GU) medicine clinics ( n = 933) and general practice-based Locally Enhanced Services for Sexual Health (GP-LESSH, n = 111) in Cornwall, England, in 2009/2010, to compare patients’ characteristics and experiences. Patients completed a pen-and-paper questionnaire that was then linked to an extract of their clinical data. GP-LESSH patients took longer both to seek and to receive care: medians of nine and seven days, respectively, versus GU medicine patients: medians of seven and one day, respectively. GP-LESSH patients were less likely than GU medicine patients to report symptoms (19.6% versus 30.6%) and sexual risk behaviours (33.3% versus 44.7% reported new partners) since recognizing needing to seek care; 5.0% versus 10.2% were men who have sex with men). However, they were equally likely to have sexually transmitted infections (STIs) diagnosed (23.3% versus 24.8%). As GP-LESSH may operate infrequently, local services must work collaboratively to ensure that those seeking care for suspected STIs receive it promptly. Failing to do so facilitates avoidable STI transmission.
Sexual behaviour and desire to discuss mental health as reported by HIV-infected men who have sex with men
Authors: Safran M A , Hoover K W , Tao G , Butler M O
Published: May 2013

We assessed sexually transmitted infection risk behaviours and desire to discuss mental health, as reported by 426 HIV-infected men who have sex with men receiving HIV care in eight urban clinics. Most of these patients (90%) had begun HIV care >1 year ago. In the past year, 74% had multiple sexual partners, 75% engaged in anal intercourse, 48% had >1 HIV-uninfected partner and 82% used illegal psychoactive drugs. Among those reporting anal intercourse, approximately 61 % reported using a condom during the most recent episode. Among all patients, 70% wanted to talk with their clinicians about how they felt mentally or emotionally. Using a two-tailed chi-squared test, we found that patients who engaged in unprotected receptive anal sex were more likely to want such a conversation than those who did not (80% versus 62%, P < 0.01); and those who engaged in unprotected insertive anal sex were also more likely to want such a conversation (81 % versus 63%, P < 0.01). The findings highlight the prevalence of risky sexual behaviour and of mental health concerns in the participating patient population. Patients reporting risky sexual behaviour were more likely to want to discuss how they felt mentally or emotionally than those not reporting such behaviour.
Clinical spectrum of peripheral facial paralysis in HIV-infected patients according to HIV status
Authors: Riancho J , Delgado-Alvarado M , Valero C , Echevarría S , Fariñas M C
Published: May 2013

Although peripheral facial palsy is the most common cranial neuropathy in HIV-infected patients, no series have been reported recently in the literature. In this study we reviewed the clinical records of HIV-infected patients with a diagnosis of peripheral facial palsy between 2000 and 2011 attending the Hospital Marqués de Valdecilla (Infectious Diseases Unit), a 900-bed university hospital in northern Spain. We identified eight patients (4 men, 4 women): median CD4 count and viral load were 232 cells per μL and 130,000 RNA copies per mL, respectively. Most of them presented co-morbidities, including hepatitis C virus in 75%, hepatitis B virus in 15% and tuberculosis in 15%. Aetiologies of palsy were varied: idiopathic Bell's palsy predominated at early stages of the disease, whereas secondary causes, such as lymphoma and infections were frequently the cause of paralysis in advanced HIV/AIDS. At early stages of HIV infection, facial palsy is similar, both in aetiology and prognosis, to cases in the general population. However, in advanced stages the palsy is frequently secondary to underlying complications. Clinicians should be aware of these differences to tailor the diagnostic work-up.
Factors associated with timely initiation of antiretroviral therapy in two HIV clinics in Lilongwe, Malawi
Authors: Johnson D C , Feldacker C , Tweya H , Phiri S , Hosseinipour M C
Published: May 2013

The World Health Organization (WHO) estimates that only 30% of eligible, HIV-infected individuals start antiretroviral therapy (ART). This study seeks to explore the geographic and individual factors associated with starting ART on time. This retrospective study includes 15,734 HIV-positive adults initiating ART at two HIV clinics in Lilongwe, Malawi. The outcome was starting ART within two weeks of meeting ART eligibility as defined by the Malawi ART guidelines. Euclidean distance from patient neighbourhood to their clinic was calculated using Google Earth. Logistic regression models assessed factors influencing starting ART on time. Of 15,734 adults initiating ART, 8178 were from Lighthouse (LH) and 7556 were from Martin Preuss Center (MPC). Combined, 68.7% started treatment on time. Patients who were eligible for ART based on a CD4 cell count <250 cells/mm3 versus WHO stage were less likely to begin ART on time at both LH (odds ratio [OR] 0.16; 95% CI 0.13–0.19) and MPC (OR 0.24; 95% CI 0.21–0.28). Likelihood of starting on time decreased with each kilometer further from clinic location among LH patients (OR 0.97; 95% CI 0.94–0.99); distance was not significant at MPC. In conclusion, predictors differed by clinic. Distance to clinic and type of eligibility for ART significantly influence starting ART on time.
Liver involvement in HIV-infected patients with early syphilis
Authors: Palacios R , Navarro F , Narankiewicz D , Marcos M , Jiménez-Oñate F , de la Torre J , Santos J
Published: May 2013

The aim of the paper is to analyse the prevalence of liver involvement and related factors in HIV-infected patients with early syphilis (<2 years). Liver involvement was defined as an elevation above normal ranges of alanine transaminase, aspartate aminotransferase, gamma-glutamyltransferase and/or alkaline phosphatase during early syphilis, or doubling of previous levels in patients with liver enzyme elevation before syphilis. We undertook a multicentre study and of the 147 cases, 86.4% were men who had sex with men, and the diagnoses of syphilis and HIV infection were coincident in 48 (32.7%). Liver involvement was detected in 45 (30.6%) and the only related factor was a rapid plasma reagin (RPR) titre ≥1/64 (odds ratio 3.76; 95% confidence interval 1.3–10.5; P = 0.012). In conclusion, liver involvement occurs in around one-third of HIV-infected patients with early syphilis and is associated with high RPR levels. Syphilis should be included in the differential diagnosis of liver enzyme elevation in HIV-infected patients.
A case of HIV-1 slow seroconversion: diagnostic implications
Authors: Pollett S , Wienholt L , Lee F , Adelstein S , Macleod C , Chen R F , Garsia R
Published: May 2013

We report the case of a 30-year-old woman who failed to achieve diagnostic Western blot criteria for HIV-1 infection until 21 months after her initial presentation. This case highlights the importance of suspecting delayed HIV seroconversion in cases with persistently indeterminant Western blots.
Immune reconstitution inflammatory syndrome Kaposi sarcoma in the liver manifesting as acute obstructive hepatitis: another potential role for montelukast?
Authors: Read P J , Lucas S , Morris S , Kulasegaram R
Published: May 2013

Immune reconstitution inflammatory syndrome has been described in Kaposi sarcoma, but does not usually manifest as acute hepatitis. We describe a case of rapid obstructive jaundice after initiation of antiretroviral therapy, in which the liver biopsy confirmed hepatic Kaposi sarcoma, and the clinical course was altered by the addition of montelukast.
Communicating Shared Knowledge in Infancy
Authors: Egyed Katalin , Király Ildikó , Gergely György
Published: May 2013

Object-directed emotion expressions provide two types of information: They can convey the expressers’ person-specific subjective disposition toward objects, or they can be used communicatively as referential symbolic devices to convey culturally shared valence-related knowledge about referents that can be generalized to other individuals. By presenting object-directed emotion expressions in communicative versus noncommunicative contexts, we demonstrated that 18-month-olds can flexibly assign either a person-centered interpretation or an object-centered interpretation to referential emotion displays. When addressed by ostensive signals of communication, infants generalized their object-centered interpretation of the emotion display to other individuals as well, whereas in the noncommunicative emotion-expression context, they attributed to the emoting agent a person-specific subjective dispositional attitude without generalizing this attribution as relevant to other individuals. The findings indicate that, as proposed by natural pedagogy theory, infants are prepared to learn shared cultural knowledge from nonverbal communicative demonstrations addressed to them at a remarkably early age.
Effect of Elastic Taping on Postural Control Deficits in Subjects With Healthy Ankles, Copers, and Individuals With Functional Ankle Instability
Authors: Shields Christina A. , Needle Alan R. , Rose William C. , Swanik Charles B. , Kaminski Thomas W.
Published: May 2013

Background:

Ankle sprains are the most common injury among physically active people, with common sequelae including repeated episodes of giving way, termed functional ankle instability. Copers are a cohort in ankle research comprised of those who have sprained their ankle but have not suffered any further dysfunction. The use of an elastic tape, Kinesio Tape, in sports medicine practice has recently gained popularity and may help improve postural control deficits related to functional ankle instability. The purpose of this study was to examine the immediate and prolonged effects of Kinesio Taping on postural control in healthy, coper, and unstable ankles as measured through single-limb balance on a force plate.

Methods:

Sixty physically active, college-aged participants (72.5 ± 9.7 cm, 74.2 ± 16.2 kg, 21.5 ± 2.6 years) were stratified into healthy, coper, or unstable groups using the Cumberland Ankle Instability Tool (CAIT) combined with their history of ankle injury. Dependent variables included time-to-boundary (TTB) measures and traditional center of pressure (COP) measures in both the mediolateral (frontal) and anteroposterior (sagittal) planes. Testing was performed prior to tape application, immediately after application of the tape, 24 hours following tape application, and immediately after tape removal.

Results:

Significant differences between groups were observed for COP standard deviation and range in the sagittal plane. Significant differences between tape conditions for TTB absolute minima and standard deviation were also noted. Post hoc testing revealed large to medium effect sizes for the group differences and very small effect sizes for the differences between conditions.

Conclusions:

Our study did not reveal decisively relevant changes following application of Kinesio Tape to the ankle. However, we did observe sagittal plane postural control deficits in subjects with ankle instability measured through summary COP variables over 20-second trials.

Clinical Relevance:

Ankle instability is a concern for many clinicians. Kinesio Taping, although a popular form of clinical intervention, remains understudied. Evidence from this study does not support the use of Kinesio Taping for improving postural control deficits in those with ankle instability.
Factors Associated With Choice of Web or Print Intervention Materials in the Healthy Directions 2 Study
Authors: Greaney Mary L. , Puleo Elaine , Bennett Gary G. , Haines Jess , Viswanath K. , Gillman Matthew W. , Sprunck-Harrild Kim , Coeling Molly , Rusinak Donna , Emmons Karen M.
Published: May 2013

Background. Many U.S. adults have multiple behavioral risk factors, and effective, scalable interventions are needed to promote population-level health. In the health care setting, interventions are often provided in print, although accessible to nearly everyone, are brief (e.g., pamphlets), are not interactive, and can require some logistics around distribution. Web-based interventions offer more interactivity but may not be accessible to all. Healthy Directions 2 was a primary care–based cluster randomized controlled trial designed to improve five behavioral cancer risk factors among a diverse sample of adults ( n = 2,440) in metropolitan Boston. Intervention materials were available via print or the web. Purpose. To (a) describe the Healthy Directions 2 study design and (b) identify baseline factors associated with whether participants opted for print or web-based materials. Methods. Hierarchical regression models corrected for clustering by physician were built to examine factors associated with choice of intervention modality. Results. At baseline, just 4.0% of participants met all behavioral recommendations. Nearly equivalent numbers of intervention participants opted for print and web-based materials (44.6% vs. 55.4%). Participants choosing web-based materials were younger, and reported having a better financial status, better perceived health, greater computer comfort, and more frequent Internet use ( p < .05) than those opting for print. In addition, Whites were more likely to pick web-based material than Black participants. Conclusions. Interventions addressing multiple behaviors are needed in the primary care setting, but they should be available in web and print formats as nearly equal number of participants chose each option, and there are significant differences in the population groups using each modality.
Dreaming fairness and re-imagining equality and diversity through participative aesthetic inquiry
Authors: Page Margaret , Grisoni Louise , Turner Arthur
Published: May 2013

This article presents the findings of a participative action research project into how arts-based inquiry can revitalise equality and diversity organisational practices. We demonstrate that the arts-based methodologies introduced enabled participants to explore the meanings they brought to equality and diversity work, by creating a liminal space for learning. We illustrate our findings through an exploration of how participants engaged with the inquiry, the learning about equality and diversity that took place in the workshops and the challenges and opportunities of translating this into change practice in the workplace. The article’s originality lies in its analysis of poetic writings, dreams and visual artefacts created in the context of participative inquiry. Engaging with tacit knowledge extended understanding of the contribution that arts-based, aesthetic inquiry can bring to organisational practice, and more specifically towards restoring the transformative potential of organisational practices to promote equality and diversity.
An international pilot study of asynchronous teleconsultation for oropharyngeal dysphagia
Authors: Malandraki Georgia A , Markaki Vasiliki , Georgopoulos Voula C , Bauer Jaime L , Kalogeropoulos Ioannis , Nanas Serafim
Published: May 2013

We investigated whether an expert's consultation provided via telemedicine could improve the quality of care for patients with dysphagia. A trained clinician completed videofluoroscopic swallowing studies (VFSS) of 17 consecutive patients in a Greek hospital. The videofluoroscopic images were then stored on a website for independent review by an expert Speech and Language Pathologist in the US. An extra Rater evaluated 20% of all data for additional reliability testing. Eight diagnostic indicators of swallowing impairment and an overall subjective severity index were recorded for each study. Clinicians were also asked to choose from ten common treatment options for patients with dysphagia. There was good inter-rater agreement for most of the diagnostic indicators examined (ranging from 78% to 90%; kappa = 0.52-0.71) between all three Raters. Agreement on overall severity ratings was exact for more than half of the patients and within one-point on the 4-point scale for all other patients except one. However, the quality of care would have been substandard for more than half of the patients if teleconsultation had not been employed. In settings where a swallowing expert is not available and real-time telemedicine is not feasible, the use of asynchronous teleconsultation can produce better quality of care for patients with dysphagia.
Access, use and completion of a brief disaster mental health intervention among Hispanics, African-Americans and Whites affected by Hurricane Ike
Authors: Price Matthew , Davidson Tatiana M , Andrews Jeannette O , Ruggiero Kenneth J
Published: May 2013

Sumary

African-Americans and Hispanics are disproportionally affected by disasters. We evaluated differences in the use and completion of a web-based mental health intervention, Disaster Recovery Web (DRW), by White, African-American and Hispanic adults in the aftermath of Hurricane Ike. Approximately one year after the hurricane, a telephone survey was carried out with adults from Galveston and Chambers counties. A total of 1249 adults participated in the survey (80% White, 14% African-American and 6% Hispanic). Mental health and mental health service utilization were assessed. Whites were more likely to have previously used the Internet to obtain general health information than African-Americans or Hispanics ( P < 0.001). A logistic regression was used to identify differences in the use of the Internet intervention after controlling for covariates. There were no differences in rates of non-use and dropout attrition between Whites, African-Americans and Hispanics. Thus the findings suggest that web-based mental health interventions can be used to reach African-American, Hispanic and White adults at similar rates after a disaster.