bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors during the prenatal period and the first year of life associated with overweight in 7‐year‐old low‐income Chilean children
Authors: Rios‐Castillo Israel , Cerezo Sheila , Corvalán Camila , Martínez Mario , Kain Juliana
Published: December 2012

The objective of this study was to identify in low‐income Chilean children with normal birthweight which factors occurring during the prenatal period and the first year are associated with overweight (OW)/obesity at 7 years. The sample included 652 7‐year‐olds from a larger cohort study. We collected anthropometric data at 0, 12 and 84 months, maternal pre‐pregnancy and pregnancy characteristics, early feeding practices, number of siblings, birth order, breastfeeding, and timing of solid introduction information. We determined the residuals for z‐scores for body mass index (BMI) (BAZ), weight/age and height/age0–12 months, run univariate analysis (X2 or t‐test) and multivariate logistic analyses (stepwise approach); P < 0.05 was considered significant. We evaluated the goodness of fit of the model using the Hosmer–Lemeshow test and checked for overdispersion using the Pearson's X2. The odds of children being OW at 7 years increased if their mothers were OW before pregnancy, if born with a higher BAZ (increase of 18–74% per each additional unit of BAZ) and if their BAZ growth during the first year was higher (62–239% per each unit over the predicted BAZ increase). Higher birth order was protective (6–68% less risk for 2nd birth compared with 1st and 10–73% less for ≥3rd child). All other variables, including gender, were non‐significant (P > 0.1). In low‐income Chilean children with normal birth, four factors during the prenatal period and the first year were associated with OW at 7 years: pre‐pregnancy BMI, BMI at birth, BMI gain between 0 and 12 months, and birth order.
The Toxoplasma nuclear factor TgAP2XI‐4 controls bradyzoite gene expression and cyst formation
Authors: Walker Robert , Gissot Mathieu , Croken Matthew M. , Huot Ludovic , Hot David , Kim Kami , Tomavo Stanislas
Published: December 2012

Toxoplasma gondii undergoes many phenotypic changes during its life cycle. The recent identification of AP2 transcription factors in T. gondii has provided a platform for studying the mechanisms controlling gene expression. In the present study, we report that a recombinant protein encompassing the TgAP2XI‐4 AP2 domain was able to specifically bind to a DNA motif using gel retardation assays. TgAP2XI‐4 protein is localized in the parasite nucleus throughout the tachyzoite life cycle in vitro, with peak expression occurring after cytokinesis. We found that the TgAP2XI‐4 transcript level was higher in bradyzoite cysts isolated from brains of chronically infected mice than in the rapidly replicating tachyzoites. A knockout of the TgAP2XI‐4 gene in both T. gondii virulent type I and avirulent type II strains reveals its role in modulating expression and promoter activity of genes involved in stage conversion of the rapidly replicating tachyzoites to the dormant cyst forming bradyzoites. Furthermore, mice infected with the type II KO mutants show a drastically reduced brain cyst burden. Thus, our results validate TgAP2XI‐4 as a novel nuclear factor that regulates bradyzoite gene expression during parasite differentiation and cyst formation.
Serum fetuin‐A concentration and fetuin‐A‐containing calciprotein particles in patients with chronic inflammatory disease and renal failure
Authors: Smith Edward R , Cai Michael M , McMahon Lawrence P , Pedagogos Eugenie , Toussaint Nigel D , Brumby Catherine , Holt Stephen G
Published: December 2012

Aim

Fetuin‐A (Fet‐A) is an important regulator of extracellular matrix mineralization. Fet‐A plays a critical role in the formation and stabilization of high molecular weight colloidal protein–mineral complexes known as calciprotein particles (CPP). The aim of this study was to examine the effects of inflammation, renal function and dialysis modality on serum Fet‐A and CPP.

Methods

This is an observational study of patients with chronic kidney disease (CKD) and those with chronic inflammatory disease (CID) but normal renal function. Serum CPP were quantified indirectly by analysing the apparent reduction in serum Fet‐A concentration (reduction ratio, RR) after high‐speed centrifugation.

Results

Serum total Fet‐A concentrations are reduced in renal disease and in patients with CID. CPP were not detectable in the serum of normal individuals. CPP represent an increasing percentage of total circulating Fet‐A concentrations in patients with CID (RR, 13.3 ± 8.5%), as well as in patients with pre‐dialysis CKD (12.4 ± 7.3%) and those undergoing peritoneal dialysis (RR, 22.8 ± 6.0%) or haemodialysis (RR, 38.1 ± 12.8%). The highest Fet‐A RR were found in patients with calcific uraemic arteriolopathy (CUA) on haemodialysis (73.9 ± 15.6%). Serum total Fet‐A concentrations and Fet‐A reduction ratios decreased during a single haemodialysis session, by 24% (P < 0.001) and 34% (P < 0.001), respectively.

Conclusion

Inflammation appears to be associated with mineral stress even in the absence of renal dysfunction. Patients with CUA on haemodialysis have very high serum Fet‐A reduction ratios, suggesting that this measurement may have a prognostic/diagnostic role in this condition.
Smallest detectable differences in clinical functional temporomandibular joint examination variables in juvenile idiopathic arthritis
Authors: Stoustrup P. , Verna C. , Kristensen K. D. , Küseler A. , Herlin T. , Pedersen T. K.
Published: December 2012

Structured Abstract

Objective

Temporomandibular joint (TMJ) arthritis in juvenile patients may interfere with optimal joint function and mouth opening patterns. Clinical assessment of maximal mouth opening capacity, laterotrusion and protrusion is critical to TMJ arthritis diagnosis, treatment choice and evaluation of a therapeutic intervention. The aim of the study was to determine the smallest minimal threshold at which differences in maximal mouth opening capacity, laterotrusion, and protrusion between two consecutive observations can be determined.

Setting and Sample Population

Department of Orthodontics, University of Aarhus, Denmark. Forty‐two consecutive patients with juvenile idiopathic arthritis.

Material and Methods

Two experienced dentists used a calibrated metallic ruler to measure maximal mouth opening capacity, laterotrusion, and protrusion. Each measurement was carried out thrice by each observer. Intra‐ and inter‐observer variation and the smallest detectable difference were calculated for each variable.

Results

The smallest detectable differences were as follows: maximal mouth opening capacity 4.9 mm, laterotrusion 2.4 mm, and protrusion 2.8 mm (one observer and one measurement). These differences declined when measurements were repeated; maximal mouth opening capacity 3.3 mm, laterotrusion 1.4 mm, and protrusion 1.8 mm (two observers with three measurements each). We found no support for a relationship between measurement variation and patient age, measurement variation and TMJ pain, or between measurement variation and previous/current TMJ arthritis.

Conclusion

The importance of the implementation of a standardized measurement protocol is emphasized including repeated measurements to reduce the smallest detectable difference.
Non‐invasive mechanical ventilation in obesity hypoventilation syndrome: Are multimodal therapeutic strategies disease essential?
Authors: Esquinas Antonio M. , Petroianni Angelo
Published: December 2012

See reply, page 386
Oral manifestations and dental management of a child with Zellweger syndrome
Authors: Lertsirivorakul Jinda , Wongswadiwat Malinee , Treesuwan Panta
Published: December 2012

Zellweger syndrome (ZS) is a rare autosomal recessive disorder, resulting from an impairment in peroxisome function. It is characterized by craniofacial dysmorphism and neurological abnormalities, and involves several systems, which may complicate dental and anesthesia management. The case of a 7‐year‐old girl diagnosed with ZS is described with emphasis on oral manifestations, oral rehabilitation under general anesthesia (GA), and home oral care. Apart from the unique features of ZS, she presented with clinodactyly, distinctive palatal vault, Class III malocclusion, missing teeth, microdontia, and delayed dental formation. Dental treatment under GA was conducted with concerns of risk of respiratory insufficiency. Oral home care by the parent and regular recall visits were essential to maintain good oral health. Children with ZS may survive into late childhood. They, however, present multiple health problems that are of special concern for not only the pediatric dentist but also the anesthesiologist. Collaboration with the medical team is essential for optimal care of these patients.
The effects of baicalein on canine osteosarcoma cell proliferation and death
Authors: Helmerick E. C. , Loftus J. P. , Wakshlag J. J.
Published: December 2012

Flavonoids are a group of modified triphenolic compounds from plants with medicinal properties. Baicalein, a specific flavone primarily isolated from plant roots (Scutellaria baicalensis), is commonly used in Eastern medicine for its anti‐inflammatory and antineoplastic properties. Previous research shows greater efficacy for baicalein than most flavonoids; however, there has been little work examining their effects on sarcoma cells, let alone canine cells. Three canine osteosarcoma cell lines (HMPOS, D17 and OS 2.4) were treated with baicalein to examine cell viability, cell cycle kinetics, anchorage‐independent growth and apoptosis. Results showed that osteosarcoma cells were sensitive to baicalein at concentrations from approximately 1 to 25 μM. Modest cell cycle changes were observed in one cell line. Baicalein was effective in inducing apoptosis and did not prevent doxorubicin cell proliferation inhibition in all the cell lines. The mechanism for induction of apoptosis has not been fully elucidated; however, changes in mitochondrial permeability supersede the apoptotic response.
Indigenous knowledges: Circumspection, metaphysics, and scientific ontologies.
Authors: Gillett Grant
Published: December 2012

still to be written by author
Topogenic Forms in New Georgia, Solomon Islands
Authors: Thomas Tim
Published: December 2012

James Fox coined the term ‘topogeny’ to refer to practices where the recitation of an ordered sequence of place names is employed as a means of categorizing and transmitting social knowledge. In the Solomon Islands such narratives are an important component of tribal identity, typically tracing ancestral origins to inland mountains and then descending in a sequence of migratory steps towards the coast where present-day groups reside. Previous accounts have sometimes argued that the recurrence of such narratives on virtually every island indicates that they are ideological impositions on the landscape, perhaps having a post-colonial origin. Archaeological dating of ancestral sites on the other hand demonstrates that such narratives can have historical content. This tension between historical ‘truth’ and ideological narrative is the primary concern of this paper. I argue that it can be resolved by focusing on the materiality of topogenic forms.
‘Quiet as lambs’: Communicative Action in the New Zealand Parliamentary Debates on Human Assisted Reproductive Technology
Authors: McLauchlan Laura , Park Julie Katherine
Published: December 2012

Communicative action in the Human Assisted Reproductive Technology (HART) debates in the New Zealand Parliament in 2004 is analysed in this paper using Habermasian concepts of deliberation. The marked cooperativeness of these debates, which surprised the elected participants themselves, is demonstrated through a comparison with the related and almost simultaneous Care of Children debate, using a Discourse Quality Index inspired by Steiner et al (2004), assisted by qualitative analysis software. Using the thematic content of HART debates themselves, assisted by international literature on related debates, how this cooperativeness was accomplished is examined. Our analysis suggests that “conscience” voting, intentional sequestration of potentially destructive topics, active attempts to create unity, and a degree of Habermasian “deliberative reasonableness” all had parts to play. Why these debates exhibited these features is discussed in the conclusion where we draw attention to concepts of “the greater good”, the perceived importance of the topic and reference to aspects of New Zealand identity. Finally, we point to a contradiction in the resulting legislation which relegated on-going debate on HART to appointed committees meeting in private.
‘SHE’S FROM BOTHY SIKE’ CHALLENGES TO RESEARCH AND THE EXPERIENCE OF BELONGING
Authors: Blenkinsop Heather
Published: December 2012

All too often, we see what we expect to see and it is easy to miss what we are not looking for. Using a personal narrative approach, this paper reflexively explores the unexpected opportunities that research challenges can raise. The following experience forms part of a broader ethnographic project concerned with the performance of belonging and community in rural villages. Challenged by limited research funding, I chose to reduce my costs by volunteering at a nearby backpackers in exchange for accommodation. I soon realized that I was seen to belong to the backpackers community, not only by my fellow workers, but also by residents of the nearby villages I wished to research. Ultimately, this paper proposes that researchers embrace research challenges and be open to the unexpected advantages and experiences they can provide.
The Ruatoki Valley 'Anti-terrorism' Police Raids: Losing 'Hearts and Minds' in Te Urewera
Authors: Sluka Jeffrey Alan
Published: December 2012

This paper was written in response to being invited to be the guest speaker at the one year commemoration of the 2007 police ‘antiterrorism’ raids in the Rūātoki Valley, and forty copies were distributed at the talk, held at the Te Rewarewa marae in Rūāatoki. Addressing an audience of Tūhoe and their guests, it presents perspectives from political anthropology which would be relevant to their experiences. I describe my research on the conflict in Northern Ireland and relate it to the ‘anti-terrorism’ raids in New Zealand, address the debate about ‘terrorists’ and ‘freedom fighters’ and identify how indigenous and ethno-national armed resistance has been misrepresented as ‘terrorism,’ provide a critical introduction to the concept of ‘terrorism’ and the significant criticisms anthropologists and others have concerning how it evolved and has been used mainly for the purposes of state propaganda and political control. I argue that the Ruatoki Valley ‘anti-terrorism’ raids can be interpreted as a form of pre-emptive counterinsurgency operation during which acts amounting to state terrorism caused significant ‘collateral damage’ to innocent members of the community. I conclude that raids not only failed in their stated aim to protect New Zealand from ‘terrorism’ but, by losing the ‘hearts and minds’ of local people, possibly increased the potential for political violence or ‘terrorism’ in this country.
Storytelling - the past and the present
Authors: Walton Sue
Published: December 2012

ABSTRACT
The care people deserve when their health moves along the continuum from curable to one when death is imminent needs to be personalised and holistic. Palliative care requires health professionals who have a person-centered approach, and a willingness to listen and get alongside people during vulnerable times. As a registered nurse, ‘Bob’s story is describes a palliative care critical incident and also incorporated is the Stroebe and Schut (1999) dual process model of coping with bereavement. The impact that bereavement and loss has can be immense and seemingly overwhelming. However with ongoing integration of the person or event including the past, the present and the future, adjustment and healthy grief outcomes can be achieved.
'Like tiddlywinks for grown-ups": communicative artistry in a 'Westie' comedy performance
Authors: Lloyd Mike
Published: December 2012

Comedians develop and hone a persona that reflects their particular type of humour, thus greatly aiding in the economy that so typifies comedy performances. This paper considers the case of the well-known New Zealand comedian Ewen Gilmour, whose persona is a ‘Westie’ - someone from the working class area of West Auckland. This persona has equivalents in most countries, its central characteristics being hard-drinking, ready-swearing, stereotypical working class behaviour, that also strongly adheres to traditional gender roles. The paper focuses on one of Gilmour’s short standup comedy performances filmed in front of a live audience and then screened on public television. The performance features a potential disjuncture: the Westie comedian narrates activities that he and a ‘mate’ engage in that could be interpreted as ‘homoerotic’. Nevertheless, the performance ends with the Westie persona under no apparent threat of misinterpretation, that is, his character is obviously not gay. This ‘agreement’ stems in part from dynamic cooperation between the comedian and audience, which similar to many social activities, is more tacit than explicit, and yet this cooperation and understanding has to be somehow achieved. Looking in detail at exactly how the comedian ‘works’ the audience with his comedic material, and his embodied display, leads to the conclusion that the performance qualifies as ‘communicative artistry’ even if the joke material is relatively well worn.
Modes of mobility: An interdisciplinary search for bodies in action
Authors: Bell Martha G
Published: December 2012

This paper explores the paradox of the promotion of access and inclusion through mobility for persons who experience different modes of mobility as their sensory experience of self in interaction. In this investigation, I focus on the interaction space and draw together the literatures on the sociology of the body, the sociology of action and the sociology of mobility with the aim of asking how the body in social anthropology is a moving body. I hope to illustrate the interdisciplinary connections between sociological and anthropological views of sensory embodiment, ritualised modes of mobility and cultures of movement.
Structural, morphological, and band alignment properties of GaAs/Ge/GaAs heterostructures on (100), (110), and (111)A GaAs substrates
Authors: Hudait Mantu K. , Zhu Yan , Jain Nikhil , Hunter Jerry L.
Published: December 2012

Structural, morphological, and band offset properties of GaAs/Ge/GaAs heterostructures grown in situ on (100), (110), and (111)A GaAs substrates using two separate molecular beam epitaxy chambers, connected via vacuum transfer chamber, were investigated. Reflection high energy electron diffraction (RHEED) studies in all cases exhibited a streaky reconstructed surface pattern for Ge. Sharp RHEED patterns from the surface of GaAs on epitaxial Ge/(111)A GaAs and Ge/(110)GaAs demonstrated a superior interface quality than on Ge/(100)GaAs. Atomic force microscopy reveals smooth and uniform morphology with surface roughness of Ge about 0.2–0.3 nm. High-resolution triple axis x-ray rocking curves demonstrate a high-quality Ge epitaxial layer as well as GaAs/Ge/GaAs heterostructures by observing Pendellösung oscillations. Valence band offset, ΔEv, have been derived from x-ray photoelectron spectroscopy (XPS) data on GaAs/Ge/GaAs interfaces for three crystallographic orientations. The ΔEv values for epitaxial GaAs layers grown on Ge and Ge layers grown on (100), (110), and (111)A GaAs substrates are 0.23, 0.26, 0.31 eV (upper GaAs/Ge interface) and 0.42, 0.57, 0.61 eV (bottom Ge/GaAs interface), respectively. Using XPS data obtained from these heterostructures, variations in band discontinuities related to the crystallographic orientation have been observed and established a band offset relation of ΔEV(111)Ga>ΔEV(110)>ΔEV(100)As in both upper and lower interfaces.
Impact of low-k structure and porosity on etch processes
Authors: Darnon Maxime , Casiez Nicolas , Chevolleau Thierry , Dubois Geraud , Volksen Willi , Frot Théo J. , Hurand Romain , David Thibaut L. , Posseme Nicolas , Rochat Névine , Licitra Christophe
Published: December 2012

The fabrication of interconnects in integrated circuits requires the use of porous low dielectric constant materials that are unfortunately very sensitive to plasma processes. In this paper, the authors investigate the etch mechanism in fluorocarbon-based plasmas of oxycarbosilane (OCS) copolymer films with varying porosity and dielectric constants. They show that the etch behavior does not depend on the material structure that is disrupted by the ion bombardment during the etch process. The smaller pore size and increased carbon content of the OCS copolymer films minimize plasma-induced damage and prevent the etch stop phenomenon. These superior mechanical properties make OCS copolymer films promising candidates for replacing current low-k dielectric materials in future generation devices.
Gallium nitride MIS-HEMT using atomic layer deposited Al2O3 as gate dielectric
Authors: Lossy Richard , Gargouri Hassan , Arens Michael , Würfl Joachim
Published: December 2012

Metal–insulator–semiconductor high-electron-mobility transistors (MIS-HEMTs) were fabricated with an AlGaN/GaN heterostructure. The ALD-deposited Al2O3 layer served as gate dielectric under the gate electrode and as passivation layer in the access region. Different processing routes were tested and confirm that choosing the optimum order of processing steps is required to take full advantage of MIS-HEMT capabilities. Gate leakage currents as low as 2 × 10−10 A/mm at VGS = −20 V were measured. They are 4 orders of magnitude lower compared to the Schottky reference. Also, drain leakage went down to 10−8 A/mm and thus reduced by 3½ decades compared to the Schottky-type. The corresponding on/off-ratio rates 108. The subthreshold swing improved considerably from 180 mV/dec for the Schottky type to 90 mV/dec for the MIS-HEMT. Breakdown voltage is >200 V for a gate-drain distance >4 μm. From S-parameter measurements ft = 18 GHz and fmax = 72 GHz were extrapolated.
Scaling‐law for the energy dependence of anatomic power spectrum in dedicated breast CT
Authors: Vedantham Srinivasan , Shi Linxi , Glick Stephen J. , Karellas Andrew
Published: December 2012

Purpose:

To determine the x‐ray photon energy dependence of the anatomic power spectrum of the breast when imaged with dedicated breast computed tomography (CT).

Methods:

A theoretical framework for scaling the empirically determined anatomic power spectrum at one x‐ray photon energy to that at any given x‐ray photon energy when imaged with dedicated breast CT was developed. Theory predicted that when the anatomic power spectrum is fitted with a power curve of the formk f−β, where k and β are fit coefficients and f is spatial frequency, the exponent β would be independent of x‐ray photon energy (E), and the amplitude k scales with the square of the difference in energy‐dependent linear attenuation coefficients of fibroglandular and adipose tissues. Twenty mastectomy specimens based numerical phantoms that were previously imaged with a benchtop flat‐panel cone‐beam CT system were converted to 3D distribution of glandular weight fraction (fg) and were used to verify the theoretical findings. The 3D power spectrum was computed in terms of fg and after converting to linear attenuation coefficients at monoenergetic x‐ray photon energies of 20–80 keV in 5 keV intervals. The 1D power spectra along the axes were extracted and fitted with a power curve of the form k f−β. The energy dependence of k and β were analyzed.

Results:

For the 20 mastectomy specimen based numerical phantoms used in the study, the exponent β was found to be in the range of 2.34–2.42, depending on the axis of measurement. Numerical simulations agreed with the theoretical predictions that for a power‐law anatomic spectrum of the formk f−β, β was independent of E and k(E) = k1[μg(E) − μa(E)]2, where k1 is a constant, and μg(E) and μa(E) represent the energy‐dependent linear attenuation coefficients of fibroglandular and adipose tissues, respectively.

Conclusions:

Numerical simulations confirmed the theoretical predictions that in dedicated breast CT, the spatial frequency dependence of the anatomic power spectrum will be independent of x‐ray photon energy, and the amplitude of the anatomic power spectrum scales by the square of difference in linear attenuation coefficients of fibroglandular and adipose tissues.
A digitally reconstructed radiograph algorithm calculated from first principles
Authors: Staub David , Murphy Martin J.
Published: December 2012

Purpose:

To develop an algorithm for computing realistic digitally reconstructed radiographs (DRRs) that match real cone‐beam CT (CBCT) projections with no artificial adjustments.

Methods:

The authors used measured attenuation data from cone‐beam CT projection radiographs of different materials to obtain a function to convert CT number to linear attenuation coefficient (LAC). The effects of scatter, beam hardening, and veiling glare were first removed from the attenuation data. Using this conversion function the authors calculated the line integral of LAC through a CT along rays connecting the radiation source and detector pixels with a ray‐tracing algorithm, producing raw DRRs. The effects of scatter, beam hardening, and veiling glare were then included in the DRRs through postprocessing.

Results:

The authors compared actual CBCT projections to DRRs produced with all corrections (scatter, beam hardening, and veiling glare) and to uncorrected DRRs. Algorithm accuracy was assessed through visual comparison of projections and DRRs, pixel intensity comparisons, intensity histogram comparisons, and correlation plots of DRR‐to‐projection pixel intensities. In general, the fully corrected algorithm provided a small but nontrivial improvement in accuracy over the uncorrected algorithm. The authors also investigated both measurement‐ and computation‐based methods for determining the beam hardening correction, and found the computation‐based method to be superior, as it accounted for nonuniform bowtie filter thickness. The authors benchmarked the algorithm for speed and found that it produced DRRs in about 0.35 s for full detector and CT resolution at a ray step‐size of 0.5 mm.

Conclusions:

The authors have demonstrated a DRR algorithm calculated from first principles that accounts for scatter, beam hardening, and veiling glare in order to produce accurate DRRs. The algorithm is computationally efficient, making it a good candidate for iterative CT reconstruction techniques that require a data fidelity term based on the matching of DRRs and projections.
EF-P Is Essential for Rapid Synthesis of Proteins Containing Consecutive Proline Residues
Authors: Doerfel Lili K. , Wohlgemuth Ingo , Kothe Christina , Peske Frank , Urlaub Henning , Rodnina Marina V.
Published: December 2012

Translating Polyproline

Translation of messenger RNA into protein is carried out by the ribosome, together with a variety of accessory factors, which offer the potential for regulation of this critical step in gene expression (see the Perspective by

Buskirk and Green

).

Ude
et al.

(p.
82
, published online 13 December), using bacterial genetics and an in vitro reconstituted translation system, and

Doerfel
et al.

(p.
85
, published online 13 December), using a model assay for peptide bond formation, find that the universally conserved bacterial elongation factor P (EF-P) (which is orthologous to the archaeal and eukaryotic initiation factor 5A) is required for the efficient translation of polyproline-containing polypeptides. Such short polyproline stretches (with runs of two, three, or more proline residues) would otherwise cause ribosomal stalling.
Resveratrol: Too Early to Bring Out the Wine?
Authors: Nakamura Takahisa
Published: December 2012

Resveratrol supplementation does not improve metabolic parameters in nondiabetic obese men or nonobese women.
Cross-cultural adaptation of the VISA-P questionnaire for Greek-speaking patients with patellar tendinopathy
Authors: Korakakis Vasileios , Patsiaouras Asterios , Malliaropoulos Nikos
Published: December 2012

Objectives

To cross-culturally adapt the VISA-P questionnaire for Greek-speaking patients and evaluate its psychometric properties.

Background

The VISA-P was developed in the English language to evaluate patients with patellar tendinopathy. The validity and use of self-administered questionnaires in different language and cultural populations require a specific procedure in order to maintain their content validity.

Methods

The VISA-P questionnaire was translated and cross-culturally adapted according to specific guidelines. The validity and reliability were tested in 61 healthy recreational athletes, 64 athletes at risk from different sports, 32 patellar tendinopathy patients and 30 patients with other knee injuries. Participants completed the questionnaire at baseline and after 15–17 days.

Results

The questionnaire's face and content validity were judged as good by the expert committee, and the participants. Concurrent validity was almost perfect (ρ=−0.839, p<0.001). Also, factorial validity testing revealed a two-factor solution, which explained 85.6% of the total variance. A one-factor solution explained 80.8% of the variance when the other knee injury group was excluded. Known group validity was demonstrated by significant differences between patients compared with the asymptomatic groups (p<0.001). The VISA-P-GR exhibited very good test–retest reliability (ICC=0.818, p<0.001; 95% CI 0.758 to 0.864) and internal consistency since Cronbach's α analysis ranged from α=0.785 to 0.784 following a 15–17 days interval.

Conclusions

The translated VISA-P-GR is a valid and reliable questionnaire and its psychometric properties are comparable with the original and adapted versions.
Consensus views on implementation and measurement of enhanced recovery after surgery in England: Delphi study
Authors: Knott Amy , Pathak Samir , McGrath John S , Kennedy Robin , Horgan Alan , Mythen Monty , Carter Fiona , Francis Nader K
Published: December 2012

Objective

The Department of Health's Enhanced Recovery Partnership Programme (ERPP) started a spread and adoption scheme of Enhanced Recovery After Surgery (ERAS) throughout England. In preparation for widespread adoption the ERPP wished to obtain expert consensus on appropriate outcome measures for ERAS, emerging techniques being widely adopted and proposed methods for the continued development and sustainability of ERAS in the National Health Service. The aim of this study was to interrogate expert opinion and define areas of consensus on these issues.

Design

A Delphi technique using three rounds of reiterative questionnaires was used to obtain consensus.

Participants

Experts were chosen from teams with experience of delivering a successful ERAS programme across different surgical specialties and across various disciplines.

Setting

The first two rounds of the questionnaire were completed online and a final, third round was undertaken in a meeting using interactive voting.

Results

86 experts took part in this study. Consensus statements agreed that patient experience data should be recorded, analysed and reviewed at regular ERAS meetings. Recent developments in regional analgesia, the increased use of intraoperative monitoring for fluid management and cardio-pulmonary exercise testing were the main emerging techniques identified. National standards for those outcome measures would be welcomed. To sustain success in ERAS, the experts highlighted clinical champions and the presence of a dedicated ERAS facilitator as essential elements. For future networking, a unanimous agreement was achieved on the formation a national network to facilitate spread and adoption of ERAS and to promote research and education across surgery.

Conclusions

Consensus was achieved on regular measurement and review of patient experience in ERAS. Agreement was reached on the role of regional analgesia and the use of oesophageal Doppler for intraoperative goal-directed fluid therapy. In order to facilitate the further spread and adoption of best practices and to promote research and education, an ERAS-UK network was recommended.
Protocol for a phase III randomised trial of image-guided intensity modulated radiotherapy (IG-IMRT) and conventional radiotherapy for late small bowel toxicity reduction after postoperative adjuvant radiation in Ca cervix
Authors: Chopra Supriya , Engineer Reena , Mahantshetty Umesh , Misra Shagun , Phurailatpam Reena , Paul Siji N , Kannan Sadhna , Kerkar Rajendra , Maheshwari Amita , Shylasree TS , Ghosh Jaya , Gupta Sudeep , Thomas Biji , Singh Shalini , Sharma Sanjiv , Chilikuri Srinivas , Shrivastava Shyam Kishore
Published: December 2012

Introduction

External beam radiation followed by vaginal brachytherapy (±chemotherapy) leads to reduction in the risk of local recurrence and improves progression-free survival in patients with adverse risk factors following Wertheim's hysterectomy albeit at the risk of late bowel toxicity. Intensity Modulated Radiotherapy (IMRT) results in reduction in bowel doses and has potential to reduce late morbidity, however, needs to be confirmed prospectively in a randomised trial. The present randomised trial tests reduction if any in late small bowel toxicity with the use of IMRT in postoperative setting.

Methods and analysis

Patients more than 18 years of age who need adjuvant (chemo) radiation will be eligible. Patients with residual pelvic or para-aortic nodal disease, history of multiple abdominal surgeries or any other medical bowel condition will be excluded. The trial will randomise patients into standard radiation or IMRT. The primary aim is to compare differences in late grades II–IV bowel toxicity between the two arms. The secondary aims of the study focus on evaluating correlation of dose–volume parameters and late toxicity and quality of life. The trial is planned as a multicentre randomised study. The trial is designed to detect a 13% difference in late grades II–IV bowel toxicity with an α of 0.05 and β of 0.80. A total of 240 patients will be required to demonstrate the aforesaid difference.

Ethics and dissemination

The trial is approved by institutional ethics review board and will be routinely monitored as per standard guidelines. The study results will be disseminated via peer reviewed scientific journals, conference presentations and submission to regulatory authorities.

Registration

The trial is registered with clinicaltrials.gov (NCT 01279135).
Relationship between baseline resting diastolic function and exercise capacity in patients with hypertrophic cardiomyopathy undergoing treadmill stress echocardiography: a cohort study
Authors: AlJaroudi Wael A , Desai Milind Y , Alraies M Chadi , Thamilarasan Maran , Menon Venu , Rodriguez L Leonardo , Smedira Nicholas , Grimm Richard A , Lever Harry M , Jaber Wael A
Published: December 2012

Objective

Diastolic dysfunction (DD) is often incriminated in the symptomatology of patients with hypertrophic cardiomyopathy (HCM), but with limited supporting data. This study sought to assess the relationship between baseline diastolic function and exercise capacity in patients with HCM.

Design

Retrospective study.

Setting

Tertiary referral centre from Cleveland, Ohio, USA.

Participants

695 consecutive patients with a diagnosis of HCM who underwent exercise stress echocardiography between 1996 and 2011.

Primary and secondary outcome measures

Diastolic function was reassessed from the resting echocardiograms by two blinded board-certified cardiologists. Maximal metabolic equivalents (MET) were extracted from the records. Multivariate regression analysis was performed to determine independent predictors of METs achieved.

Results

Of 695 patients, 130 were excluded because of inability to assess diastolic function. There was no significant difference in maximal METs achieved between those excluded and included in the analysis (p=0.80). There were 495 remaining patients with a mean age (SD) of 50 (15) years, and 32% women among whom 102 (21%) had normal diastolic function, 243 (49%) stage 1 DD; 131 (26%) stage 2 DD and 19 (4%) stage 3 DD. Patients with advanced DD had lower maximal METs achieved compared with those with normal diastolic function (OR 3.18(1.96 to 5.14) for stage 1 versus normal, and 3.21(1.89 to 5.43) for stage ≥2 versus normal, p<0.0001 for both). After adjustment for demographics, comorbidities, echocardiographic parameters and haemodynamics, baseline DD was not an independent predictor of maximal METs achieved.

Conclusions

Although baseline DD is common in patients with HCM, it does not predict maximal METs achieved beyond traditional risk factors.
Clinician beliefs and attitudes about home haemodialysis: a multinational interview study
Authors: Tong Allison , Palmer Suetonia , Manns Braden , Craig Jonathan C , Ruospo Marinella , Gargano Letizia , Johnson David W , Hegbrant Jörgen , Olsson Måns , Fishbane Steven , Strippoli Giovanni F M
Published: December 2012

Objectives

To explore clinician beliefs and attitudes about home haemodialysis in global regions where the prevalence of home haemodialysis is low, and to identify barriers to developing home haemodialysis services and possible strategies to increase acceptance and uptake of home haemodialysis.

Design

Semistructured interviews, thematic analysis.

Setting

15 dialysis centres in Italy, Portugal, France, Germany, Sweden and Argentina.

Participants

28 nephrologists and 14 nurses caring for patients receiving in-centre haemodialysis.

Results

We identified four major themes as being central to clinician beliefs about home haemodialysis in regions without established services: external structural barriers (ready access to dialysis centres, inadequate housing conditions, unstable economic environment); dialysis centre characteristics (availability of alternative treatments, competing service priorities, commercial interests); clinician responsibility and motivation (preserving safety and security, lack of awareness, knowledge and experience, potential to offer lifestyle benefits, professional interest and advancement); and cultural apprehension (an unrelenting imposition, carer burden, attachment to professional healthcare provision, limited awareness).

Conclusions

Despite recognising the potential benefits of home haemodialysis, clinicians practicing in Europe and South America felt apprehensive and doubted the feasibility of home haemodialysis programmes. Programmes that provide clinicians with direct experience of home haemodialysis could increase acceptance and motivation for home-based haemodialysis, as might service prioritisation and funding models that favour home haemodialysis.
Comparative genomics of JapaneseErwinia pyrifoliaestrain Ejp617 with closely related erwinias
Authors: Thapa Shree P. , Park Duck H. , Kim Won S. , Choi Beom S. , Lim Jong S. , Choi Ik Y. , Hur Jang H. , Lim Chun K.
Published: December 2012

Japanese Erwinia pyrifoliae strains cause bacterial shoot blight of pear (BSBP) in Japan. The genetics of Japanese Erwinia remains largely unknown relative to the abundant genomic information available for other Erwinia strains. We compared the genome of Japanese and Korean E. pyrifoliae strains along with those of E. amylovora and E. tasmaniensis. Comparisons with the Korean E. pyrifoliae strain revealed numerous gene insertions/deletions, rearrangements, and inversions in the central regions of the chromosomes. Approximately 80% (2843) of coding DNA sequences (CDSs) are shared by these two genomes which represent about three-quarters of the genome, and there are about 20% unique CDSs. Comparative analysis with closely related erwinias showed that 1942 (more than 50%) core open reading frames (ORF) are shared by all these strains. In addition to two type III secretion systems (hrp/dsp and inv/spa), the genome of Ejp617 encodes numerous virulence factors, including a type VI secretion system, an exopolysaccharide synthesis cluster, and another protein secretion system present in plant pathogenic Erwinia strains. The availability of whole genome sequence should provide a resource to further improve the understanding of pathogenesis in Japanese E. pyrifoliae Ejp617 and to facilitate evolutionary studies among the species of the genus Erwinia.
Reduced expression of the dysbindin-like gene in the Bombyx mori ov mutant exhibiting mottled translucency of the larval skin
Authors: Wang Lingyan , Kiuchi Takashi , Fujii Tsuguru , Daimon Takaaki , Li Muwang , Banno Yutaka , Katsuma Susumu , Shimada Toru
Published: December 2012

The ov (mottled translucent of Var) mutant, an oily mutant of Bombyx mori, exhibits mottled translucent skin with a varying degree of transparency among individuals. By linkage analysis of 2112 backcross individuals using polymorphic DNA markers, we successfully mapped a 179-kb region of chromosome 20 responsible for the ov phenotype. This region contains nine predicted genes. We compared the mRNA expression of these nine genes between the wild type and mutants and found that the expression of one of them, Bmdysb, was strikingly decreased in the epidermis of ov as well as its allelomorph, ovp. Moreover, its expression level was well correlated with the degree of transparency among individuals. Bmdysb was homologous to DTNBP1 encoding human dysbindin, a subunit of the biogenesis of lysosome-related organelles complex-1. Our results suggest that the translucent skin may be due to repression of Bmdysb in the ov mutants and that Bmdysb plays an important role in the formation and accumulation of urate granules in the silkworm epidermis.
Nutritional Strategies to Minimise Exercise-Induced Immunosuppression in Athletes
Authors: Gleeson Michael , Lancaster Graeme I. , Bishop Nicolette C.
Published: December 2012

Strenuous prolonged exertion and heavy training are associated with depressed immune function. Furthermore, improper nutrition can compound the negative influence of heavy exertion on immunocompetence. Dietary deficiencies of protein and specific micronutrients have long been associated with immune dysfunction. An adequate intake of iron, zinc, and vitamins A, E, B6 and B12 is particularly important but excess intakes can also impair immune function. Immune system impairment has also been associated with excess intake of fat. To maintain immune function, athletes should eat a well balanced diet sufficient to meet their energy requirements. An athlete exercising in a carbohydrate-depleted state experiences larger increases in circulating stress hormones and a greater perturbation of several immune function indices. Conversely, consuming carbohydrate during exercise attenuates rises in stress hormones such as cortisol and appears to limit the degree of exercise-induced immunosuppression, at least for non-fatiguing bouts of exercise. Strong evidence that high doses of antioxidant vitamins, glutamine supplementation or echinacea extracts can prevent exercise-induced immunosuppression is lacking.
Energy Needs of Athletes
Authors: Burke Louise M.
Published: December 2012

Each athlete has unique energy requirements, which underpin their ability to meet total nutritional goals. For everyday dietary planning and evaluation, energy requirements can be predicted via estimations of RMR and activity levels. Research methods such as indirect calorimetry and DLW allow energy requirements to be measured, and may be useful to confirm situations in which an athlete has a true energy balance anomaly. There is some evidence that individual athletes may have reduced energy requirements, although this occurs less frequently than is reported. Most self-reports of food intake substantially under-estimate energy intake, due to under-reporting or under-eating during the period of record keeping. Many athletes are over-focused on reducing body mass and body fat below levels that are consistent with long-term health and performance. Restrained eating can cause significant detrimental outcomes to body function. Leptin may be involved in modulating or mediating some of these changes. Athletes should use their energy budget to choose foods that provide macronutrient and micronutrient needs for optimal health and performance. Practical advice may help athletes to achieve energy intake challenges.
Dietary Strategies to Promote Glycogen Synthesis After Exercise
Authors: Ivy John L.
Published: December 2012

Muscle glycogen is an essential fuel for prolonged intense exercise, and therefore it is important that the glycogen stores be copious for competition and strenuous training regimens. While early research focused on means of increasing the muscle glycogen stores in preparation for competition and its day-to-day replenishment, recent research has focused on the most effective means of promoting its replenishment during the early hours of recovery. It has been observed that muscle glycogen synthesis is twice as rapid if carbohydrate is consumed immediately after exercise as opposed to waiting several hours, and that a rapid rate of synthesis can be maintained if carbohydrate is consumed on a regular basis. For example, supplementing at 30-min intervals at a rate of 1.2 to 1.5 g CHO kg-1 body wt h-1 appears to maximize synthesis for a period of 4- to 5-h post exercise. If a lighter carbohydrate supplement is desired, however, glycogen synthesis can be enhanced with the addition of protein and certain amino acids. Furthermore, the combination of carbohydrate and protein has the added benefit of stimulating amino acid transport, protein synthesis and muscle tissue repair. Research suggests that aerobic peiformance following recovery is related to the degree of muscle glycogen replenishment.
Time Spent at a High Percentage of max for Short Intermittent Runs: Active Versus Passive Recovery
Authors: Dupont Grégory , Berthoin Serge
Published: December 2012

The purpose of this study was to compare the effects of recovery type (active vs. passive) on the time spent at [Formula: see text]max and above 90% of [Formula: see text]max during short intermittent runs (15 s) at 120% of maximal aerobic speed. Twelve male subjects peiformed a graded test and intermittent runs (15 s) alternated with 15 s of active recovery (50% of maximal aerobic speed) or with 15 s of passive recovery to exhaustion. The time to exhaustion during the intermittent runs with active recovery (445 ± 79 s) was significantly shorter (p < 0. 001) compared with passive recovery (745 ± 171 s). No significant difference wasfound between time spent at [Formula: see text]max and above 90% of[Formula: see text]max for intermittent runs alternated with active recovery (180 ± 121 s and 282 ± 1 17 s, respectively) and intermittent runs alternated with passive recovery (191 ± 135 s and 317 ± 132 s, respectively). The times spent at [Formula: see text]max (p < 0.05) and above 90% of [Formula: see text]max (p < 0.00 1), expressed in percentage of time to exhaustion, were significantly longer for intermittent runs alternated with active recovery (41 ± 27% and 64 ± 24%, respectively) than with passive recovery (25 ± 16% and 43 ± 1 6%, respectively). In conclusion, the present study has shown that the time to exhaustion during repeated highintensity exercise was significantly greater for passive compared with active recovery, despite no difference in absolute time spent at a high percentage of[Formula: see text]max. However, the time spent at a high percentage of[Formula: see text]max, expressed as a percentage of time to exhaustion, was significantly higher for active compared with passive recovery.
QUASILINEAR PROBLEMS WITH THE COMPETITION BETWEEN CONVEX AND CONCAVE NONLINEARITIES AND VARIABLE POTENTIALS
Authors: COVEI DRAGOS-PATRU
Published: December 2012

The purpose of this paper is to prove some existence and non-existence theorems for the nonlinear elliptic problems of the form -Δpu = λk(x)uq ± h(x)uσ if x ∈ Ω, subject to the Dirichlet condition u = 0 on ∂Ω. In the proof of our results we use the sub-solution, super-solution methods and variational arguments.