bluuebunny/crossref_metadata_2025 huggingface dataset:
Sunlight UV-Induced Skin Cancer Relies upon Activation of the p38α Signaling Pathway
Authors: Liu Kangdong , Yu Donghoon , Cho Yong-Yeon , Bode Ann M. , Ma Weiya , Yao Ke , Li Shengqing , Li Jixia , Bowden G. Tim , Dong Ziming , Dong Zigang
Published: February 2013

The activation of cellular signal transduction pathways by solar ultraviolet (SUV) irradiation plays a vital role in skin tumorigenesis. Although many pathways have been studied using pure ultraviolet A (UVA) or ultraviolet B (UVB) irradiation, the signaling pathways induced by SUV (i.e., sunlight) are not understood well enough to permit improvements for prevention, prognosis, and treatment. Here, we report parallel protein kinase array studies aimed at determining the dominant signaling pathway involved in SUV irradiation. Our results indicated that the p38-related signal transduction pathway was dramatically affected by SUV irradiation. SUV (60 kJ UVA/m2/3.6 kJ UVB/m2) irradiation stimulates phosphorylation of p38α (MAPK14) by 5.78-fold, MSK2 (RPS6KA4) by 6.38-fold, and HSP27 (HSPB1) by 34.56-fold compared with untreated controls. By investigating the tumorigenic role of SUV-induced signal transduction in wild-type and p38 dominant-negative (p38 DN) mice, we found that p38 blockade yielded fewer and smaller tumors. These results establish that p38 signaling is critical for SUV-induced skin carcinogenesis. Cancer Res; 73(7); 2181–8. ©2013 AACR.
Human Regulatory T Cells Do Not Suppress the Antitumor Immunity in the Bone Marrow: A Role for Bone Marrow Stromal Cells in Neutralizing Regulatory T Cells
Authors: Guichelaar Teun , Emmelot Maarten E. , Rozemuller Henk , Martini Bianka , Groen Richard W.J. , Storm Gert , Lokhorst Henk M. , Martens Anton C. , Mutis Tuna
Published: February 2013

Purpose: Regulatory T cells (Tregs) are potent tools to prevent graft-versus-host disease (GVHD) induced after allogeneic stem cell transplantation or donor lymphocyte infusions. Toward clinical application of Tregs for GVHD treatment, we investigated the impact of Tregs on the therapeutic graft-versus-tumor (GVT) effect against human multiple myeloma tumors with various immunogenicities, progression rates, and localizations in a humanized murine model.

Experimental Design: Immunodeficient Rag2−/−γc−/− mice, bearing various human multiple myeloma tumors, were treated with human peripheral blood mononuclear cell (PBMC) alone or together with autologous ex vivo cultured Tregs. Mice were analyzed for the in vivo engraftment, homing of T-cell subsets, development of GVHD and GVT. In additional in vitro assays, Tregs that were cultured together with bone marrow stromal cells were analyzed for phenotype and functions.

Results: Treatment with PBMC alone induced variable degrees of antitumor response, depending on the immunogenicity and the growth rate of the tumor. Coinfusion of Tregs did not impair the antitumor response against tumors residing within the bone marrow, irrespective of their immunogenicity or growth rates. In contrast, Tregs readily inhibited the antitumor effect against tumors growing outside the bone marrow. Exploring this remarkable phenomenon, we discovered that bone marrow stroma neutralizes the suppressive activity of Tregs in part via production of interleukin (IL)-1β/IL-6. We furthermore found in vitro and in vivo evidence of conversion of Tregs into IL-17–producing T cells in the bone marrow environment.

Conclusions: These results provide new insights into the Treg immunobiology and indicate the conditional benefits of future Treg-based therapies. Clin Cancer Res; 19(6); 1467–75. ©2012 AACR.
Differences in Relative Hippocampus Volume and Number of Hippocampus Neurons among Five Corvid Species
Authors: Gould Kristy L. , Gilbertson Karl E. , Hrvol Andrew J. , Nelson Joseph C. , Seyfer Abigail L. , Brantner Rose M. , Kamil Alan C.
Published: February 2013

The relative size of the avian hippocampus (Hp) has been shown to be related to spatial memory and food storing in two avian families, the parids and corvids. Basil et al. [Brain Behav Evol 1996;47:156–164] examined North American food-storing birds in the corvid family and found that Clark’s nutcrackers had a larger relative Hp than pinyon jays and Western scrub jays. These results correlated with the nutcracker’s better performance on most spatial memory tasks and their strong reliance on stored food in the wild. However, Pravosudov and de Kort [Brain Behav Evol 2006;67:1–9] raised questions about the methodology used in the 1996 study, specifically the use of paraffin as an embedding material and recalculation for shrinkage. Therefore, we measured relative Hp volume using gelatin as the embedding material in four North American species of food-storing corvids (Clark’s nutcrackers, pinyon jays, Western scrub jays and blue jays) and one Eurasian corvid that stores little to no food (azure-winged magpies). Although there was a significant overall effect of species on relative Hp volume among the five species, subsequent tests found only one pairwise difference, blue jays having a larger Hp than the azure-winged magpies. We also examined the relative size of the septum in the five species. Although Shiflett et al. [J Neurobiol 2002;51:215–222] found a difference in relative septum volume amongst three species of parids that correlated with storing food, we did not find significant differences amongst the five species in relative septum. Finally, we calculated the number of neurons in the Hp relative to body mass in the five species and found statistically significant differences, some of which are in accord with the adaptive specialization hypothesis and some are not.
Ultrastructure of Interstitial Cells in Subserosa of Human Colon
Authors: Rumessen Jüri Johannes , Vanderwinden Jean-Marie , Hansen Alastair , Horn Thomas
Published: February 2013

We studied the ultrastructure of interstitial cells in the subserosal/adventitial layer in human colon. An interstitial cell type with an ultrastructure intermediate between fibroblast-like cells (FLC) and interstitial cells of Cajal was identified (IC-SS). IC-SS had thin and flattened branching processes, most densely arranged close to the longitudinal muscle cells. Caveolae, bundles of intermediate filaments and membrane-associated dense bands, often with a patchy basal lamina, were characteristic. Secretory organelles (granular endoplasmic reticulum, smooth endoplasmic reticulum, Golgi, coated vesicles) were prominent. The IC-SS ultrastructure was different from that of FLC in the longitudinal layer, which had no caveolae and fewer intermediate filaments. Peg-and-socket junctions between IC-SS and between IC-SS and muscle cells were present, and IC-SS processes had close, selective appositions to muscle cells. Gap junctions were not observed. Small nerve bundles were abundant, but close contacts (<100 nm) between IC-SS or muscle cells and nerves were inconspicuous. Close appositions between IC-SS and mast cells were present; close relations to macrophages were not observed. The myoid features of IC-SS are thus more pronounced in comparison with FLC of other locations in the gastrointestinal muscle. The organization and ultrastructure may suggest a regulatory nature of IC-SS on the colonic muscle layers.
Cognitive Impairment in Studies of 5HTTLPR and Psychosis in Alzheimer’s Disease: A Systematic Review
Authors: Creese Byron , Ballard Clive , Jones Emma
Published: February 2013

Background/Aims: Cognitive impairment is a well-established correlate of psychotic symptoms in Alzheimer’s disease (AD-P). We review whether this relationship has confounded previous genetic association studies of 5HTTLPR and AD-P. Methods: We reviewed all studies on 5HTTLPR and conducted a semi-quantitative analysis. Results: Three out of 4 studies with low MMSE reported a significant association, while 1 out of 4 with high MMSE reported a significant association. Conclusions: Variation in cognitive impairment in past studies has contributed to the inconsistency in findings. The findings presented here bring a greater clarity to our understanding of the role of 5HTTLPR in AD-P.
Abnormal Lung Function in Adults With Congenital Heart Disease: Prevalence, Relation to Cardiac Anatomy, and Association With Survival
Authors: Alonso-Gonzalez Rafael , Borgia Francesco , Diller Gerhard-Paul , Inuzuka Ryo , Kempny Aleksander , Martinez-Naharro Ana , Tutarel Oktay , Marino Philip , Wustmann Kerstin , Charalambides Menelaos , Silva Margarida , Swan Lorna , Dimopoulos Konstantinos , Gatzoulis Michael A.
Published: February 2013

Background—

Restrictive lung defects are associated with higher mortality in patients with acquired chronic heart failure. We investigated the prevalence of abnormal lung function, its relation to severity of underlying cardiac defect, its surgical history, and its impact on outcome across the spectrum of adult congenital heart disease.

Methods and Results—

A total of 1188 patients with adult congenital heart disease (age, 33.1±13.1 years) undergoing lung function testing between 2000 and 2009 were included. Patients were classified according to the severity of lung dysfunction based on predicted values of forced vital capacity. Lung function was normal in 53% of patients with adult congenital heart disease, mildly impaired in 17%, and moderately to severely impaired in the remainder (30%). Moderate to severe impairment of lung function related to complexity of underlying cardiac defect, enlarged cardiothoracic ratio, previous thoracotomy/ies, body mass index, scoliosis, and diaphragm palsy. Over a median follow-up period of 6.7 years, 106 patients died. Moderate to severe impairment of lung function was an independent predictor of survival in this cohort. Patients with reduced force vital capacity of at least moderate severity had a 1.6-fold increased risk of death compared with patients with normal lung function (
P
=0.04).

Conclusions—

A reduced forced vital capacity is prevalent in patients with adult congenital heart disease; its severity relates to the complexity of the underlying heart defect, surgical history, and scoliosis. Moderate to severe impairment of lung function is an independent predictor of mortality in contemporary patients with adult congenital heart disease.
Assembling Old Tricks for New Tasks: A Neural Model of Instructional Learning and Control
Authors: Huang Tsung-Ren , Hazy Thomas E. , Herd Seth A. , O'Reilly Randall C.
Published: February 2013

We can learn from the wisdom of others to maximize success. However, it is unclear how humans take advice to flexibly adapt behavior. On the basis of data from neuroanatomy, neurophysiology, and neuroimaging, a biologically plausible model is developed to illustrate the neural mechanisms of learning from instructions. The model consists of two complementary learning pathways. The slow-learning parietal pathway carries out simple or habitual stimulus–response (S-R) mappings, whereas the fast-learning hippocampal pathway implements novel S-R rules. Specifically, the hippocampus can rapidly encode arbitrary S-R associations, and stimulus-cued responses are later recalled into the basal ganglia-gated pFC to bias response selection in the premotor and motor cortices. The interactions between the two model learning pathways explain how instructions can override habits and how automaticity can be achieved through motor consolidation.
Penguin and post-colonial publishing 1948–1972
Authors: McCleery Alistair
Published: February 2013

This article examines the trading structures within which UK publishers operated in the markets of Empire and Commonwealth and, in doing so, concentrates on the development there of Penguin Books. It proposes a model of this development mapped onto a movement from the colonial to the postcolonial to the globalized. A discussion of the Traditional Market Agreement 1947–1975 presents this as a significant factor in the postcolonial phase while the Penguin Africa Library acts as a case study of the specific operations of Penguin during this phase. The article concludes with an account of the transition of Penguin from independence to take-over by Pearson Longman.
Keeping It Complex
Authors: Lampert Magdalene , Franke Megan Loef , Kazemi Elham , Ghousseini Hala , Turrou Angela Chan , Beasley Heather , Cunard Adrian , Crowe Kathleen
Published: February 2013

We analyze a particular pedagogy for learning to interact productively with students and subject matter, which we call “rehearsal.” Our goal is to specify a way in which teacher educators (TEs) and novice teachers (NTs) can interact around teaching that is both embedded in practice and amenable to analysis. We address two main research questions: (a) What do TEs and NTs do together during the kind of rehearsals we have developed to prepare novices for the complex, interactive work of teaching? and (b) Where, in what they do, are there opportunities for NTs to learn to enact the principles, practices, and knowledge entailed in ambitious teaching? We detail what happens in rehearsals using quantitative and qualitative methods. We begin with the results of our quantitative analyses to characterize how typical rehearsals were structured and what was worked on. We then show how NTs and TEs worked together to enable novices to study principled practice through qualitative analyses of a particularly salient aspect of ambitious teaching, namely, eliciting and responding to students’ performance.
Transformational Leadership Skills and Correlates of Prison Warden Job Stress
Authors: Atkin-Plunk Cassandra A. , Armstrong Gaylene S.
Published: February 2013

Job stress is related to poor job performance, dissatisfaction, and turnover for correctional officers in the workplace. Despite parallel implications for correctional administrators, an extension of the correctional officer job stress literature to prison wardens is virtually absent. Yet the dynamic correctional environment includes many added challenges for prison wardens that could lead to a stressful work experience. Similar to those of officers, coping mechanisms for prison wardens may include peer support, but the extent of a warden’s transformational leadership skills could be related to a more positive work experience. Results indicate that wardens who perceived themselves as having higher levels of transformational leadership capacity also experienced less job stress. Peer support was unrelated to job stress, but employee trust was a robust correlate. In addition, although corrections tenure was unrelated, a wider breadth of corrections experience (holding treatment and custody positions) was related to less stress.
(Not) Bringing Up Baby
Authors: Hill Sarah E. , DelPriore Danielle J.
Published: February 2013

The present research uses insights from evolutionary psychology and social cognition to explore the relationship between jealousy—both experimentally activated and chronically accessible—on men’s and women’s desire to start a family and invest in children. In our first two studies, we found that chronically jealous men and women responded to primed infidelity threat by exhibiting a diminished interest in infants (Study 1) and reporting less happiness upon receiving pregnancy news (Study 2) relative to controls. Study 3 extended these results by examining the effects of jealousy on desired parental investment. Consistent with the proposed theoretical framework, chronically jealous men, but not women, respond to infidelity threat by decreasing their desired level of parental investment relative to controls. Together, these results provide novel empirical support for the hypothesis that jealousy functions to attenuate the reproductive costs associated with partner infidelity.
Brain Lesions Associated With Clostridium perfringens Type D Epsilon Toxin in a Holstein Heifer Calf
Authors: Mete A. , Garcia J. , Ortega J. , Lane M. , Scholes S. , Uzal F. A.
Published: February 2013

A 6-month-old dairy heifer calf with no premonitory signs was acutely down after the morning feeding and could not rise. On presentation, the heifer was in right lateral recumbency and moribund with opisthotonus and left hind limb paddling. Following euthanasia, gross examination of the brain revealed multifocal loss of gray-white matter distinction and extensive petechiae throughout the brainstem. On histopathological examination, there was striking white matter edema and marked perivascular proteinaceous edema surrounding many arterioles and venules (microangiopathy), mainly in the white matter of the internal capsule, thalamus, midbrain, cerebellum, and cerebellar peduncles. The perivascular neuropil was strongly positive for Alzheimer precursor protein A4. Clostridium perfringens epsilon toxin was detected in the intestinal contents. This is the first report of microangiopathy in postneonatal cattle associated with the detection of epsilon toxin in the intestinal contents.
Fatal Combined Infection With Canine Distemper Virus and Orthopoxvirus in a Group of Asian Marmots (Marmota caudata)
Authors: Origgi F. C. , Sattler U. , Pilo P. , Waldvogel A. S.
Published: February 2013

A fatal combined infection with canine distemper virus (CDV) and orthopoxvirus (OPXV) in Asian marmots ( Marmota caudata) is reported in this article. A total of 7 Asian marmots from a small zoological garden in Switzerland were found dead in hibernation during a routine check in the winter of 2011. The marmots died in February 2011. No clinical signs of disease were observed at any time. The viruses were detected in all individuals for which the tissues were available ( n = 3). Detection of the viruses was performed by reverse transcription polymerase chain reaction. The most consistent gross lesion was a neck and thorax edema. A necrotizing pharyngitis and a multifocal necrotizing pneumonia were observed histologically. Numerous large intracytoplasmic eosinophilic inclusions were seen in the epithelial cells of the pharynx, of the airways, and in the skin keratinocytes. Brain lesions were limited to mild multifocal gliosis. Phylogenetic analysis revealed that the marmot CDV strain was closely related to the clusters of CDVs detected in Switzerland in wild carnivores during a local outbreak in 2002 and the 2009–2010 nationwide epidemic, suggesting a spillover of this virus from wildlife. The OPXV was most closely related to a strain of cowpoxvirus, a poxvirus species considered endemic in Europe. This is the first reported instance of CDV infection in a rodent species and of a combined CDV and OPXV infection.
Perceptions of Nutrition Support in Pediatric Oncology Patients and Parents
Authors: Montgomery Kathleen , Belongia Meghan , Haddigan Mulberry Mollie , Schulta Christina , Phillips Sharon , Simpson Pippa M. , Nugent Melodee L.
Published: February 2013

An estimated 60% of pediatric oncology patients experience malnutrition during cancer therapy. Initiation of enteral nutrition (EN) and parenteral nutrition (PN) are interventions aimed at maintaining and promoting growth. Limited literature addressing perceptions of nutrition support methods exists. To develop effective guidelines on nutrition education, it is important to understand perceptions regarding nutrition support. The purpose of this pilot study was to describe perceptions of pediatric oncology patients and parents regarding the use of EN and PN and identify influencing variables. A convenience sample of pediatric oncology patients and parents were surveyed at a large Midwestern children’s hospital. The majority of those surveyed chose PN over EN if they or their child were unable to eat or maintain their nutritional status. Perceptions may be influenced by comfort, ease of nutrition or medication administration, experience, health care team’s recommendation, choice, and image. This study provides health care professionals an initial opportunity to understand perceptions of EN and PN, which may provide a foundation for a multi-institutional study and enhance patient and family education.
Development of an Evidence-Based Clinical Guideline for Age-Appropriate Screening, Prevention, and Management of Bone Abnormalities in Children Post–Hematopoietic Stem Cell Transplant
Authors: McDonald Lisa , Luke Julie , Jude Veronica , Chan KaWah , Cuellar Norma
Published: February 2013

Musculoskeletal complaints, pain, and weakness are common among children post–hematopoietic stem cell transplant (HSCT). Bone abnormalities include decreased bone mineral density and avascular necrosis, both affecting ambulation and quality of life for survivors. Several risk factors for both disorders among adults have been described along with suggested interventions. However, similar recommendations for screening and management of bone abnormalities among children and adolescents post-HSCT are not clearly defined. A review of the literature using PubMed, CINAHL, National Guideline Clearinghouse, and Cochrane Collection databases identified a paucity of reports specific to the management of bone abnormalities in children and adolescents post-HSCT. Although guidelines for evaluation of bone health in pediatric patients with cancer exist, none specifically address early screening and prevention. The purpose of this article is to provide a review of the literature on current evidence for age appropriate screening, prevention, and management of bone abnormalities in children post-HSCT and to present a clinical guideline for bone abnormalities in children post-HSCT used in a hospital-based outpatient center.
Electrical discharge machining characteristics of nickel–titanium shape memory alloy based on full factorial design
Authors: Alidoosti Ali , Ghafari-Nazari Ali , Moztarzadeh Fathollah , Jalali Newsha , Moztarzadeh Sina , Mozafari Masoud
Published: February 2013

Among many shape memory alloys, nickel–titanium (NiTi) alloys are popular due to their superior properties in shape memory effect and superelasticity. They are presently often used in microengineering and medical technology especially in orthopedic and orthodontic implants due to their specific properties. In this study, the electric discharge machine characteristics of NiTi shape memory alloys have been fully investigated by full factorial design. Analysis of mean showed that the material removal rate of NiTi in the electric discharge machine process significantly related to the electrodischarge energy, involving the pulse current and pulse duration. Many electrodischarge craters and recast layers were observed on the electric discharge machine surface of NiTi samples. In addition, there was no significant difference between copper (Cu) and tungsten–copper (W-Cu) electrodes in material removal rate but work stability of W-Cu electrode was longer. On the contrary, quantity of impurity on the surface of the Cu electrode was lower. The specimen’s hardness near the outer surface could reach 1200 Hv, which originated from the hardening effect of the recast layer. Here, the microstructure, composition, and hardness of electric discharge machine surfaces are also discussed.
Operative Treatment of Nonunion Following Distal Fibula and Medial Malleolar Ankle Fractures
Authors: Khurana Sonya , Karia Raj , Egol Kenneth A.
Published: February 2013

Background:

The purpose of this study was to evaluate the outcomes following operative treatment of nonunited rotational distal fibula and medial malleolar ankle fractures.

Methods:

Seventeen patients were identified as having a nonunion of a rotational ankle fracture. All patients were evaluated clinically, radiographically, and functionally with the Short Musculoskeletal Functional Assessment (SMFA) questionnaire. They were divided into lateral and medial malleolus groups and compared with 44 patients following a nonoperative (SE2/3) ankle fracture and 25 patients who underwent operative fixation of their SE4 ankle fracture for functional comparison.

Results:

Two of the 17 patients were excluded. The patients in the medial malleolar group were notably older than those in the other groups. Nonunions included 12 distal fibulas and 3 medial malleoli. All patients were treated with open reduction with plate and screw fixation or screw fixation alone. Adjunctive grafting was performed in all but 2 cases. The average time to healing was 5.2 months post surgery. At latest follow-up, mean 33.9 months, all nonunions had resolved. Standardized SMFA scores differed notably among the groups in the Bothersome, Emotional, and Mobility categories. There was no difference between lateral malleolar nonunion patients and surgically treated SE4 patients.

Conclusions:

Reports of nonunions of fractures of lateral and medial malleoli have been rarely reported. Operative treatment of these nonunions in this study led to reliable bony healing. Patients who underwent surgery for these nonunions ultimately had similar outcomes and range of motion compared with patients who underwent operative treatment for acute ankle fractures. Level of Evidence: Level III, retrospective comparative series.
Injectable Treatments for Noninsertional Achilles Tendinosis
Authors: Gross Christopher E. , Hsu Andrew R. , Chahal Jaskarndip , Holmes George B.
Published: February 2013

Background:

Although there has been a recent increase in interest regarding injectable therapy for noninsertional Achilles tendinosis, there are currently no clear treatment guidelines for managing patients with this condition. The objective of this study was (1) to conduct a systematic review of clinical outcomes following injectable therapy of noninsertional Achilles tendinosis, (2) to identify patient-specific factors that are prognostic of treatment outcomes, (3) to provide treatment recommendations based on the best available literature, and (4) to identify knowledge deficits that require further investigation.

Methods:

We searched MEDLINE (1948 to March week 1 2012) and EMBASE (1980 to 2012 week 9) for clinical studies evaluating the efficacy of injectable therapies for noninsertional Achilles tendinosis. Specifically, we included randomized controlled trials and cohort studies with a comparative control group. Data abstraction was performed by 2 independent reviewers. The Oxford Level of Evidence Guidelines and GRADE recommendations were used to rate the quality of evidence and to make treatment recommendations.

Results:

Nine studies fit the inclusion criteria for our review, constituting 312 Achilles tendons at final follow-up. The interventions of interest included platelet-rich plasma (n = 54), autologous blood injection (n = 40), sclerosing agents (n = 72), protease inhibitors (n = 26), hemodialysate (n = 60), corticosteroids (n = 52), and prolotherapy (n = 20). Only 1 study met the criteria for a high-quality randomized controlled trial. All of the studies were designated as having a low quality of evidence. While some studies showed statistically significant effects of the treatment modalities, often studies revealed that certain injectables were no better than a placebo.

Conclusions:

The literature surrounding injectable treatments for noninsertional Achilles tendinosis has variable results with conflicting methodologies and inconclusive evidence concerning indications for treatment and the mechanism of their effects on chronically degenerated tendons. Prospective, randomized studies are necessary in the future to guide Achilles tendinosis treatment recommendations using injectable therapies.

Level of Evidence:

Level II, systematic review.
Nature of pectin–protein–catechin interactions in model systems: Pectin–protein–catechin interactions
Authors: Zhao Guang-Yuan , Diao Hua-Juan , Zong Wei
Published: February 2013

Apple pectins, proteins and catechins were combined in model systems, and the resulting hazes were measured by spectrophotometric method, a zeta potential and particle size analyzer and Ostwald viscosimeter. The amount of hazes formed depends on the concentrations of both protein and pectin. The cooperative hydrogen bonding between the numerous hydroxyl groups of pectins and hydrone and the gel-like structure developed by pectin induced the solvation or solubilization of polymers, and the protein molecule has a fixed number of polyphenol binding sites. The influence of pectin relative molecular mass and degree of esterification on the formation of suspended particles is prominent, and this makes the number of hydroxyl groups and charge of pectin which is concerned with combining protein and catechin to change a lot. More haze was observed when model systems were heated, suggesting that hydrophobic groups of protein are beneficial to their binding with phenols and pectins. The pH value affects the charged state of the protein and pectin, which influences the combination of pectin–gliadin–catechin.
Treating Comorbid Anxiety in Adolescents With ADHD Using a Cognitive Behavior Therapy Program Approach
Authors: Houghton Stephen , Alsalmi Nadiyah , Tan Carol , Taylor Myra , Durkin Kevin
Published: February 2013

Objective: To evaluate an 8-week cognitive behavior therapy (CBT) treatment specifically designed for adolescents with ADHD and comorbid anxiety. Method: Using a multiple baseline design, nine adolescents (13 years to 16 years 9 months) received a weekly CBT, which focused on four identified anxiety-arousing times. Participants self-recorded their levels of anxiety for each of the four times during baseline, intervention, and a maintenance phase. Anxiety was also assessed using the Multidimensional Anxiety Scale for Children (MASC). Results: Paired samples t tests supported the success of the intervention. Interrupted time-series data for each participant revealed varying rates of success across the four times, however. The MASC data revealed significant reductions in Physical Symptoms of Anxiety, Social Anxiety, Separation Anxiety, Harm Avoidance, and Total Anxiety. Conclusion: The data demonstrate the efficacy of a CBT program for the treatment of comorbid anxiety in adolescents with ADHD.
Perioperative Management of Shock in Two Fontan Patients With Plastic Bronchitis
Authors: Singhal Niel Raj , Da Cruz Eduardo M. , Nicolarsen Jeremy , Schwartz Lawrence Israel , Merritt Glenn Richard , Barrett Cindy , Twite Mark David , Ing Richard John
Published: February 2013

Plastic bronchitis is potentially a life-threatening complication of long-standing surgically palliated single ventricle congenital heart disease. Patients can present with hypoxia requiring urgent bronchoscopy for removal of bronchial casts. Perioperative care for these patients is challenging and anesthesia is associated with significant cardiac risk. As more surgically corrected single ventricle patients survive to adulthood, these patients are expected to present more frequently. This report details the perioperative management of 2 Fontan patients with hypoxia and significant plastic bronchitis disease burden.
The Pharmacokinetics of Phenylethyl Alcohol (PEA)
Authors: Politano Valerie T. , Diener Robert M. , Christian Mildred S. , Hawkins David R. , Ritacco Gretchen , Api Anne Marie
Published: February 2013

The present studies were conducted to compare the dermal absorption, plasma pharmacokinetics, and excretion of phenylethyl alcohol (PEA) by pregnant and nonpregnant rats, rabbits, and humans. The PEA is a natural fragrance material that is widely used in perfumes, soaps, and lotions and is a major ingredient of natural rose oil. Following dermal (430, 700, or 1400 mg/kg body weight [bw]), gavage (430 mg/kg bw), or dietary (430 mg/kg bw) administration of PEA to rats, plasma concentrations of PEA were found to be low regardless of the route of administration. The plasma concentrations of phenylacetic acid (PAA, the major metabolite of PEA) greatly exceeded the concentrations of PEA and were highest after gavage, followed by dermal then dietary administration. Absorption, distribution, metabolism, and excretion were compared following topical application of 14C-labeled PEA to rats, rabbits, and humans (specific activities of dosing solutions: 58-580, 164, and 50 µCi/mL, respectively). In rabbits, the plasma concentration–time profile for PAA was markedly prolonged compared to rats or humans. In humans, only 7.6% of the applied dose of PEA was absorbed, versus 77% in rats and 50% in rabbits. Based on a human dermal systemic exposure of 0.3 mg/kg per day from the use of multiple consumer personal care products containing PEA, a rat dermal no observed adverse effect level of 70 mg/kg per day, and the percentage of dose absorbed in humans, the margin of safety exceeds 2600 concluding that, under normal fragrance use conditions, PEA is not a developmental toxicity hazard for humans.
Multimodal analgesia for perioperative pain in three cats
Authors: Steagall Paulo VM , Monteiro-Steagall Beatriz P
Published: February 2013

Adequate pain relief is usually achieved with the simultaneous use of two or more different classes of analgesics, often called multimodal analgesia. The purpose of this article is to highlight the use of perioperative multimodal analgesia and the need to individualize the treatment plan based on the presenting condition, and to adjust it based on the response to analgesia for a given patient. This case series presents the alleviation of acute pain in three cats undergoing different major surgical procedures. These cases involved the administration of different classes of analgesic drugs, including opioids, non-steroidal anti-inflammatory drugs, tramadol, ketamine, gabapentin and local anesthetics. The rationale for the administration of analgesic drugs is discussed herein. Each case presented a particular challenge owing to the different cause, severity, duration and location of pain. Pain management is a challenging, but essential, component of feline practice: multimodal analgesia may minimize stress while controlling acute perioperative pain. Individual response to therapy is a key component of pain relief in cats.
Prevalence of brain magnetic resonance imaging meeting Barkhof and McDonald criteria for dissemination in space among headache patients
Authors: Liu Syrone , Kullnat Jonathan , Bourdette Dennis , Simon Jack , Kraemer Dale F , Murchison Charles , Hamilton Bronwyn E
Published: February 2013

Background:

Incidental T2 white matter hyperintensities (WMHs) in headache patients on brain magnetic resonance imaging (MRI) may prompt concern for demyelinating disease.

Objective:

We reviewed brain MRI studies in patients with headaches without known demyelinating disease to determine the prevalence meeting imaging criteria for multiple sclerosis (MS) using two different definitions of “juxtacortical” and “periventricular”.

Methods:

Consecutive patients undergoing pre- and post-contrast MRI for headaches over a 25-month period were retrospectively identified. Exclusions included patients under age 10 and over 55 years or with known demyelinating disorder. Patients were classified as meeting: 1) Barkhof and 2) 2010 McDonald dissemination in space criteria for MS based on: FLAIR/T2 scans for WMH and enhanced T1-weighted images for enhancement. Both groups were further differentiated by defining “periventricular” and “juxtacortical” as WMH contacting ventricle and cortex (Barkhof “touching”, McDonald “touching”) versus WMH within 3 mm (Barkhof – 3 mm, McDonald – 3 mm).

Results:

326/564 (58%) studies met inclusion criteria. WMH prevalence was 168/326 (51.53%). Barkhof “touching” criteria were met in 4/168 (2.4%) and in 12/168 (7.1%) of the 3 mm group. McDonald criteria were met in 41/168 (24.4%) for “touching” and 58/168 (34.5%) for 3 mm, respectively.

Conclusion:

Barkhof and McDonald criteria were met in 2.4–7.1% and 24.4–34.5%, respectively.
Parent–child interactions in autism: Characteristics of play
Authors: Freeman Stephanny , Kasari Connie
Published: February 2013

Although the literature on parent–child interactions in young children with autism has examined dyadic style, synchrony, and sustained engagement, the examination of parental skill in sustaining and developing play skills themselves has not been targeted. This study examined the extent to which parents of young children with autism match and scaffold their child’s play. Sixteen dyads of parents and their children with autism participated in this study along with 16 matched dyads of typically developing children. Both groups were administered a structured play assessment and were observed during a 10-min free play situation. Strategies of play were examined and results revealed that parents of children with autism initiated more play schemes and suggested and commanded play acts more than parents of typical children. They also responded to their child’s play acts more often with a higher level play act, while parents of typical children matched/expanded their responses to their child. Parent imitation was also related to longer sequences of play. The findings can guide further research and play intervention for parents.
Bipolar disorder: Idioms of susceptibility and disease and the role of ‘genes’ in illness explanations
Authors: Baart Ingrid , Widdershoven Guy
Published: February 2013

This qualitative study explores (1) how members of the Dutch Association for People with Bipolar Disorder explain the affliction of bipolar disorder; (2) the relationship between genetic, environmental and personal factors in these explanations and (3) the relationship between illness explanations, self-management and identity. A total of 40 participants took part in seven different focus group discussions. The results demonstrate that there are two different explanatory idioms, each one centred around an opposing concept, that is, susceptibility and disease. Individuals who construct explanations around the concept of ‘disease’ attach more importance to ‘genes and chemicals’ than to environmental components in the onset of the disorder, whereas individuals adhering to the central concept of ‘susceptibility’ tend to do this much less. Compared with individuals using the ‘susceptibility’ idiom, those who use a ‘disease’ idiom tend to observe fewer possibilities for self-management and are less inclined to construct normalcy through a quest for personal growth. Stories of suffering seem more integral to the ‘disease’ idiom than to the ‘susceptibility’ idiom. The ‘disease’ idiom seems less integrated in a contemporary surveillance psychiatric discourse than the ‘susceptibility’ idiom; however, both vocabularies can offer normative constraints.
Hesitant geographies of power: The materiality of colonial rule in the Siin (Senegal), 1850–1960
Authors: Richard François G.
Published: February 2013

This essay draws on archival and archaeological sources to examine historical matters of power in the Siin province (Senegal) and their inscription in village landscapes. It focuses specifically on the entanglements of the longue durée binding Siin’s Serer peasantry and the ‘colonial state’. Building on the work of Michel Foucault, the article suggests that historical archaeology is in a prime position to study the construction of colonial rule in African settings, and to shed light on the workings, logics, and ambiguities of state power on imperial margins. Going beyond arguments of domination and resistance, it seeks to examine the intended and unexpected effects of colonial government, how it transformed the lifeworlds of rural Africans while creating conditions for the emergence of new modes of social action.
Development and evaluation of a telehealth videoconferenced support group for rural spouses of individuals diagnosed with atypical early-onset dementias
Authors: O’Connell Megan E , Crossley Margaret , Cammer Allison , Morgan Debra , Allingham Wendy , Cheavins Betty , Dalziel Donna , Lemire Maurice , Mitchell Sheri , Morgan Ernie
Published: February 2013

Atypical and early-onset dementias can be particularly problematic for family caregivers, and support groups aimed at memory loss and Alzheimer’s disease are not always helpful. Unfortunately, little has been developed specifically for caregivers of individuals with atypical dementias such as the frontotemporal dementias. Compounding the lack of access to interventions targeted specifically at caregivers of individuals with atypical and early-onset dementias are the unique needs of rural caregivers. Due to the relative infrequency of these particular dementias and the large geographical distances between rural caregivers, technology-facilitation is required for any group-based intervention. This paper describes the development of a secure telehealth videoconferenced support group for rural spouses of individuals with atypical and early-onset dementias. In addition, we provide preliminary evidence of effectiveness and describe a template for future groups based on the key therapeutic aspects of this novel technology-facilitated intervention.
Integrated care model with self-management in chronic obstructive pulmonary disease
Authors: Bourbeau Jean , Saad Nathalie
Published: February 2013

Patient with chronic obstructive pulmonary disease (COPD) has to become a partner and an active participant in his own care, that is, disease self-management. The goal of this article is to present successful and unsuccessful interventions using patient self-management and to propose a model of integrated care more suitable to the needs of COPD patients. This is a narrative review and an opinion article. Many systematic reviews have shown positive outcomes for patients with COPD. These studies have in common a self-management intervention including an action plan in the event of an exacerbation embedded in an integrated health-care system coordinated by a case manager for educational sessions and regular communication. Recently published trials have brought controversy with respect to the effectiveness of self-management programmes, especially in patients with high burden of disease and co-morbidities. It may be more challenging to make the patient with high burden of disease a partner and not without risk of serious adverse events. Finally, our health-care delivery has to be well integrated and more coherent, that is, strategic alliance between primary and secondary care, and supported by interdisciplinary teams for patients with high-risk and complex COPD. Clinical practice has to be structured to address COPD throughout the disease spectrum, that is, secondary versus primary, team work, partnership, self-management and continuity of care.
What factors do senior community nurses (Grade 7) consider in the provision of effective pressure ulcer preventative care in older aged patients?
Authors: Papanikolaou Panos
Published: February 2013

This research identifies the views of senior community nurses (Grade 7, often known as District Nurse Team Leaders) in relation to the different service descriptions of pressure ulcer preventative care for older people. The discrete choice experiment (DCE) approach was employed. Scenarios were developed based on: ease of treatment management, impact of treatment on patient lifestyle, affordability of treatment, strength of current evidence and speed for obtaining the equipment. These scenarios were identified from focus discussions and incorporated into a self-administered questionnaire. This questionnaire was posted to 124 nurses in Wales, UK and regression analysis was applied to 85 consistent responses. The results demonstrate that the most preferred treatments are affordable, evidence-based and manageable, and use readily obtainable equipment. The impact of treatment was not significant for this experiment. The usefulness of the DCE approach in the nursing context is discussed in relation to this study.
Curse of the ghost pills: the role of oral controlled-release formulations in the passage of empty intact shells in faeces. Two case reports and a literature review relevant to psychiatry
Authors: Tungaraza Tongeji Elifazi , Talapan-Manikoth Pravija , Jenkins Rosemary
Published: February 2013

Orally taken tablets in different formulations continue to have a central role in the treatment of various psychiatric and medical conditions. In order to improve compliance, reduce the frequency of taking medications and minimize the peaks and troughs associated with certain immediate-release formulations, pharmaceutical companies have developed a number of novel methods of delivering oral solid dosage medications in the form of controlled-release (CR) formulations. Some CR formulations have been associated with pharmacobezoars and false-positive findings on certain physical investigations. Though CR drugs are commonly used in psychiatry, clinicians appear to have a limited understanding of how they are released for absorption once ingested. Some have insoluble parts that are excreted in faeces as ‘ghost pills’. Due to lack of awareness of this phenomenon to both patients and the physicians, anxiety has ensued in some patients. Some clinicians have been puzzled or have been dismissive when faced with curious patients wanting to know more after they had observed tablet-like looking structures in faeces. We present two cases from our clinical setting and a few drawn from the World Wide Web to highlight the role of CR medications and their association with the ghost pill phenomenon. The mechanisms involved in drug release relevant to psychiatry medications are also briefly reviewed. The ghost pill phenomenon occurs with certain CR medications. This is a normal and expected outcome related to drug-release mechanisms of some of these products. It is inevitable that some patients will see what looks like tablets or capsules in faeces. Raising awareness of this phenomenon among clinicians would facilitate discussions and information sharing at the initial process of medication prescribing. Awareness among patients and carers would also help to allay anxiety.
Gender Differences in the Determinants of Distress, Alcohol Misuse, and Related Psychiatric Disorders
Authors: Elliott Marta
Published: February 2013

This study examines why women exhibit higher rates of psychological distress and affective and anxiety disorders whereas men report more problems with alcohol and alcohol-related disorders. Using two waves of panel data from 5,001 respondents to the National Co-morbidity Survey, confirmatory factor analysis and structural equation modeling are utilized to compare the stress process of distress, alcohol misuse, and meeting the diagnostic criteria for affective, anxiety, and alcohol-related disorders according to access to resources and exposure to stressors. Theories of emotional socialization, self-salience, and gender roles are applied to interpret gender differences in the determinants of mental health outcomes. The results reveal that gender role theory fits best for models of psychological distress and affective and anxiety disorders, whereas emotional socialization and self-salience theories fit best for models of alcohol intake and alcohol-related disorders. The implications of these results and directions for future research on gender differences in mental health are discussed.
Plasma Epstein-Barr virus DNA predicts outcome in advanced Hodgkin lymphoma: correlative analysis from a large North American cooperative group trial
Authors: Kanakry Jennifer A. , Li Hailun , Gellert Lan L. , Lemas M. Victor , Hsieh Wen-son , Hong Fangxin , Tan King L. , Gascoyne Randy D. , Gordon Leo I. , Fisher Richard I. , Bartlett Nancy L. , Stiff Patrick , Cheson Bruce D. , Advani Ranjana , Miller Thomas P. , Kahl Brad S. , Horning Sandra J. , Ambinder Richard F.
Published: February 2013

Key Points

Plasma EBV-DNA is highly concordant with EBV tumor status in Hodgkin lymphoma. Plasma EBV-DNA has prognostic significance in Hodgkin lymphoma, both before therapy and at month 6 of follow-up.
Combining BCR-ABL1 transcript levels at 3 and 6 months in chronic myeloid leukemia: implications for early intervention strategies
Authors: Neelakantan Pratap , Gerrard Gareth , Lucas Claire , Milojkovic Dragana , May Philippa , Wang Lihui , Paliompeis Christos , Bua Marco , Reid Alistair , Rezvani Katayoun , O'Brien Stephen , Clark Richard , Goldman John , Marin David
Published: February 2013

Key Points

Response to TKIs can be accurately established by measuring the 3-month transcript level. An additional measurement of the transcript level at 6 months adds very little useful clinical information to the 3-month result.