bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood tuberculosis and its treatment outcomes in Addis Ababa: a 5-years retrospective study
Authors: Hailu Dereje , Abegaz Woldaregay Erku , Belay Mulugeta
Published: March 2014

Background

Tuberculosis (TB) remains a significant public health problem leading to high morbidity and mortality both in adults and children. Reports on childhood TB and its treatment outcome are limited. In this retrospective study, we analyzed the epidemiology and treatment outcomes of TB among children in Addis Ababa.

Methods

Children registered for TB treatment over 5 years (2007 to 2011) were included in the analysis. Demographic and clinical data including treatment outcomes were extracted from TB unit registers of 23 health centers in Addis Ababa. Multivariate logistic regression was used to identify predictors of poor treatment outcomes.

Results

Among 41,254 TB patients registered for treatment at the 23 health centers, 2708 (6.6%) were children. Among children with TB, the proportions of smear positive PTB, smear negative PTB and EPTB were 9.6%, 43.0% and 47.4%, respectively. Treatment outcomes were documented for 95.2% of children of whom 85.5% were successfully treated while rates of mortality and defaulting from treatment were 3.3% and 3.8%, respectively. The proportion of children with TB tested for HIV reached 88.3% during the final year of the study period compared to only 3.9% at the beginning of the study period. Mortality was significantly higher among under-five children (p < 0.001) and those with HIV co-infection (p < 0.001). On multivariate logistic regression, children 5–9 years [AOR = 2.50 (95% CI 1.67-3.74)] and 10–14 years [AOR = 2.70 (95% CI 1.86-3.91)] had a significantly higher successful treatment outcomes. On the other hand, smear positive PTB [AOR = 0.44 (95% CI 0.27-0.73), HIV co-infection (AOR = 0.49(95% CI 0.30-0.80)] and unknown HIV sero-status [AOR = 0.60 (95% CI 0.42-0.86)] were predictors of poor treatment outcomes.

Conclusion

The proportion of childhood TB in this study is lower than the national estimate. The overall treatment success rate has met the WHO target. Nonetheless, younger children (< 5 years), children with smear positive PTB and those with HIV co-infection need special attention to reduce poor treatment outcomes among children in the study area.
Main barriers to effective implementation of stroke care pathways in France: a qualitative study
Authors: Gache Kristel , Leleu Henri , Nitenberg Gérard , Woimant France , Ferrua Marie , Minvielle Etienne
Published: February 2014

Background

Stroke Care Pathways (SCPs) aim to improve quality of care by providing better access to stroke units, rehabilitation centres, and home care for dependent patients. The objective of this study was to identify the main barriers to effective implementation of SCPs in France.

Methods

We selected 4 types of SCPs currently implemented in France that differed in terms of geographical location, population size, socio-economic conditions, and available health care facilities. We carried out 51 semi-structured interviews of 44 key health professionals involved in these SCPs and used the interview data to (i) create a typology of the organisational barriers to effective SCP implementation by axial coding, (ii) define barrier contents by vertical coding. The typology was validated by a panel of 15 stroke care professionals.

Results

Four main barriers to effective SCP implementation were identified: lack of resources (31/44 interviewees), coordination problems among staff (14/44) and among facilities (27/44), suboptimal professional and organisational practices (16/44), and inadequate public education about stroke (13/44). Transposition of the findings onto a generic SCP highlighted alternative care options and identified 10 to 17 barriers that could disrupt continuity of care.

Conclusion

Lack of resources was considered to be the chief obstacle to effective SCP implementation. However, the main weakness of existing SCPs was poor communication and cooperation among health professionals and among facilities. We intend to use this knowledge to construct a robust set of quality indicators for use in SCP quality improvement initiatives, in comparisons between SCPs, and in the assessment of the effective implementation of clinical practice guidelines.
The mitochondrial ATPase6 gene is more susceptible to mutation than the ATPase8 gene in breast cancer patients
Authors: Ghaffarpour Massoud , Mahdian Reza , Fereidooni Forouzandeh , Kamalidehghan Behnam , Moazami Nasrin , Houshmand Massoud
Published: March 2014

Background

Breast cancer is the most common malignancy in women throughout the world. Mitochondria play important roles in cellular energy production, free radical generation and apoptosis. Identification of mitochondrial DNA mutations and/or polymorphisms as cancer biomarkers is rapidly developing in molecular oncology research.

Methods

In this study, the DNA alterations of the mitochondrialATPase 6and8genes were investigated in 49 breast cancer patients using PCR amplification and direct DNA sequencing on mtDNA. A possible association between these variants and tumorigenesis was assessed. Furthermore, the impact of non-synonymous substitutions on the amino acid sequence was evaluated using the PolyPhen-2 software.

Results

Twenty eight distinct somatic mitochondrial DNA variants were detected in tumor tissues but not in the corresponding adjacent non-tumor tissues. Among these variants, 9 were observed for the first time in breast cancer patients. The mtDNA variants of A8384 (T7A), T8567C (I14T), G8572A (G16S), A9041G (H172R) and G9055A (A177T) showed the most significant effects probably due to damaging changes to the resulting protein. Furthermore, non-synonymous amino acid changing variants were more frequent in theATPase6gene compared to theATPase8gene.

Conclusion

Our results showed that theATPase6gene is more susceptible to variations in breast cancer and may play an important role in tumorigenesis by changing the energy metabolism level in cancer cells.
Mental health outcomes of mothers who conceived using fertility treatment
Authors: Raguz Nikolett , McDonald Sheila W , Metcalfe Amy , O’Quinn Candace , Tough Suzanne C
Published: February 2014

Objective

To compare the proportion of women with self-reported depression and anxiety symptoms at four months postpartum between mothers of singletons who conceived spontaneously and mothers who conceived with the aid of fertility treatment.

Methods

The sample used for this study was drawn from The “All Our Babies Study”, a community-based prospective cohort of 1654 pregnant women who received prenatal care in Calgary, Alberta. This analysis included women utilizing fertility treatment and a randomly selected 1:2 comparison group. The data was collected via three questionnaires, two of which were mailed to the participants during pregnancy and one at four months postpartum. Symptoms of depression and anxiety at four months postpartum were measured using the Edinburg Postnatal Depression Scale and the Spielberger State Anxiety Inventory. Secondary outcomes of parenting morale and perceived stress were also evaluated. Descriptive statistics were used to characterize the population. Chi square tests and in cases of small cell sizes, Fisher Exact Tests were used to assess differences in postpartum mental health symptomatology between groups.

Results

Seventy-six participants (5.9%) conceived using a form of fertility treatment. At four months postpartum, no significant differences were observed in the proportions reporting excessive depression symptoms (2.6% vs. 5.3%, p = 0.50), anxiety (8.1% vs. 16.9%, p = 0.08) or high perceived stress scores (7.9% vs. 13.3%, p = 0.23). Women who conceived with fertility treatment were less likely to score low on parenting morale compared to women who conceived spontaneously and this was particularly evident in primiparous women (12.5% vs. 33.8%, p = 0.01). There were no group differences in proportions reporting low parenting morale in multiparous women.

Conclusion

This study suggests that at four months postpartum, the proportion of women who experience elevated symptoms of depression, anxiety or perceived stress do not differ between mothers who conceive using fertility treatment and those who conceive spontaneously. Parenting morale at four months postpartum is significantly lower in primiparous mothers conceiving spontaneously compared to those who conceive with fertility treatment.
Understanding diagnosis and management of dementia and guideline implementation in general practice: a qualitative study using the theoretical domains framework
Authors: Murphy Kerry , O’Connor Denise A , Browning Colette J , French Simon D , Michie Susan , Francis Jill J , Russell Grant M , Workman Barbara , Flicker Leon , Eccles Martin P , Green Sally E
Published: March 2014

Background

Dementia is a growing problem, causing substantial burden for patients, their families, and society. General practitioners (GPs) play an important role in diagnosing and managing dementia; however, there are gaps between recommended and current practice. The aim of this study was to explore GPs’ reported practice in diagnosing and managing dementia and to describe, in theoretical terms, the proposed explanations for practice that was and was not consistent with evidence-based guidelines.

Methods

Semi-structured interviews were conducted with GPs in Victoria, Australia. The Theoretical Domains Framework (TDF) guided data collection and analysis. Interviews explored the factors hindering and enabling achievement of 13 recommended behaviours. Data were analysed using content and thematic analysis. This paper presents an in-depth description of the factors influencing two behaviours, assessing co-morbid depression using a validated tool, and conducting a formal cognitive assessment using a validated scale.

Results

A total of 30 GPs were interviewed. Most GPs reported that they did not assess for co-morbid depression using a validated tool as per recommended guidance. Barriers included the belief that depression can be adequately assessed using general clinical indicators and that validated tools provide little additional information (theoretical domain of ‘Beliefs about consequences’); discomfort in using validated tools (‘Emotion’), possibly due to limited training and confidence (‘Skills’; ‘Beliefs about capabilities’); limited awareness of the need for, and forgetting to conduct, a depression assessment (‘Knowledge’; ‘Memory, attention and decision processes’). Most reported practising in a manner consistent with the recommendation that a formal cognitive assessment using a validated scale be undertaken. Key factors enabling this were having an awareness of the need to conduct a cognitive assessment (‘Knowledge’); possessing the necessary skills and confidence (‘Skills’; ‘Beliefs about capabilities’); and having adequate time and resources (‘Environmental context and resources’).

Conclusions

This is the first study to our knowledge to use a theoretical approach to investigate the barriers and enablers to guideline-recommended diagnosis and management of dementia in general practice. It has identified key factors likely to explain GPs’ uptake of the guidelines. The results have informed the design of an intervention aimed at supporting practice change in line with dementia guidelines, which is currently being evaluated in a cluster randomised trial.
Sputum myeloperoxidase in chronic obstructive pulmonary disease
Authors: Zhu Alling , Ge Dehai , Zhang Jingying , Teng Yue , Yuan Cheng , Huang Mao , Adcock Ian M , Barnes Peter J , Yao Xin
Published: March 2014

Background

Airway inflammation, especially neutrophilic airway inflammation, is a cardinal pathophysiologic feature in chronic obstructive pulmonary disease (COPD) patients. The ideal biomarkers characterizing the inflammation might have important potential clinical applications in disease assessment and therapeutic intervention. Sputum myeloperoxidase (MPO) is recognized as a marker of neutrophil activity. The purpose of this meta-analysis is to determine whether sputum MPO levels could reflect disease status or be regulated by regular medications for COPD.

Methods

Studies were identified by searching PubMed, Embase, the Cochrane Database, CINAHL andhttp://www.controlled-trials.comfor relevant reports published before September 2012. Observational studies comparing sputum MPO in COPD patients and healthy subjects or asthmatics, or within the COPD group, and studies comparing sputum MPO before and after treatment were all included. Data were independently extracted by two investigators and analyzed using STATA 10.0 software.

Results

A total of 24 studies were included in the meta-analysis. Sputum MPO levels were increased in stable COPD patients when compared with normal controls, and this increase was especially pronounced during exacerbations as compared with MPO levels during the stable state. Theophylline treatment was able to reduce MPO levels in COPD patients, while glucocorticoid treatment failed to achieve the same result.

Conclusion

Sputum MPO might be a promising biomarker for guiding COPD management; however, further investigations are needed to confirm this.
Late preterm births: a retrospective analysis of the morbidity risk stratified for gestational age
Authors: Marrocchella Sonia , Sestilli Veronica , Indraccolo Ugo , de Rosario Filomena , Castellana Lara , Mastricci Anna Lucia , Calo’ Anna , Magaldi Rosario , Del Bianco Antongiulio , Greco Pantaleo , Matteo Maria
Published: February 2014

Purpose

Late-preterm births are considered functionally mature but, several line of evidences suggest that, compared with term neonates, they have a higher risk of complications. The aim of this study was to compare the incidence of maior clinical complications of late preterm infants born in our division, compared to those born at term.

Methods

We retrospectively analysed late preterm deliveries occurred in a twenty-months period. Late preterms were divided in 3 sub-groups according to gestational age at delivery: 34 0/6 , 35 0/6 , 36 0/6 weeks of gestation. The incidence of maior clinical complications was evaluated. Statistical analysis was performed by using the Z- test.

Results

Among term deliveries 17.24% were admitted to the neonatal intensive care unit and 69.01% presented one major adverse outcome: 25.35% jaundice, 25.35% hypoglycemia , 11.26% RDS , 4.22% intraventricular hemorrhage (IVH), 4,22% anemia. The incidence of IVH was significantly higher only at 340/6 weeks of gestation compared to term infants. The incidence of anemia and RDS was significantly higher at 34 0/6 and 35 0/6 weeks of gestation, but it was not significantly different at 36 weeks of gestation, compared to full-term infants. Finally, the incidence of hypoglycemia and jaundice results significantly higher in all the 3 sub groups of late preterms, compared to full term infants.

Conclusions

Results demostrated an increased risk of morbidity in the late preterm period. Results also showed that the gestational age at delivery of late preterms can influence the risk of adverse neonatal outcomes.
Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study
Authors: Cao Yuelong , Jones Graeme , Han Weiyu , Antony Benny , Wang Xia , Cicuttini Flavia , Ding Changhai
Published: March 2014

Introduction

The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults.

Methods

A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs).

Results

Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P <0.01). In multivariable analyses, popliteal cysts were significantly associated with increased osteophytes in both medial and lateral tibiofemoral compartments while subgastrocnemius bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs.

Conclusions

Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities.
Impact of compliance with infection management guidelines on outcome in patients with severe sepsis: a prospective observational multi-center study
Authors: Bloos Frank , Thomas-Rüddel Daniel , Rüddel Hendrik , Engel Christoph , Schwarzkopf Daniel , Marshall John C , Harbarth Stephan , Simon Philipp , Riessen Reimer , Keh Didier , Dey Karin , Weiß Manfred , Toussaint Susanne , Schädler Dirk , Weyland Andreas , Ragaller Maximillian , Schwarzkopf Konrad , Eiche Jürgen , Kuhnle Gerhard , Hoyer Heike , Hartog Christiane , Kaisers Udo , Reinhart Konrad ,   for the MEDUSA Study Group
Published: March 2014

Introduction

Current sepsis guidelines recommend antimicrobial treatment (AT) within one hour after onset of sepsis-related organ dysfunction (OD) and surgical source control within 12 hours. The objective of this study was to explore the association between initial infection management according to sepsis treatment recommendations and patient outcome.

Methods

In a prospective observational multi-center cohort study in 44 German ICUs, we studied 1,011 patients with severe sepsis or septic shock regarding times to AT, source control, and adequacy of AT. Primary outcome was 28-day mortality.

Results

Median time to AT was 2.1 (IQR 0.8 – 6.0) hours and 3 hours (-0.1 – 13.7) to surgical source control. Only 370 (36.6%) patients received AT within one hour after OD in compliance with recommendation. Among 422 patients receiving surgical or interventional source control, those who received source control later than 6 hours after onset of OD had a significantly higher 28-day mortality than patients with earlier source control (42.9% versus 26.7%, P <0.001). Time to AT was significantly longer in ICU and hospital non-survivors; no linear relationship was found between time to AT and 28-day mortality. Regardless of timing, 28-day mortality rate was lower in patients with adequate than non-adequate AT (30.3% versus 40.9%, P < 0.001).

Conclusions

A delay in source control beyond 6 hours may have a major impact on patient mortality. Adequate AT is associated with improved patient outcome but compliance with guideline recommendation requires improvement. There was only indirect evidence about the impact of timing of AT on sepsis mortality.
Kraken: ultrafast metagenomic sequence classification using exact alignments
Authors: Wood Derrick E , Salzberg Steven L
Published: March 2014

Kraken is an ultrafast and highly accurate program for assigning taxonomic labels to metagenomic DNA sequences. Previous programs designed for this task have been relatively slow and computationally expensive, forcing researchers to use faster abundance estimation programs, which only classify small subsets of metagenomic data. Using exact alignment of k-mers, Kraken achieves classification accuracy comparable to the fastest BLAST program. In its fastest mode, Kraken classifies 100 base pair reads at a rate of over 4.1 million reads per minute, 909 times faster than Megablast and 11 times faster than the abundance estimation program MetaPhlAn. Kraken is available at http://ccb.jhu.edu/software/kraken/.
Development and Effectiveness of an Educational Card Game as Supplementary Material in Understanding Selected Topics in Biology
Authors: Gutierrez Arnel F.
Published: March 2014

The complex concepts and vocabulary of biology classes discourage many students. In this study, a pretest–posttest model was used to test the effectiveness of an educational card game in reinforcing biological concepts in comparison with traditional teaching methods. The subjects of this study were two biology classes at Bulacan State University–Sarmiento Campus. Both classes received conventional instruction; however, the experimental group's instruction was supplemented with the card game, while the control group's instruction was reinforced with traditional exercises and assignments. The score increases from pretest to posttest showed that both methods effectively reinforced biological concepts, but a t test showed that the card game is more effective than traditional teaching methods. Additionally, students from the experimental group evaluated the card game using five criteria: goals, design, organization, playability, and usefulness. The students rated the material very satisfactory.
Coal seismic surveying over near-surface basalts: Experience from Central Queensland, Australia
Authors: Zhou Binzhong , Hatherly Peter , Peters Troy , Sun Weijia
Published: March 2014

Seismic reflection surveying in basalt-covered areas often fails to image underlying reflectors. To gain insights into the nature of the problem and obtain potential solutions, we have conducted experimental 2D seismic reflection and offset VSP surveys at two coal mines in the Bowen Basin of Australia. At the first mine, the basalt is relatively deep (114 m) and relatively thin (20 m). Conventional seismic acquisition and processing of a 2D seismic line provide poor results. However, upgoing reflections from layers below the basalt are clearly evident in the VSP survey and prestack depth migration is able to improve the continuity of the reflectors beneath the basalt. At the second mine, the 360 m wide basalt is at a depth of 40 m and has a thickness of about 40 m. It is fresh and unweathered and consists of multiple flows which are interlayered with unconsolidated sediments. Long-offset data acquisition combined with prestack depth migration was expected to produce satisfactory results but this is not the case. The associated VSP survey suggests that the problems at this mine are due to (1) the generation of complex downgoing and upgoing wave-fields within the basalt and (2) significant scattering of surface waves from outside the basalt at the margins of the basalt. Another problem is that the target coal seams are at about 300 m depth and the muting required to remove refraction events limited the effectiveness of the prestack depth migration. Reducing the strength of the surface waves through selection of an appropriate source and placement of shots at the base of the low-velocity zone (as had been the case at the first mine) will therefore improve the chances for a successful outcome. A Vibroseis survey subsequently undertaken at the second mine, which produced shot records with reduced surface waves, shows this to be the case.
Implementation of treatment guidelines for specialist mental health care
Authors: Barbui C. , Girlanda F. , Ay E. , Cipriani A. , Becker T. , Koesters M.
Published: March 2014

A huge gap exists between the production of evidence and its take-up in clinical practice settings. To fill this gap, treatment guidelines, based on explicit assessments of the evidence base, are commonly employed in several fields of medicine, including schizophrenia and related psychotic disorders. It remains unclear, however, whether treatment guidelines have any impact on provider performance and patient outcomes, and how implementation should be conducted to maximise benefit.
Seeking clarity in the twilight zone
Authors: Vallance Aaron K.
Published: March 2014

This commentary offers further arguments relating to the ambiguities inherent in the new concept of the zone of parental control (ZPC) as defined by the revised Mental Health Act Code of Practice, but argues that a directive approach needs to be balanced with flexibility. The conflicting rights of child, parent and State are also discussed. Whereas medico-legal discourse tends to base itself on previous legislative frameworks, it is argued that an evidence-based approach may also be valuable in order to ascertain and incorporate young people's views on the matter.
Rates of violence in patients classified as high risk by
structured risk assessment instruments
Authors: Singh Jay P. , Fazel Seena , Gueorguieva Ralitza , Buchanan Alec
Published: March 2014

Background

Rates of violence in persons identified as high risk by structured risk
assessment instruments (SRAIs) are uncertain and frequently unreported by
validation studies.

Aims

To analyse the variation in rates of violence in individuals identified
as high risk by SRAIs.

Method

A systematic search of databases (1995–2011) was conducted for studies on
nine widely used assessment tools. Where violence rates in high-risk
groups were not published, these were requested from study authors. Rate
information was extracted, and binomial logistic regression was used to
study heterogeneity.

Results

Information was collected on 13 045 participants in 57 samples from 47
independent studies. Annualised rates of violence in individuals
classified as high risk varied both across and within instruments. Rates
were elevated when population rates of violence were higher, when a
structured professional judgement instrument was used and when there was
a lower proportion of men in a study.

Conclusions

After controlling for time at risk, the rate of violence in individuals
classified as high risk by SRAIs shows substantial variation. In the
absence of information on local base rates, assigning predetermined
probabilities to future violence risk on the basis of a structured risk
assessment is not supported by the current evidence base. This
underscores the need for caution when such risk estimates are used to
influence decisions related to individual liberty and public safety.
Intra- and interspecific challenges modulate cortisol but not androgen levels in a year-round territorial damselfish
Authors: Ros Albert F.H. , Vullioud Philippe , Bruintjes Rick , Vallat Armelle , Bshary Redouan
Published: February 2014

Interactions between individuals of different species are commonplace in animal communities. Some behaviors displayed during these interspecific social interactions may be very similar to those displayed during intraspecific social interactions. However, whether functional analogies between intra- and interspecific behaviors translate at the proximate level into an overlap in their underlying endocrine mechanisms remain largely unknown. Because steroids both mediate social behaviors and respond to them, we approached this question by comparing the behavioral and steroid response of free living dusky gregories (Stegastes nigricans [Lacepède, 1802]) to standardized territorial intrusions (sTI) of either conspecific or heterospecific food competitors. S. nigricans is a year-round territorial fish that “cultivates” the algae on which it feeds and is highly aggressive to both intra- and interspecific intruders. Behavioral differences between intra- and interspecific aggressive responses to sTI were marginal, and sTI tests caused an increase in cortisol levels that was positively related with the levels of aggression. In contrast, androgen levels did not increase in response to sTI, yet they showed a positive relationship with agonistic behavior. These results parallel a pattern that was first described for year-round territorial bird species. Furthermore they suggest that changes in endocrine-hormone levels during territoriality might be independent of the species that induces the territorial response.
The olfactory neuron AWC promotes avoidance to normally palatable food following chronic dietary restriction
Authors: Olofsson Birgitta
Published: February 2014

Changes in metabolic state alter foraging behavior and food preference in animals. Here I show that normally attractive food becomes repulsive to C. elegans if animals are chronically under-nourished due to alimentary tract defects. This behavior plasticity is achieved in two ways: increased food leaving and induction of aversive behaviour towards food. A particularly strong food avoider is defective in the chitin synthase that makes the pharyngeal lining. Food avoidance induced by underfeeding is mediated by cGMP signaling in the olfactory neurons AWC and AWB, the gustatory neurons ASJ and ASK. Food avoidance is enhanced by increased population density and is reduced if the animals are unable to correctly interpret their nutritional state due to defects in the AMP kinase or TOR/S6kinase pathways. The TGF-β/DBL-1 suppresses food avoidance and the cellular basis for this is distinct from its role in aversive olfactory learning to harmful food. This study suggests that nutritional state feedback via nutrient sensors, population size, and olfactory neurons guide food preference in C. elegans.
Characterisation of An Inexpensive Sonic Spray Ionisation Source Using Laser-Induced Fluorescence Imaging and Mass Spectrometry
Authors: Stindt Arne , Warschat Carsten , Bierstedt Andreas , Panne Ulrich , Riedel Jens
Published: February 2014

A commercially available airbrush gun as a new source for spray ionisation is presented. It is best operated employing moderate stagnation pressures, resulting in a sonic gas flow. A mass spectrometric investigation on the amino acid lysine and several peptides reveals that this inexpensive approach results in reproducible mass spectra. The ion patterns strongly resemble the results from other studies obtained with custom-made sonic spray vaporisers. The patterns also resemble the mass spectra recorded with electrospray devices. For a better understanding of the vaporisation process, the mass spectrometry experiments are accompanied by laser-induced fluorescence experiments. Inverse Abel Transform of the obtained fluorescence maps allows the determination of the full three-dimensional distribution of the spray cone. Furthermore, via exploitation of the solvatochromism of the used dye the solvation-state distribution can be visualised. In addition, expansion parameters, such as droplet size and velocity, are obtained by laser stroboscopy. The experiments demonstrate that the analyte hardly desolvates throughout the expansion. This indicates a subsequent vaporisation of the residual solvent in the intermediate pressure region of the mass spectrometer.
Monetary Policy and Rational Asset Price Bubbles
Authors: Galí Jordi
Published: March 2014

I examine the impact of alternative monetary policy rules on a rational asset price bubble, through the lens of an overlapping generations model with nominal rigidities. A systematic increase in interest rates in response to a growing bubble is shown to enhance the fluctuations in the latter, through its positive effect on bubble growth. The optimal monetary policy seeks to strike a balance between stabilization of the bubble and stabilization of aggregate demand. The paper's main findings call into question the theoretical foundations of the case for “leaning against the wind” monetary policies. (JEL E13, E32, E44, E52, G12)
Do Prices and Attributes Explain International Differences in Food Purchases?
Authors: Dubois Pierre , Griffith Rachel , Nevo Aviv
Published: March 2014

Food purchases differ substantially across countries. We use detailed household-level data from the United States, France, and the United Kingdom to (i) document these differences; (ii) estimate a demand system for food and nutrients; and (iii) simulate counterfactual choices if households faced prices and nutritional characteristics from other countries. We find that differences in prices and characteristics are important and can explain some difference (e.g., United States–France difference in caloric intake) but generally cannot explain many of the compositional patterns by themselves. Instead, it seems an interaction between the economic environment and differences in preferences is needed to explain cross-country differences. (JEL D12, I12, L11, L66, Q11)
School Choice, School Quality, and Postsecondary Attainment
Authors: Deming David J. , Hastings Justine S. , Kane Thomas J. , Staiger Douglas O.
Published: March 2014

We study the impact of a public school choice lottery in Charlotte-Mecklenburg schools on college enrollment and degree completion. We find a significant overall increase in college attainment among lottery winners who attend their first-choice school. Using rich administrative data on peers, teachers, course offerings, and other inputs, we show that the impacts of choice are strongly predicted by gains on several measures of school quality. Gains in attainment are concentrated among girls. Girls respond to attending a better school with higher grades and increases in college-preparatory course taking, while boys do not. (JEL D44, H75, I21, I23, J16)
A Study of Power Transmission through a Finite Periodic Dual-Layer Beam Structure with Transverse Connection
Authors: Yun Y. , Mak C. M.
Published: February 2014

A study of the structure-borne sound power transmission through a finite periodic dual-layer beam structure with connection branches was conducted. The results suggest that the power transmitted through the beam structure into the supporting structure depends not only on the characteristics of the source and the supporting structure, but also on the attenuation of the periodic beam elements with the coupling branches and the exciting position of the source. The results also reveal the model under the mono-coupling condition to be similar to that under the multi-coupling condition in the relatively low frequency region. The transmitted power was strongly attenuated in a number of frequency regions, and in a few regions the power was even transmitted into the second layer of the supporting structure. The analysis indicated that this study is useful in understanding the structure-borne sound transmission from the first layer into the second layer of the beam structure.
Roll Movement Control of a Spray Boom Structure Using Active Force Control with Artificial Neural Network Strategy
Authors: Tahmasebi Mona , Rahman Roslan Abd , Mailah Musa , Gohari Mohammad
Published: February 2014

Currently, most of modern sprayers are equipped with suspensions for improving the uniformity of spray application in the field. Therefore, this paper represents the possibility of applying active force control (AFC) technique for the control of a spray boom structure undesired roll movement through a simulation analysis. The dynamic model of the spray boom was firstly defined and an AFC-based scheme controller was designed and simulated in MATLAB environment. Artificial neural network (ANN) is incorporated into the AFC scheme to tune the proportional-derivative (PD) controller gains andcompute the spray boom estimated mass moment of inertia. The training of both ANN with multi layer feed forward structure was done using Levenberg-Marquardt (LM) learning algorithm. To evaluate the AFC-ANN control system robustness, various types of disturbances and farmland terrain profileshave been used to excite the spray boom. The results of the study demonstrated that the AFC-based method offers a simple and effective computation compared to the conventional proportional-integral-derivative (PID) control technique in attenuating the unwanted spray boom roll oscillation or vibration. The AFC-ANN scheme is found to exhibit superior performance for different proposed terrain profilesin comparison to the AFC-PD and pure PD counterparts.
An epidemiological study of rotator cuff pathology using The Health Improvement Network database
Authors: White J. J. E. , Titchener A. G. , Fakis A. , Tambe A. A. , Hubbard R. B. , Clark D. I.
Published: March 2014

Little is known about the incidence of rotator cuff pathology or its demographic associations in the general population. We undertook a large epidemiological study of rotator cuff pathology in the United Kingdom using The Health Improvement Network (THIN) database. The incidence of rotator cuff pathology was 87 per 100 000 person-years. It was more common in women than in men (90 cases per 100 000 person-years in women and 83 per 100 000 person-years in men; p < 0.001). The highest incidence of 198 per 100 000 person-years was found in those aged between 55 and 59 years. The regional distribution of incidence demonstrated an even spread across 13 UK health authorities except Wales, where the incidence was significantly higher (122 per 100 000 person-years; p < 0.001). The lowest socioeconomic group had the highest incidence (98 per 100 000 person-years). The incidence has risen fourfold since 1987 and as of 2006 shows no signs of plateauing.

This study represents the largest general population study of rotator cuff pathology reported to date. The results obtained provide an enhanced appreciation of the epidemiology of rotator cuff pathology and may help to direct future upper limb orthopaedic services.

Cite this article: Bone Joint J 2014;96-B:350–3.
Delayed debridement of severe open fractures is associated with a higher rate of deep infection
Authors: Hull P. D. , Johnson S. C. , Stephen D. J. G. , Kreder H. J. , Jenkinson R. J.
Published: March 2014

This study explores the relationship between delay to surgical debridement and deep infection in a series of 364 consecutive patients with 459 open fractures treated at an academic level one trauma hospital in North America.

The mean delay to debridement for all fractures was 10.6 hours (0.6 to 111.5). There were 46 deep infections (10%). There were no infections among the 55 Gustilo-Anderson grade I open fractures. Among the grade II and III injuries, a statistically significant increase in the rate of deep infection was found for each hour of delay (OR = 1.033: 95% CI 1.01 to 1.057). This relationship shows a linear increase of 3% per hour of delay. No distinct time cut-off points were identified. Deep infection was also associated with tibial fractures (OR = 2.44: 95% CI 1.26 to 4.73), a higher Gustilo-Anderson grade (OR = 1.99: 95% CI 1.004 to 3.954), and contamination of the fracture (OR = 3.12: 95% CI 1.36 to 7.36). These individual effects are additive, which suggests that delayed debridement will have a clinically significant detrimental effect on more severe open fractures.

Delayed treatment appeared safe for grade 1 open fractures. However, when the negative prognostic factors of tibial site, high grade of fracture and/or contamination are present we recommend more urgent operative debridement.

Cite this article: Bone Joint J 2014;96-B:379–84.
The use of the transverse acetabular ligament in total hip replacement
Authors: Fujita K. , Kabata T. , Maeda T. , Kajino Y. , Iwai S. , Kuroda K. , Hasegawa K. , Tsuchiya H.
Published: March 2014

It has recently been reported that the transverse acetabular ligament (TAL) is helpful in determining the position of the acetabular component in total hip replacement (THR). In this study we used a computer-assisted navigation system to determine whether the TAL is useful as a landmark in THR. The study was carried out in 121 consecutive patients undergoing primary THR (134 hips), including 67 dysplastic hips (50%). There were 26 men (29 hips) and 95 women (105 hips) with a mean age of 60.2 years (17 to 82) at the time of operation. After identification of the TAL, its anteversion was measured intra-operatively by aligning the inferomedial rim of the trial acetabular component with the TAL using computer-assisted navigation. The TAL was identified in 112 hips (83.6%). Intra-observer reproducibility in the measurement of anteversion of the TAL was high, but inter-observer reproducibility was moderate.

Each surgeon was able to align the trial component according to the target value of the angle of anteversion of the TAL, but it was clear that methods may differ among surgeons. Of the measurements of the angle of anteversion of the TAL, 5.4% (6 of 112 hips) were outliers from the safe zone.

In summary, we found that the TAL is useful as a landmark when implanting the acetabular component within the safe zone in almost all hips, and to prevent it being implanted in retroversion in all hips, including dysplastic hips. However, as anteversion of the TAL may be excessive in a few hips, it is advisable to pay attention to individual variations, particularly in those with severe posterior pelvic tilt.

Cite this article: Bone Joint J 2014;96-B:306–11.
Decision making regarding spinal osteotomy and total hip replacement for ankylosing spondylitis
Authors: Zheng G. Q. , Zhang Y. G. , Chen J. Y. , Wang Y.
Published: March 2014

Few studies have examined the order in which a spinal osteotomy and total hip replacement (THR) are to be performed for patients with ankylosing spondylitis. We have retrospectively reviewed 28 consecutive patients with ankylosing spondylitis who underwent both a spinal osteotomy and a THR from September 2004 to November 2012. In the cohort 22 patients had a spinal osteotomy before a THR (group 1), and six patients had a THR before a spinal osteotomy (group 2). The mean duration of follow-up was 3.5 years (2 to 9). The spinal sagittal Cobb angle of the vertebral osteotomy segment was corrected from a pre-operative kyphosis angle of 32.4 (SD 15.5°) to a post-operative lordosis 29.6 (SD 11.2°) (p < 0.001). Significant improvements in pain, function and range of movement were observed following THR. In group 2, two of six patients had an early anterior dislocation. The spinal osteotomy was performed two weeks after the THR. At follow-up, no hip has required revision in either group. Although this non-comparative study only involved a small number of patients, given our experience, we believe a spinal osteotomy should be performed prior to a THR, unless the deformity is so severe that the procedure cannot be performed.

Cite this article: Bone Joint J 2014;96-B:360–5.
Exam Corner – March 2014
Authors: Khanduja V.
Published: March 2014

The FRCS (Tr & Orth) examination has three components: MCQs, Vivas and Clinical Examination. The Vivas are further divided into four sections comprising Basic Science, Adult Pathology, Hands and Children’s Orthopaedics and Trauma. The Clinical Examination section is divided into Upper and Lower limb cases. The aim of this section in the Journal is to focus specifically on the trainees preparing for the exam and to cater to all the sections of the exam. The vision is to complete the cycle of all relevant exam topics (as per the syllabus) in four years.
A preliminary study of manipulation under anaesthesia for secondary frozen shoulder following breast cancer treatment
Authors: Leonidou A , Woods DA
Published: February 2014

Introduction

The aim of this paper is to present the results of manipulation under anaesthesia (MUA) and injection of local anaesthetic and corticosteroid followed by a physiotherapy regime for secondary frozen shoulder after breast cancer treatment (surgery, radiotherapy), and to compare them with a control group.

Methods

Patients referred to the senior author for secondary frozen shoulder following breast cancer treatment over a ten-year period were investigated. Recorded data included age, treatment for breast cancer, length of symptoms, Oxford shoulder score (OSS) and range of motion before and after shoulder MUA. These data were compared with a control group of patients with frozen shoulder.

Results

A total of 263 patients were referred with 281 frozen shoulders. Of these, 7 patients (7 shoulders) had undergone previous breast cancer treatment and the remaining 256 patients (274 shoulders) formed the control group. None of the patients were diabetic. The mean preoperative OSS was 31 for the study group and 27 for the control group, improving to 43 for both groups following MUA. Forty-two per cent of the study group and fifteen per cent of the control group had a second MUA subsequently. At the long-term follow-up appointment, 71% of the study group patients were satisfied with their result.

Conclusions

The results of this preliminary study suggest that MUA, corticosteroid injection and subsequent physiotherapy have achieved good final results in a series of patients with frozen shoulder secondary to breast cancer treatment. Members of the multidisciplinary team looking after breast cancer patients should be aware of this management option and, on manifestation of this pathology, should refer the patient to an orthopaedic surgeon.
Western Elements in the Early Thule Culture of the Eastern High Arctic
Authors: Schledermann Peter , McCullough Karen M.
Published: February 2014

Excavations of Thule culture winter sites in the Bache Peninsula region on the east coast of Ellesmere Island have yielded a number of finds which indicate a strong relationship to cultural developments in the Bering Sea region. Specific elements under discussion include dwelling styles, clay pottery, needle cases, a brow band and harpoon heads. Evidence is presented suggesting an initial arrival of the Thule culture Inuit in the eastern Arctic around 1050 A.D.
Predicting supervisor capacities to foster higher forms of learning through undergraduate medical student research
Authors: MacDougall Margaret
Published: March 2014

The credibility of short-term undergraduate research as a paradigm for effective learning within Medicine has been recognized. With a view to strengthening this paradigm and enhancing research-teaching linkages, this study explores whether particular types of research supervisor are pre-disposed to providing supportive learning environments.  Correspondingly, a novel solution is offered to addressing clinical governance concerns about failings in preparing students for a supercomplex world. While recommendations for addressing these concerns have previously focused on curriculum delivery and assessment, this study affords a fresh perspective through consideration of research supervisor attributes, behaviours and experiences.   Using statistical analyses of response data from a large cohort of experienced research supervisors who completed an online survey, evidence is found to suggest that staff involvement in personal research ought to enhance student learning through research. In turn, the supervisor factors which are most supportive of this effect may vary according to how we measure higher forms of learning. Supervisors are advised to design successive follow-on research projects to facilitate cross-disciplinary research. In preparing medical graduates for survival in a super-complex world, more needs to be done, however, to investigate why supervisors who see their students more regularly are more likely to provide cross-disciplinary research opportunities. By contrast, potential to engage in risk-taking behaviours and maintain or progress to an advanced stage of learning may originate more precisely with the student.